He knows it’s all in his head.

Everyday is a battle with paranoid schizophrenia. things are going well for Sebring now. For three years, he has held down a full time job and paid for his own apartment. It took him more than 30 years struggling with drug abuse and homelessness, though, to get the upper hand on his mental illness.

Mental illness ranks third after substance abuse and lack of affordable housing on the list of the most commonly cited causes of homelessness. between 20 and 25 percent of the homeless population in the United States suffer from some form of severe mental illness, according to the Substance Abuse and Mental Health Services Administration. The percentage nearly doubles if lesser illnesses like clinical depression and anxiety disorders are taken into account.

When it comes to beating homelessness, it’s these people who often struggle most, said Neil Donovan, executive director of the National Coalition for the Homeless. many turn to illegal drugs as a means to self medicate.

“Pulling out of homelessness is hard,” Donovan said. “Mental illness makes it exponentially harder.”

But there is hope. Sebring is proof of that.

Sebring, a short, stout man who keeps his cinnamon-colored facial hair trimmed in a neat goatee, smoked his first marijuana joint in the fourth grade.

His grandmother, who raised him, was a chain smoker. one summer evening, he snuck a cigarette from her stash and took it behind the chicken coop. he lit. he inhaled. And he gagged. The smoke burned his lungs. It tasted terrible. That might have been the end of it, but, just then, his uncle came lumbering through the bushes. Watching Sebring hacking and hacking, the uncle shook his head.

“Don’t smoke cigarettes,” he said. “I’ve got something better.”

The following decades were a drug-induced blur. Sebring became a drug dealer. he got kicked out of one school and failed most of his classes in the next. he isn’t sure when he started experiencing symptoms of schizophrenia. It was hard to tell the drug hallucinations from the schizophrenic ones. he couldn’t sleep because the voices in his head were too loud. he self medicated by doing more drugs.

“The voices were relentless,” he said.

“Leave the state,” the voices told him. “You’re an alien.” “The FBI is tracking you.”

Attention deficit hyperactivity disorder is one of the most common reasons children are referred for mental health services. it affects as many as one in every 20 children. Although boys are three to four times more likely than girls to experience ADHD, the disorder affects both genders.

There are three main types of ADHD. one type is characterized by inattentiveness, one type is characterized by hyperactive or impulsive behavior, and the third type is combined — when children exhibit signs of both types. Symptoms are often unnoticed until a child enters school.

To be diagnosed with ADHD, a child must show symptoms in at least two settings, such as home and school, and the symptoms must interfere with the child’s ability to function at home or school for at least six months. Specialists have agreed that at least six symptoms from the following lists must be present for an accurate diagnosis, and symptoms must begin by age 7.

n Signs of inattentive behavior: has difficulty following instructions; has difficulty focusing on tasks; loses things at school and at home; forgets things often; becomes easily distracted or has difficulty listening; lacks attention to detail, makes careless mistakes or is disorganized; fails to complete homework or tasks.

n Signs of hyperactive behavior: is fidgety; leaves seat when should not; runs or climbs inappropriately; talks excessively; has difficulty playing quietly; is always on the go; blurts out answers; has trouble waiting turn; interrupts.

The presence of some symptoms, however, does not confirm a diagnosis of ADHD. just because a child has a lot of energy or difficulty paying attention in school does not mean the child has ADHD. An accurate diagnosis relies on the presence of a range of symptoms and difficulties that prevent the child from performing at an appropriate level for his or her age and intelligence level. Teachers often first observe these issues, and their input should be considered seriously.

Children and adolescents with ADHD are more likely than children without the disorder to suffer from other mental disorders. About half of all young people with ADHD have oppositional defiant disorder; about a quarter have an anxiety disorder; as many as one-third have depression; and one-fifth have bipolar disorder. Adolescents with untreated ADHD are at higher risk for substance abuse disorders.

Children with symptoms of ADHD should be referred to and evaluated by a mental health professional who specializes in treating children, unless your primary care doctor has experience in treating this disorder. The diagnostic evaluation should include behavioral observation in the classroom and at home. a comprehensive treatment plan should be developed with the family, and, whenever possible, the child should be involved in making treatment decisions. Educational testing should be performed when learning disabilities are present.

Treatment for ADHD is effective for most children. Early identification, diagnosis and treatment help children reach their full potential.

If your child or a child you know is diagnosed with ADHD, be patient. even with treatment, symptoms may take time to improve. Instill a sense of competence in the child or adolescent. Promote his or her strengths, talents and feelings of self-worth.

Remember that the side effects of untreated ADHD (such as failure, frustration, discouragement, social isolation, low self-esteem and depression) may cause more problems than the disorder itself.

For more information, contact the professionals at Acadia Abilene at 325-698-6600 or AcadiaAbilene.com.

Newswise — the Department of Psychiatry at Case Western Reserve University School of Medicine has received a $7.8 million renewal grant from the National Institute of Mental Health (NIMH) for the long-term study of manic symptoms in children.

The grant from the NIMH, one of the National Institutes of Health (NIH), funds the continuation of a study launched five years ago in which 707 children between the ages of six and 12 years were screened and evaluated for elevated symptoms of mania (ESM), a common indicator of bipolar disease and other childhood psychiatric disorders.

“We want to develop the means by which to more accurately diagnose bipolar disease in children,” says Robert L. Findling, MD, the Rocco L Motto, M.D. Professor of Child & Adolescent Psychiatry at the School of Medicine, and director of the Division of Child and Adolescent Psychiatry at University Hospitals (UH) Case Medical Center. he is the study’s coordinating principal investigator.

From the point of enrollment, children participating in the study’s initial phase have been evaluated every six months for their psychiatric diagnoses, symptoms, use of mental health services and medication, and psychosocial function. the NIMH renewal grant allows researchers to continue these six-month evaluations among participants, who will now be between eight and 17 years of age. This will enable the collection of data during a period when study participants are at greater risk of developing a bipolar spectrum disorder, Dr. Findling says.

Researchers will also incorporate both neurocognitive testing (evaluations that assess how well a person processes new data, as well as their ability to process information and pay attention) and neuroimaging. the aim is to identify possible biomarkers that signal or reflect underlying biological mechanisms that predispose individuals to bipolar disease, a type of mood disorder that affects an estimated 5.7 million Americans who often report symptoms that can be traced back to their childhood.

“We’re particularly excited about adding neuroimaging to this next phase of the study to examine brain functioning in these children,” Dr. Findling says. “This research component is very innovative and will lay the groundwork for future studies between the child and adolescent psychiatry and radiology departments through collaborations involving neuroimaging in children.” Neuroimaging involves the use of functional magnetic resonance imaging (MRI), a type of brain scan that maps brains activity. in this area, Dr. Findling is collaborating with neuroradiologist Jeffrey Sunshine, MD, PhD, associate professor and vice chair of the Department of Radiology at the School of Medicine and UH Case Medical Center.

The continued research will further document the trajectories of children with ESM and related psychiatric disorders to better determine the most appropriate points for intervention. Study goals include assessing the nature of manic symptoms over time in relation to changes in mood. Researchers hope to enhance their understanding of the predictive value of manic symptoms, alone and in combination with other symptoms, developing evidence-based criteria for diagnosing the spectrum of bipolar disorders in children; and identifying risk factors associated with poor functional outcomes among youth with manic symptoms.

The investigators will examine the relationships between mood episodes and clinical outcomes over time. they will also evaluate neurocognitive performance, together with functional abnormalities, to better understand how these relate to ESM and the development of bipolar disorder in childhood through early adulthood.

In addition to the School of Medicine and UH Case Medical Center, children enrolled in the study have been recruited from three other collaborating sites: University of Pittsburgh Medical Center, the Ohio State University Medical Center, and Cincinnati Children’s Hospital.

About Case Western Reserve University School of Medicine Founded in 1843, Case Western Reserve University School of Medicine is the largest medical research institution in Ohio and is among the nation’s top medical schools for research funding from the National Institutes of Health. the School of Medicine is recognized throughout the international medical community for outstanding achievements in teaching. the School’s innovative and pioneering Western Reserve2 curriculum interweaves four themes–research and scholarship, clinical mastery, leadership, and civic professionalism–to prepare students for the practice of evidence-based medicine in the rapidly changing health care environment of the 21st century. nine Nobel Laureates have been affiliated with the school of medicine.

Annually, the School of Medicine trains more than 800 MD and MD/PhD students and ranks in the top 20 among U.S. research-oriented medical schools as designated by U.S. News & World Report “Guide to Graduate Education.”

The School of Medicine’s primary affiliate is University Hospitals Case Medical Center and is additionally affiliated with MetroHealth Medical Center, the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, and the Cleveland Clinic, with which it established the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in 2002. casemed.case.edu.

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The National Weather Service has issued a freeze warning for Wednesday night, saying temperatures could drop to the upper teens in the foothills and the lower 20s in valley regions. The freeze warning is schedule to last until 10 a.m. Thursday.  A freeze watch will remain in effect from late Thursday night through Friday morning.

In Placer County, the main resource for homeless residents and others who need shelter is The Gathering Inn, a faith-based organization that operates nomadic shelters throughout the year in Placer County

Suzi deFosset, The Gathering Inn’s executive director, reported that her organization opened two shelters last night because of the unusually cold weather. A total of 67 people stayed at the shelters overnight.

She reported only one shelter is scheduled to be open tonight, because last night’s turnout was only seven people more than normal and traditionally some homeless residents spend the Thanksgiving holiday at the homes of family members.

DeFosset noted that agencies such the Placer County Sheriff’s Department, other local law enforcement agencies, county Mental Health Services and the county’s Adult System of Care pay special attention to the shelter needs of the homeless and others during unusually cold weather and often refer them to the Gathering Inn.  

For more information, contact The Gathering Inn at 916-791-9355. 

“The public needs to be aware of the dangers of extremely cold weather and take necessary steps to stay warm and safe,” said Dr. Jim Gandley, assistant director of the Placer County Health and Human Services Department.

He urged residents to look out after family members, friends and neighbors who are medically fragile, elderly or ill

COLD WEATHER PRECAUTIONS

1. make sure you and your family are prepared.* Review and update your family emergency plan.* Replenish emergency supply kits, including battery-operated radio and flashlights.* have extra blankets on hand.* have a plan for meeting the needs of infants, children, seniors and those with disabilities. * Winterize your house, barn, shed and any other structure that may provide shelter for your family, neighbors, livestock or equipment.* move family pets indoors or to an enclosure out of the elements.  likewise protect livestock or other large animals from the cold weather.* move plants indoors or cover them with blankets or plastic to prevent freezing.* Maintain a sufficient supply of heating fuel.* Insulate pipes and allow faucets to drip during cold weather to avoid freezing.* keep fire extinguishers on hand, and make sure everyone in your house knows how to use them. House fires pose an additional risk, as people turn to alternate heating sources without taking the necessary safety precautions. * do not bring heating devices into the home that are intended for outdoor use, such as barbecues and other cooking equipment or other fuel-burning devices.  These items can produce deadly carbon monoxide.* Learn how to shut off water valves in case a pipe bursts.* Hire a contractor to check the structural ability of the roof to sustain unusually heavy weight from the accumulation of snow or water if drains on flat roofs do not work.  2) Dress for the weather.* Wear several layers of loose-fitting, lightweight, warm clothing, rather than one layer of heavy clothing. The outer garments should be tightly woven and water repellent.* Wear mittens, which are warmer than gloves.* Wear a hat.* Cover your mouth with a scarf to protect your lungs. 3) Travel with caution.* have your car winterized and make sure it is working properly.* Install good winter tires. make sure the tires have adequate tread.* Augment your car’s emergency supply kit with a shovel, windshield scraper and blankets.* Maintain at least a half tank of gas during the winter season.* Check road conditions before departing.* let others know of your route and your estimated time of arrival. 4)  Recognize symptoms of exposure.* Confusion, dizziness, exhaustion and shivering are signs of hypothermia. If you experience any of these symptoms, seek medical attention immediately.* Gray, white or yellow skin discoloration, numbness or waxy skin are symptoms of frostbite. If you experience any of these symptoms, seek immediate medical attention.* In the case of overexposure to freezing temperatures, remove wet clothing and immediately warm the body with a blanket or warm fluids like hot cider or soup. Avoid caffeine or alcohol.

Drug addiction and alcoholism among people affected by schizophrenia is emerging as a significant problem among the agencies that are involved in treating the condition of schizophrenia.

Families who have members that are mentally ill are generally compounded by problems of substance abuse. Unfortunately, not many mental health services will be ready to handle cases with schizophrenia substance abuse. This becomes a matter of dual diagnosis; and the picture of dual diagnosis isn’t a very positive one at this given point in time. In most cases, only one of the two conditions might get identified. In the rare cases where both get identified, the patient might be bounced back and forth between two services where he/she might be treated for these conditions separately.

Research has been (and is being) conducted to throw light on the state of these mentally ill individuals. As per most of these studies, almost 50% of the population that is suffering from schizophrenia and other such mental illnesses will be dealing with a substance abuse problem as well. In most cases, alcohol is used frequently. Alcohol is followed by marijuana and cocaine.

The incidence of this sort of abuse is seen to be greater amongst the males; and most of them fell into the age bracket of 18 to 44.

In most cases, these individuals covertly used the drugs, without letting their caregivers know. Given the fact that their normal mode of behavior was also similar to that of being drug-induced, there were high chances of the caregivers missing symptoms of schizophrenia substance abuse.

The Drawback:

Schizophrenia substance abuse might the treatment for the person’s schizophrenia less effective. Drugs like marijuana might end up making the symptoms worse. Research has also found that there is an evident link between schizophrenic symptoms and marijuana. Moreover, people who abuse themselves with drugs are less likely to follow a treatment plan.

Smoking and Schizophrenia:

Addiction to nicotine is another common form of substance abuse among people who suffer from schizophrenia. they are said to be addicted to nicotine at almost three times the rates of the general population. the numbers stand at 75% to 90% with schizophrenia, as opposed to 25% to 30% without schizophrenia.

There is a complex relationship between the existence of smoking and schizophrenia. Schizophrenics claim that they have an incessant urge to smoke; and owing to this confession, researchers are investigating the biological basis for such an urge. Smoking, too, is known to affect the effectiveness of antipsychotic drugs.

Withdrawal symptoms, in the case of people suffering from schizophrenia, might be even worse. Nicotine replacement therapies might do better than expecting them to quit cold turkey.