Mental Health & Stigma Conversations with Patient Advocates Gabe Howard & Rie Lopez

May is Mental Health Awareness Month. Did you know that 43.8 million adults experience mental illness in a given year (NIMH .org)? In an effort to amplify the voices of those living with or experiencing mental health or behavioral health issues, here are a few video discussions aiming to bring awareness to stigma and its effect on wellbeing.



GABE HOWARD is an award-winning writer and speaker who lives with bipolar and anxiety disorders. In 2003, he was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital.

“Its weird that in this country we separate out mental health and physical health because mental health is your brain. what’s more physical than your brain?



Rie Lopez, MPH A ‘Professional Patient’, Rie is a health educator, skilled public speaker and writer, and serves as a patient advocate for mental health, chronic pain conditions, and clinical trials.  Rie is also actively using her voice on social media

“ From a societal level trying to embrace that mental health is as important to our physical health. A lot of it comes down to making sure that people understand that they are as important”.  

Gabe and Rie are members of the Society for Participatory Medicine. Recorded at 2018 Connected Health Conference.

Ashley Elliott, The Road to Sobriety; A Call for Resources in Rural Communities to Combat Drug Usage, Stigma & Addiction.

"The more we talk the more we bring it out and the more we bring it up, I think the quicker we can get past the stigma. Get past the negativity of addiction and see it simply as what it is and that's a disease" Ashley Elliot.

 


Ashley’s Health Journey Through Addiction

My story more often than not, coincides with addiction. I am a recovering heroin addict. I've been clean since December 28th 2012 and since I've gotten clean I decided to take a path to help others whenever they're struggling. I know for me when I felt hopeless if it wasn't for the women in my life that had lifted me up I don't think I would have made it .

My goal is to help those find hope that think there's no hope. In my darkest days I would say I probably had no idea what was going on at any given time. I went from being an all honor student in my freshman and sophomore years of high school-- straight A's to slowly decreasing my workload. I was a merit student my junior year and by the time was a senior I was a general student. Luckily enough I still graduated with merit a diploma.

That was the start of the dark days that really just kind of involved drinking along with experimenting with a few different substances, nothing too extreme. By the time I had graduated high school I would consider myself pretty deep into my addiction not rock bottom but still pretty deep. What would happen over the next twelve years would be me finding my own, falling in love.

I always made the joke that heroin was my first love, it never failed me, it never let me down. Every time I wanted to do something it changed the way I felt, it did just that. After that point it was really weird. I went from using to needing and I don't remember it. I don't remember when I went from recreational use to addiction, to dependency.

I would go through several different treatment centers, methadone centers. I tried suboxone. I tried moving to California. I thought if I just packed my bags, leave and go somewhere else where nobody knew me I could just start over and be whoever I wanted to be. The problem with that is wherever you go there you are you know. At that time I didn't realize the problem was me. I thought it was the drugs. I was in two very abusive relationships. The first one was we were living in Nevada and he ended up head-butting me and breaking my nose in the front lawn of our home. Shortly after that I had ended up running into an old friend out in California. She saw me and I think I’d probably been about 140lbs at the time. My collar bones were sticking out, I was rather frail. She bought me a plane ticket and three days later I came home.

When I came home I just got involved with the same people. When I did that, that’s is when the legal stuff started happening. The first time I ever got I trouble I had actually lived right up the street. The apartment that I was living in got raided and that was the first time I had been arrested. After that point it was just one after another getting arrested. Eventually I tried to do it on my own. Got involved with another boyfriend who was rather abusive. Fast forward my first treatment center I decided to leave AA, which is against medical advice. My thought process was; I was going to leave, come home, use go to court and go to jail

I was okay with that. I thought that was a solid plan to me. That's how crazy the disease of addiction is. I did that, I left, I came home, I used, went to court and the judge said “Punish her to rehab”, which was not a part of my plan. Over the next two months I had to wait 30 days because I left AA. I had to wait another 30 days for a bed to open up. Within those two months the apartment I was living in had burned down. Under the Influence I had fallen asleep on my hand for an extended period of time which caused something called Saturday Night Palsy.

It’s where an addict or an alcoholic passes out on the extremity and does nerve damage. I had no use of my hand for over three months. I was an I.V. user and there was a point in time where a needle had broken off into my arm and I left it there for six years until I had gotten clean and got a straight head on and I had surgery to have that removed. My kidney functions are extremely low. The way they explained it to me is that my kidney function is that of a 70 year old. I think that's due to all of the different opioids and the wear and tear on the body.

Emotional Health and Addiction

A big part of the health effects is the emotional state that people wanders in while being in addiction---I'm a very outgoing person and I can talk to just about anyone, anywhere about anything. When I was using, I was afraid to leave my house. I'd lived less than two or three hundred yards from a grocery store and it took everything inside of me to get up, get myself dressed to go to the grocery store just because my anxiety levels were so high. A lot of people use to try and escape their feelings of depression or anxiety.

In reality the only thing it does is increase this. I was going through panic attacks, and a lot of the different medications. I was having on medication induced seizures. I just think of it I felt like my body just couldn't go anymore. My sister pointed it out the most. The way that my family always knew I was using, was how much I weighed because I would get her periods of extreme weight loss while using and then gaining that back while attempting to get clean. The health effects I had have lasting effects, psychologically, physically, and emotionally. It takes a long time to heal all that stuff, to accept it, deal with it and move forward with it.

Finding a Support System in a Sponsor

I do honestly say that without my sponsorship family I don't think I would still be clean today. When I went into treatment the first thing I told my counselor was “I'm going to tell you I want to go home, not to let me go home. Don’t let me go home”. But she didn’t, she relocated me to a halfway house down in Frederick Maryland. While you're in treatment it's basically almost like a brainwash. I’ll say if I needed to be brainwashed to get away from whatever I was doing before I was totally okay with it. I really got involved in a twelve step program. It took me about six months after I was really involved in the program to be clean.

The reason that is like I said look for my clean is December 28, 2012. This was the first year I was down in Frederick, I was my first Christmas. I remember I was getting ready to come home and my sponsor and I had come up with this plan where I stay at my sister's, she's my safe zone. No contact with old friends or ex’s. I didn't do anything she suggested. When I went home I think the first thing I did was contact my ex. he brought my dog over. My sister's kids were so I ended up staying at my parents which I ended up using, so I'd used all over Christmas. It was December 27th, my best friend and my sponsorship family called me to wish me a Merry Christmas. I thought what we had was just a normal conversation. When I got off the phone probably less than five minutes later my sponsor called me and trying to walk me through my thought process.

I had my dog which meant I saw my ex, I was at my parents which is not a good place for me. She was trying to get me to realize all the decisions I was making weren’t necessarily the best ones. The last thing she said to me was---she worked the night shift as a security guard at a prison and she said “I don't have to work tonight. I don't know if you want to white knuckle your way through this situation, but if you don't I'll come and get you”. I was kind of just like “Okay you know I'll think about it. I'll call you back”.

When I hung up the phone it was at that moment that I realize that these people that I barely knew six months really wanted nothing but the best for me. I think that was my reality check. I ended up calling her back and I said “Come get me”. My sponsor and my best friend drove three and a half hours from Frederick up to Garrett County in the middle of a snow storm to pick me up and take me back home. That’s why I consider the 28th my clean date because I haven’t used since. I don’t drink, I pretty much don’t do anything.

Trials During Recovery

Throughout my early recovery and my first year or two I remember a period where it was around my first year clean and they say in the twelve step program that at your anniversaries you start going crazy. That's what I was experiencing. It was around my first year I had no idea why but I just wanted to mess things up. You know I knew I couldn't quit my job because I needed my job. I liked my friends so I didn't want to screw anything up with them.

I just couldn't come up with anything to ruin, but that's all I was thinking about because I was an addict. A lot of times my first thought is self-destruction especially when I can’t deal with feelings whether they be good or bad. I remember texting both my sponsor and my best friend and telling them that everything I was doing was reminding me of using.

My best friend sent me this long message of all of the things she knew about me through my active addiction, including you know the abusive ex's and going to jail and all that stuff. Then she sent me another message of everything that we had done in recovery and now. I'm saying your first year of recovery I lived more than I did in those twelve years of using even though I went all over the place, California, Nevada etc.. I still didn't really experience anything because I was never present in the movement. When she sent that to me she followed it up with “Think about those two and then tell me if you still want to use”. I was living with my sponsor at the time, I’d gotten home and she told me to get dressed and I didn't know why, she didn't tell me. She just tell me to get dressed.

I got dressed and my grand sponsor, which was her sponsor showed up and they took me to a baseball game and made me sit there. I sat at this baseball game and I cried. I cried and I cried and I cried and my grand sponsor's theory was always “When you don't know what to do you sit on your hands”. That's what I did. I just had to sit through it and here I am at the Frederick baseball game, everyone’s having a heyday and I'm bawling because honestly I don't know why.

Situations like that, like if they weren't there for me in those moments, if I were to allow my own thought process to continue I eventually would have came up with the idea of the best solution right now is to go use. I strongly agree that a social support, an emotional support, it is a key component of recovery, you cant do it alone. It’s a lot easier when you have people who understand what you've been through.

Sobriety & Stigma from the Medical Setting to Society.

I know for me sometimes it's tough with my health issue trying to talk to a doctor and being taken seriously. I'm a recovering addict and once they hear that, the word human being goes out the window. It's definitely tough and sometimes you've got to have thick skin because there are some pretty mean people that have a very closed mind and aren't very understanding. I kind of just smile and nod at those people. It’s been six years since I entered my first treatment center and in two days I'll graduate from college. That's crazy to me to think back to where I was.

Sharing Story to Impact Change

I remember when I went to MedX to speak on a panel session. Standing outside and seeing the big sign that said Stanford University and I just thought to myself “How did I get here?” I didn't understand it was so weird. I do attribute it a lot of this to Regina Holliday. If Regina hadn't brought me to Cinderblocks, if she wouldn't have asked me to share my story, all of these other people wouldn’t have heard it and I wouldn’t have had the opportunities that I've had over the past year. I remember when I told my family what was wrong with me, what was wrong with me being addicted to drugs at that time.

It was suggested to me by my counselor at the treatment center that I was at. I was an outpatient methadone treatment center. I gather my family together granted my family is well known in the community. My brother in the department of juvenile justice for 20 years. He’s the Cub Scout leader. Everybody knows my brother, both my sisters, one’s a teacher an elementary school teacher and the other one is a guidance counselor secretary. You could definitely say I was the black sheep of the family and I remember when I told them they didn't understand because they didn't know and they didn't know anything about it.

Public Health, Education & Addiction

If people were more educated about addiction, what causes it. The interactions, the pharmacology between the different substances. How they affect the brain. Just stepping outside of their shoes and trying to look at it from a different perspective I think that would have a huge impact on things. A lot of people feel shame and guilt because of their addiction and are embarrassed to talk about it. One of the doctors on the panel at MedX said it best, for years addicts have been lepers. That's what we are once you have that label there's no turning back. Again, when people don't have that in mind, the empathy or compassion to understand, they don't get it.

It’s a fruitless battle. I definitely feel that education, knowledge, understanding simple human being decency is needed. Nobody deserves to die no matter what they choose to do or chose to do it, I hear that a lot. “They chose to use so they deserve to die”. I can speak from experience that there were many times I used against my own will. I did want to be doing what I was doing but I knew physically I couldn’t go on without it because I was dependent on it. In our twelve step program we say “Drugs aren't the issue. Drugs are side effects of addiction”. Our real problem is the way that we think and the way that we feel and not being able to cope with those things. It's exhausting and it's long it does take a lot of motivation. I would say self-will but that's really nothing at all one has to deal with.

A Call for Resources in Rural Communities.

Whenever I was using in this small town I had no idea about resources because it wasn't something people talked about. I remember going to treatment and going to my first twelve step program and they're like “You’ve never been to a meeting before?” and I had no idea what a meeting was. I didn't have the resources here. The more we talk the more we bring it out and the more we bring it up, I think the quicker we can get past the stigma.

Get past the negativity of addiction and see it simply as what it is and that's a disease. Much like a diabetic who takes their insulin every day, an addict get a daily reprieve by simply choosing not to use and more often than not when the addict that chooses not to use is a miracle. Because everything in my being says use, use, use and every day that I choose not to do that is a miracle and nothing short of that.


Ashley Elliott is a recovering addict, patient advocate, psychology major, guest speaker at Medicine X and repeated speaker at Regina Holliday’s Cinderblocks5

Contact Ashley Elliott: Twitter

Gabe Howard Bipolar Speaker & Writer

It is my job, goal and life’s work to have more conversations surrounding mental, mental illness, and psychology because people experience this, yet most people aren’t talking about it 
— Gabe Howard

GABE HOWARD

 Award-Winning Writer | Mental Health Activist | Sought-After Speaker| Educator

It is my job, goal and life's work to have more conversations surrounding mental, mental illness, and psychology because people experience this, yet most people aren't talking about it. When a mental crisis or a mental health illness issue occurs, we're sort of behind the A ball as a society because we don't know how to react. I'm looking to flip the script on that and get people to the knowledge before they need it rather than after.

I was formally diagnosed in 2003. I was admitted to a psychiatric hospital and I really speak from experience when I say that I had to learn all of this after the fact. The day before I was diagnosed, I knew nothing about mental illness, nothing about mental health. I thought I was interested in physiology but I wasn't. Then, I'm diagnosed I'm in a hospital, in a locked psychiatric ward and I needed to learn everything instantly.

I really wished that I would of had a lot of knowledge ahead of time, because I think if I would of been diagnosed sooner, I probably wouldn't have been suicidal and in crisis. Thankfully, I ended up in a physiatrics hospital. I could of easily ended up in jail, or in a morgue, it could of turned out a lot worst.

Whats interesting is people are like "you were in a locked psychiatric ward, thats literally the worst case scenario". Interestingly, its not! Thats like the best case scenario for somebody that has untreated mental illness that their unaware of and that their doing nothing about, a psychiatric ward is the best case.

The worst thing about being in a psychiatric ward is, its a complete lack of control. Its locked, the doors are locked. Everything is controlled, and regimented. When I checked in they took stuff from me. The things that I brought in from home to make myself feel better in the hospital they were like "you can't have that". My girlfriend at the time brought me, my favorite drink and they were like, "no that has caffeine in it, he can't have it".

At the end of the first visit I wanted to walk her to the elevator, and they were like "no you can't". Thats kind of devastating to your psyche a little bit, because I'm like GROWN! their like "NO". It was for my own good, they were trying to keep me alive, I was there because I was suicidal. But from my perspective in that moment I just felt weak. Those are the things that I remembered; just how little agency I had.

I'm lucky for an incredible number of reasons. 1st, I'm lucky that I had money, my care over the next four years was a couple hundred thousand dollars. I was able to be hospitalized, I was able to see a psychiatrist every 4-6 weeks. I was able to try the best medications on the market. I was able to go to intensive outpatient treatment. I was able to go to the hospital for 8 hours a day 5 times a week. I was able to do that twice. I was able to go to support groups led by psychologist and psychiatrist, there wasn't really any sort of care that I wasn't able to afford. That was so important to me.

Secondly, I did have a good family, while they made a ton of mistakes they were there for me. They didn't run away from me, they were there for little things. My whole family helped me move out of my house into a smaller apartment when money got tight and when I lost my job. When I did lose my job, I had plenty of people to talk to me and say "Hey you're more than just a job, you're going to focus on wellness" and that pumped me up. Of course I had my number one (then girlfriend now wife), who was there for those really low points. Lastly, I worked very hard.

Somebody who doesn't have all those resources, they only can have one of those things, and that is to work really, really hard. Maybe, they can have two of those things, because they can work really, really hard and they have a really good family but if they don't have the money they are not going to have access to the same amount of care that I did.

Then even that fractures out, theres plenty of people that have good health insurance but maybe they live in rural America where these programs are not there or they can't afford these programs. Maybe they have the money but they don't have an number one, or a good family. If you don't know what to buy the amount of money isn't going to be helpful. You need to find a way to pay for treatment because treatment is so important. You need to take your medications as prescribed and get the right medications. You need to have a support system because thats so important.

There are things that you can do if you're not as fortunate as I was;

  1. Support can come from many different places, find peer support groups.

  2. Find consumer operated drop in centers.

  3. Find a sponsor.

  4. Find people who have been there; Theres lots of free support groups sponsored by mental health charities all over.

  5. Find a buddy, who is willing to help you and be respectful of their boundaries.

  6. Ask questions,

  7. Go to all of the appointments, even when you don't want to, even if you've been in the same clothes for five days and you haven't showered, find a way to get to that appointment. The people there will understand more than you think.

  8. If you don't have health insurance you have to find health insurance.

  9. Apply for disability, welfare, medicare, social services: some people that I talk to are like "I don't want to do that, I don't want to be a mooch". Listen, its a social safety net, for a reason. You're going to use that safety net to get well and then when you're well, you'll be happy, you'll go back to work, and your work and earnings will help fund these social nets for the next person

  10. Fight really hard for a better future, and find the things that you need.

As much as I hate to say it, it does boils down to advocacy, you're now sick and you have to advocate for yourself, this is an overwhelming task, but it is not an impossible one

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