‘What Should We Have Known?’

A conversation with FOX News Health host, Dr. Manny Alvarez.

Mental illness, unlike breast cancer, isn’t celebrated with big marches or pink ribbons. The stigma is stifling and it prevents most people from seeking help. David, my husband, refused to accept the label of bipolar disorder. He could not imagine a life of medications and therapy, which did so little to help. David’s path is not unique. Suicide is now the ninth most common cause of death for men and women in America. Every thirteen minutes, another American dies from suicide.

What could we have done differently?

What should we have known?

It is my belief that many people could benefit from hearing more about how psychiatric conditions unfold. In the years, months and days leading up to David’s death, I didn’t classify him as mentally ill. I missed many signs. I ignored others, believing it could get better. And I scrambled, as the world came crashing down around us, I scrambled to maintain my own sanity and the health of our daughter.

Our daughter celebrates her birthday each June. I can’t help but measure her birthdays with an equal sense of apprehension and elation. She’s a teenager now, and still no sign of the brooding, the polarity, the darkness that descended on David like Portland’s thick gray clouds in January, refusing to budge. Yes, she has his intellect but she also has my relatively sunny nature. She is physically stunning with long, muscular legs and a waist that defies her voracious appetite. She has David’s European cheekbones. The color of her skin is his. Her ears have the same shape. There are times I find myself staring at one of her features for too long. She bats me away, “Mom, enough.”

After David’s death, I’d read every book I could get my hands on about bipolar disorder. I’d measured the likelihood of a genetic inheritance against the things I could influence– her diet, her sleep, exercise, a sense of well-being and unconditional love. She is just fine, so far. Becoming aware of our family’s genetic vulnerabilities was painful, but it provided a unique gateway to also focus on our genetic strengths, and Sophie has inherited a majority of the good stuff. She’s attending college now with the sensitivity, compassion and intellect of a person who will be better than “just fine.”

I want everyone to know about the signs and symptoms that I missed with David. The anxiety, confusion, disorganization, trouble completing tasks and how withdrawn he became. My interest is in preventing another loss of life as exquisite as David’s. I welcome your emails, your stories, and hopefully, your support. Connect with me and sign up for my newsletter. I’d be so grateful if you did.

What is the most important factor in treating mental illness? Competence.

It’s been nine years this week since my late husband David died by suicide. Everything about this time of year releases a cascade of emotion that is unbearable, the softening of the light, the gold and amber in the leaves, the heat during the day dissipating to cold nights. There is a vivid memory of David’s state of mind, a cold, agitated horror at his state of being. Even breathing seemed to be an effort that exhausted him.

At a time when we needed the very best care we could get, we experienced a system that retraumatized David to the point of hopelessness. An initial misdiagnosis, a prescription that pushed David over into a state of akathisia and suicidality, a lockup care center whose contracted doctors made money– not by helping people– but by admitting as many patients as they could squeeze into a bland and hopeless enclosure. We knew it was oppressive when we were in it, but, in insight, it was also a shameful failure of care.

Currently, there is no standard of education for a diagnosis. Many people treat depression, including family practitioners and social workers, and the varying degree of competence is maddening for families who are desperate for quality care. Families seeking help find professional camps divided between psychopharmacology and psychotherapy. And often, medications compound the suffering. Caught in the middle, patients are dying.

This year marks the tenth consecutive year our nation’s suicide rate has increased while outcomes for heart disease, diabetes, and cancer are improving. Half of those who died by suicide were under the care of a general practitioner. One-third of those who died by suicide were under the care of a psychiatrist. As one doctor told me, “It’s time to put the head back on the body.”

We demand excellent outcomes for every other major disease. We track success rates for heart surgeons. We compare and contrast survival rates for cancers. Why has the treatment of mental illness in our country been so lacking that many inpatient psychiatric centers don’t even bother tracking the outcome of their patients? David’s doctors didn’t realize he’d killed himself just one day after his release!

We could be saving lives by coordinating patient care- sharing essential treatment information, scheduling and tracking referrals, and providing proper follow-up care. With today’s technological advances, a fully coordinated system of care is possible, and is even being practices in some parts of the country with very good outcomes.

I’m just one survivor. But for every death by suicide, the National Institute for Mental Health suggests eight people are profoundly affected. Last year, 41,000 Americans died by suicide. The toll of grief, confusion and chaos impacts hundreds and thousands of people every year.

What is the most important factor in treating mental illness? Competence. We should demand it.

Dear Grandma, Here’s Why I Missed My Partner’s Mental Illness.

A reader of my book, ‘All The Things We Never Knew’  suggested it would be impossible to be married to someone for ten years and not realize that they had a mental illness:

Dear Grandma in Arizona,

I’d like to give you some insight into my experience of loving someone with a mental illness. Contrary to what Dr. Phil has said, most people who experience mental illness don’t  “howl at the moon.” The early behaviors of mental illness are elusive, intermittent and commonly misunderstood.

Have you ever felt rage and not understood it? Have you distanced yourself from others? Have you been sensitive to light and sound? Eaten too much or too little?  Have you felt as if you don’t belong? Have your thoughts been slow and depressed or fast and racy? Have you been uninterested or unable to complete a task you know you need to do? Have you ever lost hope?

Maybe you have a few weeks or a few months when you feel better. You try to reconnect, you promise you’ll be a better person. You laugh. And then, your brain goes dark again. You cheat and you lie, denying these recurring depressions are happening, even as the symptoms are occurring with more frequency and more severity.  Your family and friends are frightened, confused and unsure of  how to help. You blame your behaviors on your partner, or your job, or your parents.  As you self-stigmatize and withdraw, you are getting sicker and sicker.

Now, throw in a few traumas. The death of your father. The crumbling of your business. The pending separation of your life’s partner. Boom. All of those methods you used to compensate are gone. Then, a well-meaning doctor gives you an anti-depressant, and suddenly, you are thrown into mania and Akasithisa, an agitated, skin-crawling, can’t sleep state that induces suicidal thoughts.

Then, you find a gun.

Now, you are hospitalized against your will.  A nurse who doesn’t know your name takes your clothes and personal belongings. A doctor who has only fifteen minutes a day for you prescribes more drugs, and when those don’t work, different drugs to counteract the side-effects. You are a threat. And hopeless. You lie about your state of mind to get out of the hospital.  To be free of it all.

This is my experience of my partner’s illness, but in conversations with hundreds of other family members who have cared for someone with a brain illness, there is a shared sense of confusion, guilt, and even denial. It helped me immensely to hear from a primary care physician who shared just how difficult it is to detect and treat bipolar illness.

Recognizing the early signs of mental illness is difficult, but even trickier is getting good care. If our  mental health and medical systems are not changed to stop re-traumatizing people in crisis, our rate of mental illness will continue to climb. If we don’t do a better job of recognizing the sometimes elusive symptoms of mental illness (especially in high-functioning people), our rate of suicide will continue to climb.

That’s why I wrote, All The Things We Never Knew. I laid bare my mistakes in an effort to try to help others recognize mental illness and intervene earlier than I did.  I worked very hard to compile resources for others and investigate the programs and people who are giving people hope. We must believe in the tenants of recovery. It will take a tectonic shift in the way we deliver care.

Grandma, I hope this has given you a bit more understanding and empathy of my story and the stories of others. I wish you and your family only good health and happiness.

With kind regards,

Sheila Hamilton

All The Things We Never Knew is available here:



Mass Shootings: It is a mental health problem. And it’s a gun problem.

A reporter wrote me the other day asking for a quote in the wake of the Roseburg shooting. She wanted to talk about how mental illness is being stigmatized by the NRA.

“Is it a gun problem,”  she asked, “Or a mental health problem?”

“It’s not either, or.” I answered. “It’s both.”

In Roseburg, in Springfield, in Denver, in Newtown, in a dozen or so fill-in-the-blank shootings in our country, the male shooter also had a serious mental illness.  James Holmes, Adam Lanza, Kip Kinkel, Seung-Hui Cho, Jiverly Wong, Major Nidal Hasan, Jared Laughner-ALL of these shooters had a psychiatric disorder, many of them were under the care of a psychiatrist.

Christopher Harper-Mercer, who killed nine people and wounded nine others at a rural community college in Oregon had been discharged from the Army after attempting to commit suicide, according to the Wall Street Journal and law-enforcement officials familiar with the case.

Yet, the mental health community argues, “This is not our problem,” and the public is left shaking its head.

Instead, health providers could be saying, “Yes, there is a tiny fraction of seriously disturbed young males who commit mass violence. We’d be happy to take a portion of Homeland Security funding and attempt to help!”

The NRA loves the diversion. It doesn’t actually support more funding for mental health programs and neither do the politicians who point the finger of blame at mental health providers. So, let’s be blunt: These deeply troubled men would have remained unknown to most of us, except that, they got access to a weapon, or two, or fifteen.

Meanwhile, some common sense advice doesn’t get said: If you are aware that your son, brother, or father is one of the fraction of disturbed young men who might be capable of committing an act of mass violence, hide or take away their guns. If you don’t know what a mass killer looks like, here’s a sample of the most relevant risk factors from a 2001 study of 33 mass killers: a. loner status b. substance abuse problem c. preoccupations with weapons d. victim of bullying  and e., lastly, a psychiatric history.  These risk factors are heightened by violent or aggressive behavior.  If you just said, “check, check, check” to that list, and your kid or brother or dad has access to weapons and ammunition, you’ve got a responsibility to get involved NOW.

A reader wrote me recently to say, “My son is just like the other shooters. He’s on meds. He stays in the basement all day, complaining of having no friends. He is obsessed with his guns. He plays violent video games all day long. He’s verbally abusive. I’m scared of him. What do I do?” It’s as if people are waiting for the government to wave a magic wand and help them navigate the most precarious and potentially deadly territory.

First, take the guns out of your household. It’s your home. If a friend or young adult fits this category, talk to them about their reasons for stockpiling weapons. You may be able to detect a plan they are only now sharing with the darknet. You are, sadly, the front line of defense. Call it  “a temporary gun restraining program because I love you and you’ve shown intent.” Second, attempt to get some help. Your county mental health services is the best place to begin. And for support for yourself, please learn more about NAMI.

Mental health advocates are accurate. The vast majority of people with a mental health problem will not commit an act of violence, in fact, statistically, they are much more likely to become a victim of violence or hurt themselves than the general population. But, we cannot deny that a tiny fraction of people who also happen to have a mental illness are causing a ton of heartache in our country. Nor, can we deny that if those people hadn’t had access to guns, they would not have been capable of massive slaughters.

Nobody’s coming for your guns, but it’s time to re-evaluate how accessible they are to others.

An Open Letter to Responsible Gun Owners

I was one of the television reporters on the scene of Oregon’s first mass shooting, May 21, 1998. When Kip Kinkel opened fire in a lunchroom full of his fellow classmates, many of the students thought the sounds of gunfire was a joke or they would have ducked for cover sooner.
I’ll never forget the ashen faces of young people standing in shocked silence outside the police line, dressed in the uniform of youth, jeans, t-shirts, hoodies. Two of the girls I interviewed still had blood spatters on their tops.

Kinkel, who’d also murdered his parents the night before, loaded and unloaded the three weapons he’d brought with him, a .22 caliber rifle, a .22 caliber handgun and a 9mm Glock automatic pistol. “He just kept shooting,” one of the girls said. “The sound is still ringing in my ears.”
By the time Kinkel was finished, two were dead, twenty-five students were seriously wounded. “Jake finally stopped him,” the student told me. “After Kip shot Jake, Jake must have thought, what the hell, we’re all going to die anyway.” The girl pushed her shoe in the mud.

I thought I’d witnessed the worst trauma our state could endure. Not even close. In October, nine  people were killed and seven more seriously wounded in another campus horror. It’s the 296th mass shooting in America in 274 days. Columbine followed Springfield, Virginia Tech followed Columbine, Sandy Hook followed the Colorado theater shooting. Keeping track of the horror is a mind-boggling exercise.

When you read the descriptions of the history of mass shooters in America, you recognize one thing immediately. They are all male. They are young when they shoot up schools and middle-aged when they shoot up their offices. They are obsessed by guns and in various states of psychological unraveling. They are described as loners, and they are often known to their friends and families as being “in trouble.”

Access to mental health treatment in America is like running the gauntlet of the worst kind of bureaucracy. Services are fractured. There are far too few psychologists and psychiatrists, especially in rural areas, where mass shootings tend to occur more frequently. Treatment is often prescribed in the form of anti-depressants, which can induce mania and ideation in young people.

And yet, access to guns is easy. It’s as simple as buying on the internet or buying from a gun show dealer who is exempted from conducting a private background check. Angry callers on talk radio shouted, “If only we allowed all students to be armed.” They maintain that the mass shooting problem will be solved with more guns. There are 310 million guns in America and 11. 1 million people carry a concealed weapon legally. Yet, the number of mass shootings stopped by an armed civilian in the past thirty years is one, a documented account of an Uber driver who stopped a passenger from opening fire on a crowd in Chicago. http://www.businessinsider.com/uber-driver-with-concealed-handgun-prevents-mass-shooting-in-chicago-2015-4

The other numerous events sent to me for review are not verifiable.

Owning a gun has been linked to higher risks of homicide, suicide and accidental death by gun. For every time a gun is used in self-defense, there are 7 assaults or murders, 11 suicide attempts, and 4 accidents involving guns in or around the home. These are not made up statistics. The Centers for Disease Control is non-biased, evidence-based and gathers data only from verified sources.

Responsible gun owners, what is your solution? You must look at these mass shootings with the same concern for your children that I have for mine. Can we have a real conversation about gun violence in America? Could we at least agree that the parents of deeply troubled young men shouldn’t be buying more guns to fuel the obsession? Could we agree on safer storage methods? No? What then? Is there a dialogue we can have and change we can make that doesn’t end in more violence?

Four years ago, my daughter and I were talking about terrorism and the various measures America had taken to make itself safer. “I’m not afraid of terrorism,” she said, looking out the window. “I’m afraid of being shot at school.”

Music, play and faith in mental wellness

Ty Taylor is the explosive and dynamic frontman for Vintage Trouble, a funk, soul and rock band out of Los Angeles who is now playing to crowds upward of 125,000. The band has opened for the Rolling Stones, The Who, and just finished touring with ACDC. I don’t know who loves them more, the critics or the fans.

Taylor’s energy channels the positivity of another time, a modern day James Brown reminding us all to go to the club to forget our worries, to dance until we are soaking wet with sweat, to jump and play and get out of our effing heads for once. Vintage Trouble’s performances create a juke joint of joy, with music and community as an ultimate healer.

Ty has strong opinions about wellness, often asking his Facebook followers how they are keeping well, even when the odds of life get complicated. Taylor’s mother, a psychiatric nurse, could have worried about the ADHD nature of her spotlight seeking son. Instead, she encouraged his creativity, she gave him plenty of space to jump, flip, twirl and sing, and she encouraged a belief-system in a higher power.

Get to know Ty Taylor and Vintage Trouble now, before their juke joint gets so packed you can’t get in.

Healing one chord at a time: My Voice Music

I am in LOVE with this program. Ian Mouser is a local singer-songwriter who worked in a therapy setting with kids struggling with behavioral problems. Ian noticed the almost immediate reduction in harmful behavior when he allowed kids to work out their emotions to music. He started a non-profit called My Voice Music where kids find like-minded artists and learn new musical skills, all while giving voice to the thoughts and emotions they are experiencing.

Please give this a listen and share with families whose kids may benefit from the program.

Happiness is a garden. Tend to it.

Eric Hutchinson gladly lent his support to the #KeepOregonWell campaign. The singer-songwriter talked openly about battling depression and why he thinks everyone should consider talking with a therapist about the challenges they face.

Eric was in town with Kelly Clarkson at the Moda Center.

Alpha Rev Frontman Casey McPherson/Suicide Survivor, mental health advocate

Alpha Rev’s Casey McPherson’s music has so much emotional depth and beauty, one begins to sense that this charismatic frontman has been to very, very dark places and lived to tell about it. McPherson was incredibly open in this interview about his father’s suicide, and later, the suicide of his only brother. The former front man of Endochine, Mcpherson dissolved his band of five years and formed Alpha Rev to grapple with the aftermath of grief.

Today, McPherson helps other suicide survivors by advocating for mental health with the National Institute of Mental Health and offers up layered, orchestral, melody driven masterpieces.

Casey’s father suffered from Bipolar disorder and Mcpherson says he likely also suffers from the disorder. However, Mcpherson’s self-care is so exact, and his heart so open to accepting the beauty and the heartache of bipolar disorder, that he manages without medication.

“Music changes people,” says McPherson. “We’re trying to find happiness in music as opposed to self-destruction,” Indeed.

David Gray on self-care and mental health awareness`

If a young musician asked me whose career to emulate, I’d have no hesitation in answering David Gray. Gray has managed to achieve both commercial and critical success while maintaining an artistic vision. He’s had multiple albums and then none at all for years while he regroups to find his muse. He’s been very poor and very rich, without gaining an attachment to either economic category. He’s been a multi-platinum success and still has more energy and passion on stage than most twenty-year -old performers.

Gray is interested in two things, heart, and art, and when you get him talking about those topics he is a non-stop churn of rapid fire ideas and opinions. Yet, Gray describes himself as a pensive kid, puzzling over questions, ruminating over his life and often caught in his earliest pictures with his hand to his chin, his eyebrows furled, thinking, worrying, and puzzling.

Thank God Gray found art as a way to express himself. He experienced enormous success with his fourth album, White Ladder, in the early 2000’s and moved from near obscurity in the United States to owning one of the best selling songs of the decade, Babylon. Gray says it was a big thing to live through, going from obscurity to ubiquity, and he sees the richness of that success, but also the restrictions of fame.

It has been four years since Gray’s last album, Foundling, and he’s found a new partner, Andy Barlow of trip hop duo Lamb, to help him out of his comfort zone and into a newly expansive creative period.
In the end, it was the joy of hearing his finished sound on Mutineers along with a discovered method for writing and arranging, that helped conquer his demons of doubt.

Here, in this incredible interview with Sheila Hamilton of Kink and Logan Lynn of Trillium Family Services, David Gray talks about how he uses music to keep his finely tuned equilibrium in working order, and why it is so important for artists to pay attention to our bearings. “Artists. We’re all a bit mental,” says Gray, laughing. “And all of us suffer. It’s how we cope that matters.”

Thanks to @TrilliumFamilyServices for sponsoring this @SkypeLounge interview with David Gray and for its #KeepOregonWell campaign, encouraging you to find out more about fighting stigma at www.KeepOregonWell.com