Links for Mental Health Assistance

Caffeine and related Methylxanthines

Medical and psychiatric literature includes many articles testifying to the toxic effects of these drugs.  Although, caffeine is touted occasionally as having some benefit to the consumer, these chemicals are of dubious nutritional value.  What is not in dispute are the following conditions, all made worse by the caffeine:

✦Seizures

✦Peptic ulcer

✦Prostate problems

✦Side effects of Neuroleptics

✦Anxiety and panic

✦Arousal states (violence, loss of self-control)

✦Sleep disorders

✦Cardiac arrhythmias

And many others.  There is even an antidepressant (Luvox), which cannot be taken without severe agitation, if combined with caffeine.


Caffeine in Psychiatric illness:

The Diagnostic and Statistical Manual, the mental health guide to specific mental illnesses, now includes Caffeine Related Disorder in recognition of the impact of this drug.  Far from being a simple indiscretion that may trigger annoying physiological consequences (indigestion, headache, or palpitations), for the mentally ill, use of caffeine has demonstrable neurotoxic effects.  These effects reduce the clarity of the sensorium, increase the intensity of thought disorder and produce irritability with heightened potential for violence.  This places the need for restricting use of the drug on a par with other chemical treatments.  Adherence to the regimen (no dietary methylxanthines) seen in this light is a liberating factor for our residents, reducing the frequency of overt psychosis and the frequency of acute care episodes and hospitalization.


Treatment and Caffeine:

We emphasize the strict avoidance of methylxanthines for clients.  When ordered, this diet is an integral part of the chemical treatment.  We believe that the methylxanthines are at least as important as medication in controlling psychosis and preventing violence.  Experience over the years has born this out.  Many clients are able to reduce their use of psychotropics, once caffeine is out of their system.  This very gratifying result, approximating the effect of combination medications, carries no risk of side effect, unlike the pharmaceutical agents that may be needed to establish symptom control. 


Circadian Pacing

The term “circadian” describes a 24-hour oscillation of physiologic processes that determine sleep-wake cycles, brain wave activity, hormone production, cell regeneration and every other time-sensitive biological function.  Disrupted circadian rhythms exacerbate the symptoms of most mood disorders, including depression and bipolar disorder.  The pacing of circadian rhythms is one of the primary responsibilities of all staff at WGCC.  Circadian pacing is the core treatment intervention for the stabilization of affective and impulse control problems.  It is the least invasive and most restorative intervention staff can implement with Bipolar and Depressed clients.  It is also a very effective adjunct to the treatment of schizophrenic, obsessive and anxious clients.  Tools used in circadian pacing include:


✦Restoring a day-active/nocturnal-sleep cycle

✦Regular meals and exercise

✦Hygiene routines

✦Optimized interpersonal interactions



All of the above have direct input and impact on the client’s biological clock and facilitate the “resetting” of circadian cycles and the improvement of physiological (chemical) functioning.  Disrupted or harmful circadian pacing (e.g. interruptions of sound/sight during a deep sleep) can perpetuate abnormal clock functions and lengthen a client’s course of treatment.  Education about circadian pacing is reinforced by clinician and program staff at every opportunity. Additionally, it is the responsibility of all staff to ensure that facility operational activities (meal times, changes of shift, milieu rounds, etc.) are done so in a way which minimizes or eliminates any interference with the circadian pacing of the client.


Wellness & Recovery

The final component of the program is the adoption of Wellness and Recovery principles into each element of the program.  The goal of wellness and recovery is to assist clients to achieve a sense of good emotional health, the development of a personal support network, an increased personal sense of quality of life and the reestablishment of normal roles in their home community.

Wellness is expressed as the clients’ sense of good emotional, physical and spiritual health.  Achieving wellness is the process by which clients actively develop and practice the skills necessary to shift the responsibility for their recovery away from the professional and to the individual.  When empowered through information and choice, wellness can be achieved and maintained by persons with mental illness.

Recovery is a common human experience, as most people have recovered from injury, illness or trauma at some point in their lives. Mental illness is particularly devastating because people with a psychiatric disability are often left profoundly disconnected from themselves, others, their community or their own sense of purpose and meaning.  Stigmatization of those with mental illness further compounds the sense of alienation because it presents a barrier to rebuilding connections with themselves, others and their community.

The program will assist the client in authoring a strength-based Personal Recovery Plan that focuses on:

•Personal acceptance of the mental health condition

•Building on the existing strengths of each individual

•Teaching new skills to maintain individual wellness and recovery

•Facilitating self-reliance, self advocacy and empowerment

•Supporting the client’s sense of autonomy and hope

•Facilitating the client’s reintegration into the community

•Supporting the integrity of each person’s journey

Through the wellness and recovery process, individuals will rebuild and further develop important personal, social, community, spiritual and environmental connections through personal empowerment.  Recovery is a process of adjusting attitudes, beliefs, perceptions and goals in life; it a process of self-discovery and transformation.  It is the goal of the program to provide the education, support and opportunity for each client to improve their sense of self-reliance, autonomy, empowerment and hope.

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