“May is the month of flowers and mental health awareness” in this week’s issue of the MANILA MAIL (May 13-19, 2015; page A5)

Pilipinasblitz Forever
A column by Bles Carmona

For the week of May 13-19, 2015

May is the month of flowers and mental health awareness

When I was young, I remember being excited once school was out during April and May. I remember looking forward to the month of May because it seemed that many special events were happening in our community. The pomp and pageantry of the Flores de Mayo and Santacruzan processions come to mind. I remember being in awe of all those beautiful young women wearing makeup and shiny-with-sequins gowns, their handsome escorts in barong Tagalog, and the decorative arches that tower over each pair.

“Flores de Mayo” (flowers of May in Spanish) is held as a Catholic devotion to the Blessed Virgin Mary by offering flowers and prayers in her honor for the entire month. On the last day of Flores de Mayo, the “Santacruzan” (procession of the holy cross) pageant is held in honor of Reyna Elena and her young son, Emperador Constantino, for finding the true cross in Jerusalem. In the Santacruzan procession, many Biblical figures are represented, among whom are Methuselah, Ruth and Naomi, and Queens representing Faith, Hope, and Charity (Reynas Fe, Esperanza, and Caridad, respectively). The various titles of Mary based on a litany are personified by young women bearing symbols of what they represent, for example: Reyna Justicia (“mirror of justice”) who carries a weighing scale and a sword, or Reyna del Cielo (“queen of heaven”) who carries a flower and accompanied by two little “angels.” But don’t worry, if the symbolism gets lost on you, you can always read the young lady’s title across her “arko” or arch which looks like a rainbow banner over each maiden and carried on each side by a couple of strapping youths.

All in all, the Flores de Mayo, and especially the final salvo, the Santacruzan, could be one long procession indeed, complete with a marching band. However, you know what we Filipinos say: “Pagkahaba-haba man ng prusisyon, sa simbahan din ang tuloy.” (No matter how long the procession is, it still winds up in church.) This could be taken to mean that even a longstanding courtship still ends up in a church wedding, or that a long-standing matter will be resolved in the best way possible, or that patience and perseverance will be rewarded with God’s blessings. These traditions held during the month of May have been handed down through the Spanish Catholic branch of our Filipino heritage in our birth country.

Closer to our current home and much more recently in history, May 2015 has been declared by President Barack Obama as National Mental Health Awareness Month (https://www.whitehouse.gov/…/presidential-proclamation-nat…/). It begins thus: “This year, approximately one in five American adults — our friends, colleagues, and loved ones — will experience a diagnosable mental health condition like depression, anxiety, bipolar disorder, schizophrenia, or post-traumatic stress, and many others will be troubled by significant emotional and psychological distress, especially in times of difficulty.

For most of these people, treatment can be effective and recovery is possible. Yet today, millions of Americans still do not receive the care they need. This month, we stand with those who live with mental illness, and we recommit to ensuring all Americans have access to quality, affordable care.” The proclamation proceeds to mention that the Affordable Care Act has extended benefits to over 60 million Americans with mental health and substance abuse issues. The statistics from the National Alliance on Mental Illness (NAMI) still says that one in five Americans between 13-18 will have a severe mental disorder in a given year, and that mood disorders are the third leading cause of hospitalization among the 18-44 age bracket. We have been bombarded with media packets, articles, and websites aimed at helping us detect depression. I don’t have any argument with that and I truly recommend being familiar with the signs and symptoms of depression, especially if we are dealing with a loved one with a mental health disorder. Please do check out http://www.nami.org for additional resources.

Personally, I check three things as part of my mental health hygiene: my mood, appetite, and number of hours of sleep. It’s my sleep time which is the first to be affected when I notice myself about to slip into a mood change, and this means I need to see my doctor right away. A lot of our resources have rightly been allocated toward facing the aftermath of severe depression, in terms of consultation hours, medications, and other interventions which may reach crisis proportions.

However, I do think that we should also turn part of our focus toward the prevention of depression. What can we do to help ourselves? What definite strategies can we use to lift our mood?

I found a promising article (http://southtahoenow.com/…/spring-wellness-promoting-positi…) by Betsy Glass, MSW in the South Tahoe Now online news.
1. Practice relaxation skills: You can try guided imagery, meditation, or what I do sometimes, which is to tense then relax my muscles starting from my feet, then my legs, then my thighs, going up… they call it progressive muscle relaxation for short.
2. Socialize: Seek out a family member or friend. Volunteer or join a group.
3. Strive for growth: Challenge yourself by actually following your heart’s desire in your choice of jobs or activities.
4. Balanced diet: Make sure you get nourished properly with fruits, vegetables, whole grains, and proteins, which are all full of mood-energizing nutrients.
5. Try something new and creative: Adding something new to your routine has been shown to be a mood booster.
6. Exercise regularly with others: You can walk, do aerobics or other activities with your friends!
7. Practice gratitude: If it were up to me, this should be a daily habit. Appreciate yourself, what you have, and the presence of others in your life.
8. Aim for at least 7-8 hours of sleep: Anything less, like I said, affects mood adversely. Develop a sleep routine that does not involve caffeine or the glare of TV screens.
9. Recognize when you evaluate yourself or others. Review the Serenity Prayer by Reinhold Niebuhr (1892-1971): “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”
10. Do one thing at a time with your undivided attention: Let go of distractions, whether they be thoughts, feelings, or actions, then gently guide your focus back to your task.
11. Surround yourself with nature: Find a quiet place where you can take in the sun for a while. Plant or place flowers in your work and leisure spaces. Maybe take off your shoes and stand safely on some grassy piece of earth. This is very grounding when you notice that you’re living too much in your head.

Wherever we are this month, my hope is that we will reflect upon our experiences and be all the better persons for it. Enjoy the flowery, mentally healthy month of May!


“CARING FOR YOUR LOVED ONE WITH A MENTAL ILLNESS THIS HOLIDAY SEASON” in this week’s issue of the MANILA MAIL, page A7) www.ManilaMailNewspaper.com

Pilipinasblitz Forever
A column by Bles Carmona
For the week of Dec. 10-16, 2014
Early this year, I was browsing through the offerings of The Book Shop in Hayward, my favorite local bookstore, and came across a precious resource that I promptly snapped up. It’s a book called “When Someone You Love Has a Mental Illness: A Handbook for Family, Friends, and Caregivers,” revised and expanded, written by Rebecca Woolis, MFT, a licensed family therapist with more than 20 years of experience in working with people who suffer from mental illness, and with their families. She is in private practice in Berkeley, CA.
I felt that it would be helpful to approach the topic of mental illness and stress during the holiday season from the perspective of the family, caregivers, and friends of someone with a mental illness. Although statistics says that 1 in 5 Americans suffers from some form of mental illness, a happier flipside interpretation of this fact also means that the other 80% of you are free of any psychiatric symptoms. If you belong to the “sane” and “normal” 80%, please count your blessings. Someone like me with bipolar disorder and my 20% group mates would have to contend with the same life challenges like you do but we have a disability which may impact our coping skills in many ways.
Here is an excerpt from Woolis’ book, a quick reference guide (one among many within its pages) and this is “How to behave around people who have a mental illness”:
1. Treat them with respect, even if you do not understand some of the things they do or say.
2. Be as supportive, accepting, and positive as you can.
3. Be calm, clear, direct, and brief in your communication with them.
4. Engage them in casual conversation or activities with which you and they are comfortable.
5. Do not touch them or joke with them unless you know them well and know they are comfortable with such interactions.
6. Do not ask a lot of questions about their lives.
7. Do not give advice unless they request it.
8. Do not discuss in any detail religion, politics, or any other topic that is highly emotional for them, as these topics may be intertwined with delusional thinking. Explain that these are personal or individual issues that you prefer not to discuss.
9. If they behave in ways that are unacceptable to you, calmly tell them specifically what they can and cannot do. (pp. 106-107)
Now the holidays, for some mysterious reasons, seem to either excite or depress people with mental illnesses. Folks are hustling and bustling all around, making party and family reunion preparations, thinking up gift ideas, shopping, planning a vacation, sprucing up the home, and doing a million other things during this season. These could be positive sources of stress that bring out the best in a lot of people, inspiring them to give their all into this festive, joyous time. However, for someone with a mental illness, facing these situations could be daunting, overwhelming, or downright confusing. The result could either be feelings and thoughts of amped-up excitement as they look forward to all the celebrations, or paralyzing depression at the thought of having to go through what in their minds will be a joyless holiday for one reason or the other. Sometimes the anticipation, the very thought of all that has yet to happen, could rob a person of the appreciation for the present moment. Conversely, if this holiday reminds them of a significant event in the past, then they can get sad, agitated, stressed out. Notice here that in both cases, there is an under-appreciation of today. Who was it who said that today is a gift and that’s why it’s called the present? My sentiments exactly. With a measure of mindfulness, we can ditch the guilt about the past or anxiety about the future and just focus on how blessed we are today, right at this present moment. You may say, yeah, easier said than done, to which I will counter, hey, it’s worth a try.
Now here’s what Woolis suggests in her quick reference guide on “Handling the Holidays”: You can help your relative reduce stress by:
1. Discussing plans in advance
2. Acknowledging any mixed feelings he or she may have. Do not make assumptions about how he or she will feel or act.
3. Keeping expectations realistic, especially regarding whether your relative can tolerate a gathering, for how long, and what kind of participation he or she is capable of
4. Respecting and supporting your relative’s choices and decisions regarding whether he or she is comfortable participating and in what way
5. Accepting your and relative’s limits
6. Helping your relative figure out how to handle some of the stress (e.g., how the person might answer questions, what task he or she might like to focus on, how long to stay, places to go to take breaks), if he or she is willing and able to discuss the event and his or her feelings. It may be important to acknowledge all family members’ needs, preferences, and limits before a workable solution can be reached. (pp. 166-167)

Now let’s talk about “Minimizing relapses.” According to Woolis, you must see to it that your loved one with a mental illness has a “therapeutic day-to-day lifestyle” which includes regular exercise, recreational activities, a daily routine, eating a balanced diet, and avoiding the use of alcohol and illegal drugs. Make sure that you can identify the early warning signs of relapse, such as: any marked change in behavior patterns (eating, sleeping, social habits); absent, excessive, or inappropriate emotions and energy; odd or unusual beliefs, thoughts, perceptions; difficulty in carrying out usual activities; impairment in communication; and any idiosyncratic (i.e., unique to the person) behavior that preceded past relapses.

When warning signs do appear, do the following: Notify the doctor and request an evaluation, maybe an increase in medication is indicated; maintain involvement in any ongoing psychiatric treatment program; responsibly decrease any known environmental stressors; minimize any changes in routine; maintain the “therapeutic lifestyle” described above, especially keeping the environment as calm, safe, and predictable as possible; and discuss your observations with your relative, talk about steps he or she might take to prevent another relapse, hospitalization, or incarceration. To minimize the impact of a relapse, it pays to be prepared: Have a crisis plan ready for yourself; keep emergency phone numbers and procedures in a convenient place; know your limits and how you will proceed if they are exceeded; and tell your relative calmly and clearly what your limits are, what they need to do next, and what you will do if those limits are exceeded. In some cases, you may have to call the police.
Be prepared. But also be kind to yourself. Neither you nor your loved one with a mental illness had a choice about your respective roles. However, from this point on, you know that facts and awareness are now being thrust upon you. Ms. Rebecca Woolis, MFT, in her book, “When Someone You Love Has a Mental Illness,” talks about various other topics which are so crucial in your shared difficult journey with your loved one. Her book is a valuable resource to me personally because I get to appreciate how hard it must be for my family and friends to cope when I am undergoing either the delirious hyperactivity of mania or the energy-less stupor of depression. Now through this book, they can be equipped with the tools to deal with me while at the same time protecting themselves by being urged to set limits.
This year marks my second relapse-free year and I am thankful to Spirit for guiding my thoughts, feelings, and behavior. I thank my family and friends for their love, loyalty, and support. I am thankful for my caring, competent, and compassionate psychiatrist, Dr. Gilda Versales, my doctor since early 2009. To all of you, blessings and light! Maraming salamat po sa inyong lahat!
Find advisor Blesilda44 at KEEN.com, 1-800-ASK-KEEN (1-800-275-5336), extension 05226567 either by phone or chat: Mon-Fri 7-10 pm, Sat-Sun 7-11 pm Pacific. I speak English, Tagalog, and some Spanish. For personal readings (fee required), email me here: blessingsandlight725@gmail.com


Dear BISIG* members and supporters:
*Biopsychosocial Support & Interaction Group

By now you have heard of the unfortunate news that the great actor Robin Williams has taken his own life by asphyxiation through hanging. This saddens me to no end because he was one of us, being diagnosed with bipolar disorder aside from battling drug addiction and alcoholism. Robin’s death means that another one of us has succumbed to the most fatal consequence of an untreated mental illness or severe depression in particular: death by suicide.

All of us have cycled through our erratic moods throughout our lives. We’ve been there. We know. But you know what? We can’t presume to know anything about what Robin himself was going through. Each of our agonies is our own. We know well enough not to judge one another as we go through our “dark night(s) of the soul,” for there are many of those nights, indeed.

We’ve been there. We know.

Being depressed, in my personal experience, is being devoid of all feeling. My movements become listless and mechanical. I just want to stay in my room with the curtains drawn. My mind is so slow and uninspired, and there is such a psychic pain that is too deep for words that it cries out for release. When the depression is already this severe, I begin to seriously entertain the thought of ending my life, or as the euphemism goes, “I just want to disappear.”

When I am already at this point, nothing matters anymore. I become blasphemous: I simply don’t care anymore that taking my life would offend a Supreme Being or that taking my life would surely devastate my family and friends. I simply do not care anymore. But deciding to commit suicide is rarely the selfish decision that people with so little understanding consider it to be.

To the person about to commit suicide, what they’re probably thinking is that they don’t want to be a burden to their caregivers anymore so the family will be better off with him/her dead. Other reasons may justify the act in the mind of the afflicted that is already twisted with unbearable pain and despair. In the final analysis, who can ever understand why those “completed suicides” committed the ghastly deed?

Please bear with us.

I wish that people who do not have this terrible affliction (bipolar disorder, major depression, dysthymia, etc.) would begin to understand those of us who have one mental illness or another. Let’s keep the conversation open and loving. Let us be there for one another and PLEASE, remember that there is no shame or blame warranted when it comes to mental illnesses.

And for those of us who are battling depression now, please get help as soon as possible before your depression worsens. YOU DO NOT HAVE TO SUFFER THROUGH YOUR DEPRESSION ALONE. Reach out to me, reach out to the group, reach out to your mental health professional, family, and the few friends who really understand you and are able to support you.

We thank God and Goddess for celebrities like Robin Williams for raising our consciousness about such a serious issue. I’m sorry that Robin has to die so that the spotlight can be focused on mental health. But just remember that suicide can also happen to ordinary people “leading lives of quiet desperation.” Let it not be you, let it not be me.

After I got through a very tough depressive period in my life years ago, I realized that hey, life is still worth living. YOUR LIFE IS WORTH LIVING.

Life may be painful sometimes, but it is always, always painfully beautiful.

“24 YEARS: THE IMPACT OF THE AMERICANS WITH DISABILITIES ACT OF 1990” in this week’s issue of the MANILA MAIL (July 23-29, 2014)

Pilipinasblitz Forever
A column by Bles Carmona
For the week of July 23-29, 2014

For someone with a disability like me (I have bipolar disorder) and for the rest of us who have physical or mental disabilities, Sen. Tom Harkin (D-IA) is our champion for being the prime author of the Americans with Disabilities Act of 1990 (ADA). He even spoke part of his introductory speech in the Senate in sign language so that his deaf brother could understand the proceedings. Twenty-four years ago this month, on July 26, 1990, the ADA was signed into law, resulting mainly in the lifting of discriminatory practices in employment situations for the disabled, and other major benefits for the disabled community as well.

The ADA is a civil rights law that prohibits discrimination based on disability, much like the Civil Rights Act of 1964 made illegal any discrimination based on sex, national origin, race, religion, and other characteristics. The determination of whether or not a condition is a disability is made on a case to case basis, but this excludes visual impairment that can be corrected by prescription lenses and current substance abuse. The original law has five titles under which major provisions in employment and access are enacted: Title I-Employment, Title II-Public Entities and Public Transportation, Title III-Public Accommodations and Commercial Facilities, Title IV-Telecommunications, and Title V-Miscellaneous Provisions.

The ADA defines disability as “…a physical or mental impairment that substantially limits a major life activity.” In 2008, with the ADA Amendments Act (ADAAA of 2008), significant additions to “major life activities” now include, but are not limited to, “caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working” as well as the operation of several specified major bodily functions (“ADA Amendments Act (ADAAA)—What Employers Need to Know”. HR.BLR.com. 2008).

Let’s deconstruct these definitions of disability for a little bit. Does it work better for you to understand disability in terms of people you may know or even people within your family? In the past 24 years, have you seen the ADA result in improvements in their lives in terms of educational and employment opportunities and the basic everyday reality of accessibility? Those ramps, those rails, those assistive devices – have you seen them benefit the disabled among us?

Disability defined is Benjamin, an African-American adult learner in his 50s with polio that I am tutoring under the Literacy Plus program of the Hayward Public Library. He moves around everywhere in his motorized wheelchair. He can commute from his apartment in Oakland to the Hayward main library precisely because of wheelchair-accessible buses and roads. Benjamin is an excellent visual artist and would like to be an architect someday. More than a year ago, I asked him to keep a gratitude journal as a part of our weekly lessons so that he can work on his spelling and grammar. Every week, his first entry is always about how grateful he is to God. The next entries are about mentioning by name the people who help him with his everyday tasks which he enumerates. However, the most beautiful entry he wrote was something that he was able to read aloud to a captive audience in last year’s Literacy Plus Reception at the Hayward City Hall Council Chambers. He wrote: “I thank God that the world is round and has four corners. Even if people are different, they are still the same.”

Disability defined is Eugene, the 33-year old Korean-American adult learner with cerebral palsy that I am also tutoring under the Literacy Plus program of the Hayward Public Library. Like Benjamin, he, too, is also in a wheelchair but not a motorized one since his spastic hands have a little difficulty mastering the controls. Eugene is very thoughtful and considerate, and when you hear him speak, you would know that you are talking to a deep and sensitive young man. He likes sports (Go Giants and 49ers!), he and I both like “Melissa and Joey,” and he likes some reality shows on TV. He also has a devoted mother, Sue, to whom Eugene is not defined solely by his disability, but also by his sweet and caring character.

Disability defined is Blesilda: yes, me. Mine is not the type of disability that is immediately obvious because right now I am being maintained on a cocktail of psychotropic medications. I have bipolar disorder; I’ve had it since I was in my early 20s, which is the typical time when such a mental illness manifests, most of the time due to a combination of genetic predisposition and stress. Bipolar disorder is called a mood disorder, as opposed to a thought disorder, since it primarily affects feelings. Hence, a person with bipolar disorder is prone to manic highs or depressed lows, swinging from one extreme to the other unless medicated via conventional psychiatric prescriptions or controlled through more natural means like diet, supplements, and/or other alternative treatments.

Mental disability is a little bit “harder” to prove than physical disability because for example, when I tell people that I have a mental illness or am bipolar, they go, “ WTF?! You don’t look crazy at all. You look normal to me.” However, if we go by the ADAAA expanded version of major life activities, I have significant difficulties in the following areas: concentrating, learning, working, communicating and thinking. I am being helped in my community college education by the Department of Vocational Rehabilitation through the recommendation of the school’s disabled student resource center. Never too late to study at 44.

If I am in one of my manic phases, I may be quiet for a while but my mind is going 90 thousand miles a minute with crazyweird sorts of intersecting ideas that are too profound for words and yet are always somehow irrevocably connected. The mantra, “Everything is connected” may have been the product of a eureka moment of one manic dude or dudette.

However……….when……….I……….am……….depressed…..I……….cannot………. think……….clearly……….and……….my………. mind……….is……….so……….slow.*** I am not motivated, not inspired, not titillated. When I am depressed sometimes the psychic pain cuts so agonizingly deep that I just want to die. Yes, it could get that serious. Suicide is a serious and dangerous possibility when one is depressed. It’s a good thing that so far I have not experienced a depression as deep as this in a long time.

Benjamin, Eugene, and I are just some real-life examples of people with disabilities so I could make you feel that we are still humans with hopes and aspirations despite our limitations. We are so very grateful that the ADA was passed 24 years ago. We are being helped by this law.

With inclusive legislation like this, it is clear that any kind of discrimination has got to go.
Find advisor Blesilda44 at KEEN.com, 1-800-ASK-KEEN (1-800-275-5336), extension 05226567 either by phone or chat: Mon-Fri 7-10 pm, Sat-Sun 7-11 pm Pacific. I speak English, Tagalog, and some Spanish. For personal readings, email me here: pilipinasblitz@gmail.com

“How to intervene in a crisis situation” – in this week’s issue of the MANILA MAIL (June 4-10, 2014)

Pilipinasblitz Forever
A column by Bles Carmona
For the week of June 4-10, 2014


Crisis intervention is a needed skill in this topsy-turvy world of ours when almost anything can happen in the blink of an eye: natural or man-made disasters, accidents, health crises, medical emergencies, or even some child’s pet being run over by a vehicle. It is thus very important to be prepared with at least the very basic skills needed to intervene in a crisis.
Assessing is a pervasive strategy by the crisis worker – that’s you – throughout crisis intervention. This assessment is action-oriented and situation-based, fluid and non-mechanistic, able to adjust to even the slightest change in circumstances. The first three steps you will read are more of LISTENING activities than they are actions. The final three steps are largely ACTION behaviors on your part as the crisis worker, although you are continuing to listen and assess the whole time.
As to difficulty: These steps could be moderately challenging. You may need special training to be able to respond effectively to crises. However, in a pinch, these steps can serve as the broad outlines of what you need to do in a crisis situation.

1. Step One: Define the problem. Understand the problem from the client’s point of view. You are addressing how the client is reacting to the crisis event, not the event itself. Try to perceive the crisis situation as the client sees it, so that your intervention may not miss its mark. Practice the core listening skills of empathy, genuineness, and acceptance or positive regard. For example, a client just broke up with her boyfriend of 3 months. It may not seem like much of a crisis to you, but it may be a huge crisis to her and that is why she’s in the emergency room with imperfectly slashed wrists talking to you in a hushed monotone.

2. Step Two: Ensure the client’s safety. This means minimizing further physical and psychological danger to the client and others. Although we put this down as Step Two, we apply this step in a fluid way, meaning that client safety is actually a primary concern throughout crisis intervention. I encourage you to make client safety a natural part of your thoughts or behavior as a crisis responder.
3. Step Three: Provide support. Communicate to the client that you care about her. You cannot assume that a client experiences feeling valued, prized, or cared for. This is your opportunity to show the client that someone actually cares about her, and that someone is you in an unconditional, positive way, regardless of whether the client can reciprocate or not.
4. Step Four: Examine alternatives. Given the present crisis, explore people, situations, and coping mechanisms, positive and constructive thinking patterns that may just provide a way out of the current dilemma. Think with the client about what would get her out of her present state of numb immobility or hysterical panic.

5. Step Five: Make plans. This flows directly from Step Four. The plan should identify additional persons, groups, and other referral sources that can be contacted for immediate support, and provide coping mechanisms. By these I mean that the client should be given something concrete and positive for the client to do now, definite action steps that the client can own and understand. Help the client problem-solve and cope.
6. Step Six: Obtain a firm commitment from the client. This means that you ask the client to verbally summarize the plan. Remember the SMART goal? A goal has a better chance of being achieved if it is SMART: S- specific, M- measurable, A- attainable, R- relevant, and T- time-bound. So it is with goal-setting with your client. Make sure that they get out of that ER/clinic/specific setting in a pre-crisis mode before terminating the contact with the client.

Later, follow up on the client’s progress and make the necessary and appropriate reports. Remember the overarching strategy of assessment and the twin components of listening and acting which are incorporated in the six steps of crisis intervention – and you’re all set! Remember that in crisis intervention, it’s not enough that you have good intentions: you have to have certain skills as well. This six-step model is a good way to get you started. Good luck!

Find advisor Blesilda44 at KEEN.com, 1-800-ASK-KEEN (1-800-275-5336), extension 05226567 either by phone or chat: Mon-Fri 7-10 pm, Sat-Sun 7-11 pm Pacific. I speak English, Tagalog, and some Spanish. For personal readings, email me here: pilipinasblitz@gmail.com