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Carisa Cegavske

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January 8, 2014
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Douglas County program stresses early detection of mental illness

Roseburg resident Ashley Zeigler wishes she could have had help from the Douglas County Early Assessment and Support Alliance a few years ago when she struggled with the mood shifts that characterize bipolar disorder.

“I remember thinking I was so alone. I didn’t tell anybody I had bipolar disorder until last year and I’m 27,” she said.

Zeigler shared her secret on stage in July in Chicago at Miss International, a pageant for women 19 to 30 years old. Zeigler, the reigning Miss Oregon International, chose mental health awareness as her platform issue and talked about her experiences. Zeigler is a chiropractic assistant at Wisdom of Wellness Chiropractic and Massage in Roseburg and a former Miss Rodeo Oregon.

She said she believes life could have been easier if Douglas County’s EASA program, which started in 2010, had been operating just a few years earlier.

EASA helps teens and young adults by identifying psychoses early and offering individual and family therapy, skills training and medical help.

Psychosis symptoms include hallucinations, inability to distinguish what is real or not and sometimes fears of persecution or delusions of grandeur such as the belief that one can fly.

Causes range from sleep deprivation to vitamin deficiencies, but most patients that EASA treats have early symptoms of either schizophrenia or bipolar disorder.

Statewide, EASA programs in 19 counties have assisted about 1,000 young people and their families, according to Tamara Sale, director of the EASA Center for Excellence at Portland State University.

The Douglas County Mental Health Department’s EASA program has about 10 clients between ages 15 and 25, but counselor Jessica Hansen said the need is likely much greater. She said she hopes the program will expand to include as many as 100 young people at a time.

Zeigler said she cycled through manic and depressive episodes, sometimes very rapidly.

“I had a hard time differentiating reality. I used to be able to easily make things up and believed them in my mind,” Zeigler said.

She said being diagnosed with an illness like bipolar disorder can shape how young men and women see themselves.

“It’s like a sticker that’s been stuck on their forehead. It’s stamped. It’s like the scarlet letter. It’s scary,” she said.

Zeigler said she finally decided to share her own diagnosis at this summer’s pageant when she was asked to choose a platform.

“I was going to choose healthy eating, but about eight of the others had already chosen healthy eating. My mother said, ‘Why don’t you do mental health?’ So I started out speaking about living a healthy life for your brain and then I realized I needed to go a little bit farther.”

According to the National Institutes of Health, 1 percent of Americans have schizophrenia and the hallucinations and delusions associated with the disorder typically start between ages 16 and 30.

Bipolar disorder affects about 2.6 percent of American adults, according to the National Institutes of Health. Half of all cases start before age 25.

Some, but not all, people with bipolar disorder experience psychosis during manic episodes, Hansen said.

Usually the more severe symptoms of psychosis don’t appear out of the blue, Hansen said.

“Before it gets to the point that they can’t tell what’s real or not, we would expect to see some signs,” she said.

An adolescent or a young adult at risk may have difficulty organizing information. Understanding long sentences or following multistep directions may suddenly become more difficult, Hansen said.

Early symptoms can be similar to those of acute psychosis. A person may be suspicious of others, have difficulty concentrating or develop unusual beliefs, like being in possession of magical powers. Early on, individuals are usually aware their experiences are not real but as symptoms get worse they lose that ability.

Increased sensitivity to light or sound may occur. Withdrawal from friends, family or group activities can be another warning sign.

“They’re not likely to be the ones who are causing a scene. It’s the ones who are withdrawing,” Hansen said.

EASA offers clients a two-year program to stabilize their lives through medicine, counseling and job support.

The program reduces hospital visits and increases success in education and employment, according to Sale.

Statewide, between 40 and 60 percent of EASA clients had been hospitalized in the three months prior to joining the program. Just 10 percent were hospitalized in the three months after joining. About two-thirds are in school or working when they complete the program, Sale said.

Hansen said EASA’s goal is to help patients stay on the same life path they would have chosen before they began experiencing symptoms of psychosis.

“Whatever the vision they wanted for themselves was before they had a diagnosis, that’s what we want for them,” Hansen said.

Rick Morris, a psychiatric mental health nurse practitioner for the Douglas County EASA, said early intervention puts Oregon at the cutting edge of psychosis treatment.

“In the past, the practice has been to ‘let it break,’ meaning the person would usually end up in the hospital after the symptoms became so severe that they were not able to function,” he said.

Often, a hospital would be the first place a person experiencing psychosis would be treated, Morris said.

“EASA seeks to identify and support before the break, possibly avoiding the break or minimizing the effects of the break. It is a fresh and promising culture shift and one that has me excited,” he said.

Zeigler said she wants to help young people in the EASA program learn — as she has — not to let their diagnoses define them.

“It’s not something that’s going to stop me from doing what I want to do,” she said.

• You can reach reporter Carisa Cegavske at 541-957-4213 or ccegavske@nrtoday.com.

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The News-Review Updated Jan 13, 2014 11:47AM Published Mar 4, 2014 06:07PM Copyright 2014 The News-Review. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.