Holiday Triggers

Holiday stress and depression are often the result of three main trigger points. Understanding these trigger points can help you plan ahead on how to accommodate them.

The three main trigger points of holiday stress or depression:

• Relationships. Relationships can cause turmoil, conflict or stress at any time. But tensions are often heightened during the holidays. Family misunderstandings and conflicts can intensify — especially if you're all thrust together for several days. Conflicts are bound to arise with so many different personalities, needs and interests. On the other hand, if you're facing the holidays without a loved one, you may find yourself especially lonely or sad.
• Finances. Like your relationships, your financial situation can cause stress at any time of the year. But overspending during the holidays on gifts, travel, food and entertainment can increase stress as you try to make ends meet while ensuring that everyone on your gift list is happy. You may find yourself in a financial spiral that leaves you with depression symptoms such as hopelessness, sadness and helplessness.
• Physical demands. The strain of shopping, attending social gatherings and preparing holiday meals can wipe you out. Feeling exhausted increases your stress, creating a vicious cycle. Exercise and sleep — good antidotes for stress and fatigue — may take a back seat to chores and errands. High demands, stress, lack of exercise, and overindulgence in food and drink — all are ingredients for holiday illness.

12 tips to prevent holiday stress and depression

When stress is at its peak, it's hard to stop and regroup. Try to prevent stress and depression in the first place, especially if you know the holidays have taken an emotional toll in previous years.

Tips you can try to head off holiday stress and depression:

1. Acknowledge your feelings. You can't force yourself to be happy just because it's the holiday season.
2. Seek support. If you feel isolated or down, seek out family members and friends, or community, religious or social services. Consider volunteering at a community or religious function. You don't have to go it alone.
   
3. Be realistic. As families change and grow, traditions and rituals often change as well. Hold on to those you can and want to. But accept that you may have to let go of others.
   
4. Set differences aside. Try to accept family members and friends as they are, even if they don't live up to all your expectations. Practice forgiveness.
   
5. Stick to a budget. Before you go shopping, decide how much money you can afford to spend on gifts and other items. Then be sure to stick to your budget. Don't try to buy happiness with an avalanche of gifts.
6. Plan ahead. Set aside specific days for shopping, baking, visiting friends and other activities. Expect travel delays, especially if you're flying.
7. Learn to say no. If you say yes only to what you really want to do, you'll avoid feeling resentful, bitter and overwhelmed.
   
8. Don't abandon healthy habits. Don't let the holidays become a dietary free-for-all. Some indulgence is OK, but overindulgence only adds to your stress and guilt. Continue to get plenty of sleep and schedule time for physical activity.
9. Take a breather. Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm.
10. Rethink resolutions. Resolutions can set you up for failure if they're unrealistic. Set smaller, more specific goals with a reasonable time frame. Choose only those resolutions that help you feel valuable and that provide more than only fleeting moments of happiness.
11. Forget about perfection. Holiday TV specials are filled with happy endings. But in real life, people don't usually resolve problems within an hour or two. Accept imperfections in yourself and in others.
12. Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, unable to sleep, and unable to face routine chores. If these feelings last, talk to your doctor or a mental health professional.

Read the whole article from the Mayo Clinic here, cut yourself some slack and have a relatively safe and sane holiday season:)

Study Finds Happiness Is Infectious

Forget six degrees of separation. How about three degrees of happiness? Researchers from Harvard University and the University of California, San Diego have mapped the relationships of happy people and found that happiness is a collective phenomenon that spreads like a virus through social networks - affecting even strangers three times removed from each other. The theory builds on the notion of emotional contagion, the process at work when a person smiles back at someone who smiles at him. Human emotions appear in clusters, behaving like stampeding animals, says study co-author Nicholas Christakis.

"You would never think to ask a particular buffalo in a herd, ‘Why are you running to the left?'" says the Harvard Medical School sociology professor. "The whole herd is running to the left."

Misery, on the other hand, does not love company as much as happiness does. "Unhappiness doesn't spread as intensely or as consistently as happiness," he says.

The research, being published today in the British Medical Journal, is the latest analysis of data gleaned from the Framingham Heart Study, a longitudinal U.S. survey begun in 1948. The researchers, who have previously published similar findings on the spread of obesity and smoking from the data, focused on 4,739 individuals over 20 years, accounting for 50,000 social and family ties. As the mantra goes in real estate, the top factor in happiness is location, location, location.

Using a standard measure of well-being, the Center for Epidemiological Studies Depression scale, they found that when an individual becomes happy, a friend who lives nearby experiences a 25-per-cent increased chance of becoming happy. And the more centrally located you are in your social cluster of happy people, the more likely you are to become happy.

Read the rest of the article by Tralee Pearce here.

Feeling SAD?

Darker days making you feel blue? Suffering from unrelenting cabin fever? Are you sleeping more, lacking energy, craving sweets? You may be feeling SAD, or seasonal affective disorder, a type of depression that can seriously impact your daily life. As many as half a million people in the United States may have winter-onset depression and another 10% to 20% may experience mild SAD according to the American Association of Family Physicians.

Research at Loyola University seems to indicate that SAD is first and foremost a physical disorder where reduced exposure to natural light leads to biochemical imbalances in the brain. This may be a sort of genetic leftover; the human equivalent of hibernation. But rather than retreat to the nearest cave (with a bag of Oreos,) try some of these mood lifters:

• Get outside for at least 30 minutes a day, preferably at mid-day. Lunch walk anyone?
• Take a multivitamin that includes magnesium, B-complex and minerals.
• Aerobic exercise. (My favorite.)
• Avoid caffeine. (You've got to be kidding me.)

If you're less than thrilled with these suggestions, you might try light therapy. Light therapy mimics outdoor light and causes a biochemical change in your brain that lifts your mood and relieves symptoms. In light therapy, you sit a few feet from a specialized light therapy box so that you're exposed to very bright light. Light therapy is generally easy to use and has relatively few side effects. However, light therapy hasn't been officially approved as a treatment by the Food and Drug Administration because of a lack of definitive evidence about its effectiveness in clinical trials. Before you purchase a light therapy box or consider light therapy, consult your doctor or mental health provider to make sure it's right for you. (Got my light from Costco...)

Most people experience some days when they feel down. But if you feel down for days at a time and you can't seem to get motivated to do activities you normally enjoy, see your doctor. This is particularly important if you notice that your sleep patterns and appetite have changed — and certainly if you feel hopeless, think about suicide, or find yourself turning to alcohol for comfort or relaxation. More than usual. (Frankly, just thinking about the impending holidays makes me feel hopeless, think about suicide, and turn to alcohol for comfort.) Find more info here.

Talk it out...

For decades, lithium was the front-line treatment for bipolar disorder. The mysterious salt—doctors still don’t know exactly how it works—stabilizes the intense high and low moods that are hallmarks of the illness.

But after its use for nearly 40 years (the U.S. Food and Drug Administration approved lithium for control of manic episodes in 1970), doctors and consumers have come to the realization that lithium—as well as other mood stabilizing medications—are not the cure-alls initially hoped for.

“It took the field about 25 years to notice that outcomes were not always so good,” says Ellen Frank, PhD, a psychologist and a professor of psychiatry and psychology at the University of Pittsburgh School of Medicine, and director of the Depression and Manic Depression Prevention program at Western Psychiatric Institute and Clinic.

“We don’t know why [people] relapsed—whether there was a non-adherence to medication, or if the early results for lithium were overly optimistic or there was a co-morbid use of illicit drugs, or a combination of those things,” Frank says.

Indeed, lithium’s limitations led researchers to reexamine psychotherapy’s role and potential. In the 1950s and 1960s, therapy for bipolar consisted chiefly of psychoanalysis, founded by Freud; and psycho dynamic therapy, which focuses on a patient’s previous experiences to understand current conflicts, according to Gregory Simon, MD, a psychiatrist and researcher at Group Health Cooperative, a consumer-governed, nonprofit health-care system based in Seattle, Washington.

“Then more came out about the inheritability of the illness, which led people to look for [other] treatments,” says Simon, who is also chair of the Scientific Advisory Board of the Depression and Bipolar Support Alliance (DBSA).

Over the past decade or so, researchers have developed several psychotherapies that are specifically designed for the treatment of bipolar disorder. Most of these therapies, including cognitive behavioral therapy (CBT) and interpersonal social rhythm therapy (IPSRT), were retooled from existing therapies for other mental illnesses, such as those for anxiety and depression, according to researchers.

Early results have been promising: Clinical studies indicate that therapies targeted for bipolar—when combined with appropriate medication—result in greater mood stability and medication compliance, reduction or elimination of hospitalizations, a faster recovery from a bipolar depression, and better overall quality of life.

According to Joseph R. Calabrese, MD, bipolar disorders research chair and professor of psychiatry at Case Western Reserve University, “The best treatment for bipolar disorder includes both a mood stabilizer, which is used to prevent future mood episodes; and psychotherapy/counseling, which is used to help people learn how to manage the symptoms of their illness. Either alone does not work as well.”

Excerpt from Psychotherapy retooled from the Fall 2008 issue of bp Magazine

Veteran's Day 2008

Consider these statistics:

• Nearly 33 percent of those who have been deployed to Iraq and Afghanistan will experience mental health issues.

• In 2007, the suicide rate among veterans who served in the US Army was at an all-time high.

• Approximately 40 percent of all homeless veterans live with mental illnesses.

• Nearly 57 percent of this aforementioned group are African American or Hispanic veterans.

•  Approximately 30 percent of veterans treated in the Veterans health system experienced depressive symptoms, two to three times the rate of the general population.

With an historic Election now behind us, Americans turn to Veterans Day on November 11 to honor all those who once served in our Armed Forces. Michelle Obama has said that, " The struggles of America's families aren't new to Barack... He also knows that when our military goes to war, their families go with them. He's a strong advocate for predictable deployments and better healthcare - including mental health - for returning service people." It is with renewed hope that we hear these words. (Read the rest here.)

Stand with NAMI and make a donation in support of better mental health care resources for veterans, active duty service members, and their families. You may even make your gift in tribute to a veteran, active duty service member, or other loved one, and include a message of support for display on the NAMI's Veterans Tribute Honor Roll.

So today let us say thank you to our veterans - including my son, whose bravery in facing the struggles of his daily life is my constant source of inspiration.

Not at my best...

It's been awhile since I've been on medication. I'm pretty par with the average consumer that I loathe the side effects of anti-depressants and I'm probably better than average at finding other ways to cope. Notice I didn't say healthier ways, just other - although as I've grown older I've tried to avoid self medicating with substances or food. sigh... key word - TRIED. Sometimes I'm pretty good at avoidance.... sometimes what I'm avoiding isn't necessarily what I should be avoiding.

I'm pretty much free falling at present - enough that I think I may have no other choice but to go to my doc and ask for meds. Again. This in and of itself, is not making me feel better.

I know that my current depression is mostly due to my reactions to some very specific current events, some of them personal and some of them the world at large. I tend to soak up the free floating anxiety that our current economy and pre-election hysteria send out to the ether; like many with depression, I feel everything personally and intensely. I just spent a full week in a training to become a WA State Certified Peer Counselor and came home pretty shook up. (Imagine a week of intensive group therapy.) Then I had someone I thought of as a friend tell me she is "done," (with me? I assume) - leading me to ruminate on how she got to "done" without me even guessing that there was a problem. ( I will think this to death. It will be my fault. Can't maintain even the most rudimentary adult relationships - just like your mother - bladdda, bladda, blah.)

The level at which I am NOT coping right now is pretty clear. Binge eating is being narrowly avoided, or not avoided depending on your point of view... I'm bingeing but on pretty low calorie fare so it hasn't left me feeling a complete failure... only a minor one. I'm avoiding social contact. I'm a complete bitch to my poor husband, because he's around me enough to catch the brunt of my misery. I haven't started drinking for relief. I cry myself to sleep after an hour or two of mindless mental activity to wear me out... or I have to take something to sleep - tylenol PM or Xanax (down to my last 6 pills and hoarding them. Don't really want to go the doc.)

Is it enough for me to say that I need help, even while I'm avoiding getting it?

Older. with Bipolar.

No sour grapes for David Zagorsky—the acronym GRAPES means something quite the opposite for this vibrant 63-year-old living in seaside Del Mar, California.

Zagorsky participated several times in a cognitive program that taught him to incorporate these words into his daily life: 'Gentle, Relaxation, Accomplishment, Pleasure, Exercise, and Social.' GRAPES, he says, are great motivation. "Just do a little of each. For example, walking to the local convenience store accomplishes both the exercise and social components."

Sometimes you'll need to dig deeper, Zagorsky admits. "When you're really down, challenge yourself, and say, 'I'm going to get up at a certain time and move on with my day. I've just got to do it.' You give in to this illness, and you're done." He knows that maturity means being able to handle what is often a full plate. "Go to work on behalf of other people to escape your own misery."

The determined and reflective Zagorsky, diagnosed with bipolar I at age 24, is a dedicated facilitator at the peer-to-peer Depression and Bipolar Support Alliance (DBSA), San Diego chapter. He relies upon his "three-legged stool"—medical management, a skilled therapist whom he trusts, and his family and friends. These friends include his DBSA group, which meets each Monday "because illness does not know vacation and it's not a walk-in-the-park illness, but one that is chronic and cyclical," he says. "You never know when it's going to sneak up on you again, so be aware of 'gradations,' those subtle changes."

Read the rest of the article by Stephanie Stevens here.

Anger Management

Mood specialists are careful to distinguish between occasional hot flashes of anger and the long-simmering irritability and rage—angry outbursts lasting over several days, during both manic episodes and agitated states of depression—that is symptomatic of bipolar disorder. During a manic episode, experts say, mood changes can swing from irritability to euphoria to depression—all within a 25-minute period of time.

“Instantaneous anger that lasts a few minutes and occurs twice a week is not bipolar, it’s being angry,” says David L. Dunner, MD, FACPsych, director of the Center for Anxiety and Depression in Mercer Island, Washington. “Irritability can be present during highs and lows, but irritability without elated mood makes me suspect the illness may not be bipolar.”

In other words, everybody gets angry. Just because you have a head-turning temper tantrum doesn’t mean you have bipolar disorder. Anger is a common response to both physiological illnesses like cancer and heart disease and mental illnesses such as intermittent explosive disorder, major depressive disorder and substance-induced mood disorder.

“As bipolar disorder receives more media attention, it’s easy for any type of abhorrent behavior to be attributed to it when in fact, this has to do with one’s temperament,” says Ronald A. Remick, MD, a consultant psychiatrist at St. Paul’s Hospital in Vancouver, British Columbia.
“Bipolar patients are not angry, hostile, irritable people with short fuses,” he emphasizes. “If people with bipolar illness have anger issues, they have anger issues.”

It is, however, a side of bipolar disorder that has long passed under the radar screen. Many people with bipolar say that uncontrolled anger has destroyed their marriages, families and personal relationships, ruined their careers and left them emotionally isolated...

ANGER MANAGEMENT 101

Here are some suggestions from both doctors and patients to help you get a handle on your anger.

• Ask yourself these questions when you feel yourself on the verge of anger: Is this really what I want to do? Do I want to have this conversation or explosion now? Maybe I should wait until I feel better. Answering “no” could buy you a few precious seconds to consider your next move,” says Roy Perlis, MD, MSc, medical director of the Bipolar Clinical and Research Program at Massachusetts General Hospital in Boston.
• The same goes for email. Don’t let loose too soon. Print is forever.
• If you’re prone to anger outbursts you know it by now. “For some people, this feels like a panic attack, a rush of adrenalin, heart pounding, skin flushed,” says Perlis. Have a plan in place about how you intend to RRespond—and keep to it.
• Remove yourself immediately from the situation. That’s appropriate especially if you’re a parent with a child or even a pet owner. At work, excuse yourself and go to the restroom.
• Explore relaxation techniques for managing anxiety, like visualization, listening to music, or maybe doing a task that distracts you.
• Exercise daily.
  
• Communicate with your doctor, advises Sharon Lyons. And be creative, like Jeff McDonald, who shouts the odd-sounding name of Providence Bruins hockey goalie, Finnish player, “Tuukka Rask!” Why? “It makes me laugh,” he says.

Excerpt from Stuck on the rage road in the Fall 2008 issue of bp Magazine

(I'm out of town until Oct. 18th... am attending WA State Peer Counseling Training... sort of mental health camp:)

As We Countdown to the Election

Mental Illness Awareness Week is October 5-11. That same week, our presidential candidates will hold a “town hall” debate—in which up to a quarter of the audience are likely to have experienced a mental illness.

That’s because one in four adults lives with depression, bipolar disorder, schizophrenia, post-traumatic stress disorder (PTSD) and other mental illnesses every year. That’s almost 60 million Americans.

Mental illness does not discriminate between Republicans and Democrats. It can strike anyone at any time.

Mental health is part of health care and it is essential that it be included in the nation’s health care reform debate.

Mental illness affects children. It affects people of color. Two million Americans live with schizophrenia—twice the number of those with HIV/AIDS. One in five veterans of Iraq and Afghanistan—almost 300,000 troops—will experience major depression or PTSD upon returning home. Unfortunately, two-thirds of people who live with mental illnesses do not receive treatment.

But treatment works. Recovery is possible. Between now and Election Day, every candidate needs to talk about these facts.

See how the presidential candidates responded to a NAMI survey here.

Then... VOTE.

Carrot, Egg or Coffee Bean?

A young woman went to her mother and told her about her life and how things were so hard for her. She did not know how she was going to make it and wanted to give up. She was tired of fighting and struggling. It seemed as one problem was solved, a new one arose.

Her mother took her to the kitchen. She filled three pots with water and placed each on a high fire. Soon the pots came to boil. In the first she placed carrots, in the second she placed eggs, and in the last she placed ground coffee beans. She let them sit and boil; without saying a word.

In about twenty minutes she turned off the burners. She fished the carrots out and placed them in a bowl. She pulled the eggs out and placed them in a bowl. Then she ladled the coffee out and placed it in a bowl. Turning to her daughter, she asked, ' Tell me what you see.'

'Carrots, eggs, and coffee,' she replied.

Her mother brought her closer and asked her to feel the carrots. She did and noted that they were soft. The mother then asked the daughter to take an egg and break it. After pulling off the shell, she observed the hard boiled egg.

Finally, the mother asked the daughter to sip the coffee. The daughter smiled as she tasted its rich aroma. The daughter then asked, 'What does it mean , mother?'

Her mother explained that each of these objects had faced the same adversity: boiling water. Each reacted differently. The carrot went in strong, hard, and unrelenting. However, after being subjected to the boiling water, it softened and became weak. The egg had been fragile. Its thin outer shell had protected its liquid interior, but after sitting through the boiling water, its inside became hardened. The ground coffee beans were unique, however. After they were in the boiling water, they had changed the water.

'Which are you?' she asked her daughter. 'When adversity knocks on your door, how do you respond? Are you a carrot, an egg or a coffee bean?

Think of this: Which am I? Am I the carrot that seems strong, but with pain and adversity do I wilt and become soft and lose my strength?

Am I the egg that starts with a malleable heart, but changes with the heat? Did I have a fluid spirit, but after a death, a breakup, a financial hardship or some other trial, have I become hardened and stiff ? Does my shell look the same, but on the inside am I bitter and tough with a stiff spirit and hardened heart?

Or am I like the coffee bean? The bean actually changes the hot water, the very circumstance that brings the pain. When the water gets hot, it releases the fragrance and flavor. If you are like the bean, when things are at their worst, you get better and change the situation around you. When the hour is the darkest and trials are their greatest do you elevate yourself to another level? How do you handle adversity? Are you a carrot, an egg or a coffee bean?

Editor's note: I'm up to my eyeballs in a new Family to Family class - 12 weeks of immersion. Bear with me and my tardy posting:)

Healthy Ideas to Manage Life's Pressures Part 3

Here is the final installment in our series on strategies to reduce the every day stress in our lives courtesy of Mental Health America. Living with mental illness is a stress in and of itself - with or without the moment to moment drama of modern life. The neurotransmitters adrenaline and epinephrine evolved to help us react quickly to an immediate threat - fight or flight - great idea if you need a speedy response to stumbling upon lions, or tigers or bears! However, we never did adapt to a steady stream of these useful chemicals - the so called 'stress response.' Long term, an overabundance of fight or flight chemicals is damaging to our health, resulting in heart disease and a host of pathological conditions. So, take a deep breath and try these ideas...

• Watch your negative self-talk. Try not to put yourself down. For example, if you don’t make it to the gym this week, don’t call yourself lazy. Instead think about the specific factor that may have kept you from going to the gym. “I wasn’t able to work out because I had to work late hours this week, but next week, I’ll make it a priority to go.” The problem is temporary and can be overcome.

• Get involved in spiritual activities. Studies have shown that religious involvement and spirituality are associated with better health outcomes, such as greater coping skills, less anxiety and a lower risk of depression. Spirituality may provide a sense of hope, meaning and purpose in life, a way to understand suffering and illness, and a connection with others. Religious and spiritual practices, such as prayer and meditation, can evoke positive emotions that can lead to better health.

• Write down three good things that happen to you each day for a week. Also write down why each good thing happened. Thinking about the good things in your life and expressing gratitude may actually help you feel happier.

And finally, deep breathing is a great way to de-stress. It actually changes your brain’s chemical balance to calm you down.

Here’s how to do it:

1. Lie down or sit on the floor or in a chair.
2. Rest your hands on your stomach.
3. Slowly count to four and inhale through your nose. Feel your stomach rise. Hold it for a second.
4. Slowly count to four while you exhale through your mouth. To control how fast you exhale, purse your lips like you’re going to whistle. Your stomach will slowly fall.
5. Do this a few times.

Check out Part 1 and Part 2 of this list for a refresher and start chillaxin!

View from her side...

You've often heard my side of the continuing saga of my son and his disease... I thought I would share a recent post from my daughter-in-law, another side of the story. And in case you're wondering, this is just one of the many reasons that I adore her and hold her in awe...

"I have shared before that my husband is sick. John has Bi Polar disorder, which makes our life together really challenging. Actually, challenging is an understatement. It is sometimes im-****ing-poss-i-ble to even look him in the eye when he is cycling, or off his meds, or one of the other frighteningly cliche things he does because his brain chemicals are out of whack and he cannot process information like I do. Simple things become herculean for him, things like remembering to turn his phone on, brush his teeth, put gas in the car, lock the dogs up before leaving for work, or, god forbid, the one one I fear the most... not taking his meds.

This last one, the big one, the deal breaker, is exactly what he was doing for about 3 months. John is so damn smart, and he's become a master at cloaking when he's off kilter, or when he's feeling really out of whack. I see signs, they are sometimes subtle and sometimes glaring, but when I am busy with school or preoccupied with my own woes, I fall prey to the safety I feel in believing him when he tells me he is fine, even when I know that he is not.

I don't want to type out the details and I'm sure you don't really want them. It is a messy messy story, and it is so full of pain and worry and heartbreak and anger that I can't really recount it all, anyway. The end result is that when the crash came, it was colossal. There were a series of small wrecks, like fender benders, that I thought we'd be able to patch up, but then came the train wreck. That was more like parking a car on the tracks. Everything derailed and it was bloody. John ended up in the hospital, completely blacked out about the incident, and I ended up putting my anger aside to seek him out in the ER while we waited for a social worker, all night. I gave him juice, I slept next to him on a hospital bed, I called his mom, our best friend and pseudo brother, signed forms, talked to his boss, got my own work covered, and did what needed doing. It was all auto pilot.

Eventually, he was home. I decided that the best thing I could do for him, and the best thing I could do to see if our marriage had a future after this episode, was to let him recover at home instead of shipping him off to his mom's in Anacortes like we have done after each episode he's had. She came here and stayed, helped look after him, helped by being there and watching over him.

It was touch and go. Even on the burnt pie day, I was still not feeling centered or balanced or like I knew him, really, at all. I kept plugging away, week after week, because if I really want to be married to this man I need to work hard at it, until I don't want to work at it anymore. I thought I'd reached that point, several times. I thought that maybe, this time, there would be no coming back from this, no point where trust could be established or I could feel anything but anger when I looked at him. No matter how many times I'd tell him this, though, he'd smile and hold my hand, touch my face, and tell me that I'm still here, and that means enough to him to keep hoping that we'll be able to get back there, that being able to hold my hand and touch my face mean that I'm still willing to try and that's more than he feels like deserves, so he's gonna keep doing his damndest.

Well, he really is doing his best. In fact, right now, today, this minute, John is trying harder and being more self reliant than I have EVER seen him in the 2 years (almost) we have been married and the 3 we've been together. He is getting regular counseling and really doing his homework outside of his sessions. He's telling me what he's working on and working towards, goals he and his counselor have set up together. He's taking responsibility for his medication, involving me only to reassure me that he's taking them, but the onus of ordering and dosing and remembering goes to him. I'm just the check and balance system. He is cleaning the house without being told, trying to learn to budget money (another one of his goals) and helping with the cooking and the planning of meals.

The last few days, I've noticed, all of the sudden, that he's making me laugh again, that I am looking forward to him getting off work and coming home at night, that I'm imagining where he is on his drive and what he's doing in the car (one of my favorite things to do when he lived in Anacortes and I knew he was on his way to visit me. I'd tingle with anticipation, bustling around my apartment, picking things up and putting them down, checking the clock every couple minutes to see how much longer until I'd hear his car in my driveway.) I held his hand in the car the other day. He played me "Calling You" by Blue October and instead of being irritated, I bawled. I set my alarm for earlier so I could wake up and snuggle him instead of getting right out of bed and into the shower. I don't have a problem telling him I'm proud of his progress and that he's doing so well, and telling him I appreciate his efforts instead of feeling entitled to a break from dealing with his disease.

Last night, he met me at Usice, our fave pub, for my Friday after work drink. He called me to tell me to have as many as I wanted, that he'd gladly drive me home and take me to work in the morning. He was attentive and kind, affectionate and sweet, and I almost fell off my barstool giving him silly kisses on his eyelids, cheeks, nose and forehead. He got up early and took me to work with no complaining, and made it back down for my lunch. He took me to brunch for my favorite food (crawfish and crab eggs benedict) and then put up with me indulging another craft outlet. (I'm learning to make soap!) He teased me about my crafting ADD and walked around the supply store with me, carrying items and finding essential oils for my endeavor. He held my hand in the sun, made me laugh outrageously, and all of the sudden I realized that he is my husband again. He is himself, he is loving and kind, and I am feeling like I'm seeing him again after a long absence.

I know that eventually this will cycle round again, and we may very well end up back at the hospital again at some point. I am taking hope and comfort in hearing him say things like "I never want to be unmedicated again, as long as I live" and "I love going to counseling" because they show me he is committed to making this change for himself in how he manages his disease and his life. I am hoping that the love we build and the hope we store and the coping strategies we learn while he is well will last us through the long cold spells when his illness takes over and my John just isn't there.

Today was just so good, so sweet and close and quiet. He let me knit while he looked around and cleaned the house. I asked him what he was doing, and he said he's getting some stuff done because his mom is coming tomorrow and he knows the house needs to be cleaned before she gets here. Holy shit, it's the first time I've heard something like that from him since, well... March or so? He told me not to worry about it, that I should just veg out and knit and relax, and that he'd take care of it. I didn't need to make him a list, remind him what needed doing, or chide him to finish a task. He brought me a ginger ale, cleaned the dog bowls, even dusted everything, all without word one from me.

We went out to say goodbye to Ryan's girlfriend, Nikki. I drove this time, he had himself a drink and then wanted Taco Bell. Even though we're trying not to eat fast food, I really didn't want to cook, so I caved. He was hilarious in the car, a riot at the house, and then sweetly sleeping on my leg while I finished the glove I was knitting. He's asleep in the other room, and I should be there, too, but I wasn't ready to let go of this day quite yet. I wanted to write about it, to remind myself later when things get dark that today at the end of summer I was full of hope again, and I told my husband that I love him and really meant it without anger or a "but" lingering at the back of my statement.

I turn 30 in 5 days. If this week continues like my last few days have been, it's going to be the best birthday ever."

To sleep, perchance to dream

Sleeping is one of those things reserved for other people... Lack of a healthy sleep pattern is one of the early warning signs of oncoming mania, or in my case, the precursor to exhausting depression. I came across this personal account in one of my favorite magazines, The Sun, which publishes original writing without the support of advertisers. Thought I'd share it with you.

"At the age of twenty-four, after my mood swings and irrational behaviors grew more frequent and I started to hear whispering, I was diagnosed with bipolar disorder. Seven years later I have learned to live with this disease and have even formed a relationship with it. We meet after dark.

A manic episode can keep me up for days on end. My wild thoughts - which at the time seem rational - will not allow me to sleep. I might believe that the glow of a streetlight outside is an alien spacecraft, or that the shadows are wild animals out to attack me.

I must confess, I love the energy that an episode brings. I can write for hours on end. If I had the means and the knowhow, I could probably build a boat! I have fallen in love with the night, because then there is no doctor to advise me, no family to interrupt; no time to think about the consequences, no time for regrets.

I take my medication because I don't want to be a burden on my loved ones. But if it were up to me, I would forget all about medication and let the night swallow me whole."
Name withheld

Martin Seligman on Positive Psychology

Another Day in the Dark

The sun is shining. Just not in here.


"Stand Still, Look Pretty" by the Wreckers

I want to paint my face
And pretend that I am someone else
Sometimes I get so fed up
I don't even want to look at myself

But people have problems that are worse than mine
I don't want you to think I'm complaining all the time
And I hate the way you look at me I have to say
I wish I could start over

[Chorus]
I am slowly falling apart
I wish you'd take a walk in my shoes for a start
You might think it's easy being me
You just stand still, look pretty

Sometimes I find myself shaking
In the middle of the night
And then it hits me and I can't
Even believe this is my life

But people have problems that are worse than mine
I don't want you to think I'm complaining all the time
And I wish that everyone would go and shut their mouths
I'm not strong enough to deal with it

I am slowly falling apart
I wish you'd take a walk in my shoes for a start
You might think it's easy being me
You just stand still, look pretty

Depression just hurts. Check out this interesting site for young people: To Write Love on her Arms.

Seven Healthy Habits for Fighting

In his book I'm Right, You're Wrong, Now What? Xavier Amador wants to show people how not to argue. "There are situations that are inherently unresolvable," he acknowledges, "but how you don't resolve it is far more important than the fact that you didn't resolve it. The trick is not to avoid a fight, but to fight right." Amador's method shows people how to step aside in order to get what they need - while agreeing to disagree. When that happens, impasses can be broken. Here are some of the basics:

• Don't insist you're right - being adamant only makes the other person more stubborn.

• Don't engage in insults or name calling - it only makes the other person angrier and more rigid.

• Pick the right time - pay attention to whether you or the other person are too angry, defensive, stressed or tired to be receptive.

• Don't use absolutes - people become more rigid or defensive in the face of absolute claims such as "you always" or "you never."

• Don't throw in the kitchen sink - bringing up past conflicts or transgressions only makes another person angrier and more rigid and derails attention to the issue at hand.

• Listen without defending - let the other person feel that they are being heard or understood, which reduces defensiveness.

• Reflect back what you hear - one of the most effective ways to "lower the temperature" of an argument and open up the other person to your own point of view.
  

I Grieve

My heart aches tonight. It is a familiar ache. Some days I almost forget. There are times when life seems so benign, so calm, so normal that I don't believe that he is ill. For awhile I have another life - a simple life - uncomplicated by the doubt and the grief I feel today. Some days I'm just an empty nester - my kids are fine; out living their lives - some days I think about growing older; about things I'd like to do while I have the time. Then the phone will ring.

I can almost begin to trust the ring of a phone after a time. I can get to the point where it doesn't make my breath catch. But I know in the back of my mind that a panicky phone call or a series of alarming text messages are always on the horizon. When they come it is almost a relief - like something I've been waiting for. Another crisis. Another crash. My son is sick, so sick, again. I grieve. Again.

He made me listen to this song, once. We sat and cried. I know that for all the pain I feel for him, his pain is worse. I would take the heart from my body if it could give him a normal life. I would give anything, anything I could give, to spare him this.

"Hate Me by Blue October"

(If you're sleeping are you dreaming
If you're dreaming are you dreaming of me?
I can't believe you actually picked me.)

(Hi Justin, this is your mother, and it's 2:33 on Monday afternoon.
I was just calling to see how you ware doing.
You sounded really uptight last night.
It made me a little nervous, and a l... and... well... it made me nervous, it sounded like you were nervous, too.
I just wanted to make sure you were really OK,
And wanted to see if you were checking in on your medication.
You know I love you, and...
Take care honey
I know you're under a lot of pressure.
See ya. Bye bye.)

I have to block out thoughts of you so I don't lose my head
They crawl in like a cockroach leaving babies in my bed
Dropping little reels of tape to remind me that I'm alone
Playing movies in my head that make a porno feel like home
There's a burning in my pride, a nervous bleeding in my brain
An ounce of peace is all I want for you. Will you never call again?
And will you never say that you love me just to put it in my face?
And will you never try to reach me?
It is I that wanted space

Hate me today
Hate me tomorrow
Hate me for all the things I didn't do for you

Hate me in ways
Yeah ways hard to swallow
Hate me so you can finally see what's good for you

I'm sober now for 3 whole months it's one accomplishment that you helped me with
The one thing that always tore us apart is the one thing I won't touch again
In a sick way I want to thank you for holding my head up late at night
While I was busy waging wars on myself, you were trying to stop the fight
You never doubted my warped opinions on things like suicidal hate
You made me compliment myself when it was way too hard to take
So I'll drive so f***ing far away that I never cross your mind
And do whatever it takes in your heart to leave me behind

Hate me today
Hate me tomorrow
Hate me for all the things I didn't do for you

Hate me in ways
Yeah ways hard to swallow
Hate me so you can finally see what's good for you

And with a sad heart I say bye to you and wave
Kicking shadows on the street for every mistake that I had made
And like a baby boy I never was a man
Until I saw your blue eyes cry and I held your face in my hand
And then I fell down yelling 'Make it go away!'
Just make a smile come back and shine just like it used to be
And then she whispered 'How can you do this to me?'

Hate me today
Hate me tomorrow
Hate me for all the things I didn't do for you

Hate me in ways
Yeah ways hard to swallow
Hate me so you can finally see what's good for you
For you
For you
For you

[Children voices:]
If you're sleeping, are you dreaming,
if you're dreaming are you dreaming of me.
I can't believe you actually picked me

All I can do is love him.

Healthy Ideas to Manage Life's Pressures Part 2

Let's return to Mental Health America and their list of ways to cope with day to day stress. Remember - stress affects us all, but when living with a brain disorder it can be dramatically devastating to overall health and well being. Any and all strategies to reduce the effects of stress should be incorporated into a health plan. So with no further ado let's see if we can find a method that we haven't tried...

• Get Enough Rest. Getting enough sleep helps you recover from the stresses of the day. Try to get seven to nine hours of sleep every night. Visit the Sleep Foundation for tips on getting a better night’s sleep.

• Help Others. Helping others builds social networks, improves self-esteem and can give you a sense of purpose and achievement.

• Know your limits. Let others know them, too. If you’re overwhelmed at home or work, or with friends, learn how to say “no.” It may feel uncomfortable at first, so practice saying “no” with the people you trust most.

• Keep a journal. Writing down your thoughts can be a great way to work through issues. Some researchers have reported that writing about painful events can reduce stress and improve health. You can also track your sleep to help you identify any triggers that make you feel more anxious.

Revisit the beginning of this list, watch for the last items on the list in a future post and be sure to visit Mental Health America. Have a peaceful day!

A Stroke of Insight

The Trevor Project

Excerpt:
The transgendered woman on the other end of the line was threatening to kill herself by jumping off of a parking structure. The Trevor Helpline counselor who answered the phone worked to get the 24-year-old calm and immediately called police for help.

Exactly one month later, that same woman called the helpline back -- to thank them for saving her life.

Stories like these are the reason The Trevor Project operates its helpline, the only nationwide, around-the-clock crisis and suicide prevention number for gay and questioning youth. More than 500 volunteers are trained for 40 hours to run the bicoastal call centers.

"There's a high level of stress that youth face in the transition from youth to adulthood," Charles Robbins, executive director of The Trevor Project, said. "Add on top of that the challenges of sexual orientation or gender identity and we get 15,000 calls a year."

A 2005 Massachusetts Department of Education survey of 3,500 high school students, in partnership with the Centers for Disease Control and Prevention, found almost 11 percent have seriously considered suicide. And that percentage is almost four times as high for 10 to 24-year-olds who identify themselves as gay, lesbian or bisexual.

"Because of the unfortunate stigma that still exists in the United States around homosexuality ... youth tend to hold back their feelings, don't disclose, live in denial or shame," Robbins said.

Every year The Trevor Project honors one individual who publicly works to reject that stigma and helps in the group's overall goal: to promote the acceptance of gay and questioning youth in society. This year's honoree, actor Alan Cumming, has been "unapologetic, and true to himself," Robbins said.

"Anything that helps those people have a voice and have someone to talk to and have somewhere to turn is really important," Cumming said. "Suicide is in the top three causes of death for teens. That's a shocking statistic."

Read the rest of the CNN article here or visit The Trevor Project.

Smiling Through

Excerpt:

I know that everyone here knows that feeling when people say to you, “Hey, shape up! Stop thinking only about your troubles. What’s to be depressed about? Go swimming or play tennis and you’ll feel a lot better. Pull up your socks!” And how you, hearing this, would like nothing more than to remove one of those socks and choke them to death with it.

Such inane advice of the “socks up” variety, by the way, can only be excused by the fact that if you’ve never had it you can never begin to imagine the depth of the ailment’s black despair. Another tip: Do not ask the victim what he has “to be depressed about.” The malady doesn’t care if you’re broke and alone or successful and surrounded by a loving family. It does its democratic dirty work to your brain chemistry regardless of your “position.”

While not wishing to become the poster boy for depression, I still found the rewards undeniably pleasant, gratifying and touching.

As in: Dear Mr. Cavett, You don’t know it but you saved my dad’s/ wife’s/daughter’s life. Followed by various forms of, My dad’s seeing that Dick Cavett could have it made him feel he wasn’t a freak, and he finally went for treatment. We are so grateful.

Apparently one thing I said on “Larry King” back then hit home hard. It was that when you’re downed by this affliction, if there were a curative magic wand on the table eight feet away, it would be too much trouble to go over and pick it up.

There’s also the conviction that it may have worked for others but it wouldn’t work for you. Your brain is busted and nothing’s going to help.

Read the rest of this funny and touching personal testimony here.

Fear

If there is one thing that motivates me lately, this is it. I am afraid. It's right at the edge of my mind these days, like a nagging little itch that I can't scratch. I'm not always giving it my attention - sometimes I go all day without consciously acknowledging that it's even there - but push comes to shove this is what is turning my gears. I'm afraid.

Now I suppose what makes this attack of monumental cowardice interesting is that the current reason for all this distress is something incredibly positive in my life. I don't have cancer (I think,) I'm not facing unemployment or homelessness or armed terrorist thugs. No one is going to shoot at me, or take away my loved ones or my stuff. Of all that, I am reasonably sure. The devil in the dark, for me, is actually going to prolong my life, improve my health and make me more socially comfortable. However, it is incredibly scary because it challenges my comfort zones and my very identity. For the first time in my life, I am successfully losing weight and this diet is working so well that I can almost imagine myself achieving the lifelong goal of not being "the fat chick."

However, "the fat chick" is who I am. It's almost inconceivable to me that I could be anything else. SOOO, if that isn't who I am - who will I be? This is a freak out of biblical proportions. Especially when I don't have an answer. Most people really don't understand the nature of this anxiety. They are all so happy for me. Or amazed that I am actually doing this. Or envious (which weirds me out, too - my fat friends are uncomfortable with my weight loss.) I am merely afraid. Afraid that I don't know the person in the mirror. Unsure where her boundaries are (being overweight puts lots of boundaries up for you...) Right now it's all I can do to take one day at a time and eat in this new and curiously simple way. Right now it's actually difficult to give up my comfortable baggy clothes because they don't fit. Right now somebody lavishing praise upon me for being less of me can bring me to tears. It's not rational. Fear rarely is.

I'll let you know when I feel like I'm through it. Right now I'm still afraid.