Mermama's Mind

Anniversary

2011-03-26T10:22:00.000-07:00

"In addition to friendship, attitude is one of the few things in life where we have a true choice. We cannot change what is fated to happen or the actions of events or other people.

What we can change is our reaction to such things with the attitude we adopt. In truth, our attitude can be more important than anything we do. It can make or break families, companies, and nations. It is more important than schooling, talent, looks, or wealth.

How we react is everything and our attitude is the choice we have; it is a choice we make every minute of every day. It is a state of mind that no one can take from us. If we are in control of our attitudes, we are in command of our lives. And that is the best way to live."

I would love to say that I wrote that, but I stole it from a blog who stole it from the company who makes his snow boarding equipment. Whatever. I'm quoting it to you now, because it is the essence of what gives our life any sort of meaning. I've struggled for a year now asking myself that very sort of question. Today is the anniversary of a suicide - a friend of mine who took her life and left us all behind with nothing but questions. I have lived a year longer than her and I'm never sure which of us made the right decision. There are days that I am so unhappy that I just don't want to draw another breath, so how can I blame her for choosing not to? And yet I still do. I'm still angry. But I am ultimately in control of my attitude.

So what does that leave me with? Some wisdom, perhaps. I get up and I live with depression, in a society that so often lacks compassion, and I love the people that I love regardless of their flaws and insensitivities, or maybe because of them. I can choose to be wounded by my day or to feel blessed by the gift of it. I can weep with the overwhelming pain of it all or I can move through it. Every single day I make choices. And they are mine to make.

I miss Dianne. I miss the father that I never got to know. I miss the woman I would be if all these and a hundred other tragedies hadn't happened. I wish I had done things differently - for a minute or two - and then I try to absorb the fact that things happen to us regardless, that one can't prepare for a tsunami or a foreclosure or cancer. That these too are the stuff of which our lives are made. I must define my life on my own terms and not be a victim of the things I can not control. I must choose.

All in all, I am very blessed. I've a roof over my head, a job, enough to eat. I've a family that means the world to me and a cat who woke me with a wet nose kiss this morning. And even though the sun isn't shining, I know it will shine again. Attitude is everything. Today I will be happy...

Errors lead surgeons to contemplate suicide

2011-01-20T08:40:00.000-08:00

A study suggests medical errors, job burnout and depression lead surgeons to contemplate suicide at higher rates than the general public, and they're much less likely to seek help.

Fear of losing their jobs contributes to surgeons' reluctance to get mental health treatment, according to the study. Nearly 8,000 surgeons participated.

About 6 percent reported recent suicidal thoughts; the rate was 16 percent among those who'd made a recent major medical error although it wasn't known if that was the reason.

Only about one-fourth of those with suicidal thoughts said they'd sought professional mental health treatment. By contrast, among the general population, about 3 percent have suicidal thoughts and 44 percent of them seek mental health treatment, other studies have shown.

The research didn't address specific reasons why they had contemplated suicide but strongly suggests depression, job burnout and medical errors were contributing factors. To a lesser extent, being unmarried, divorced and childless also were linked with contemplating suicide. Other factors also could have contributed to a risk for suicidal thoughts.

Results published previously from the same survey showed almost 9 percent of participating surgeons said they'd made a recent major medical error. Overall, surgeons queried worked 60 hours per week on average; 40 percent felt burned out; and 30 percent had symptoms of depression. Most said their work left little time for personal and family life.

Read the whole article by Lindsey Tanner here.

A brain is a terrible thing to waste....

2010-11-21T15:21:00.000-08:00

Most people haven't noticed that this country is suffering from a severe brain shortage. "Sure, I've noticed," you may chuckle, pointing a finger at Washington or the local government of your choice. But that's not the kind of brain shortage we're talking about. We mean gray matter, white matter, brain tissue -- the stuff in your head that neuroscientists need to investigate a variety of diseases, disorders, and dilemmas.

During the Eighties, investigators learned more about the central nervous system than in all prior human history. The Nineties promised to be even more enlightening. "The brain is the last biological frontier," says neuroscientist Deborah Mash, director of the University of Miami Brain Endowment Bank. Founded in 1986, it's one of only three general brain banks in the nation. "We need to study the human brain postmortem--diseased brains and healthy ones for comparison."

Dr. Jill Bolte Taylor became a neuroscientist precisely to study the brains of people diagnosed with severe mental illness, specifically schizophrenia and bipolar disorder. ( Dr. Taylor has a brother living with schizophrenia and you may remember her from her book, A Stroke of Insight.) She was shocked to learn that the "tissue issue" - or lack of postmortem brain tissue from the psychiatrically diagnosed - has really held back the scientific community from unraveling the mysteries of severe mental illness. Dr. Taylor has made it her mission to bring this shortage to the attention of the population at large.

Individuals who've noted on their drivers licenses that they are organ donors have willed everything but the brain, although most are not aware of that. If a person is interested in donating his or her brain to science, they will need to make specific arrangements. The Harvard Brain Tissue Resource Center has created a specialized collection specifically for NAMI families, where operators are available 24/7 at 1-800-BRAINBANK. The bank collects brain specimens from parents, siblings, and children of psychiatrically diagnosed as well as those living with mental illness. So-called "normal" brains are just as much in demand as unhealthy ones.

The reality is that if the tissue was more readily available, more scientists would be studying mental illness. If someone has passed they sure don't need it anymore, but that brain tissue may help us understand, treat, and cure biological disorders of the brain. And that would be the greatest gift you could give.....

Gay in America

2010-10-24T16:12:00.000-07:00

In 1973 the APA did away with homosexuality as a mental disorder. The change wasn't easy, but the weight of the scientific evidence suggested that same-sex attraction was a normal variant of sexuality among well-adjusted people. Today, you can hardly open a paper or turn on the news that you aren't hearing some new horror show about gays in America - from teens being bullied to suicide to states denying civil liberties to same sex couples. I'm often mortified because I grew up knowing that some people are gay - in fact, both of my uncles were homosexual. I never occurred to me as a child that there was anything wrong with that. I called their partners 'uncle,' too. It seemed like the most natural thing in the world.

I didn't realize until I was an adult, the price that every gay man or woman must pay to live in our society. And although I have gay people in my life who have found a measure of happiness; who have found someone to love and were lucky enough to have an accepting and loving family, even these people bear the scars of being different in a culture that grows less and less accepting of anything but some idealized 'normal' (which seems to me to be white, male, straight and Protestant.) I watched a beloved uncle die of AIDS back in the day where it was referred to as "the gay plague" and watched nurses refuse to touch him because of their ignorance. I watched another struggle with his faith, a faith that denied who he was and labeled him a 'sinner' for loving the people that he loved. He lived a monogamous life for nearly 25 years with the same partner, but could never be married. He is a veteran (both of my gay uncles served their country... imagine that,) and lives with bi-polar disorder. I know of two (thankfully) unsuccessful suicide attempts.

In my opinion, every human being is the result of a nearly infinite number of variables. Many of these variables are visible to us in our lifetimes - where we were born and to whom, our social situation and nationality, our training into that society and into spirituality, and all the things we experience from our birth to where we are now. Perhaps we can decipher some of these variables, although I suspect that many people never feel the need to. In addition, we consist of innumerable amounts of genetic code; codes that give us our gender and the color of our eyes and skin, our height and body type, even five fingers and toes. But there are codes for every possible variation in the human being and scientists have only scratched the surface of these. Some codes make people susceptible to disease, or unable to moderate their mood, and yes, I do believe that some people are genetically homosexual. With all that infinite variety, from completely straight to completely gay, and every variation in the middle of that, human sexuality simply is. We are sexual beings. It shouldn't be a big thing.

Statistically, twenty percent of the human population is gay. Always have been. Always will be. I've always thought of it as a type of natural birth control. Some of those gay people have brain disorders, some have hemophilia, heart disease or diabetes, some will stay in the closet, some will become activists and fight for their basic rights. In the end, all of them are simply human beings and as such are entitled to basic human rights and basic human dignity. And as such they want what we all want, to be loved... and to live without fear.

10 Tips to Manage Your Scattered Brain

2010-10-15T22:41:00.000-07:00

Let’s start right away. I want to eliminate anything that can distract you from finishing this post.

Do you feel like you want to do a million and one things this instant?
Do you lack the ability or desire to stay with your task till you complete it, including the simplest of tasks?
Do you feel unmotivated to start on something that you really want to accomplish?
Are you easily distracted and everything in the entire world seems more interesting than what you’re doing?
Are there things you need to do that remain undone because there is no outside pressure/deadline to force completion?

If you answered yes to any or all of the above questions then you are a scattered brainer. Welcome to the club . There is nothing wrong with being distracted every now and then, or not even getting anything done. But when it becomes a constant in your daily life, you can fall into a stressful trap of avoidance, or worse, trying to catch up and make up for lost time.

I have been implementing the tips below to deal with my scattered brain. I’m slowly regaining my focus and brain power. Hope you find these tips useful. Try to work with as many of them as you can.

1. Know what you want to do and prioritize.

This is the most obvious and probably one that is listed in every productivity book and article out there. The importance of this step cannot be overstated.

If you don’t know what you want and stuff is just floating in your head, you’ll never get the satisfaction of doing anything. So yes make a list of everything that is on your mind. Then Prioritize—with a capital P. This is where you get to tell your brain to stop fretting about the small stuff and focus on what is really important.

2. Break it down and keep it simple.

Once you have your list and you determine your top two or three tasks, choose one to start with and break it down to the simplest form of action. Every step should not take more than 15 to 30 minutes to complete. If it takes longer, break it down further.

The smaller the task, the less time it takes to get done, the more you’re likely to stick with it. This is a good way to tell your brain to just stay with it for 15 minutes.

3. Start and do it slowly—one task at a time.

Don’t try to speed thing up in an effort to save time. This triggers your brain to drift to what you want to do next instead of what you’re doing right now. Your brain can focus on one thought at a time, so make it about what is right in front of you. Do things slowly and deliberately. You will feel much better once you complete your task.

4. Take breaks.

Don’t be tempted to work nonstop for hours on end. This will lead to burn out and you won’t have enough motivation to start again.

After completing a 15-30 minute task, take a break and do something fun. You can stretch, move, read an article or whatever you feel like doing. Just don’t take too long. I would suggest 5-10 minutes.

Once you complete 4 tasks, take a longer break—an hour or so. This is your free time to do whatever you like—guilt free.

5. Learn to focus.

If you want to have laser sharp focus, you need to learn how to meditate and do it.

Meditation is becoming more mainstream now and is really easy to do. You don’t need to spend an hour. Start with a few minutes and move up to 15 – 30 minutes. Do a search and pick a breathing or mantra meditation. The most important thing is to train your brain to relax, and focus on one thing (the mantra or your breath).

6. Ditch your clock/watch. Work in intervals.

Forget about the clock and don’t obsess over time. It doesn’t matter when you start working on something. Use a timer and set it to the estimated time to complete your task (an interval of no more than 30 minutes). Start the timer and go for it. Don’t stop until your time is up. Take a break and repeat.

Focus on working and getting your tasks done, regardless of what time it is. This way you are guaranteed to work instead of finding excuses to postpone things till tomorrow, when you can work on them bright and early.

7. Don’t do anything else until your interval is done.

Don’t do anything else while your timer is running for a specific task. If it is something that requires inspiration (like writing) and you can’t seem to find any, just sit still and think about the task until your time is up.

Don’t be tempted to do something else because you can’t seem to get started on the task at hand. Sooner or later inspiration will come—you’ll be surprised by how effective five minutes of silence can be in sparking your genius.

8. Keep going.

If you fall off the wagon, just pick up and start again. There is no reason for you to give up. Review what you did and what went wrong, learn from it and move on to your next task or interval.

Remember: practice makes improvement.

9. Power down and reboot.

Give yourself free days to enjoy yourself away from tasks and to do’s. Keep it free and don’t commit to anything new. This is a time for you to relax, have fun and spend time with your loved ones.

Use your off days to unwind and empty your mental cache. Don’t try to squeeze in anything else. After a break, you’ll feel energized and motivated to get back to your tasks.

10. Make it fun.

Embrace your playful inner child and use your imagination to make the best out of every task. Even the most mundane thing can be fun and entertaining.

When you are working on a task, imagine that someone is watching you and commenting on how brilliantly you’re working. Or that you are trying to set a world record, or break your own. You can have a conversation with yourself as you work … you get the picture.

Your results depend on where you choose to put your focus and energy. So do what gives you the most effective results in the most enjoyable manner. Once you get going and you keep going, there is no turning back—things get easier and you start harnessing more of your mental power.

Ed. note: snagged this from One With Now.

It Gets Better

2010-10-05T20:55:00.000-07:00

Should You Disclose Depression To Your Employer?

2010-09-21T23:33:00.000-07:00

"If I had diabetes I would probably tell my company," Sandy says. "But I've never told them this." By "this," she means the fact that she suffers from depression. Today, CNN tackles a huge question: If you're suffering from depression, should you let people at your job know?

As the piece by Health.com's Anne Harding points out, happy employees are productive employees. So it's in a company's best interests to make sure workers get what they need to be healthy — mentally and physically. The problem, of course, is that a stigma surrounds mental illness.

Depending on the atmosphere and environment you work in, disclosing depression (or bipolar disorder, or any kind of mental illness) can seem like asking for trouble. Your coworkers may see it as an excuse; your boss may think of you as weak, and you might even be the subject of gossip. Of course, this shouldn't be the case. But who hasn't worked at a company where acting human — instead of like a cog in the machine — was viewed as a flaw? Any kind of personal issues were frowned upon; nothing mattered except the work.

The thing is: The more people admit to depression and other mental illnesses, the faster these conditions would lose some of the stigma. And if your job is part of what's making you depressed, well, at least take comfort in knowing we've all been there.

Depression In The Workplace: Don't Ask, Don't Tell? [CNN]

Read more: http://jezebel.com/5642864/should-you-disclose-depression-to-your-employer?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+jezebel%2Ffull+%28Jezebel%29#ixzz10EoE3c7h

Top 10 Controversial Psychiatric Disorders -Part 2

2010-09-11T08:04:00.001-07:00

8. Narcissistic Personality Disorder - Someone with an inflated ego, need for constant praise and lack of empathy for others might sound like a shoe-in for psychotherapy. But the introduction of narcissistic personality disorder into the DSM in 1980 was not without controversy. The biggest problem was that no one could agree on who had the disorder. Up to half of people diagnosed with a narcissistic personality also met the criteria for other personality disorders, like histrionic personality disorder or borderline personality disorder, according to a 2001 review in the Journal of Mental Health Counseling. Which diagnosis they got seemed almost arbitrary. To solve the problem, the American Psychiatric Association has proposed big changes to the personality disorder section of the DSM-5 in 2010. The new edition would move away from specific personality disorders to a system of dysfunctional types and traits. The idea, according to the APA, is to cut out the overlap and create categories that would be useful for patients who have personality problems, not just full-blown disorders.

7. Dissociative Identity Disorder - Once known as multiple personality disorder, dissociative identity disorder was made famous by the book "Sybil" (Independent Pub Group, 1973), which was made into a movie of the same name in 1976. The film and book told the story of Shirley Mason, pseudonym Sybil, who was diagnosed as having 16 separate personalities as a result of physical and sexual abuse by her mother. The book and the movie were hits, but the diagnosis soon came under fire. In 1995, psychiatrist Herbert Spiegel, who consulted on Mason's case, told the "New York Review of Books" that he believed Mason's "personalities" were created by her therapist, who -- perhaps unwittingly -- suggested that Mason's different emotional states were distinct personalities with names. Likewise, critics of the dissociative identity diagnosis argue that the disorder is artificial, perpetuated by well-meaning therapists who convince troubled and suggestible patients that their problems are due to multiple personalities. Nonetheless, dissociative identity disorder has weathered this criticism and won't undergo any major changes in the DSM-5. (ed. note - Having met someone who underwent extensive therapy and reached recovery with this diagnosis, I'm having trouble believing it doesn't exist... it may be rare, but I think it's real.)

From an article by Stephanie Pappas. First installment here.

Top 10 Controversial Psychiatric Disorders -Part 1

2010-09-11T07:55:00.001-07:00

The proposed revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have spurred debate over what illnesses to include in the essential psychiatric handbook. Everything from gender identity disorder to childhood mood swings has come under fire, and it's not the first time. The history of psychiatry is littered with impassioned fights over controversial diagnoses.

10. Hysteria -In the Victorian era, hysteria was a catch-all diagnosis for women in distress. The symptoms were vague (discontentment, weakness, outbursts of emotion, nerves) and the history sexist (Plato blamed the wanderings of an "unfruitful" uterus). The treatment for hysteria? "Hysterical paroxysm," also known as orgasm. Physicians would massage their patients' genitals either manually or with a vibrator, a task they found tedious but surprisingly uncontroversial. More contentious was the practice of putting "hysterical" women on bed rest or demanding that they not work or socialize, a treatment that often worsened anxiety or depression.According to a 2002 editorial in the journal Spinal Cord, the diagnosis of hysteria gradually petered out throughout the 20th century. By 1980, hysteria disappeared from the DSM in favor of newer diagnoses like conversion and dissociative disorders.

9. Penis Envy - Sigmund Freud revolutionized psychiatry in the late 1800s and early 1900s with his theories on the unconscious state, talk therapy and psychosexual development. Nowadays, many of these theories -- like his conclusion that young girls' sexual development is driven by jealousy over lack of a penis and sexual desire for their father -- seem outdated. But not everyone has consigned Freud to the dust heap. Organizations like the American Psychoanalytic Association still practice and promote Freudian-style psychoanalysis, and groups like the International Neuropsychoanalysis Society try to combine cutting-edge neuroscience research with Freud's century-old theories. How successful they'll be is unknown: A 2008 study in the Journal of the American Psychoanalytic Association found that today's psychology departments rarely teach psychoanalysis.

Ed. note: From an article by Stephanie Pappas on LiveScience.

10 Ways to Reduce Anxiety... Part 4

2010-09-04T08:09:00.001-07:00

8. Breathe it out. You may notice that when your body is tense you hold your breath. Focusing on breathing is a common but effective technique for calming the nerves. Where is your breath now, and where is your mind? Bring them together. Listen to the movement of your breath. Does your mind wander somewhere else? Call it back. Concentrate only on breathing in and out, beginning and ending, breath to breath, moment to moment.

9. Make peace with time. When you're a worrier, everything can feel like an emergency. But notice this about all your anxious arousal: It's temporary. Every feeling of panic comes to an end, every concern eventually wears itself out, every so-called emergency seems to evaporate. Ask yourself, "How will I feel about this in a week or in a month?" This one, too, really will pass.

10. Don't let your worries stop you from living your life. Many of them will turn out to be false, and the consequences of your anxiety -- less sleep, a rapid pulse, a little embarrassment-- are just inconveniences when it comes down to it. What can you still do even if you feel anxious? Almost anything.

Ed. note: Part of an excellent series by Robert L. Leahy, PhD and director of the American Institute for Cognitive Therapy in NY, NY. See the first three installments here, here, and here.

‘Magic’ anti-depressant?

2010-08-19T21:42:00.000-07:00

Ketamine, a general anesthetic usually administered to children and pets but perhaps best known as a horse tranquilizer, is also highly effective in low doses as an anti-depressant, according a study published Thursday.

Researchers at Yale University wrote in the August 20 issue of the journal Science that unlike most anti-depressants on the market which can take weeks to take full effect ketamine can begin to counter depression in hours.

"It's like a magic drug -- one dose can work rapidly and last for seven to 10 days," said Ronald Duman, professor of psychiatry and pharmacology at Yale and senior author of the study.

The researchers noted that ketamine was tested as a rapid treatment for people with suicidal thoughts. Traditional anti-depressants can take several weeks to take effect, they noted.

About 40 percent of people suffering from depression do not respond to medication, and many others only respond after many months or years of trying different treatments.

Read the rest of the story here....

I Walk Alone

2010-08-18T23:16:00.000-07:00

I walk a lonely road

The only one that I have ever known

Don't know where it goes

But it's home to me and I walk alone

I walk this empty street

On the Boulevard of Broken Dreams

Where the city sleeps

and I'm the only one and I walk alone

My shadow's the only one that walks beside me

My shallow heart's the only thing that's beating

Sometimes I wish someone out there will find me

'Til then I walk alone

I'm walking down the line

That divides me somewhere in my mind

On the border line

Of the edge and where I walk alone

Read between the lines

What's fucked up and everything's alright

Check my vital signs

To know I'm still alive and I walk alone

My shadow's the only one that walks beside me

My shallow heart's the only thing that's beating

Sometimes I wish someone out there will find me

'Til then I walk alone

I walk this empty street

On the Boulevard of Broken Dreams

Where the city sleeps

And I'm the only one and I walk alone

My shadow's the only one that walks beside me

My shallow heart's the only thing that's beating

Sometimes I wish someone out there will find me

'Til then I walk alone...

So Green Day hits the nail on the head with this song, no? Sometimes checking my vital signs doesn't convince me.... and the truth of the matter is that no one "out there" will find me, or give me any answers. Not today anyway.

A few moments with Schizophrenia

2010-08-03T21:33:00.000-07:00

Was Bullying Really Behind Phoebe Prince's Suicide?

2010-07-21T22:32:00.001-07:00

Coverage of Phoebe Prince's bullying (ours included) has told the story of a clique of evil kids systematically tormenting an outcast. But now one reporter says this isn't accurate — and the bullies are victims too.

In an exhaustively researched and frankly pretty disturbing series of articles for Slate, Emily Bazelon questions the dominant narrative (again, promulgated in this space as elsewhere) of South Hadley High School mean girls and their erstwhile boyfriends hounding Phoebe Prince to death. Her basic points:

— Prince was depressed and troubled before the bullying started. She missed her absent father, engaged in self-mutilation, and had tried to commit suicide once before, in response to the breakup of a relationship (with senior Sean Mulveyhill, now charged with a civil rights violation and statutory rape in connection with Prince's death).
— Though it led to tragedy, the bullying Prince suffered was neither systematic nor organized (one teen actually stopped when school officials told her to, yet still faces criminal prosecution), and was not extraordinary for teens — several students called it "normal girl drama."
— The six students charged in Prince's death face prosecution not because their actions were so heinous, but because South Hadley has an overzealous district attorney with a history of seeking excessive punishment.

Of these, the last is the most upsetting. In 2007, South Hadley DA Elizabeth Scheibel slapped a 17-year-old kid who had Asperger's with charges carrying a maximum 60-year sentence, all for making YouTube videos of himself lighting explosives in a field (he was acquitted). And there's evidence, according to Bazelon, that Scheibel was punishing the bullying teens for their school's negligence. Bazelon writes, "Scheibel and her staff stepped in because they thought South Hadley High mishandled the lead-up to and the aftermath of Phoebe's death. Does that amount to penalizing teenagers because the adults failed to do so?" Maybe — especially if it's true that, as Bazelon says, their bullying was far less organized and far shorter in duration than Scheibel claims. And certainly the teens, who could face up to 10 years in prison, are being much more harshly punished now than they ever could have been by their school.

This new take on the Prince case exposes two serious and related problems. One is how catastrophically bad schools are at identifying and helping at-risk kids. Bazelon writes that Phoebe's mom told the school that Phoebe had suffered bullying in her native Ireland and was on antidepressants, but the school didn't mount any sort of concerted effort to help her, or notify administrators of her troubles — even after her first suicide attempt. The principal even said "she seemed to be doing pretty well when she came back" from that attempt, and didn't seem in need of further monitoring. But all the while, Prince was, according to Bazelon, "asking for help from older boys who seemed ill-equipped to provide it." In a heart-wrenching statement, one such boy told police,

She lifted up her hoodie and showed cuts on her chest above her bra and all the way down to her hips. I really didn't look too long. I found it to be very painful. This was someone I cared about and she was harming herself. Phoebe asked for help healing them. I told her to use Neosporin but I wasn't too sure.

And these boys lead into the second problem that contributed to Prince's death: slut-shaming. Phoebe's bullying back in Ireland also had to do with her seeing older boys, and an anonymous adult says of her troubles at South Hadley, "In the end you can call it bullying. But to the other kids, Phoebe was the one with the power. She was attracting guys away from relationships." Not all the boys Prince has been linked to were actually in relationships at the time she was seeing them, but regardless, the claim that she "attracted them away" is a bit slut-shaming in itself. A fellow student seems to understand the situation better: "Each person had his own conflict with Phoebe-that's what no one outside our school seems to understand. The girls found out she'd been with the boys, and true to high-school girls, they got mad at the girl instead of the boyfriend."

That's how society seems to work too, not just high-school girls, and it appears Prince got caught in a vicious cycle. No adults stepped in to help her, so she turned to older guys, which only made other girls madder. There's no excuse for the way some of these girls — and allegedly Sean Mulveyhill as well — treated Prince. Bazelon doesn't dispute that the teens called Prince a "whore" and a "cunt" and harassed her in school on at least two occasions. But it's not clear that this behavior deserves a ten-year prison sentence, especially since throwing the book at the teens may obscure the systemic problems that led to Prince's death in the first place. Nothing Bazelon has uncovered excuses bullying — but it does expose how deeply incompetent schools are at protecting troubled kids and preventing slut-shaming, and how endemic such shaming is both here and, apparently, in Ireland. To pretend that Prince's death was solely caused by a few kids who were simply evil is to ignore these very serious problems — and potentially to keep other kids like Prince from getting the help they need.

Thanks to Jezebel for this story.

Heat and Medication

2010-07-16T06:55:00.000-07:00

MYTH: During the dog days of summer, everyone is affected equally by the blistering heat.
FACT: Certain groups of people are more likely to develop dangerous responses to high temperatures, including heat stroke or certain medical conditions. Children and older adults fall into this category, but people of any age who are living with mental illness also need to be very careful during extremely hot weather.

Stay Safe
Educate yourself about the symptoms of heat stroke, such as:
An extremely high body temperature (above 103 degrees Fahrenheit)
Red, hot and dry skin (no sweating)
Rapid, strong pulse
Throbbing headache
Dizziness
Nausea
Confusion

Individuals living with mental illness may be more prone to heat stroke because some medications alter the body's response to heat. In addition, people taking specific medications may be at a higher risk of developing Neuroleptic Malignant Syndrome (NMS), a serious condition that may be connected to high temperatures and the dehydration that can result from heat stroke. NMS and heat stroke have similar symptoms, so it is especially important that people with mental illness inform their doctors of all medications they are currently taking.

Stay Informed
The National Weather Service is the hub of information about heat alerts. The Weather Channel offers a free service that will send updates about heat advisories to your phone.

Stay Inside
On extremely hot days, limit your exposure to the heat and sun, especially during the hottest part of the day. Don't walk long distances if you don't have to. Some public transportation systems offer free bus service on days with a dangerous heat index.

Stay Cool
If you do have an air conditioner, change the filter and perform other maintenance that will keep the unit working at peak capacity. If you don't have an air conditioner, try to spend a few hours a day in an air-conditioned public place like a library or mall. Look into area programs that may provide air conditioners for people with disabilities for free or at a reduced cost. In the past, some local United Way chapters have collected donated units and redistributed them to people with the most need.

10 Ways to Reduce Anxiety... Part 3

2010-07-04T09:28:00.000-07:00

5. Turn your anxiety into a movie. You can let go of a worry by disconnecting yourself from it. One way is to imagine that your anxious thoughts are a show. Maybe they're a little guy in a funny hat who tap dances and sings out your worry while you sit in the audience, eating popcorn, a calm observer.

6. Set aside worry time. All too often we take a "Crackberry" approach to our worries: They show up unannounced, like constantly dinging e-mails, and we stop everything to address them - even if we should be doing something else. But what if you don't respond right away? Try setting aside 20 minutes every day - let's say at 4:30 PM - just for your worries. If you are fretting at 10 AM, jot down the reason and resolve to think it through later. By the time 4:30 comes around, many of your troubles won't even matter anymore. And you will have spent almost an entire day anxiety-free.

7. Take your hand off the horn. You constantly check the weather before a big outdoor event. You replay that clumsy comment you made, wishing you could take it back. And, yes, you honk your horn in traffic. When you desperately try to take command of things that can't be controlled, you're like the swimmer who panics and slaps at the water, screaming. It gets you nowhere. Instead, imagine that you are floating along on the water with your arms spread out, looking up to the sky. It's a paradox, but when you surrender to the moment, you actually feel far more in control.

Ed. note: Part of a series by Robert L. Leahy, PhD and director of the American Institute for Cognitive Therapy in NY, NY. Part 1 - here. Part 2 - here.

Let's talk about Dianne (sorry about the language...)

2010-06-19T22:06:00.001-07:00

She did the deed on March 26th and was tidily buried on April 1st. I still expect her to walk in the shop, late, opening a bottle of water and cracking wise. It's not like I think about it every day. But it's there, isn't it?

What was so fucking bad, Di? I'm not so simple a creature that I think everything is clear to someone outside the situation, but come on. Two beautiful (irritating, unappreciative, typical) teenagers. A husband who loves you (and doesn't hear you, and isn't a communicator, duh.) Your adorable puppies (who shit in the house,) your hobbies (miniatures might not be for the obsessive,) your friends (the church was full of people you obviously never confided in.) Gorgeous house (mortgage,) nice clothes and humongous diamonds everywhere (maybe they were your friends?) Parents who drank and didn't understand you? Rough life. Fuck you.

I guess I'll never have the chance to know why you didn't share your pain with me. I guess I shouldn't presume to understand the level of your unhappiness or judge your decision to check out. It's not fair of me to do so. I didn't walk in your shoes. But I'm pretty pissed off because I was always honest with you and you LIED to me. Apparently a lot. Over a ridiculous amount of time. So you're going to have to bear with me when I say that you fucking copped out.

But then I'm still breathing and you're not.

I'm still dealing with all the disappointment of the imperfect life. Didn't get the perfect parental units. Didn't marry the perfect man. Haven't found my bliss, or my purpose, or even a simple fucking reason to keep drawing breath, but here I am still doing it. Some days I drown in it. Some days I'm numb. But. I'm. Still. Here. And you, my fucked up friend, are not.

I win.

I think.

are smarter people really more likely to take their own lives?

2010-06-15T23:12:00.000-07:00

"Conventional wisdom says that gifted artists like Vincent van Gogh and Sylvia Plath had something in their constitution that made them much more susceptible to depression, and thus, to suicide. One of the smartest people I ever knew, a former high school classmate who was also a world-class rower, took his own life as pressures for perfection at his Ivy-League university became too much for him. Such stories, painful and tragic, lend credence to the belief that smart people are more likely to commit suicide. But do we remember these stories because they are commonplace, or are they notable only because they are also actually rare?

Because of the relative rarity of suicide, researching its causes is problematic. Most studies therefore investigate attempted suicide, which is much more common. Since attempted suicides are very strongly correlated with actual suicides, they can serve as a reasonable proxy measurement.

Two studies by Martin Voracek seem to uphold the notion that more intelligent people are more likely to commit suicide. Voracek looked at national suicide rates and average IQ, and found that countries with higher average IQs also had higher suicide rates. But a study released last week suggested the opposite might be true. A team led by G. David Batty looked at military conscription records of over 1 million Swedish men, and found that those with higher IQs were significantly less likely to be admitted to a hospital for a suicide attempt than those with lower IQs. Even after adjusting for socioeconomic status, education, and a variety of other factors, those in the top 10 percent of IQ scores were about four times less likely to attempt suicide than the bottom 10 percent."

Read the rest of the article by Dave Munger here.

More troops hospitalized for mental health than any other reason

2010-05-17T08:30:00.000-07:00

More U.S. troops were hospitalized for mental health disorders than any other reason in 2009.

Mental health hospitalizations throughout the military topped injuries, battle wounds and even pregnancy and childbirth for the first time in 15 years of tracking by the Pentagon's Medical Surveillance Monthly report.

Four mental health issues — depression, substance abuse, anxiety and adjustment problems such as PTSD — cost the Pentagon 488 years of lost duty in 2009.

Obviously PTSD, depression, anxiety and substance abuse are not limited to American soldiers. According to a new U.K. Ministry of Defense study covered Thursday by The Guardian, troops serving in Iraq and Afghanistan have a 22% higher risk of alcohol misuse than their fellow servicemen and women.

Reservists serving in Iraq and Afghanistan were found to be three times as likely to suffer PTSD as other reservists, while regular personnel in combat roles there were found to be twice as likely to report the disorder.

Simon Wessely of the Institute of Psychiatry at King's College London thinks alcohol abuse is even more of a concern than PTSD. "Our view is that alcohol misuse is actually a greater problem for the armed forces than PTSD," he said.

Another article about the new UK report, from Reuters, points out a "striking" difference in mental health between US and UK troops. US personnel deploy for longer than UK troops – 15 months compared with six months – and American troops are younger. Combined with the numbers from the Pentagon, it is clear that US soldiers are undergoing intense mental pressure.

Read the whole article at The Raw Story.

May is Mental Health Month

2010-05-12T21:18:00.000-07:00

Check out NKM2 for yourself!

18 a day....

2010-04-25T16:19:00.001-07:00

By Rick Mays for the Army Times

Troubling new data show there are an average of 950 suicide attempts each month by veterans who are receiving some type of treatment from the Veterans Affairs Department.

Seven percent of the attempts are successful, and 11 percent of those who don’t succeed on the first attempt try again within nine months.

The numbers, which come at a time when VA is strengthening its suicide prevention programs, show about 18 veteran suicides a day, about five by veterans who are receiving VA care.

Access to care appears to be a key factor, officials said, noting that once a veteran is inside the VA care program, screening programs are in place to identify those with problems, and special efforts are made to track those considered at high risk, such as monitoring whether they are keeping appointments.

A key part of the new data shows the suicide rate is lower for veterans aged 18 to 29 who are using VA health care services than those who are not. That leads VA officials to believe that about 250 lives have been saved each year as a result of VA treatment.

VA’s suicide hotline has been receiving about 10,000 calls a month from current and former service members. The number is 1-800-273-8255. Service members and veterans should push 1 for veterans’ services.

Dr. Janet Kemp, VA’s national suicide prevention coordinator, credits the hotline with rescuing 7,000 veterans who were in the act of suicide — in addition to referrals, counseling and other help.

Suicide attempts by Iraq and Afghanistan veterans remains a key area of concern. In fiscal 2009, which ended Sept. 30, there were 1,621 suicide attempts by men and 247 by women who served in Iraq or Afghanistan, with 94 men and four women dying.

In general, VA officials said, women attempt suicide more often, but men are more likely to succeed in the attempt, mainly because women use less lethal and less violent means while men are more likely to use firearms.

Suicide attempts among veterans appear to follow those trends, officials said.

10 Ways to Reduce Anxiety... Part 2

2010-04-20T11:59:00.000-07:00

3. Don't fight the craziness.
You may occasionally have thoughts that lead you to think you'll do something terrible ("I'm attracted to him. Does that mean I'll have an affair?")or that you're going insane (a client of mine who is an attorney kept imagining herself screaming in court.) Remember - our minds are creative. Little synapses firing away at random,and every now and then a "crazy" thought jumps out. Everyone has them. Instead of judging yours, describe it to yourself like it's a curious object on a shelf and move on.

4. Recognize false alarms.
That fear of your house burning down because you left the iron on has never come true. That rapid heart beat doesn't mean you're having a heart attack; it's your body's natural response to arousal. Many thoughts and sensations that we interpret as cues for concern - even panic - are just background noise. Think of each of them as a fire engine going to another place. You've noticed them; now let them pass by.

Ed. note: Part of a series by Robert L. Leahy, PhD and director of the American Institute for Cognitive Therapy in NY, NY. See the first part here.

you CAN die from it

2010-04-06T20:20:00.001-07:00

Do you know someone who always brings a ray of sunshine into the room? I'm talking a person with a razor wit, an infectious grin, always willing to listen to you whine, quick with scalding sarcasm at her own expense or a painful groaner of a pun? I get to see the friend who fits this description every other Wednesday from ten until noonish - the bright spot of my Wednesday workday - and while I filled her nails we would talk about the kids, our husbands, our mothers and pets, and all the ups and downs of our lives just as we have for the past ten years or so. Occasionally we would hook up to go for a walk, getting as much exercise from the laughter as from the mileage. She once helped me reupholster a chair - I stiffened her spine when she tried to talk herself out of going to her 30th class reunion. We exchanged hysterical birthday cards and Christmas presents. I held her hands every other week.

On March 26th she took her own life.

My friend did not attempt suicide. She made a methodical, intelligent plan - dotted all the i's and crossed all the t's - timed it and executed her exit from this life with the same precision she showed in the miniature rooms that she painstakingly created as a hobby. There was no detail unattended to. She was 48 years old. My age.

Five days before I posted to this blog about the social isolation of mental illness. At her memorial service, the pastor read from the Book of Job and pointed out that in Jobs culture, it was customary to sit in front of your home dressed in sackcloth and covered in ashes - to put grief and misery on display - but that in our culture, one is expected to hide grief; to put on a smile and always keep up appearances. She was a master of deception because she felt it was expected of her; she was always smiling, laughing, joking, because it hid her pain. I held her hands every other week. I never saw it.

And now I am keeping up appearances and hiding my broken heart. I miss her so much. And it occurs to me that her pain really didn't end... it merely moved... to all who loved her.

If you've ever thought about it... think about it.

What Is "Hearts & Minds?"

2010-03-28T11:45:00.000-07:00

The NAMI Hearts & Minds program is an online, interactive, educational initiative promoting the idea of wellness in both mind and body. Wellness is an ongoing process of learning how to make choices that support a more successful, healthy life.

Engaging in a wellness effort can make a huge difference in the quality of your life. One study, published in the Journal of the American Medical Association, showed that taking the wellness approach can result in a 17 percent decline in total medical visits and a 35 percent decline in medical visits for minor illnesses.

Wellness is about the individual; you can decide what parts of your life you would like to change and you can determine your own success. The Hearts & Minds program includes information on medical self advocacy, smoking and substance abuse, healthy eating and exercise suggestions including sample journals and work sheets to download. Check out something new for your "tool box" here.

Cause of death....

2010-03-21T14:10:00.000-07:00

There are days that I think I could die of it. Wonder what they'd put down as the cause of death if you just stopped breathing in the sheer, vast, emptiness of isolation? Yeah, yeah, yeah - I know that social isolation is one of the extreme effects of mental illness, but frankly, I wonder if it isn't just the extreme effect of our social culture? Even when I'm out of my house I'm amazed at how little we interact with the people around us.

So yesterday I volunteered some of my time to help get donations for the Salvation Army and the Prenatal Care Center. Every March the Soroptimist Clubs of Anacortes and Fidalgo Island team up for a Community Baby Shower and hit the local markets encouraging folks to pick up some baby food, or diapers or such and donate it for folks that are struggling to make ends meet. It is really an easy sell; even people disinclined to contribute to the poor (perhaps buying into the idea that they must have done something wrong to be poor or homeless in the first place,) have no problem opening up their wallet for a baby. My job was to ambush shoppers at the door and present them with a list of possible contributions that they could pick up while shopping. And it was interesting to see how generally uncomfortable people are with talking to a 'stranger' - how smiling and greeting someone automatically seems to put them on the defensive. I was pretty uncomfortable, too, even though I genuinely believed that most of them would be inclined to contribute - and there were people that I couldn't bring myself to greet, as they seemed almost hostile.

Okay, so we did pretty well in the donation department nonetheless. But I marvel that anyone connects with anyone in a world where speaking banal pleasantries to someone that you do not actually know seems awkward at best. Everywhere I go I see people talking to a little square of plastic, or typing furiously on it. But where do people talk? Not at the market, not at the dinner table, not in the car, or the bus, or the train. So.... where?

As I write this I'm at home... alone... on my computer. I wonder if you can die from it...

Depression has an upside?

2010-03-14T11:00:00.001-07:00

"The mystery of depression is not that it exists — the mind, like the flesh, is prone to malfunction. Instead, the paradox of depression has long been its prevalence. While most mental illnesses are extremely rare — schizophrenia, for example, is seen in less than 1 percent of the population — depression is everywhere, as inescapable as the common cold. Every year, approximately 7 percent of us will be afflicted to some degree by the awful mental state that William Styron described as a “gray drizzle of horror . . . a storm of murk.” Obsessed with our pain, we will retreat from everything. We will stop eating, unless we start eating too much. Sex will lose its appeal; sleep will become a frustrating pursuit. We will always be tired, even though we will do less and less. We will think a lot about death.

The persistence of this affliction — and the fact that it seemed to be heritable — posed a serious challenge to Darwin’s new evolutionary theory. If depression was a disorder, then evolution had made a tragic mistake, allowing an illness that impedes reproduction — it leads people to stop having sex and consider suicide — to spread throughout the population. For some unknown reason, the modern human mind is tilted toward sadness and, as we’ve now come to think, needs drugs to rescue itself.

The alternative, of course, is that depression has a secret purpose and our medical interventions are making a bad situation even worse. Like a fever that helps the immune system fight off infection — increased body temperature sends white blood cells into overdrive — depression might be an unpleasant yet adaptive response to affliction. Maybe Darwin was right. We suffer — we suffer terribly — but we don’t suffer in vain."

Read the rest of this excellent article by Jonah Lehrer here. Found this to be a great companion piece to this previous post on Virginia Woolf.

Blue Days

2010-03-03T21:37:00.001-08:00

You can tell by the vast amount of posting I've done of late that I haven't been my usual verbose self. On the heels of the holidays, comes the natural let down - my business slows and with it I feel like I'm shrinking. Without a million gajillion things to be done, without a constant source of busywork... I slip into the blues. It doesn't happen overnight, (although sometimes it does,) and it isn't life threatening. I don't take to my bed (although sometimes I want to.) I go to work, I eat (usually too much or things guaranteed to make me feel bad about myself,) I sleep (sorta...)Everything gets... dim. Time seems to go really slowly, but the weeks can burn right by. I haven't any energy. I haven't any joy. I don't have much of anything... but a pulse and regular respiration, bills that need paying and pets that need feeding.

In the past, if this goes on long enough, or if I start feeling bad enough (where taking to my bed becomes more of a possibility) I will cave to the lure of a fix - and seek some medication. Never had too much trouble talking a doc into Prozac or Lexapro.... They love to write me a script. I know it will take the edge off of the darkness. I will feel ... better, but of course it comes with a price tag - weight gain or no interest in sex or something. And a real price tag, too, as I don't have insurance that will cover the prescription. Sometimes I just opt to wait it out or I find some project to throw my time at - volunteer work and the like - something to keep me out of my head and into exhaustion at the end of the day. And eventually business will pick up and I'll be back to working 50 hours a week at my unfulfilling, but ever so demanding job.

I'm currently still in the 'wait it out' mode of this vile cycle. I don't want medication. I'm trying the whole gamut of 'self care' that I religiously preach to my support group - get enough sleep, eat right, exercise - yadda, yadda, yadda. I've made an appointment with a new counselor - and I have mixed feelings about that. And I wonder if this is really all I can expect out of life - this eternal cycle of sort of okay, and then not okay. I really feel guilty even saying this as I know so many people who live with grave mental illness - so many brave souls who have demons that make my problems look like an ingrown toenail. I'm lucky in so many ways - I have a job, I make a living, my kids are grown and on their own, I'm relatively healthy. So is it wrong to think that I would sell my soul to wake up each morning with a smile on my face looking forward to my day? Cuz I would. I really would.

10 Ways to Reduce Anxiety... Part 1

2010-02-25T21:45:00.000-08:00

1. Repeat your worry until you're bored silly. If you had a fear of elevators, you'd get rid of it if you rode in one a thousand times in a row. At first, you would be very anxious, then less so, and eventually it would have no effect (except to make you sick of riding in an elevator.) So take the troublesome thought that's nagging at you and say it over and over, silently, slowly, for 20 minutes. It's hard to keep your mind on a worry if you repeat it that many times. I call this the 'boredom cure' for obvious reasons, but it sure beats feeling overwhelmed by anxiety.

2. Make it worse. When you try to hard to control your anxieties, you only heighten them. Instead, exaggerate them and see what happens. For instance, if you fear that your mind will go blank during a presentation, fake it intentionally in the middle of your next one. Say, "Gee, what was I saying?" Notice how this makes no difference. It's nothing to worry about, right? I did this at a lecture once and no one raised an eyebrow. (Perhaps they weren't listening anyway.!)

Ed. note: these are by Robert L. Leahy, PhD and director of the American Institute for Cognitive Therapy in NY, NY.

Virginia Woolf - Mental Illness Defined Her Craft by Richard Cytowic

2010-02-22T21:22:00.000-08:00

"Virginia Woolf’s To The Lighthouse opens in opposition, with a fragment of conversation already in progress: “Yes, of course, if it’s fine tomorrow,” says Mrs. Ramsay to her son James. “But,” contradicts his father two paragraphs later, “it won’t be fine.”

The novel is unbalanced from its first line. Within four paragraphs, points of view shift among mother, son, and father; then an omniscient voice reveals the thoughts of all three members of the Ramsay family, “that great clan which cannot keep this feeling separate from that.”

Could such opposing attitudes reflect Woolf’s own considerable ambivalence? Do the author’s real-life equivocations echo in the indecisiveness of her fictional characters and her inconclusive plot arcs? In her diaries, Woolf regularly described a recurrent “madness,” referring to the disruptive mood swings that plagued her career and ultimately led to her suicide. As a doctor who has studied neurological disorders for 35 years, I recognize such periodic and cyclical fluctuations as manic–depressive illness, or bipolar affective disorder.

Woolf could not piece herself together when unpredictable mental illness fragmented her world. “Virginia could be a very enchanting person,” said Vogue editor Madge Garland, “but there were times when I felt that she was more nearly enchanted.” When depressed, Woolf took to bed and withdrew, viewing the world as meaningless and without hope. On the upswing to mania she wrote at breakneck speed, the words seeming to compose themselves.

Because the distorted thinking of bipolar individuals persists even when they are neutrally poised between mania and depression, Woolf read meaning and portent into events that were likely coincidental. This tendency may be one reason Woolf’s novels are strewn with odd, minute details that lure readers to hunt for significance in them.

Critics and therapists often presume psychodynamic explanations of causation despite lack of evidence in Woolf’s writing. The thinking goes that because the young Virginia was sexually abused, she portrayed the sexes as incommensurable, misogynistic in the way Richard Dalloway is in The Voyage Out or Mr. Tansley is in Lighthouse. The modern habit is to think about mental forces in terms of cause and effect.

What if instead one took a biological perspective and asked how the distorted perceptions and self-absorption typical of bipolar individuals might have colored the thinking of one of the 20th century’s most celebrated authors? Such a mind makes it hard to see objectively, let alone distinguish facts from its projections. Though Woolf confused subject and object most often during manic upswings, she also did so to varying degrees all the time.

From my perspective as a neurologist who studies minds and as a creative writer who imagines characters’ inner lives, Virginia Woolf’s mind is a marvel to behold. No two books are alike. “Not this, not that,” she seems to be saying as she rejects convention and hones her technique in a lifelong experiment to portray consciousness and the character of thought. Her ideas about the unreliability of language were prescient given what science now knows: that the very structure of human brains allows language to introspect only a fraction of consciousness."

Read all of this insightful article here.

Reasons to be Cheerful by Jurrian Kamp

2010-02-15T18:54:00.000-08:00

I was having dinner with a friend when she told me she was taking antidepressants. That surprised me, because my friend had never seemed to be lacking in self-esteem or social support. In fact, she had always seemed rather cheerful and I was quite sure it wasn't the mediocre ravioli that lifted her out of existential crisis. My friend is among the millions of people around the world who take anti-depressants, a number that in the U.S. alone has doubled within the past 15 years and is expected to continue to rise.

In a recent contribution to The Huffington Post, physician Andrew Weil hinted at the correlation between the forces of capitalism and the "fact" that depression is now widespread. Among other factors, Weil blames the TV commercials which spread the message that "all sadness is depression, depression is a chemical imbalance in the brain, this pill will make you happy, your doctor will get it for you." Weil suggested that because of overdiagnosis many people who are occasionally -- and quite normally -- a bit sad or insecure are labeled as depressed and in need of a pill to quickly solve their problems.

When I told my friend about Weil's ideas to alleviate depression -- lifestyle changes including less caffeine, more excercise and a diet high in fruits and vegetables, supplemented with omega-3 fatty acids -- she didn't seem particularly convinced. In fact, she seemed almost depressed. Apparently, taking responsibility for your own health can be a tough pill to swallow. But I think the fact that we can do so much to improve our mental and physical health is a reason to be cheerful.

Ed. Note - clinical depression IS a chemical imbalance in the brain and medication can and often does bring much needed relief... HOWEVER - I personally do think that many people seek an easy answer to the ups and downs of life - something these drugs were not intended for - and needlessly put themselves at risk for side effects. Read more of Dr. Weil's ideas on depression here.

Are you an orchid or a dandelion?

2010-02-03T20:31:00.000-08:00

Most of us have genes that make us as hardy as dandelions: able to take root and survive almost anywhere. A few of us, however, are more like the orchid: fragile and fickle, but capable of blooming spectacularly if given greenhouse care. So holds a provocative new theory of genetics, which asserts that the very genes that give us the most trouble as a species, causing behaviors that are self-destructive and antisocial, also underlie humankind’s phenomenal adaptability and evolutionary success. With a bad environment and poor parenting, orchid children can end up depressed, drug-addicted, or in jail—but with the right environment and good parenting, they can grow up to be society’s most creative, successful, and happy people.

Read the amazing article in the Atlantic: The Science of Success... here.

Sink or Swim

2010-01-27T21:00:00.001-08:00

One of the things that has been weighing really heavy on my mind lately is the process of recovery in Bi-Polar people. John and I have a few close friends who are Bi Polar as well, (imagine that, similar disorders find comfort in proximity) and at least two of them are in constant cycles of "okay" and then "really not okay" with no real indication they will break out. One friend, in particular, has really been on my mind a lot lately. He's just not coping. At all. It's not that he doesn't have the tools or support. He blames it on a lack of self worth, and is perfectly willing to let his shitty self esteem be the reason that his cyclical behavior produces the predicted and tragic results. It's a catch 22 that I can't get him to comprehend as being a mere excuse. If he feels shitty about himself and feels worthless, he doesn't need to take the steps to take care of himself because the effort to spend on himself is "not worth it" in his eyes. So he cycles. And he crashes. And he feels worse, i.e. more worthless. And the effort it takes to feel better, by making better choices, is unimaginable, because he doesn't deserve it, so why should he try?

It's a victim mentality. Complete and total. No matter your chemistry, no matter your synapse relay, choosing to stay sick because it's easier is just another version of self serving pity partying. I used to put it to John like this: If you try, and fail horribly, and fall several feet, I will still tell you HOORAY for the incremental progress you managed to make, even if it's only measurable in nanometers, because when you are making a commitment to your health and to managing your disease when you are well, you never EVER fall as far or as hard when you are sick. If you have a routine that becomes second nature, the crash that comes may disrupt your routine, but it's still there, like muscle memory. You take your meds because you always take your meds and you know you have to take your meds. You eat real food because you always eat real food and you know you have to eat real food. You look at your lists, you have your network help you identify your flags, and you take the hands that are offered to you when people who love you reach out for you, to keep you from hitting the ground.

Our friend doesn't see it this way. He doesn't want to confront his disease or his triggers when he is more stable because he fears that examining his triggers will in and of itself trigger a cycle. He lives in fear, and so reverts to self pity and blame game. "It's not me. This is just what I do. It's what I know how to do. It's how I was raised."

It is frustrating, to know that he has this potential, to have seen him more happy and more healthy, and see him now, angry and barely coherent. I hate this disease. I hate it so much. I hate what it does to my sweet teddy bear of a husband, to our soft and giving friend, to the other remarkable people I know that fight their own brains, every minute of every day. I hate that I can see the pain in John's eyes on days when he just CAN'T do it, when he can't face people and cannot make himself get out of bed. I look into his face, and I see the small line between his eyebrows, I see this weary and cautious soul. I see it in our friend, too. He has this big love of everything, a childlike glee in beauty and nature, an adoration for all things living, a deep and abiding chest ache for injustice, or people he cares about being hurt. He is sore in his heart parts, lost, and instead of choosing NOT to let his disease define him and NOT to allow himself to wallow in a self-created Hell, he is falling away from us. I can't get through. He spent last night on my couch. I needed to know that he was safe, that he was around other people. I told him to pack a bag and I left a message for his psychiatrist that he was seeing today about his crash. I told him that until he is past this crisis, and still seeing his shrink daily, he should be here at night so we can be sure he is okay.

I'm doing it, and it feels just like starting over with John, at square one. I do not love this person as much as I love my husband, but I sure do care about him a great deal, and it is anguish to watch him flail out like this. I need to set boundaries. I need to keep a safe space for John, and for me. (Too much more like this and we will need to set up another place for our friend to go, because this eventually will push John into a cycle, too.)

So, I told our friend last night a version of what I tell John: Ultimately, the battle to be healthy comes down to a choice: You can choose to be healthy and make steps in that direction or your can choose to not be healthy and live a broken life forever. Choosing to be healthy means taking responsibility for your choices and actions, even when they're not what you intended and you're not proud of them. It means when you get set back and you crash, you go to your routine to pull up, and you do it over and over and over and over again. Living a broken life means you wallow in your misfortune and you end up hospitalized. There is no middle ground for a person who has this disease as badly as our friend, or as badly as John. You either choose to learn to swim, or you sink. I told our friend that I will be here and be support if he wants to be well, but if he just wants to be sick, well, then he needs to do it elsewhere, because I won't watch it and won't stand for it.

I am hoping that in the next couple of days, he will take a turn for the better, and that John helping him out will actually help John level out instead of going from our friend crashing to John crashing.

Ed. note: This was written by my beautiful and brave daughter in law and swiped without her permission... One of my favorite sayings: What if all the dragons in our lives are really princes waiting to see us once beautiful and brave? Love you, Sweetness.

The Americanization of Mental Illness

2010-01-20T08:14:00.001-08:00

AMERICANS, particularly if they are of a certain leftward-leaning, college-educated type, worry about our country’s blunders into other cultures. In some circles, it is easy to make friends with a rousing rant about the McDonald’s near Tiananmen Square, the Nike factory in Malaysia or the latest blowback from our political or military interventions abroad. For all our self-recrimination, however, we may have yet to face one of the most remarkable effects of American-led globalization. We have for many years been busily engaged in a grand project of Americanizing the world’s understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad.

This unnerving possibility springs from recent research by a loose group of anthropologists and cross-cultural psychiatrists. Swimming against the biomedical currents of the time, they have argued that mental illnesses are not discrete entities like the polio virus with their own natural histories. These researchers have amassed an impressive body of evidence suggesting that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places.

In any given era, those who minister to the mentally ill — doctors or shamans or priests — inadvertently help to select which symptoms will be recognized as legitimate. Because the troubled mind has been influenced by healers of diverse religious and scientific persuasions, the forms of madness from one place and time often look remarkably different from the forms of madness in another.

That is until recently.

For more than a generation now, we in the West have aggressively spread our modern knowledge of mental illness around the world. We have done this in the name of science, believing that our approaches reveal the biological basis of psychic suffering and dispel prescientific myths and harmful stigma. There is now good evidence to suggest that in the process of teaching the rest of the world to think like us, we’ve been exporting our Western “symptom repertoire” as well. That is, we’ve been changing not only the treatments but also the expression of mental illness in other cultures. Indeed, a handful of mental-health disorders — depression, post-traumatic stress disorder and anorexia among them — now appear to be spreading across cultures with the speed of contagious diseases. These symptom clusters are becoming the lingua franca of human suffering, replacing indigenous forms of mental illness.

Read the rest of this fascinating article here.

Lack of Health Care Killed 2,266 US Veterans Last Year: Study

2009-11-11T21:30:00.000-08:00

WASHINGTON - The number of US veterans who died in 2008 because they lacked health insurance was 14 times higher than the US military death toll in Afghanistan that year, according to a new study.

The analysis produced by two Harvard medical researchers estimates that 2,266 US military veterans under the age of 65 died in 2008 because they lacked health coverage and had reduced access to medical care.That figure is more than 14 times higher than the 155 US troop deaths in Afghanistan in 2008, the study says.

Released as the United States commemorates fallen soldiers on Veterans Day, the study warns that even health care provided by the Veterans Health Administration (VA) leaves many veterans without coverage.The analysis uses census data to isolate the number of US veterans who lack both private health coverage and care offered by the VA.

"That's a group that's about 1.5 million people," said David Himmelstein, an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program who co-authored the study. Himmelstein and co-author Stephanie Woolhandler, also a Harvard medical professor, overlaid that figure with another study examining the mortality rate associated with lack of health insurance.

"The uninsured have about a 40 percent higher risk of dying each year than otherwise comparable insured individuals," Himmelstein told AFP."Putting that all together you get an estimate of almost 2,300 -- 2,266 veterans who die each year from lack of health insurance."

Only some US veterans have access to medical care through the VA and coverage is apportioned on the basis of eight "priority groups.""They range from things like people who were prisoners of war, who have coverage for life, or who have battle injuries and therefore have coverage for their injuries for life," said Himmelstein.

Veterans who fall below an income threshold that is determined on a county-by-county basis can qualify for care, but many veterans are "working poor" and fall just above the bracket."The priority eight group, the lowest priority, are veterans above the very poor group who have no other reason to be eligible and that group is essentially shut out of the VA," according to Himmelstein.

The study comes as the US Senate weighs health care reform legislation and whether to offer government health insurance.Himmelstein warns that congressional proposals could still leave veterans uncovered and favors a national health care program similar to those in Britain and Canada.

precipice

2009-11-10T22:08:00.000-08:00

I'm standing on the edge of the world. Been standing here as long as I can remember. I guess we have. I wonder if you'll fall. I wonder if you'll take me with you. I wonder if I can stand waiting any longer.

I breathe in. I breathe out. I don't look over the edge. But then I do. I breathe in for you. I breathe out for her. I don't look over the edge.

She would be fine without me. I don't want to leave her, but she would. You... I'm not so sure. I breathe in. I don't look over the edge. But then I do.

Sometimes I dream. But then I watch the edge. Breathe in, breathe out. I wonder if I can stand waiting any longer. Breathe in, breathe out.

If only you'd step away from the edge...

the day after I wrote this I found this in a John O'Donohue book -

"When near the end of the day, life has drained
Out of light, and it is too soon
For the mind of night to have darkened things,

No place looks like itself, loss of outline
Makes everything look strangely in-between,
Unsure of what has been, or what might come.

In this wan light, even trees seem groundless.
In awhile it will be night, but nothing
Here seems to believe the relief of dark.

You are in this time of the interim
Where everything seems withheld.

The path you took to get here has washed out;
The way forward is still concealed from you.

'The old is not old enough to have died away;
The new is still too young to be born.'

You cannot lay claim to anything;
In this place of dusk,
Your eyes are blurred;
And there is no mirror.

Everyone else has lost sight of your heart
And you can see nowhere to put your trust;
You know you have to make your own way through.

As far as you can, hold your confidence.
Do not allow your confusion to squander
This call which is loosening
Your roots in false ground,
That you might come free
From all you have outgrown.

What is being transfigured here is your mind,
And it is difficult and slow to become new.
The more faithfully you can endure here,
The more refined your heart will become
For your arrival in the new dawn."

Every Stinking Year

2009-10-31T10:34:00.000-07:00

Clinton 'Asylum of Terror' haunted house angers N.J. mental-health advocates
By Veronica Slaght/For The Star-Ledger

CLINTON -- Every fall, the Red Mill Museum here hosts a haunted house. But this year’s "Asylum of Terror," has angered mental health advocates who said the theme perpetuates ugly stereotypes. The show, which ends today, warns visitors of hopeless, mindless and deranged patients lurking in dark corners ready to lunge.

"Dementia, paranoia, violent sociopathic behaviors, physical abnormalities and deformities ... these are but a few of the afflictions that torment the wretched souls imprisoned within the walls of the Asylum," reads an advertisement for the haunted house. It continues: "In 1942, the doors of the asylum and the grounds were abruptly closed to the patients and the public after the inmates of the asylum overtook the staff and in one devastating night, tortured and then slaughtered all 200 staff members on duty ... Come if you dare."

Nearly 60 cast members put on the elaborate show, performed every weekend in October at the mill, which is located along the South Branch of the Raritan River in Hunterdon County. Celina Gray, executive director of the Governor’s Council on Mental Health Stigma, said she has heard from dozens of people who are upset by the show’s portrayal of the mentally ill as violent and scary.

"So many people white-knuckle through mental illness and don’t realize how it’s impacting their life," she said. "There could be people out there in the audience who are struggling with a mental illness and will not come out and say a word to anyone now." "I look at it this way," Gray said. "I love Halloween ... but there must be another way to celebrate it."

Responding to a letter about the "Asylum" from the council, Charles Speierl, executive director of the Red Mill Museum, said in an email that he forwarded concerns to event organizers and the museum’s board of trustees. Calls to the museum, which is run by a non-profit organization, were not returned.

Mental health advocates at the national level have also gotten involved. The National Alliance on Mental Illness issued a nationwide alert about the Clinton haunted mill.
"It’s trick or treat time again. We don’t mind ghosts and goblins, but when ‘haunted house’ attractions become ‘insane asylums,’ featuring ‘mental patients’ as murderous ghouls, we protest," reads a message on www.nami.org. The alliance is asking people to e-mail the mill to tell them mental illness is a national, as well as local, concern.

According to the U.S. Surgeon General, stigma is the number one reason why people don’t seek treatment for mental health, said Phil Lubitz, associate director of the New Jersey chapter of NAMI. "There are real consequences for perpetuating this kind of stigma," he said. Clinton Mayor Christine Schaumburg said, "I’m sure there were no bad intentions on the part of the mill." She hadn’t been aware of this year’s theme, she said. Gray agreed. "I’m unbelievably encouraged about the conversation that’s happening ... I think this came out of good people not understanding what it is and what the impact is."

Heard this morning... sorta fits

2009-10-28T08:34:00.000-07:00

"Rain" by The Wreckers

You never give up
I can't believe anything you say
And it must be my luck
'Cause no one else gets treated this way

And I wanna know
What goes on in that head of yours
Yeah, I wanna know
'Cause I don't think I can take much more

Rain
You must be sick or something
I can't take another day
Rain
Is falling down
But will the sun come out again?

I never speak up
I just try and stay out of the way
But I must have messed up
'Cause that's all I hear you say

And I wanna know
What on earth makes you act like this
Yeah, I wanna know
'Cause I don't think I can take this shit

Rain
You must be sick or something
I can't take another day
Rain
Is falling down
But will the sun come out again?

Accepting the Diagnosis

2009-09-06T16:04:00.001-07:00

Many factors influence how well a consumer is able to adapt to bipolar. These include the severity of the illness, level of self-awareness, one’s attitude about mental illness, availability of a support system, and access to quality health care. Some consumers are able to accept their illness after one or two manic episodes. Others remain in denial for years, burning through relationships, jobs, and money until they hit rock bottom.

“Bipolar is one of the illnesses people have the hardest time accepting,” says Sagar V. Parikh, MD, deputy psychiatrist-in-chief at the University Health Network in Toronto and professor of psychiatry at the University of Toronto. “Maybe one third accept [the diagnosis] right away. At least a third totally reject it, and a third believe it, but when they are better for a while, begin to doubt it again.”

“It’s common for acceptance to take years,” agrees Evette J. Ludman, PhD, a clinical psychologist and researcher at Group Health Cooperative in Seattle and coauthor of Overcoming Bipolar Disorder: A Comprehensive Workbook for Managing Your Symptoms and Achieving Your Life Goals (New Harbinger Publications, 2009).

Fully accepting the diagnosis is “almost like joining the priesthood,” Parikh says. “The commitment to treatment is a major one that involves going to the doctor regularly and paying a lot of effort to regulating one’s lifestyle. It’s not just a commitment to medication, but a way of life.”

In his research, Parikh found that consumers with bipolar II have greater difficulty acknowledging the diagnosis than do those with bipolar I, which is typically characterized by clear-cut episodes of mania and depression.

The symptoms of bipolar II are subtle, he explains, making it difficult to perceive the hypomania as a symptom of the illness, rather than part of one’s identity. “Your highs are mild, your brain is working faster, you have more confidence and energy, you need less sleep—it’s the ideal human condition,” says Parikh. Because the symptoms of bipolar II tend to be sporadic, “it is difficult to conceptualize it as an illness,” he adds.

excerpted from the Sept. issue of Bipolar Magazine.

It's NOT all in your mind...

2009-08-27T21:54:00.001-07:00

by David Servan-Schreiber, author of Healing Without Freud or Prozac
Modern medicine calls it the "placebo effect." This refers to the cultural and relational factors that make someone who's sick feel better when a doctor prescribes treatment, regardless of its biological impact. Nowadays, doctors think they know everything about the placebo effect. They were taught that 30% of sick people treated with placebos show signs of improvement. But they're also taught that this improvement is subjective and temporary - because the illness continues to take its course.

Yet after studying the placebo effect, some scientists wonder whether it may be one of the strongest driving forces in medicine. A study published in Clinical Psychology Review in 1993 concludes that several types of placebos are effective in treating illnesses such as stomach ulcers, angina pectoris and herpes 70% of the time. In addition, rare but famous cases testify to the effectiveness of placebos in reducing cancerous tumors or regenerating the immune cells of AIDS sufferers. The part of our brains known as the hypothalamus directs the distribution of essential hormones and operates the diffuse network of nerves controlling the function of the internal organs. The most intriguing mechanism is that proposed by pharmacologist Candace Pert, author of Molecules of Emotion: The Science Behind Mind-Body Medicine. She demonstrated that neuropeptides - molecules that help transmit messages among the brain's neurons - affect the behavior of nearly all the body's cells. This means that what we refer to as our mind isn't located just in the brain but throughout the body. It also implies that, driven by the comings and goings of these molecular messengers, the mind constitutes an immense communication network encompassing the functions of the organism.

So what is the placebo effect? Everything we don't know about the capacity of the brain to heal the body. Therein, undoubtedly lies the secret of the shamans and other healers. Their rituals, chants and restorative acts address the most archaic parts of the brain, those that regulate our organism and can participate in its healing ... Scientific medicine has replaced this knowledge with mechanical principles that allow the illness to be cured without speaking to the sufferer's spirit.

Ed. note: As a Reiki practitioner I have personally experienced the healing power of the mind/body/spirit connection. Hopefully, Western medicine will come around.

Black Cocktail

2009-08-23T09:03:00.000-07:00

Switters was instantly reminded of something Maestra had said almost twenty years before: "All depression has its roots in self-pity and all self-pity is rooted in people taking themselves too seriously."

At the time Switters had disputed her assertion. Even at seventeen, he was aware that depression could have chemical causes.

"The key word here is roots," Maestra countered. "The roots of depression. For most people, self-awareness and self-pity blossom simultaneously in early adolescence. It's about that time that we start viewing the world as something other than a whoop-de-doo playground, we start to experience personally how threatening it can be, how cruel and unjust. At the very moment when we become, for the first time, both introspective and socially conscientious, we receive the bad news that the world, by and large, doesn't give a rat's ass. Even an old tomato like me can recall how painful, scary, and disillusioning that realization was. So, there's a tendency, then, to slip into rage and self-pity, which, if indulged, can fester into bouts of depression."

"Yeah, but, Maestra---"

"Don't interrupt. Now, unless someone stronger and wiser -- a friend, a parent, a novelist, filmmaker, teacher, or musician -- can josh us out of it, can elevate us and show us how petty and pompous and monumentally useless it is to take ourselves so seriously, then depression can become a habit, which, in turn, can produce a neurological imprint. Are you with me? Gradually, our brain chemistry becomes conditioned to react to negative stimuli in a particular, predictable way. One thing'll go wrong and it'll automatically switch on its blender and mix us that black cocktail, the ol' doomsday daiquiri, and before we know it, we're soused to the gills from the inside out. Once depression has become electrochemically integrated, it can be extremely difficult to philosophically or psychologically override it; by then it's playing by physical rules, a whole different ball game. That's why, Switters my dearest, every time you've shown signs of feeling sorry for yourself,I've played my blues records really loud or read to you from The Horse's Mouth. And that's why when you've exhibited the slightest tendency toward self-importance, I've reminded you that you and me-- you and I: excuse me-- may be every bit as important as the President or the pope or the biggest prime-time icon in Hollywood, but that none of us is much more than a pimple on the ass-end of creation, so let's not get carried away with ourselves. Preventive medicine, boy. It's preventive medicine."

"But what about self-esteem?"

"Heh! Self-esteem is for sissies. Accept that you're a pimple and try to keep a lively sense of humor about it. That way lies grace-- and maybe even glory."

from Fierce Invalids Home From Hot Climates by Tom Robbins... thought provoking, no?

Okay, This is morbid... but fascinating.

2009-08-15T07:45:00.000-07:00

It’s 75 metres (245 ft) down from the deck of the Golden Gate Bridge to the water below. That drop will kill most people (after a fall of about 4 seconds, a jumper would hit the water at approximately 140 km/h (87 mph) – lethal in most cases. Those surviving the actual fall usually succumb to hypothermia, induced by the cold (8°C/47°F) water of the Bay.) And that’s exactly what it did to over 1,200 people who jumped off the bridge since its opening in 1937. Over the decades, 26 people are known to have survived the fall and the cold water.

San Francisco’s most famous landmark, the world’s longest suspension bridge at its opening, has earned the sad distinction of being the world’s most popular suicide spot (others include Aokigahara, the “Sea of Trees” at the foot of Mount Fuji [Japan], Niagara Falls [US/Can], Beachy Head and Clifton Bridge [both in England]).

The number of jumpers from the bridge, spanning the over 2 km (6,700 ft) wide strait at the entrance of San Francisco Bay, has varied greatly throughout the years, never more than around 10 until 1960 (with the exception of the 20 of 1948), then rising dramatically to peak at 40 in 1977 and dropping again to a low of less than 10 in 1990.

In 2004, 24 people jumped off the Bridge, spiking to 38 in 2007 – an increase many blamed on The Bridge, a documentary about the place’s fatal attraction. In 2008, authorities voted to install a ’safety net’ six metres below the Bridge (although how this should prevent people from jumping from the net is a question that should definitely be covered by the study to be conducted on the net’s impact).

This cartogram details the exact locations of the suicides, corresponding them with the 128 light poles that line the Bridge (east to west, even ones on the oceanside, uneven ones on the bayside). For obvious reasons, the areas closest to the edges of the Bridge are less popular (most suicides aim for maximum effect, i.e. longest way down). Remarkably, the bayside is a lot more popular than the oceanside. The hotspot is light pole 69 with – if I counted correctly – 56 recorded suicides.

* See a larger version of the map here. Thanks to my Captain for the link.

Perfectionism and the Little Hater

2009-08-10T08:01:00.000-07:00

So I've written about the evils of perfectionism (something I sadly know a LOT about;) but I saw this and thought of you and hope that it helps you identify (and choke) YOUR Little Hater...

Don't Ask Why, Ask How

2009-08-02T07:20:00.000-07:00

Some therapists are suggesting a new approach to depression. Avoid dark thoughts and temporary distractions; neither confronts or prevents the feelings. Instead, each time the physical symptoms and dark thoughts return, adopt an anthropological approach to exploring the workings of body and mind.

The instructions are unbelievably simple. Sit on the edge of a chair with your back straight and your hands resting on your thighs. Fix your attention on the physical sensations of your body and on finding an image or words that best describe the nature of those feelings. If thoughts come into your mind unbidden, observe them and let them fade. Then look for the next thought or image that follows, but don't judge it as 'good' or 'bad.' Bring your attention back to your breathing and observe what new flow of thoughts is taking the place of the last. Don't worry about why you feel what you feel or why you think what you think; concentrate purely on HOW.

'How' instead of 'why' is so simple, yet so important. If you're unconvinced, imagine a doctor who asks, "Why did you put on 10 pounds?" and one who says, "How are you feeling about your body?" It's the difference between feeling judged and feeling heard. That little word 'how' is a gesture that opens the door to deeper understanding. Professor John Teasdale of Cambridge University demonstrated that it was possible to reduce relapses for patients with depression by more than 50% with meditation, a success rate comparable to that of antidepressant medication. We can all benefit from a finer understanding of ourselves and others. All we have to do is avoid the intimidating 'why?' and offer our trust to the kinder 'how?'

paraphrased from the article by David Servan-Schreiber in Ode Magazine.

Putting Brains on the Couch by Susan Begley

2009-07-13T06:51:00.001-07:00

For doctors who treat illnesses that strike from the neck down, a patient's symptoms are only the first step toward a diagnosis. No sooner do they hear 'it hurts when I climb stairs' than they order blood work, x-rays or other tests. In psychiatry, though, the laundry list of symptoms is it, the only basis for diagnosis. Maybe that helps explain why 70% of patients with bipolar disorder are misdiagnosed, as are up to half of women with depression. They take drug after drug, taking each dose of each medication for four to six weeks until one works or they give up, wasting money and time while their suffering continues. It's hard to avoid the sense that psychiatry could stand to be dragged into... well, let's start with the 20th century.

The American Psychiatric Association is updating its immense diagnostic manual, which offers 20 forms of bipolar disorder alone. "But it's still just a checklist of symptoms, which different physicians can interpret differently," says psychiatrist James Greenblatt, who directs the eating-disorders unit at Waltham Hospital in Massachusetts. For him and a growing number of psychiatrists, the search for a modern, objective diagnostic tool has led to the past: the electroencephalogram, first used in 1929 to record the brains electrical activity.

For an EEG, which typically costs about $150 and takes 45 minutes, a patient has about 20 electrodes pasted to his scalp, where they measure the electrical activity of neurons - brain waves - directly beneath. In the 1980's, researchers tried to base diagnoses on EEGs, but it didn't work. The same squiggles could mean different illnesses, and one illness could be marked by different EEG's. The new use of EEG's skips the diagnosis and goes straight to a recommended treatment. An EEG is compared to a database that includes 13,000 pairings of EEGs with which drugs helped in each case. A California company called CNS Response, which runs the database, finds a match and sends the physician an analysis indicating which drugs patients with that EEG are sensitive or resistant to.

That would be humdrum if, say, the analysis said 'Prozac' for a patient with depression. But according to the studies of hundreds of patients "in some three quarters of patients the EEG database leads the physician to something he wouldn't have thought of," says CNS President Len Brandt. The EEG matches aren't perfect. For about one quarter of patients, the $500 analysis suggests treatments that work no better than what they'd already tried. It has proved most beneficial in stubborn cases and in those with no obvious first line drug, such as eating disorders and addiction.

One reason for the sometimes odd pairings of illnesses and drugs is that many different brain states can produce the same mental symptoms, and many different symptoms can arise from the same brain state. The mind has not yielded all its mysteries quite yet.

(Edited for space. Thanks to Al & Judy Peraino for this!)

Who's your anchor? (I know who mine is....)

2009-07-06T20:52:00.000-07:00

When Medicine Got it Wrong

2009-06-29T21:39:00.000-07:00

NAMI will kick off its 30th anniversary on July 5th at the national convention in San Francisco with a special screening of the PBS documentary When Medicine Got it Wrong. The film, produced by Katie Cadigan, is about NAMI's dramatic grassroots origins and founding as a national organization.

When Medicine Got it Wrong focuses on the years when most doctors blamed parents for schizophrenia or other disorders in their children and the loving parents who rebelled against the conventional wisdom and rejected those theories. Their activism helped revolutionize treatment and spur investment in scientific research, recognizing mental illness as a physical illness involving the brain. The documentary will premiere nationally on PBS in the fall of 2009.

Cadigan hopes the film will inspire people "to evaluate our collective responsibility to treat and care for those among us with severe mental illness... The film will be a success if it sparks dialogue about the current state of our mental health care system." Cadigan's brother, John, lives with schizophrenia and in 2004 she won a NAMI award for producing People Say I'm Crazy, directed by her brother -- the first major film directed by a person living with schizophrenia.

To Dad, with love

2009-06-21T15:50:00.001-07:00

This morning I got a text from my dear daughter-in-law that read,"Happy 'Father's day' to a lovely lady who did both parenting roles for two kids. You are loved by all your youngins.!" Tickled me pink to get that as I clearly remember the challenge of trying to fill those shoes... buying my son a jock strap for Little League, explaining the birds and the bees and later having the "protection" talk over a box of condoms- not much fun for either of us. I often fretted about the lack of a healthy male role model, for both of my kids, as a little girl also learns how a woman should relate to a man from her father. But for my son (with the challenge of a mental illness,) this lack of a role model and of the acceptance and approval of a man- it always seemed so hurtful to him. His biological father just wasn't up to the challenge of accepting his boy as perfectly imperfect.

Father's Day means more to me today than it ever has. My life has been graced by a wonderful, caring man who has embraced the role of 'Dad' like he was born to it. His affection and acceptance of my children is unprecedented as he never had any of his own. But it goes beyond that. My husband and I had only been married for 4 months when my son attempted suicide. While my son slept on my couch, not showering, moving only to eat and then to engage only with a computer for months, my new husband rose to the challenge. He attended the 12 week Family to Family course with me and learned about mental illness. He talked to my boy, and really listened, he gave him space, he gave him time. Their relationship has only grown sweeter to me through the last four years. I realized I didn't have to be 'dad' anymore.

I missed out on a father. I'm so glad my kids finally have a Dad. Happy Father's Day.

Bullied to Death

2009-06-16T19:15:00.000-07:00

Addressing harassment and suicide prevention in schools
By Charles Robbins, Executive Director & CEO, The Trevor Project and Eliza Byard, PhD, Executive Director, the Gay, Lesbian and Straight Education Network (GLSEN)

The impacts of language and behavior can be deadly, especially in a school environment where young people are already highly impressionable and vulnerable. Unfortunately, this difficult lesson has been conveyed many times when young people resort to drastic and permanent measures to escape the despair of enduring constant bullying and harassment at school.

It is deeply disturbing that on April 6, Carl Joseph Walker-Hoover, an 11-year-old sixth-grader from Springfield, Mass., hanged himself with an extension cord in his family’s home after being subjected to continuous anti-gay bullying and harassment at his middle school. It is equally as disheartening that on April 16, less than two weeks later, Jaheem Herrera, an 11-year-old fifth-grader from DeKalb County, Ga., also hanged himself at home after being the subject of anti-gay taunts from his classmates. These were two completely separate and isolated instances, but the tragic and preventable nature of each unfortunate loss of life remains the same.

Neither Carl nor Jaheem identified as gay, yet their peers’ defamatory language and hurtful behaviors broke the barriers of sexual orientation and gender identity. Being taunted as “faggot,” “queer” or “homo” by classmates is offensive and demeaning to any student – straight, gay, lesbian, bisexual, transgender and questioning alike.

Carl is the fourth middle school student this year to complete suicide due to bullying, and Jaheem was still in elementary school. Older students are also at a high risk, as suicide is one of the top three causes of death among 15 to 24-year-olds and the second leading cause of death on college campuses. Lesbian, gay, bisexual, transgender and questioning youth are up to four times more likely to attempt suicide than their heterosexual peers, and those who come from a rejecting family are up to nine times more likely to do so.

Enough is enough. It is time for school administrators, educators, parents, students and the government to work together to stop bullying and harassment in schools. Furthermore, we must teach young people to understand the profound impact of words and actions, and to recognize depression and suicidal ideations amongst their peers. By helping young people take responsibility for their actions and respect their peers, and simultaneously empowering them with the knowledge and skills they need to understand when their classmates are in crisis, we can work toward ending the dual epidemics of school bullying and youth suicide once and for all.

It is our hope that in memory of Carl and Jaheem, and in honor of all young people who have completed suicide after enduring constant torment at school, we will be able to work together to promote school environments that celebrate diversity and encourage acceptance of all people. Only then will we be confident that our children are receiving the respect and education they deserve today in order to become the successful and equality-minded leaders of tomorrow.

The Trevor Project is the non-profit organization that operates the only nationwide, around-the-clock crisis and suicide prevention helpline for lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth. The Trevor Project was established in 1998 to promote acceptance of LGBTQ youth, and to aid in crisis and suicide prevention among that group.

GLSEN, the Gay, Lesbian and Straight Education Network, is the leading national education organization focused on ensuring safe schools for all students. Established nationally in 1995, GLSEN envisions a world in which every child learns to respect and accept all people, regardless of sexual orientation or gender identity/expression

Musing on suicide as we say goodbye to David

2009-06-07T07:09:00.000-07:00

On June 4th, we lost one of my favorite actors, David Carradine. I loved the old Kung Fu series and watched it in syndication for years... I still use the moniker "grasshopper" when explaining just about anything to anybody; it will probably always make me smile. I had a huge pre-adolescent crush on Caine, who was so unshakable and such a badass. I was delighted to see Carradine in the Tarantino Kill Bill flicks, back to work in something worthy of him and looking fabulous for his age. I was horrified to hear the news of his death, an apparent suicide.

Of course, now the word "apparent" is taking the forefront; Carradine was working on a film and in good spirits and it seems far more likely that his death was accidental. This brought me back to a recent conversation in our mental health support group - we often talk about suicidal feelings as many of us experience them and support group is for... support. Talking about difficult feelings in a safe place often diffuses them somewhat and it never hurts to know that you are hardly the only one who feels that ending the pain might just be a workable solution.

So anyway, part of this conversation revolved around how many suicides are indeed accidental... the result of simply not being too on top of just how many xanax you've actually taken and rinsing them down with wine instead of water. Let's face it, if you're in the pit of depression or, even worse, flying high on the wave of mania, you are not exactly thinking clearly. You are NOT rational, you are NOT in control, and you are probably NOT the person who should be dispensing your medication, or driving your car, or trying some new risky adventure. But you're probably still going to do those sorts of things and you might end up dead. Even if that really wasn't your intention.

This brings us to the question of having a safety plan. I nag about this constantly. You need to create a plan when you're good, when you're rational, and you need to know it by heart so that when you're not good and not rational, you will turn to it by rote, out of habit. That plan needs to include someone you trust that can look after you a bit, check up on you, say NO to you. That plan needs to include a place of safety and a thing that will take you from zero to survival. The thing can be a walk, a long bath, going to a movie, getting out with people - only you know what will turn you momentarily away from the abyss. Let me emphasize that this thing only has to take you from zero to survival - not to feeling well, or even feeling better. If you're still willing to breathe another breath, that's the ticket.

Maybe David didn't have a safety plan. And maybe it was all just a horrible accident. Either way he will be missed.

And so would you.

Mental Health and the Fairer Sex

2009-05-31T19:53:00.000-07:00

A new report released today on gender-based differences in mental health shows women are nearly twice as likely as men to suffer from major depression. The report addresses many other mental health issues facing women, including the effect trauma and violence can have on long term mental health, and outlines action steps for policy makers, health care professionals and researchers.

Action Steps for Improving Women's Mental Health, released by the U.S. Department of Health and Human Services' Office on Women's Health (OWH), brings together the most recent research on mental health issues in women and explores the role gender plays in diagnosing, treating and coping with mental illness. It also points to resiliency and social support systems as key factors in overcoming mental illness. Other highlights include:

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Rates of anxiety disorders are two to three times higher in women than men.
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Having a history of violence, trauma or abuse is associated with increased risk of depression, post traumatic stress disorder (PTSD), panic disorder and a tendency to engage in risky behaviors.
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Female veterans may face a higher risk of PTSD than their male counterparts.
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Family and other interpersonal connections in a woman's life may play an important role in building resiliency and offering protection from mental illness.

Acting Surgeon General Steven Galson, M.D., M.P.H., emphasizes, "Mental illness is often incorrectly perceived as a weakness, which prevents women from recognizing the signs and symptoms and seeking treatment. In order to reduce stigma, we need to encourage open, honest conversations."

The report also outlines specific action steps for policy makers, health care providers, and researchers to take in an effort to address the burden of mental illness on women's lives and increase their capacity for recovery. "We have an unprecedented opportunity to improve the mental health of women," says Dr. Wanda Jones, Director of the Office on Women's Health and Deputy Assistant Secretary of Health in the U.S. Department of Health and Human Services. "Our hope in releasing this report is that these groups will come together and turn these recommendations into action so that we better the health of our nation."

The Office on Women's Health also produced a booklet for women that addresses the stigma associated with mental health. Women's Mental Health: What It Means To You includes information on the signs and symptoms of mental illness, suggestions about where to turn for support and solutions for preventing and coping with mental illness.

Action Steps for Improving Women's Mental Health and Women's Mental Health: What It Means To You are available for free by visiting www.womenshealth.gov or by calling 1-877-SAMHSA-7 (1-877-726-4727).

Why I Volunteer

2009-05-20T22:14:00.000-07:00

I have a tendency to rely on familiar phrases a little too heavily, so I wonder how many times someone has heard me say that no one learns about mental illness until the train hits them. I dearly love the visual of that metaphor ... can think of few things that capture the essence of serious brain disorder more completely than a train wreck. The onset of mental illness is a scene of total chaos and destruction, and it matters little if that onset happens to you or to someone you love. In an instant the world is transformed into a scary and perilous place; there is only darkness, twisted metal and pain.

The train hit me four years ago when a sobbing girl called my cell phone to tell me my son was on his way to St. Joseph's - that he had taken a lot of pills and she had called 911. I was standing in Safeway at the time, and I thanked her and left a cart full of groceries to start the hour drive it would take me to get to the hospital. I wasn't sure what I would find when I got there. It was the longest hour of my life. I don't remember what went through my head as I drove. Maybe darkness, twisted metal and pain.

That was the beginning of this journey, and I've been trying to make sense of the train wreck ever since. Luckily, my son came home with me the next day and began his own journey of recovery, slowly and shakily at first; but always making some progress. Medications, the frustrations of dealing with the VA, relapses, lost jobs, different medications, breaks, weight gain, counselors, blood tests and on and on it goes. Good days, a wedding, and growth as well. Lots and lots of learning - book after book and then the NAMI Family to Family course. A learning curve of unbelievable proportions for everyone. Through it all - love - and a deepening respect for anyone who has to live with these things. And more love.

So why do I volunteer? Penance, I'll tell you with a laugh. Doing time for all the mistakes I made before I understood the nature of the disease. As a way to honor his fight to survive and define my own. But more than that, volunteering is a way for me to help someone who just got hit by a train. Volunteering helps me shine a little light on the wreckage and find the survivors. So I'll teach a class, or facilitate a group, listen on the phone or pass on some information. It takes so little. It does so much.

Find your local NAMI affiliate for volunteering opportunities here.

Listening to Madness

2009-05-11T20:32:00.001-07:00

We don't want to be normal," Will Hall tells me. The 43-year-old has been diagnosed as schizophrenic, and doctors have prescribed antipsychotic medication for him. But Hall would rather value his mentally extreme states than try to suppress them, so he doesn't take his meds. Instead, he practices yoga and avoids coffee and sugar. He is delicate and thin, with dark plum polish on his fingernails and black fashion sneakers on his feet, his half Native American ancestry evident in his dark hair and dark eyes. Cultivated and charismatic, he is also unusually energetic, so much so that he seems to be vibrating even when sitting still.

I met Hall one night at the offices of the Icarus Project in Manhattan. He became a leader of the group—a "mad pride" collective—in 2005 as a way to promote the idea that mental-health diagnoses like bipolar disorder are "dangerous gifts" rather than illnesses. While we talked, members of the group—Icaristas, as they call themselves—scurried around in the purple-painted office, collating mad-pride fliers. Hall explained how the medical establishment has for too long relied heavily on medication and repression of behavior of those deemed "not normal." Icarus and groups like it are challenging the science that psychiatry says is on its side. Hall believes that psychiatrists are prone to making arbitrary distinctions between "crazy" and "healthy," and to using medication as tranquilizers.

Hall and Icarus are not alone in asking these questions. They are part of a new generation of activists trying to change the treatment and stigma attached to mental illness. Welcome to Mad Pride, a budding grassroots movement, where people who have been defined as mentally ill reframe their conditions and celebrate unusual (some call them "spectacular") ways of processing information and emotion.

Just as some deaf activists prefer to embrace their inability to hear rather than "cure" it with cochlear implants, members of Icarus reject the notion that the things that are called mental illness are simply something to be rid of. Icarus members cast themselves as a dam in the cascade of new diagnoses like bipolar and ADHD. The group, which now has a membership of 8,000 people across the U.S., argues that mental-health conditions can be made into "something beautiful." They mean that one can transform what are often considered simply horrible diseases into an ecstatic, creative, productive or broadly "spiritual" condition. As Hall puts it, he hopes Icarus will "push the emergence of mental diversity."

Read all of this fascinating article here, and thanks to Mike for the link.

New Web Site

2009-04-21T21:58:00.001-07:00

During these difficult times, Mental Health America wants Americans to know that there are tools that can buffer the effects of stress and help them cope better with the many challenges they face. This May, in honor of Mental Health Month, the organization is launching the Live Your Life Well campaign to provide people with 10 specific, research-based tools that can combat stress and promote health and well-being.

From relaxation techniques to journaling exercises to simple ways to get better sleep and improve eating habits, the materials offer a wide range of resources to build resiliency and well-being. The 10 Tools of Live Your Life Well also includes information on seeking the help of a mental health professional.

Check out this new resource here.

Female Vets Struggling to Get Treatment for Post-Traumatic Stress Disorder

2009-04-13T21:58:00.000-07:00

The war in Iraq has been now been raging for six years.

It's the first war where women in the U.S. military are in combat roles.

Even years after serving in Iraq, female veterans are still adjusting to civilian life.

At a women's veterans art show in San Francisco vets say the six year anniversary of the war brings back painful memories.

"The 6 year anniversary has me thinking about the friends that I lost. And the friends that I still have who have been forever scared by the war," said Iraq war veteran Lindsey Rousseau-Burnett.

Many of the women we talked to say they are getting psychiatric help from the Veteran's Administration.

But they say the agency is behind the times.

"Because women supposedly aren't in combat they have a higher burden of proof to try and prove they have PTSD," said vet Kayla Williams.

The veteran's service organization Swords to Plowshares says female Iraq war vets are the fastest growing population of homeless.

"There numbers in terms of homelessness is growing exponentially. There are very few services for them because homeless veterans services, VA services have grown up serving a male cliental," said Swords to Plowshares Amy Fair-Weather.

These vets are hoping sharing their stories through pictures and books will help make the road to recovery easier for the women currently serving in Iraq.

© 2009 NBC News

A General's Personal Battle by Yochi J Dreazen

2009-03-29T22:26:00.001-07:00

Maj. Gen. Mark Graham is on the frontlines of the Army's struggle to stop its soldiers from killing themselves. Through a series of novel experiments, the 32-year military veteran has turned his sprawling base here into a suicide-prevention laboratory.

One reason: Fort Carson has seen nine suicides in the past 15 months. Another: Six years ago, a 21-year-old ROTC cadet at the University of Kentucky killed himself in the apartment he shared with his brother and sister. He was Kevin Graham, Gen. Graham's youngest son.

After Kevin's suicide in 2003, Gen. Graham says he showed few outward signs of mourning and refused all invitations to speak about the death. It was a familiar response within a military still uncomfortable discussing suicide and its repercussions. It wasn't until another tragedy struck the family that Gen. Graham decided to tackle the issue head on.

"I will blame myself for the rest of my life for not doing more to help my son," Gen. Graham says quietly, sitting in his living room at Fort Carson, an array of family photographs on a table in front of him. "It never goes away."

Suicide is emerging as the military's newest conflict. For 2008, the Pentagon has confirmed that 140 soldiers killed themselves, the highest number in decades.

At a Senate hearing last week, Gen. Peter Chiarelli, the Army's vice chief of staff, told lawmakers that 48 soldiers have already committed suicide in 2009. The figure puts the Army on pace for nearly double last year's figure. "I, and the other senior leaders of our Army, readily acknowledge that these current figures are unacceptable," Gen. Chiarelli said at the hearing.

Beyond Fort Carson, the Army has launched a broad push to reduce the incidence of suicide. Over the next four months, all soldiers in the Army will receive additional training on suicide prevention and broader mental health issues. The Marine Corps, which is also being hit hard by suicide, will give all Marines similar training this month. In February and March, the Army for the first time ever excused units from their normal duties so, one by one, they could learn new ways of trying to identify soldiers in need of help.

Read the rest of the article here.

Yesterday

2009-03-23T21:09:00.000-07:00

Yesterday, I got some inspiration to purge... and pulled out some boxes from the garage with the intent of clearing them out and consolidating. Everybody has some stupid cardboard boxes full of stuff, you know. Old stuff that seemed too important to toss but not important enough to have sitting in the room with you. Usually the stuff remains in the cardboard box forever, being dutifully moved from home to home until you die and then your offspring become in charge of tossing it out unceremoniously whilst muttering under their collective breath. This is the way of stuff.

However, I seem to have some odd recessive gene that occasionally prompts me to rid myself of the weight of some of the stuff. Unfortunately, this gene is not of the sort of nature that might suggest that I just march into the garage, pick a couple of boxes at random and heave them into the dustbin without a peek. There must be peeking and consideration, lest I might divest myself of something of deep and irreplaceable value. This is a good thing, as in this last batch of peeking I finally located my long lost divorce decree - which does indeed have some value and although not irreplaceable, could lead to a good deal of unpleasantness if suddenly needed and not available.

Within this box of divorce decrees (keep,) notebooks of adolescent poetry (pitch!) the first board I broke with my fist in karate (PITCH,) tax records from 1998 (still have to keep?) and such, was a rather nondescript envelope. And within the envelope was a photocopy of a death certificate and another copy of a handwritten note. And then I was crying and the purging of stuff came to an untimely end. Like the life described therein.

I wonder if I will ever really heal from the loss of my father. It's funny that I didn't miss him until I was 32 years old. Until then, I had this sad dream of a daddy who died tragically just before my arrival on the scene - snatched from life by an untimely accident. I spotted him occasionally in the pain in my mother's eyes, but beyond that he was only this tragic and beautiful fellow in my dreams. Then, as an adult with children of my own, that death certificate came home to roost and answered my questions once and for all. My father wasn't snatched from life at 25. My father took his life.

So, who am I crying for? Not sure about that. Suffice it to say that I have come far enough to say that I can understand the wish to have it end. Not so much a wish for death... just a wish for an end to the pain of living. Buddhists suggest that we embrace the pain; accept that pain is the whole substance of living - I haven't figured out how to do that. Not by a long shot. There are days that I open my eyes and my first thought is one of dread. Joy feels alien. Sunlight makes me wince. I often wonder if the one cell that my father gave me held all his pain as well. I often wonder if I didn't pass it on to my son.

In another nondescript envelope are some photos of my dad as a kid. As I rifled and sniffled one photo jumped out at me - like I'd never seen it before. Suddenly on a mission, I found another photo from another box and laid the two side by side. My dad at 15. My son at 15. I never noticed how much they looked alike.

I'm crying again. I'm still not sure for whom.

Shame

2009-03-23T20:59:00.000-07:00

I don't look at mirrors.
Okay, maybe sometimes. At my face.
I don't mind my face too much,
if I don't look too hard and skip the eyes.
I don't watch as the soap slips along
standing in the shower.
I close my eyes to wash
or watch the water.
Reflections in windows
can be handily avoided
by keeping a sharp eye on the movement of feet;
avoiding judging eyes a value added.
At worst a window glance is brief
and thankfully clothed.
Bathrooms are harder.

The Right Thing

2009-03-09T07:48:00.000-07:00

The question, friends, that is always on the tongue of those who live with a loved one with mental illness, is startling in it's simplicity. Because after you have come to grips with a diagnosis, or at least wrapped your mind around the reality that your child, spouse, parent, or sibling is not okay in the traditional sense of the word - after you have educated yourself about that malady and done your homework by reading book after book or endlessly surfing the net - after you've sought out support groups and doctors and counselors and social workers - after all due diligence you find yourself still grappling with that one question.

What is the right thing to do?

I live in America. This is a the "land of the free, home of the brave." This is a culture that looks disapprovingly upon failure, weakness and lack of a stiff upper lip, whatever that is supposed to mean. Homeless? You've failed to 'pull yourself up by your bootstraps.' Jobless? You aren't taking advantage of your opportunities. Ill? Well, how long can it take to get better? Take your pills for heaven's sake and get on with it. Addicted? That's just pathetic; we'll let you hit bottom and then you'll see the error of your ways and become a responsible citizen.

This is how the New Collegiate Dictionary defines the term enabler: "one that enables another to achieve an end; especially: one who enables another to persist in self-destructive behavior (as substance abuse) by providing excuses or by making it possible to avoid the consequences of such behavior." This has become the dirty word to fling at the family of the afflicted - as if they have caught some vile social disease by association. Not enough to blame the victim... blame the victim's family as well. This is how compassionate our culture is to the most vulnerable.

The flipside, of course, is that often our loved ones become most ingenious at using our compassion for them to their own ends. That just because a person is ill, does not mean he or she is not capable of being devious and manipulative, or lazy and unwilling to compromise. A person with mental illness may very well have the ability to decide that sitting at home playing video games trumps working at a dull minimum wage job hands down, or that Mom will clean up the mess if I don't. A little show of temper or the silent treatment may get the family back to walking on eggshells - and off my back. Which brings us back to the question.

What is the right thing to do?

The line between "enabling someone to achieve an end (recovery)" and "enabling someone to continue self destructive behavior" is always in motion. The ability to discern when a behavior is a direct result of the disease or a reactive coping mechanism is an ongoing learning curve - and just when I think I've got it down, I catch myself and have to reevaluate. The line is dependent on so many factors - what illness, how severe, what stage of recovery are we in, what outside factors are contributing, are the meds working, are they being taken... and so on and so on and so on. Sometimes it's too much to grapple with and I abdicate - and my fall back position is usually to help in some way, even if that help is enabling. But I fear that if I am always there to clean up the mess, to provide comfort, or just plain to save his butt from consequences that a normal (as in not mentally ill) person would have to face - that I am somehow doing him a disservice. How will he mature and grow and learn to handle things himself if I never let him deal with his own mistakes?

What is the right thing to do?

Coping with Hearing Voices by Rethink

2009-02-22T15:16:00.000-08:00

Most people in modern-day western culture think of hearing voices as a clear sign of mental illness but it's as well to remember that not everyone shares this opinion. A report published by the British Psychological Society in (2000) claims that 10-15 % of the population hear voices or experience other hallucinations at some point in their life. However, only about 1 % of the population is given a diagnosis of schizophrenia and a similar number get a diagnosis of manic depression (often called 'bi-polar disorder'). In some other cultures hallucinations are thought of as spiritual gifts. So not everybody who hear voices is thought of as having a mental illness by themselves, their families or even the mental health services.

Hearing voices in itself may not necessarily be distressing. What really matters is the effect that hearing voices has upon the person's life. For some voice hearers the experience is highly distressing and disturbing and it has a negative impact upon their life. Voices can be critical, hostile and even result in suicide. For others the experience is not distressing; it can even be positive, comforting or inspiring. Sometimes, hearing voices becomes distressing in itself because of the way it is viewed by our culture and because of the way the media portray people who hear voices as dangerous to others, which is very rarely the case.

But many people who hear voices find themselves having to deal with a different world, which may at times be overwhelming and may shut out everything else. As a result reasoning may be almost taken away, making it difficult or even impossible to go about life without being affected by such penetrating and confusing experiences.

What are the voices?

Using brain imaging techniques (ie using a brain scanner), researchers can see which parts of the brain are active during different tasks. So, using these brain imaging techniques researchers can see which parts of the brain are active whilst you are experiencing psychotic symptoms, such as hearing voices. This shows that when you are hearing voices part of the brain, called Broca's area, is active. This is the same area that is active when a person without psychosis makes inner speech, such as when reciting a poem to themselves. This shows that the voices originate within the brain, in just the same way inner speech is generated. The difference is that with hallucinations (e.g. voices) the auditory cortex is also activated. The auditory cortex is normally active when we are listening to sounds, such as somebody talking. So, when you have hallucinations of hearing voices, Broca's area and the auditory cortex are both active, making it seem like the voices are coming from outside. Whereas, in inner speech (such as silently reciting a poem to oneself) only the Broca's area is active and we recognize it as our own silent speech.

See the rest of the article, including strategies for coping, here.

Vets and Depression

2009-02-16T19:35:00.000-08:00

* An estimated 9.3 percent of veterans aged 21 to 39 (312,000 persons) experienced at least one major depressive episode (MDE) in the past year.

* Among veterans aged 21 to 39 with past year MDE, over half (51.7 percent) reported severe impairment in at least one of four role domains (i.e., home management, work, close relationships with others, and social life), and nearly one quarter (23.5 percent) reported very severe impairment in at least one of the domains.

* More than half (59.6 percent) of veterans aged 21 to 39 who experienced past year MDE received treatment for depression in the past year.

Recent research indicates that an estimated 25 to 30 percent of the veterans of the wars in Iraq and Afghanistan have reported symptoms of a mental disorder or cognitive condition. Untreated mental health problems can result in long-term negative consequences for the affected individuals, their families, their communities, and our Nation as a whole.

The National Survey on Drug Use and Health (NSDUH) includes questions about military veteran status, major depressive episode (MDE), and treatment for depression. This issue of The NSDUH Report examines data from veterans aged 21 to 39, an age group that includes veterans with relatively recent service.

Read the rest here.

The wolf you may know

2009-02-11T18:17:00.000-08:00

"WHEN YOU SAY THE WORD "sociopath" most people think of serial killers. But although many serial killers are sociopaths, there are far more sociopaths leading ordinary lives. Chances are you know a sociopath. I say "ordinary lives," but what they do is far from ordinary. Sociopaths are people without a conscience. They don't have the normal empathy the rest of us take for granted. They don't feel affection. They don't care about others. But most of them are good observers, and they have learned how to mimic feelings of affection and empathy remarkably well.

Most people with a conscience find it very difficult to even imagine what it would be like to be without one. Combine this with a sociopath's efforts to blend in, and the result is that most sociopaths go undetected.

Because they go undetected, they wreak havoc on their family, on people they work with, and on anyone who tries to be their friend. A sociopath deceives, takes what he (or she) wants, and hurts people without any remorse. Sociopaths don't feel guilty. They don't feel sorry for what they've done. They go through life taking what they want and giving nothing back. They manipulate and deceive and convincingly lie without the slightest second thought. They leave a path of confusion and upset in their wake.

Who are these people? Why are they the way they are? Apparently it has little to do with upbringing. Many studies have been done trying to find out what kind of childhood leads to sociopathy. So far, nothing looks likely. They could be from any kind of family. It is partly genetic, and partly mystery." (read more of this article here.)

So here's a little test... actually a question devised by a psychologist to see who thinks like a sociopath. Read the question carefully and give it some thought.

A woman, while attending her own mother's funeral, meets a man. She has never set eyes on him before and yet she finds him to be delightful. She is sure he is 'the one.' But somehow he leaves the funeral before she can get his number, or even his last name. A few days later, she murders her sister. SOOOO, what was her motive for killing her sister.

You'll have to check the comment thread to get the answer... and if you get it right, please let me know (so I can block your email.....:)

Read The Sociopath Next Door last year.... chilling.....

Help Prevent Overdose Deaths in WA State

2009-02-05T20:12:00.000-08:00

The rate of overdose deaths in Washington State has been steadily climbing in recent years. According to the Washington State Department of Health, in 1999 there were 403 unintentional drug poisoning deaths in this state; by 2006, the number had increased to 707. Drug overdose is the second leading cause of injury death in the United States, behind only motor vehicle accidents and ahead of firearms.

Most drug overdose deaths are preventable through timely medical attention. Researchers consistently identify fear of arrest or police involvement as the most significant barrier to people calling 911 when they think a friend may be experiencing an overdose. We should encourage people to get emergency medical help sooner by removing that obstacle.

Washington should take the modest step of providing limited immunity from drug charges to people who seek medical assistance during an overdose situation. A human life is just too great a loss.

Take action on House Bill 1796 and Senate Bill 5516.

Hypothesis Re: the Rise of Recognised Mental Disorders

2009-02-02T21:06:00.000-08:00

The New York Times recently published an article on the evolving Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is the official source for psychologists who are diagnosing patients with mental disorders. The article points out that the number of disorders in the manual has more than doubled since the 1950s:

Hypothesis One: The DSM reflects an increasingly sophisticated and exhaustive compendium of all possible mental disorders.

Hypothesis Two: More psychological disorders = more people diagnosed with mental disorders = more money is siphoned off to hospitals, treatment centers, drug companies, mental health professionals, social workers, school counselors, etc. (Scientists who are currently working on the next version of the DSM have agreed to restrict their income from drug makes to $10,000 a year or less.)

Hypothesis Three: We are an increasingly rationalized society and all things are becoming increasingly listed, compiled, organized, and annotated.

Hypothesis Four: What is considered a “problem” depends on the social context. (”Homosexuality” used to be in the DSM, but it isn’t any longer.) Perhaps a shift in the last 50 years has created a social context that is less tolerant of difference, more insistent upon happiness, or requires a more compliant citizen.

Hypothesis Five: Grassroots activists get together and lobby scientists to include disorders in the DSM so that they can raise awareness and money for research.

What do you think?

Thanks to Sociological Images for this post and check out my comment!

Making Amends

2009-01-29T00:34:00.000-08:00

Grant “Skip” Treaster remembers his hand trembling the day he sat down to write a long-overdue letter to his son. It was his son’s 39th birthday. And Treaster, diagnosed with bipolar disorder in 1995, hadn’t seen his son since he was a 9-year-old boy.

“I wish I could just say sorry, that this card is a couple days late,” Treaster wrote his son. “But it’s been more like a couple decades. I don’t know where to even begin to say I’m sorry, but I truly am.

“I’m sorry I just up and disappeared from your life,” his card message continued. “I never really intended to do that. But I turned out to be one of those men who leave. Leave jobs when they get too hard. Leave relationships when they get too complicated. Leave town when things get hot. I’m sorry I left you and I’ll never be able to forgive myself for that.”

Treaster, a former advertising executive who lives in Arizona with his fourth wife, has spent the past several years rebuilding his world after battling bipolar disorder for decades without a diagnosis. As part of the process, he’s beginning to try to make amends to those he hurt, including his three adult sons from his first marriage—whom he all but abandoned—as well as two adult daughters from his second marriage.

“I’ve left quite a wake of ruined relationships and destruction in my path because it took so long to get diagnosed,” says Treaster, now 59. “And even the diagnosis doesn’t change things, necessarily. It takes time. And a diagnosis doesn’t undo all the past mistakes.”

Indeed, we have all been hurt, or have hurt others in relationships. Whether unintentional or purposeful, it happens. But when bipolar disorder is at the source of the wound inflicted on another, things such as out-of-control spending, infidelity, anger outbursts, or long periods of isolation brought on by depression can amplify and confuse those hurts. The pain is real, but how can we hold a grudge against someone who has a mental illness? On the other hand, if we have a mental illness, how do we begin to make amends for things we did when we were ill?

While medication and therapy are the building blocks to recovery from mental illness, making amends and seeking forgiveness play a role as well. As Treaster has discovered, asking for forgiveness—and forgiving himself—have been the hardest part of his climb to wellness.

Read the rest of the article, including tips for healing here.

Mental Illnesses: Misunderstood

2009-01-20T22:42:00.000-08:00

(Thanks to Debbie Pearson for this post:)

Dead Horse Theory

2009-01-11T13:38:00.001-08:00

The tribal wisdom of the Dakota Indians, passed on from generation to generation, says that, "When you discover that you are riding a dead horse, the best strategy is to dismount."

However, in government, education, corporate management and health care, more advanced strategies are often employed in such situations, such as:

Buying a bigger whip.

Changing riders.

Appointing a committee to study the horse.

Checking the internet for information on various means of riding dead horses.

Lowering standards so that dead horses can be included.

Reclassifying the dead horse as living impaired.

Hiring an outside contractor to ride the dead horse.

Harnessing several dead horses together to increase speed.

Providing additional funding and/or training to increase the performance of the dead horse.

Doing a productivity study to see if lighter riders would improve the performance of the dead horse.

Declaring that as the dead horse does not have to be fed, it is less costly, carries lower overhead and therefore contributes substantially more to the bottom line of the economy than do other horses.

Rewriting the expected performance requirements for all horses.

Promoting the dead horse to supervision as an incentive.

Doing a needs assessment on the dead horse and then establishing best practice findings to address the needs.... of the dead horse.

This year let's consider that tribal wisdom and simply dismount.
Happy 2009!

Holiday Triggers

2008-12-13T14:52:00.001-08:00

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:

Acknowledge your feelings. You can't force yourself to be happy just because it's the holiday season.
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.
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.
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.
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.
Plan ahead. Set aside specific days for shopping, baking, visiting friends and other activities. Expect travel delays, especially if you're flying.
Learn to say no. If you say yes only to what you really want to do, you'll avoid feeling resentful, bitter and overwhelmed.
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.
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.
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.
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.
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

2008-12-05T22:08:00.000-08:00

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?

2008-11-23T21:45:00.001-08:00

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...

2008-11-16T00:11:00.001-08:00

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

2008-11-09T10:37:00.001-08:00

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...

2008-10-26T08:32:00.000-07:00

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.

2008-10-18T22:40:00.000-07:00

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

2008-10-06T22:50:00.001-07:00

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

2008-09-30T21:24:00.000-07:00

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?

2008-09-26T18:27:00.000-07:00

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

2008-09-06T23:40:00.000-07:00

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:

Lie down or sit on the floor or in a chair.
Rest your hands on your stomach.
Slowly count to four and inhale through your nose. Feel your stomach rise. Hold it for a second.
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.
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...

2008-08-31T08:59:00.001-07:00

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

2008-08-20T21:30:00.001-07:00

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

2008-08-20T20:51:00.000-07:00

Another Day in the Dark

2008-08-14T07:26:00.001-07:00

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

2008-08-05T05:00:00.000-07:00

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

2008-07-31T20:36:00.000-07:00

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

2008-07-25T18:13:00.000-07:00

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

2008-07-19T17:10:00.000-07:00

The Trevor Project

2008-07-08T23:00:00.000-07:00

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

2008-07-01T00:17:00.000-07:00

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

2008-06-15T22:46:00.001-07:00

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.

Let's Go To The Movies II

2008-06-04T21:28:00.001-07:00

So last time I took you to the movies, it was all about how mental illness is portrayed in popular media, which is usually inaccurately at best. BUT it seems that there is more to this whole movie watching thing than I realized. In fact, watching a carefully selected DVD can be therapeutic.

"Cinema therapy is the process of using movies made for the big screen or television for therapeutic purposes," says Gary Solomon, PhD, MPH, MSW, and author of The Motion Picture Prescription and Reel Therapy. "It can have a positive effect on most people except those suffering from psychotic disorders," says Solomon, and can offer " an opportunity to do interventional work by yourself." The idea is to choose movies with themes that mirror your current problem or situation and then look for the therapeutic context.

Interesting, but I would think that this brings us back to the question of the accuracy of the portrayal of the mental illness. To that end, there's Roland Atkinson, a Professor of Psychiatry at the Oregon Health & Science University in Portland and self confessed film nut, who offers detailed reviews on 555 films with mental health, psychiatric or substance abuse themes on his website Psychflix.com. Dr. Roland gives every movie two scores - one for overall dramatic effect and one for psychiatric accuracy of the condition portrayed. Okay, I might argue with some of his tastes, but it is fascinating to hear his viewpoint on accuracy.

So here's the picks of the post:

Fight Club - Personality disorder (?) and obsession are the themes here, with some insomnia, and neurosis thrown in for luck. I adore both Brad Pitt and Ed Norton and this film is so bizarre and so nakedly male oriented that I found it nothing but amusing. I'm not at all sure that there is anything therapeutic in this film, or even remotely believable, but I was still very amused. Not for the faint of heart (or stomach.)

Girl, Interrupted - This is probably more about adolescent angst than real mental illness, although the film is based on the authors 18 month stint in an institution, and the patients there range from believable to not. Winona Ryder and Angelina Jolie are the main attractions and I fail to see any talent in Winona (think she peaked in Beetlejuice,) so I didn't love it.

Michael Clayton - One of the better depictions of Bipolar Disorder that I have ever seen, and one heck of an entertaining film. Tom Wilkinson plays a brilliant lawyer who, off his meds and clearly psychotic, tries to turn whistle blower and winds up murdered. George Clooney unravels the mystery.

And here's a shameless plug: Read my movie review blog here!

Bipolar Survey - Consumers and Caregivers

2008-05-21T08:18:00.000-07:00

PatientView, an independent research-and-publishing organization, along with the World Federation of Mental Health (WFMH ) and other European-based groups are conducting a survey to guide them in creating a global website for people living with bipolar depression. The survey can be taken online, and participants can remain anonymous if they choose. The survey closes June 30, 2008. The survey hopes to find out: 1. What people with Bipolar think are the most important types of healthcare information for them; 2. other key subjects of importance to people with Bipolar; and 3. What people with Bipolar think sets them apart from other people with a mental health condition.

(This takes a few minutes to fill out, but how often does anyone even ask what we think about the quality of information available to consumers and their loved ones, and the quality of the care we receive? Almost every question has a field where you can leave comments. Take the time to take this survey. Maybe someone is listening.)

Healthy Ideas to Manage Life's Pressures

2008-05-18T20:11:00.000-07:00

So we know it's all not going to be a carousel ride, don't we? How we handle the ups and downs of day to day living can profoundly affect our mental and physical health. With a brain already chemically out of balance, any disruption can seem unbearable; even missing a meal or not getting enough sleep can spiral into something much worse. Let's think of some ways to take care of ourselves, shall we? (With a little help from Mental Health America...)

Connect with others. You don't have to cope with stress or other issues on your own. Talking to a trusted friend, family member, support group or counselor can make you feel better. Spending time with positive, loving people that you care about and trust can ease stress and improve your mood. (duh. Going it alone sucks.)

Relax your mind. Each person has his or her own ways to relax. You can relax by listening to soothing music, reading a book, or doing a quiet activity. Also think about deep breathing, yoga, meditation or massage therapy. (I'm all over that massage thing.)

Exercise. Exercising relieves your tense muscles, improves your mood and sleep, and increases your energy and strength. In fact, researchers say that exercise eases symptoms of anxiety and depression. You may not even need to exercise intensely to get the benefits of activity. Try taking a brisk walk or use a stationary bike. See what it takes for you to feel better. (If you answered "not exercising" you are not trying.)

We'll continue this discussion later.... You can check out Mental Health America here.

Happy Mother's Day

2008-05-11T21:31:00.000-07:00

Although this post might be better saved for Father's Day - I happen to be reading David Sheff's book Beautiful Boy - A Father's Journey through his Son's Addiction. Although I've been lucky and haven't had to deal with this issue as a parent (not drug abuse, but addiction,) I can't help but notice the parallels with dealing with a child with mental illness. Consider this paragraph in the introduction:

"Like many in my straits, I became addicted to my child's addiction. When it preoccupied me, even at the expense of my responsibilities to my wife and other children, I justified it. I thought, How can a parent not be consumed by his child's life-or-death struggle? But I learned that my preoccupation with Nic didn't help him and may have harmed him. Or maybe it was irrelevant to him. However, it surely harmed the rest of my family -- and me. Along with this, I learned another lesson, a soul-shaking one: our children live or die with or without us. No matter what we do, no matter how we agonize or obsess, we cannot choose for our children whether they live or die. It is a devastating realization, but also liberating. I finally chose life for myself. I chose the perilous but essential path that allows me to accept that Nic will decide for himself how -- and whether -- he will live his life."

As I continue to come to terms with my son and his illness, I have come face to face with this decision. I sometimes wonder if I have the courage to let go - or if I will keep trying to save him from himself indefinitely. I do this not only at the expense of my health and well being, but also at the expense of others that I love. Others who often deserve more of my attention, while I'm busy worrying about my boy. It's a posh kind of selfishness - this mother obsession. My son will be 24 this year; not only is he an adult in every socially recognized way, but he is a married adult. He will most likely continue to make decisions that I think are irrational - he will continue to lie reflexively (a maladjusted protective strategy that works too well to be abandoned,) he will continue to fly by the seat of his pants, forget his medication and fight with his spouse. The question is: Will I continue to live on the edge of the precipice fearfully awaiting the next hysterical phone call? Or will I choose to lead my own life? Can I let go and simply let him live his?

Happy Mother's Day.

Hiatus due to insanity....

2008-05-04T18:52:00.000-07:00

Typical exchange: A - "How've you been?"
B - "uhhh, well you know."
A - "That good, huh?"
B - "Life with mental illness."

I feel like I'm eternally on the edge of the abyss. The stupid worst of it is that the better things seem to be, the closer I feel to falling off. I've learned that this is often truly the case, and so I now suffer from a sort of constant negative paranoia. When I don't hear often from my son, no news is definitely not good news; it's just the quiet before the hysterical phone call from his wife. It's not a question of IF something bad will happen. It's a question of WHEN. I'd say conventional wisdom will give that quiet period an average lifespan of six months. Tops.

It doesn't matter that I've worked hard to educate myself about the nature of his disease (and probably hers as well,) and for that matter, my own. When the doodoo hits the fan, I'm back to square one. Back to being pissed off. Back to wondering if I'll ever have a life of my own, free of the day to day drama of theirs. Back to a grief so deep I think I'll never stop crying - that I am the cause of his suffering, the carrier of mental illness, that I passed this on to him and probably made it worse by every parental failure. Back to the futile sense of responsibility and the desire to fix it, somehow, someway. This usually pulls me full circle back to pissed off - that someone who is chronologically an adult can do such bonehead things, make such awe inspiring errors in judgment and then put the cherry on top by lying about it.

I'm being selfish here. I'm struggling with my own depression, the beginning of summer when my husband is away for the better part of four months, living alone for essentially the first time of my life, weight and health issues and trying to redefine myself with an empty nest. I was pretty wrapped up in all of that and having a nifty little pity party when the phone call came. Now I'm in the limbo of waiting to see what they will decide to do with the newest crisis. My self assigned role as their main support means I must remain rational, reasonable and available. I try.

But although I never miss the onset of crisis, I'm rarely in on the work of it. I hope that they are talking, that the rush of discovery and accusations has been replaced with the labor of staying committed to one another despite the obstacles. Marriage is damn hard work. Marriage with mental illness in the mix? I believe that they love each other, despite his knee jerk habit of lying to her and despite her knee jerk habit of saying it's over. They've been through a lot and still come out together. I believe they can handle this. I hope they can. And I'll do my best to handle whatever comes out of this. Life with mental illness.

Check it out

2008-04-10T03:23:00.000-07:00

What little most of us know about mental illness, we probably picked up from watching TV or from the movies. Unfortunately, these impressions are usually pretty ridiculous - the mentally ill are portrayed as dangerous killers or laughable buffoons. Let's face it, few people bone up on the subject until it intrudes into our lives; but intrude it does. Everyone knows someone with a brain disorder. The quiet coworker, the eccentric aunt, the lifelong friend who has suddenly changed in some subtle way - mental illness is a fact of modern life that is kept in the attic away from public discussion. This needs to change.

But where do you start to look for real information? Trust me that a Google search on "mental health" is going to leave anyone pretty overwhelmed. Bipolar? Depression? Anxiety? We who live with brain disorder know that a diagnosis is not usually a simple thing. You may know that something is wrong, but what specifically? Look at NIMH? or NAMI? Heavens, there are a lot of initials and most of it looks pretty technical and confusing and you have to know what you're looking for.

Here is a site for that first search. Refreshingly simple and in human language, not medical-ise, it's aimed at folks 18-25 (most common age of onset) and includes a state by state search engine for mental health services, an overview of common disorders and real life testimonials of people living with these problems. "What a difference a friend makes?" You bet. Check it out...

Away from the Sun

2008-04-03T18:15:00.000-07:00

The dark times come and the dark times go. I try to stay upbeat. But you know there's not much looking good out there - and sometimes it's so dark inside, I don't know if I can keep breathing. So I'm on the treadmill (physical activity is supposed to help. Right.) And this song comes on the old ipod, and I realize I'm not the only one who feels alone in the dark... Away from the Sun by 3 Doors Down.

It's down to this
I've got to make this life make sense
Can anyone tell what I've done
I miss the life
I miss the colours of the world
Can anyone tell where I am

'Cause now again I've found myself
So far down, away from the sun
That shines into the darkest place
I'm so far down, away from the sun again
Away from the sun again

I'm over this
I'm tired of living in the dark
Can anyone see me down here
The feeling's gone
There's nothing left to lift me up
Back into the world I know

And now again I've found myself
So far down, away from the sun
That shines into the darkest place
I'm so far down, away from the sun
That shines to light the way for me
To find my way back into the arms
That care about the ones like me
I'm so far down, away from the sun again

It's down to this
I've got to make this life make sense
And now I can't tell what I've done

And now again I've found myself
So far down, away from the sun
That shines to light the way for me

'Cause now again I've found myself
So far down, away from the sun
That shines into the darkest place
I'm so far down, away from the sun
That shines to light the way for me
To find my way back into the arms
That care about the ones like me
I'm so far down, away from the sun again

Oh no...
Yeah...
I'm gone

So a song connects me back to the world. For now. How about you?

Misreading of Faces May be Risk Marker

2008-03-25T17:03:00.000-07:00

"Youngsters with pediatric bipolar disorder and healthy peers who have first-degree relatives with bipolar disorder share the same difficulty labeling facial emotions, NIMH researchers have discovered. Reporting in the February 2008 online edition of the American Journal of Psychiatry, the scientists suggest that the facial emotion recognition impairment might be part of an inherited predisposition to the illness.

Two related imaging studies traced face emotion labeling deficits in youngsters with pediatric bipolar disorder to weak connections and differences in activity of a brain circuit responsible for interpreting the meaning of social and emotional stimuli. Evidence suggested that the differences were stable traits, unrelated to effects of medications or mood states.

“Since we know more about the circuitry of basic processes like facial emotion processing than we do about the circuitry of complex psychiatric symptoms like mania and depression, it serves as a kind of Rosetta Stone for unearthing new clues,” explained Ellen Leibenluft, M.D., chief of the intramural NIMH Section on Bipolar Spectrum Disorders, Mood and Anxiety Disorders Program, which is conducting the studies.

Understanding such specific vulnerabilities in emotional processing may someday lead to improved treatment, diagnosis, and ultimately prevention of bipolar disorder in children, say the researchers."

Read the rest of the article here.

Let's Go To The Movies

2008-03-16T14:28:00.000-07:00

I have given some thought to how the mentally ill are portrayed in films. Mostly it's awful - another way in which our National Stigma Institute continues to pump out vitriol to support discrimination against a biological disease. "One Flew Over the Cuckoo's Nest" comes immediately to mind. Or "Psycho."

But a few films stand out in my mind as sympathetic. A few actually manage to shed a little light into the corners - educating as well as entertaining. So I thought I'd like to share some of my favorites:

A Beautiful Mind - Probably the most powerful look at the functioning life of a paranoid schizophrenic that you'll find. Furthermore it addresses the issues of what constitutes recovery. Russell Crowe was brilliant...

Reign Over Me - This look at Post Traumatic Stress is genuine and sympathetic and Adam Sandler and Don Cheadle are wonderful.

Mr. Jones - Richard Gere stars in a very real portrayal of Bipolar Disorder. Points off for romantic involvement with his doctor, but still really good.

As Good As It Gets - Jack Nicholson (who usually just plays himself) portrays a rather crusty case of Obsessive-Compulsive Disorder in this delightful film. It's all about acceptance, folks.

Off the Map - This one is a little out there, but it shows an intimate portrait of clinical depression even if the characters are... shall we say... different. Starring Sam Elliot and Joan Allen as a couple living a minimalist lifestyle with a precocious daughter and a confused IRS agent in the mix. I found this film realistic in it's interpretation of depression and its impact both on the sufferer and those around him. It's a little bit of a fairy tale, but I enjoyed it.

I'll try to think of more.

Famous Faces of Mental Illness

2008-03-12T00:40:00.001-07:00

"For many years, Margaret Trudeau thought her up and down moods were just part of her life. After all, her story resembled a movie script. She won the heart of Canadian Prime Minister Pierre Trudeau while vacationing as a teenager with her family in Tahiti, and at the age of 22, became the youngest First Lady in Canadian history.

She was one of the world's most glamorous and scrutinized women in the '70s, an A List celebrity as capable of attracting headlines as Princess Diana.

"I thought my life was just taking me high and low," she says. "I had been given so many rich opportunities in my life."

In 2001, Trudeau ended years of denial and checked herself into an Ottawa hospital where she was diagnosed with bipolar disorder. Five years later, when she felt her recovery was as complete as it needed to be, Trudeau announced at a hospital fund-raiser she had been struggling with bipolar for years, and had been misdiagnosed for decades.

Consider this the latest chapter of Trudeau's remarkable life: She's an eloquent and compelling advocate for people with a mental illness, in particular those living with bipolar. Instead of running from reality, she flies across North America to discuss that reality with eager audiences. Now she uses her celebrity (celebrity she says once used to be "infamy") to bring attention to world-wide causes.

"Bipolar is an exaggeration of your emotions, so when you do get knocked down by life -- which you will because everyone will be knocked down at some point -- it's very hard to bounce back. Some people can live with sorrow for awhile and get on with their lives. I didn't have that ability. I got very knocked down and it was very hard for me. What learned is that it's awfully hard to do it on your own.

"And that's my message: to reach out and get help."

Read the entire article by Charles Anzalone here.

Blood Tests for Brain Disorders?

2008-03-01T14:13:00.001-08:00

According to an article for MSNBC by Steve Mitchell, we could be on the brink of genetic blood testing for mental illness.

"A blood test could be used to diagnose and assess the severity of certain mental illnesses, such as bipolar disorder, according to a new study. But some experts think this raises ethical concerns about prying into a person's mental status.

Lab tests that can accurately detect mental illnesses have long been considered the “Holy Grail” of psychiatry. Currently, bipolar disorder and other conditions such as depression are diagnosed based on the patient's description of their symptoms and the physician's judgment, sometimes making it difficult to get an accurate diagnosis or determine the severity of a patient's condition. But now researchers have shown that 10 genes that can be detected in the blood could provide a better way to assess a patient.

“Patients aren’t sure how ill they really are, and neither is the clinician — sometimes dismissing their symptoms, sometimes overestimating them,” said Dr. Alexander Niculescu, III, a psychiatrist at the Indiana University School of Medicine in Indianapolis, who led the research published Tuesday by the journal Molecular Psychiatry. “Having an objective test for disease state, disease severity, and especially to measure response to treatment, would be a big step forward.”

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