10 Ways to Reduce Anxiety... Part 1

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

"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

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?

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

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

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

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.