A New York Times Article on Military Suicides, and Another Gratitude List

November 26, 2009 at 7:13 am | Posted in Uncategorized | Leave a comment

The New York Times published an article today on military suicides that’s surprisingly similar to that published yesterday in the Wall Street Journal, right down to the closing quote from the soldier’s father. It makes you wonder: has the Times stooped to merely echoing the Journal, or (and I think this is quite likely) did they both get the same talking points memo from a lobbying organization and write similar stories because they had access to the same sources? It makes you wonder. I think it’s an important story and I’m glad that both papers chose to cover it, but the fact that two major papers published such similar stories within a day of each other says something pathetic about the state of journalism in this country. When I was a kid, damn it, my high school newspaper would have been ashamed to publish a mere follow-on story like that in the Times.

Okay, enough grumbling. The fact that both papers have demonstrated some commitment to fighting the stigma surrounding mental illness ought to please me. And does please me — I’m not ungrateful.

Early this Thanksgiving morning is an excellent time to write another list of things for which I am not ungrateful (for some reason I’ve been inclined to double negatives this week). I find that this exercise really does help me to tune in to the blessings in my life, and to turn down the volume on the 24-hour Eyore and Grouch channels in my brain. So, here goes:

1. I am ever so grateful for my delightful family. I wish my sister and her family were here in Cloudcroft this morning.
2. I am thankful to be at my folks’ home here in the Sacramento Mountains of New Mexico. True, the weather at home is exquisite and it’s mighty cold here at 9,000 feet, but there is at least a small chance of snow, and a large chance of deer or even elk.
3. I am grateful that so many neat opportunities are opening up for me at work.
4. I am grateful that the cat-sitting lady from Reigning Cats and Dogs was able to look after the lovely Julia and the sweet, timid Sky at the last minute so that I could come up here.
5. I really enjoyed holding Thanksgiving this past Sunday (or, rather, having my folks hold it) and getting to see aunts, uncles and a cousin whom I hadn’t spoken to in years in some cases.
6. I am both grateful for and alarmed by the Apple App Store. A side note: I am definitely one of those people who can’t just enjoy technological improvements — I’m always anxiously wondering if they’re sustainable, and if they will have some terrible long-term consequence, like turning my brain to mush or making me chemically dependent on a device the size of a deck of cards. My relationship with my iPhone really is unnaturally close. I mean, I’m surprised I haven’t named it.
7. That sounded ungrateful. I am grateful that my Aunt Sharon has launched a huge geneological study of my mom’s side of the family. I will be the first person to list “bipolar disorder” as a medical condition; may others follow suit if they are, indeed, bipolar. My latest theory is that my paternal grandfather was bipolar. My grandmother divorced him when my dad was four or so, and he seems to have led the life of an unreliable and itinerant man. So different from my upstanding (if moody) dad and deeply ethical grandmother. But that’s mere speculation — there may well be mood disorders on both sides of the family tree.
8. I am grateful that they still make office supplies like staples and paper clips, and that we do not yet live in a paperless world. I like paper, and I will miss it when it goes. In fact, I revel in all office supplies. Another divergent note: apparently my great-aunt Marion and great-uncle Bob did, too, since we discovered three lifetime supplies of staples and Scotch tape among their effects. My uncle Bob was an interesting dude — some day I will write a blog post just about him. Lately I’ve been taken with the idea of writing his biography. It would be a challenge, since he seems to have been agoraphobic, but I have long been fascinated with that deeply odd soul. A few tidbits: He gave me the Burton translation of the Thousand Nights and One Night when I was 11 or 12. Very instructive for a kid who was trying to make intellectual and emotional sense of sex. He commmitted suicide not long after that, I believe when I was 13 and going through my own first, mild depression. His scores on standardized intelligence and college entrance exams were supposedly phenomenal. Later in life he rarely spoke to my grandmother, and never to their sister Pat, whom they both cut off entirely for reasons that remain mysterious to me. He puzzles me. I liked him, and fear becoming like him.
9. Onward and downward. I am grateful that I read the collected works of Harlan Ellison around the time when I was learning to become a writer. Let me just run and check Wikipedia to see if Ellison died while my back was turned. Nope! Still kicking, and apparently as cantankerous as ever. Yippee! His writing would probably appall me now.
10. I am grateful for bifocal glasses.
11. I was just thinking yesterday how glad I am that modern fax/scanner/copy machines are so shockingly reliable. At work they spit out reams of paper a day, day in and day out, only making the occasional, modest request for a toner cartridge. Why, back in my day…
12. It’s nice being just old enough to justify my frequently patronizing and always curmudgeonly tone.
13. Shooting for 20 here … I still retain all sorts of gratitude to my beautiful and perfect cats. I should take a shot of Sky and publish it in this space, since his sister has already had that honor. Perhaps if I can catch him doing his special anti-anxiety mudra.
14. I am grateful that my employer uses a manufacturing calendar, and that we therefore shut down entirely between Christmas and New Year.
15. I had a lovely childhood, and I am very grateful for that. I was a very odd, moody, and sometimes violent child, but I was largely happy.
16. I am grateful that I seem to have come to terms with the fact that I am not Martin Heidegger. Let me explain. An old professor (and, alas, later boyfriend) of mine used to talk about how, when he was 27 and finishing up graduate school, he realized that he was not as brilliant as the German philosopher Martin Heidegger. His dissertation was on Heidegger, and the work seems to have driven that point home with particular ferocity. When I was younger, I was convinced that I would do great things — publish immortal poetry, revolutionize political and philosophical discourse surrounding rape … all sorts of ill-defined, unnamed Great Things. At a certain point, I realized that this was not to be. When I entered grad school I thought there was some chance that I could be Heidegger (or, rather, Kierkegaard) if I got cracking and made up for the deficits in my education. By the time I finished up in 2000, I knew that this wasn’t so. I am not the heroine of a novel, or even a likely entry in Who’s Who in America. I was a good professor, but by no means one who changed lives. I never suffered over this, though, and for that I am grateful.
17. I am grateful that my dear friend Al seems to be doing better. I love him very, very much.
18. I am grateful that a Sephora store opened up in my hometown, and that I can afford to shop there.
19. I am grateful that health care reform has moved to the Senate floor for debate.
20. I am grateful for the very idea of built-in bookshelves.

God, my head aches. That’s reason enough to stop here. I will make every effort to search out some good links later today, and perhaps come up with topics for more creative posts. A brief biography of Uncle Bob might be a good place to start.

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A Heart-Wrenching Story from the Wall Street Journal about a Soldier’s Suicide

November 25, 2009 at 11:29 am | Posted in Uncategorized | Leave a comment

…And a really rotten executive policy. According to this Journal article, the White House does not send letters of condolence to family members of servicemen and -women who commit suicide. That is a travesty. It’s terrible to think of people braving such dangers and suffering such losses — risks and losses that drive them to the desperate step of suicide — and being treated dishonorably in death. That enrages me. Barack’s website is in for a dose of vitriol later today.

More later.

Thank You So Much to All of You

November 25, 2009 at 4:58 am | Posted in Uncategorized | Leave a comment

People have been very sweet and supportive over the last several days — it’s very important for me to remember and acknowledge this. I’ve gotten text messages, emails, and even flowers, and all of these have lifted my spirits and demonstrated to me that people do care and I do make a difference in other people’s lives. It’s easy to forget that, or to persuade myself that it’s not the case. I will thank each of you separately, too, but I wanted to send a big shout out first.

I’m hoping to blog daily over the coming holiday. I have both Thursday and Friday off, and will be traveling with my folks to the mountains in New Mexico. They only have dial-up there, but there are internet cafes, and I have the patience of a spider. So expect to see book reviews, links, and, of course, more grumbling. I am also bringing Volume IV of the Liturgy of the Hours, the new book by Anthony Beevor on D-Day, my shrinky-dinks plastic (with which I make pendants), and my astrology books. Anna, who, along with her sister Mary takes care of my nail and brow needs, gave me her birth data, and I plan to hand-draw a chart for her over the weekend, an enterprise that can take up to 12 hours. It’s the least I can do — she and Mary work seven days a week, and are having trouble getting and staying ahead in this economy. They have tough lives, and I wish I could do more to help.

I found what appears to be an excellent book on anxiety, a sort of companion volume to John McManamy’s book on depression and bipolar disorder. I also found a new handbook on bipolar, and am bringing along one of the dozen or so workbooks intended for us bipolar folk…

…I just spent the last 45 minutes writing intensely about a subject that I’m not sure I’m ready to address publicly, since it means getting specific about some of the meds I take. We’ll see. In the meantime, know that I am so serious when I give my love to all.

In Which I Embrace My Inner Mean Parent

November 24, 2009 at 4:43 am | Posted in In the News, Links, My Fascinating Mood, Philosophical Problems | Leave a comment

Here’s an article from The New York Times on how to seek mental health help when money is tight. There are some good suggestions in here, but I would recommend that you try them only if you’re experiencing what they quaintly call “deep malaise.” For anything more serious — what? Emigrate to Europe, perhaps.

I am woefully far behind on the whole health care reform issue, although I read in the selfsame Times this morning that the despicable Sen. Lieberman has vowed not to vote for anything with a public option attached. My advice to the democrats and the president: Don’t whore yourselves out looking for his support.

What else? My mental health continues to improve, and I continue to be humbled by the violent upheaval depression can cause. It will be awhile before I reach that calm, even arrogant advice-giving place that I occupied so comfortably for so many weeks here. My shrink’s advice in these troubled times: Have compassion for myself. I told her that I’m not even sure what that means — it strikes me rather like those bumper stickers that order me to Thank a Cop. I can puzzle over those for five minutes at a time while whizzing down the freeway. I understand the order, obviously, but I don’t get the sentiment behind it.

I failed to explain two things to her: first, why I like myself less and less with the passing years, and second, the importance of what she calls my “inner mean parent.” Both points are important, and both contradict conventional therapeutic wisdom that I must love and pamper myself. Let’s start with the last.

I am still a tremendously disciplined person. I am still 10 minutes early for everything, and not just because I have a mechanical watch that runs fast. When I was a kid, my dad taught me both by precept and by example that you should always be 10 minutes early to work — you settle in, disposition your jacket and your lunch, and fire up your computer on your own time, not on company time. You show up early for a job interview, not on time. Showing up early communicates respect, and also demonstrates discipline and a willingness to give your all to your job while you’re there.

This code of conduct also demands that you show up to work unless you’re vomiting or suffering extreme intestinal distress, and that your lunch break be precisely 30 minutes long — not 35, and certainly not 65. You give the company just a bit more than it formally demands, and in return you get not just a paycheck, but the satisfying conviction that you’ve earned it. My mom was always the same — there, early, and ready to get cracking. Conscientious. As they would both tell me, following Woody Allen, 90 percent of success is showing up. Neither parent was a workaholic, but both were present and hard-working. They cared about their jobs and felt that it mattered to get the details right.

This ethic has served me well. It’s the reason why I always get offered the job after working temp, and why I passed my qualifying exams with distinction. I really believe that I wouldn’t have made it as far as I have, and would not be as functional as I am if I hadn’t embraced this work ethic. And I’ve lived up to this ideal, not by being compassionate with myself, but by being disciplined and, to a certain extent, self-denying. That’s one thing I really liked about Get It Done When You’re Depressed, a book that I reviewed and recommended in this space. The author orders you to embrace your “inner drill sergeant,” and places a value of productivity for its own sake. It’s good to get things done, and hard work will serve you better than tender regard for yourself.

I may be totally wrong in this — I may well be hanging my pathology out the window for all to see right about now. But, damn it, it isn’t easy to stay off the streets and out of jail when you’re bipolar. In many ways, it’s a damn sight easier to give in to the little voices that tell you to take it easy (voices which St. Augustine would identify as sin speaking). If I followed my deepest inclinations and took it easy, I wouldn’t go to work at all. I wouldn’t soldier myself out of bed and off to the pharmacy when I run out of a crucial medication. I wouldn’t bother to sit here tapping away many mornings when I could be sleeping in or clicking around on You Tube. For me, my discipline — my inner mean parent, my overactive superego — has saved me from a much worse fate. I really believe that, and blaming either my inner or actual parents for my depression amounts to fighting words.

This is closely connected to how I’ve changed for the worse over the course of my illness. Allow me to explain by telling a little story.

By common consent, my family celebrated Thanksgiving this past Sunday. A cousin of mine was in town from Alaska, and it was more convenient for him and his parents, my aunt and uncle, to pick up the the turkey and trimmings and transport them to Sunday.

My cousin is about five years older, and he has clear memories of visiting my family in St. Paul when I was two or so. I learned to talk at a bizarrely young age, and though my elocution was not clear, I was voluble and opinionated. One of his clearest memories of the visit is of me talking persistently and energetically during his entire visit.

As he told this story on Sunday, I smiled silently down at my plate. Up until I was about 30, both of my parents used to say that I started talking at 18 months and hadn’t stopped since. Except, I did stop. Have stopped. I spoke very little on Sunday, and am generally quiet to the point of seeming odd. As I tried to explain to my shrink yesterday, at some point my light simply went out. I lost the exuberance which was one of my most notable qualities from earliest childhood.

What happened? “The depression was such a punishing experience,” I told her. And that word choice was not a slip — depression has seemed to me like an arbitrary, cruel punishment. Thus, she concluded, my harsh inner mean parent.

This isn’t totally accurate, however. I lost the enthusiasm that propelled me out towards life, that helped me to embrace my work and the world. The overactive superego is what keeps me going. The depression isn’t the result of my superego; rather, my superego is the last bit of me left standing in the storm.

Well, that’s probably all wrong, and I’ll almost certainly repudiate it over the next several weeks as I get deeper into therapy and begin to pet and caress my self. And, in my doctor’s defense, I did decide to give myself a treat after my appointment — I bought tangerine juice and a bouquet of gladiolas at Trader Joe’s on the way home. These treats did please me.

That’s enough for now. I’ll work on digging up more links later — I have almost 300 items waiting in my blog feed, so I’m sure there’s some great stuff out there.

Love to all.

After the Hurricane: Rebuilding

November 20, 2009 at 5:04 am | Posted in Uncategorized | Leave a comment

Perhaps the hardest thing about the end of a depressive episode is waking up and seeing what’s become of your life. I spent the last several months building a comfortable little place for myself in my new house, and now, after two and a half weeks, I’m standing in the middle of a wind-torn mess. There are ants in the cat food. My carefully tended garden has shriveled away. There’s wet laundry in the washing machine and I have no idea how many days it’s been there. The cats have thrown up here and there. Stacks of unopened mail jostle with dirty dishes on my desk.

All of that is nothing, though, compared to the damage I’ve done through neglect of relationships. One example: it’s been four weeks since I attended the class at my church that I started with such enthusiasm two months ago. I can’t go back, and I have no idea how to explain myself to the nice facilitators. I feel like it’s not enough to say, “I got depressed. I couldn’t leave my house except to go to work. I’m sorry.” First, it seems like they won’t understand that I truly couldn’t leave the house. I whipped myself mercilessly, and that got me to work most of the time. I really couldn’t do more.

And, too, I hate telling people that I’m bipolar, especially people I don’t know well. At work, during my educational talk, I do it as a political act — it’s hard, but my purpose is clear, and people see me performing at my best when I say it. At times like this, it feels both too personal to admit and like a lame excuse. It feels like exposing an intimate and deeply defective part of myself to public view. Bad enough that people can often guess that there’s something wrong. I can talk all day long about mad pride, but the fact is that I’m ashamed of what this disease makes me do, and it takes more strength than I have most days to try to explain why I can’t just go places and do things like normal people do.

It also feels like once I start talking I won’t be able to stop. I don’t want to go on and on about my problems; I just want to explain why I haven’t fulfilled a commitment. I want them to understand that I really am ill and not just making excuses; at the same time, I cringe at the idea of people knowing exactly how sick I am.

The net result is, I usually don’t explain myself. I just continue to avoid the people and situations that I neglected during my depression, and my social options narrow just a little bit further. It will be hard to go back to my church at all, especially since this is the second time that I’ve gotten involved in several activities and then disappeared abruptly. Essentially, I have to choose between exposing myself and running the risk of being judged and misunderstood, or simply disappearing. It’s a lot easier to disappear.

In these moments I often wish that I had the hubris of hypomania, and that I could whiz around repairing and untangling strained relationships with a touch. As it is, I’m feeling fairly fragile, and thinking about everything I’ve neglected is nearly enough to send me back to bed.

More later. This has been a tough post to write.

Things Are Getting Worse, Not Better — What to Do? What to Do?

November 17, 2009 at 5:23 am | Posted in Cognitive Problems, Wellness, Work Life | 2 Comments

Over the last several days, I have been wrestling with a difficult issue: in three crucial ways, I am getting worse, not better.

Most people around me deny it, but I know damn well that my cognitive problems are getting more serious. I’ve gone from mild difficulties with word recall to forgetting that entire conversations ever occurred. This has led to several incidents at work ranging from embarrassing to near-catastrophic, and I am afraid — and I think this fear is realistic — that eventually I may not be able to work.

I’m also becoming more withdrawn socially, and this affects me in a couple of ways. First of all, during my depressed phases, I find it nearly impossible to carry out commitments I’ve made. For instance, if I sign up for a class, as I did at church, I know damn well that depression will prevent me from finishing it.

At the same time, because of my bouts of severe depression, I find it hard to maintain the social supports that I need. When I am truly down I simply withdraw. I can’t talk to people that I don’t know well or enter unfamiliar social situations. I don’t have a good social network now, and despite my best efforts, I don’t seem to be able to keep it together long enough to expand it.

All of this leads to a larger existential question which I will certainly not answer today, but which I’d like to pose to you, the readership: I think it’s fair to say that my adult life up until now has not been a happy one. I’ve been crushingly depressed, in and out of hospitals, and unable to maintain the sort of stable relationships that preserve sanity. Given that things are getting worse and not better, what kind of quality of life can I expect as I grow older? It’s unlikely that I will enjoy a fruitful retirement that includes a loving spouse, friends and hobbies, and travel. In fact, I’m facing the very real possibility that I may not be able to work to retirement age. If my life was unhappy at the height of my intellectual and social powers, what is it likely to be in the future? Tied to this is the question of what I have to offer potential friends or a hypothetical spouse.

As I said in my last post, both of those questions may be the wrong ones to ask if, as I suspect, the answer could lead to further depression. I don’t want to torture myself with unanswerable questions or insoluble problems. So I’d like to set the larger issues aside and start with a relatively concrete piece: my cognitive lapses.

First, what am I doing already to cope? Well, at work and at home I keep detailed lists of things to do, and this does help to prevent any given task from falling through the cracks. I’m also extremely organized. I do not count on memory to help me to locate files, for example — I just file them properly. These two strategies are not enough, however, since I tend to forget either that I’ve had a conversation regarding a particular issue — say, that I’ve asked the preparer about the status of a data deliverable — or I can’t remember what was said a day later.

So what else could I be doing? I could document every conversation that I have, or conduct all important conversations via email. However, the first is a little too obsessive even for me, and email is often not the most effective way to either get information out of people or get them to take action. So I’m not quite sure what to do.

When I don’t know what to do, I look for resources that will tell me. So:

1. If my shrink can’t help, maybe there’s a local therapist or psychiatrist who specializes in dealing with early memory loss. I can ask my therapist for a referral, and I can Google local resources.

2. I can also call the Employee Assistance Program at work, which is amazingly efficient when it comes to finding everything from cat-sitters to house cleaners. Granted, this is more serious than finding a good accountant. Nonetheless, it might be worth a try.

3. I also wonder if there are books that address these problems. I’ve never seen anything in a book on bipolar disorder, though the research shows that cognitive problems are inherent in the illness. People do have memory loss for other reasons, however: chemotherapy, normal aging, and the various forms of dementia being obvious examples. So it might be worth my while to search Amazon for books on coping with memory loss.

One thing is for sure: I can’t continue to pretend this isn’t happening. It’s a threat to my livelihood, and thus to the core of my identity; I need to confront it, and to try everything in my power to reverse or compensate for my cognitive deficits.

So here’s the plan: I will hit Google, the EAP hotline, and Amazon, and report on what I find. I will also continue to write about these three intertwined issues, as frightening as they are.

Odds and Ends for Your Delectation

November 15, 2009 at 5:55 am | Posted in Dealing with Depression, My Fascinating Mood | 2 Comments

The last two weeks have been damn rough, in case you haven’t guessed. I’ve been largely silent because my mood fell off a cliff two weeks ago, and I have a hard time saying anything at all when I can’t say something nice. There are so many excellent bipolar blogs in which the authors share their anguish eloquently — here I am trying to remain realistic but upbeat, and upbeat hasn’t been a part of my repertoire for the last several days.

This morning I reread this entire blog, partly hoping to benefit from my own advice. Such good suggestions. If only I had the power or conviction to follow them, I’d be well on the road to recovery. As someone — I think William Styron — once wrote, depression is annoying to outsiders partly because when you’re depressed, if someone put a pill that would instantly cure you across the room, you wouldn’t — couldn’t — bestir yourself to pick it up and take it.

When I came to my shrink talking of hopelessness and helplessness, she took the usual steps: we restored a medication that I’d dropped, then she lectured me on wellness. I wanted to smack her, which leads me to wonder how many of you have wanted to smack the Pollyanna me on occasion. It’s odd, though, that someone with degrees in both psychology and psychiatry wouldn’t understand that when I’m depressed, I’m in no shape to reach out and establish a support network. She also chirped that having a spouse and children can provide insurance against severe depression. Thanks. If I should ever remarry, my chances of divorcing again are twice the already miserable 40-50%, and I have a genetic illness that precludes me from reproducing responsibly. I would expect greater sensitivity from one who often waxes earnest about the need to have compassion for my inner child.

(By the way, I know that bipolar people do have actual outer children — sometimes even deliberately. Some may even prove to be excellent parents. But it would tear my heart out to see a daughter or son of mine suffer the torments of the damned because I wanted the love, companionship and long-term eldercare that children can offer. I have always wanted children, but I will never have them.)

So. Friday’s head-shrinking conversation wasn’t tremendously helpful. The medication change seems to have worked, however — I am ramping up on my mood stabilizer again, and am already a good deal more sane, if still disgruntled.

So I’m back here, having suffered a reminder that the advice that I give here can be fruitless when one is truly, crushingly depressed.

I took notes as I re-read: here are some of the fruits of my self-review.

I must blog more resources on the health care reform bill that passed the House. I actually had a chance to meet my Congresswoman last week and thank her for her “Yes” vote. Digression of misery: She is so impressive — such an excellent extemporaneous speaker, so charismatic. And a year younger than me. Grr. I used to be impressive. In fact, I’m still a damn good speaker. But, oh, sometimes I would give anything to have my whole brain back. These cognitive deficits are humbling, humbling. In any case, I will make a point of rooting up some resources for those of you who have a little time to kill by mastering the details of a bill that is, apparently, longer than Richardson’s Clarissa, a novel that took me two weeks of eight-hour days to complete when I was studying for my qualifying exams.

2. A tough question: What can you do, what hope can you nurse, if your life has not been a happy one, and it seems to be getting worse, not better? That’s a hell of a question, but it’s the one that I ultimately face. I feel like I need to think that one through in these pages. There may not be an answer, or it may be the wrong question entirely, but I need to at least take a whack at it over the next couple of days.

3. It is beneficial and easy to keep a gratitude list. Studies show (doesn’t that assertion just make you bristle?) that people who regularly and explicitly count their blessings gain from the exercise. So. You don’t need to do it every day, but every now and then sit down with paper and pen (or laptop and keyboard, or iPhone and finger) and list 10 things that you’re grateful for. Here are mine for this morning:

1. My lovely and excellent cats.
2. My exceptionally cool dad, who ran in the eights yesterday with his home-built race car. That is to say, he topped 150 in the quarter mile, roaring down the track in just under nine seconds. That’s fast, and it’s a tribute to his amazing, self-taught engineering skills. Mom, Dad, email me a photo that I can attach — I’m that proud.
3. My outstanding mom, who quilts, paints, and has so mastered Suduko that she is entirely over it.
4. My sister, who forged the way for both of us to become Christians, though admittedly of very different denominations.
5. My garden, which is small and shabby, but which is still an amazing creative outlet.
6. A Beacoup Conge, the local bead store. Every time I go I see new and vintage beads gathered from around the globe, and the helpful and talented staff often warble along with the radio out of sheer high spirits. The bead store is definitely one of my happy places.
7. My thesaurus. My journalistic training has drilled me in avoiding the temptation to deploy the same words over and over. Therefore the thesaurus lives right here by my desk, and I’m not afraid to use it.
8. The Central Arts Collective, which has a wall of art under a hundred bucks. I recently bought a delightful framed photographic print by an artist who composes brilliant abstractions by shooting close-ups of rust and other forms of weathering. He was so happy to sell the work, and I was so happy to buy it! If you can buy, beg, or steal original art, do.
9. I am trying to add “my job.” It’s sort of a dysfunctional relationship, but I know that the structure and the social challenges are ultimately beneficial.
10. The New York Times, which I read free online.

As often happens, I am tempted to go beyond 10 items. So a couple more:

11. The sunrises and sunsets here in my hometown, which really are remarkable. Visitors are knocked speechless, and even natives will call to each other and crowd outside excitedly during an especially amazing show.
12. Root candles, which smell delicious and are actually made by a several-decades-old privately held company that manufactures ecclesiastical candles as well as ornamental ones. When I complained about poor wicks in one batch of votives, they responded to my indignant email with personal concern and sent me a free candle in my favorite scent, Victorian Fantasy. And how’s that for an evocative name? Because of the folks at Root, I live in a permanent cloud of Victorian Fantasy.
13. The teachers who drilled me so mercilessly in grammar and other aspects of good writing. Talent is nothing without craft, and this blog is the result of decades spent honing my craft.
14. My iPhone. I know it’s shallow and consumerist to have a love affair with an expensive gadget, but it’s so attentive that I’m pretty sure it loves me back.
15. Pandora free streaming radio and the music genome project that makes it possible. I’m listening to my station, Music for Cats, right now. Through my iPhone.

And as I reflect upon my position — sitting in my condo, listening to my homegrown radio station, within earshot of loving cats (why does Julia make those weird grunting noises all the time? I can hear them from the next room), with art on the walls and the internet at my fingertips, I feel that perhaps everything will be all right. It’s true that I have no kids, no husband, a precarious grip on my profession, and a bad migraine, but I really do have a lot of cool blessings. Bringing them to consciousness occasionally is an excellent exercise.

Another random note from my legal pad: “My conversation with Mom and Dad about the genetic causes of bipolar disorder. Possible evolutionary advantages?” Now that’s a post I may well never write. My interest in sociobiology is limited at best, based as it is on equal parts speculation and wishful thinking.

Next: “Optimism mood-tracking software.” Um, yes, that. I sort of fell of the wagon — I usually do when things get bad, it’s that whole overwhelming business of having to mouse-click on an icon — but I will get back to it! I will!

More: “How amino acids, vitamin B, and fish oil are working.” Not well, thanks. Though the nasty cracks at the corners of my lips healed once I started seriously supplementing B vitamins. Otherwise, though, these supplements appear to be an expensive boondoggle.

“My programmable thermostat — status.” Oh, right. Well, I haven’t learned how to program it, but I did figure out how to run it like a regular thermostat. The first step was remembering to flip the circuit back on. From there, everything else was a piece of cake.

“The relief I experience — and don’t experience — while kidding around” at the disabled people’s group at work. It’s very freeing to be able to crack jokes about disabilities, and disabled people are generally the first people to get off a zinger when conversing among themselves. However, in our group I am one of a very few people with a hidden disability, and the only person I’m aware of with a serious mental illness. This gives me a bit of a sense of restraint. After all, being legally blind, for example, doesn’t automatically grant understanding and empathy for those of us whose thoughts are so very deeply weird. So I enjoy the company of my wry disabled work friends, but I remain conscious of a certain difference and distance, too. I can’t know what it’s like to have a visible disability, though I understand intellectually that the discrimination is outrageous. At the same time, they can’t know my daily struggle to render myself acceptable to the more normal folk around me. That desperate and always unsuccessful effort exhausts and alienates me in ways that I can’t even begin to explain.

That’s enough for now. As usual, just when I thought the springs of inspiration were at the lowest possible ebb, I find myself filled to overflowing with commentary and, yes, complaints. I think I will go make another bead project now.

Mental Health Parity, Depression as Specialness, and the Difference Between Mental Illness and Terrorism

November 10, 2009 at 4:57 am | Posted in Fighting Prejudice, In the News, Philosophical Problems, The Heath Care System | 1 Comment

In all the excitement over heath care reform passing the House, it’s easy to overlook another huge (if equivocal) step: the mental health parity law that will take effect next year. The New York Times offers this sweetly naive guide to taking advantage of mental health care under the new system. I’m not sure that my advice would be any better, but, man, there’s something downright dewy-eyed about suggesting that we “be pushy” in asking for care.

A little background: the law requires that large employers offer the same coverage for mental health and substance abuse programs as they do for physical health. The practical results are twofold. First, many plans will remove arbitrary limits, such as caps on the number of appointments available for mental health care. My employer-provided health insurance will be doing just that, in fact. I haven’t checked specifically, but I wouldn’t be surprised if they’ve taken another common step, which is to throw up additional barriers to care, such as requirements for precertification. The Times’ advice on how to negotiate the system? Well, it’s sensible. Be persistent. Make those phone calls. Negotiate lower rates with your provider.

Unfortunately, when people are suffering from depression, anxiety, or chronic mental illness such as schizophrenia, it’s difficult if not impossible to take these steps. One book that I read on bipolar disorder (I wish I could remember which one) explained precisely why bipolar people are typically at a disadvantage when making calls to a customer “service” line: difficulties with short-term memory and executive function make it hard for us to organize our thoughts and follow a complicated, emotionally charged discussion of the sort required to get precertification. Your hatred of calls to 800 numbers is not mere whim or laziness — we are actually at a disadvantage when it comes to these sorts of conversations, and it’s natural that we should dread and avoid them. Thus it’s cruel — but not surprising — that insurers will require us to go through such an exercise before qualifying to receive help that we desperately need. Just another one of the sweet ironies of mental illness.

Over on Knowledge is Necessity, John McManamy considers a problem that we’ve all wrestled with: Is my depression pathological, or is it a fundamental part of who I am? Is there some sort of trade-off that is lost when we erase depression? I find myself thinking, Hell, no, there’s no value in depression. I want to pop that happy pill and dissolve this “deep” self. Of course, if a biotech cure for bipolar disorder were available, I would happily serve it to any children I had with breakfast; some people would consider this one step in genocide of a special population; I would consider it a mercy. I can very much understand the first view, but I would definitely rather be healthy than special, and I wouldn’t wish this sort of specialness on any child of mine.

That last was part of a wide-ranging discussion I had with my parents on Saturday, a conversation that covered everything from my Dad’s advice on how to handle freeway tailgaters to how we cope with choosing the slow line at the grocery store to why micromanagement is so agonizing to the managee. I wish I had a transcript or a YouTube video for you all — perhaps we’ll record future conversations for podcasting purposes.

McManamy recommends Therese Bouchard’s blog Beyond Blue, and, boy, so do I. She’s focused on wellness, but acknowledges the mourning process involved in accepting a chronic illness. It’s a good combination of reminiscence and practical advice, most recently on combating anxiety.

Philip Dawdy at Furious Seasons feels no empathy whatsoever for the Ft. Hood shooter, calling him a “loser” and a “domestic terrorist.” Hmm. I’m surprised that someone who covers mental health news so closely would fail to see the tragedy of Maj. Hasan’s situation. It’s easy to feel for the victims, and to be inspired by the courage of the first responder who ended the disaster at the cost of an injury to herself. To me, however (and feel free to spray vitriol at me for this position), if we hope to end the War on Terror more successfully than we did the War on Drugs (remember that?), then we need to understand how trapped and desperate Hasan and many other Islamic people feel both in the U.S. and abroad.

Hasan believed that he would be sent abroad to fight people of his own apparently deeply held religion, perhaps at the cost of his soul. Setting aside souls for the moment, it’s not a bad exercise to imagine how you would feel if you had to fight against American troops, and if that war were promoted precisely as an ideological battle against, say, capitalism and democracy. Not so easy, hm? Sure, it’s a volunteer army and he may have been able to claim conscientious objector status, but do you think that in his position he really got accurate or helpful advice about how to do that? In all honesty, I think that his situation was genuinely tragic. Obviously, shooting up Ft. Hood was not the answer. But imagine how trapped he must have felt to even consider such a horrific step.

In the end, I believe that this is how the debate will go surrounding Hasan’s act, if there is, indeed, a debate. Commentators will paint him as either “crazy” — i.e., entirely irrational and inexplicable (unlike “mentally ill,” which implies a diagnosis and an effort to understand) — or a “terrorist.” Both labels are designed to allow us to ignore the very real contents of his madness and disaffection, and to avoid considering how the institutions around him shaped his actions. A professor of mine at the University of Arizona who studied assassinations points out that when we don’t like assassins’ politics, we brand them crazy and ignore the crucial social and political dimensions of their acts. This prevents us from seeing and perhaps correcting the brutality of our own institutions and political discourse. We wouldn’t re-enslave Black people as a result of understanding why Boothe shot Lincoln, but such an understanding will prove a much more effective way of preventing domestic terrorism than simply branding terrorist acts as crazy.

To bring things to a more concrete level, I’m surprised at Dawdy’s stance because labeling Hasan as a crazy loser tends to worsen the stigma surrounding mental illness. If we reduce his act, with its undeniable political elements, to “madness,” then we obscure crucial facts about both mass murder and mental illness. The facts on the latter should be familiar to all of us: insofar as anyone has bothered to measure, the mentally ill are no more likely than the general population (whatever that is) to commit violent acts. To suggest that Hasan was just crazy is a very real insult to the mentally ill.

At the same time, mass murder may be difficult to explain rationally, but it is not mere madness, with no logic or reason behind it. Quite the contrary. Hasan’s logic is horrifying, but hardly difficult to follow. By refusing to follow or acknowledge it, we refuse to see ourselves, our weaknesses, and our institutions more clearly.

Enough of that. I realize that this whole discussion will be offensive to many of you, and I apologize for that. I do feel strongly, though, that this point ought to be made somewhere, by someone.

What Little I Know About Motivation

November 8, 2009 at 8:50 am | Posted in Dealing with Depression, My Fascinating Mood | Leave a comment

I know very little about motivation. I am, however, deeply intimate with its opposite, acedia, a feeling of jaded exhaustion so destructive that it’s considered a sin.

Acedia. Yes. The jaded sense of exhaustion that comes over me on a Sunday afternoon, and that can easily persist all week — or for two weeks — if I won’t or can’t put in the hard work needed to shake it off. When I’m depressed, which is most of the time, my default mode is physical immobility and a blank stare. It’s a huge effort to move, speak, and, at times, to look up. I get some relief when I’m actually engaged in a task, but as soon as the task ends, I lapse into a sad stillness.

I have dozens of gambits to lash myself into action, and I’ve recounted many of them here: breaking down a task into its smallest possible elements, setting a timer for 10 or 15 minutes and working just for that time, performing the elaborate anti-procrastination rituals found in The Feeling Good Handbook. At work I struggle constantly to stay active, to avoid falling into that silent, dazed stare which normal people probably find creepy. The thing is, when I get home from work, I sometimes resent hugely having to flog myself further to get anything done in my private life. I get tired of essentially tricking myself into action again and again, for all of my waking hours. Sometimes I long to just stare and let misery overwhelm me. The sensation this creates is painful, but it’s also easy, and sometimes I just need to do what’s easiest.

For the past two weeks, I’ve been unable to act much at home. Sometimes I manage to fool myself into some sort of activity, but more often I’ve just been drifting — falling asleep, or just lying in an agonizing daze from which I cannot seem to extricate myself. I did finally manage to shake this mood off on Friday, but I admit that I’m afraid of today. It is Sunday, and I can feel the abyss of inaction right there next to me.

So here’s a brief memo to myself. I hope that I will be able to cling to these words for the next several hours, and that they will buoy me up.

1. There will be times when you feel motivated and excited, but those times will be rare. Treasure them. It might be a good idea to jot down a few notes on what brought the enthusiasm on, and to see if you can reproduce it.

2. It doesn’t really matter all that much what you do, but you do need to do something. A week ago, I wrote on a loose scrap of paper: “Drive to La Encantada.” Then, several lines down, “Why?” Do not ask this question. While your actions shouldn’t be entirely random (in other words, you should have goals and pursue them), you needn’t choose the “right” thing to do. Driving to La Encantada might not be the optimum thing to do on a Sunday afternoon, but it beats staring at the wall. You can agonize all day about which item on your to do list is the thing that you need to do, the thing that will cure your unhappiness. Probably all of them can, or none of them. You can become absorbed in just about anything — even in walking around a pretentious rich-people mall like La Encantada. Human beings are meaning-making creatures, and you will construct meaning and even a smidgen of joy out of anything you do.

3. It doesn’t matter if you do the thing well. Of course, that’s not entirely true — at work they will probably insist upon some basic level of competence — but when you’re on your own time, you can afford to suck, to struggle, and to fail. You need not avoid activities simply because you might not be good at them, or the product might be less than brilliant. In other words, embrace making an ugly necklace.

4. You do not feel yourself into working. You work yourself into feeling. It’s not reasonable to expect to start every task with a rush of enthusiasm. Sure, when you’re hypomanic you’re overcome with excitement over every chance-met chore, but this is not your normal state of being, and if you wait for this state to descend over you, you will waste your life in a weltering pool of inaction. So act!

I feel that I should polish this a bit, but I’m losing momentum as I write. I think I will simply publish it, hoping that it will do some good as it is, and knowing that it’s better than not publishing at all.

3.

Book Review: Healing Bipolar Disorder and Depression Without Drugs

November 1, 2009 at 6:55 am | Posted in Uncategorized | Leave a comment

I would like to like every book I review here, and I would like to keep an open mind about wellness possibilities. However, I have to admit that Gracelyn Guyol’s Healing Bipolar Disorder and Depression Without Drugs pissed me off and, yes, depressed me. There are some valuable ideas in here, but they’re overshadowed by a dangerous emphasis on going entirely medication-free. I know that many people believe that it’s possible and even necessary to get off of psych drugs, but my own experience without them has been so downright terrifying that I get annoyed when writers suggest that you should just drop the drugs and start acupuncture. Or whatever.

The funny thing is, I’ve tried a lot of the alternative therapies suggested in this book, and, of course, none of them worked. I’ve taken every imaginable herb and supplement, been treated for yeast overgrowth and food allergies (neither of which I actually have), and had acupuncture. Each time I started out with a rush of enthusiasm, then ground to a halt as the depression returned or simply continued unabated.

These sorts of books have a fairly simple premise: depression and bipolar disorder are typically caused by other underlying conditions — anything from worms to unbalanced chi — and simple, cheap therapies will effect a miraculous cure. The author buys into the usual conspiracy theory that doctors don’t try these therapies because they aren’t profitable to the major pharmaceutical companies. Now, I’m just as cynical about big pharma as the next person, but you can’t tell me that supplement and herb companies aren’t raking it in by pushing 5-HTP, Chinese herbs, amino acids, and what-all. The New Age treatments that such authors always suggest are easily available, and I find it hard to believe that people wouldn’t be flocking to practitioners if any of these things actually worked. Of course, every chapter cites a couple of studies or an anecdote or two. The studies consistently lack control groups, however, or are sponsored by the very guy who just happens to have created the wonder supplement being studied. As a result, the book has a dangerous sheen of science, but actually relies primarily on anecdotal evidence to support many of its claims. A person could very well come away feeling that science shows that, say, reflexology can cure bipolar disorder. This is a dangerous belief, to say the least.

The opening chapters are probably the best researched, and seem to offer the best science. They primarily concern vitamins and amino acids, both of which are essential to the body’s ability to use psych drugs. In fact, I realized after reading the chapter on vitamin supplements that I had all of the symptoms of a B2 deficiency. It swiftly goes downhill from there, descending into a mishmash of Kerlian auras, chakras, prana, and every other known form of witchdoctoring. Don’t get me wrong — I believe that yoga, meditation, and perhaps even acupuncture can be beneficial. However, I think it’s incredibly irresponsible to suggest that any combination of alternative therapies can completely cure a good, solid case of bipolar disorder.

What enrages me the most is how much I want to believe. I found myself dog-earing pages on omega-3 fatty acids and glyconeutrients, and plotting a buying spree at the health food store. In the end, though, as much as I’d like to, I can’t believe. One of the worst things about having a poorly understood chronic illness is that people will suggest all sorts of goofy therapies. Some of them may even be mildly beneficial. But none of them is going to cure a lifelong, degenerative disease.

Grr. Enough of that. For some reason, I felt like I had to write that review before moving forward with this blog. The book depressed me and angered me a lot more than I anticipated, and I didn’t think it would be a pleasant read. I just hate to think of the alternating hope and despair that I experienced while searching for a diagnosis and cure, when, in fact, no cure exists.

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