Book Review: Unclutter Your Life in One Week

The cover of Erin Rooney Doland's excellent book on organizing.

In case you hadn’t guessed, I am a huge believer in being organized, and in self-improvement in general. Nothing jazzes me quite like a complicated project that promises me a bright, shiny new life of simplicity and ease. On a more practical level, I believe that bipolar folk need to have good systems in place to keep us functioning when depression strikes.

Imagine my delight, then, when I read a review recommending Unclutter Your Life in One Week, a summary of wisdom from Erin Rooney Doland’s Unclutterer blog. I ordered it immediately, even though I thought I didn’t really have a tremendous amount of clutter in my home. How could I? I moved into my lovely new condo at the beginning of May, and purged crap madly before packing.

Of course, I do, indeed, have a good deal of clutter at home and at work. Why, my excess beauty supplies would keep a small village clean and preened for a month; my file drawers at work are crammed with outdated papers and office supplies that past data managers have bequeathed upon me, including, to my dismay, transparencies for overheads (which demonstrate that people bored each other well before PowerPoint) and printable labels for floppy disks.

Once I realized how dire the situation had become, I plunged into Doland’s program, and found her advice to be excellent. I would give one caveat: the agenda for each day is crazily ambitious. Unless you want to bog down and get discouraged, I suggest that you set aside two or three weeks for the dramatic cleanup that she recommends. I’m also a believer in incremental rather than dramatic habit change, if only because I’ve committed to so many radical new plans only to discard or simply forget them in the hustle of daily life. Again, I recommend that you allow several months to implement all of Doland’s cool systems.

The book is divided into separate chapters for each day of the week, each one focusing on a different area of the home and office. She begins by telling you how to clean, simplify and organize the area, then gives a system for maintaining your progress and streamlining the activities associated with the area. So, for example, Monday is devoted to tackling your wardrobe at home and your desk at work, and to setting up a “reception station” by your front door that will give you a transitional zone that will keep you from bringing clutter like loose change and unopened mail into your home.

I tackled the wardrobe project on Sunday, and am still working on it sporadically along with my bathroom. It’s Friday and I haven’t even touched the kitchen or living room. Of course, my wardrobe situation had become pretty grim. I love clothes and shoes, and tend to accumulate them willy-nilly without much regard for fit or function. Following her instructions, though, I managed to pare down my holdings and tidy the floor and storage bins. I haven’t yet established a routine for getting dressed, partly because that entails purchasing at least one big item — a full-length mirror. Also, Doland’s goal with getting dressed is to save time — she believes that it should take no more than five minutes — while I actually enjoy putting together the day’s stunning outfit. So I’m modifying her plan to make dressing fun and sensual rather than simply fast.

Doland provides examples of several wardrobe systems that could work, and encourages you to adopt one that you will actually maintain. This is a real advantage over programs like Getting Things Done that tend to seem elaborate, rigid, and overwhelming to us mentally ill folk. Again and again, Doland emphasizes that the goal is productivity, not maintaining a system for the sheer pleasure of being hyper-organized and precise. This is crucial, since I tend to use things like to do lists to procrastinate and engage in obsessive-compulsive checking behavior rather than as productivity tools.

All in all, though there are plenty of other systems out there (many of which I’ve tried), hers ranks in the 90th percentile, certainly. The same is true of her advice on emailing, filing, and running meetings — her systems are certainly not the only ones, and perhaps not the absolute best, but they are an excellent starting point if certain areas of your life have drifted out of control. Doland’s book rises above the competition because she breaks each project down into tiny steps and shows you exactly where to start on what could otherwise be an overwhelming project.

There are two odd omissions: there’s no advice on organizing storage closets (mine is quickly descending into chaos) or junk drawers (ditto). I can happily turn elsewhere for these, though, so it’s no big loss.

Overall, Doland’s book is a valuable organizing tool. Even if I only follow one-seventh of her advice, my quality of life will improve, and I’m all about quality of life. Too, this book showed up in the mail at just the right time: when I was digging out from a depressive episode and becoming discouraged by the disorder around me. I’m ready for some good old-fashioned goal-directed behavior, and Doland’s book has provided structure and encouragement. So buy it and jump in, or store it until you’re neck-deep in clutter and desperate for a cure.

Love to all.

My Worst Worry: What if I Get Laid Off?

For me, there's something especially poignant about packing up the few little items that made your office seem like home.

The times being what they are, I fear being laid off. In fact, you could say that I’ve developed a morbid anxiety about the subject. Two nights ago I spent an hour staring out into space worrying with my cuticles and fretting about whether, like about half of my friends, I will be let go. A part of me feels like this would truly be the end of my life. So much of my identity is wrapped up in my work that losing it would feel like losing everything. So what to do?

As usual, it’s list-making to the rescue. Here are strategies that anyone can apply:

1. My first concern would be paying my mortgage, but the same step holds true if you rent: get a roommate. I am lucky enough to have a two-bedroom condo, but during a bad recession (so bad that it might even be a depression) it’s not a bad idea to try even if you can only rent out the living room. I did that as an undergraduate, and it can work. Sure, it’s uncomfortable and it will affect your privacy, but it will also halve the amount you pay for housing. Before you start advertising, though, make sure that your landlord or homeowners’ association approves; otherwise you and your new roomie could end up in hot water.

2. Register for unemployment payments immediately. As I’ve said before in this space, unemployment is not a form of welfare — it’s insurance for which both you and your employer pay premiums. Many people are reluctant to collect, but it’s something to which you are entitled if you should be fired or laid off. It’s important to register right away, since there may be a waiting period. Also, you will be required to hunt for a job actively while collecting it, so dust off your resume and make a plan.

3. Contact all of your creditors, explain your situation, and see if you can get some sort of temporary relief from payments. It’s best to start this process early since, in my experience, qualifying can involve a lot of red tape.

4. Once money starts to run low, sell everything nonessential. Have a big yard sale and either prepay your bills or apply the money towards debt reduction.

5. If you are a homeowner and the situation is truly dire, you can rent out your place and move in with friends or family. This would dramatically lower your costs; of course, it would also represent a serious blow to your quality of life.

6. Register for whatever mental health plan your state offers as a part of Medicaid. If your state has a program through which you can be declared Seriously Mentally Ill, apply for it and be prepared to document your situation and past treatment thoroughly.

7. Start volunteering. Choose activities that play to strengths that you’d like to use in your next job, and spend at least a couple days a week doing them. For instance, if I were laid off tomorrow, I would offer to work on my church’s newsletter and website.

8. Sign up with temporary employment agencies and work at getting a permanent job that way. This has worked well for me in the past. I got my current, excellent job by temping and impressing my boss, and this isn’t the first time that’s happened. At the end of a recession, employers will often begin hiring by taking on temporary employees, seeing how they work out, and then making them permanent. Remember, though, that you should never have to pay a fee to any agency to find a job; the employer should be paying all fees.

9. Take classes online or at a community college on Excel, PowerPoint, and other commonly used software. Learning a new skill always pays off, sometimes in cold, hard cash, sometimes in your ability to find a job at all. I would take a class in web design, since most people who sell their writing skills are now expected to be able to maintain, if not create, company websites.

10. Most importantly, don’t blame yourself, and don’t dwell on anything that you might have done wrong in the months leading up to your layoff. Instead, make lists of the ways you succeeded at your last job. What skills did you pick up that you would like to use in your next job? You must have done well on some projects; list them. Remember, no job or relationship is a failure just because it comes to an end.

The moral is, I wouldn’t drop dead if I got laid off — I probably wouldn’t even starve or go homeless. The same goes for you if you’re working right now. Bipolar disorder makes it harder to find a job, and much more difficult to go without employer-provided insurance, but it’s still possible to survive these times.

And now for a change in topic: I’ve mentioned my programmable thermostat several times in this space. I’d just like to send a shout out to my dad for installing it when my feeble efforts ground to a halt. Next: programming that sucker. I’m sure I’ll be turning the air blue with curses.

Love to all.

Book Review: John McManamy’s Living Well with Depression and Bipolar Disorder

McManamy's message: though it will be a bloody battle, you can defeat your demons.

About three weeks ago, I picked up a copy of John McManamy’s Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn’t Tell You … That You Need to Know. It’s a tribute to the richness and complexity of the book that it took me until now to get around to reviewing it.

To be honest, I’m a little intimidated. McManamy is the author of McMan’s Depression and Bipolar Web, an encyclopedic site of the sort that makes me wonder what aspects of this disease haven’t already been hashed over on the internet in some detail. I highly recommend both the book and the site; I’ll discuss the former today, and the latter tomorrow — or when I get to it, whichever comes last.

The book is divided into four parts: “Diagnosis,” “Brain Science 101,” “Roads to Recovery,” and “Special Populations.” We’ll travel through the book by sections.

It is, perhaps, unfortunate that McManamy begins the book with such a lengthy and, well, depressing discussion of the two diseases. Unlike so many books and sites, he doesn’t pull any punches. He makes it clear that mood disorders are brutal, and that it will take plenty of hard work and all of your ingenuity to avoid suicide and live a decent life. While most books candy-coat the diagnosis, merely saying that you have a “broken brain” that can be made right with meds, McManamy argues that existing meds are at best crude tools, and that for most people, a diagnosis is the beginning of a long — perhaps lifelong — carousel of medications and side effects both trivial and crippling. The first section, then, on diagnosis, is a downer, and it’s a bit of a struggle to get from there to more hopeful sections on recovery.

I don’t blame McManamy for his approach, however. Too often, as David Karp points out in The Burden of Sympathy, health care providers both oversimplify the impact of the disease, and, at the same time, tend to give up on patients, essentially telling them that they will never live a normal life. While the latter may be true, the first two are inexcusable, and though McManamy’s approach may sadden you, it is realistic. After all, either disease can prove fatal, either through suicide or comorbidities, and existing medical therapies are partial at best.

In this first section, McManamy gives an excellent phenomenological sense of mood disorders — that is, he describes the feeling of having them from the inside. He also presents an argument that he will stick to though the next 300 pages: he considers depression and manic depression to be two faces of the same illness, bipolar spectrum disorder. In essence, he believes that many depressed people are just one bad antidepressant trip away from a diagnosis of bipolar disorder, and, as he points out, bipolar people spend most of their time depressed, and with a diagnosis of major depression. In his opinion, then, a firm distinction between the two is a false one. Though both diseases take many, many forms, and we can draw some distinctions between bipolar and unipolar depression, the two are intertwined, both in the experience of sufferers and in treatment.

In this first section, McManamy describes and analyzes the most terrifying and discouraging aspects of both diseases, and lays out clearly their ability to destroy the lives of patients and the people around them. He provides an unflinching picture of the isolating effect of depression, and lays out how common co-occurring conditions such as substance abuse and anxiety are. Neither disease is to be taken lightly, he writes; both require tremendous determination and resources if sufferers hope to live with dignity and some enjoyment.

The second section, “Brain Science 101,” should probably be titled, “Brain Science 401” — rather than the same old outdated and oversimplified description of how neurotransmitters work, McManamy explores cutting-edge research that suggests that therapies directed at boosting neurotransmitter availability may be crude at best compared to the subtle processes of the brain.

McManamy also provides a nuanced account of the current confused state of genetic research into bipolar spectrum disorders. Again, he moves beyond even the more subtle discussions one typically finds — the ones that talk about a combination of genetic vulnerability combined with triggering events — to explore the complexities of how genes turn on and off production of various proteins, and how these proteins appear to work in the brain and elsewhere. I learned more from this section than even the most sophisticated extant textbook, Goodwin and Jamison’s tome Manic Depressive Illness, which does, after all, date back to 1990. His discussion of depression, in particular, goes well beyond what is available elsewhere.

Once the reader has negotiated these two formidable sections, she finally gets some useful, if limited, good news. It is possible, of course, to combat the diseases on several fronts, from nutrition to exercise to mindfulness meditation and yoga, and that’s what McManamy recommends. He states unequivocally that it is never enough simply to pop a pill, or even a half-dozen pills, and to expect to recover. His refreshing decision to deal with complimentary treatments before turning to meds places the emphasis on what you can do — must do — to combat either malady with some success. Only then does he move on to a thoughtful and detailed dissection of available medical treatments and talk therapy.

Though there is, in his words, “No Magic Bullet,” it is, he argues, our right to expect remission and normal functioning. This is a remarkably optimistic stance given the litany of horrors that take up the first two sections. Even so, I find myself totally agreeing with him. If your doctor writes you off and suggests that you’re incapable of working or sustaining a relationship, in my opinion, you need to find doctor who will work tirelessly with you to find a combination of medical and alternative treatments that will help you to achieve the highest level of functioning of which you are capable — which is probably higher than either you or your doctor may expect upon initial diagnosis.

From here, McManamy moves on to discuss “Special Populations” — children and the elderly — and to consider the special challenges facing each of the sexes, from postpartum psychosis to “Why Psychiatry Fails Men.” He even weighs the question of whether we should have children, given the severity of the two diseases, concluding that the chances of raising a normal child outweigh the odds of passing on either disease.

Each part of the book contains many more intriguing details than I can possibly convey here. A few tidbits that caught my attention:

His assertion that “We may hate our illness, but we can hardly hate what our illness has made of us,” which goes hand-in-hand with his claim — true, I believe — that our courage is incredible even when our outcomes and behavior are less than stellar;

A large study that indicates that “symptomatic individuals [are] only half as likely to marry and twice as likely to separate or divorce,” a finding that has been borne out in my own life and the lives of many of my bipolar friends;

A spirited debate on whether we are special and sensitive, or simply cursed

The excellent suggestion that “[t]hose who are unable to work … do a day or two a week of volunteer work” to lend structure to their lives and gain the feeling that they contribute to society;

Advice that you enjoy “the serotonin benefits of a pet”;

And the recommendation, when it comes to reaching goals, you “start anywhere” rather than getting bogged down in calculating the perfect place to begin;

Finally, he concludes with a truly compelling statement:

Writing is what helped to bring me back from the dead. For me, it is a healing activity. If I were a basketball player, I would be shooting hoops; if I were a gardener, I would be out with the petunias. Healing is about finding something that makes you feel alive and doing it.

So true. I keep telling you that here because I believe it. As with anyone, the more you pursue your passions, the more likely you are to succeed in all areas of life, and to become a person you’d like to meet. He ends, then, on a surprisingly upbeat note: It’s a bloody struggle, but it is possible to survive and thrive. I couldn’t agree more.

It should be clear by now that I give this book the highest possible recommendation. Combined with more specific works that will help you to implement his suggestions for wellness, it may bring you a good deal of relief. Certainly it will reward you with a tremendous store of knowledge with which to make informed decisions about your treatment.

Book Review: You Can Do It! The Merit Badge Handbook for Grown-Up Girls

Man, You Can Do It! is an awesome book. The premise is ingenious: the author offers six categories — Dare, Create, Learn, Play, Deal (as in, “deal with it!”), and Connect — each of which contains 10 intriguing projects, ranging from walking on fire to basic saving and investment.

This book is not specifically tied to bipolar disorder, obviously, but it’s jam-packed with fun projects for those of us who have a hard time thinking of or maintaining hobbies. On those days when you’re absolutely bereft of ideas, this is a great book to pick up. In fact, this book has had a substantial influence on my life, since two of the projects — yoga and beading — have turned into life-improving near-obsessions.

The author, Lauren Catuzzi Grandcolas, divides each project into several sections, including basic information on how to get started, “The Payoffs,” a mentor spotlight on a woman accomplished in each discipline, project-specific sidebars (the section on starting a rock band includes a list of “rock music Meccas”), and resources that include websites, books, movies, and classes and workshops. For each project, she really does provide all of the information you need to get started.

Though the book focuses on women, men could benefit from the step-by-step instruction as well — certainly most guys can use advice on gardening, budgeting, negotiating, and basic car repairs, though they may be too cool for the sections on, say, knitting and flower arranging.

Unfortunately, Grandcolas won’t be writing any more kick-ass books. She was one of the passengers on United Airlines Flight 93 during the 9/11 attacks. That’s the flight on which the passengers rebelled and succeeded in crashing the plane in a deserted area before terrorists could ram it into a fourth target. A trained emergency medical technician and all-around resourceful gal, she may well have been involved in that courageous uprising. Proceeds from the book go to a foundation named after the author that supports scholarships and aid for abused women and children. Yet another reason to shell out.

Happy doing!

Finally, an Excellent Crisis Plan Form, Plus the Most Fine Madness First Aid Kit

I’ve been searching for awhile now for a decent crisis plan or advanced directive; I finally found one by opening a document that had been sitting neglected on my desktop for weeks: Sonny Kentucky’s Madness First Aid Kit, which I stumbled upon while strolling around the Icarus Project Website. (I just can’t say enough good about those folks — it’s a community of people with whom I really resonate. The link is on the right.)

Anyway, here’s the link for the crisis plan. Like the author, Mary Ellen Copeland, I suggest that you fill it out slowly over the course of several days rather than trying to rip through it in one sitting. If you’re like me, you may tend to whip through such things in a burst of enthusiasm, then lose them or forget to implement them.

The Crisis Plan above comes from mentalhealthrecovery.com; I was impressed during my short (30-minute) visit — Copeland has many excellent suggestions for improving wellness. I particularly like how she gives specific, concrete suggestions concerning how to go about certain activities that bossy people like me always recommend. For example, people preach that you must have friends, but it can be hard for mentally ill people to develop and maintain friendships. Copeland explains how to make friends, and gives a lot of basic dos and don’ts that you’ll need to bear in mind as you reach out. (And that I need to bear in mind as I reach out.)

Copeland offers a $15 online course on how to develop what she calls a Wellness Action Recovery Plan; I think I will take it and report back. I liked her free material enough to want to support her, and to know that I could benefit from her insight. Also, $15 seems like a really reasonable price. I like the fact that many bipolar people (who may be unable to work or underemployed) can probably afford it.

Coming up, perhaps even today: the benefits of engaging in mental health advocacy and stigma-busting, and another book review.

A Morning of Delightful Fake Drug Sites and Head Decoration

An excellent resource and good for a laugh: sites featuring made-up drugs, via Finding Optimism, which I found by way of Mind Hacks. The Panexa website, in particular, is a hoot, featuring as it does a drug with the tagline, “Ask your doctor for a reason to take it.”

The Finding Optimism site is pretty intriguing in itself, since it sells some pretty kick-ass mood-tracking software. The premise is this: you enter basic information such as the number of hours of sleep you got, your mood on a scale of one to 10 (a bit difficult for those of us who can range from three to six, as I did yesterday), then check off items on customized lists of triggers, wellness activities, and symptoms. Over time, not only do you get mood information, you can theoretically begin to make connections between, say, anxiety and too much coffee. It also produces nifty charts and reports that give a scientific feel to the whole. And, hey, if they’re willing to blog fake pharma sites, they at least have a sense of fun.

Finding Optimism’s systematic approach seems to beat most of the mood charts that I’ve tried in the past. The problem, of course, is that I may not actually use it, since it requires me to single-click to launch a program, always intolerable drudgery. I downloaded the trial version for kicks. I’ll let you know how it goes.

In other news, I dyed my hair three times this weekend, passing from dark red to brilliant blond by way of pale orange. I use extreme head decoration both to improve my mood and as an expression of exuberance, so I try to keep an eye on it as an early sign of mood change. In fact, now that I think about it, what with chattiness, buying shoes, and elaborate craft projects, I’d better keep a weather eye out for hypomania.

Wow, A Wonderful Thing Happened This Morning

I managed this pose, full pigeon, in today's amazing, failed practice.

I read this blog post by J.S. Dixon. It was a guest post on Illuminated Mind. In the post, Dixon challenges readers to triple their rate of failure — to fail a lot and to fail big. That is, of course, the only way you succeed at anything from playing a musical instrument to beating an ugly, chronic illness. So this morning I vowed to fail at three things this weekend:

1. Having one of the best yoga practices of my life;

2. Topping 50 hits at this blog;

3. And helping five bipolar people to improve their wellness.

Now, none of these three is impossible. I’ve done some pretty amazing things at yoga, have had over 40 hits in one day, and have, to my knowledge, helped at least one or two bipolar people out in key moments. But none of them is particularly likely or easy. I knew when I made this pact with myself that I would have to try damn hard to do any of the three, and that, yes, I would probably fail at all three.

And that’s how I had one of the best yoga practices of my life this morning. It was wonderful. In each pose that I thought would be impossible, I dared myself to fail — and thereby succeeded well beyond what I thought I could do. That was especially true of the balancing poses. Of the three aspects of yoga — flexibility, strength, and balance — balance is definitely my weak point. But though I fell out of Lord of the Dance and Half Moon on my right side, I held both on my left. I even managed to bind in Side Angle, which takes strength, flexibility, and balance, believe me. It was an amazing practice. Almost certainly one of my best.

So now I’m very excited about failing further, and I invite you to come along with me. Fail at something this weekend, preferably publicly (I did it in front of 10 people, after all). Fail big. And see if you don’t mess up and succeed.

More later.

Love to all.

P.S. J.S. Dixon’s blog is A Little Better. I’m going to subscribe and see if I have any more breakthroughs.

Even If You’re Shy, Consider This

President Obama will be giving a crucial speech on health care tomorrow evening (Wednesday 9/9/09), and there will be watch parties all over the country. If you have a chronic, serious mental health condition, then health care reform is your issue. To find a party, go to my.barackobama.com, register, and search for events in your area. If there was ever a time to get out, this is it.

Love to all.

Wow, Wow, Wow: The Icarus Project Website

I’m deeply impressed with the Icarus Project website — the artwork, the poetry, the organizing information. This is a truly great mad pride site for those of us who feel both blessed and cursed by madness, and who produce art about the things that really matter: delusions and dreams, bread and roses, suicide and swallowing life whole.

Love to all.

Writing and Distributing a Crisis Plan

I knew that I’d seen a good crisis plan somewhere — I had a PDF of an excellent one on my desktop. Turns out it’s from the Depression and Bipolar Support Alliance’s online toolkit, Facing Us. You will need to register for a free account and go under “Wellness Plan” to find and download it. It’s definitely worth it for this excellent resource alone. If the form seems valuable to you, I would suggest filling it out and giving a copy to your closest associates. The same goes for the list of warning symptoms supplied there.

I’ve filled out the Wellness Plan, too, but I admit that I don’t use it — I love to fill out wellness forms online, and am less enthusiastic about actually following through.

I’ve probably said this before — in fact, I know I have — but there are so many resources on the DBSA home page that it’s almost bewildering. My favorite is the Advocacy in Action section, where you can register to vote and get updates on current legislation and tips for rooting out and fighting stigma. It may simply be where I am with my illness, but I find it tremendously empowering — an eminently hateable word, don’t you think? — to get their infrequent emails and act on them by writing my representative and urging all of my friends to do so, too. (Whether my friends like it is another matter.) I like to think that my impassioned letter helped the Mental Health Parity Act passed, and that the screed I sent to the Obama transition team had some tiny influence on the legislation that’s Congress is currently piecing together.

So, yeah, emergency plans: consider making one and distributing it.

Love to all.