Monday, April 30, 2007

Losing My Sense of Humor

Today I was going to write more about yesterday's comments from the college senior who's bipolar, was quickly diagnosed, easily able to find medication that works, is stable, and wonders why there aren't more "happy" bipolars out there with a sense of humor.

Actually, her questions made me think about a lot of issues that aren't easily answered. However, it turns out that she prefers to communicate privately with me. So I have time to think about the questions she posed, which I will address in the weeks to come. (I do want to thank Polly and Marja and everyone else who wrote to her, told their stories, and offered such hopeful advice.)

However, I must admit that I, too, wonder why some of us use humor to write about pain, suffering, and disappointment, and others don't. One of the reasons I was unable to sell my memoir for so long, fourteen years. was that it wasn't sad enough. After numerous rejections, my agent lost faith in it. So I began sending it out myself until I couldn't deal with any further rebuffs.

It sat in a manuscript box in the closet for three years until I decided that I wouldn't feel better until I could tell my story. I began sending it out once more. A few months ago, while I was waiting to hear from the publisher in London, I sent a few chapters to a small local publisher.

Within a few hours, she rejected it and wrote the following email. "I recently bought a book from a mother of bipolar children. I cried the entire time I read it. I don't think this subject is funny. I just want you to know where I'm coming from."

Her response infuriated me. Like all "well-behaved authors," I had remained silent when I had been rejected by "A" list publishers for similar reasons, among others. I barely blanched when my agent told me that an important editor from a major New York publishing company had said, "Susan's book is too amusing and a bipolar friend assures me that this illness is not amusing at all."

I gritted my teeth when the senior vice president of another big house wrote, "Maybe Susan should consider turning the manuscript into magazine articles. She's a talented writer but she's not famous. No one's interested in a 'disease of the week' book by someone who's not a celebrity."

Perhaps, the most disappointing rejection came from an assistant editor who worked for a very famous (or infamous) publisher. I was walking my dog when my husband took the phone call. I returned it immediately but couldn't get through. For the next two hours, I danced around the house with high expectations.

"You know, they never call if they're not going to buy your book," I told my husband. "This is incredible. Ms. X is the perfect person to publish this. She's a marketing maven. I'll be the new bipolar poster woman. Wow! Maybe I'll be on Oprah this time."

When the assistant editor finally answered his phone he said, "Ms. X just wanted me to call to let you know that she still loves your writing style. (The word "still" was telling because she'd rejected The Mommy Guide ten years earlier even though she "loved" my writing style then.) She thinks you're very talented but...the topic's already been done by Lauren Slater with Prozac Nation. However, Ms. X wants me to let you know that she's interested in seeing your next book."

"Who calls to tell you you're being rejected?" I asked my husband. "When I didn't say anything in response, this guy said...Susan, are you still there?"

"Maybe, I should have pretended I was mute," I told my husband. "Do you think there's a market for a book written by a mute manic-depressive? It's got a certain alliterative appeal."

Yet, all these years later, I wasn't going to let some "C" list publisher so rudely reject me and remain silent. So I decided to eschew the rules of publishing etiquette and respond.

"It's fine that you don't like my manuscript," I wrote. "But if you truly think that the world needs another doom and gloom book about bipolar disorder, you're mistaken. The fact that I've survived so many depressions with my sense of humor in tack is far more noteworthy!"

Upon reading my response, the publisher probably said to her husband and co-publisher, "Wow! How unprofessional can you get? She'll never get published."

Yet, writing to her was truly cathartic. It's bad enough to be bipolar but to allow someone else to tell me how to express my feelings of pain and suffering was a joke--and not a very funny one--as far as I'm concerned. Or have I finally lost my sense of humor?

Sunday, April 29, 2007

Bipolar Lyrics 2

Actually, I already posted lyrics to two other songs, I Feel Pretty from Westside Story and On Top of Old Smokey on my other site, Honk If You Write to Heal. Today's lyrics are from Puff, The Magic Dragon, a folk song, which was written by Leonard Lipton and Peter Yarrow and sung in 1963 by Peter, Paul, and Mary. (For some reason, I'm having trouble showing the guitar chords, and I'll add them later today.) Who says we bipolars don't have a sense of humor?

Susan, A Bipolar Mother

Susan, a bipolar mother, lives in West L.A.,
And does the best that she can do, with her illness every day.
She takes her pills religiously, keeps mood charts like a pro.
Drinks no liquor, takes no drugs, which are bad things as you know. Oh!

Susan found a good psychiatrist, who explained what she should do,
how to cope with a mon-i-ker of atypical bipolar II.
Medications were a problem; they failed when er'r prescribed,
Her disappointment was intense, and sometimes Susan cried.

Lithium and Depakote, and Lamictal too,
didn't stabilize her moods or chase away the blues.
Neurontin and Abilify didn't make a dent.
Only finalized the tag of treatment re-sis-tent.

The side effects were legion, dry mouth was a drag.
Head sweats were embarrassing, and weight gain made her gag.
Heart palpitations worried her; the rashes were a pain.
Forgetfulness was really bad, but hair loss was her bane.

The illness lives forever; it doesn't go away.
The optimum is maintenance, each and every day.
Stay focused and resilient; research all you can,
Get a doctor who's darned good; take an aggressive stand.

Don't give into bleakness; tomorrow's always near.
Hold on to the ones you love; they chase away the fear.
Their strength is like a tether, in depths and flights beyond,
A grounding to the safest place while you await the dawn.

Friday, April 27, 2007

Work Wrap-Up

First, congrats to Syd and Polly on their new jobs! I'm thinking it would be great if everyone who reads this blog spends a few moments sending positive thoughts their way.

Second, check out my new chatbox in the left column. I've decided it might be a great way to send messages between posts or for people to mention something they've written about in their blogs. It can be a message board for all of us. Thanks to Owen at Tips for New Bloggers for all his technical help. If you're using blogspot to host your blog, the tips that he and his partner provide are wonderful.

Third, there were some wonderful comments on yesterday's blog. I'm going to post them in their entirety. I'm still new to blogging and I'm not sure if everyone goes back and rereads comments, so here they are. The subject is whether or not to disclose your illness at work.

Jinnah from the LivingManicDepressive website and Blog writes:

Here's a good one. I'm in a management position where I do have to make decisions regarding hiring / firing people.

I cheat - I am in my family's business and can't be (easily) fired - my boss is my brother.

However I do know over the years my contribution to the business has been substantial - I am not enjoying a free ride.

I have slowly let out the fact that I am bipolar over a long period - more than five years - enough so that the employees that I deal with can see that the quality of my work is not affected by my being bipolar. I do have their respect.

Now, here's the kicker. Our business is the provision of security officers. If someone mentioned they were bipolar when being hired, I would not hire them - too many potential liabilities. If however they were already working solidly for a while before the information is disclosed, we would just keep an eye on them.

Interestingly enough, if the person said they wanted to work part time (as in missing a lot of days) for health reasons, without telling us they were bipolar, we might be able to accommodate them.
* * *
BamaGal from Back Across the Line writes:

I work in the mental health field---so you would think they would be more understanding--not so--I actually had a fellow employee make the comment--why did they(the company) give the keys to the crazy house to a crazy person--I happen to work in a group home with Forensic consumers--

but in my work with in APSE--I've given seminars on working and having a severe mental illness--if you fail to disclose when taking a job--you can not ask for an accomodation at a later date--example if you need to change your hours or go part time--but it boils down to being a personal decision--I'm one of those who is very open about my diagnosis--I use the opportunity to educate the masses--but it does not define who I am it is just a part of me.
* * *
Syd from Bipolarity writes:

Excellent post. As usual, you raise some very interesting issues, and they're timely too. Today I was offered, and enthusiastically accepted a new job. I start next week (YEAH!). It's a small company, I met with and will report directly to the President, but it never even occurred to me to mention BP in the interview. I guess I inadvertently assumed the "don't ask-don't tell" posture. Ideally, it won't have to come up given the nature of the job, but if it does, hopefully it'll be after I've worked there long enough to have proven myself capable.

As for the insurance question, you've got me wondering. I didn't realize that health insurance companies can/do disclose the nature of an employee's medical condition(s) to the employer. Am I being incredibly niave about this? This employer covers 100% of the health care premiums, it's probably one of the best health insurance providers around, and I can't imagine NOT utilizing this great benefit. Can you post more about how that works?

Does anyone have the answer to Syd's question about insurance?
* * *
Polly from polarcoaster writes:

I think it's usually better not to disclose, because people usually will discriminate against you if you do. I've never told anyone I've ever worked with that I was bipolar.

I just started a new part time job today, though, and there was a sheet we had to fill out about emergency contact information and stuff. One question was "Do you have any medical conditions we should know about?" and I left that blank, but the next question asked about medications, and I was feeling reckless so I actually answered, "sertraline hydrochloride and divalproex sodium." I don't plan to be there very long and I have another part time job I like better, so if they decide to fire me for being crazy, I don't really care.

Thanks one and all!

Thursday, April 26, 2007

Disclosing Your Illness or Not?

In the Bipolar Disorder Daily News Blog from September 16, 2006, the writer quotes David J. Miklowitz, a professor of psychology at the University of Colorado at Boulder and author of The Bipolar Survival Guide: What You and Your Family Need to Know. When asked whether bipolar workers should disclose their illness or not, Mikowitz talks about the stigma and says bipolar workers usually adopt one of four strategies.

-"Tell everyone about the condition, including the boss and co-workers.

-Tell one or more trusted co-workers who don't hold positions of authority.

-Don't tell anyone, but admit to having a bipolar disorder on any work-sponsored health insurance claims, opening the possibility that the employer may find out.

-Don't tell anyone at work, and don't use your employer-provided health insurance to cover treatment costs."

I'd be interested in knowing other people's point of view. Since my illness wasn't diagnosed until so late in my career, my experience may be quite different, and so might my opinion. Having said that, personally I think it's a bad idea to disclose this illness. In my case, I only told two employers, and each time it was a disaster.

The first and worst case was about five years ago when I decided to pursue a part-time fundraising position for a non-profit organization. My reason for the disclosure was that they wanted a full-time employee and I was only interested in a part-time job. Although I had been freelancing for years, I'd decided to see whether a part-time staff position would be less stressful.

The problem with being a freelance grant writer is that there are high expectations from the "get-go." You're seen as an outsider who's being brought on board to work miracles. As a staff member, organizations expect a learning curve, you are "one of them" rather than an outsider, and it's more of a team effort.

It was challenging to try and convince my future boss to hire me part-time when she truly wanted a full-time person. During our initial conversation, it became quite clear that I needed to provide a "real reason" why I could only work part-time.

So, I took a deep breathe and said, "I'm bipolar. I can only work part-time."

Because a job interview is like selling a product--with the job seeker being the product--the rest of the conversation focused on how much money I'd raised through my grant writing efforts, the breadth of my experience, an analysis of their current program, and how I felt I might contribute. I've been told by any number of clients that they've never met anyone who prepares for these meetings as diligently as I do.

Because of how many successful grants I'd written and my level of experience (which was far greater than hers), Ms. Puddse (an acronym; see next paragraph) agreed to hire me on a part-time basis.

In our initial interview, I only wish Ms. Puddse had been as open about her condition as I was about mine. After a few weeks, it became clear that she suffered from undiagnosed paranoia (she truly thought her office was bugged), severe unpleasantness that revealed itself when she felt her employees knew more than she did, duplicity, dishonesty, and a lack of self-esteem that was masked by aggression.

Needless to say, the situation didn't work out, and I leaned that this was a fairly common occurrence. A co-worker told me that Ms. Puddse was universally disliked (although she was highly competent in some ways) and her staff frequently quit or moved to other departments within the organization.

Once Ms. Puddse "turned on me," I would have preferred to have remained and to have reported to someone else. But because of my disclosure, I realized I had given Ms. Puddse a weapon to use against me. And I also believe that no matter how competent I was, the very mention of "mental illness" makes high level management wonder "who's really the problem employee," even when a supervisor has a history of bad behavior. Ultimately, I quit before I got sick.

That's my opinion in a nutshell. Whether or not employees should refrain from using an employer's insurance policy (in order to keep their illness a secret) is actually another issue altogether, and one we'll address some other time. If you'd like to share your experience--and I'm hoping you will--or give advice, I'll include your comments in Saturday's post. Starting on Monday, I'm moving on to other topics.

Wednesday, April 25, 2007

Saying No to "F" Jobs

For today's post, I had intended to focus on an interview in the December 2003 issue of Psychiatric Times with Zlatka Russinova, Ph.D., a senior research associate at Boston University's Center for Psychiatric Rehabilitation who has specialized in researching the connections between mental illness and employment. But when I read my email this morning, I found some important comments, which I'd like to share. So I'll give you the highlights of the Russinova interview and include the comments as well.

In the article, Employment Programs Help Patients with Mental Illness Succeed, Russinova is quoted as saying, "One of the old myths was that people with serious mental illness could only do low-level jobs--the so-called F jobs: flowers, filing, food. We have done studies that have documented capacity of the mentally ill to be successful."

Don't you just love it that she uses the term, the "so-called F jobs"? While some of us can think of another "F" word to describe those jobs, she's on the right tract.

In the late 1990s, Russinova did a study with Marsha Langer Ellison, Ph.D., M.S.W., in which they looked at 495 people who were engaged in professional and managerial careers. Despite their illnesses, these people were able to retain their jobs. While I think it would be helpful to know how they did it, and what tips and advice they might give to others, that's not the focus of this piece. However, the stats are encouraging.

"Seventy-five percent were employed full time; 62% had held their position for more than two years; 28% had held the same job for more than five years. Thirty-three percent were working in non-helping professions; 16% were working in health and social services other than mental health. Thirty percent were in mental health; 21% in self-help advocacy jobs."

Again, if you'd like to read the article on the study, it can be found on the Psychiatric Times site.

* * *
Now, on to the quotes from people who read this blog. Thanks to Syd, Bipolarity, who posted the following: "One resource that I stumbled on last week that I thought I'd share is vocational counseling. I contacted the State Dept of Rehab Services in the state where I live and found out that there are a wide variety of no-cost career counseling and job placement assistance resources available, and at least in my state, BP does qualify for assistance in this program. Examples included aptitude testing, job search support, interview coaching, and even some job training to make transition into the new job easier.

In my case, the counselor seemed very interested in working with me, but suggested (and I believe rightly so) that it would be in my best interest to focus first on getting the proper meds and getting my mood stabilized in order to avoid the job-hunting process itself becoming yet another trigger.

I did find an this article on the subject that may be helpful in your research.

* * *
Thanks to BamaGal, who sent an impassioned comment last night. I've edited it a bit (Hope that's okay BamaGal), but you can read it in its entirety as well.

I had to leave my nursing career behind for awhile. I'm a member of APSE, Association for Persons in Supported Employment (the voc rehab Syd was talking about). They do have a lot of excellent programs to assist you in returning to the work force after an absence. What I'm trying to change within APSE and voc rehab is that they tend to focus more on the MR/physical disability.

Face it. Most employers run at the very mention of severe mental illness. Then, if you try to find a position in another field---you are questioned repeatedly about why you cannot work in your trained field. If it had not been for the local mental health facility, where I had lived at a time in my life, I would not have a job today. I'm very active in our state in the consumer movement. The fate of the mental health system should be placed in the hands of consumers/survivors.

Like the new program that the state of Georgia has put into place, psych rehab tech, recovery is possible. I'm tired of the so-called professionals in the field saying, "Here's your diagnosis. Get used to it." My own therapist tries to get me to just quit work and live off of disability.

Working keeps me more stable. Granted that stress can be a trigger for a big mood swing, one way or the other, but that's where I come into play. I do what I can to keep myself stable. I exercise, eat right, take my meds, and get enough sleep. And, if things go too far south, I have a psychiatric advanced directive in place letting my family know what course of action to take.

* * *
Thank you BamaGal and best of luck with all your advocacy efforts! Then, there's Polly, polarcoaster, who wrote about her experience at the university. Jinnah responded, and now Polly's written back. Thank you Polly!

Jinnah -- thanks for the encouragement in your earlier comments, but you don't have to worry about me giving up on my education, 'cause I'm finally finished with it (unless I decide someday I want a third degree). I didn't listen to the people who said I couldn't do it and I received my master's degree last fall. (Okay, so it was supposed to be last spring, but a few hospitalizations last year messed that up.)

I am not minding working at low-paying jobs so far, but eventually I'm going to have to find something that is actually in my field, which probably won't happen until my boyfriend and I leave this town. I'm not in a rush. Last year was awful, so I don't mind spending a while just getting used to being stable before I start my first real career-type job.

* * *
Good luck one and all. Tomorrow's post will be the last one on work for awhile until I'm able to provide some more substantive information.

The Voice of Vocation

While this post isn't about the special challenges that bipolar people experience at work, I must share a wonderful book that I bought when I was feeling depressed and I was concerned about whether I was pursuing the right path. It's called Let Your Life Speak: Listening for the Voice of Vocation, and was written by Parker J. Palmer, a senior associate of the American Association for Higher Education and senior adviser to the Fetzer Institute, a nonprofit organization with the mission of fostering love and forgiveness in the emerging global community.

Perhaps the best description of the book comes from the copy on the inside flap. "'Is the life I am living the same as the life that wants to live in me?" With this searching question, Parker Palmer begins an insightful and moving meditation on finding one's true calling. Let Your Life Speak is an openhearted gift to anyone who seeks to live authentically.

"The book's title is a time-honored Quaker admonition, usually taken to mean 'Let the highest truths and values guide everything you do.' But Palmer reinterprets those words, drawing on his own search for selfhood. 'Before you tell your life life what you intend to do with it,' he writes, 'listen for what it intends to do with you. Before you tell your life what truths and values you have decided to live up to, let your life tell you what truths and values you embody, what values you represent.'"

Palmer is an interesting man. After he graduated from college, he joined the Union Theological Seminary in New York, thinking he was meant to spend his life in the ministry. He says that mediocre grades and "massive unhappiness" led him to quit and to pursue a doctorate in sociology at UC Berkeley in the sixties.

Although he loved teaching, he felt compelled to work on the "urban crisis" and became a union organizer in Washington D.C. for the next two years. He was then offered a faculty position at Georgetown University where he was encouraged to help students get involved in community organizing as part of his job. After five years, he became burned out and took a yearlong sabbatical at Pendle Hill, which he describes as "a Quaker living-and-learning community of some seventy people whose mission is to offer education about the inner journey, nonviolent social change, and the connection between the two."

Palmer says Pendle Hill was a "transformative passage" and he was invited to become the dean of students. Although he stayed at Pendle Hill for a decade, he continued to doubt his path. One day when he was looking at the portraits of past presidents, he stared at the face of the man who had recruited him for the board of trustees. Palmer felt that the man was starring back at him and saying, "What do you think you're up to? Why are you wasting your time? Get back on track before it is too late."

"Perhaps this moment precipitated the descent into darkness that has been so central to my vocational journey," Palmer writes, "a descent that hit bottom in the struggle with clinical depression that I will write about later in this book."

Palmer thoughtfully writes about his battle with depression as well as work , fulfillment, and joy, "illuminating a pathway toward vocation for all who seek the true calling of their lives." While the book is a small one, and is only 115 pages long, I find it to be a fount of wisdom. It's not meant to tell you "what career you should pursue" and may not be helpful if you're feeling depressed or need very specific career advice. But if you want to read about vocation in a more spiritual way, it's quite wonderful. If you want to learn more, I'm including a link to a web site that provides articles by Palmer, interviews with him, and more biographical information.

Tuesday, April 24, 2007

Work: A Bipolar Bummer (Part 2)

Yesterday's blog on work tied for the top number of "hits" on any subject I've written about thus far. And more people posted comments than on any other topic.

Clearly, we all agree it's a very important topic and as far as I'm aware, there's not a lot written about it--in books. Perhaps, it's been discussed on some of the major bipolar web sites but I'm not sure. As I mentioned in an earlier posting, I rarely read these sites because dwelling on the sad aspects of this illness doesn't make me feel well. While I'm happy to discuss any and all problems, by nature I'm a solution-oriented problem solver.

Having said this, I suddenly realized that I wasn't sure how to proceed on this topic. I'm not sure how to use the blogging format to discuss individual questions that may be pressing. For example, I read Syd's comment and she needs help right now. She was recently diagnosed. She's currently experiencing a depression. She's been a freelancer for the past six years and she needs to find a job.

The other comments ran the gamut. Dootz, who's a full-time fundraiser, gave helpful tips on how he handles stress in a high pressure job. Marja talked about switching her career because of stress to that of a part-time freelance photographer. Polly discussed problems at the university because of the seasonal nature of her illness. Jinnah posted three times. He posed some interesting questions as well as providing support to Polly.

Privately, Jinnah wrote an email to me and suggested that we move this discussion to a Google discussion group. Two days later, we both decided that it's too much of a commitment although I must admit that I was initially intrigued. The reason I've never participated in bipolar discussion groups (in the past), is that they've always seemed so downbeat to me. When I was at my sickest moments and spent hours online trying to find "success stories," all I found was despair.

When I've had specific problems, where I've needed some truly insightful advice from someone who's bipolar, I couldn't find anyone whose situation was similar to my own. More than a year ago when I was in a depression and truly needed some career advice, I began researching the topic of work and bipolar disorder, and the information was unbelievably depressing.

In my journal, I wrote, "Where are the bipolar people like me? I'm having some career-related problems and the only advice I can find is geared for people who feel that it's a step up to pursue careers as members of clean-up crews, as restaurant workers, or low level office workers. (I'm not being critical here, it's just that all of the services seem geared for this population.) Why doesn't anyone seem to care about those of us in professional occupations?

"Perhaps it's because they feel we can privately pay for the services we need. What they're missing is that the financial fall-out from this illness hits us particularly hard because we don't get any help whatsoever. And it's not like people who provide career advice have any insight about the special work issues related to being bipolar."

Because it was my personal journal, I went on and on. The more I wrote, the angrier I became. The more research I did, the more hopeless it seemed. Finally, I found a 2004 study on unemployment and depression from Psychiatric Services Online.

While you should evaluate this article for yourself, I must admit that upon reading it, I laughed out loud. While I do have a quirky sense of humor, I was stunned that it took ten doctors, psychologists, and social workers to figure out that people who suffer from depression have more disability, less job retention, and more diminished performance on the job than a healthy control group and a group of people who suffer from rheumatoid arthritis (Where do they come up with these control groups?).

Their conclusion? "In addition to helping employees with depression obtain high-quality depression treatment, new interventions may be needed to help them to overcome the substantial job upheaval that this population experiences."

What a "frigging" waste of money. All of us who are depressed and/or bipolar are well-aware that we need treatment for our illness and that we may need job-related advice. Surely, the grant money these people received would have been better spent providing services for us rather than subsidizing studies for academics.

What services would I like to see? Free high-level career counseling for bipolar professionals. Government funding for small business loans for bipolars. Research on the best working environments for bipolar professionals, tips on coping with job-related problems, a hot-line for immediate work-related problems, government tax breaks for companies that are willing to provide flex-time schedules for bipolars or job-sharing arrangements, free seminars on how to find a job when you're depressed, grants for bipolar writers and artists, and the list goes on.

In the short-term, I realized that I should have researched the topic of work and bipolar disorder before I planned on publishing daily posts about it. The preliminary research I've done is not encouraging and I don't see that it would be valuable to post it. Personally, I don't find it uplifting to read stats on how many bipolars are unemployed and how many problems we have in work situations.

So, while I'm committed to exploring this topic and will continue to try and post something on it every day this week, the best I think I can hope for is to try and find resources to explore further, individual success stories, or perhaps sites where helpful articles are listed. And I promise to do that. I'm hoping that I'll be able to provide a much higher level of advice--down the road--after I spend a lot more time researching this topic. If you have specific questions you'd like me to try and find answers to, please let me know.

Monday, April 23, 2007

Work: A Bipolar Bummer

Although I was able to work full-time for almost 20 years, once I began taking medication and I got sicker and sicker, I was unable to work on site. Both the severity and duration of my depressive episodes increased. I went from having two annual six-week depressive periods, one in April and the other in October, to having one depressive episode last an entire year.

Luckily, I had already developed a number of skills that initially enabled me to continue working as a freelance writer, grant writer, and author. The bummer was that my second book, The Mommy Guide, was published just before I started this downward spiral. While I was initially able to attend a number of book signings at bookstores and even do a few radio interviews, my greatest opportunity came when the medication was producing terrible side effects.

I was approached by an international advertising agency who wanted to send me on a six-city book tour if I would endorse a baby formula that one of their clients manufactured.. Ordinarily I wouldn't have considered it because it was too commercial for the purist that I used to be (and still am in many ways). But, it wasn't a problem because I actually used that formula for my son.

Still, I had to decline because of the way I looked and talked. The Depakote had caused about 1/3 of my hair to fall out. What remained was thin and curly (not in an attractive way), which was unusual because my hair had always been straight and I'd worn it in a bob style for most of my adult life. Depakote also caused a 20 pound weight gain and significant hand tremors. The Depakote and Zoloft combined caused excessive dry mouth and head sweats. Out of nowhere, two to three times a day my head began to perspire so severely that it looked like I had dunked my hair in a pail of water.

The severity of the depression and the medication were responsible for memory loss and an inability to articulate simple thoughts. I, who had always prided myself of my mental acuity, sounded like a female version of Lenny in John Steinbeck's Of Mice and Men.

Years later, things got much worse...[to be continued]

Because work is such an important topic, I plan on spending the entire week focusing on it. Tomorrow, I'll have some bipolar employment facts and stats. I'd also like to print--in the main body of the blog--other people's experiences. Let me know if you have a story you'd like to share. Are there any questions we should explore or tips you have for others?

My first book was called Job Search Strategy for College Grads, which I co-wrote with a dear friend who's a career counselor and human relations specialist. Although it's currently out of print, years ago I wrote a lot of freelance articles about employment issues, did job search seminars for college students, and helped students in a program I oversaw for UCLA Extension, get jobs.

Personally, I've had a number of really wonderful jobs, most of which I've hated. I've often wondered if that's just me, whether it's a sign of the illness, or whether it was because it took so many years for me to realize my true vocation.

But I must admit, the problems that we bipolars have with work, are in a class of their own. I wish I had the answers but honestly I don't. Still, maybe together we can brainstorm. If anyone has solved their work problems in a positive way, I'm sure we'd all like to hear about it. I'll also recommend some books, mention any research trials in this area, and see if I can find any career professionals or psychologists who might have good advice. Stay tuned!

Sunday, April 22, 2007

Bipolar Quotes

"Holding back our thoughts, feelings and behaviors can place people at risk for minor and major diseases."
~James W. Pennebaker, Ph.D., Opening Up: The Healing Power of Expressing Emotions

"The human body experiences a powerful gravitational pull in the direction of hope. That is why the patient’s hopes are the physician’s secret weapon."
~Norman Cousins, Anatomy of an Illness

"Now, why is it that most of us can talk openly about the illnesses of our bodies, but when it comes to our brain and illnesses of the mind we clam up and because we clam up, people with emotional disorders feel ashamed, stigmatized, and don’t seek the help that can make the difference."
~Kirk Douglas, My Stroke of Luck

"I contemplated suicide. My main concern was that I would not make the New York Times obituary page."
~Art Buchwald

"The statistics on sanity are that one out of every four Americans are suffering from some form of mental illness. Think of your three best friends. If they're okay, then it's you."
~Rita Mae Brown

Saturday, April 21, 2007

Pollyanna and the Shrieking Woman

The term "arts and crafts" has a bad connotation for some of us because it connotes visual images of patients in mental hospitals making ashtrays. And I imagine that if I’d been forced into doing art therapy, I wouldn't enjoy it either. But when one thinks of arts and crafts as a voluntary pursuit, it’s got a lot going for it.

My first attempt at identifying a fitting form of artistic expression was based on wanting to enhance my mood charts. I had kept them for six years in my DayTimer, and while they were illuminating, they were visually uninteresting. I wondered how I could enliven them, given my lack of artistic talent.

I thought about it for months and one day when I was at a bookstore, I saw a rubber stamp kit and decided that rubber stamps were the perfect solution. On the days when I felt well, wouldn’t it be fun to stamp a happy face, or perhaps a flower, star, or even a heart? On the days when I felt depressed—since there were so many more of these—I could use a sad face, rain, dead flowers, thunder, lightning…well you get my drift.

When I looked more closely at the little kit, I realized the happy faces, flowers, and stars didn’t do it for me. And, of course, there were no sad images at all. In the upcoming weeks, I went to a few local stamp stores but while I found many stamps that symbolize happiness and well being, I just couldn’t find the bleak stuff.

So I logged onto Rubber Stamps of America and after skimming a few of their many categories, I found Ken Brown’s stamps. He's a genius and his rubber stamp art is extraordinary. When I first clicked on "Shrieking Woman" (top left), I was sure Ken must know how I felt when taking Wellbutrin. And "Crazed Housewife"(left) was a perfect portrayal of me on Geodon. "Sobber" (right) was a fairly accurate view of how I felt when none of the medication worked or the side effects were so awful. Of course, I only wished I would have remained as well coiffed and dressed as Ken's sobber.

(By the way, the stamps for men are even more evocative. My two favorites are "Ave Ai Ai" and "Screamer," although I think it's a bit bleak so you'll have to look at it online. The "men" stamps are bigger and I don't know how to reduce them further.)

Soon, I plan on ordering my stamps online, and I'll buy some stamp pads as well. It's all quite exciting. If you think I'm beginning to sound a bit like Pollyanna (the main character in a 1960 North American film who believes that every cloud has a silver lining), I'd have to say, "Isn't it great that this illness is causing me to pursue an area of interest I never would have anticipated?" (Kind of makes you want to gag, doesn't it?)

Friday, April 20, 2007

Exercise To Beat the Blues

When I’m depressed, exercise is one of the last things I feel like doing. Years ago I asked my psychiatrist (whom I saw for four years) whether exercise would help alleviate depression. He said, “There is no evidence to support that it does.”

Of course, he has since been proven wrong. Researchers at Duke University Medical Center studied 156 depressed patients 50 and older and found that after 16 weeks, those who exercised showed significant improvement compared to those who either took medication alone or those who combined medication and exercise.

In a six-month follow-up study, Duke psychologists found that depression returned in only 8 percent of the patients in the exercise group, versus 38 percent for the drug-only group and 31 percent for the drug and exercise combined group.

And Dr. Robert N. Butler, President of the International Longevity Center at Mount Sinai Medical School in New York City, said, “If exercise could be put in a pill, it would be the number one anti-aging medicine and the number one anti-depression medicine.”

Still, for those of us who suffer from depression, motivating ourselves to exercise when we can barely get out of bed, isn’t easy. But as a long-term strategy, it may work better than antidepressants.

Inquiring minds would like to know. How do you exercise? Are you able to continue exercising even when you're depressed? Do you exercise with a buddy or by yourself? What tips can you give to others?

Thursday, April 19, 2007

Successful College Depression Program

Under the guidance of Professor Stephen S. Ilardi, Kansas University has instituted the Therapeutic Lifestyle Change (TLC) program to treat depression for community members and Kansas University students. The concept is based upon the idea that people used to be hunters and gatherers who spent most of their time outdoors. We used to live in small tribes, sleep regular hours, eat a simple diet, and spend a lot of time looking for food.

Professor Ilardi believes that even though our lives have changed, our bodies and constitutions haven't. He believes that depression is the result of a "toxic lifestyle." To that end, he's developed a program with six component parts.

1. Exercise. Three times a week, participants are encouraged to engage in 30 minutes of aerobic exercise, including running, biking, walking fast, or playing basketball--anything that gets their heartbeat up to 120-160 beats a minute.

2. Omega 3 fatty acid supplements. On a daily basis, they recommend 1000 mg of EPA and 500 of DHA.

3. Light exposure. On a daily basis, they recommend 30 minutes of sunlight or 30 minutes from a light box. (Personally, I've tried a light box and it hasn't worked for me but that's not to say it won't work for you. Also, some psychiatrists believe a light box can cause a mania or hypomania so you may want to check with your doctor.)

4. Anti-rumination strategies. Rumination means dwelling on negative thoughts. Dr. Ilardi believes that thinking negative thoughts makes you feel worse. (I couldn't agree more.) He suggests that when you start to ruminate, you need to stop, and do something else whether it's writing in a journal, knitting, or talking with a friend.

5. Social support. He discusses the importance of spending time with other people--even when you feel depressed. (Of course we all know this is easier said than done but it's certainly something to strive for.)

6. Sleep Hygiene. He recommends eight hours of sleep each night. He suggests that it's important to develop a bedtime ritual and to avoid caffeine and alcohol for a few hours before you go to bed.

The great news about all this is that it's working. I'm not sure how many people have participated but among those who have, they have reduced their symptoms by 60 percent!

The College Mental Health Crisis

Tears streamed down my face as I watched the news last night and saw clips of the students and professors who had been killed. To think about so many people unnecessarily losing their lives because of the actions of someone who was delusional, sick, unhappy, angry, isolated, and violent is incomprehensible to me.

How does this happen? I wondered. Earlier in the day, I had read an article in the Los Angeles Times, A Puzzling Start to a Deadly Day, in which I learned that Seung-hui Cho had been a silent bully for quite a while before he exploded like a time bomb. He'd frightened other students in his classes by refusing to make eye contact with them or talk to them. In an English class, he took their photographs with his cell phone, and everyone was so uncomfortable with his behavior that they stopped coming to class. His professor talked to the department chair and she tutored him privately so that the other students could resume their studies. At the end of the semester, she gave him an "A," not because he deserved it but because she was afraid of him. She recommended that he get counseling but he didn't.

Last night on MSNBC Countdown with Keith Olbermann, I learned that Cho lived in a suite with four other students and they never talked. A roommate from last year said Cho preferred to communicate by instant messaging--even with the kids who lived with him. In December of 2005, he had been evaluated as incompetent by a judge who had said Cho was dangerous to himself and to others.

From everything I've seen and read, Cho was totally alone in a community of 25,000 students. How does this happen? When should college administrators have intervened? When should they have determined that his behavior wasn't acceptable? When should they have demanded he receive help in order to remain on campus?

How do parents who are from a culture so very different from ours, recognize that their child is in dire straights? How do they seek help for an illness that is so stigmatic and "shameful" in a culture where "shame" is a "dirty" word?

In their 2005 book, College of the Overwhelmed: The Campus Mental Health Crisis and What to Do About It, authors Richard Kadison (he's chief of mental health services at Harvard) and Theresa Foy DiGeronimo discuss their concerns about the serious mental health problems on campuses throughout the country. They note statistics showing that one in ten students say they have seriously considered suicide. They outline the stressors that students face, the self-destructive behavior they engage in, and they recommend ways for dealing with these problems.

In the February 28, 2007 issue of The Cornell Daily Sun, college president David J. Skorton has written an article, "Facing Mental Health Issues: Looking Out for Each Other." In it, he expresses his concern for the "level of stress and for the mental health issues that affect our campus." He talks about student suicides and notes that "the rate of referral and self-referral for mental health services at Cornell has risen briskly...increasing 128 percent in the last eleven years."

This is true across the country. In a 2006 piece on Fox News entitled "Colleges Struggle, Innovate to Meet Mental Health Needs of Students," Dr. Trisha Suppes, director of the Bipolar Disorder Research Program at the University of Texas Southwestern Medical Center in Dallas, is quoted as saying "We know that psychiatric distress among college students is very high. It's in the past five years that an effort for greater awareness has been made."

"According to the 2005 National Survey of Counseling Center Directors--which represents the responses of 366 college counseling centers across the country--90.3 percent of directors reported a rise in the number of students with severe psychological problems, and 95 percent reported an increase in the number of students coming to counseling who already are on psychiatric medication. Directors overall reported that more than 43 percent of their student clients have severe psychological problems."

Statistics from Active Minds, a mental health student advocacy program on some college campuses, are staggering. "Young adults aged 18-24 have the highest prevalence of diagnosable forms of mental illness in the whole population at 27%. Half of all adults with depression report onset before age 20. 75 % of people with schizophrenia develop the disease between the ages of 15-25."

While one can only hope and pray that there will be no more Seung-hui Cho's, there is clearly a mental health crisis on college campuses, which needs to be addressed. Like everyone else, I probably have more questions than answers. But I do believe that as long as "mental illness" is stigmatized, students will not get the help they need.

If we continue to view every problem as "pathological," rather than understanding that in some cases, students just need help in adjusting to college, or they need to learn stress management techniques, or they need psychoeducation, or they need to learn coping skills, we will miss out on opportunities to help them in a non-threatening environment.

In other cases, students have more serious problems. They may need to remain on medication or have medication prescribed for them. They might require regular counseling sessions and participation in support groups. It might be best for them to take time off from college in order to regroup and recover.

In all cases, mental health must come out of the closet. Just as we teach our children how to take care of their physical needs, we need to teach them how to take care of their emotional needs. In a perfect world, we would address mind-body issues together rather than separating them. Until that happens, we must teach our children that it's important to seek help--whether for a physical or psychological problem. And we must teach them to help others in need as well.

As the parent of a 17-year-old son who will be going away to college in the fall, I cannot begin to imagine the pain and sadness that the parents of the slain Virginia Tech students are feeling. And I am certainly not excusing Cho's behavior in any way. I believe he's totally responsible for his actions.

But I do agree with David J. Skorton, the president of Cornell University, who wrote the following words last February, "All of us must acknowledge our interdependence and share responsibility for our own and others' health and well-being...When we are aware of someone who is in distress, we demonstrate compassion when we extend ourselves to that person, rather than ignoring the need."

Wednesday, April 18, 2007

Blogger, Word Press, Pencils, and Paper

Thanks to Syd, Marja, and LuckyMud for their comments on yesterday's blog. If you read Dr. Healy's article, you might be interested in the follow-up articles. Also, you should read LuckyMud's comments on this blog. She's very articulate and thoughtful. I wish I could figure out how to let the comments show on the main page of my blog. Under Settings, on the Comments page, I've checked "no" for the pop-up window but it doesn't seem to matter. I've searched for this in the blogger help areas but as far as I can tell, they seem to suggest that it can't be done. If I'm missing something, please let me know.

What I'd like to be able to do is to encourage "conversation," to allow for more of a "back and forth" relationship between readers. One of the reasons I started a second blog on Word Press was to try and see if that platform has any advantages. While I seem to have gotten more "hits" on Word Press more quickly, it's more difficult to figure out how to do things. Yesterday, I went out and bought a few books on blogging, but I'm just beginning to read them.

Perhaps my problem with all this is that I'm truly old-fashioned at heart. When I'm writing a book, I write on a pad of paper and use pencils. I physically enjoy the act of writing. I like hearing the sound of a pencil on paper. When I'm a bit flush, I buy more expensive pads. My very favorites can be found at Levenger. I also love their pens and ink. Actually, in the best of all world's, I would buy everything they sell. My sister-in-law introduced me to them and has bought me some wonderful items for gifts.

In terms of pencils, my every day ones that I buy at Office Depot or Staples are Sanford Eagle Number 2. But I've also bought some great specialty pencils. My most recent purchase is Translation Pencils, which are made out of Japanese newsprint and they come in a tubular package that's also made from newsprint. For a review, you can see them at one of my new favorite online sites, Pencil Revolution.

My favorite notebook is from Moleskin. It's 3" x 5" and comes three to a pack for $9.95 (in American money). I often buy them at Barnes and Noble but there's this very neat blog, Moleskinerie, which you might like.

I must admit that so far I've learned nothing from my blogging books. What I read yesterday was that blog posts are supposed to be short and to the point. If you write about a topic, you're supposed to stick with it. The example, oddly enough, was folk music (something I love). But the author wrote, "If you write about Celtic music, then stick to that. Don't go off on tangents." Also, she said that you should be judicious with graphics because it takes longer for the blog to load.

Clearly, I don't listen. Otherwise, why would I start writing about yesterday's blog, move on to a discussion about Blogger and Word Press, end with moleskin notebooks, and include three graphics? I wonder if this inability to do what I'm told is a bipolar personality trait or just me?

Tuesday, April 17, 2007

Some Interesting Sites and Articles

Because I'm new to blogging, I realize that if I continue at my present level of activity I'm going to burn myself out. Also, I spent years where I tried not to think about this illness--as a method of healing--and I'm not sure how I feel about blogging about it on a daily basis. I'm learning as I go along. Today, I'd like to recommend a few other sites and a controversial and interesting article by Dr. David Healy, a psychiatrist and professor of psychiatry in Wales.

While I already provide links to these sites and blogs, I think it's nice to highlight what other people are doing.

LivingManicDepressive is a site that was established by Jinnah, who lives in Trinidad and Tobago. He's been manic-depressive since the age of 18 but his illness wasn't diagnosed until 1997. He's developed a major site where he provides all kinds of great information as well as a new blog. His web site sections include: The Bipolar Diary, How It Feels, Ideas for Coping, and so much more. (In fact, he even mentions my blog.) What I particularly like is Jinnah's upbeat and positive attitude.

Bipolarity: Perspectives on Life from a Bipolar Lens by Syd is a wonderful blog. Syd's a terrific writer, sensitive and talented. For anyone who's experienced long and difficult depressions, yesterday's post, Darkness Falls, should resonate. "I’ve experienced chronic physical pain and I’ve experienced deep and chronic depression. Given the choice, I’d choose physical pain any day." Wouldn't we all.

Roller Coaster by Marja from British Columbia, is a terrific blog as well. If you log on now, you'll smile as soon as you see her wonderful photographs of children. Marja is a professional photographer who specializes in child photography. She's also the first person who emailed me once I started this blog, which made my day. Marja's particular interest is in faith-based healing.

One Year of Writing and Healing: A Conversation and Workshop is by Dr. Diane Morrow, a physician and writer who lives in North Carolina with a long term interest in how the act of writing can benefit healing. Diane is the doctor we all wish we could see but since we can't, she provides wonderful exercises in writing and healing and a host of resources. She's also a talented writer.

Finally, I'm recommending you take a look at Dr. David Healy's article, The Latest Mania: Selling Bipolar Disorder. It's controversial, alarming, and informational. I'm hoping we can chat about it.

Stay tuned...I'll recommend more blogs and sites as we move along. Today's picks are the ones I know best and are written by people with whom I've developed relationships. Also, because of an email by Lucky Mud, I plan on writing more about my experience with Integrative Medicine in future posts.

Have a nice day!

Monday, April 16, 2007

Feeling Grateful (Part 3)

So...given that Feeling Angry, Hostile, and Outraged, would have been a more apt title for my last post, I now wish to list the 10 ten things I felt grateful for during our brief college tour.

1. I am grateful I felt well enough to make the trip. It was very important for my son, my husband, and for me as well.

2. I am grateful I felt well enough to do so much of the driving and spend hours each day walking around the two campuses and the two cities. (Isn't it amazing how different our energy level is when we're not depressed? When I'm very depressed, I can barely walk from the bedroom to the bathroom, and now I was walking miles each day.)

3. I am grateful I was genuinely upbeat and truly could enjoy the excitement we all felt. (When I'm depressed, I know that my face changes and I have a pinched look. No matter how hard I try, it's difficult to pretend I feel well when I don't. I seem to lose half of my brain cells and all of my memory cells. My voice changes and I find it difficult to articulate fairly simple thoughts.)

4. I am grateful that I had excised my demons from Berkeley a few years earlier and could now enjoy the campus for what it has to offer--without any baggage.

5. I am grateful that the trip could focus on my son and his needs--as it should have--and that my health was a non-issue.

6. I am grateful that my son is a wonderful person, whom I'm so proud of, and that he has flourished despite my illness.

7. I am grateful that my husband is a saint who has stood by me for more than 20 years--in sickness and in health.

8. I am grateful that I've stopped being worried about my son's college experience. I'm not sure why so many people undergo their first depression or mania during their college years. (One would think this is an area that bipolar researchers would explore.) But, I realize that because of what happened to me, I will be able to provide much better help and guidance to my son--whatever his needs might be.

9. I am grateful that despite all my suffering and pain, I still am able to experience great joy and happiness.

10. I am grateful that despite a few years of feeling so angry and hostile because of treatments that didn't work and healers who didn't heal, I have retained my optimism and sense of humor.

Sunday, April 15, 2007

Feeling Grateful (Part 2)

As you'll remember from my earlier post, the purpose of my trip to Berkeley and to Davis, California, was to support my son who was viewing college campuses. (In a few days, I'll begin a series on "triggering events," which will provide a different look at all this.)

Although my husband, son, and I had a wonderful four-day trip, and that is truly something to be grateful for, I was concerned about my ability to express true happiness. About a year ago, I realized that even when I was happy, I felt a certain level of sadness. It's difficult to explain but the underlying problems were anger, grief, and loss.

During the years of my medication merry-go-round,when I was taking so many drugs that didn't work, caused such horrific side effects, and made me sick almost every day, I never "blamed anyone" because I accepted my doctors' explanation that I was medication resistant and thus one of the most difficult cases to treat.

In 2003, I learned that all of this was a lie. The real problem was that bipolar depression had been largely ignored. Psychiatrists were prescribing medications for which few studies had been conducted. In fact, the first full scale clinical study of the efficacy of medication, the Systematic Treatment Enhancement Program for Bipolar Disorder, STEP-BD, didn't begin until 1998 and concluded in 2005.

What that meant to me was that from 1993 to 2003, I'd been taking medication that had barely been tested. This was confirmed by the American Psychiatric Association 2003 Practice Guideline for the Treatment of Patients with Bipolar Disorder," in the section on "Somatic Treatments of Acute Depressive Episodes." (Although I can't find the report online any more, I will write about its findings tomorrow.)

Once I realized that I had been a guinea pig for a decade, I felt I'd been sucker-punched. I realized that I was sick because I never had a chance to be well. I was taking medication that no one had tested because they'd been concentrating on the manic side of this illness rather than the depressive side. Somehow, they "didn't realize" that most of the suicides occur during depression rather than mania, that more people relapse into depression than into mania, and that depression is responsible for a higher level of disability.

How could I have spent ten years researching this illness without understanding how little was being done by the psychiatric profession? I wondered.

I wished I'd never begun taking medication and that I hadn't bought into the whole story that "responsible people need to be compliant." And I was outraged at the psychiatric establishment in the United States for pretending they knew what they were doing when they clearly didn't.

While my illness had saddened me, this information enraged me. I felt such an overwhelming sense of loss and grief that I didn't know what to do with my feelings. I wanted someone to care that my treatment for bipolar depression was worse than the illness itself. I wanted them to publicly admit they were prescribing drugs without any idea of their short-term or long-term effect. I wanted them to apologize to my son.

It was bad enough that I had been sick, but none of us are sick in a vacuum. This illness has had a huge impact on my son. It wasn't diagnosed until after he was born. I began taking medication when he was four years old and continued until he was fourteen.

Over the years, I can't even begin to tell you how guilty I've felt about its impact on him. The day-to-day stuff was bad enough, even though I tried--with all my strength--to mitigate it. Yet, each time we had to cancel a family vacation, or change plans, or send him to an extra session of computer camp (because I used to feel terrible during August), I was devastated.

In 2003, once I began seeing a doctor of integrative medicine and started feeling better again--for much longer periods of time--a part of me couldn't seem to resolve my feelings of loss. Now that I believed that there had been no real reason for all my suffering, my grief was overwhelming. Writing about it wasn't enough. I felt like I wanted to go to the Wailing Wall in Israel, pound my chest, and cry aloud--preferably for months. I wanted to hike up to the Hollywood sign (I live in Los Angeles) and shout, "The treatment for bipolar depression is worse than the illness." (Yes, I realize that would have been "mentally ill" behavior.) I wanted to write a letter of condemnation to someone in Washington D.C. but I didn't know who to write to.

Finally, a few months ago, I decided I had to let go of my anger. At best, it was non-productive. At worst, it made me sick. I realized that I've got six months left until my son leaves for college. While there is no way to make up for what he's lost, there is no value in continuing to dwell on "loss and grief" rather than happiness and joy.

[to be continued]

Saturday, April 14, 2007

Feeling Thankful (Part 1)

We have just returned from a four-day-trip to the University of California at Berkeley (and Davis), two of the four campuses my 17-year-old son has applied to. Because he's a community college transfer student, he won't know where he's been accepted for another two weeks. But this week was spring vacation and so we had to take advantage of his time off.

I can't tell you how thankful I am that I felt well enough to go. To be honest, even though I may have seemed fine for the past few months, I have been recovering from a depression that started at the end of November. I've been feeling better for the last few weeks but not "as good as it gets."

Before we left, I had been able to do errands, household chores, and accomplish a multitude of small tasks, but I still didn't feel well enough to spend time with friends. I had begun working for short periods outdoors but I hadn't started the Wellness Walking program that was one of my New Year's resolutions. Still, I was bound and determined to make this experience a memorable one for my son and my husband. And it was.

What amazed me was that I was able to carry all this off even though UC Berkeley holds terrible memories for me. Thirty-nine years ago--almost to the day--I was a freshman there myself. After a truly wonderful high school experience, I started college as a mid-semester graduate (This was quite common in California) in April 1968, and within four weeks, I experienced the first depressive experience of my entire life.

While I had gone back to Berkeley a few years ago to excise my demons--and bring closure to my "triggering event"--this time, all I wanted was the ability to allow my son to look at the campus without prejudice. College should be the most exciting period of his life thus far, and I wanted to be supportive and helpful.

[to be continued]

Tuesday, April 10, 2007

Life Mirroring Art (Part II)

As I sat at dinner with my mother, I took out my new moleskin pocket notebook--a birthday gift from my mother-in-law. On a piece of light yellow lined paper, I wrote down my name and phone number as well as the name of my blog. I intended to give it to the actress before she left, and I planned on asking her to call me. I had some ideas for publicizing her play and I was interested in talking with her about how to write a one-woman show. It's something I've always wanted to do and with the success of selling my memoir under my belt, I felt it was time.

I walked over to her table and handed her the page. When she looked at it and saw that the name of my blog is Bipolar Wellness Writer, she said, "Why is your blog about that?"

"Because I'm bipolar," I answered, "but I write about it in a funny way," I quickly added, in case mentioning the illness made her uncomfortable. "I know it would work as a one-woman show."

Tears came to her eyes although she was smiling. "Black humor," she said.

I nodded.

"Eighteen years ago, my sister lost her fight with bipolar disorder."

"I'm so sorry," I said.

She wiped the tears from her eyes. We chatted a bit more, and promised to get in touch with each other when I return from a brief vacation (we're leaving tomorrow).

As I pushed my mother's wheel chair out of the restaurant, I shook my head. I never discuss my illness with strangers. I haven't mentioned my book in years because I was so devastated by my agent's inability to sell it. And now that I've recently begun to have some level of success again, I was stunned to find that the one person I talked to--had a bipolar relative. Who better to understand what the illness is like? Who better to "play me" in my one-woman show?

"Thank you God," I whispered, looking upward. "I can't tell you how much I appreciate it." Besides my husband and son, perhaps God was the only one who knew that last Christmas I had shredded more than 100 file folders of research, which filled 8 large black plastic trash bags. In the depths of yet another depression, I had decided I was deluding myself into thinking that I could ever write another book and it was time to give up--once and for all.

Here I was four months later, writing a new blog, working on two new book ideas, and thinking about writing a one-woman show. The amazing part of this illness is how things can shift from month to month, day to day. That night when I fell asleep, I dreamed I was sitting in a large auditorium. The actress I'd met at dinner was performing my play. The audience was laughing with delight. My husband nudged me.

"What?" I asked, suddenly awake.

"You're laughing out loud," he mumbled. "I can't sleep."

"It's the sound of the crowd," I whispered as I went back to bed.

Monday, April 9, 2007

Life Mirroring Art (Part 1)

On Saturday night I was having dinner with my 85-year-old mother at a neighborhood restaurant. It was early and there were only two other parties at the tables next to us. We began chatting and it turned out that one of the other diners is an actress whose one-woman play will be premiering in October at a small community theater. As a writer, I was thrilled for her. After 14 years, I recently sold my memoir to a London publisher and I couldn't be more delighted.

As mother and I continued eating our meal, I decided that before leaving I would give the actress my name and phone number. I've always dreamed of writing a one-woman play about bipolar disorder although I'm not sure how big an audience I could draw. The problem has always been that while the illness is devastating, I tend to write about it with humor.

Even when I'm terribly depressed, I come up with ideas that amuse me. When I had a bad experience trying to find a support group, I decided I would write a one-act play called Support Group Auditions that I'd pattern after Chorus Line. The reason why is simple. Writing about sadness and despair makes me feel more sad. Poking fun at it has always enabled me to laugh at the absurdity of the situation and more survive.

Early on, an "A-list New York publisher" rejected my manuscript because it wasn't sad enough. I was furious. "Norman Cousins wrote about the healing power of laughter in dealing with physical illness," I said to my husband. "Why can't I have the same freedom in writing about mental illness?"

"It's probably because no one feels comfortable with your poking at an illness that causes so much despair," he answered. "Clearly they don't understand that you've suffered more than most."

"I wonder what the criteria is for allowing someone to write about bipolar disorder with humor," I mused aloud. "I think it should be their level of suffering."

We were both stunned by what I'd said but we laughed out loud. Since my suffering has been legion, I figured I can write about this illness however I choose. [to be continued]

Saturday, April 7, 2007

Pet Therapy

When my son was five years old, he wanted a dog. Preferably a small black male dog whom he could call "Spike." Having grown up with dogs, I felt it was a good idea so I went to our local rescue agency, talked with the executive director, and laid out my son's criteria as well as my own.

I wanted a dog who was good with children for obvious reasons, and was calm and quiet because I work at home. We ended up with Prince, a 21 pound black male terrier mix (He looks like a Manchester Terrier with a Chihuahua face) who allegedly had all the traits we desired. (I don't have a picture of Spike from that period but I did find one online that looks almost like he did.)

As it turned out, Spike, formerly known as Prince, had all of the physical attributes my son was seeking but none of the personal qualities I cared about. He dislikes most children except my son who is now 17, all men except my husband, and all other dogs except Murphy, a black Lab mix we rescued eight years ago so Spike could have a friend.

Still, I fell in love with Spike from the start and he is an important member of our small family. One quality I would have sought—had my illness been diagnosed before we adopted Spike—was loyalty. After I began taking psychotropic medication in 1993, I was severely depressed for almost a year.

Who was to know that my ever-present companion would be Spike? From the moment I awakened in the morning—and even on those days when I could barely get out of bed—he would greet me by tenderly licking my face, mold his body next to mine, and remain by my side all day long.

A year later, when the depression finally passed, and I regained a normal level of activity, Spike bounded around the house with renewed energy, happily went on walks, maintained his vigilant level of barking at strangers who passed by, growled at other dogs, snapped at small children, and embodied few of the qualities the American Kennel Club finds important.

According to them, Spike’s temperament should be as follows: "The Manchester Terrier is neither aggressive nor shy. He is keenly observant, devoted, but discerning. Not being a sparring breed, the Manchester is generally friendly with other dogs. Excessive shyness or aggressiveness should be considered a serious fault." And..."A Chihuahua is alert, with terrier-like qualities."

Although Spike clearly has "serious faults" and would never win a "best of breeds" award, he's been a wonder dog for me. And how was I to know--all those years ago--that "pet therapy" would be an important part of my healing process?

Love, Medicine & Miracles

Much of what I've learned about wellness has been from oncologists. I've learned nothing about it from psychiatrists. Almost 18 years ago, when my father was diagnosed with an advanced stage of prostate cancer, I tried to find books to inspire him. One of my favorites back then, which I still frequently turn to, is Love, Medicine & Miracles by Dr. Bernie Siegel. While the following quote didn't pertain to my father, it does pertain to me.

"If a person deals with anger or despair when they first appear, illness need not occur. When we don't deal with our emotional needs, we set ourselves up for physical illness. Yet what are most of us more comfortable with--telling the neighbors we have to see a psychiatrist or that we need an operation? We're uncomfortable saying we're being driven crazy but not that we're being driven to illness.

"The simple truth is, happy people generally don't get sick. One's attitude toward oneself is the single most important factor in healing or staying well. Those who are at peace with themselves and their immediate surroundings have far fewer serious illnesses than those who are not."

When I think about the treatment for bipolar disorder, I ask myself, "Where are the Dr. Bernie Siegel's in the psychiatric field?" When you look at the link to Bernie's Siegel's "exceptional patients retreat," ask yourself if that wouldn't be a healing experience for you. Wouldn't you enjoy a few days where you could study the following topics?
• The Science of Whole Person Bipolar Treatment Care:
the latest research; why this approach works

• Beliefs & Perceptions: the biology we manifest

• How To Live Between P-doc Visits:
become an informed patient

• Spirituality and Healing:
discovering our inner connection

• Building Futures One Step at a Time:
a rational approach

Friday, April 6, 2007

Celebrating My Bipolarity

Today is my birthday. It's been 39 years since I experienced my first depressive episode. I was a college freshman and it was triggered by "life events." I picked the wrong school and I didn't know how to ask for help or admit that I'd made a mistake.

It's kind of amazing that no one was able to diagnose my illness for 25 years. Once I graduated from college, every year I experienced two six-week depressions; one in April and one in October. For most of my life, they weren't that bad. I knew I didn't feel well but I was still able to work and live my life. Over time, the episodes became more painful and disruptive and I went into long-term therapy to see what changes I needed to make in my life.

In hindsight, these depressions may have been SAD (seasonal affective disorder) or they might have been caused by the "anniversaries" of the event. As a mid-semester graduate, I started college in April although the fall semester began in October.

Despite the common wisdom about the advantages of early detection, a part of me is glad it took so long to receive a diagnosis. Since I am so opposed to the classification of this illness as a "mental illness," I'm not sure how I would have coped with such a stigmatic label when I was only 18 years old. It seems to me that unless a person is harming themselves or others and needs immediate hospitalization, it's quite a burden to carry through life.

When I was young and trying to figure out who I was, what I aspired to, what dreams I wanted to fulfill, what the possibilities were--I think that wearing the yoke of this illness on my shoulders would have been limiting. During difficult times, I wonder whether I would have stopped trying because I was "sick." Would I have married and had a child (truly my greatest joy) if I had known I could pass my illness on to him? Would my husband have taken the risk if we had foreseen all the difficulties we would encounter on our journey?

Psychiatrists define manic depression as a lifelong "disease." Although it may need to be treated throughout a person's life, what if it just were considered to be a personality trait? What if we looked at the strengths it affords us rather than the weaknesses and devastation it can cause? In celebration of my birthday, I would like to write about what I consider the best aspects of this illness--for me.

In a hypomania I feel a kind of aliveness and joy that I think few "normal" people ever experience. When I'm hypomanic and I walk outside and feel the sun on my face, it literally warms my heart. When I look at trees, I notice the color and texture of their bark and leaves. When I walk around the park, I hear the birds chirping, the whack of golf clubs hitting golf balls, the scratching sound of squirrels climbing trees. When I'm with people I care about, I feel a love that is so pure and full that my heart feels like it might burst with happiness. When I am hypomanic, I feel a level of energy that is truly blissful.

In a depression (once the bad part is over but I'm not yet ready to rejoin the world), I have the time to reflect on my life. I ask myself why this recent episode happened? Was I straying from my path? Am I meant to move in another direction? Is this a message of some sort? What was the trigger? What does it mean? What changes do I need to make? How can I make use of the quiet time to replenish myself? Was I listening to my inner voice before this happened?

I often wonder if we who are bipolar--as long as the symptoms are controlled, our behavior isn't harmful to ourselves or to others, and we have developed coping mechanisms and/or skills that enable us to temper the hypomanias and reduce the severity of the depressions--aren't the luckiest people? Who else can feel so fully or so deeply? Who else can experience the entire spectrum of feelings? Who else must explore the very essence of who they are--while there is still time to change things?

Wednesday, April 4, 2007

Wellness Activity: Email

Email is a lifeline for a sick person. It always worked for me when I felt depressed and and wasn't interested in squandering my reserves by trying to amuse my friends.

My friend Darcy said she felt the same way when she was undergoing chemotherapy. "I would come home from chemo and feel nauseous with flu-like symptoms for hours. The last thing I wanted to do was to talk with people on the telephone but I did want them to know I was okay. So I'd email everyone but my mother, who doesn't have a computer.

"It was great," she continued. "When I'd awaken, I'd have all these emails in my inbox wishing me well. Some friends would send me funny email cards from American Greeting although they don't really have a category for cancer survivors. But they should, don't you think?"

While writing greeting card copy for cancer patients with a sense of humor may be Darcy's new career path, we both agree that the value of email as a lifeline has the following advantages:

1. We don’t have to respond to messages until we're ready.
2. Writing email gives us the freedom to craft our message, review it, edit it, and rewrite it.
3. Whether our voices sound sad or weary, no one can tell, and we both appreciate that kind of privacy.

While some might argue that being unable to hide illness is good because it enables your loved ones to "reach out and touch you," Darcy and I disagree. Life, after all, isn’t a telephone commercial.

Tuesday, April 3, 2007

One Small Accomplishment

During the worst depressions, I have always found that it's helpful to recognize that there are people who are--or have been--in worse shape than I. Helen Keller frequently comes to mind, and I love this quote from her book. "I long to accomplish a great and noble task; but it is my chief duty to accomplish small tasks as if they were great and noble."

When I can barely function, my memory is shot, I can't read, I don't feel like going online, I can't concentrate on anything I care about, and feel totally lousy, I have always tried to find one small task each day that I can accomplish.

Sometimes, it is a baby step like sharpening the pencils on my desk, going through my change and putting 50 pennies into a roll, writing one email to a friend, walking outside and sitting in the sun--even if it is just for 10 minutes--running a load of dishes through the dishwasher, or reading a children's book.

One activity I have always enjoyed is "handwriting." Years ago, I bought a writing tablet, which I keep by my bed. On my worst days, I take it out and just write my letters. I have lovely penmanship. Cursive writing reminds me of simpler times and childhood memories. The physical act of writing makes me feel good.

Although these activities seem negligible when I'm well, I've learned that the smallest step forward is important when I'm ill. As Carl Rogers said, "What I am is good enough if only I could be it openly."