Monday, September 29, 2008

High School Reunion

Dear Friends and Readers,
My 40th high school reunion was a wonderful event. As I may have mentioned, we were a mid-semester class of about 250 people; 100 attended the reunion. Rather than have it at a country club (as many classes do), or hosted by a professional for-profit reunion group, we planned it ourselves.

The process of working on it with three high school friends was as much fun as the event itself. We've been meeting for the last few months and not only did we work well together, but we laughed the way we did when we were in high school. There is something about remembering old times, thinking about how we acted when we were 15-18 years old, looking at a seminal period in our lives 40 years later, recounting things we said and did, and just enjoying each other's company--that was so much fun and so very satisfying.

The event itself was extraordinary. I had been told that the 40th reunion is truly special because people are so glad to reconnect, yet they're still in great shape (only 12 of our classmates had died), and it all proved to be true. Without sounding corny, there was so much love and goodwill on Saturday night at a small restaurant in West Los Angeles that it must have radiated throughout the universe.

How fun was it for me when people said, "Susan, you look just the same" (I'm not sure I really do but a lot of people said it so it must be true, mustn't it? ;)--or "I can't thank you enough for doing this because I'm having such a wonderful time."

And there is so much more...but I'm still a bit tired...I've got badminton today...and then it's time to return to my life--which will be that much richer because old friends have become new friends...and it doesn't get much better than that!


Salisian Class Treasurer

Thursday, September 25, 2008

On Vacation

I'm taking tomorrow off and will return to blogging on Monday. Saturday is my 40th high school reunion. I've got a ton of work to do on it, and will barely be online for the next four days. Hope everyone has a happy and healthy few days.

FYI...the photos are allegedly fashions people wore in 1968, the year I graduated from high school. I didn't know anyone who dressed that way, but the photo on the left was featured in The Saturday Evening Post, and the one on the right in Life magazine.


When I thought about the last two days' posts, I realized how powerful a tool "hope" is. If a person honestly doesn't believe that things will get better when he/she is down, I would have to say, "Then, how do you go on?"

My parents were great optimists and they passed that quality on. I can't remember a day going by in my childhood when they didn't feeling optimistic about their own lives, my siblings, and mine. I should imagine it's very difficult to feel hopeful when your parents aren't. And I'm in awe of people who grew up in non-supportive, pessimistic, or abusive households and still have hope.

What exactly is hope? Perhaps the following people define it best:

"The capacity for hope is the most significant fact of life. It provides human beings with a sense of destination and the energy to get started." ~Norman Cousins

"The natural flights of the human mind are not from pleasure to pleasure but from hope to hope." ~Samuel Johnson

"Hope is a renewable option: If you run out of it at the end of the day, you get to start over in the morning." ~Barbara Kingsolver

"Hope is the thing with feathers - that perches in the soul - and sings the tune without words - and never stops, at all." ~Emily Dickinson

Wednesday, September 24, 2008

You Can't Heal a Story

The quote, "You can't heal a story," comes from Stephen Wolinsky and is one of many wonderful quotes found in If the Buddha Got Stuck: A Handbook for Change on a Spiritual Path by Charlotte Kasl, Ph.D.

There is so much about this book I like, so I will share another quote with you--from the chapter Notice the Stories You Tell Yourself. "Buddhism teaches us to be aware of the stories we tell ourselves. Stories are usually about the past or center around wishful thinking. They take us into our heads and stop us from being in our current experience with our feelings and emotions. It's like commenting on life rather than living it.

"Because is a common word in many stories. 'I can't swim because someone scared me as a child.' 'I don't push myself because I don't want to outshine my family.' 'I can't lose weight because I'm afraid of intimacy.' The internal response to such statements could well be, 'How do you know?' 'What have you tried?'"

Tuesday, September 23, 2008

When You're Stuck

I'm reading a book I'm really enjoying, If the Buddha Got Stuck; A Handbook for Change on a Spiritual Path by Charlotte Kasl, Ph.D. What I particularly like about it is that she presents seven "simple yet profound steps on the path to change." They are:

1. Notice When You're Stuck. "Be aware of your unrest, unhappiness, and longing for something richer, more balanced, and meaningful."

2. Show Up. "With curiosity and fascination, go beyond your prescribed life and explore the world beyond your usual--rituals, beliefs, and habits..."

3. Pay Attention. "Go deeper into the experience of inner awareness on a moment to moment, daily basis...You notice when you are tense, afraid, hungry, tired or in need of comfort...Paying attention is grounded in the body and expressed through these questions: What is right for me? What do I really want to do? What is my body telling me?

"You also start to notice your mind--how opposing voices argue, censor, judge, and reel off the same stories day after day. You become aware of the allegiance you pay to rules and beliefs --being nice is good, angry is bad, you should never talk back, you can't do that--and start to notice the limitations those thoughts create."

4. Live in Reality. "Sort out the past from the present. Is this flame of anger connected to my childhood or is it appropriate to this current situation? Am I feeling relaxed and clear--like a grownup--or uneasy and afraid like a child?"

5. Connect with Others, Connect with Life. "Genuine connections ease anxiety and help assuage our essential aloneness. They provide the secure base from which we can venture into scary places, celebrate our joys, and take risks, knowing someone is there either to cheer for us or catch us if we fall."

6. Move from Thought to Action. "Taking action becomes the process of how you live on a daily basis--from taking care of your body to signing up for a class, completing tasks, speaking out when someone is hurting you, getting out of bed early to take a walk, watering the plants before they wilt, throwing away the excess stuff that clutters your life. It's about movement, flow, energy, shifting, and shaking up the status quo.

7. Let Go. This step means that we stop grasping at all that is temporal--mind, thoughts, body, life situation--and experience being one with aliveness that penetrates all things. Instead of being the 'doer,' we experience an expression of life that flows through us.

So, what's holding you back? What step is most difficult? As Dr. Kasl asks, "What regrets would you have if today were your last?"

Friday, September 19, 2008

An Expert on Me

In the last few weeks, a number of people have told me how good it is that I'm able to figure out what's wrong when I feel ill and correct it. At this stage in my life, it would be great to say, "Thank you. I'm so intuitive. It’s easy for me."

But that would be a downright fabrication. The truth is that the reason I'm able to do this is because I kept a detailed mood chart for six years, in which I noted what medication I took and in what dosages, how it made me feel, how I felt in general, how much sleep I got each night, what I ate, how much exercise I did, and detailed records of all my psychiatric visits as well as those with alternative practitioners.

In fact, I have been keeping a daily journal--albeit not as detailed--for almost 20 years. I began it when I started working as a freelance writer and had to bill clients for my time. There have been years where I have kept more or less detailed notes.

But, if you want me to tell you how I felt when I was taking Lamictal, Depakote, or Wellbutrin (or 22 other medications), I can do that.

It is this discipline, which enables me to remain well today. What I decided years ago--when my medication was making me sicker and sicker and my psychiatrists were incompetent--was that I needed to become an "expert on me." And so I have.

What I find very interesting is that while I've said numerous times that keeping mood charts is a critical wellness activity, I sense that few people are doing it. And I'm not really sure why.

If your psychiatrist said, "In order for you to become well, you need to keep a mood chart," would you do it?

It's certainly something to think about. Because if he/she did say it, and if you wouldn't take the time to do it, what does that say about your commitment to wellness?

In my case, I have done everything humanly possible to become well...and so I finally have. Years ago, when I was so depressed that I didn't see how I could survived, I searched the WEB for someone who suffered from bipolar depression and was well. I wanted to know what they were doing that I wasn’t. If I had found that person, I would have religiously tried what they recommended to see if it worked for me.

I now realize I have become the person I was seeking. It’s a great feeling of accomplishment!

Thursday, September 18, 2008

Medication Again

It just goes to show you how powerful medication can be--even a really small dosage. For the last three weeks, I've been taking 10 mg. of Adderall in order to get up in the morning. I've been slightly depressed due to the seasonal change.

Despite having taken Adderall for a number of years now (but only for a few months at a time), I didn't truly realize its effect...until today. For the last few weeks, every time I've played badminton, my new sport, I've had to quit after about 45 minutes, and sit and rest because my face has been so flushed that I looked like I was having a stroke.

Monday was the worst. Not only did I feel flushed, but after I sat down and rested, it still took 30 minutes for me to feel better. And then once I did, I began feeling chilled. So I left class early, showered, and changed. As I started walking to my car, I felt so tired that I had to stop for an orange juice as a pick-me-up.

I just assumed that the entire episode was caused because I was so tired from packing boxes due to our remodeling job.

But today when I awakened I didn't need the Adderall, and today was the first time where I could play badminton for the entire 90 minutes with only a brief 10 minute rest.

Since I don't believe in coincidence, what I do believe is that the Adderall, which is a stimulant, has caused the flushing, the slight shortness of breath, and the extreme tiredness. So, hopefully I'm now off it for good.

I hesitate to think what damage all the other medications I took for six years--including Abilify, Adderall, Ativan, Buspar, Celexa, Concerta, Cymbalta, Depakote, Effexor, Geodon, Klonopin, Lamictal, Lexapro, Lithium, Neurontin, Parnate, Prozac, Seroquel, Strattera, Tegretol, Topamax, Trileptal, Wellbutrin, Zoloft, and Zyprexa--caused, and I'm so grateful I'm no longer on it.

Wednesday, September 17, 2008

Taking a Day Off

Dear Readers and Friends,
The carpet installers came today and will finish the job tomorrow. The house looks great although I'm thoroughly exhausted. My husband has had a cold, and tonight I feel like I'm getting it. I hope not, because I'd hate to miss badminton tomorrow.

So, I'm lying in bed and listening to Sweet Baby James. My 40th high school reunion is in two weeks, and I've been listening to all the music I loved when I was 18. How fun is this?

In the meantime, I have to take a day off because everything I need is in boxes and I don't have the energy to unpack them. I'll be back on Thursday.

P.S. As tired as I am, I can at least be grateful that I'm not balding like James Taylor. How lucky we women are to keep our hair as we age! No offense Bradley. I think baldness is attractive; just not for me!

Tuesday, September 16, 2008

Wellness Activity: Badminton

While I've already written about my new sport, badminton, I have to tell you it's truly great. This morning I was really tired because I'm still not sleeping very well due to my Ativan withdrawal. Yet, I was truly excited about my badminton class, which meets at 11:00 a.m.

For years I have sought an aerobic activity that I would enjoy. According to the American College of Sports Medicine, an aerobic exercise is "'any activity that uses large muscle groups, can be maintained continuously, and is rhythmic in nature.' It is a type of exercise that overloads the heart and lungs and causes them to work harder than at rest. The important idea behind aerobic exercise is to get up and get moving."

I have tried swimming, but I have to force myself to do it. I hate gyms, and in years past I've spent a fortune joining and then going for a total of one month during the entire year. I like tennis, but I've always enjoyed doubles more than singles and it's a pain to try and get four people together on a regular basis. Besides, when you do, they want to play for more than an hour and socialize to boot. It takes too much time in my day.

While I regularly walk around the block, that's not an aerobic activity nor is gardening, which is healing but doesn't make my heart pump more quickly.

But badminton is terrific. We spend the first fifteen minutes of class doing warm-up exercises. We spend the next half hour learning new skills. And we spend the rest of class playing each other. While I'm the oldest person in the class, one of my best skills has always been my athleticism, which I had let lapse years ago.

You can't imagine how much fun it is for me to beat 18-20-year-old students. And from the moment class starts, I don't think about anything but playing hard. There's a sort of Zen in that. While I still don't have the stamina I used to, I'm getting better every session. And since my teacher is just a little younger than I am, she's couldn't be nicer about letting me rest when I'm so tired that the only thing that would truly help is oxygen.

It remains to be seen whether badminton will chase my winter blues away. But, I must tell you that while I was tired when I came home--it was the best kind of tired. It was being tired because of physical activity, which has always made me feel good. I just forgot about how much I enjoy physical competition!

Monday, September 15, 2008

Light Therapy and Medication

As I mentioned in an earlier post, I have known for years that my depressions have a seasonal element. About 12 years ago, I tried a light box and it didn't work. Last week, a new neighbor moved next door from Washington state, and she gave me a dawn simulator, which I've been using for a few days. It's too soon to tell if it's working, but I'll keep you posted.

Also, I thought I'd share an additional bit about medication. As most of you know, I've been off all medication for months. But...about three weeks ago, due to the change of seasons I began feeling a little bit down, and I've needed to take 10 mg. of Adderall in the morning because I've had early morning obligations and didn't have time to awaken more slowly, take a walk, and do my usual wellness activities.

The Adderall does the trick, but the problem is that when I take it--even if it's just a small amount--my mood elevates throughout the day. And by the time I'm ready to go to bed--usually at midnight, I'm not tired. So, I have to take Ativan to sleep. Although I'm only taking 1/2 mg. of Ativan, and while it's not supposed to have a residual effect, it does.

In fact, it's ever so clear to me why my depressions lasted for so many years. At one time, all the medication I was taking caused terrible mood swings, which I had never experienced before I started taking medication. And it also caused heightened hypomanias. My psychiatrist at the time said, "Sleep is really important, so I don't care if you become addicted to Ativan."

What he didn't say was that the more Ativan I took at night--and at one point I was taking 7 mg.--the worse I felt in the morning. And for me, Ativan has always been the most difficult medication to titrate off. It takes me months to get off 2 mg.

What's interesting is that even with the small dosage I took last week, I could barely sleep for the first three days of titrating off it, and I also had terrible night sweats. And once again, the minute I stopped taking it, I had terrible dreams that were so vivid, and lasted interminably. It usually takes a few weeks for these to subside.

On a related subject...when yet another friend recently told me about her son who's taking a ton of psychiatric medication and getting worse and worse, I didn't know what to say. My feeling is that her son should titrate off everything since they have no idea what's wrong with him and yet have piled one drug on top of another, and he's feeling worse and worse.

But, I don't even have a recommendation for a good doctor--psychiatrist or otherwise--who could help him determine what is truly the matter. Now, that's depressing!

FYI...I'm having a really busy week so I apologize if I'm not able to visit your blogs. Also, while I will respond to comments, it may take me hours to moderate them and write a response. I promise I will respond...just not in a timely fashion! Have a happy and healthy week!

Friday, September 12, 2008

A Different Look at Bipolarity

The painters finished yesterday afternoon. I need a few days of rest before the carpet installers arrive on Tuesday. I just realized there are bipolar feelings that are truly healthy.

In this case, I am so happy we are able to redo our house, and yet the process is exhausting. I am so grateful to my mother (who died last October and father who died 19 years ago) for leaving me a small nest egg, which enables us to pay for the job, but I miss them terribly.

Because we had to box up the house, which was so tiring, we are able to look at it anew. And we realized that we (who are minimalists to begin with) no longer need as many things. So, we're giving away a lot of books and other items, which is difficult for me, but freeing as well.

I'm rearranging my work space and finally feel that I no longer need a desktop computer (I have a laptop) or my big lateral file cabinet and one of my smaller ones because I no longer download so much material, and I have shredded bags of files. I feel good because I am working hard to conserve paper and space, and yet I'm concerned because it's a big step for me to work in a smaller space without some of my "things," which I've had for the last 20 years.

And all of this may just be the tip of the iceberg. Who knows?

Have a happy and healthy weekend. I'll be back on Monday.

Thursday, September 11, 2008

Taking Care of Myself

When I sat down to write Wednesday's post (which I do late the night before), I was literally exhausted. In fact, I was so tired I was concerned a depressive episode might be on the horizon.

What differentiates a depression from fatigue? For me, it's having so little energy that I'm unable to take a bubble bath. It's feeling so tired that walking into the kitchen to get a glass of water feels like taking a hike. It's feeling like I have so little energy that I can't stay awake one minute longer. Since I felt like this at 9:00 p.m. and I usually don't go to bed until midnight, I was concerned.

So...I did what I needed to do to take care of myself. 1. I posted to let you know that I wouldn't be posting, but I didn't write a longer post. 2. I went to bed at 9:00 and slept until midnight, but since I knew I needed more sleep than that, I took 1/2 mg. of Ativan (which I sometimes use as a sleeping pill, although I've been off it for months). 3. Since we had painters arriving at 8:00 a.m. and I knew I needed to box up our bedroom, I awakened at 7:00 a.m. and took 10 mg. of Adderall, which I haven't taken in months.

In terms of the medication, I must tell you that while I have been off it for months, I have no trouble taking it when I feel I need to. Since my response to medication is unusual, I am able to titrate off the Adderall in one day, because I can tell when my body doesn't need it. And while I always hesitate to go back on Ativan (since it usually takes a month to begin sleeping normally again), if I need to sleep and I can't, I take it--knowing I will stop within a few days.

Before I went to bed, I had already decided that I wouldn't be going to school on Wednesday. I didn't feel well enough to play badminton, and I didn't have enough energy to drive myself to school and concentrate on music theory. Again, this wasn't a problem. I'm taking the music class on a pass/not pass basis, and I'm taking it for pleasure rather than for a degree, which I already have.

My only goal yesterday was to box up the bedroom--which I had to do because the painters are on a deadline. I felt well enough to do that. But...I rested for the remainder of the day. I worked at my desk. I chatted with a neighbor. And by the end of the day, when I felt so much better, I called a friend and we walked around the park, which is 3.2 miles.

All in all, it was a very pleasurable day. I was proud of myself for doing what I needed to...and not doing what I felt I couldn't. As I sit down to write this post, I feel like I've fully recovered and only need one more night of sound sleep to be back to normal.

These days it is very easy for me to achieve wellness; I wish it had always been so!

Wednesday, September 10, 2008

Under the Weather

I seem to either have a slight case of the flu, or I'm just plain tired. We've had painters in the house for the last five days. We had to box up everything in the house, and I'm pooped. I'll start posting again as soon as I feel better. It probably won't be until Thursday.

Stay well!


Tuesday, September 9, 2008

Spousal/Partner Lack of Support

While yesterday's post was about spousal/partner support, Josh wrote a comment, which made me realize that I should also write about spousal/partner lack of support. While I don't know about this first-hand, I do know what it's like to be deserted by other family members and friends. And it's terribly disappointing and painful.

I would imagine it's just devastating to have an illness that is as horrific as bipolar mood disorder, clinical depression, or seasonal affective disorder, and feel that your spouse/partner isn't supportive.

In fact, I have an acquaintance who divorced her husband because he is bipolar and she was tired of having him live off disability, sleep a lot of the time, and show no initiative in changing his situation. Since I heard about his situation through his mother-in-law--who was a friend of my mother's--there wasn't much I could say.

Had the BIP's wife been a friend of mine, I would have told her how horrific depressions feel and how difficult it is to survive them. I would have explained how difficult it is to work when you're constantly struck by depressive episodes. I would have asked what kind of help and support her husband was getting from his doctor, and perhaps have suggested other wellness activities.

I did tell my mother's friend that I would be happy to talk to her son-in-law or daughter, but I got the impression they wouldn't call me or email me, and they didn't. It seemed like the BIP's illness wasn't something they publicly talked about.

And this isn't the first time I've offered to help people who won't seek help. I once met a woman in a manicure shop whose grandson had been diagnosed as bipolar. We spent an hour talking about the illness and I offered to discuss things with her grandson and/or his mother. This woman, who so loved her grandson and felt so happy that I could provide hope, sadly said she didn't think her daughter would call me. And the woman didn't. Again, it wasn't something this family publicly discussed.

Josh, in terms of your situation, I don't know what to tell you. My husband and I had been married for many years before I was diagnosed as bipolar. For much of our relationship I was only depressed for two six-week episodes each year, and I was well enough to work even though I didn't feel well.

For most of our marriage, I was able to plan our social life and participate in it, travel, and assume marital and family obligations. Even during my six-week depressions, I was able to go out at night, share household responsibilities, and spend fun weekends with my husband.

I wasn't diagnosed until our son was five-years-old. But once I was diagnosed and went on medication, everything changed. Since I've written about this before, I won't repeat it here.

I believe that one of the reasons my husband stood by me is because that's just the kind of person he is. But, I also believe he knew that there wasn't anyone who tried harder than I did to achieve wellness. Also, I tried very hard to remain upbeat--even when I was personally devastated. I always tried to hide the worst of my illness from our son so that he didn't feel he was living in an "ill" household, or that his mother was "mentally ill."

My husband knew I would do everything possible to take care of our son to my fullest ability. And he knew that I hated canceling plans as much as he did, that I would try to socialize, try to participate in family events and holidays, and that as soon as I was well, I worked as hard as I could to get freelance grant writing assignments, and financially contribute.

I'm not sure if there are different dynamics when it's the husband who's ill, rather than the wife. Since I don't know you, I have no idea what your marriage was like before your illness. These are both important questions.

I guess if I had any advice to offer, I would suggest couples counseling. While I don't know anything about it, I would imagine that both of you need a therapist or counselor of some sort to open up lines of communication, and see if you can work this out. If any of my readers have advice, or have been in Josh's shoes, it would be nice to hear from you.

Josh, in the meantime, I believe there are sites for relatives of people who are bipolar. I'm not sure how helpful they are, but perhaps someone reading this can make recommendations.

I'm sorry you're not only having a tough time with this illness, but with your marriage as well. I truly hope that things get easier for you and your wife.


Monday, September 8, 2008

Spousal/Partner Support

As my regular readers know, personally I am neither for nor against medication--for other people. I believe it's a personal decision. While medication doesn't work for me, I can see it does work for others who have different issues--both medical and psychological--than I do.

So, ordinarily I might not post about another blogger's medication withdrawal. However, my friend Gianna from Beyond Meds has been going through a Herculean effort to stop taking medications, and I truly applaud her bravery and endurance.

But her post about this process that has struck me so emotionally was written by her husband Daniel (with a postscript by her) a few days ago. What I love about what Daniel has written is his love and support, which I can relate to because my husband has been as supportive of me.

When I read bipolar blogs, I often wonder whether we let our spouses/partners and those who stand by us know how much we appreciate them.

I have told my husband how much I appreciate him. I have let him know that I never could have gotten well without his unwavering support. I am grateful that his love for me never diminished. And his pride over what I have accomplished has been evident throughout.

But perhaps I have not told him often enough., I celebrate Bernie, Daniel, KJ, Wes, Maurice, and Carolyn--six spouses/partners whom I know have supported their mates in extraordinary ways. If you want to add your spouse's/partner's name to the list, let me know! Or if you want to share the ways in which your spouse/partner helps you, I welcome your comment!

P.S. In response to Josh's comment, tomorrow I'll write about spouses/partners, friends, and relatives who don't help out. On Wednesday, I'll write about mindfulness meditation and depression.

Saturday, September 6, 2008

10 Questions to Ask When You're Depressed

While I don't usually post on weekends, Catatonic Kid wrote a very interesting piece about depression, and asked for help in figuring things out. I gave her a list of ten things to think about, which I've decided might be helpful to others.

Let me preface this by saying that I don't believe depressive episodes come out of nowhere. I don't think there's some mysterious little biochemical misfiring that causes us to feel bad for no reason despite what our psychiatrists tell us.

But, I didn't always feel this way. After my diagnosis, and all that I read, I was sure there was nothing I could do about my depressive episodes--which is a terribly powerless position to be in. For me, it meant that I could work hard to heal, but if a depression hit, BAM, that was it. I could try to medicate it away, but for the most part I was stuck with it until it ended.

I now believe that feeling helpless to change things contributed to my illness. The fact that most medication didn't work was a huge problem. And what it all meant was that I wasn't in the driver's seat. When I felt a depression on the horizon, I was terrified. I prayed that the next episode wouldn't be as bad as the last one, and hoped I could survive one more time.

After ten years of horrible depressions--one worst than the next--I finally decided this was all a bunch of bull pucky. If people who have cancer cancer can cure themselves, so could I. And so I have.

The list of questions I provided for Catatonic Kid is the one I used to review my situation and to change my life. Hope it helps!

1. Do you keep detailed mood charts so you can see patterns–either seasonal ones or situational ones?

2. Do the depressions come out of nowhere or are there triggers? What are the top triggers? Are they people? Situations? Stress? Seasons?

3. Are you exercising on a daily basis?

4. Are there foods that aggravate your depressions?

5. Have you been to a doctor to check out that it’s nothing physical?

6. Do you like your job? Do you feel your life has meaning?

7. Are you socializing on a daily basis with people you care about?

8. Do you ruminate (tend to think about the same things over and over)?

9. How do you deal with things when you’re unhappy? Do you keep your feelings inside or do you have ways of expressing anger? Disappointment? Irritability?

10. Are there unresolved issues that you need to discuss with a therapist or counselor in order to get well?

Next week, I'll write about various topics within this list. Hope you have a nice weekend!

Friday, September 5, 2008

Quotes and Poems about Seasons

Since this week was devoted to Seasonal Affective Disorder (SAD), I felt it was fitting to end with happy quotes and poems about the seasons.

"The seasons are what a symphony ought to be: four perfect movements in harmony with each other."
~Arthur Rubinstein

"Live in each season as it passes; breathe the air, drink the drink, taste the fruit, and resign yourself to the influences of each. Let them be your only diet drink and botanical medicines."
~Henry David Thoreau

"Our seasons have no fixed return,
Without our will, they come and go;
At noon our sudden summer burns,
Ere sunset, all is snow.
~James Russell Lowell

The Twelve Months
Snowy, Flowy, Blowy,
Showery, Flowery, Bowery,
Hoppy, Croppy, Droppy,
Breezy, Sneezy, Freezy.
~George Ellis

Thursday, September 4, 2008

Light Therapy

Before I discuss light therapy, I must admit that about ten years ago, I read about seasonal affective disorder, and my mother bought me a $250 light box, which I religiously tried. My psychiatrist at the time didn't agree that I might be suffering from SAD, even though my depressions were clearly seasonal and had been for more than 25 years. I went ahead and pursued light therapy, although it didn't end up working for me. At the time I thought my doctor must have been right since the light box didn't make a difference.

If I had known then what I know now, I would have realized there were other alternatives to a light box--all of which I'm doing now. I should have spent more time outdoors. I should have changed the blinds in our bedroom to allow for more morning light. I should have opened all the blinds in our house each morning so that when I awakened, the house was lighter.

So, I guess what I'm saying is that light therapy is a far-reaching topic. If you think SAD might be a problem, it's worth discussing with your doctor. However, whether or not your doctor knows about SAD, I highly recommend reading Dr. Norman Rosenthal's book: Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder.

In terms of light therapy, light boxes do work for a significant part of the SAD population. A dawn simulator, which can be attached to any incandescent lamp so that it starts working while you're still sleeping, has been shown to have a big effect when you wake up. Some people use both the dawn simulator and light box in the morning and also at night to create an artificial dusk.

In Sweden, there are at least 80 light therapy rooms, at least there were when Dr. Rosenthal checked them out before his book was published. In these public rooms, people are exposed to 2,500-lux-intensity light in any direction. The rooms are a light color and so is the carpeting and furniture.

Again, if SAD is a problem for you, the idea would be to try and recreate this kind of environment in your own home. I have always thought our home was light, but we made the fairly minor changes I mentioned above, and I can feel the difference.

Some people who live in geographic areas which exacerbates their condition have made more dramatic changes. They have moved across the country in order to live where there is more sunshine. There are others who take vacations in winter so they can spend time in a lighter environment. But no matter what the climate, most people find it's very important to spend time outside each and every day, because outside light is so very important.

And light therapy isn't just important for people who have SAD. Dr. Rosenthal writes, "Our group and others have found that sub-groups of patients with eating disorders, obsessive compulsive disorder, panic disorder, and schizoaffective disorder show a degree of seasonal variation, with symptoms worsening during the winter. It would be reasonable to consider light therapy for people suffering from these conditions."

Whether you need to make a big change or small ones, if you're like me you will immediately see a difference. I am convinced that one of the key reasons I feel well most of the time is because I realized that whether or not I suffer from SAD, being outside and increasing the level of light in our house is a key wellness activity for me.

P.S. The graphics are examples of a light box and dawn simulator. I'm not recommending any products because I haven't used them, but if you check out Dr. Rosenthal's site, he has links.

Wednesday, September 3, 2008

Summer Blues

I was going to write about light therapy today, but in response to yesterday's post both Jazz and Tamara wrote that they feel worse in the summer. According to Dr. Norman Rosenthal, author of Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder, "Studies indicate that most people in the northern United States dislike winter more than summer. When you look as far south as Florida, however, the pattern is reversed and more people dislike the summer.

"In our NIMH (National Institute of Mental Health) survey of seasonal changes in Maryland, we found about five cases of winter SAD to one case of summer SAD. While winter difficulties are more prominent in the United States and Europe, in Japan and China more people are having trouble in summer than in winter."

Dr. Rosenthal states that he and Dr. Thomas Wehr studied some people with summer SAD. Dr. Wehr postulated that "the heat of the summer might be triggering a particular patient's depressions and that the cool air and her swims in the cold, spring-fed lakes of the North might have exerted a therapeutic influence on her moods (in the fall). He suggested that temperature changes have been suggested as a cause for depression since Aristotle."

Dr. Rosenthal also mentioned that some Australian researchers had found a difference between summer SAD and winter SAD. "Whereas the patients with winter SAD feel physically slowed down by depressions, those with summer SAD are more agitated."

"Summer depressives frequently ascribe their symptoms to severe heat while winter depressives more often attribute their symptoms to lack of light."

My feeling is that there remains a tremendous amount that is unknown about SAD. A lot of the information seems to be anecdotal. Dr. Rosenthal says that while there is a very active SAD organization for consumers in England, there isn't one in the United States. (At least there wasn't one in 2006, which is when the book was published.)

Tomorrow, I will write about light therapy.

Tuesday, September 2, 2008

Seasonal Affective Disorder

I've been under the weather for about 10 days, and I've been working very hard to reverse my mood. The cause is seasonal affective disorder, which I believe probably should have been my diagnosis rather than bipolar mood disorder.

As I've read a number of different blogs, I think that other people may be having difficulties as well. The question is whether the trigger is the change in weather or whether there are the usual triggers: relationships, stress, work, anger, and more.

In case you believe your mood is affected by seasonal elements, I plan to spend the week writing about moods, light, and related topics. In a 1988 article written for DRADA (Depression and Related Affective Disorders Association), Dr. Norman Rosenthal (one of the foremost experts on SAD) writes,
"The symptoms of SAD are very similar to those of nonseasonal clinical depression: change in appetite, weight gain, drop in energy, tendency to oversleep, difficulty with concentration, and irritability. The key factor in diagnosing SAD is its seasonal pattern: the above symptoms fade away with the arrival of spring and return in the fall.

"Another characteristic of the illness is a strong craving for food rich in carbohydrates, which increase the level of serotonin, that is thought to influence mood. It is theorized that people with SAD have difficulty in regulating serotonin levels during the winter and that their craving for carbohydrates is a way of compensating. The theory also explains why many patients respond favorably to selective serotonin-reuptake inhibitor (SSRI) antidepressants such as Prozac or Zoloft. However the cornerstone of treatment for SAD is light therapy."