Monday, March 31, 2008

Adjusting to College

Thanks to everyone who wrote last week to wish me and my family well. I appreciate the kind thoughts. As my husband and I have spent the week trying to advise our son who started college in January, I'm just grateful that I feel so well and can try and help him put things in perspective.

I written a number of posts about the mental health crisis on college campuses and I'm not surprised it's a problem. As I've been talking with my son on the telephone these past few months, I have been wondering how I can help him identify the people at his university who care about "human feelings." Perhaps John Ciardi, the famous American poet, was right when he wrote, "A university is what a college becomes when the faculty loses interest in its students."

In the 40 years since I attended the University of California at Berkeley, nothing has changed. They do as lousy a job integrating spring-admit students now--as they did then. Everybody knows that starting college is a big adjustment and one that easily could be institutionally addressed, but it isn't at Cal despite promises at orientation and emails from administrators that suggested otherwise.

As I reflect on my experience at Cal and my son's, I wonder if people in student affairs ever think about what education is all about. My own view is similar to Grayson Kirk's, the former president of Columbia University, who wrote, "The most important function of education at any level is to develop the personality of the individual and the significance of his life to himself and to others. This is the basic architecture of a life; the rest is ornamentation and decoration of the structure."

And certainly Carl Jung was right as well, when he wrote, "One looks back with appreciation to the brilliant teachers, but with gratitude to those who touched our human feelings. The curriculum is so much necessary new material, but the warmth is the vital element for the growing plant and for the soul of the child."

Sunday, March 23, 2008

In Celebration of My Father's Birthday

My father, Berny Schwartz, has been dead for more than 18 years. He died in February of 1989, during the fifth month of my pregnancy. I loved him dearly. Today is his birthday. He would have been 87. Although I don't have much that he's written, I do have poems that my mother wrote about him and to him.

To Berny: 1992
Between Tracy's birthday and St. Valentine's day
My beloved slipped away
Although I love being a new grandmother
In my other life
What I loved the most...
was being your wife.

I Miss You
It's almost 3 years
And your face is beginning to fade
And the plans that we made
I have finally laid to rest
But those 45 years
Were the best
And even though your face is dimming
And you are gone and I am living
I miss you...
with every breath I take.

Saturday, March 22, 2008

Quotes to Ponder

"The great majority of us are required to live a life of constant systematic duplicity. Your health is bound to be affected if, day after day, you say the opposite of what you feel, if you grovel before what you dislike and rejoice at what brings you nothing but misfortune. Our nervous system isn't just a fiction; it's part of our physical body, and our soul exists in space and is inside us, like the teeth in our mouth. It can't be forever violated with impunity."
~Boris Pasternak

"One does not become enlightened by imagining figures of light, but by making the darkness conscious."
~Carl Jung

"The ultimate metaphysical secret, if we dare to state it so simply, is that there are no boundaries in the universe. Boundaries are illusions, products not of reality but of the way we map and edit reality. And while it is fine to map out the territory, it is fatal to confuse the two."
~Ken Wilber

"Consult not your fears but your hopes and your dreams. Think not about your frustrations, but about your unfulfilled potential. Concern yourself not with what you tried and failed in, but with what it is still possible for you to do."
~Pope John XXIII.

Friday, March 21, 2008

What Being Bipolar Has Taught Me

When I am depressed, I believe I have learned nothing from being bipolar. I look at the depressions as a waste of time. Because my hypomanias were medication-induced, in retrospect, I see them as an embarrassment rather than a source of pleasure. When I think about the excesses of my behavior, I wonder why I thought it was okay, how I could have been so clueless, and why I didn't see the patterns earlier.

But sometimes, usually at the end of a depressive episode, I see life with a startling clarity. It doesn't make up for the difficulties of being bipolar, but it does give me pause to think. Last night I realized that my bipolarity has reduced me to my elemental self. I've had an unusual opportunity to experience the polar opposites of my life.

I have had "big" jobs that were so prestigious that they garnered a great degree of respect and approbation, and "small" jobs that forced me to struggle to maintain my dignity. I've had decades of "popularity" where people coveted my friendship and sought my companionship, and almost ten years of illness where I have felt like a pariah and lived in relative isolation.

I have known what it's like to feel the responsibility, pleasure, and joy of familial devotion and loyalty, and I know what it's like to feel the devastation, disappointment, and separation caused by familial treachery.

I have spent much of life feeling physically strong and attractive, and I have spent years when I have felt so weak, ill, and impaired that I could barely recognize my face in the mirror. I know the joy of feeling special and blessed, and I know the sorrow of feeling despairing and abandoned.

Last night as I sat and reflected, I realized that my life has now come full circle. I have finally returned to what Parker J. Palmer calls, "the original selfhood given to me by God."

Or as May Sarton has written in her poem,
"Now I become myself.
It's taken time, many years, and places,
I have been dissolved and shaken,
Worn other people's faces..."

But now, I am back to the place I began. "What a long time it takes to become the person one has always been," Palmer writes in Let Your Life Speak: Listening for the Voice of Vocation. "How often in the process we mask ourselves in faces that are not our own. How much dissolving and shaking of ego we must endure before we discover our deep identity--the true self in every human being that is the seed of authentic vocation."

And while it seems to be late in my life to discover my authentic vocation, I believe it is my bipolarity that will lead me in the right direction.

***
For all of you who celebrate Easter, I wish you a happy holiday! See you on Monday!

Thursday, March 20, 2008

Bipolar Questions and Answers

Today, I've decided to answer a few questions that have recently brought people to Bipolar Wellness Writer. I'm assuming everyone knows that if you have a stat counter, you can get all kinds of valuable information about your readers. Mine is free and it's from statcounter.com. (I can't seem to link to it without giving you my password, so you'll have to type it in yourself.)

Q: Can you get off jury duty if you're bipolar?
A: Yes, if you have your doctor write a letter on your behalf or fill out the information on the jury summons. Because I have regular depressive episodes, I don't serve on juries. **After I posted this I realized that different states may have different laws regarding jury duty. All I know about is California. So, if this is a concern, you need to check with NAMI or DBSA in your state.

Q: What is the best medication for hypomanias?
A: Unfortunately, there is no answer to this. Medication is really a personal issue and if I've learned anything writing this blog, it's that it works differently for everyone. Also, since I have no medical background, I only discuss my own experience with medication or provide information from books.

However, a few of my favorite sites for information on medication are: PsychEducation.org (It's founder is Jim Phelps, M.D., the author of Why Am I Still Depressed? Recognizing and Managing the Ups and Downs of Bipolar II and Soft Bipolar Disorder); Dr. Ivan Goldberg's Depression Central (He's a New York psychiatrist); Dr. Phillip Long's Internet Mental Health, (He's a Canadian psychiatrist), and Dr. Bob (His full name is Robert Hsiung. He's a Ph.D. from the University of Chicago, and the editor of E-Therapy: Case Studies, Guiding Principles, and the Clinical Potential of the Internet. You'll want to look up the topic Bipolar Medication on this site).

Q: What is bipolar "kenneling"?
A: Actually, it's called kindling. You can look it up online but the theory is that the more untreated depressive or manic episodes you have, the worse they'll get. Also, they suggest that even if your first episode was triggered by a "life event," after you have a few episodes, you won't need a life event to trigger it because the "wiring" of your brain changes and will automatically switch into a depression or mania.

Here's where I do have an opinion I can share. Whether kindling happens or not is unimportant to me. I believe that if we allow ourselves to worry about all the "bad" things that bipolar disorder can cause, then we will make ourselves sick. I spent ten years researching this illness and quite honestly, I wish I'd never read most of the material I found. It's downbeat and depressive.

If you have cancer and you want to get well, you read about wellness techniques. Rather than dwelling on how cancer cells spread or what your prognosis is, the best doctors tell you to visualize your healthy cells "eating" the cancer cells. They recommend relaxation and stress reduction techniques. They talk about diet, exercise, and spirituality.

So, whether or not kindling happens--and as far as I know it's only been tested on rats--I wouldn't worry about it. If you do, you'll make yourself sick rather than well.

Wednesday, March 19, 2008

In Celebration of My Mother's Birthday

Since my earlier post was somewhat of a downer, and because today would have been my mother's 86th birthday, I'd like to share a few of my thoughts and two of my mother's poems. Whenever I feel really down, I think of my mother. She was an eternal optimist. What I loved most about her was her joi di vivre, her enthusiasm, her excitement about doing the things she loved, her generosity, her stories, her thoughtfulness to her friends and family members, and her ability to make me feel so thoroughly and completed loved.

The following poem was for my grandmother.

April, 1974
if you pray
for life your way
days for laughter
and some for crying
as hard as life is, mama dear,
it's harder dying.

life has pain
and life has sorrow
but while we live
there are tomorrows

spring will come
the grass will grow
what's the hereafter?
I'll opt for what I know.

And this one was for my grandmother as well.

Mama
(December 1975)
Mama dear
If I had know you were going to die
I would have hugged you and kissed you
and said goodbye.

Cognitive Therapy (Part 2) and rant...

I would like to thank everyone who responded to yesterday's post Cognitive Therapy (Part 1): ariadnek, ph.d., Roanne, Danielle, and Gianna. Today, I was going to suggest that the one thing I liked about the idea of cognitive therapy is that it would seem to help identify patterns of behavior, and help people try to change them. What I also said was that I've never tried this form of therapy and have only read one book about it--years ago. At the time I was offended because it seemed so judgmental.

I had intended to do more research on cognitive therapy, but then I read Gianna's comment and decided not to. (Again, I'm providing a link to the Beck Institute for Cognitive Therapy and Research, so please feel free to make your own decision on this. A last minute comment by Jane Doe suggests that this was the best therapy she's ever done.)

What Gianna from Bipolar Blast said truly resonated with me so here goes...
"I've attempted to give various forms of CBT/DBT a chance and find it invariably insulting. I find the practitioners condescending and the books patronizing.

As ariadnek said---judgmental hogwash.

Personally I like the idea of taking responsibility for my psyche, but I do that by accepting myself, not forcing myself to think differently.

You know Susan, the mental health system strips us of our self-esteem because most of the people practicing don't believe we can be whole, functioning individuals who can recover. I say bulls%^& to that. It's taken years and I'm still trying to shake the self stigmatization but it is bull. If we were approached with the good faith that we are not hopeless and that we can recover we would be much better off.

I'm blessed to have everyone in my life believing that about me now, but much damage has been done."
I couldn't agree more. I spent years trying to find someone--anyone--specializing in bipolar disorder who truly is a healer. But, no one believes we can get well. And when I did find a doctor who provided hope (she specialized in Integrative Medicine) once a depression hit, I found her to be as ineffective as everyone else.

As I've said before, if you go to a heart doctor and have a heart attack, they treat you. If you go to a diabetes specialist and your blood sugar spirals out of control, they help you lower it. But when you go to a psychiatrist and have a severe depressive episode, they're willing to hospitalize you (in a lock down psychiatric ward, which anyone with normal intelligence might agree isn't the most uplifting atmosphere), but other than that, they throw some medicine at you and you're supposed to go home and try to survive.

The lack of support is truly chilling. The lack of insight into this illness is inexcusable. And the treatment protocols are so ineffective that 50 percent of the bipolar population tries to commit suicide and 20 percent is effective in doing so.

While I try to write this blog about wellness because there is so little hope anywhere, deep down I'm outraged and believe that everyone who's bipolar should be as well! I only wish there was one consumer organization who didn't wave the mental illness banner, didn't accept funding from pharmaceutical companies, and spoke out loud and clear about a Bipolar Wellness Program. I'm only sorry I can't be the one to lead it. (Having survived more than 120 depressive episodes has taken its toll.)

P.S. I'd like to acknowledge that today would have been my mother's 86th birthday. Mama, while you may no longer be here physically, I love you dearly!

Tuesday, March 18, 2008

Cognitive Therapy (Part 1)

Years ago I heard about cognitive therapy and bought a book entitled Cognitive Therapy: Basics and Beyond by Judith S. Beck, Ph.D. (Her father, Aaron Beck, M.D., developed the cognitive model.) At the time, the book presented two problems for me. The first was that it's geared toward therapists, and perhaps I felt it was too judgmental toward patients. The second was that the very definition of this type of therapy bothered me.

"In a nutshell, the cognitive model proposes that distorted or dysfunctional thinking (which influences the patient's mood and behavior) is common to all psychological disturbances. Realistic evaluation and modification of thinking produce an improvement in mood and behavior. Enduring improvement results from modification of the patient's underlying dysfunctional beliefs."

The reason this bothered me was because I was so tired of reading that everyone who's bipolar or depressed is dysfunctional and has low-esteem that I could have screamed. It felt like everywhere I looked, the doctors writing books were blaming us for our illness. (Before my diagnosis and subsequent medication merry-go-round, my self-esteem was just fine.)

If I could have gotten beyond the original definition of cognitive therapy, I might have understood that the key to cognitive therapy is that "people's emotions and behaviors are influenced by their perception of events. It is not a situation in and of itself that determines what people feel but rather the way they construe a situation."

And I agree with that. Thus, the same situation that may cause me to feel angry may not affect you at all and vice versa.

What I now believe is that this type of therapy might have been helpful. Recently, I've realized that my behavior and perceptions have changed as a result of this illness. After all these years of seeking help and finding most of the therapists and psychiatrists (I've seen) to be clueless about this illness, I can now see that with certain people in certain situations, I have become angry and unforgiving--which I never was before.

While I still dislike the word, dysfunctional, I could agree that my emotional response to situations and people isn't what it used to be. My "core beliefs," which used to be life-affirming and positive, have changed. (more to come)

If you have experience with cognitive therapy, please let us know how you feel about it.

Monday, March 17, 2008

Wellness Activity: Gardening (Again)

The weather in Los Angeles has been wonderful. I spent the entire weekend gardening outdoors. I'm finally perking up a bit. I guess it's a combination of gardening, sunshine, and physical activity. I've discussed gardening so many times but the point is that Horticultural Therapy works. Why?

According to an article by the Eva C. Worden, Theodora M. Frohne, and Jessica Sullivan from the University of Florida Extension, horticultural therapy has the following benefits:
reducing physical pain, providing sensory stimulation,improving memory and concentration, easing emotional pain from bereavement or abuse, cultivating nurturing feelings, encouraging social interaction, teaching responsibility, reducing stress and anger, and enhancing productivity and problem solving.

If you're interested in pursuing this, I'm providing a few helpful links: American Horticultural Therapy Association, Texas Master Gardner, and an article on Horticultural Therapy with lots of links.

Friday, March 14, 2008

The Mindful Way Through Depression

I've been reading The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness by Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn. There have been some very positive reviews of this book. Williams, Segal, and Teasdale are all Ph.Ds with impressive credentials in cognitive therapy for the treatment of depression, and Kabat-Zinn, also a Ph.D, is known for mindfulness meditation.

I must admit that I've only read the first 50 pages. I started with great enthusiasm, but as I mentioned in an earlier post, when I tried to find a place to learn the technique, I was so turned off by the hype and the cost of most "healers" that it thrust me in a downward spiral. (There is a CD attached to the book so I'm hoping to try this by myself.)

What I have also found difficult about reading this book is that it presents a viewpoint that is different from almost everything I've read in the past. On the one hand, that should make me feel good because perhaps it works. On the other hand, it makes me feel bad because I've spent so many years trying to attain wellness--and it would seem like my efforts were misdirected.

In a nutshell, the authors say that using critical thinking skills to figure out what is causing our depression and trying to fix it is the wrong approach. They suggest that thinking about the problems and the solutions "merely compounds our misery."

What they recommend is a concept called "mindfulness." They define it the following way: "Mindfulness is the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to things as they are."

In essence, it means that if we can learn to focus on the present, and stop thinking about past depressions, the negative thoughts and feelings they evoke, and other patterns of behavior that contribute to our downward spiral, we will be able to let go and move on.

My feeling is that I achieve somewhat of the same result when I play the harmonica. Actually, the word "playing" is a misnomer. But I use it as a breathing exercise and it, too, has a certain Zen quality, and helps me concentrate on the present moment. The problem is that walking around with a harmonica permanently affixed to my lips might be construed as "mentally ill" behavior. Thus, I guess mindfulness meditation could be considered a more "normal" alternative.

The jury is still out. I'll finish the book in the next few days, begin the program, and let you know my results. In the meantime, have a lovely weekend!

P.S. You might want to look at Aimee's comments about meditation from my Mind-Body Connection post. Although it didn't work for her, I'd be interested in hearing from others who have tried it.

Thursday, March 13, 2008

College Depression (Part 2)

Because I see from my Stat Counter that--like yesterday--I am still getting a number of college students reading this blog, I will write this post for you. Almost 40 years ago, when I was a freshman at the University of California at Berkeley, I experienced my first depressive episode. In retrospect, it was due to a number of factors. It was the height of the 60s and and I was a 50s person in terms of my morals and values. It was all about sex, drugs, and rock 'n' roll--and that wasn't me.

I was homesick. I started college as a spring admit--two quarters after everyone else had made friends and gone through their initial adjustment. I was an optimist in pessimistic times. I was an introvert by nature, and I kept my feelings to myself. And I didn't know how to say, "I'm feeling hopeless inside. I've never felt this way before. I need help."

Today, the symptoms of a depressive episode can be easily found, and I am including a link from the National Institutes of Mental Health. But they weren't well-known then. No one I knew had sought help from a psychologist or psychiatrist. We weren't bombarded by antidepressant commercials on TV. And I couldn't imagine telling a stranger that four weeks after starting college, I was feeling despairing, hopeless, and sad.

I wasn't suicidal; I just felt like I didn't fit in. I also thought that I should be able to solve my problems myself. And I couldn't understand why I was so unhappy when my friends seemed fine.

What I believe now is that if I had sought help, and if the counselor or psychologist had understood that the stress of life events can cause a depressive episode, and if I could have honestly said, "I hate it here. I don't like the environment. I don't like the people. I should have gone to a smaller college that is less political. I don't do drugs nor do I drink, and I don't feel like I fit in. I'm a virgin and it feels like I'm being pressured to have sexual relations and I'm "saving myself for marriage" (Yes, I really did believe that)--and if I could have been reassured that I wasn't alone and other people were experiencing similar feelings, and if we could have talked it all out, that might have been the end of it.

But that's not what happened. I didn't seek help for six months. The psychologist I eventually saw was a moron. We never discussed anything of importance. Worse yet, he was a terrible listener and he didn't see that my feelings were symptomatic of depression. And the episode lasted for almost five years--in a low-grade way.

After a year, I transferred to another university, but because I never resolved the problems that plagued me, I kept ruminating (thinking about it over and over) about my experience for the next 25 years, when I was finally diagnosed as bipolar.

So, take it from me--if you're feeling sad, empty, hopeless, pessimistic, and helpless (or you have some of the other symptoms that are listed on the NIMH link I've provided), get help. Find someone to talk with immediately. Don't worry about the stigma. Don't worry about what your friends or parents will think. You need to understand that these feelings can be resolved.

You also need to realize that every counselor doesn't work for every student. Some people are blessed with insight, and an ability to enable someone who's feeling bad to share the pain, and others aren't. So, if you don't begin to make progress fairly soon, it might be the counselor and not you.

But the moral of this story is that if you don't get help--for whatever the reason--the pain and suffering it will cause over a lifetime is indescribable. If there's any advice I have for college students, it is that asking for help is a strength, not a weakness. And if you don't feel well enough to seek someone out on your own, confide in your friends or your parents. Just make sure that you immediately deal with the issues causing your distress...so that you can go on and live happily ever after!

Wednesday, March 12, 2008

College Depression (Part 1)

When I looked at my Stat Counter, I was stunned to find that dozens of people had viewed my blog from a site called The Student Room in the United Kingdom. The subject was depression and suicide. I'm assuming they're students and I must tell you that the thread of conversation was so distressing to me.

If you're a college or university student, I want you to know that you're not alone in feeling depressed. I don't have statistics for the United Kingdom, but depression on college campuses has dramatically risen. According to Social Work Today, "College-aged students are more likely to experience depression than other age groups, according to published studies, statistics from mental health organizations, and observations by social workers and other professionals working with the college population.

"The 2005 National College Health Assessment (NCHA), a survey of nearly 17,000 college students conducted by the American College Health Association, revealed that 25% reported they “felt so depressed it was difficult to function” three to eight times during the past year and 21% reported they “seriously considered suicide” one or more times during the past year. In the NCHA survey, students also ranked depression as one of the top 10 impediments to academic performance."

If you're a college student in the United States, I do know that many student health services provide support, and I'm providing a link for Suicide Prevention Resources. If you're in the United Kingdom, I would imagine that every university has some sort of program, but the one I could find online is called Samaritans and there were other listings on a site called GriefNet.org.

What's important to realize is that you don't have to continue to feel despairing. I have no medical training and this blog isn't the right resource for you, but know that I have personally survived more than 120 depressive episodes. There is help available. Don't suffer in silence! Our thoughts are with you!

Tuesday, March 11, 2008

Wellness Activity 7: Gardening

I know I've written on this topic before, but for me, gardening maintenance is one of the best wellness activities there is. The odd thing is that my husband cares more about buying plants and flowers and planting them. What I enjoy is weeding, and trimming shrubs and bushes. We have a gardener as well so I don't have to mow the lawn, but I just love being outside with my hands in the dirt.

I know that the sun is an important healing element for me. Weeding is kind of a Zen-like thing. I don't think about anything but what I'm doing and it's total concentration. I'd probably be healthier if we lived in a more rural area. In fact, I'm fairly sure I never would have gotten ill if we owned a John Deere tractor and I could ride around acreage, cut down trees, and chop wood.

I must tell you that outdoor activities and exercise are far more appealing to me than yoga and meditation, which is what I've been reading about. Last night, I spent two hours online trying to find a yoga studio and a place to go for meditation, and the more I searched, the worse I felt. Maybe it's just because I live in Los Angeles--where everyone is a self-promoter--but the idea of seeing Zen masters on U-Tube was a real turn-off. To me, spirituality is a more quiet--less promotional kind of activity. But that's just me!

Monday, March 10, 2008

Wellness Activity 6: Thanking People

When I feel depressed I sometimes become so self-absorbed that I forget to thank the people who have made me feel better...even if it's just with a kind word, thoughtful comments, or an email. After I wrote the following paragraphs, I felt so much better that I decided that Thanking People can actually be perceived as a bipolar wellness activity. Here goes...

In response to my post Mind-Body Connection, Part 2, I would like to thank the following: Mariposa, I'm linking to her profile since she's got a few different blogs that might interest you, and she's a new reader who is pursuing meditation, physical activities and seeing a spiritual director in her quest for wellness; Aimee, who has tried both meditation and biofeedback and has an interesting take on it; my cousin Cami Black, an actress, who is finally receiving some much deserved support for her career; and Syd, my dear friend, ace supporter, and virtual sister.

I also want to thank JayPeeFreely, who is always there with kind words of support. And he even nominated me for this amazing honor, Should Be Famous, and I was feeling so down at the time that I never really thanked him or Patrick and Cooper who initiated this blog. Thanks so very much! The blog is a lovely idea!

Finally, thanks to: Pistol Pete, a new reader and kind fellow from Necessary Therapy; my pal Dootz from Mead on Mantattan and Lullabye; Marja from Roller Coaster, my very first reader who embodies kindness and provides a wealth of advice; Nanci from My Life with Bipolar Disorder, who's so supportive; Dream Writer from Coming Out of the Dark, Tony C. whose comments make me smile;Dirk from Dirkmonster, who laughed at my bipolar song lyrics and is thus dear to my heart, and Roanne from Own Your Own Health, who is a role model for recovery (from stroke), and sent me a poem that made me cry (It's posted on her blog).

To all, sincere thanks!

Saturday, March 8, 2008

Photo Therapy

Since I've never taken many photographs at all, and this is my first digital camera--ever--I kind of feel that anything I shoot is a big surprise. There's something nice about being a novice at something at this stage in life. My expectations are low and thus I usually meet them.

A Difficult Week

It's been a fairly difficult week. I've felt depressed much of the time, and I've been learning how to use my new camera. For most of the week, I might as well have been hiding in the tree trunk.Today, I'm finally feeling a little better.
I appreciate everyone's comments during my absence. I'll be returning on Monday, and I'll respond then. I may be posting a few photographs in the meantime.