Monday, June 30, 2008

Wanting Wellness

As far as I am concerned, the most critical component of achieving wellness is wanting it. But wanting something to me means that I will do anything possible to achieve it. And what that means is that I have been willing to change my lifestyle and certain behavioral patterns.

When I talk with people who remain sick and are making no progress, I always feel like asking, "What are you doing besides taking medication?" What behavioral patterns have you changed? Have you figured out what triggers your depressions? What steps have you taken to change the way you respond to those triggers?

Are you exercising on a daily/weekly basis? What about diet and nutrition? What do you do for stress reduction and relaxation? What hobbies are you pursuing? Are you talking with a counselor?

Do you know what your life's mission is? What steps are you taking in that direction? If you don't know, what are you doing to find out?

Wellness doesn't occur in a vacuum. Whether you believe that bipolarity and/or clinical depression is a biochemical condition--or not--the only way to achieve wellness is to be willing to ask the difficult questions, and live a life that matters.

Friday, June 27, 2008

Mood Charts (Part 5)

This is the final post in a series about mood charts. For six years I kept detailed records of my mood in my Day-Timers organizer. The following are my four final thoughts about their value.

7. In my Day-Timer, there is also a monthly calendar. I religiously recorded all my activities each day. When I review the six-years of mood charts, and skim my activity level, it's very clear to me when I was healthy and busy and when I was so sick that I couldn't do a thing. It's yet another way of determining my good months and my bad months--my good years and my bad ones.

When people say to me, "Susan, you shouldn't be so negative about medication," I have to laugh. I'm not negative about it for anyone else but myself. But my mood charts are such a clear validation of how terrible medication was for me--that I defy anyone to look at them and disagree.

8. My mood charts were the first stage of learning the value of writing to heal. While I believe my blog has taken the process one step further--and in effect it combines expressive writing with a virtual support group--my first foray into this was my mood charts. The journal page was the first time I "opened up" on paper. I wrote about how sick I was. I wrote about my anger and rage caused by the lack of competent care. I wrote about how devastating this illness was on a financial and personal level. I poured out my heart on paper, so that I didn't explode from having kept it bottled up.

9. My mood charts allowed me to become an expert on my illness. After a few years of keeping such detailed notes, I knew how far I had come in terms of understanding the vagaries of this illness. During this period, I began reading bipolar blogs and visiting bipolar websites, and I finally understand how much I knew, and how little most other people knew.

I began seeing that my orientation towards illness was different than other people's. I began understanding that my positive attitude and my perseverance were unusual qualities for someone who was experiencing such pain and suffering. I began feeling that I was truly utilizing my research and writing skills to save myself.

10. My mood charts have ultimately enabled me to heal myself. I finally realized that the reason I wasn't getting well was because the medication was making me sicker and sicker. As I reviewed my copious notes on my visits to my doctors, that became ever more clear. It was my final review of my mood charts that helped me to decide that I should go off most of the medication that had been prescribed for me.

All these years later, what's interesting to me is what I didn't initially see in the charts. I didn't see that before my diagnosis, I went from feeling depressed 85 days a year to feeling depressed 365 days a year. I went from only being ill during two-six-week periods to being ill every single day.

I went from being able to write books and grant proposals for non-profit organizations to being unable to work because of erratic medication-induced behavior and cognitive memory loss. I went from having a wide arena of friends to having only a few because after years of illness, I became irritable, annoyed, and angry--much of the time. The list could go on and on.

Nowadays, the mood charts are a reminder of how the diagnosis and subsequent medication merry-go-round almost destroyed a highly productive and creative life.

For those of you who are starting out, and those who are wedded to medication and are not pursuing any alternative forms of healing, I would not only suggest you keep mood charts, but study them. Look for patterns. Ask yourself whether you were better off before or after you started taking medication. Look for triggers that cause depressive episodes. Write about what happened, and how you responded. Figure out different ways of responding. Keep notes on it.

Experiment with exercise, music therapy, netural path therapy, prayer, mindfulness meditation, and other wellness activities. Keep detailed records of what works for you and what doesn't. Keep records of what drugs work for you, in what combinations, and what dosage--and which ones make you worse.

I believe that mood charts allow us to control this illness. To me, there is no better tool than a mood chart to help analyze different types of healing and to figure out a path to wellness.

Thursday, June 26, 2008

Mood Charts (Part 4)

This is a continuation of yesterday's post in which I discuss the value of keeping mood charts, and discuss how I used them, and what I learned from keeping a detailed record for six years.

6. At one point, I was so sick I thought I was going to die from psychic pain. My current psychiatrist had prescribed a bunch of new medications that were far more toxic than what I'd been taking. The side-effects were terrible. And I truly was at a loss.

What I decided to do was to take all of my mood charts from the previous months, and do poster board charts with all the medications and a one line description of how I felt. My hope was to see if anything had really helped, and if I had ever felt better.

My own feeling is that without charts, most people have no memory of how they feel. We all know that when we're terribly depressed it's almost impossible to remember when we felt well. And, at least for me, when I'm terribly well, I can't imagine that I ever felt awful beyond belief.

It turned out that my experiment was a failure, but it still served a purpose. The point is that I truly believe that a computerized version of our mood charts could work. And think of this...what if...everyone who's bipolar and has mood charts could feed their info into a database. And what if...we would go online and see what combination of medications and/or alternative methods of healing like exercise, meditation, neural path therapy etc. work for people like us.

What I mean by this is...if I'm categorized as atypical bipolar II, and if I believe that my illness is truly clinical depression and that my mood swings were caused by medication, where can I find a list of people like me who have healed themselves? How did they do it? What treatments did they use?

If they're taking medications, which ones and in what dosages? If they're exercising, what specific exercises are they doing? If they employ other methods of healing, specifically what are they doing?

(more to come)

Wednesday, June 25, 2008

Mood Charts (Part 3)

As I said in response to someone's comment, the moods charts I kept for six years were so detailed that I truly learned about my illness with the hope that this information would help me and my doctors "cure" me. Unfortunately, they never treated my hard work with the respect it deserved. But, after six years, this is what I learned:

1. I knew what medications I had taken in what amounts and what dosages. When I changed doctors (I saw five psychiatrists over a ten-year period), I could provide them with a list of what medications I had taken. So, when someone said, "Do you want to try Depakote again?" I could say, "I tried it for a year in 1995 and I had such-and-such side effects and it had no effect on my hypomanias, and I tried it again in 2000 and it had such-and-such side effects and still didn't work.

2. I could look back on the years and try to see if there were patterns in terms of the months when I felt hypomanic and the months when I felt depressed. While I knew that for 25-years, I had experienced my depressive episodes in April and October, after I began taking medication, the depression extended for a full year. But later, there were good and bad months--and for years, I was depressed from Thanksgiving through New Years.

My questions were: Did the depressions have a seasonal element or were they partially caused by family dynamics around holidays? What were the other triggers? (Unfortunately, no one ever bothered to help me answer these questions, but I finally answered them myself.)

3. For years, I kept track of my sleeping patterns. In my case, this wasn't a component part of my illness because I made sure that I got eight to nine hours of sleep a night. However, later I figured out that the Ativan (at one time I was on 7 mg. per night) was causing a residual depression in the morning. Why didn't my doctor figure that out? Now that's a good question.

4. I also kept track of what I was eating. For the most part, my diet has always been good. However, because I was depressed for many years, I did develop some bad habits, and found comfort foods that weren't that healthy. But, all things considered, I ate well.

5. I could look back on exercise patterns to see if exercise made a difference. It didn't, but I wonder how much of that was psychological. The psychiatrist I saw for four years was so sure that exercise wouldn't make a difference that I wonder if his negative outlook on this subject had a deleterious effect.

(to be continued)

Tuesday, June 24, 2008

Mood Charts (Part 2)

Since the Day-Timer time management system upon which I based my mood charts was the two-page-per-day model, I had a second page to use as a journal. Sometimes, I reflected upon how I felt or wrote philosophical pieces about the problems with the way this illness is treated. Other times I wrote with anger, distress, or confusion about what was happening to me. On this day, May 23, 2001, I wrote a paragraph that I entitled, Horrible Experience. (I've just rewritten it a bit to improve it and clarify my feelings; ah...the beauty of rewriting.)

(The accordion below is a 12-button accordion, which is the kind I play--although the word 'play' may suggest an ability that is misleading. Since I loaned mine to a friend, I can't take its picture even though I now have my wonderful new digital camera.)

"At 7:00 p.m., I took more Geodon, Zyprexa, and Ativan. I was feeling so lousy that I spent hours playing scales and then chords on the accordion to see if I couldn't 'concentrate' so hard on the music that it alleviated the depression. It finally lifted at about 9:00.

"I must say that today was truly horrible. Out of nowhere I felt so unbelievably awful that I thought, "Oh, my God, I'm in The Twilight Zone. It felt like being pelted with 'hail from Hell,' or being 'draped in despair.'

When the depression finally dissipated, I could have wept with joy. Instead I put Alex to bed, and went to sleep at about 11:30. When will this nightmare end?"

Tomorrow, I'll write about the importance of mood charts, what I learned from keeping a detailed record of my illness for six years, how I utilized my mood charts when my doctors couldn't help me, and how I believe they fit into the category of "writing to heal." Stay tuned!

Monday, June 23, 2008

Mood Charts (Part 1)

Hi! I'm back from three days off. I didn't do anything I'd intended to, but I had a lovely mini-vacation nonetheless. And I strongly believe that taking time off when you need it--if you're able to--is an important wellness activity.

Today's post is about mood charts. While a number of you have written to say that you've never been able to keep the mood charts that your doctors have recommended to you, I can understand the feeling. When I first started keeping mood charts, it was something that I decided to do on my own; it wasn't something that my doctor had suggested.

What I developed was based on the Day-Timer model, a time management system I have used for many years. What I did was to adapt their system to the information I wanted to chart.

The Day-Timer system has its own headings. I used some of theirs and some of mine. In the upper left was the To Be Done Today (Action List). I used it as My Daily Record, in which I'd note what I'd accomplished or how I spent my time. So, in this case, I wrote that it was an awful day. For much of the day, I worked on my book, The Mommy and Daddy Guide to Kindergarten. At 3:00, I picked up my son from school, and I noted he didn't do his homework. I wrote that we went to the mall for dinner, and when I came home, I had a terrible wave of despair. (I later figured out it was caused by the Geodon, which was a terrible drug for me.)

Beneath this, on the bottom left, is where I listed Medications I was taking. On this page, I'd written the following: 15+ 5 mg Geodon. At 7:00 p.m., I took 1.25 mg. Zyprexa, 3 mg. Ativan (which, I usually took as a sleeping pill but might have taken earlier because I was feeling so bad, and 2 mg. more at 9:00. At the time I had no idea that taking this much Ativan was harmful because my doctor prescribed it. Now, I'm stunned that he prescribed such a high dosage, and I'm sure it had a major effect on why I was so depressed.)

In the next column, Appointments and Scheduled Events, I usually noted my "To Do" list, or what meetings I had scheduled. Some days I'd list what I'd eaten, or what I'd done for exercise. On this day, I noted that I visited with my neighbor from 4:00-4:30 and wrote what we'd talked about. On the bottom on this column, I usually wrote a Mood Summary and I'd write about how I felt and how the medication was affecting me.

On this particular day, which was genuinely terrible, I didn't write a mood summary because I discussed it on the following page (which I'll show you tomorrow). But if I had written one, it might read like this, "Hypomanic in terms of physical activity. Clearly I need this amount of Zyprexa and Geodon. (It turned out that both of these drugs were awful for me.) My question is about sleep at night. I wonder if I should take the Zyprexa earlier in the day so that I don't have so much difficulty sleeping at night. (And I'd note questions like this to discuss with my doctor.)

Friday, June 20, 2008

A Three-Day Weekend

I'm taking a three-day weekend. I plan on playing my Autoharp, singing, taking photographs for my new digital photography class, and gardening. Hope you have a lovely weekend!

Thursday, June 19, 2008

Poetic Medicine (Part 2)

Sorry again about the mood charts post. I'm feeling fine, but I'm a bit tired and need to regroup before writing this post. I'll do it next week. Not only did I stop taking medication, but I started a digital photography class on Monday, and today I'm taking a "voice training" class. I love singing, and do it with my Autoharp, but I figured I could be better at it. I also decided that since blowing a harmonica is so relaxing, singing would be a great Bipolar Wellness Activity as well.

So, my post today isn't about mood charts (as promised; sorry guys), but it is the second in a series about Poetic Medicine: The Healing Art of Poem-Making by John Fox. I am loving this book and there are so many good quotes that it's difficult to decide what to share with you.

The first quote is from the Preface and was written by Dr. Rachel Naomi Remen, who is the author of The Little Book of Kitchen Table Medicine, which is a book I've just ordered and will tell you about after I've read it. Read Dr. Remen's bio. She's quite remarkable. She writes:

"Poetry is simply speaking truth. Each of us has a truth that is as unique as our own fingerprints. Without knowing that truth, without speaking it aloud, we cannot know who we are and that we are already whole. In the most profound way, speaking that truth allows us to know that our life matters, that our viewpoint has never existed before. That our suffering, our joy, our fears and hopes are important and meaningful. One of the best kept secrets in this technically oriented culture is that simply speaking truth heals."

The following quote is by John Fox. "Your life is valuable whether you feel well or ill, joy or sorrow. You may experience joy and sorrow in a single day, in the space of one hour. Allowing room for this paradox is an essential part of living a whole life. It can be difficult because our culture places values on the mythological happiness of advertising eternal youth riding high and beautiful in a brand-new Bronco.

"Finding a way to 'talk' in a poem about your real life experience, experience that includes paradox, is to embrace your whole life. In the process you may intuit the subtle thread of joy that is within you, always."

Wednesday, June 18, 2008

Getting Off Medication Again

I know I promised to post today about my mood charts, but please bear with me for a few days. As many of you know, I still take Adderall for depression and Ativan to sleep at night. But for the last week or so I've been hypomanic. Usually when that happens, I immediately go off the Adderall because my body no longer can tolerate it, and taking it heightens the hypomania.

For some reason, I am unable to get out of bed these days without the 10 mg. of Adderall in the morning. I have tried to replace it with coffee and Coca-Cola because caffeine has worked in the past. But it's not working now. I have tried to replace it with a morning walk, but that's not working either.

A few days ago, I realized that the problem is the Ativan, which I always start titrating off as soon as I go off the Adderall. I only need Ativan at night when I take a stimulant in the morning. So, two nights ago I stopped the Ativan "cold turkey" and stopped the Adderall yesterday morning.

While I feel I should offer a disclaimer, "Don't do this without the supervision of a doctor," my doctors have always felt I am qualified to make these decisions myself because I'm more knowledgeable about how my body reacts to medication than anyone else is. And since I respond to medication differently than most people, I am usually the one who decides what to do and when.

Anyway, the bottom line is that it worked. While I didn't sleep very well the first night (which always happens for a month or so when I stop taking Ativan), I was fine yesterday without the stimulant. But I was very tired last night and didn't have the energy to write today's post about mood charts, which is more complicated that just providing an update on my health.

So...have a nice day! I'll cover mood charts tomorrow. Stay tuned! And if you truly want to have a lovely day, visit Create and Live Happy (if the Magnolia tree doesn't make you smile, nothing will), Joyously Becoming (her art is also wonderful), and read about Grace, The Dove on Annie's blog.

Tuesday, June 17, 2008

Depression Recovery "To Do" List (Part 2)

6. Keep a mood chart. While this is a topic I plan on devoting an entire post to, I highly recommend keeping a mood chart. I did this every day for six years and it was an extraordinarily helpful tool for me. The chart I recommend--my own design--is quite different from anything I've read about. It's kind of a combination journal/mood chart. The purpose is to chart every day and I used my Day-Timer to do it. That way I knew how I was feeling from the time I got up until I went to bed, what medications I was taking, how much sleep I was getting, what activities I was engaged in, and how I generally felt. I'll show you an example in the next few days.

7. Do stress reduction and relaxation exercises. While it's difficult to imagine you would need to do this if you're so depressed you feel like a zombie, I think it's really important. What I have learned--after so many years of great suffering--is that every time I felt a depression on the horizon, I was terrified it would be worse than the last time. Or terrified it would last longer. Or terrified that I wouldn't survive it. But...and I believe this is terribly important, I always did survive. So, it would have been helpful to try and dissipate the anxiety by breathing exercises, meditation, or some other method of stress reduction.

8. When the depression lifts, make sure you take care of your family members. For me, even the worst depression usually lifted by 2:00 in the afternoon. At its worst, the entire episode lasted a year, but I was well almost every day after 2:00. (Of course there were months when it never lifted; but that was the exception.) And I believed that once it lifted, it was incumbent upon me to take care of my husband and son. When my son was young, that meant supervising play dates for him. Just because I didn't feel well during the time he was in school didn't mean that he shouldn't have a good day when he returned home and I was feeling fine.

9. Engage in pleasurable activities. Obviously, pleasure can be defined in different ways and is dependent upon your energy level. During my lowest periods, one of my greatest pleasures was watching DVDs or movies on TV. While some people would recommend comedies (and there is research to confirm that laughing makes you feel better), my vice is musicals and westerns. If anyone asks, I'll give you my top list of each.

10. Maintain your highest level of normalcy. Since I have experienced more depressive episodes than anyone I've ever spoken to or read about, I believe I have the right to give you this advice. Chronic depressive episodes can destroy families, and ruin friendships. Since I always hated the fact that my family and friends had to suffer during my depressions, I went out of my way to try and maintain the highest level of normalcy I could achieve.

When I felt like I was dying inside, I made every effort to be there for my son. If I was in bed when he returned from school, before he came home, I went into the bathroom, washed my face, brushed my hair, put lipstick on, and greeted him with the best smile I could maintain. When I could barely speak, I always asked him about his day, and made him a snack.

And it was the same with my husband. Throughout my illness, he has been a saint. So, when I felt well, I tried very hard to do something special for him, whether it was ordering a book online that he might like, buying special cards, or doing my share of household chores the moment I felt better.

Don't be a victim. I am always surprised when I read about people who whine online about their lot in life. Our lot in life is what we make it. While it took years for me to get well, I never felt I was a victim. And I certainly didn't want my husband and son to feel like our home was a place of illness.

Despite being ill, I loved my family dearly, and they needed to know that. Despite wondering how I was going to survive, I never discussed my unhappiness with my son. I felt bad enough that he had a sick mother. So it was ever more important for him to know that despite my illness, I loved him dearly, that I would be there for him when I could, and I would support him in every way possible.

I believe it was tips like these that saved my life. I believe it was my attitude that enabled me to remain married to the same man for more than 25 years, and to continue to have a terrific relationship with my 19-year-old son.

I may not have been able to stave off my illness, but I have tried with a Herculean effort to be the best wife, mother, daughter, sister, aunt, niece, and friend that I could be. I have been able to sustain most of the important relationships in my life. And for that I am deeply grateful!

Monday, June 16, 2008

Depression Recovery "To Do" List (Part 1)

I've been visiting some bipolar blogs and notice that a bunch of people are either depressed or manic right now, which is my prompt for this week's posts. The first is a Depression Recovery "To Do" List. I read Nancie's blog and started commenting about what I used to do when I was depressed to try to help it lift. My routine was too long for a comment, so I decided to post about it instead.

For those who regularly read my blog, you know I have a husband and son, and one of my goals during my sickest years was to try and maintain normalcy for my family. What I've since realized is that this goal is helpful to people whether they are married or not. The 10 top items on my "To Do" list may not have staved off the depression, but it certainly made me feel like I was trying my very best to get well.

1. Every morning (or whenever you can), get out of bed, shower, brush your teeth, and get dressed. It's really important to do activities that are "normal" because it's a way of saying to yourself, "I will be well today." A few tips: Cold water helps reduce depression. While I could never bring myself to shower in cold water, I did buy one of the removable shower heads so that I could use cold water on my feet and head, and it does work.

Never remain in your pajamas. It's important to get dressed in a warm-up suit even if you plan on going back to sleep. Again, the statement you're making to yourself is: "I plan to be well sometime today."

2. Walk outside every day, even if it's just for 10 minutes. The sun on your face is very important. If it's not sunny, sitting outside is still better than sitting inside. When I was at my worst, I could use my mother's walker to get outside, and I could lie on a lawn chair in our backyard. Even though I didn't feel better at first, doing that day after day had an impact.

3. Exercise. Again, even if you can only walk from your house or apartment into your yard or to the sidewalk on the street, movement is very important. In one of my worst depressions, I used my mother's walker to get down our driveway. Also, I wore a hat and dark glasses in case my neighbors could see me, because my face looked so drawn (and here I was on this walker) that I figured I'd feel worse if I was the talk of the neighborhood. We have a very steep driveway, and by the time I reached the sidewalk, I was so done in, I had to sit on the sidewalk and rest.

As I sat there--almost in tears because I couldn't figure out how I was going to get back into the house--I started laughing because I felt so terrible I didn't know what else to do. And the more I laughed, the better I felt. Finally, after about 20 minutes, I summoned the strength to walk back up the driveway and into the house. As I remember, I then slept for the next four hours, but it was still a step towards recovery.

4. Eat healthy food. Whether you're nauseous, have a bad stomach, or feel just plain awful, there is always some healthy food you can eat. At my worst, I could always eat yogurt or soup. If you don't eat, you'll feel worse. Trust me, I've vomited as many times as any human on earth and I still forced myself to eat.

5. Send out an email. Because of my son, husband, and mother (who lived nearby), I always communicated with people every day--even during the worst depressions. But, even if you live alone, you need to let someone know you're alive and feeling bad. Email is a lifeline for the depressed.

(Five more tips tomorrow.)

Sunday, June 15, 2008

Wellness Activity: Harmonica Healing (2)

At first I was going to write all about my lesson. I drove down the Pacific Coast Highway on a beautiful day, and the ocean was a blue-green. Then I drove up into the mountains--so high up that it seemed like I was going to touch the sky. I had my lesson, and truly learned how to mouth the harmonica and draw (breathe in) the second hole, which is the very hardest. And the other pupil, a guy named Brian and I jammed (after a fashion) with Jon, our teacher.

At first I thought I had enjoyed myself. Jon is undoubtedly a good teacher for many people. He truly knows how to teach blues harmonica. He's very enthusiastic and has a high energy level. And he's dedicated to teaching his students how to play so they have a feeling of accomplishment.

In fact, I was on a high when I headed home a few hours later, but it quickly dissipated, and I felt sad, and disappointed, and initially I couldn't figure out why. So, I replayed my lesson in my mind, and it came to me. Actually, there were three things about my lesson that really bothered me.

First, Brian, the other pupil, had been to three of Jon's harmonica camps, so Brian had a lot more experience than I did, and Jon knew him. That would have been okay except I felt Jon was way more supportive of Brian than he was of me. And yet, for a first lesson, I felt I did a really good job.

Second, I didn't feel that Jon listened to me. Before Brian arrived, I told Jon that my goal in taking lessons was to return to my mom's assisted living facility and play for people. He heard me say the words, but we focused on what he wanted to teach rather than on what I wanted to learn.

Third, he didn't let me play in a way that was comfortable for me. For the first part of the lesson, he kept on saying that my lips were too tight, and I was tense. He was right. Here I am playing an instrument that I've never been trained to play, and I'm playing with another student who's been doing this for years, and I'm put on the spot to play aloud when I'm making mistakes.

And I handled it all very well. But, at one point Jon said, "You need to relax. Just think about playing in your bedroom, and release the tension in your face."

I said, "Actually, I do play in my bedroom. So, if I can lie down on your couch rather than sitting upright in the chair, I'll probably do better."

He said it was okay, and the minute I lay down, and visualized myself in my bedroom, I was able to relax for the first time in the lesson, and my tone really improved. What was interesting was that within five minutes, Jon said, "I need you to sit on the chair and look at me because when you're on the couch, you're not connecting to me."

So, I sat up, and tensed up. Where Jon and I differ is that I believe the key to good teaching is to let the student learn in his or her own way. Although Jon didn't ask me, my problem was that I couldn't concentrate on him, learn all the new things he was trying to teach me, and try to keep up with Brian who had years of experience, and still enjoy myself.

When I arrived home, I was in somewhat of a funk. I realized that while I had learned how to mouth the harmonica, my other needs weren't met. Perhaps most people just want to enhance their skills, but I also want to play in a way that expresses my love of the instrument.

For almost three years, my harmonica and I have developed a relationship. It's not just the instrument that Monroe played with me at mom's assisted living facility. It's also accompanied me on the most difficult journey of my life. I quietly played it when my mother was in the hospital and sleeping, when she broke her knee and we spent ten hours in the ER at the hospital, when she was sleeping in her room and I was too exhausted to leave and needed to try and revive myself before driving home, and when she was dying and I couldn't play the Autoharp because it made me cry.

If Jon had asked me or listened to me, he might have learned that I care less about mastering skills than enjoying myself. For me, there is a Zen of harmonica playing that supersedes everything else. So, while I will practice what he taught me, I will do it at my own pace and in my own way.

I will close my eyes and hear the sounds that comforted me during the most difficult period of my life. And then, I will practice the exercises Jon, Brian, and I did together. But I will lie on my bed with my eyes closed, blow and draw, and remember mama and Monroe--both of whom would be thrilled that I'm playing music once again.

Saturday, June 14, 2008

Wellness Activity: Harmonica Healing

I think my very first post 16 months ago was about Harmonica Healing. I was going to a doctor of integrative medicine, and she recommended breathing exercises. The first night I tried to do them I was bored stiff. What she was talking about was a progression of relaxation exercises in which I was supposed to segment different parts of my body, relax them, and breathe.

She recommended a book I couldn't find. And the more I tried the exercises, the more tense I became. For example, I would focus on my left hand, try to relax it, breathe, and I would begin getting so tense, my hand would become cramped and then almost paralyzed (a writer's exaggeration), but you get my drift.

Let's segue-way to music healing. For years I had wanted to learn how to play the harmonica. I'd bought a few books that came with cheap harmonicas, and despite the fact that this was supposed to be a really easy instrument, I didn't make much progress. But I'd continue blowing and drawing on it (breathing in), and although I couldn't play one song, I found it highly relaxing.

So...after after a few nights of failing at breathing exercises, I was lying on my bed thinking, why can't I use my harmonica for breathing? I love the sound. I had progressed so that I could play single notes. Playing it always made me smile. Well, the end result was that "breathing on my harmonica" was a great success.

But I still wanted to play songs. So I bought Harmonica Americana by Jon Gindick, and made some progress. Oddly enough, not a lot. I had gotten way better at making notes, and breathing, but I still couldn't play a song without concentrating so hard that it defeated the purpose of playing.

So I stopped focusing on the songs and continued focusing on breathing. I bought a new harmonica that is much better and I bought Jon's second book Rock 'n Blues Harmonica. I still enjoyed it but I still couldn't play a song. But, more importantly, the harmonica was significantly helping me in my breathing relaxation program. And by now I was playing the Autoharp at my mother's assisted living facility with Monroe, a 90- year-old-resident who played the harmonica, and I was having a great time.

When my mother died last October, I had to stop playing the Autoharp for months because every time I played any of the songs I'd played for her and her friends, I started crying. A few months later, when Monroe died, I had to stop playing my harmonica --because every time I picked it up tears came to my eyes.

But...a few weeks ago, I learned that Jon Gindick was living about 30 miles away from me at the beach. I get his newsletter and I was thrilled to find him so close by. Then I saw that he was teaching at his house. Finally, I wrote him that I would love to learn to play the harmonica.

Today at 1:00 is my first harmonica lesson. I'm so excited, I have to remind myself to breathe. When I go to his house today for a group lesson, I'll be thinking of mama and Monroe, and smiling. Time is a healer. Somehow I know that my mom and Monroe will be smiling down on me from heaven. And my dad will be laughing out loud!

P.S. Since Coco and Bradley are already expressing interest in harmonicas, I'm going to list a few good sites. You can see John Gindick on his U-Tube site. He also has these jam camps throughout the country. You can learn about the harmonica on the following sites:, The Blue Tongue Harmonica School, Dave Gage's site, and so many more.

Friday, June 13, 2008

Death in Las Vegas

The following chapter is from my unpublished manuscript, Honk If You're on Lithium. It is copyrighted material, and may not be excerpted without my permission.
* * *
When I’m hypomanic, the idea of suicide is unfathomable and death is terrifying unless…heaven and hell are quite different than we’ve been led to believe. Say, for example that heaven has too many trees and lakes, too much sun, and is full of innocuous people who smile a lot. There’s no edge to their humor and they don’t know how to tell a punch line. They talk about money, food, and fashion. They spend all day playing golf. They think Daniel Craig is a better James Bond than Sean Connery. They prefer films with Sara Jessica Parker to those of Jessica Lange.

So my primary question is: What is hell like? For me‚ the worse case scenario would be Las Vegas. I’d spend my days and nights in the god-awful casinos, with the incessant noise, watching other overweight sinners in their Bermuda shorts and black socks lose in one night the allotment of money God gave them for their future existence. What a bummer!

The only available food would be those terrible buffets‚ the all-you-can-eat mayonnaise marathons where they serve nothing with any nutritional value. So you end up spending eternity looking like Dumbo. And since the weather in Las Vegas is as hot as Hades and you don’t get any exercise, your muscles turn from string cheese to ricotta. Now that’s depressing!

But maybe it’s different. What if once you die, the rules are reversed? All the in-your-face health clubs juice-bar-junkies suddenly find that exercise and nutritional food make you fat and Hostess Cupcakes and potato chips are thinning. We finally learn that God considers jogging and pumping iron to have been narcissistic wastes of time and hard-bodied folks go directly to hell.

Furthermore‚ He can’t fathom why anyone would have chosen carrot sticks over nachos, skinless chicken rather than marbled beef, and cantaloupe instead of chocolate soufflé. So He figures the people who made these choices weren’t very bright and He assigns them to the worst part of hell: the lounge acts. I wonder if vegans would change their views if they knew they would spend eternity in cocktail lounges watching second-rate talent.

In fact, what if God uses eternity to even the score on a major basis? He changes the sexes so that men have menstrual periods and women lose their hair. The malevolent rich are forced to work in underground garages. People who’ve been cursed with physical ailments become doctors, and the mentally ill become psychiatrists.

You know, being a psychiatrist for eternity might be entertaining—even in Las Vegas. Then I could charge ridiculous fees to shake my head in an empathic way and say, “So the antidepressant hasn’t kicked in yet and you feel suicidal?”

“Yes,” my patient listlessly replies.

“Have you tried killing yourself or have you just thought about it?”

“I’ve got a wife and daughter,” he tearfully responds. “I wouldn’t actually kill myself. I just can’t stand feeling so powerless. I’ve had to go on disability because I’ve used up all my vacation time. My wife is stressed out all the time. I worry about my daughter. It’s been four weeks now. Can’t you do anything?”

“You can check into a psychiatric hospital,” I answer cavalierly. Then we can give you a higher dosage of medication more quickly.”

“I’d never do that,” he says.

“Do you have enough medication?” I ask.

“Yes, but it’s not working.”

“Give it time. Oops, our session’s over,” I say as I write his invoice for $120 for 30 minutes of advice and schedule his next appointment.

“May I pay you after my next session?” he asks. “The illness is ruining us financially.”

“Sure,” I charitably say. “By the way,” I am almost embarrassed to ask, “what did you do in life that was so bad that you’re a manic-depressive in Las Vegas for eternity?”

“I worked for an insurance company that provided health care coverage,” he says with embarrassment.

I smile as he leaves.

Thursday, June 12, 2008

Quotes to Make You Smile

The last few days have been quite busy, and I'm pooped. Also, I was saddened to hear that Jena from Every Moment Matters is entering the hospital today. I'm not sure if she'll have access to a computer, but I hope everyone will wish her well!

When I feel depleted, I post quotes that I feel are uplifting or make me smile. Today's quotes make me smile. And since I realized that I've mostly been quoting men, the following quotes are all by women."

"When women are depressed, they go out and eat and shop. Men invade another country. It's a whole different way of thinking."
Elayne Boosler

"A bird doesn't sing because it has an answer, it sings because it has a song."
Maya Angelou

"One is not born a woman, one becomes one."
Simone de Beauvoir

"When I stand before God at the end of my life, I would hope that I have not a single bit of talent left, and could say, 'I used everything you gave me.'"
Erma Bombeck

Jena--this one's for you...
"Hope is a thing with feathers/That perches in the soul/And sings the toon without words/And never stops at all."
Emily Dickinson

Wednesday, June 11, 2008

Humbling Hypomania

Marja posted on this topic a few days ago. Her post is called "A Bit High." It caused me to think about my own behavior.
* * *
As much as I've taught myself about hypomania, I still sometimes surprise myself when I feel I have behaved badly. And it's a humbling experience. Two days ago, when I was at the event for my friend's child, in retrospect I talked too much. Without my husband to monitor me (we spent years working out a system), it's sometimes difficult for me to recognize the "Chatty Cathy" behavior until afterwards.

It's not like my behavior embarrassed my friends. And certainly there are people who aren't bipolar who talk too much, but it still bothers me. With most other things in life, once I've learn a new skill (whether it's playing a sport or a musical instrument) or figured something out about who I am (whether it's that I'm an introvert by nature or hypersensitive), I take what I've learned and go with it.

But hypomania is different. For one thing, it's seasonal--for me. In the last number of years, if it's June or July, I'm hypomanic. For another, it's not easily controllable, not matter how hard I try.

The positive side is that I've gotten much better at it. The negative side is that I've still got a ways to go. While I've developed a number of methods to slow myself down--including breathing, meditating (after a fashion), and taking an adult "time-out"--it's not always easy for me to remember to do these in a group situation.

I'm far better at utilizing these skills if I'm alone or in a small group. I wonder why it's so difficult to say to myself, "Susan, be quiet. You've talked enough." And when I forget to do this, there's an aspect of it that's quite humbling.

While I understand the importance of humility, it's not always easy to deal with.

Tuesday, June 10, 2008

Feeling Grateful

Every now and then, I realize the enormity of what it's like to have felt so sick for so long--and now to feel well so much of the time. It's really quite extraordinary. From reading other blogs, I realize that a number of you aren't feeling very well, and you have my sincere empathy. And maybe it will make you feel better to know that even someone like me--who has suffered so many depressive episodes for such a long period--can truly "cure" herself--at least for now.

Last night we celebrated my son's 19th birthday--although it's not until Wednesday (but he's starting a summer job and probably will be working Wednesday night). When I remember past birthdays when I was so ill, I could cry. On a day like yesterday, I would have had to rest the entire day just to have the energy to go out at night. And as I rested, I prayed with every breathe that the depression would lift so I could participate in the celebration with my son and my husband.

The difference between those days--and these--is stunning. Yesterday, I spent the entire day helping a friend who was catering a teacher appreciation event at his daughter's elementary school. Not only did I have a great time, but I played my Autoharp with a bluegrass band, and learned how to rope a metal cow.

And then, after a brief rest, my husband, son, and I went out to a great restaurant to celebrate my son's birthday. While most people probably don't think twice about their ability to participate in these activities, I feel so blessed I can't describe it.

So, maybe at 58 years old, I will start making a lifetime of new memories that can only get better and better. Maybe...some people are able to do this when their children are young--and my family is just different.

My attitude is that for whatever reason I was ill for so many years, I am well now--and I feel so grateful that there aren't words to express my appreciation. Perhaps some of you know what a remarkable difference there is between illness and wellness.

I hope the rest of you--who are depressed now--will someday know what it's like to achieve wellness. It is truly a miracle--and yet, one that I have achieved. I hope and pray that everyone who's reading this will know the happiness that I felt last night, and continue feeling every day. It is this level of wellness that I hope and pray that everyone will experience daily!

Monday, June 9, 2008

Poetic Medicine

I've just started reading Poetic Medicine: The Healing Art of Poem-Making by John Fox, and I'm loving it. While there's so much to say, perhaps I'll just quote the first paragraph from the first chapter.

"Poetry is a natural medicine; it is like a homeopathic tincture derived from the stuff of life itself--your experience. Poems distill experience into the essentials. Our personal experiences touch the common group we share with others. The exciting part of this process is that poetry used in this healing way helps people integrate the disparate, even fragmented parts of their life. Poetic essences of sound, metaphor, image, feeling and rhythm act as remedies that can elegantly strengthen our whole system--mental, physical, and spiritual."

This book is a true delight to read, and I highly recommend it!

Sunday, June 8, 2008

Arts and Healing

While I rarely post on weekends, I thought I'd share some resources on writing to heal, which I believe is a very important topic. My friend Jazz, who writes In Pieces, posted this great series on how to keep a journal. Today's post is on Journaling and Writing Prompts, and if this topic interests you, should should certainly check it out.

Another site of interest is Diane Morrow's A Year of Writing and Healing. She's an M.D. who also has an M.F.A. and uses writing and a lot of alternative healing practices in her medical practice. Her site provides a wealth of resources on writing to heal.

On Monday, I'm going to talk about the book, Poetic Medicine by John Fox. You might enjoy checking out The Institute for Poetic Medicine.

A few other resources, which I've only read about, but find interesting are: The Academy of Creative Healing Arts, the Arts and Healing Network, and The Center for the Creative Arts Therapies. Have a good weekend!

Friday, June 6, 2008

Writing to Heal (Part 4)

The big question that concerns people is whether "writing to heal" is somehow different than "talking to heal." In Writing to Heal, Dr. James Pennebaker, writes: "Does talking about a trauma work as well as writing about it? It depends. One study compared talking about a trauma into a tape recorder with writing. Both techniques were equally beneficial.

"Talking to someone about a trauma is far more complex than writing about it. To the degree the other person accepts you no matter what you say, and you can be completely honest in your disclosure, then talking may be more effective than writing. But here's the rub. If the person you confide in does not react favorably to you and to what you have to say, then talking may actually be worse for you than not confiding at all.

"What about writing and then reading what you have written to someone else? Same problem. If your audience doesn't react ideally to what you say, you may come away with even more negative feelings. The only study that found negative effects for emotional writing required trauma patients to write about their traumas and then read their stories to other people in a group. Contrary to the researchers' expectations, the public reading made the patients more depressed.

"...People usually don't talk about emotional upheavals because they fear others' reactions. The purpose of expressive writing is for you to be completely honest and open with yourself. Your audience is you and you alone.

"...Unlike every paper you wrote in school, expressive writing doesn't need to be read by anyone. In a study in our lab several years ago, we asked students to write about a trauma either on regular paper or on a child's Magic Pad. (Remember Magic Pad?) You write on a sheet of gray plastic, and when you lift the sheet, all the writing disappears. The same benefits accrued."

On Monday I'll discuss Poetic Medicine by John Fox. Stay tuned!

Thursday, June 5, 2008

Writing to Heal (Part 3)

FYI...Gianna's resumed posting again. It would be nice for people to drop by her blog and give her support!
* * *
There is so much more to Dr. James Pennebaker's research than what I've presented. But if you go to his website, you can read about some of it. Today, I promised to discuss my own experiences.

As soon as I was diagnosed with bipolar disorder in 1993, I began writing about my experiences. Part of the reason I wrote about it was to learn more about the illness, and part of it was to get the negative emotions out of my head and heart and onto paper. In this case, I became so sick so soon after taking medication, that I was dumbfounded by the experience.

And yet at the time, I felt that the only way I could deal with my debilitation caused by medication was through humor. So, I immediately started writing a new book, Honk If You're on Lithium: A Journey Toward Wellness. The following piece is from the Honk marketing plan, which I submitted to my agent, and she in turn submitted to a slew of publishers (all of whom rejected it).

"What do Buzz Aldrin, Patty Duke, Tim Burton, Sandra Cisneros, Carrie Fisher, July Collins, Francis Ford Coppola, Margot Kidder, Jessica Lange, Ben Stiller, and Brian Wilson have in common?

"They all suffer from manic depression (also called bipolar disorder) or unipolar depression, as do so many others. According to the National Institutes of Mental Health (NIMH), approximately 2.5 million people (they now say 5.7 million) in the United States suffer from manic depression.

"Here are some additional stats and facts (they're from the same period so they may have changed): An estimated 19 million people suffer a depressive illness each year. Between 1.5 to 3 million college students suffer from depression. Major depressive disorder is the leading cause of disability in the United States. The clinical symptoms of unipolar depression and those of the depressed phase of manic-depressive illness are virtually identical.

"Consumers with bipolar disorder face up to ten years of coping with symptoms before getting an accurate diagnosis. Bipolar disorder results in 11 years reduction in expected life span; 20 percent of the bipolar population commits suicide.

"'The failure to adequately fund research on manic-depressive illness is one of the major scandals of American psychiatry. It is the main reason why so little is known about the causes of this disease and why better treatments are not available,' writes E. Fuller Torrey, M.D., Executive Director of the Stanley Foundation Institute (one of two private foundations in the United States which funds research on bipolar mood disorder)."

to be continued)

Wednesday, June 4, 2008

Writing to Heal: (Part 2)

Yesterday, I talked about the first study Dr. James Pennebaker, author of Writing to Heal, did with 50 college students who spent 15 minutes writing for four consecutive days. Dr. Pennebaker writes that the students were stunned by his instructions to write about their deepest thoughts and feelings.

"Previously, virtually no one had ever encouraged them to write about the most significant experiences in their lives. Nevertheless, they went into their cubicles and poured their hearts out...Many students came out of their writing rooms in tears. Clearly it was an emotionally trying experience for them. But they kept coming back. And, by the last day of the experiment, most reported that the experience had been profoundly important for them."

When Pennebaker tracked these students, he found that those in the expressive writing group made 43 percent fewer visits to doctors for illness than the control group who wrote about "superficial topics."

While that first study focused almost solely on visits to physicians, subsequent studies noted other changes. Some were conducted by Pennebaker and some by other researchers, but what they found follows:
  • "Emotional writing is associated with general enhancement of the immune system."

  • Emotional writing is associated with better lung function among asthma patients and lower pain and disease severity among arthritis suffers, higher white cell count among AIDS patients, and less sleep disturbance among patients with metastatic cancer.
  • "While people are talking or writing about traumas, they often show immediate signs of reduced stress."
  • "Immediately after writing about traumatic topics, people often feel worse." And Pennebaker says that is normal. But, "the long-term effects are are surely worth the momentary sadness. People who engage in expressive writing report feeling happier and less negative after writing. Similarly, reports of depressive symptoms, rumination, and general anxiety tend to drop in the weeks and months after writing about emotional upheavals."

    While I had promised to discuss how all this relates to my bipolarity, I'll save that for tomorrow. (to be continued)

Tuesday, June 3, 2008

Writing To Heal: The Original Study (Part 1)

As I sit down to write about writing to heal, I feel so lucky that this is an outlet we all have. Yesterday was a traumatic day--with Gianna stopping her blog because of an Internet stalker. Since she will no longer be online, I'm sure we all wish her well with her recovery, and the bipolar blogging community will sorely miss her voice, and her passion.
* * *
While I have always known that writing to heal is an important activity for me, I wasn't aware of how it all began. Many years ago, when I wrote my second book, The Mommy Guide, I interviewed James W. Pennebaker, Ph.D. about the importance of new mothers being able to discuss their concerns with friends. It was illuminating to learn that "opening up" about problems was so important.

And I've written a number of times about the importance of Dr. Pennebaker's research, although I had never read his seminal book, Writing to Heal: A Guided Journal for Recovering from Trauma and Emotional Upheaval. But, I'm reading it now, and it's even better than I imagined.

The original study that Dr. Pennebaker conducted in the mid-1980s was composed of 50 college students who signed up for an experiment in which they knew they would be writing for 15 minutes a day for four consecutive days. They were given the following instructions:

"In your writing, I want you to really let go and explore your very deepest thoughts and feelings about the most traumatic experience of your life. You might try to tie this traumatic experience to other parts of your life: your childhood, your relationship with your parents, close friends, lovers, or any other people who are important to you. You might link your writing to your future and who you would like to become, to who you were in the past, or to who you are now.

"The important thing is for you to really let go, and to write about your deepest emotions and thoughts. You can write about the same thing all four days or about different things on each day; that is entirely up to you. Many people have never had traumatic experiences, but all of us have faced major conflicts or stressors, and you can write about these as well."

Tomorrow, I will talk about how all this relates to bipolarity, and what I've learned about writing about my own traumas and stressors.

(to be continued)

Monday, June 2, 2008

Bipolar Kindness

Since I've been back, I've been visiting a number of blogs, emailing back and forth with online friends, and a major issue has raised its ugly head. I have noticed some very unkind comments on bipolar blogs, and some of my friends have been recipients of this kind of cruelty. And I find it highly disturbing.

Why, I wonder, when this illness is so very difficult, would anyone treat his or her fellow BIPs badly? If a person has something unkind to say to someone who blogs, why would he/she write it as a comment? Why not keep it to yourself? If a person disagrees with another's mode of healing, why not "live and let live?"

I'm no Pollyanna, but I do believe in looking for the good in people, and I also believe in being kind. I see no reason for writing a nasty comment just because you disagree with something someone said. I find it terribly hurtful to suggest that if someone is pouring out his or her soul in their blog, they're whining.

So today, I plan to share a few uplifting quotes on kindness, and I hope that June will be a month of Bipolar Kindness.

"If you want others to be happy, practice compassion. If you want to be happy, practice compassion."
~Dalai Lama

"The kindest word in all the world is the unkind word, unsaid."
~Author Unknown

"A bit of fragrance always clings to the hand that gives roses."
~Chinese Proverb

"Have you had a kindness shown?
Pass it on;
'Twas not given for thee alone,
Pass it on;
Let it travel down the years,
Let it wipe another's tears,
'Til in Heaven the deed appears -
Pass it on."
~Henry Burton, Pass It On

Sunday, June 1, 2008

Bipolar Blogging Stress

Dear Friends,
I knew that certain aspects of blogging were getting to me, and that's why I took some time off. And it's amazing how stepping away from a stressful activity as well as leaving town for a few days can make all the difference.

Now that I'm back, I've got a few "new rules" for writing and reading blogs that I'll share with you.

1. From now on, I don't plan on discussing certain philosophical aspects of bipolarity any more. What I mean by this is that there are topics I've already responded to in past posts that I'm unwilling to revisit. Since February of 2007, I've posted 357 times. And while some of you are new readers, there are topics I've responded to over and over, and I no longer wish to do that. It's not a good use of my limited time.

So, for example, I no longer wish to discuss whether a bipolar diagnosis is helpful. It may be for you; it wasn't for me, and that's that. I no longer wish to discuss whether taking medication is helpful. Again, it may be for you; it almost destroyed my life, and I'm done talking about it.

2. Perhaps I need to let some of my new readers know something more about my background so they understand that even though I have no medical credentials, I am a professional writer and researcher, and that's how I've earned my living for the last 20 years.

I have spent 15 years researching bipolar disorder and related topics. I have read more than 100 books on bipolar disorder, depression, different kinds of healing, complementary and alternative medicine, and so forth and so on. I have downloaded more than 1,000 pages of information.

So, feel free to disagree with me, but please don't lecture me about this illness. I have very strong feelings and they go against the grain of most of what is written on the subject. I believe the treatment is a travesty. I believe that the pharmaceutical industry has a lock on this illness and that's why psychiatrists prescribe medication rather than recommending other treatments--either in conjunction with medication or to replace it. I believe that most doctors don't think "outside-the-box" about treatment. And they are failing, which is evidenced by the high rate of suicide. And I believe that for many people, the treatment has caused untold suffering.

I also believe that many people--myself included--have been misdiagnosed. And as I have stated many times before, I also believe that the experience of those of us who have been misdiagnosed may be different than those who are truly bipolar.

Having said this, I have survived 120 depressive episodes since 1968. For the last few years, I have learned more and more about ways to lessen the severity of these episodes for me. I believe that by next year, I may be able to eliminate depression from my life.

My mission in writing this blog is to write about wellness, to share information I read about, and to present new ideas. If you're healing yourself in a different way, that's great. I have no opinion about what works for you. I can only speak about what works and doesn't work for me.

3. I have been spending a lot of time responding to every comment because I believe that if a person cares enough to write a comment, they should receive an answer. However, in the future I will not respond to philosophical comments I've addressed in the past. I have a limited time to spend online, and I wish to make the most of it.

4. I've also decided that I will not longer read bipolar blogs that are negative. I've experienced enough pain and suffering to last for a lifetime. I will always take the extra step to help people who want to be helped. But, I'm not interested in reading blogs where people either seem to celebrate their misery, or recount it in great detail--without working to change their situation. That doesn't mean I'm not interested in reading about people who are putting up the good fight--and have depressive episodes. Or putting up the good fight, and have manias. But I'm a problem-solver by nature, and an optimist, and I am only willing to invest energy in people who are trying to help themselves.

5. Finally, I am working on ways to continue to present important information, but spend less time doing it. I'm in the midst of writing another book, I have a family, and I have an entire life that has nothing to do with bipolarity. So, while I will continue to write about wellness, I am rethinking how to present information so that my experience writing this blog is uplifting for me.

I realize that we all feel differently about bipolarity and wellness. We also have different priorities in life. We blog for different reasons. We like different kinds of blogs, and we are either interested in spending more or less time online.

I spend a limited amount of time online because it doesn't make me feel good to stare at a computer screen for hours on end. And because I'm a writer, I spend a few hours each day working on other projects.

My top priority is my own health, and yet my mission is to help others heal as well. I am continually working on ways to accomplish both.

Best regards to all!


P.S. I will only be responding to comments once or twice a day--probably in the morning and at night. So, if you send a comment and it's not published until hours later, please don't resend it until the next day.