Thursday, December 30, 2010

Hey! Yo! Attention! … Never mind. Thursday, December 30, 2010.

“And just fake it if you're out of direction, fake it if you don't belong here … You’re such a fuckin’ hypocrite.” – “Fake It,” Seether

So you know I’ve been in this debate with people who don’t believe there is such a thing as bipolar disorder – or mental illness in general, for that matter. And one guy is all like, “Why do you want to label yourself bipolar?” and “You’re just ignorant and doing what your doctor is telling you to do” and “Believing in mental illness just increases stigma” and blah blah blah.

And I’m all like, “But being diagnosed bipolar made me feel better ‘cuz it put things in context” and “I’d rather be considered sick than have people think I’m choosing to feel this way” and “Maybe meds don’t help everyone but they helped me” and yada yada yada.

And we’re totally talking past each other, like we’re in two different universes, you know? And before long everything escalates, and we’re like bitching at each other and name-calling and stuff. And we both walk away more sure of our own positions than ever before.

And it’s kind of funny that just a couple of weeks ago somebody threw a picture saying “BIPOLAR AND PROUD” on my Facebook wall, and the people that were tagged were debating a little bit there, too. Because someone’s like, “Is bipolar something to be proud of?” And some people are like, “For sure,” and others are like, “Oh, HELL no.”

“It’s an illness, not an accolade,” says Clarissa. “I’m bipolar and proud,” says Dee. “I’m also BPD, OCPD, PTSD and ADD and proud too!” And I really had to think about whether I should leave it on my wall. I decided to keep it there, because I’m not proud of being bipolar, but I’m proud of being in the process of RECOVERY.

I’ve already talked here about labels and assumptions and stigma. I totally get that. If people find out you’ve got bipolar disorder, there is a price to be paid.

But there’s a whole lot of way cool people that have struggled with bipolar. And as a journalist, I admit it’s kinda neat to share one thing with some of the finest writers in the world. I’m in good company, you know? Me and Mark Twain and Virginia Woolf, hangin’ out, takin’ our lithium …

But that’s where it starts getting really weird, ‘cuz I’m a bipolar journalist who’s in the closet. Never mind that in my profession, being diagnosed bipolar is practically a badge of honor! ABC News reports that in this economy, when an employee is discovered to have bipolar disorder, his career can be destroyed, even if it’s not impacting his work.

“Doesn’t having the label of bipolar lower your self-esteem?” Someone asks me, and I say no. In fact it’s just the opposite. I have an illness that drives some people to the street, but here I am – intelligent and attractive and educated and responsible, with a good job and a nice house and a lovely family. I’m a frickin’ poster child! I want to SHOUT from the rooftops: I’M BIPOLAR AND I FUNCTION QUITE WELL, THANK YOU!

It’s true. I really, really want to tell people. I want to tell everybody I know. Know why? Because the only people they KNOW are bipolar are those who have hit bottom and stayed there. The rest – the ones who are recovering, who are working, who are functioning, who are leading normal lives – we’re all keeping our mouths shut.

Guess what? We’re all around you, but we keep it a secret. There’s even a name for us: the high-functioning professional bipolar patient (PHFBP for short).

So on the one hand, I’m like, “It’s an illness, and nothing to be stigmatized for.” And on the other hand, I’m like, “I can’t tell anyone.” So does that make me a hypocrite?

Blah blah blah. Yada yada yada.

Monday, December 27, 2010

The fight club. Monday, December 27, 2010.

“Why can’t we all just get along?” –Rodney King

I admit it – I didn’t even know there were significant numbers of people who disagree with the concept of mental illness until I encountered the sentiments here on Facebook. I knew about Scientology, but I wasn’t aware of a more global movement against psychiatry. Someone who’s become a friend of mine here has written a book on the topic: “Mental Illness – Fact or Fiction?” (While she knows I don’t agree with all of her views, as a fellow author and buddy of hers, I’d like to encourage you to order a copy of her book! My own check is on its way.)

Anyway, I was fascinated by the premise, and did a great deal of reading online about it – material from the Anti-Psychiatry Coalition, Stop Shrinks, writings by Thomas Szasz, and more. While some of what I read did resonate, other arguments simply didn’t ring true to me. So I started posing questions on discussion threads. Quickly what started out as questioning turned to debate and then dissolved into battle.

While a handful of individuals can’t represent an entire movement, I must admit that being called a “sheeple,” among other names, did not give me a positive impression of this point of view. In my frustration I followed up with my own rant. (I’ve also blogged numerous times on the efficacy of antidepressants; stigma; and involuntary treatment.)

But I still had questions, so I posted a note listing 3 of them. A few weeks later I noted a thread on my feed that read, in part, “Repeat after me & then repeat 10 times plus a day: I am not mentally ill, I am not mentally ill, I never was, I never will, I am not sick, I do not have a disease.”

I find this view disturbing – because several people I care deeply about have refused treatment and wound up putting themselves and others in danger. So I responded with my concerns. Again, tempers flared on both sides. This time, I got this response (I have re-typed):

“You weren’t strong enough to deal with your issues so you turned to a pill – geez. You (people) rarely use your brain. … I think people don’t get better because they choose not to. I think if people want to get better, they will, period. … How many Americans have to pay for your ass to take medications because you need your next quick fix? How much money are you costing the American government by influencing people to get worse? How many kids to do you tell to go on medications and (they) end up shooting their classmates? … You are ignorant.”

I wound up ending the conversation because I was becoming uncivil. But then I got a delightful private message from another individual who subscribes to this view. In part, she wrote:

“Alizah, I'm sorry to hear that you were called names and insulted … I would far rather that people who are trying to create recovery for themselves have the ability to share what was helpful for them. In this manner, we can learn from each other as opposed to being pitted against one another. . I would like to see more respect for finding our own answers in accordance with who we are, the options we had at our disposal, the choices we had to make. Whichever path an individual ends up on, it's not easy.”

She signed it with the wish, “Namaste,” which means “The god in me honors the god in you.”

Those of us who agree with the “medical model,” and those who do not, have a lot in common. On both sides, most of us simply want people to be well and happy. On both sides, there are charlatans looking to cash in on peoples’ distress. And on both sides, peoples’ own life experiences will dictate their view. We’ll never agree, and we don’t have to. But wouldn’t it be awesome if we could lay down our weapons and honor the god (good) in each other?

Thursday, December 23, 2010

Alive for the holidays. Thursday, December 23, 2010.

“I never thought it was such a bad little tree. It's not bad at all, really. Maybe it just needs a little love.” – Linus van Pelt

Have you heard the one about the suicide rate going up at Christmas? Turns out it’s not true. Actually, springtime sees a larger share of suicides.

There’s a number of reasons why so many of us believe the “fact” that the holidays spark suicidal urges. For one thing, the holiday blues are real, especially for those that lack connections to friends and family. Use of alcohol goes up. And the exposure to so much conspicuous material consumption can make people facing economic hard times feel even more hopeless.

But good things happen during the holidays. More people volunteer to help those in need, and more people reach out to those who feel marginalized. For all the bad press Christmas receives, there really IS a holiday spirit, and maybe that’s why – despite all the stress and booze – the suicide rate actually doesn’t increase.

Most families I know (including my own) received fewer cards this year than usual. I’m guessing that it’s a reflection of hard times. This Christmas, our nation has an unfathomable number of people hungry, homeless and sick. These are the very people Christians believe that Jesus, whose birthday we are celebrating, held in the highest honor.

Somehow, Jesus’ birthday became about reindeer and snowmen and presents under a tree, but the true meaning of Christmas is about God’s birth inside our hearts.

Most of the people reading this blog came close to not being here to observe this holiday. At some point (or points) in the past, you decided that your life was not worth living. Your suffering was so great that you believed the only way to end it was to not be alive. You may have come to believe this even if you believe in God. You may have felt God had abandoned you. Maybe you still feel this way.

If no one reaches out to you in your need this holiday, consider reaching out to someone else. I believe that God is within us, whether or not we perceive him. Whether or not you believe in God or practice a faith tradition, and whatever your situation, my wish for you is that you experience a sense of divine peace this holiday. You are alive.

Wednesday, December 22, 2010

Great bodily harm. Wednesday, December 22, 2010.

“Wisdom is nothing more than healed pain.” –Robert Gary Lee

Not long after I started the Suicide Attempt Survivors page, I received the following PM:

“In the fall of 2006, after an undiagnosed two month depression, I jumped in front of an Amtrak Acela high speed train and survived, losing an arm and a leg in the process. I'm now diagnosed Bipolar and treating it medically and by talking openly about how I'm doing on a daily basis.”

I read the author’s words again and again. Was he really saying what I thought he was saying? He actually is a double amputee today because of his attempt on his life? Every morning he wakes up and must deal with the reality of what he has lost? My God.

Probably most of us, when we attempted suicide, didn’t stop to think about our bodies would be like if we survived. I know I didn’t. In addition to vomiting for hours and being so agitated I almost had to be held down (despite swallowing 30 Valium), I experienced a loss of hearing for about 36 hours; the deafness was a result of aspirin overdose and could have been permanent.

Another thing that could have been permanent was damage to my liver from the Tylenol OD. I spent more than 12 hours hooked up to an IV of N-acetylcysteine to literally cleanse my liver. I had no clue that death from Tylenol overdose is actually excruciatingly painful and lengthy, caused by the liver shutting down.

But the thing that doesn’t ever let me forget is the scarring on my wrists. The scars from the cutting and the stitches are over a year and a half old, and they are as light as they are ever going to get. Objectively, they probably aren’t extremely noticeable – but to me they are like giant neon signs, announcing to the world, “I’M UNSTABLE.”

Bracelets only partially cover my scars. I worry about shaking hands with people in the professional world; I can’t always wear long sleeves. Every time I look at my arms, my mind shoots back in time, triggering fear and shame.

A friend of mine attempted suicide by slicing his jugular vein; unless he wears a turtleneck, his history is there for all to see. An acquaintance of the family attempted to shoot himself; bizarrely, he blew off part of his foot. People who attempt to hang themselves, or who swallow Draino, or who jump from high places, will face varying degrees of disfiguration and disability of they survive.

Psychiatrist Herbert Hendin suggests that sometimes a self-inflicted permanent injury is "therapeutic" in the sense that it satisfies a need for self-punishment. That might be true for some, but not for me. I detest the scars on my arms. I’m fastidious about my appearance, but despite my outfit, hairdo or makeup, the scars are always there, reminding me that one day, I lost control – and warning me that I have the capability of being a danger to myself. I carry the battle scars of a fight that I don’t want to remember.

Friday, December 17, 2010

The Suicidal Trance. Friday, December 17, 2010.

Sera: “Is drinking a way of killing yourself?”
Ben: “Or, is killing myself a way of drinking?”
–“Leaving Las Vegas”

Ben Sanderson has lost it all. His wife is gone, and has taken their son. He’s been fired. And he’s lost all control of his drinking. Facing a life that appears to be devoid of choices, he nevertheless makes one final choice: to go to Las Vegas and drink himself to death.

In the process, he meets the beautiful Sera, who falls in love with him and begs him to reconsider. But Ben is determined; it’s too late to turn back. Unable to switch gears, Ben ignores Sera’s pleas and drinks until he is dead.

Nicholas Cage won an Oscar for best actor in “Leaving Las Vegas” (1995), and Elisabeth Shue was nominated for best actress. But John O’Brien, the author of the novel on which the film was based, was actually writing his autobiography; he drank himself to death shortly after his movie was released.

Cage delivered his tour de force in his portrayal of what Richard A. Heckler, Ph.D., calls “The Suicidal Trance” in his book, “Waking Up, Alive.” Heckler describes a state in which someone apparently loses the ability to turn away from suicidal ideation. The process, he says, can take hours or years; but once someone reaches that point, other options seem to evaporate, and suicide simply makes sense.

“Ultimately the trance narrows the person’s perspective until the only inner voices that can be heard are those that enjoin him or her to die,” says Heckler. “The trance marks the moment at which the world becomes devoid of all possibilities except one: suicide.”

I remember being in this trance, and I think Heckler explains it well. It’s a sort of auto-pilot that allows an override of one’s basic instinct to stay alive. At the time, there is no emotion. In his book, Heckler talks about the matter-of-fact way suicide attempt survivors secured a rope to a tree or located an appropriate bridge to jump off of. In the Trance, their actions seem unremarkable, even sensible.

As an attempt survivor, the Trance is very frightening to recall. And it’s probably frightening for family and friends to hear about. It means that there is a point during a suicidal attempt where despite their best intentions, loved ones might not be able to impact someone’s behavior. Short of having someone taken into protective custody, there comes a point where you might not be able to prevent an attempt. As Heckler says, “Suicidal Trances beckon.”

Does that mean you shouldn’t try to help someone who is suicidal? Absolutely not. Just please understand that if the person is in the Trance, it might not be enough to simply talk someone down from a cliff – he may just return to the site the next day.

Realize that you might have to risk someone’s ire by having their freedoms taken away until they’re in a safer place emotionally.

The Trance is powerful. If you love someone, you have to be twice as strong.

Wednesday, December 15, 2010

With no warning. Wednesday, December 15, 2010.

"I'm as puzzled as everyone else. There were no clues. There were no red flags." – Teacher Keith Schroeder

Monday, November 29, started out like any average day at Marinette High School. And 15-year-old sophomore Sam Hengel was like any average kid – except more so.

“Better than average,” like all youth in the mythical Lake Wobegon, Sam was one of those kids that were too good to be true. He was good-looking, in an innocent sort of way. He was a Boy Scout, working hard toward a variety of badges. He enjoyed doing community service in the small community of Marinette, Wisconsin, and was known to treat adults respectfully.

Sam’s grades were excellent, and he struck everybody – his friends, family and teachers – as a happy, laid-back kid. He loved outdoor sports like hunting and canoeing, and enjoyed time with his family. He was popular and had no record of disciplinary actions at school. Sam had everything going for him.

But Sam had something else. He had a duffel bag with 9mm and .22 caliber handguns, as well as more than 200 rounds of ammunition. And at the beginning of sixth hour, as the class started to watch the movie “Hercules,” he took two dozen students and a teacher hostage. Their ordeal ended six hours later, when Sam shot himself to death.

Six hours is a very long time. And Sam had a captive audience. He could have made some sort of demand – money, for instance. He could have railed about school pressures, or bullying, or trouble at home.

But as the minutes and hours ticked away that day, Sam did none of that. His best friend, Nick Nelezen, says he was thinking, “’Sam, what’s going through your mind? This is not you.’” Sophomore Nathan Miller says that Sam did not appear to be angry during the ordeal; in fact, the hostages said, Sam barely said a word the whole time.

Marinette is a close-knit, quiet, homogeneous community where the crime rate is low and not much seems to happen. The city’s police department poured all their resources into finding out why the tragedy happened, and came up with nil. "There is no common thread coming out (of interviews) regarding motive," Marinette Police Chief Jeff Skorik said. "There is nothing unusual that is coming out (of the investigation) about this boy or his family."

Hundreds of Sam’s classmates attended his funeral, including most of the hostages. “We're not angry at him,” said one of the hostages, Zach Rastall. “We feel worse for his family and we want to support his family because they're going through a much more difficult time than we are.”

I don’t believe that people “just snap” for no reason. The fact that a motive was not offered and has not been discovered doesn’t mean there isn’t one. What secret did Sam take to the grave with him? We may never know – and that’s a pity in so many ways.

Thursday, December 9, 2010

Programmed to self-destruct. Thursday, December 9, 2010.

“My head was full of wild ambitious urges to hurt myself. I tasted the ambrosia of maddened impulse. I wanted my interior pain out in my body somehow. I wanted this vague pain to be specific. That’s how I explain it.” –Charles Baxter

I was invited to a Facebook group today. It turned out to be a pro-ana group, and the girls there were looking for “buddies” – people who would join them in the quest of starving themselves to death. I declined.

I checked out this young girl’s FB profile. She’s a very pretty girl. But most of her photos are graphic, triggering shots of self-harm, drugs, and starvation.

Since we’ve never communicated, I don’t know what to say to her. But I read her profile description, and I fear it speaks for many girls – girls who have suffered abuse (usually of the sexual sort), and who continue the pain by abusing themselves. Saddest of all, it seems these young people have made a decision – they prefer sickness to health, pain to comfort, death to life. Here are her words:

I'd rather stay home and get high then go to school. I'd rather get paid for fucking someone then go to an actual job. I'd rather be skinny and pretty then a fat pig. I'd rather have my little episodes then have to deal with real life. I'd rather live my life through a haze of pills then with nothing.

I'd rather be in the hospital then at home. I'd rather inhale the toxins from a cigarette than go and try and calm down another way. I'd rather cut myself with the ice cold metal of a razor blade then cry myself to sleep. I'd rather go out and get a police record then be the good little girl who never does wrong.

I'd rather drink myself into a coma then reminisce about my past. I'd rather be fake and happy then let you know I'm dying inside.

What does all this crap mean? Let me lay it out for you straight. I skip school, I do a ton of drugs, I'm a prostitute, I'm anorexic/bulimic, I have a ton of mental illnesses, I pop pills, I've been in a hospital 4 times, I smoke, I cut and burn, I get in trouble with the police and school alot, and I drink. All in all, I'd rather be anyone else but who I really am. I'm truly a child from hell.

Wednesday, December 8, 2010

Here she comes a-tapping. Wednesday, December 8, 2010.

“(The) combination of tapping the energy meridians and voicing positive affirmation works to clear the ‘short-circuit’ – the emotional block – from your body's bioenergy system, thus restoring your mind and body's balance.” –Dr. Joseph Mercola

Did you know there really are “snake oil salesmen” – people who literally sell snake oil? The oil comes from the Chinese Water Snake and is supposed to help with joint pain. Snake oil probably works better than a sharp stick in the eye. (But wait, that stick in the eye could be a distraction, so maybe it would be effective.)

In America, though, “snake oil” is a derogatory term for medical treatments that aren’t really treatments. Most people see copper bracelets sold as cures for arthritis pain as a kind of snake oil; a few people swear by them. Some people believe that all mind-altering pharmaceuticals are snake oil; I disagree.

I first heard about EFT, the Emotional Freedom Technique, from an open-minded Christian counselor who was helping me deal with stress. Two years ago, when my anxiety began to become truly disabling rather than simply a nuisance, I was desperate to find non-drug help and I ordered an EFT manual online.

EFT sounds a little silly. In EFT therapy, the client taps on acupuncture points, supposedly manipulating energy fields, while focusing on fears or traumas and thereby releasing them. As a journalist, I don’t buy into anything without checking it out first. Some of the studies on EFT have shown that it works; others have shown that it does not. When there is success, researchers attribute it to a variety of factors: either the placebo effect is happening, or the client is being helped by talking about their fears, or there really are energy fields that – when tapped – promote emotional healing. The bottom line is, no one knows for sure.

I recently started seeing a new psychologist, one recommended to me by my P-Doc. I never believed that my healing could come from pills alone, and as much as I liked my former therapist, I came to the realization that I needed someone who could help me go deeper.

Enter Dr. M., a bearded, Birkenstock-wearing Buddhist who believes in conventional medicine AND alternative treatments. A medical doctor, he’s covered under my insurance plan. And his office smells like lavender.

One of his treatment methods is EFT. And while I tried it on myself, unsuccessfully, right after my suicide attempt, I am willing to give anything a try right now. I don’t know whether or not I believe in EFT, but I do know that my treatment today opened my emotional floodgates. I tapped and cried. I tapped and cried harder.

So Dr. M. gave me a homework assignment – to do EFT on myself once a day, every day, until I see him again in two weeks. We shall see. We shall see.

Tuesday, December 7, 2010

You bet I’m pissed. Tuesday, December 7, 2010.

“The ‘mental illness’ brigade always talks about how much suffering ‘mental illness’ causes, and that everybody who doesn't buy into their ‘mental illness’ denies their suffering. Well, maybe their suffering really isn't that bad. Or they might bring up the courage to face their trauma, instead of hiding behind their ‘mental illness.’” – Facebook status of an anti-psych

Let’s get three things out of the way:

First, I’m no fan of Big Pharma. I’m disgusted by their profit margin; I believe they should not be allowed to advertise; I’m concerned about drug safety; and I feel vulnerable because I depend on corporate health insurance to afford my medication.

Second, I don’t believe in throwing drugs at everyone who complains of being depressed or anxious. Most of the time, feelings of sadness and fear are normal reactions to the trials of life, and they’ll pass when the situation improves.

Third, as someone who has experienced Haldol Hell I know what it feels like to trust a doctor only to be prescribed a harmful drug.

But I know something else. Somewhere along the line, something in my mind and body went haywire. My mind would get stuck in a loop of thoughts I could not control, and my body pumped out so much adrenaline that I couldn’t eat or sleep for weeks. This has happened to me a few times over the past 30 years – sometimes when I was under stress, and sometimes not – once culminating in a suicide attempt.

And I know that medication has helped lessen the severity of my symptoms.

The anti-psych movement (not all of them are Scientologists, BTW) believes there is no such thing as “mental illness,” simply people who think and behave outside the norm. They feel that diagnoses such as schizophrenia and bipolar stigmatize and dehumanize people. They believe psychiatric medications are worthless at best, and deadly at worst.

They’re free to their opinions, but I start feeling defensive when I read posts calling people who take meds ignorant “sheeple” who simply “believe the ads they see on TV” and “want to be compliant ‘patients’ to please their doctors.” I get angry when I read that autistic behaviors should be blamed on faulty parenting, and that people who are delusional are simply acting out their individuality, regardless of their safety.

Most of all, I feel dismissed and stigmatized by the very people who claim that society is dismissing and stigmatizing me by labeling me as bipolar. To me, personally, understanding that I have a disorder that is biologically based and can be treated makes me feel less ashamed and gives me hope. It gives me a feeling of solidarity with others who have bipolar disorder as well as the many people who are recovering from mental illness with therapy, medication or both.

I tried, for many years and on several occasions, to control my symptoms without meds. I got a BA in psychology. I delved into my past in talk therapy, and I’ve used CBT, EMDR, EFT, Magnesium, Vitamin D, hypnotherapy, aromatherapy, acupuncture, and prayer. There is nothing wrong with any of these therapies, and in fact I am trying several of them again.

But the severity of my depression and anxiety was such that I did not begin to recover until I was on the right meds. And I ask the anti-psych people: Does that make me some kind of failure…? Because when I see words like “sheeple” and “ignorant” and “compliant,” I sure feel like one. No one who believes in the “biological theory” is calling me names like that. No one else is putting “mental illness” in quotation marks, or dismissing my suffering as “not that bad,” or saying I “lack courage.” But I didn’t choose this.

So long, and thanks for the stigma.

Monday, December 6, 2010

What I can do. Monday, December 6, 2010.

“Act as if what you do makes a difference. It does.” ~William James

There’s so many things I can’t do. There are a few things that I can.

Yesterday my friend came to me. She was sick, she said, and she needed help. Tearfully, shaking, she asked me to accompany her to the ER.

Ella has dealt with paralyzing depression, anxiety, and sometimes psychosis for years. Unable to work, she depends on Disability, which offers minimal health insurance. Before she got Disability, she lived for a time in her car.

An intelligent woman, my friend recognizes she’s functioning at a low level; this knowledge makes her feel frustrated and ashamed. Raised in a home where she was taught to be subservient, lacking in any occupational skills, and having survived severe abuse, Ella barely talks above a whisper and breaks into tears every few minutes. She is filled with grief, regrets, and unresolved anger.

A few years ago Ella became suicidal and delusional. Her family and I felt she was a danger to herself, and we cooperated to get her placed in an inpatient facility for one week to get her past the immediate crisis. I’d be lying if I said she wasn’t angry at the time, but, she says to me now, “I know your heart is in the right place.”

In the months following her inpatient stay, Ella did very well. But like so many people in our society, she was teetering alongside cracks. And eventually, she fell into one. The community center where she was supposed to be receiving counseling did not provide her with a particular therapist; instead, they rotated, so she saw a different person each time.

Ella has led a difficult life, suffering multiple traumas over many years. She is a person in need of intensive, ongoing support. Instead, she found herself trying to explain her complex situation to one therapist and then to another (on the infrequent occasions she was actually able to get an appointment). No one had the big picture of her life. Who could make any progress in a situation like that?

After just a few sessions, she quit going. She didn’t like talking about her problems anyway. Ella took her pills sometimes, and got a couple of refills from a GP. But no psychiatrist was assigned to oversee her care. Her medication was as useless to her as her “therapy.”

At the moment, Ella is not suicidal, thank God. She’s not hallucinating, and she is not delusional. Last night, after nine hours in the ER, the doctor released her with a cheerful reminder take her medication and call a social service agency. She already has the number.

Ella has no voice. There’s so many things I can’t do. I can’t take away the traumas from Ella’s past. I can’t give her the occupational training she needs to find a job that might raise her self-esteem. I can’t make sure she takes her meds properly. I can’t change the social services system to give her continuity of care.

What I can do is hold her hand as she cries. So that’s what I did.

Saturday, December 4, 2010

Worth more dead? Saturday, December 4, 2010.

“[Suicide’s] against the law where I come from, too.” Clarence the angel, “It’s a Wonderful Life”

Last night I went to a sweet, funny, and heartwarming play about suicide.

Usually, when people think of “It’s a Wonderful Life,” they think of Christmas. But the story could take place any time of year. Ultimately, it’s a story about suicide and the intangible worth of a single human life.

We went to a stage adaptation of Frank Capra’s movie last night. Of course, I’ve seen the movie a million times, but it was the first time I’d seen the story since – like unfortunate George Bailey – I made the calculation that I was worth more dead than alive.

You see, unlike most people who are suicidal, George isn’t particularly depressed. Although he’d missed out on his dream of traveling the world, George was a happy husband, father, and business owner up until that fateful Christmas Eve. For George, principle had always mattered more than money – that’s why he turned down the evil Mr. Potter’s offer of $20,000 a year (about $150,000 in today’s money) to work for him.

But suddenly the unthinkable occurs. A sum of $8,000 vanishes – hidden inside a folded newspaper by an absent-minded employee – and George faces bankruptcy. Within a couple of hours and after a few drinks, George concludes that Mr. Potter is right – because he has a life insurance policy, he IS worth more dead than alive. Next thing you know, he’s standing on a bridge, preparing to jump into the river.

Most people think that life insurance policies don’t pay out for suicides. Actually, most do – provided you’ve had the insurance for more than two years. I know this because I checked my policy a few days before my attempt. I’d been obsessed with the threatened bankruptcy of our company, and with the shame of losing our home. Since I was a lousy wife and mother (according to me), I figured my family would be better off with the cash from my life insurance, which would pay toward the mortgage for a couple of years.

In “It’s a Wonderful Life,” George has a guardian angel: Clarence Obody (Angel Second Class – he still needs to earn his wings). I don’t know where other suicidal people’s guardian angels are, but George can see and talk to his. I’d been praying nonstop for weeks for a break from my anxiety, and I continued to pray in that motel room. I would have liked to see a guardian angel – even an Angel Second Class – but maybe my angel worked undercover and kept my OD from being lethal and prevented too much blood loss from my veins. I don’t know.

At any rate, I feel an affinity to George. We both have wished we hadn’t been born (I reflected a few months ago about the way things might have been if I’d never existed). And we both thought our deaths would result in our families’ being taken care of financially. After my attempt, when I was home from the hospital, I still believed I’d made a logical decision. My husband, angry and hurt, shouted, “I’d rather live in a homeless shelter with you alive than in the house with you dead!”

But people that kill themselves to benefit their families financially are misguided. First, most peoples’ life insurance policies will only cover their families’ expenses for a few short years. Second, only about one of 20 suicide attempts are completed. The rest of the time, the attemptor wakes up alive, facing even more financial stress.

There’s the cost of an ambulance, if it’s not covered in your community or by your insurance. There are emergency room costs, well over $1,000 a day. If you’re admitted to the psych ward, you’re looking at maybe $1,500 for every day you spend there. If you’re lucky enough to have insurance, you probably still owe a deductible or co-pay. Then there is the time lost from work, as well as the stigma you’ll have to deal with if people find out: you can’t even put a price tag on that.

Suicide’s expensive. This is one favor your family can't afford.

Friday, December 3, 2010

Suicide Awareness Friday. Friday, December 3, 2010.

“Nine men in 10 are would-be suicides.” –Benjamin Franklin

Are you wearing red today? I am – in honor of friends who ended their lives; in honor of my own attempt and my continuing effort to heal, and in honor of friends I have met through the SAS group that are fighting their own battles with suicide.

In honor of the day, I’d just like to present some facts, care of Suicide Awareness Voices of Education.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Suicide takes the lives of nearly 30,000 Americans every year.

Many who attempt suicide never seek professional care.

There are twice as many deaths due to suicide than HIV/AIDS.

Between 1952 and 1995, suicide in young adults nearly tripled.

Over half of all suicides occur in adult men, ages 25-65.

In the month prior to their suicide, 75% of elderly persons had visited a physician.

Suicide rates in the United States are highest in the spring.

Over half of all suicides are completed with a firearm.

For young people 15-24 years old, suicide is the third leading cause of death.

Suicide rates among the elderly are highest for those who are divorced or widowed.

80% of people that seek treatment for depression are treated successfully.

15% of those who are clinically depressed die by suicide.

There are an estimated 8 to 25 attempted suicides to 1 completion.

The highest suicide rate is among men over 85 years old: 65 per 100,000 persons.

1 in 65,000 children ages 10 to 14 commit suicide each year.

Substance abuse is a risk factor for suicide.

The strongest risk factor for suicide is depression.

By 2010, depression will be the #1 disability in the world. (World Health Organization)

In 2004, 32,439 people died by suicide. (CDC)

Suicide is the 11th leading cause of death in the U.S. (homicide is 15th). (CDC)

Suicide is the 3rd leading cause of death for 15- to 24-year-old Americans. (CDC)

It is estimated that there are at least 4.5 million survivors in this country. (AAS)

An average of one person dies by suicide every 16.2 minutes. (CDC, AAS)

There are four male suicides for every female suicide. (CDC, AAS)

Research has shown medications and therapy to be effective suicide prevention.

Suicide can be prevented through education and public awareness.

Last year SAVE educated 10,618 youth & parents on depression and suicide prevention.

Last year SAVE received 810 requests for information from 72 countries.

In 2004 it is estimated there were 811,000 suicide attempts in the US. (AAS)

There are three female suicide attempts for each male attempt. (CDC, AAS)

According to the Violent Death Reporting System, in 2004 73% of suicides also tested positive for at least one substance (alcohol, cocaine, heroin or marijuana).




Thursday, December 2, 2010

Seeing red. Thursday, December 2, 2010.

“I'm sorry but this is stupid. It's not like with breast cancer awareness. At least with it, the people didn't choose to have it. With suicide, they knew what they were doing and did it so I can't help raise awareness for that.” – A comment regarding suicide awareness

I dug through my closet last night to find a red sweater to wear to work tomorrow in honor of Suicide Awareness Friday. It must be exclusively a Facebook thing, because the official World Suicide Prevention Day is September 10. No matter; it’s good to build awareness more than once a year. As of this morning, 15,042 Facebookers are “attending” the event tomorrow. Cool.

But as usually happens on suicide-related Internet boards and walls, the critics are front and center. Suicide, they remind us, is cowardly and self-centered. “It’s very selfish…and stupid. Anyone willing to commit suicide obviously only cares about themselves, and they aren’t thinking about the pain they’ll inflict on family and friends,” says one post. “It also shows just how much of a coward a person really is, being unable to deal with their problems.”

I wrote a few months ago about the reason I created the Suicide Attempt Survivors group in the first place – because the “Suicide Survivors” groups on Facebook were all for bereaved family members (many of them quite angry, and some of whom attacked me).

In addition, my search for books written for suicide attempt survivors yielded only a couple of titles, while there are dozens of books for family and friends left behind. (Some shameless self-promotion: because of the dearth of books available for us, I’ll be publishing my “Death to Life” blog as a book, volume 1, very soon. It will be available on Amazon.)

So we’ve established that suicide appears to be a selfish act. Really, how can I say otherwise, when I, too, have lost loved ones to suicide? I’ve experienced that toxic mix of shock, loss, and red-hot anger at people who apparently didn’t care enough about me (or anyone else) to stick around. I’ve watched families self-destruct after a mother asphyxiated herself, leaving three children, and after a brother hung himself in his sister’s bedroom closet. There is a reason why they say that loss due to a suicide is about the worst loss there is, because it implies “choice.”

As I write this, the life of a friend of mine hangs in the balance. She wants very much to die (or for her suffering to end, which is what she thinks death will bring her). I want very much for her to live. There is nothing more I can say or do; it’s going to come down to her “choice,” such as it is, and she may choose to leave me despite the love I’ve shown for her. There are many others who care for her, too, and I’m concerned about how her death would affect them. I’m not sure whether it would affect five people or 500; it really doesn’t matter. People would be hurt. Does this mean that if my friend kills herself, she is being selfish? Well, by definition, yes.

But there’s a layer of complexity here. Extenuating circumstances, if you will. No one, especially me, wants to open a floodgate by saying that suicide is NOT selfish, or even by challenging the idea that it is a choice. It’s true that people that take their lives often do so after having been begged by loved ones not to do so. And it’s also true that any given suicide is the big result of probably dozens of little choices – to go to the store, to pick out the pills, to pay the cashier …

But suicide is, first and foremost, an act of desperation. No one “chooses” to commit suicide like they choose to have fish for dinner. And if you interview 10 suicide attemptors, you’ll probably find that eight of them honestly and truthfully believed that their loved ones would be happier without them. The end result of their action is extraordinary pain for those left behind. But it’s not intentional.

Does “lack of intent to harm others” make suicide okay? Of course not. But unless you have looked into that chasm yourself – unless you have experienced pain so deep that “dead” seemed like a really good thing to be – you don’t really understand.

Unfortunately, I do understand. I’ll be wearing red tomorrow. And can I ask you for prayers for my friend who is peering into that chasm now?

Wednesday, December 1, 2010

What's eating you? Wednesday, December 1, 2010.

"I'm just afraid I'm gonna miss it all ..." –Karen Carpenter, to her therapist

When singer Karen Carpenter died on February 4, 1983, of an anorexia nervosa-induced heart attack, it was the first time many people ever heard of the eating disorder. Karen had an angelic face and voice. She was 32 years old. At the time of her death, Karen was 5’4” and weighed 108 pounds.

That same year, I was 5’5” and weighed 101, making me considerably thinner than Karen. But I was not anorexic. I suffered from anxiety, which killed my appetite, and I’d been shaped like Ichabod Crane all my life. I was terribly ashamed of my scrawny, boobless and hipless frame (I’ve since grown boobs, hips, and a good-sized ass – thank you for asking).

Because of my self-image as a teenager, I’ve always had a hard time acquainting extreme thinness with beauty. When I see an extremely skinny woman, I don’t think “How beautiful she is!” I think, “She needs to get some meat on those bones!” Mary-Kate Olsen and Calista Flockhart make me cringe. I like that Marilyn Monroe was 5-1/2” and weighed 140 pounds.

A flurry of Hollywood performers have come forward to share their stories of anorexia, bulimia, and cutting (an unholy trinity of disorders that often go together). Most recently, Brittany Snow of “American Dreams” announced that during the taping of the series, she battled anorexia, depression and self-mutilation. Just a few of the others: Margaux Hemmingway, Paula Abdul, Fiona Apple, Sandra Dee, Sally Field, Jane Fonda, Tracy Gold, Audrey Hepburn, Janet Jackson, Alanis Morissette, Sharon Osbourne, and Christina Ricci.

For many years, eating disorders were seen as a rich, white girl’s disease. Young women who were spoiled and surrounded by abundance wanted their bodies to be perfect, like models’ bodies are perfect, and so they were starving themselves like bratty little children at the dinner table refusing to finish their Brussels sprouts.

But thinking has evolved. Researchers are coming to the realization that many of those who suffer from eating disorders are not Caucasian, not privileged, and sometimes, not even women. Interestingly, anorexia is popping up all over the globe, even in rural communities in Africa where food is already scarce and people are not exposed to the Western media.

I’m no expert in eating disorders, and I’ve never been diagnosed with one, although I shed 20 or 30 pounds very quickly during my bipolar mixed episode. I had several reasons for not eating: I had a medical condition that made it hard to eat; I was extraordinarily anxious and so had no appetite, and I was severely depressed and so believed that I did not deserve food. However, looking like Angela Jolie was not on the list of my priorities. (I’ve since gained back the weight, plus a good deal more. Hello, yo-yo.)

The fact is, emaciated women aren’t sexy. So I have a hard time believing that “looking good for guys” is really at the heart of most women’s eating disorders. Ask most men and they’ll tell you. They like ‘em some tits. They like ‘em some ass. When I was a too-skinny teenager, I was told by one “boyfriend” that hugging me was like holding a skeleton. He never called again.

Instead, I think there’s something to the self-mutilation connection. One phenomenon that occurs among very religiously pious women is that they stop eating as a form of self-denial, or self-punishment. Why would self-injury so often appear with anorexia and/or bulimia? No one cuts themselves to look sexy. They’re expressing self-hatred with a razor blade. They can do the same by refusing to eat, or purging what they have eaten.

Self-hatred – for all the reasons it occurs – is an equal-opportunity tormentor. Ironically, famous women might be even more inclined to self-hate, if they feel guilty or undeserving of their great fortune.

It’s not about the pounds. It’s about the pain.

Tuesday, November 30, 2010

Psych psayings. Volume 1. Tuesday, November 30, 2010.

If you can’t beat it, laugh at it. Here are my favorite psych gems … so far. Enjoy. Peace/Love, Alizah.

“I was going to buy a copy of "The Power of Positive Thinking,” and then I thought: What the hell good would that do?” –Ronnie Shakes

"I WILL NOT PRESCRIBE MEDICATION." –Bart Simpson writing on the chalkboard, "The Simpsons"

After a year in therapy my psychiatrist said to me, "Maybe life isn't for everyone." – Larry Brown

CLIENT: "That’s why yellow makes me sad, I think."
FORMER DRILL SERGEANT, TURNED BAD PSYCHIATRIST: "That’s interesting. You know what makes me sad? You do! Maybe we should chug on over to mamby-pamby land and find some self confidence for you, you jack wagon! Tissue…? You cry baby!" –Geiko commercial

The voices in my head may not be real, but they have some good ideas!

A man goes to see his psychiatrist. He says, "Doctor, I've been having suicidal tendencies. What should I do?" The psychiatrist replies, "Pay your bill today."

"We are bringing a revolutionary new medicine to them, a medicine with which the Federation hopes to eliminate mental illness for all time!" –Captain Kirk's log, "Whom Gods Destroy," "Star Trek," January 1969

“I’m on Adderall and Xanax. So I’m ignoring you, but I don’t care.”

MRS. BAKERMAN: Dr. Hartley, if you're looking for a new member of our group, I know a nice schizophrenic.
MR. PETERSON: Or how about a manic-depressive? At least you know they'll be fun half the time.
–“The Bob Newhart Show”

"I told my therapist I was having nightmares about nuclear explosions. He said don't worry, it's not the end of the world." – Jay London

‎"'Neurotic' means he's not as sensible as I am, and 'psychotic' means he's even worse than my brother-in-law." –Karl Menninger

“He fills me with hope. Plus some other emotions which are weird and deeply confusing.” –Captain Zapp Brannigan, “Futurama”

BARRY: "I wanted to ask you something because you're a doctor ... I don't like myself sometimes. Can you help me?"
WALTER: "Barry, I'm a dentist." – "Punch Drunk Love”

‎"I am the Lord they God. Thou shalt not have strange gods before Me. Out of my way, asshole." –Jack, "The Dream Team"

"I read somewhere that 77% of all the mentally ill live in poverty. Actually, I'm more intrigued by the 23% who are apparently doing quite well for themselves." –Emo Philips

Out of my mind. Back in five minutes.

‎"Shit happens. Mostly to me, so don't worry." –Anonymous

“After 10 years in therapy, my psychologist told me something very touching. He said, “No hablo ingles.’” –Dennis Wolfberg

‎"If you talk to God, you are praying. If God talks to you, you have schizophrenia." – Thomas Szasz

Reality is overrated.

There are 3 kids, named Nobody, Somebody and Crazy. One day, an accident happens and Crazy runs like hell to the police station. Crazy: "Somebody killed Nobody!" Police: "Are you crazy?!" Crazy: "YES!"

‎"The other day, I cried. But you know what? Fuck that day. That's why God, or whoever, makes other days." – "Precious"

"I was depressed at that time. I was in analysis. I was suicidal as a matter of fact and would have killed myself, but I was in analysis with a strict Freudian, and, if you kill yourself, they make you pay for the sessions you miss." –Woody Allen, "Annie Hall"

Religion isn't the opium of the people. Opium is the opium of the people.

Why do psychiatrists give their patients shock treatment? To prepare them for the bill.

“If one person calls you a horse’s ass, you can blow it off. If 10 people call you a horse’s ass, it is time to buy a saddle.” –John Collis

‎"I remember when I lost my mind ... There was something so pleasant about that place." –"Crazy," Gnarles Barkley

‎"Can't a person sit here and have a nervous breakdown without being asked if something's the matter?!" –Charles Barsotti cartoon

"Marge, I know you've tried everything to keep Bart under control: Ritalin, Lithium, Zoloft. Well, they didn't work. He has moved on to DRUGS." – Superintendent Chalmers, "The Simpsons"

“One does a mitzvah, and this is the thanks one gets?” –The Dybbuk, “A Serious Man”

"What sane person could live in this world and not be crazy?" – Ursula K. LeGuin

DONNIE:" I made a new friend today."
DR. THURMAN: " Real or imaginary?"
DONNIE: "Imaginary."
–"Donnie Darko"

‎"If you could understand crazy, it wouldn't be crazy." -"Splice"

TODAY'S INSPIRATIONAL THOUGHT: Some people are like Slinkies. Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.

You have the right to quit Toxic People. (They're contagious.) –Dr. SunWolf

“I hope some animal never bores a hole in my head and lays its eggs in my brain, because later you might think you're having a good idea but it's just eggs hatching.” – Jack Handy

"I'm so happy, I found my friends. They're in my head." –"Lithium," Nirvana

Monday, November 29, 2010

What shade of blue are you? Monday, November 29, 2010.

“Every man has his secret sorrows which the world knows not; and often times we call a man cold when he is only sad.” –Henry Wadsworth Longfellow

I woke up sad this morning. I’m sure this has happened to you: you have that familiar lump in your throat and pressure on your chest the moment you gain awareness, as if you’ve just had a very disturbing dream. But the dream (or nightmare?) has already faded from your memory, leaving the blue mood behind.

I had some chores to take care of this morning, but ruminated on all the things left undone around the house. I worried again about my job and our finances, my ailing elderly father, and my mother who seems to be getting old suddenly and quickly. I cried briefly as my cat stared at me, and then I re-applied my mascara and went to work.

For somebody with bipolar or clinical depression, this nebulous kind of sadness is a scary thing. Does it mean you’re on your way down again? And if so, how low will you go? When I got to work, I filled out today’s Mood Tracker and felt relieved to see I’d gotten the same score a few times over the past month but that it had always improved within 48 hours.

The bottom line is this: “sadness” and “depression” are not the same thing. One’s a chest cold; the other is emphysema. One is a bit of heart burn; the other is a potentially fatal case of e. coli. The anti-psych people say that mental illness “labels” stigmatize people for having normal emotions (I’ll be blogging on our debates soon). The truth is, everyone feels depressed sometimes, but not everyone gets depression – at least not the kind I’m talking about.

Unfortunately, there are many bad doctors who diagnose (and medicate) “the worried well.” Their patients are people who are perturbed by a contentious divorce, or who feel unfulfilled in their career, or who are finding it boring to be a stay-at-home mom. Allow me to be first in line to say that these people probably don’t need a psychiatric label, or the pills that go with them.

Likewise, I cringe when a friend who is going through an immediate crisis, like the death of a parent, is given a script for Prozac or Xanax – especially when they’re not referred to a talk therapist. I agree that you can’t just throw pills at people when their fear or grief is legitimate and must be worked through.

But again, I’m talking about something else.

* Have you ever lost more than 20 pounds because you felt that eating was a waste of food?

* Have you experienced several months unable to sleep for more than three or four hours a night?

* Have you had to lock yourself in the bathroom at work and do jumping jacks because you were so anxious and agitated? Ten or 12 times a day? Every day for two months?

* Have you gone from someone who always enjoyed wearing makeup and pretty outfits to someone who barely showered and wore the same clothes to work for days in a row?

* Have you ever laid down on the floor of the supermarket because you were so overwhelmed and confused by the different colors and labels?

* Have you ever been envious of people on the obituary page?

* Have you wondered whether you are still capable of love?

* Have you prayed for God to take you while you are asleep?

* Have you lost the ability to cry?

* Have you ever felt as if you are already dead?

Then you have experienced the deepest, darkest shade of blue.

Sunday, November 28, 2010

The horror of housework. Sunday, November 28, 2010.

“At some stages of your life you will deal with things and at others you are overwhelmed with misery and anxiety.” –Nigella Lawson

I have laundry to do. I have bills to pay. I have bathrooms to clean.

Let’s be honest. There was never a time in my life when I looked forward to any of these tasks. My mother is the neatest, most organized, most squeaky-clean person in the world. If she sees a speck of dust, she’s right there with the Pledge. My living room furniture is covered with six months’ worth of dust; I didn’t inherit her perfection gene. I don’t invite her over anymore. She’d faint dead away.

Since I got really sick, though, my procrastination over these matters has become much, much worse. When I was in my mixed state, I couldn’t – literally couldn’t – do these jobs. Organizing the laundry was overwhelmingly confusing. Accounting for things in my checkbook was like trying to remember the first 75 numbers of pi. My brain honestly couldn’t comprehend things. And I was so weak from not eating and not sleeping that I couldn’t even carry the laundry to the basement.

I’m better now. Not a great deal better, but better enough to function. Still, thinking of doing distasteful tasks doesn’t just make me feel lazy – it makes me feel overwhelmed and anxious. Is there such a thing as a fear of housework? Strangely, I seem to have it.

I’m trying to figure out why. I used to get a feeling of satisfaction when finishing my checkbook or the bathroom. Now, I just feel ashamed because I got upset when I was doing the work and I cried. Doing the bills triggers my anxiety about money. Doing the housework triggers pathetic comparisons to my mom. Besides, I live with a couple of hoarders. Cleaning the house is like taking a thimble to the ocean. So it’s hard to even start.

I have to get over this thing. I have laundry to do. I have bills to pay. I have bathrooms to clean.

Friday, November 26, 2010

Greed Friday. Friday, November 26, 2010.

“Earth provides enough to satisfy every man’s need, but not every man’s greed.” –Mahatma Gandhi

Today in the United States, it’s a bizarre “holiday” of sorts – Black Friday. It’s the day after Thanksgiving, the official beginning of the Christmas shopping season, when retailers make their biggest profits of the year and “go into the black.”

Unlike many Americans, I didn’t get to the stores at 3 a.m. with a fistful of shopping circulars, pushing other people down to acquire the top-selling gift this year (whatever that is). Luckily, I have to work today, so maybe I have an excuse not to observe this “holiday” by shopping.

Actually, I made an agreement with my family that this year: we will all purchase second-hand Christmas gifts at the thrift store. That way, we’ll save money during this time of economic uncertainty; the money we do spend will support non-profit organizations; and we won’t be supporting sweatshops in China and India. But in a way, this makes me a bad American. People have bought so little the last couple of years, it’s affected the retail and manufacturing industries, costing many people their jobs.

“Greed, for lack of a better word, is good,” said corrupt billionaire investor Gordon Gekko in the 1987 film “Wall Street.” “Greed clarifies, cuts through and captures the essence of the evolutionary spirit.” But at the end of the film, Gekko goes to prison. It was greed that caused the economic crash at the end of 2007 and the resulting Recession. And strangely, it will be a kind of greed that will promote an economic recovery – people will need to start buying again (hopefully American-made goods) in order for others to go back to work. Thrift is a good thing individually, but a bad thing for society as a whole.

It was the fear of losing my income that triggered a major depressive episode. It’s the ongoing fear of the same that keeps my emotional recovery from being complete. But if anyone thinks I’m materialistic, they’ve got me wrong.

For some people, money represents “stuff.” People who are addicted to consumption soothe their depression by acquiring more and more things. I once had a boss who would come into the office every week with some incredibly expensive article of clothing – a $500 Prada sweater, or a $700 pair of Manolo Blahnik shoes. She eventually ran her business into the ground and lost her “McMansion” as well.

For me, money represents security. I bought a little house so we would have a place to live and as an investment toward retirement, not as a showpiece to brag about. I bought an economy car to get from Point A to Point B. I carry significant credit card debt not because of “stuff” I bought, but because I was forced to use credit to purchase health care coverage when I lost a job six years ago. I’m more worried about money than about anything else, but not because I want a Prada or a pair of Blahniks. It’s because I want a secure place to live, a car that works, and medical care.

I know several people that say they’re not worried about money. Interestingly, they’re pretty well off. Strangely in our society, one must have a certain amount of purchasing power to live “simply.” Several years ago I purchased a book on how to live the simple life. Suggestions included driving a hybrid car, eating organic foods, and using various herbal supplements rather than prescription medications. Frankly, I can’t afford to practice these forms of “simplicity.”

It’s early afternoon, and Reuters has reported that Black Friday shopping has increased from a year ago. I’m relieved about that. Maybe it means things are turning around. Maybe layoffs will continue to slow. Even though I’m not celebrating this “holiday,” I want it to be successful. The security of millions – not just the greedy – depends on it.

Wednesday, November 24, 2010

Attitude of gratitude. Wednesday, November 24, 2010.

“Thanksgiving Day comes, by statute, once a year; to the honest man it comes as frequently as the heart of gratitude will allow.” –Edward Sandford Martin

Tomorrow we Americans will celebrate our holiday, Thanksgiving, when we honor that which we believe in (God, the Universe or whatever) and express our appreciation for our families, homes and lives.

It’s part of American lore that the holiday’s origin was in 1600s Plymouth, Massachusetts, when the Pilgrims and their Native American friends shared friendly a meal together. Whether or not that’s true, my extended family – along with millions of Americans nationwide – will be gathering for the traditional turkey dinner and football game.

I can’t pretend it’s not true: this year’s Thanksgiving will be a bittersweet one, with so many Americans tumbling into poverty – many for the first time in their lives – over the past two years.

As I write this, our nation’s official unemployment rate stands stubbornly at 9.6 percent (even though economists say the Recession ended last summer). But the “real” unemployment rate (taking into account people whose unemployment benefits have run out, and those who are working part-time and unable to make ends meet) has been estimated to be as high as 23 percent – as high as it was during the Great Depression.

Today, more than two million homes in the United States are in the foreclosure process. And because health insurance is usually tied to one’s job in America, millions are unable to get the health care they need. But perhaps the worst news is that there is really no end in sight; economists say that it may take 8 to 10 years before things improve, and that’s assuming things go very well.

So, you may ask, what the hell is there to be thankful for this Thanksgiving?

I do fear for the future of my family and my country. It’s easy to tick off all the things that are bad today, and that may be bad in the future.

But my husband once taught me a technique for feeling gratitude when you don’t think you have much to be grateful for. It goes like this: you take a breath, grab on to a tiny detail of your life in that moment, and thank (God, the Universe or whatever). With the next breath, you grab on to another tiny detail.

For example, as I’m writing this right now, I can say “Thank you, God, for this chair.” “Thank you, God, for the lights.” “Thank you, God, for the keyboard.” “Thank you, God, for my fingers to type on the keyboard.” “Thank you, God, for my eyes to see the screen.” “Thank you, God, for this can of Coca-Cola.” “Thank you, God, for the socks on my feet.” And so on. You get the idea.

By doing that, you put yourself into a different frame of mind. Before long, you start seeing the Divine in the details, no matter what your current situation.

Speaking for myself, I’m very fortunate. Today, I have a job. (A year ago, I feared I would not be able to say that. I don’t know if I’ll still have a job a year from now, but at this moment my company is still in business. I’m thankful for that.) I’m thankful that today, we have our home. I’m thankful that today, I have health insurance. I’m taking a Polaroid snapshot of this moment in time, thankful for my life today, this moment.
This Thanksgiving, I am grateful for my husband, my son and my mom, even though it’s been a tough couple of years. I’m thankful for my doctor and my therapist, and for the medications that have helped decrease my anxiety and depression.

And I’m deeply appreciative for all the members of my Suicide Attempt Survivors group on Facebook, so many of whom have written me such encouraging messages over the past several months. Since so few of my “IRL” people know my story, it means the world to me that so many of you have reached out to support me in my journey to wellness. You truly give me something to be thankful for.

I hope that whatever your situation, you can find something to be grateful for this holiday. May God bless you all.



Monday, November 22, 2010

Breathing in time. Monday, November 22, 2010.

“Ouch I have lost myself again / Lost myself and I am nowhere to be found / Yeah I think that I might break / I've lost myself again and I feel unsafe” – Sia, “Breathe Me”

I bought myself a bottle of perfume a few days ago. It was an inexpensive brand, nothing fancy – anyone who knows me knows I like to be beautiful on a budget – but the important thing was that it was a scent I’d never purchased before.

You see, I’d noticed that every morning, as I stood in my bathroom putting on my makeup and cologne, I’d suddenly feel a wave of grief. I finally realized it happened when I was putting on my perfume – a luxurious brand my girlfriend gave me for Christmas two years ago. I’d been wearing the scent during the period of time that I sank into a depression and a mixed state. Given that the sense of smell is the one most closely linked to memory and emotion, I guess it’s not surprising that my perfume was triggering upsetting memories.

When you pause to consider it, a suicide attempt (and the emotional state that precedes it and follows it) is an extremely traumatic event. There may be some Post-Traumatic Stress Disorder around it. And although my attempt was in the spring, it was right around this time of year two years ago – Thanksgiving, going into Christmas – that I began my emotional descent.

Situationally, it had been a month since our company’s “restructuring” had begun. We were hemorrhaging staff, causing all of us to wonder if we’d still be employed after Yuletide, and the reality of our uncertainty about the future was sinking in. Medically, my P-Doc was making changes to my prescription regimen, and had taken me off one particular drug that had been extremely helpful for me.

And at home, my husband and I were just finishing the “Six Feet Under” DVD set. We’d gotten the HBO series from the library, and had watched a couple of episodes a night for a number of weeks. I had become alarmingly attached to the show; the characters seemed real to me, like a second family, and the central theme – death – had wedged deeply into my consciousness. The night we watched the final episode, when (SPOILER ALERT) all of the characters die, I sobbed for hours. I attributed it to work stress and going through menopause, but it was really the beginning of a bipolar mixed episode.

This morning at work, I popped a random CD into my player. (Quiet music in the background helps me write.) Partway though the morning, I became conscious that tears were rolling down my cheeks. I realized that the song playing was “Breathe Me,” by Sia. This deeply emotionally evocative song – truly, one of the most beautiful songs I have ever heard (listen to it if you don’t believe me), was featured in the finale of “Six Feet Under.”

“Breathe Me” makes me want to curl up inside of it, letting its haunting melody surround me. But it also takes me back to that time two years ago when I began to lose myself. When I heard it this morning, it was as if no time had passed. I am sitting here in a fall outfit that I wore two years ago …writing for a publication I worked for two years ago … listening to a song I first heard two years ago.

If I don’t turn and look at my calendar, the only proof that time has passed are the scars on my wrists.

I wiped the tears from my face, and I hit the “repeat” button. I have been listening to “Breathe Me” for three hours now. I love this song, and I want to be immune to its power. I want to hear it so many times it reminds me of today, not two years ago.

At the same time, though, I am breathing in my new perfume. It’s a reminder that while pain has occurred, so has healing.

Sunday, November 21, 2010

It’s the stigma, stupid. Sunday, November 21, 2010.

“Roses are red, violets are blue, I’m schizophrenic and so am I.” – Oscar Levant

The problem with Levant’s famous little poem is that schizophrenia and Dissociative Personality Disorder are not the same thing. But most people still believe that people with schizophrenia have “multiple personalities.” We’ve come a long way, but apparently, not far enough.

The first time I was hospitalized for my bipolar was in the early 90s. For a week I’d been suffering from a panic attack that would not go away. My “manias” are atypical – anything but euphoric. I had a feeling of terror, a pounding heart, an inability to eat or sleep, and I knew from experience that this state could last weeks or months. So I admitted myself to the hospital.

The good news is that I had health insurance that covered a two-week stay – enough to be stabilized on meds. I was in a wonderful facility and received excellent care. The bad news was that I had to explain my absence to my boss. I decided to call in and say that my appendix had ruptured.

One of the psych nurses overheard my call. That evening she came into my room with a pile of medical books. “What are those for?” I asked. “Well,” she said, “if you’re going to lie about your reason for being gone, you’d better study up on appendicitis so you can answer any questions.”

In two weeks I returned to work, feeling much better, but still clinging to my appendicitis story. However, I noticed that people were avoiding me, and a few times people would quit talking when I came into the room. After a few days my boss called me into his office. “You should know there’s a rumor going around,” he said. “People are saying that you had a nervous breakdown.”

I finally realized what the nurse had been trying to help me understand. I went back to my desk and typed up a real explanation. I did, in fact, have “a nervous breakdown” (as we called it then). I had an illness called manic-depression (as we called it then). I had been in the hospital to stabilize my medication. I was feeling much better. And if anyone had any questions, they could just ask me. I sent it to everyone in the building.

From that time on, things changed. People came to me, praising my courage and, in a couple of cases, apologizing for having laughed behind my back. They told me about relatives and friends that were suffering from a mental illness. And a few of them shared that they, too, suffered from depression. I went from being a laughingstock to a bit of a hero.

That was my former life. I had no husband, no child. I had an apartment, no mortgage. And my job was secure.

All of those things were different this time around. When I “came out” the first time, I really had nothing to lose. I could bear the threat of the stigma. This time I don’t feel like I can. I have my husband, our church, my son to think about. My current boss and co-workers don’t know my like they did at the place I worked before, and my entire field is in upheaval, with people clinging to their jobs like lifesavers. It’s not about shame; it’s about the mortgage.

I’ve been debating on a Facebook page about whether or not mental “illness” exists. Some people believe that there really is no such thing, and that people who behave dysfunctionally are simply reacting to early childhood abuse. “I find it utterly dehumanizing and actually re-traumatizing to be called biologically, genetically defective,” one woman told me.

For me, it’s just the opposite. Understanding that I have an illness is comforting, freeing. I don’t feel like less of a person for having bipolar any more than I’d feel like less of a person for having diabetes. I’m not apologetic about taking meds either. They work for me, and as long as I’m functional, that’s all I care about.

But, you see, I’m not the one with the problem. Other people are. I have no idea how my current boss would react. I suspect my treatment costs the company money, and wonder if they’d prefer to replace me with someone cheaper. The people in our church are mostly immigrants and are very conservative. Many of them would see my situation not as an illness, but rather as a spiritual failing. My son’s friends might be uncomfortable around his “crazy” mom. And so it goes.

Maybe someday I’ll be ready to send out another message to everyone I know, telling them that I have an illness, that I take meds, that I feel OK, and that they can come to me with any questions. But not today.

Saturday, November 20, 2010

Farewell, cruel world. Saturday, November 20, 2010.

“Screw you all. You don’t care about me anyway. No one cares about me. This is it. I’m done. I’m throwing myself onto the subway tracks. I hope you all are happy!!!!” – Fictional compilation of dozens of suicidal farewells I’ve seen on Facebook

I don’t have many rules for the Suicide Attempt Survivors board, but this is one of them: If I see a suicidal farewell note, I will delete it.

One such note appeared recently. I removed it and sent out a reminder about my rule. I received the following PM from a fellow who then blocked me:

“wow I see if i got in crises I'm wasting my time in your group. sorry but whats the point to have a group about suicide and help if don't want see goodbye notes, hello excuse me you'll see them duh. specially from people who don't have any places to look for help. i haven't see any more selfish and sucker than that. and giving her a simple # won't help.”

Wow. Maybe I need to clarify.

SAS IS a place to come for help. I want it to be an online support group. Those of us who have survived a suicide attempt are the only ones who can really understand each other. If you’re feeling depressed and anxious, if suicidal thoughts keep invading your mind and you don’t want them there, if you’re feeling misunderstood or triggered, by all means post about your feelings. You must realize that the board is not moderated 24/7, that we can’t help in an emergency, and that we’re not professionals. But we can lend an ear and a virtual hug.

However, if you’re just pissed at the world, or you’ve already decided you’re going to do yourself in and you’re hoping for an audience, then I suggest another board like “Suicidal Venting.” There is a big difference between seeking help and seeking attention.

What happens when you post a suicidal farewell on Facebook? Well, you upset a lot of people, many of whom are depressed, anxious, and vulnerable. But it’s not like announcing your intent IRL. Here on Facebook, we don’t know who you really are, where you really live, or how to really help you. So all we can do is feel scared and helpless. And for every Facebook farewell that culminates in a real suicide (and there have been some), there are probably 500 that do not. Which means in a few days or weeks, chances are you’ll be posting your farewell again.

So please. We are all here because we are healing, and because we’ve hit bottom and don’t want to be there again. We all know how it feels. If you are feeling depressed and hopeless, go ahead and tell us about it. If you are scared because you might hurt yourself, there are numbers to call (like 1-800-suicide).

But if you just want to shock people or make us feel guilty, there are other places to post.



Wednesday, November 17, 2010

Putting on boots. Wednesday, November 17, 2010.

“It's not our fault that we got sick, but it is our responsibility to get well.” –Dr. Abraham Low

One day when my son was about 4, I had to make a run to the Laundromat to rescue a basket of clothes I’d left behind. His dad had just left for work, and I had forty-eleven things I needed to get done that day. “Get your coat and boots on, Eli,” I said. “We have to do a quick errand.”

Eli had always been an exceedingly obedient kid, so I was surprised when he refused. “No,” he said. “I want to stay here by myself.”

“It will take five minutes, and I don’t feel comfortable leaving you at home alone yet,” I said. “Come on. Jacket and boots.”

Eli put his jacket on, but he drew the line at his boots. “I don’t want to go,” he said. “I’ll just stay here and watch TV.”

“Honestly, Eli, it’s not an option,” I said, mentally checking off the various tasks I was attempting to complete as I headed out the door. “This is not an Eli-decision. This is a mom-decision. You need to follow me, right now.”

I walked out to the porch, which was covered with several inches newly-fallen snow. With a loud sigh, Eli followed me, stepping out into the snow – in bare feet.

Eli screamed like I’d driven a metal stake through his skull: “IT’S COLD!”

“Jeez Louise, Eli! Of course it’s cold. It’s snow! Where are your boots?”

“You let me come out here like this!” Eli cried. “It’s YOUR RESPONSIBILITY to make sure I have boots on!”

I still laugh at Eli’s little rebellion that day. I made it clear that it was his own feet, and therefore his own responsibility; he had the option of going to the car with or without boots. He chose boots.

People recovering from emotional disorders are much the same. I’m not saying that we’re like 4-year-old children (although some of us can be). I’m saying that recovery is hard work, and often, we would prefer that someone else do the heavy lifting.

As the facilitator of an online support group for survivors of suicide attempts, I get a lot of PMs from people who are depressed, anxious, and discouraged. I’ve been where they are; sometimes I am still where they are; and I’m sure I will be where they are again. I’m not a doctor, and I have a family and a full-time job, so there is not much I can do except lend moral support.

Often, in an effort to help, I’ve done research to find books people can read or support groups in their area. I’ve found websites and online articles that might be of help. I’ve suggested social services they might contact. What I’ve discovered, though, is that very often I’m the only one making an effort in the scenario. I hear, “I’m so lonely.” I provide a half-dozen suggestions for meeting people. But a few days later, I get another PM: “I’m lonely.” “Did you try X?” “No. I’m too depressed. Because I’m lonely.”

Know what? I’ve hit bottom. I’ve hit bottom so hard that a razor blade and four bottles of pills seemed like a good idea at the time. But I also know that no one can get well for me but me. It’s not my doctor’s responsibility, or my husband’s, or my mother’s or my son’s. It’s mine.

My boots are my boots. Your boots are yours.

Tuesday, November 16, 2010

Sticky-glue. Tuesday, November 16, 2010.

“Once you label me, you negate me.” –Soren Kierkegaard

I am female. I am blonde. I am Christian. I am educated. I am intelligent. I am pretty. I am bipolar.

Which sentence caused you to sit up and take note?

It’s a strange thing about many mental illnesses. Unlike most other kinds of illnesses, their names are labels that define us. I have a friend who HAS cancer. Another friend who HAS lupus. But another friend of mine IS schizophrenic. Huh. Interesting.

Like most rules, this one has exceptions. For example, my husband is diabetic and my son is asthmatic. But there’s a reason why many advocates for the mentally ill work so hard to reframe the language around these illnesses, conditions, disorders and syndromes. When it comes to differences of the mind, labels cling to us like sticky-glue.

Of course, the language wouldn’t matter if there weren’t a stigma attached. When I was young and single, I was very open about my “manic depression” (as they called it then). Now that I support a family and make my living in publishing, I keep my diagnosis to myself.

I shouldn’t have to do that, and some people would tell me I SHOULDN’T do that – that by my silence I’m only increasing the stigma. There’s probably people who want to “out” me. It’s precisely because I work in a demanding field, take care of my family, and “seem normal,” they would tell me, that I should tell everyone who will listen about my diagnosis.

They’re probably right, but I can’t take the chance. It’s not about me anymore – it’s about my family, their privacy, and my ability to support them. There are laws that protect me, but I’m not so foolish to put my trust in them.

Besides, my credibility matters to me. As I wrote in October, it’s interesting that once you’re diagnosed with a mental illness, you no longer have the freedom to have the emotions others do. I know once my bipolar cat is out of the bag, all of my behavior is blamed on that. I’m not irritated because a co-worker missed a deadline, I’m in an agitated depression. I’m not in a good mood because I did well on a project, I’m in a manic high. No thank you. I’ll keep that cat in the bag.

None of this SHOULD be the case. And in reaction, some people go so far as to say there are no disorders at all, only different kinds of people. But I believe a label can be incredibly important and helpful. A label helped me to understand that I wasn’t just a pathetic loser, just as a different label helped me to understand why my father is the way he is. Labels give us an important context for emotions and behavior.

But just like sex and Merlot, labels have their time and place.

Monday, November 15, 2010

‘Don’t call me daughter.’ Monday, November 15, 2010.

For D.J.

“Schizophrenia cannot be understood without understanding despair.” –R.D. Laing

Chyna was halfway through her second try at college when “the Choir” came to visit.

The daughter of Laurie – a dear friend of mine that I’ve known literally since I was born – Chyna had dropped out of college a few years earlier after a nearly-fatal battle with lupus. All of Chyna’s organs had shut down. Laurie had stayed by Chyna’s bedside for weeks, caring for her and praying with her. Chyna’s survival was a medical miracle that literally cost the family everything they had. But Laurie adored her daughter. The sacrifice was more than worth it.

Now, things were slowly returning to normal. Laurie was back to work. She’d found an apartment she could afford, even if it wasn’t in the best neighborhood. And Chyna was very excited to be back at school. But she found it hard to concentrate. It seemed that “holes” were opening up inside her brain and swallowing memories – entire years were disappearing by the week. And then the Choir arrived.

At first, Chyna thought it was a little strange that no one else could hear the Choir. But she could hear them quite clearly, and she felt compelled to do whatever they told her to do. When they instructed her to prepare for a marriage with her (already married) pastor, she ordered a wedding dress with money she didn’t have. When they told her to rip up a Bible, or shave off her long, beautiful hair, she did as they said.

When the Choir told her to take off her clothes and walk around the neighborhood naked at midnight, Chyna did that, too. In fact, she started doing it a lot. Laurie’s warnings about nearby drug houses and gang territory went unheeded – only the Choir was worth listening to. Having dealt with the fear of losing her daughter due to a physical illness, Laurie was now even more terrified for her daughter’s mind.

You’d think that a concerned mother could bring her daughter to the doctor, explain the situation, and get some treatment for her daughter. But Chyna was 29, legally an adult, and many of the professionals refused to provide information to her mom even though Chyna was clearly psychotic. Laurie needed to become Chyna’s legal guardian, and so began the long and complicated process.

What Laurie did learn from the doctors was sketchy. Chyna tested negative for street drugs. That left several possibilities: the lupus, or possibly the chemotherapy used to combat it, could have created lesions on her brain. She could be developing schizophrenia. She might have Huntington’s disease or early-onset Alzheimer’s. Perhaps she had suffered a number of mini-strokes.

The more questions Laurie asked, the more questions were uncovered. Medication was prescribed for her Chyna’s hallucinations and anxiety. The mediation would ease symptoms for a time, and Chyna would have glorious spells of normalcy. But her father, who lived out-of-state and hadn’t seen his daughter for years, was enraged that she was taking psychiatric medication and told her the pills were “poison.” Of course, the Choir agreed.

Chyna went off her meds, and Laurie had no legal means to force her to take them. Now the Choir began to order Chyna to hurt herself with whatever was handy – a fork here, a glass trinket there. The apartment had to be made “Chyna proof” and trips to the emergency room became weekly occurrences.

Chyna receives some state aid for medical care, and gets bare-bones treatment that might disappear if certain politicians have their way. The kind of group home her plan would pay for would be worse than living in hell, Laurie thought. So Laurie would stay awake all night long to prevent Chyna from running naked into the night, and her sister would watch Chyna while Laurie was at work. Sleep-starved, Laurie found it hard to function, and lost her job. “But at least I can keep an eye on Chyna all the time now,” she told me.

Still, Chyna managed to wriggle out the window or run through the door if Laurie or her sister took a 10-minute cat-nap. Finally, in an act I’m sure Laurie would never have dreamed of three months before, she installed bars on her apartment windows and key-locks on the doors – not to keep the gang-bangers out, but to keep her beloved daughter in.

A few days ago, things took a turn for the even-worse. Chyna’s father came to town to see her; she believed he was her pastor, finally come to marry her. Nothing he could say or do would dislodge her delusion. Laurie began making dinner in the kitchen. Chyna stared at her, her huge brown eyes registering nothing. Finally, she said, “Who are you? What are you doing in my house? … I know who you are. You’re Satan.”

Laura sobbed in my arms as she recounted the story. The Choir had grown louder and it was now telling Chyna to commit suicide. Laurie had already lost her brother to suicide; she was not about to lose her daughter as well. She’d checked into it before, and had found out that a 72-hour hold in the psych ward would cost $43,000 – more than twice her annual income. Didn’t matter. That time, when Laurie and her sister drove Chyna to the hospital, they came home alone.

When I saw her yesterday, Laurie looked like she had aged 10 years. A beautiful woman, Laurie’s eyes were puffy, her hair was graying, she’d lost weight and hot tears were streaming down her cheeks. “I love her so much,” she sobbed into my chest. “I know you do, hon,” I said.

Please don’t talk to me about how only unloving families opt for forced treatment, or how all psychotropic medicines are evil, or how there is no such thing as mental illness, only creative and unusual people who are unfairly labeled. I don’t want to hear it today.