death to life

Why I wore a seat belt on my way to my suicide

2012-01-19T13:05:00.000-08:00

“A man's as miserable as he thinks he is.” – Lucius Annaeus Seneca

On the morning I drove to the motel to take my life, I wore my seatbelt.

Sound counter-intuitive? Really, it’s not. The issue wasn’t safety, it was control.

In a dozen ways, I had lost control of my life. Control was something I’d always valued highly. I was never about chaos and drama. And on that day, when I looked into the future, I believed I’d lost the ability to have a positive impact on my family, my job, my tomorrows. I believed I had only one option, and that was death. I’d entered the “suicidal trance.”

Trapped inside the trance, I was zeroed in on one single goal. I wasn’t making a “gesture;” I meant business. I didn’t want anything to get in my way. That’s why I wore a seatbelt – I didn’t want to be pulled over by the cops, or to get minor injuries in a car accident, which would keep me from achieving my goal. Having lost control of all else, I had to maintain control over this one final thing.

Recently a friend recommended a documentary on happiness. I’m only part-way through it, but so far I’ve learned about someone else who also slit his veins and poisoned himself: Lucius Annaeus Seneca (Seneca the Younger), a Roman philosopher who committed suicide in 65 AD on orders from the emperor Nero.

Seneca was a Stoic, and what he taught about anger sounds a lot like what we call Rational Emotive Behavioral Therapy today. Essentially, Seneca believed that we become dissatisfied when circumstances go against our unrealistically high expectations of things that are outside of our control. If we prepare for the worst – if we assume things will go badly – then we’re less likely to be disappointed. Essentially, Seneca believed, optimism can be the enemy of well-being.

In the 1950s, pioneering psychotherapist Dr. Albert Ellis – whose theories would lead to today’s Cognitive Behavioral Therapy – said something very similar: that certain core beliefs (that we must always perform well; that others must treat us fairly and kindly; and that our lives must be favorable, safe and hassle-free), would lead to panic, despair and anger. Ellis called these beliefs “musterbation.”

CBT has become the most non-medical therapy for depression and anxiety today. But what struck me as I watched the documentary about Seneca was how this philosophy is completely opposite from the other popular movement in mental health today – the idea of positive thinking (or its siblings, the Law of Attraction, Creative Visualization, and Abundance Theology).

In these schools of thought, happiness comes about because we expect it to. We either see good things in our minds until they materialize, or we “act as if” these things are already true, or we pray and God (or the Universe) will give them to us. I wrote last March in “The Perils of Positive Thinking” about the fate of a girlfriend who was obsessed with “The Secret.” She actually became a millionaire. Within two years, she was bankrupt.

I think it’s fascinating that the two most popular theories of happiness today are diametrically opposed, and actually mutually exclusive. Millions of books are being sold about both theories, and millions of people attribute their happiness to one or the other.

But I believe both theories can be dangerous if taken too far. If we believe we have NO control over our lives – if we simply accept a bad marriage, or a lousy job, because we have no expectation that things can (or should) be better for us – then we resign ourselves to much less than we could (or should) have. And if we believe we have ULTIMATE control over our lives – with some kind of magical thinking – then we resign ourselves to bitter disappointment if things don’t turn out as we want.

Either way, the issue of control – not enough, or too much – can lead us down a pathway of despair.

The fact that both these philosophies are so prominent right now tells me that the truth lies somewhere in the middle. Part of my recovery will be in finding out where that truth lies for me.

Of cherry lollipops

2011-12-07T15:12:00.000-08:00

“A consistent soul believes in destiny, a capricious one in chance.” – Benjamin Disraeli

I wasn’t raised by religious parents. But one of the things my mother taught me from the very beginning was that “Things happen for a reason.”

All my life, even when I was disappointed with the way things turned out, that thought was in the back of my mind. I never believed in a Supreme Being who moved us all around like chess pieces on a board. But once I got past the initial shock of a negative experience, I was usually able to soothe myself with some thought of fate or destiny.

Things didn’t work out for this trip, because the plane would have crashed. Things didn’t work out with this boyfriend, because my soul mate was waiting in the wings. Things didn’t work out with this job, because there was a better one out there.

And over the years, I have to admit that things DID usually work out for the best, just as my mom always said they would.

But when I became suicidally depressed and all hope disappeared, the belief that “Things happen for a reason” was one of the casualties. Although I had begun suffering clinical depressions as early as high school, I had still always been an optimist by nature. But now so many of the truisms that I’d lived by – “Life never gives you more than you can handle,” “If it’s meant to be, it will be;” “This too shall pass” – became nothing more than trite platitudes. Life had suddenly become terrifyingly random.

Recently, some friends and I were talking about politics, and about the scary state of the economy. We were imagining the solutions we’d bring to the table if elected President. Of course, every idea was impossible. Jokingly, my friend Jake said, “If I were President, I’d give every man, woman and child a lollipop. Because how can you be sad if you’re holding a lollipop?”

“Make mine a cherry,” I laughed.

The very next morning at work, something truly bizarre happened. The public relations director of a local health organization came to talk to me. I’d never met her before, so she brought in a package of information about the organization. And tied to the package, with a ribbon, was a cherry lollipop.

I froze. I had not thought about or seen a cherry lollipop, probably, for years. And suddenly, after the topic came up, here was one. “Why did you put the lollipop on there?” I asked her, and she said, “Oh, it was on my desk, and I figured, ‘I bet she’d like a cherry lollipop.”

I’ll be honest: I ate it. But I kept thinking about the coincidence, because one of the platitudes I’d also always believed was that “There are no coincidences.”

A few weeks later, I went to a Halloween event where a Jack-o-Lantern of candy was passed around. I reached in and grabbed the first thing my hand touched. It was a lollipop. Cherry.

I’m still suffering from a crisis of faith. As they used to say on “The X-Files,” “I want to believe.” I’m having a problem doing that.

But I hung the cherry lollipop from the Halloween party on my cubicle wall at work, and I look at it several times a day. Could there be a message here? Is it possible that despite all my fears, there is a force looking out for me after all? Is it a sign that the Universe is not as chaotic as I’ve come to fear it may be?

I hope my mom was right. I want to believe.

Secrets no one told you

2011-11-08T15:24:00.000-08:00

“Three can keep a secret, if two of them are dead.” – Benjamin Franklin

This morning I lay down – cold and cramping – on a medical examination table, my bladder filled past capacity, as an ultrasound was taken to see how quickly my kidneys are dying.

There’s no emergency here. When he diagnosed me with third stage renal disease, the doctor was clear that decades could pass before I might suffer ill effects from a slow shut-down of my kidneys, which are now working at 42% capacity. People donate kidneys, after all. They’re a hardy part of the human body.

I’ve not blogged on “Death to Life” for about six months – since my second “anniversary” of my suicide attempt. During that time, I’ve worked to distance myself from that particular period in my personal history. I’ve thrown myself into my work (both paid and volunteer). I’ve rebuilt trust with friends and family that I hurt – or that I felt hurt me – when my illness was at its peak. I’ve forged new and healing relationships.

But just as I’m forced to remember that day every morning as I put on the bracelets that hide the scars on my wrists, today’s examination was a reminder that I’ve survived a suicide attempt. Unlike surviving cancer or a heart attack, it was a “survival” I didn’t celebrate at the time. It was a “survival” against my will. And with each passing week, I grow more and more estranged from that part of myself. What was I thinking? What can I do to be certain I’ll never think that way again?

You see plenty of suicides on TV and in the movies. But there are things about suicide that no one tells you. Even those of us who have tried and “failed” rarely speak of these things amongst ourselves.

But if you’re considering suicide, I’ll break the silence and tell you some of the things that I found out, which no one else will tell you:

If you attempt suicide, chances are overwhelming that you will survive. There are more than 20 attempts for every “successful” suicide. So when you wake up alive – as you most likely will – you’ll be faced with a whole new set of problems that you didn’t have before.

If you slit your wrists, you probably will not die (even if you swallow a bottle of aspirin first and slice your arteries the “right” way). Instead, you will have scars for life that will make you feel embarrassed and ashamed.

If you overdose, you will probably throw up (even if you take anti-nausea medicine and take the pills with food). If you don’t throw up while conscious, you’ll throw up when you’re unconscious; either way, your body will reject the pills. That’s what your body is designed to do.

If you overdose on acetaminophen (Tylenol), you will damage your liver. “Good,” you think? Think again. Dying from liver damage takes days, even a week. You’ll still wake up alive – you’ll just have to suffer for a long time.

If you OD on Tylenol and are discovered and rescued by emergency personnel within 8 hours, you will be hooked up to an IV of N-acetylcysteine. For 24 hours, this antidote will drip into your body, and you won’t know until the next day whether you will live or die.

If you OD on other medications, such as sleeping pills, lithium or ibuprofen, you will damage your kidneys and other vital organs. This damage may not manifest for months or years, but it will be with you the rest of your life.

In the ICU, if you are agitated and fight against medical treatment, you will be restrained either chemically, manually or both. Decisions will be made for you. You will not have control over the outcome.

During the first 24 hours, especially if you ingested multiple medications, you will be confused and panicky. You won’t know day from night. You won’t recognize people. You will be cold and hungry. But medical personnel will not be sympathetic. They are accustomed to caring for patients who wish to live. They won’t feel sorry for you.

If you attempt to sleep, you will be awakened each hour. Each time, you’ll be asked three questions: “What is your name?” “Do you know why you are here?” and “Are you going to attempt suicide again?” (The correct response to the last question is “no.”) The questions will be barked out as if you’re being interrogated (which, really, you are). The people interrogating you won’t feel sorry for you, either.

Once you pass the critical stage medically, you get to go to the psych ward. You won’t think you belong there, but that’s where they will put you. First, though, they’ll go through your financial situation. You’ll be informed the cost is $1,500 per day. Even if you have insurance, you’ll be out, at the very least, a grand for the ICU. And even though you have the legal right to refuse treatment, they’ll make it very hard for you to leave – whether you can afford to be there or not.

You’ll be in the psych ward at least three days. If you have a job, and you want to keep it, you’ll have to come up with a good excuse for your employer. And once you return to work, you’ll have to worry every day that you’ll be found out. You’ll have a better reception coming out as someone with AIDS than as a survivor of suicide.

In the psych ward, you’ll be at the bottom of the pecking order. Like child molesters in prison, suicide attempters are the objects of scorn. Everyone else wants to stay alive; you did something stupid to wind up dead. And what’s more, you “failed.”

No one will ask why you attempted. No one will try to understand your state of mind. No one will acknowledge your pain. Instead you’ll be asked to focus on “coping methods” and “behavioral therapy” techniques.

You’ll be given printouts to help you label your emotions (Anxious! Mad! Sad!). And you’ll be required to attend classes where you paint pencil boxes and glue beads on to purses. It won’t matter if you have a Bachelor of Arts degree in Psychology and Journalism. It won’t matter that you have a higher-than-average IQ. You’ll feel condescended to … and you’ll be right.

But the worst is yet to come, because eventually – after you’ve convinced a board of staff members that you’re “no longer a danger to yourself” (even if you lie) – you’ll go home. There you will face your husband, wife, mother, father, siblings, children and friends.

This is the biggest secret no one will tell you: Your homecoming won’t be like in the movies. Your loved ones will feel angry, hurt, and betrayed. People will think you are selfish and uncaring. Some will think you did it just for attention. Others will think you’re weak. Some will avoid you completely. Others will pretend to accept you, but they’ll avoid certain topics that might “trigger” you.

They’ll edit their speech to make sure no suicide jokes slip out. And if you live with them, they won’t trust you. They’ll take the razors out of the bathroom, and if you’re in the bedroom too long, they’ll ask why. Do you like your independence? If you attempt suicide, you will lose it. Guaranteed.

These are some of the lessons I learned from my attempt. I hope you remember them the next time the thought of suicide crosses your mind. If you’re like me, the urge won’t disappear overnight; in fact, it will continue to pop up again and again. But when I review the list of secrets I’ve disclosed, I’m reminded that suicide isn’t the “easy way out.” It’s the hardest way there is.

Never far away.

2011-06-14T13:48:00.000-07:00

“My recovery from manic depression has been an evolution, not a sudden miracle.” – Patty Duke

I should have known it wouldn’t have lasted. And now I have to keep in mind that this won’t last.

It is the particular cruelty of bipolar disorder that one is perpetually on a roller-coaster ride. And on a roller coaster, what goes up must come down.

I have what’s called “atypical bipolar.” What this means is that I never enter a true “manic” phase. I go through periods of time when I feel good, even quite well. But I don’t hit the accelerator that causes many people with typical bipolar to feel “high” and reckless. I don’t gamble our life savings away, I don’t get promiscuous, I don’t call the President and invite him over to dinner.

Instead, if I’m not feeling normal, I’m either in a depressed state or a “mixed state” – characterized by extreme anxiety and agitation. People who are extremely depressed are often so immobilized they can’t summon the energy to harm themselves. But the mixed state is potentially deadly because it combines depression with a raw and awful energy. It’s not hyperbole to say that I live in terror of entering a mixed state again.

I’ve just experienced about six weeks of feeling well – or, at least, as well as I’ve felt since my suicide attempt. I had found closure in some areas of my life and some old wounds were being healed. I was beginning to become more conscious of the things I have to be thankful for. My inner narrative of fear was beginning to go silent, and in its place a new narrative of hope was beginning.

Then I woke up this morning.

I had one frustration, then another, then another. They were all trivial, but like falling dominoes, each one landed on top of the next one until I was yelling, crying, and throwing things around the room. I got to work and there were more frustrations and more anxiety-provoking triggers. Suddenly it was like the last six weeks never happened at all. I felt angry, hopeless, helpless, anxious, and unsure where this mood would take me. Am I going into another depression? Am I going mixed?

The strange thing is that I don’t know which came first – the mood or the triggers. If I had experienced these triggers two weeks ago, would I have reacted this way? Or did all the triggers cause a relapse?

It is a scary feeling, not knowing where one’s moods will go. Right now I am hoping against hope that I will get a good night’s sleep and wake up feeling better tomorrow. Now that I’ve had a taste of the good life, there is nothing I want more than to have it again.

Two years old.

2011-05-27T10:36:00.001-07:00

“When you say a situation or a person is hopeless, you are slamming the door in the face of God.” – Charles L. Allen

Today, my world is a “thin place”– in which death and life are much closer together than usual, and in which the ordinary takes on new meaning. It is May 27, and exactly two years ago today, I tried to end my life.

My suicide attempt was neither frivolous nor trivial. I didn’t do it to “get attention,” to make a statement, or to cause my loved ones to feel guilty. I did not expect to be rescued, and I didn’t anticipate “waking up alive.”

I didn’t do it because my life felt meaningless, or because I felt no one loved me (although I did believe, emphatically, that my family would be better off without me). Neither alcohol nor drugs were factors. My religious faith; my career success; my degree in psychology; and my roles as wife, mother and daughter did not insulate me.

A toxic amalgamation of factors had been assaulting me: the near-bankruptcy of my employer, and the financial stress that caused; a series of bad decisions by my doctor regarding medication; and a high degree of conflict at home. But the absolute trigger was something called a “bipolar mixed state” – a relatively rare, but incomparably deadly, emotional and biological condition.

Johns Hopkins psychiatry professor and author Kay Redfield Jamison, who is herself bipolar, writes about the “mixed state” in “Night Falls Fast: Understanding Suicide.”

“The violent agitation of some suicidally depressed patients is impossible to comprehend unless it is intimately observed or personally experienced … The patients often try to starve themselves, to hang themselves, to cut their arteries; they beg that they be burned, buried alive. The most virulent [symptoms] for suicide is the mixed of depressed mood, morbid thinking, and a “wired,” agitated level of energy. It is singularly and dangerously uncomfortable.”

Poet Anne Sexton referred to it as an unhinging agitation, an “almost terrible energy.” Edgar Allen Poe wrote of it, “I CANNOT LIVE… I [must] subdue this fearful agitation, which if continued, will either destroy my life or drive my hopelessly mad.” Researcher Jan A. Fawcett MD called the mixed state particularly risky because the person “…is experiencing severe anxiety, such as anxious thoughts [he] can't stop.”

This is precisely how it feels. It’s not simply a state of mind that can be changed by choice, will, or faith. Journaling “cognitive distortions,” taking a brisk walk, “trying to look at the bright side…” none of these will make it go away. Loved ones may be neglected, but self-absorption is the result – not the cause – of the mixed state. It is an illness. And a potentially terminal one.

I haven’t been blogging regularly for a couple of months. I’ve been really busy (a good thing), but also, there have been things I’ve needed to think about more than write about. Recently, I’ve moved ahead in some really good ways. I’ve communicated some things with my parents that needed to be said, and I’ve gotten some reassurance and validation regarding an old friendship that has brought healing into my present life.

In other ways, I’m not as far along as I’d like. I still have anxieties about the future that invade my thoughts and make me feel hopeless. I still feel terribly distant from God. And like most suicide attempt survivors, I find that thoughts of self-harm can be comforting, almost addicting, if things threaten to go bad.

But over the past year, I know I’ve helped others in their healing journey, and they have helped me. I’m only two years along the path. Recovery takes time and effort. Today, I’m willing to provide as much of those as I can.

The perils of positive thinking.

2011-03-17T16:38:00.000-07:00

“The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.” – William Arthur Ward

A few years ago, when my husband and I bought our modest little house, we met Danya. Beautiful and charismatic, Danya was our mortgage lender. She carried us through the complicated process with ease, bubbling with excitement. I envied her “don’t worry about a thing” attitude.

Danya ran an investment organization, and shortly after our closing, she invited me to her home for a cup of coffee. I felt a little intimidated as I drove up to her “McMansion” with a BMW in the driveway, but Danya made me feel at home.

Danya was living a true American Dream – and she wanted to share it with me. A proponent of investing using “OPM” – “Other People’s Money” – she confided in me that she’d earned $3 million dollars in less than two years by purchasing apartment buildings, fixing them up and selling them. “This is amazing,” she said, bursting with enthusiasm. “It’s like a dream, but it’s true.”

Danya attributed her amazing success to “The Law of Attraction.” Because “like attracts like,” they say, one’s thoughts and emotions actually impact reality. It’s positive thinking, but not in the usual sense. Anyone knows that if you’re always pessimistic, you’ll be miserable. Or if you go into a job interview expecting to blow it, you will.

But the Law is different. It’s cosmic. One’s thoughts are actually “requests” to the universe, and everything that happens to us – good or bad – is a result of those thoughts. With thoughts of wealth and success, Danya had become a millionaire. She invited me to stay and watch the film, “The Secret,” in her home theatre.

Here was the good news: Danya wanted to collaborate with me! She would even lend me the capital, knowing that I didn’t have a spectacular income. Between the OPM and the Law, she said, "There is literally no risk, Alizah. If you allow positive spiritual energy to come into you, you can do this too. And you’re just the kind of person who would be great at this!"

There are many believers in the Law, and I truly don’t mean to offend. But I couldn’t help but wonder, what about people in Africa who are starving? Or small children who are abused by their parents? Did they think negative thoughts, which resulted in their misfortune? The idea of making extra money certainly appealed to me. But a little voice inside my head said, “Finish your coffee and tell her you don’t have time to stay.” So I did.

I kept her offer in the back of my mind, though. I checked for her online every few months and saw Danya’s success grow exponentially. She was named a “Success Story” in a financial magazine, and her testimony about the Law of Attraction showed up on a number of websites. I started wondering if I should take her up on her offer after all...

Then the housing bubble popped. The economy tanked. And my own field of publishing began to collapse. I became sick, very sick. I attempted suicide. And in recovery, Danya and her Law were the furthest thing from my mind.

Today, while writing an article about mortgages, I was reminded of her. I dug around a little and was stunned by what I found. Danya’s out of business. She’s declared bankruptcy. And her properties – including her personal residence, where I had coffee that day – are in foreclosure.

So what happened? Did Danya stop thinking positive thoughts? Or was she simply another casualty of America’s financial meltdown?

I have to work at being optimistic. It doesn’t come naturally. I’m well aware that seeing the glass as half-empty makes me feel discouraged and sabotages my mental health. Because I make optimism a conscious priority, most of the people who know me see me as a cheerful, upbeat person – and would be shocked to know about my battle with suicidal depression.

But I feel like I dodged a bullet here. My innate skepticism – my rejection of “think yourself rich” – may have saved me from financial ruin. You see, there is a difference between looking on the bright side, and being blinded by the light.

You want my help. But you don’t want my help.

2011-03-15T06:43:00.001-07:00

“We fear violence less than our own feelings. Personal, private, solitary pain is more terrifying than what anyone else can inflict.” –Jim Morrison

I’m standing outside your door at night, in the freezing cold, ringing you on your intercom.

Who is it? You ask.

It’s me, Alizah, I say. You called me five times, and told me you needed to talk. So here I am.

An hour goes by; an hour of you and me and the intercom and the cold. You have a different answer each time: I’ll come and let you in … Who is this again? … I think you should go to where the people are … I’m out of cigarettes … I can’t push the button, something bad might happen … I’m not home, I’m out of town … Why aren’t you in your car if you’re so cold? … Don’t come in, it’s dangerous here.

I begin pushing buttons at random, until someone in the apartment finally lets me in. When I get to your door, it’s open. You greet me with indifference, wearing a thick winter coat, pacing slowly around the room and muttering to yourself.

You wanted me to come talk, so here I am, I say. So can you tell me what’s happening?

You respond with sarcastic rage: Well, if you don’t know what’s happening, then you don’t know much of anything, do you? You should know by now what’s happening! You talk to them behind my back. You post mean things on my Facebook page. You’re trying to turn my daughter against me. Why are you here? Who is paying you to be here?

I sit down and keep my voice low. Hun, I’m not talking to anyone about you. I didn’t post anything on your Facebook page. I’m here because I’m worried about you, and because you called me and asked me to come. So here I am. Will you talk to me?

Two more hours pass. I ask questions, gently. Have you talked to any of your family? When is the last time you saw your doctor? Did he prescribe any medication for you? Are you taking it? Are you sleeping? Are you eating?

Your responses vary. Sometimes you break out in tears. Sometimes you stare at the wall. You pick up a magazine and pretend to read. You look in the refrigerator. You turn your head away and mumble. Then you attack, accusing me of conspiring against you with people I don’t even know, saying that you had faith in me and I betrayed you.

But you don’t answer any of my questions.

You tell me your daughter is ignoring you. During my visit, your daughter pops by. She says she needs to run an errand but will be back later. When she leaves, I say, See, your daughter is talking to you. When? You ask. Just now, I say. I don’t remember that, you say. And you start digging through your purse.

Is there a doctor I can call? Do you want me to drive you to the crisis center? Wall. Refrigerator. Mumbles. Then more accusations.

I’m very concerned about you, I say. I don’t like to leave you like this. I want to know that you’re going to talk to a professional about this. Do you remember that this happened before? And you went to the hospital for a while, and then you were better for a long time? Do you want to feel better again? If not for you, for your daughter?

You’re just like everyone else, you snap. ‘Get help, get help.’ I know how to drive to the doctor. I know where the office is. I don’t need help from you. I thought you would help me, but you won’t. I don’t know why you came here. But I want you to leave. Now.

It’s gotten very late. I apologize. I say that I’m willing to help mediate between you and your daughter, but you have to work on her own recovery before I can do anything more. (I make a mental note to call NAMI this week to get advice, but I already know the answer: If you don't want treatment and you're not an immediate threat, there is nothing anyone can do.)

So I come home, after three hours. Last time you were this sick, family and friends did this dance with you for six months. Tonight, I did my best for you. And at this moment, that's all anyone can do.

Don’t look now. It’s a long way down.

2011-03-11T12:36:00.001-08:00

“My recovery from manic depression has been an evolution, not a sudden miracle.” – Patty Duke

One day last week, I was feeling pretty darn good. I was seeing certain things in a more positive light. I was getting hopeful for the future. I was feeling self-confident because of the way I’d handled some challenges in my life.

I just happened to have an appointment with my doctor on that day, and I told him I was feeling more optimistic. “I think I’m going to get through this,” I said. He replied, “I know you will.”

The next day, something happened. It’s not even important to say what it was; it wasn’t that important. It was just a disappointment, one of those things that everyone experiences. And I felt myself fall off the cliff.

If you have a mood disorder, you know what cliff I’m talking about. You literally feel as if you are crashing. You ruminate, you cry, you rue the day you were born. You wonder whether you will ever be happy again.

But worst of all, you have a hazy idea in your mind of what it was like NOT to feel this way. You could have sworn that only recently, the world seemed different. Wasn’t it only yesterday you believed you were capable? Wasn’t it only yesterday you believed that you were loved? Wasn’t it only yesterday that colors seemed a little brighter, that honey tasted a little sweeter, that music sounded a little more beautiful? Wasn’t it only yesterday…?

People that don’t believe in the existence of bipolar disorder often point out that everyone has emotional ups and downs. This is certainly true. But most people aren’t paralyzed by those ups and downs. Most people have an ability to compartmentalize. A person may have a concern, but be able to tuck that concern in the back of his mind so he can concentrate on other things.

With bipolar, there’s no compartmentalizing feelings. For me, a feeling like anxiety or depression is like a drop of dark liquid in a beacon of water. It changes everything. There’s no “getting my mind” off something. The feeling of worry or sadness is all there is, and it feels like a permanent condition.

After a day or two, I began to feel better. It was partly because my situation resolved itself (sort of), and, I believe, it was partly because medication has made it easier for me to change my emotional trajectory. No, medication has never “solved my problems,” nor has it allowed me to ignore realities of my life that I don’t like.

But in the past, a minor disappointment could bring me down for weeks – maybe longer. Today, I still fall off the cliff, but now I have a bungee cord. I’m able to climb back up. That’s a good thing.

Politics from hell.

2011-03-02T17:52:00.000-08:00

“Politics is the art of looking for trouble, finding it whether it exists or not, diagnosing it incorrectly, and applying the wrong remedy.” – Earnest Benn

I’ve been away from my blog for a few weeks. A number of things have taken my time and attention. I’ve been traveling out of state; I’ve been working on special projects; and oh yes, the political shit hit the fan. It seems the whole world has been protesting something. And so have I.

IRL (“In my Real Life”), I happen to be a very politically active person. It’s impossible not to be, given my profession as a journalist. I don’t want this blog to become my political bullhorn, and for the most part, I’ve avoided making political statements. I don’t want to debate here; I have other outlets for that. My topics here are mental health and suicide. That’s what “Death to Life” is about.

But sometimes worlds collide. And that’s happening right now.

IRL, most of my family and friends feel politically as I do. A few do not. I enjoy debating the topic on Internet forums, but I do not enjoy debating with loved ones, so I don’t do it. In fact, I really try not to argue with anyone at all, about anything (the subject of several of my past blog entries). After all, I’m a peace activist. I go to the anti-war marches. I want everyone to get along. That’s who I am.

But things are heating up right now in a way that I fear will devastate the mental health community. All around the nation, budget cuts are being proposed that will cause hundreds of thousands – eventually millions – to lose health care coverage they depend upon for medications and/or therapy. Health facilities are being closed. Social workers, nurses and therapists are being laid off.

At the same time, America’s economy continues its decline. I have my opinions as to why this is happening, but this blog is not the place to share them. But I can say, with certainty, that the more unemployment increases, the more foreclosures occur, the more bankruptcies declared … the more suicides will happen. These very fears were the trigger for my own attempt.

A few days ago, I was reading an online forum when I happened upon a post written by a relative of mine. In her post, she was complaining about me. She didn’t use my name, but she didn’t have to; she was very specific about certain details. And in the post, she mocked my political views and my concern for the lower- and middle-classes.

I have not shared the story of my suicide attempt with my extended family. But I had to let her know how I felt, and I had to give her some idea of why I felt that way. I wrote her, privately, to let her know I’d seen her insulting post. And I told her that I happen to have a life-threatening illness (which I now consider bipolar to be; it certainly threatens MY life), and that I had chosen not to share my diagnosis with family.

I told her that because America has no national health plan – something she strongly opposes – I have to live in fear that I’ll be laid off from my job and won’t be able to afford treatment for my illness. I told her that I have many friends with various health conditions that can not get health care, and other friends who must depend on government-provided care, which may now be discontinued.

I told her that people I love might die as a result of these policies – policies I believe are less about necessity and more about greed. And I shamed her, because she happens to be enjoying a wealthy lifestyle, angry that she has to pay taxes, at the same time as she condemns those who are less fortunate.

My relative never responded to my message. I’m glad she didn’t – frankly, I don’t want an argument OR and apology from her. I simply needed her to know. She doesn’t know what life-threatening illness I have – maybe she thinks I have cancer or AIDS. I really don’t care. I can pretend to be nice to her at family outings, and that’s good enough.

I’m afraid. I’m afraid for my country and its future. I’m afraid for “the least of these” – the minorities, the children, the disabled, and yes, those with mental illnesses. The cards are stacked against us. And I’m not going to debate about that.

J’accuse. Thursday, January 27, 2011.

2011-01-27T16:15:00.001-08:00

“Consider the source.” – My mom

I got accused this morning of being something I’m not. And it’s not something I really am, deep inside, but just in denial of it – it’s demonstrably false.

This individual has been a thorn in my side for years. Her behavior and attitudes are unbelievably narcissistic – I’ve never known anyone remotely like her. She obsessed with her looks, and what she believes is her intellectual superiority to everyone around her. She is convinced that everyone envies her, and that her beauty and brains (neither of which is that apparent to me) are the reason why most of her family has disowned her, and why she cannot find a job.

When she came into my life as the spouse of a relative and I began to get to know her (mostly through e-mail, as they live far from me), I was first taken aback. Then, for a long time, I was simply amused.

But things kept piling up and piling up, and eventually, I went from amused to irritated to downright offended. I found it impossible not to read her frequent, long e-mails – they had a draw similar to a car accident you happen to be driving by; you can’t help but crane your neck to see. And she went from criticizing my relatives to criticizing my religion, my profession, and finally my very existence.

“Everything goes perfect for you,” she wrote a few weeks ago angrily. “You’ve never had to work at anything in your life.” This from someone who never went to college, who never raised children, and who never held a full-time job or supported a family. (And someone who, at least to my knowledge, has never had to fight the demon of bipolar depression.)

Still, I let it all go, which is just how I am. I finally got an e-mail, cc’d to 50 of her friends, that complained about some particular things near and dear to my heart (and mind). To be honest, I’ve been stressed out lately, for about 20 reasons – so her timing was not great. I responded – respectfully, but firmly. I didn’t “yell,” I didn’t swear, I didn’t namecall. I simply pointed out where she was missing the boat, and requested she not send me any more such e-mails.

Even though I knew what was going to happen, I was still clobbered broadside when it did. In my inbox this morning was a veritable manifesto of my faults. “YOU ARE HARD-HEARTED,” she wrote, suggesting that I: 1) see a doctor and 2) pray to God for mercy – because I am so unloving, so uncaring, and just so downright MEAN. And she made it pretty clear that it will be difficult for me to communicate with my relative in the future – him being the only reason I’d put up with her so long in the first place.

As everyone has, I’ve been criticized in my life, and I don’t like it. But hard-hearted? Unloving? Uncaring? Mean? These are foreign concepts to me. I honestly don’t think I’ve ever been accused of any of these things. If anything, it’s been the opposite – I’ve been considered too sensitive, or maybe too clingy, too easily hurt.

So the thing I’m trying to figure out is why her words bother me so. They bothered me so much when I read them this morning that I threw up my breakfast, and cried on the way to work. Her words kept jumbling around in my brain. When I got to the office, I went into the women’s room and stared at myself in the mirror, trying to understand the charges against me – charges brought by someone so insecure that she actually believes she’s too perfect to be hired. Why do I let the rantings of an unbalanced individual unbalance me so?

Because there is a part of me that sucks in the negative like a sponge. Give me a compliment, and I soon forget it; say something nasty to me, and I swallow it whole, like a crockpot full of maggots.

She and I are both under a delusion. Hers is that she is perfect; mine is that I’m deeply flawed. I don’t think she’s willing to look for a happy medium. But I am.

Using my feelings words. Wednesday, January 19, 2011.

2011-01-19T10:10:00.000-08:00

“I am feeling angry and frustrated.” – Adam, age 5

My friend Makayla has a 5-year-old son who has autism.

Makayla had already raised three older children, who are good scholars, athletic, sociable and well-adjusted, so she realized early on that Adam was different.

At 2, Adam was not yet talking. But he was typing. He used a small computer keyboard to ask for milk or cereal. As he grew, he did more and more complex work on the computer, but resisted potty-training. He resisted hugs and other forms of gentle touch, stiffening up and crying.

Adam would fixate on a particular detail of a toy, such as a tire on a truck, for days. Sometimes he would sit and scream for no reason, but usually Adam was well-natured, even as he avoided gazing into anyone’s eyes. The family gave him the moniker “Peaches” because of his angelic round face and “sweetness.”

Makayla knew Peaches wasn’t developing normally. And as a highly-educated medical professional, she was familiar with the way medical systems work. So she was shocked when doctor after doctor refused to diagnose what appeared to be an obvious case of autism. His second year went by, then his third, then part of his fourth. Despite being basked in love by his family, Peaches could not be touched and had yet to say a word. Makayla knew that any special therapy for her son would have to start as soon as possible, and precious days were ticking away.

Makayla was even more shocked when Peaches finally did get a diagnosis of autism – only to be prescribed therapy that would cost more than $1,000 each week. Makayla’s insurance would not cover the cost, but Makayla was willing to move the sun and the moon for peaches. She paid for the therapy out-of-pocket for several months until she found a different employer with a different insurance plan.

Today, Peaches is a different child. You can see his world opening up around him. He greets people with a giant smile and a hug. And he is talking.

One of the things Peaches is learning to do is to label his feelings, and the feelings of others. On the wall of his room is a chart with faces, expressing anger, sorrow, joy. Peaches uses stickers to say how he is feeling, and he’s learning to speak the words.

We were at the store the other day, and it had been a long day for Peaches. It was time to go, but Peaches wanted to spend more time looking at the toy cars. “Your dad will be home for dinner soon, Peaches,” Makayla said gently. “It’s time for us to go.”

“Leaving before they want to makes people feel angry and frustrated,” Peaches said to his mom. “I am feeling angry and frustrated.”

A deal was made – five more minutes in the toy department in exchange for helping to fold laundry later. Peaches was satisfied. No tantrum necessary. No battle of wills. No spankings or public spectacles.

It struck me that most children learn about feelings by osmosis. Most parents don’t systematically explain to their kids what a feeling is, what to call it and how to express it. Too often, feelings are discouraged, ignored or punished. Some feelings, especially when experienced by children, are understood to be “bad,” like (for example) anger and frustration.

I’m working with my therapist now on “anger issues.” Somewhere along the line in the process of growing up, I learned to detest my own feelings if they weren’t positive. I became phobic of anger – mine or anyone else’s – and unable to endure it or express it in a reasonable way.

Too often, I avoid simply saying the words, “I am angry” or “I am frustrated;” instead, I swallow the feeling and eventually explode, breaking glass and kicking cabinets. I’ve had to pay to repair a hole I put in the wall in an apartment. I’ve broken objects like flashlights and coffee mugs. I lost my voice a few weeks ago because I sat and screamed in the car. In no case did I simply tell someone how I was feeling.

Peaches may be a 5-year-old child with autism, but in some ways he’s way ahead of other kids, as well as many adults, including me. He’s learning to speak his feelings. As an adult, I’m just now beginning to learn to speak mine.

Pants on fire. Monday, January 17, 2011.

2011-01-17T12:18:00.001-08:00

“The worst lies are the lies we tell ourselves. We do this because we’re afraid.” – Richard Bach

My depression lies to me. Maybe yours does too.

My depression tells me, “You are no good at what you do,” when I have a whole list of commendations and awards.

My depression tells me, “You suck at your job,” when I got three promotions in two years and nothing but stellar reviews.

My depression tells me, “Your friends don’t care about you,” when they send me e-mails asking me out for coffee or dinner.

My depression tells me, “You’re a horrible daughter,” when it would be so much easier to walk away rather than take over my parents’ affairs – and I haven’t.

My depression tells me, “You’re a neglectful mother,” when my son is a young man who has turned out very well.

My depression tells me, “You’re a terrible wife,” when my husband reminded me last night how much he loves me.

My depression tells me, “You’re a terrible housekeeper,” when that is not the measure of a person. (At least I hope not.)

My depression tells me, “You’re ugly,” when I used to model.

My depression tells me, “You just waste time on Facebook,” when every day someone contacts me and thanks me for what I write and do, and that means so much to me.

My depression tells me, “You’re pathetic to be on medication,” when I tried to heal myself for many years and found the illness winning.

My depression tells me, “You’re worthless,” when my family, my job and my church would not be the same without me.

My depression tells me, “You don’t deserve to live,” when apparently that’s wrong as despite depression’s attempt to the contrary, I happen to still be here.

My depression likes to tell me lies. And when I feel vulnerable, I believe them. I think it’s time for me to tell my depression to shut the fuck up.

What do you think?

Working for pride. Thursday, January 13, 2011.

2011-01-13T05:53:00.001-08:00

“All labor that uplifts humanity has dignity and importance and should be undertaken with painstaking excellence.” – Martin Luther King Jr.

Yesterday I talked to a young woman who was thrilled to be pushing a broom.

Kristina has a diagnosis of paranoid schizophrenia. Before she went into treatment, she said, she had never worked at any job for more than a couple of weeks. Her delusions would get in the way of basic functioning, and she’d either be fired or quit.

She wound up on disability and SSI, but that process took almost two years. She had no access to medication, counseling or treatment of any kind, since in the U.S., these “privileges” usually come attached to full-time employment. In the meantime, she found herself on the streets, turning tricks for the most basic necessities. “It was horrible,” she told me. “If I was still living like that, I’d be dead.”

Unemployment in the United States is still pushing 10 percent (and total unemployment is approaching Great Depression levels). But the unemployment rate for people with mental illness is 90 percent.

Ninety percent.

In a place like America with so few social safety nets, and no health insurance for the unemployed and for part-time workers, that is a sobering figure. A huge number of these people wind up on relatives’ couches (if they’re fortunate) or on the streets (if they’re not).

Unemployment and mental illness tend to feed off each other. Extreme mood changes, delusions and hallucinations, or confusion can make it difficult to do most jobs, or even to get the kind of education or training needed for a basic job. On the flip side, the stress of losing a job often triggers severe anxiety and depression.

People who are unemployed also have a suicide rate twice as high as those who are unemployed.

But there are little spots of hope, and one of them is The Hope House, which offers a gathering place for people with mental illness, and a variety of services including supported employment. I went there yesterday to write a story on it, and I was shown quite the welcome.

The Hope House – located in a renovated Victorian – is a place where people can hang out without experiencing stigma or judgment. They can talk about mental illness without worrying about what someone will say. They can have a sandwich, play a game of bridge or pool, watch a video. And they can work with counselors who can connect them with jobs and provide the occupational and psychological help some need in order to stay at a job long-term.

For Kristina, “long-term” means over a year now. This is huge. The longest she’d ever stayed at a job in the past was less than a month. “I’m on medication and I’m feeling a lot better now,” she says. “I’m not hearing voices anymore and I can go to work … I like my job a lot. It’s only a few hours a week but that’s OK. I get to see people and I like to make things clean. I like to keep busy, you know?”

I speak to Ken, her counselor at The Hope House. He says that at one point, more than half the members there had jobs through their supported employment program. That figure is down to one-third because of the Recession. “We really hope it changes soon,” he says. “Most of these people are surviving on (Disability) payments of $600 a month. You can’t even rent an apartment on that.”

Things aren’t easy for Kristina. She considers herself extremely lucky to be working at a janitor two days a week, to be getting a disability check, and to finally be receiving medication. But she has to rent a small one-room apartment with another girl, and there is still virtually no money for “extras.”

But she has something today that she considers priceless – a feeling of pride. “When I was sleeping with guys for money, you know, and I didn’t have anywhere to stay, I thought about wanting to die,” Kristina told me. “When I go to work and clean things and talk to people, it makes me feel good to be here.”

Not like us. Tuesday, January 11, 2011.

2011-01-11T11:12:00.000-08:00

“No! I won’t pay debt with a currency that’s not backed by gold and silver! No! I won’t trust in God!” – Jared Lee Loughner

You know what we want?

We want Jared Lee Loughner to be mentally ill.

For those who might have been hiding under a baobab tree for the last three days, Jared, a college student in Tuscon, open fired in a Safeway supermarket, killing six (including a little girl and a federal judge), and injuring 14 (including Democrat Rep. Gabrielle Giffords, who at this moment is clinging to life after surviving a bullet through the head).

Gone are the days when we had to wait for the next day’s newspaper, or even for the evening news. Within minutes of the shooting, the Internet lit up with pieces of a puzzle that may never be completely finished.

Was Jared strange? Did he have problems relating to people? Of this there can be no doubt. Campus police had been called five times to address concerns about Jared’s behavior, including one time when a teacher felt threatened by Jared’s reaction to failing an assignment.

He’d been having angry outbursts in class, talking in nonsense sentences, and becoming more and more immersed in government conspiracy theories. A classmate told Fox News, “A lot of people didn’t feel safe around him.”

Nevertheless, Jared obtained a gun – a Glock 19 handgun, to be exact.

Armchair psychologists around the country snapped to attention. Within a few hours of the shooting, the media was tossing the term “paranoid schizophrenia” around, even though no one knows – even now – whether Jared has any sort of diagnosis at all. The failure of the “mental health system” was blamed. TIME Magazine printed six “warning signs of mental illness” that had been ignored, allowing the tragedy to happen.

Jared smirked for the cops, and his mom and dad cried and expressed shock and grief in front of the TV cameras. Neighbors said no one knew the family very well, but it was reported that his dad drank a lot of beer and was quick to anger. Jared was said to have been a loner, a bit of an outcast, and a pothead who wore his hood up even in the hot summer.

So yes, it appears that Jared may have a screw loose. But is he “mentally ill?” Did he have no idea what he was doing, even though investigators found a note in his room that said, “I planned ahead?”

This is a case with a little bit of everything. Jared is said to be prone to “right-wing rants.” Was this about politics? Or was it about the pot? Or was it about his parents?

Come on, come on! There has to be a reason.

Through the decades, there have been killers that turned out to be demonstrably mentally ill. And because the entire point of news is to inform people of significant events, we tend to hear – and remember – more about those individuals.

But here’s the truth – if you know someone with schizophrenia, the chances of him being a violent killer are about the same as if you knew someone with blue shoes, or a wheelbarrow, or a Springer spaniel. (The chances of someone leaving your neighborhood bar being violent are a great deal higher.)

As Slate Magazine explained it:

Your chance of being murdered by a stranger with schizophrenia is so vanishingly small that a recent study of four Western countries put the figure at one in 14.3 million. To put it in perspective, statistics show you are about three times more likely to be killed by a lightning strike.

Why do we want Jared to be mentally ill? Why are we waiting so eagerly to hear the words, “Jared Lee Loughner is a paranoid schizophrenic?”

Because we’ll feel so relieved if he’s “different” somehow. Because then we can say, “Oh, it’s because of that,” and close the book.

Because we want “him” not to be “us.”

The illusion of honor. Friday, January 7, 2011.

2011-01-07T13:37:00.000-08:00

"Whosoever killeth a human being... it shall be as if he had killed all mankind, and whoso saveth the life of one, it shall be as if he had saved the life of all mankind." –The Koran

On New Year’s Eve, a green car drove up in front of All Saints Coptic Orthodox Church in Alexandria, Egypt, during the holiday service. A few moments later, a bomb inside the car, filled with 100 KG of explosives as well as glass, nails and iron balls, went off. Twenty-three people inside the church were killed, and more than 100 injured.

Details remain sketchy as of this writing. Depending on the news source, the bomb was planted by someone on behalf of Al Qaeda, or not. The man in the car was a suicide bomber, or else the bomb went off prematurely before he was able to get away.

Whether or not this particular act was the work of a suicide bomber, it affects me directly because I happen to have personal ties to the community that was attacked so brutally. And we hear stories every week of suicide bombings all over the world. What happened here on 9-11 was a gigantic suicide bombing, using airplanes. The media quickly spread stories about the perpetrators committing “jihad,” expecting to be rewarded in paradise with 72 virgins.

It’s not the first time suicide has been used as a war tactic. In 1945, the Japanese – who were losing WWII – began filling planes with just enough fuel for them to crash into a target, and began sending their pilots on “kamikaze” missions. The word kamikaze means “divine wind,” and even today, Japan has one of the highest suicide rates in the developed world. Culturally, the Japanese have tolerated suicide, even encouraged it for reasons of “honor.” Today, unemployment and work stressors are the main reasons for suicide in Japan. “Suicide Clubs,” which people join so they can commit suicide together, are growing as a result of economic hardship.

So it would seem that Islamic and Japanese cultures approve of suicide, even promote it, which is a foreign thought to those of us in America and Europe. But if you scratch under the surface, there’s more to the story.

Japan is largely Shinto, and the Shinto religion allows suicide for a number of reasons. However, the Japanese government recognizes suicide as a major problem it its society. The suicide rate increased almost 35 percent in 1998 alone, to almost three times that of the United States, with people jumping in front of trains and leaping off high places all over the country. “Honorable” or not, these individuals leave grieved families behind, destabilizing their communities.

The Japanese government calls the problem of suicide “very serious,” and has released a nine-step plan, called a “counter-suicide White Paper,” which is intended to curb suicide by 20 percent before 2017. Among the Paper’s goals are a change in the culture’s attitude toward suicide.

And as my Moslem friends will tell me, Islam in general rejects the beliefs of the suicide bombers and condemns the work of such terrorists. “Jihad,” they explain, simply refers to a divine struggle – which can be internal – and in no way promotes the killing of non-Muslims. And while the Holy Bible contains no verses condemning suicide specifically, the Koran has several, including “And do not kill yourselves, God is merciful with you. And whosoever does that (kills self) with aggression and inequity, we will make them suffer in Hell fire, and this is easy for God to do.”

The true martyrs in the Coptic Church bombing were the thousands of Egyptian Muslims who showed up at Coptic churches all over Egypt last night, to serve as “human shields” during Orthodox Christmas celebrations. By attending Christmas services in order to prevent radical Moslems from bombing them, these Muslims put their lives, and their families’ lives, at risk – not just now but for the foreseeable future, and all on behalf of strangers of a different religion.

While the families of suicide bombers are often given financial awards by radical Islamic organizations, these Muslims who protected Christians are on their own. But I believe their sentiments are much more typical of the average Muslim. And I believe they’re a million times more brave than any suicide bomber.

All in the family. Thursday, January 6, 2011.

2011-01-06T11:18:00.000-08:00

“Genes and family may determine the foundation of the house, but time and place determine its form.” – Jerome Kegan

My sister-in-law thinks my big brother, Charles, is bipolar.

She wrote me about his extreme mood swings, bouts of anger, anxiety and depression. Moreover, she complains that Charles can’t communicate and doesn’t understand how she feels. She’s frustrated, but she’s also terrified – Charles has been out of work for months, and he’s been mentioning suicide.

None of this should be too surprising. I’m bipolar and our father is autistic. Charles is just acting like one of the family. Obviously, he took after Dad in his difficulties with empathy and communication, and my brother and I are very much alike in other ways.

The interesting thing, though, is that Charles never knew Dad. Charles has spent a grand total of three hours with our father, when he came into town a couple of years ago and had dinner with him. He’s spent a little more time with me – three short visits; in total, about a day.

Charles was born in the 1950s to a teen mom, before Dad ever met my mother. It was the “good old days,” and when the girl turned up preggers, her parents whisked her out of town so she could have her baby in secret. Charles was taken in and raised by relatives. Dad never knew their whereabouts, and back then, didn’t even consider the option to look. Charles and I were adults before we even knew of each other’s existence.

I visited Charles this summer, and even though the visit was short, I was taken aback by how similar Charles is to Dad, and to me. Charles is definitely not autistic, but in so many other ways – his mannerisms, his tastes in entertainment, his sense of humor – he’s a reflection of me, of my Dad, or both of us.

And now his wife writes me about bipolar, which is really weird because I’ve never told her that I’ve got that diagnosis myself. And she’s afraid Charles will kill himself, and she knows nothing of my attempt. She wants him to see a counselor, but there’s no money for that.

Anyone who has had more than one child will tell you that we are born with different temperaments. One’s first baby might sleep though the night and smile at every new face from birth, while the next one screams for hours and is petrified of strangers. It’s undeniable we learn behaviors from our parents, but it’s also obvious (to me, anyway) that we don’t come into the world tabula rasa.

I learned of perhaps the world’s most extreme example of this in college, when we studied “The Jim Twins.” Jim Lewis and Jim Springer were identical twins, raised apart, and reunited at the age of 39:

Both had childhood dogs named Toy. Both had been nail biters and fretful sleepers. Both had migraines. Both had married first wives names Linda, second wives named Betty. Lewis named his first son James Allen, Springer named his James Alan. For years, they both had taken holidays on the same Florida beach. They both drank Miller Lite, smoked Salem cigarettes, loved stock car racing, disliked baseball, left regular love notes to their wives, made doll furniture in their basements, and had added circular white benches around the trees in their backyards. Their IQs, habits, facial expressions, brain waves, heartbeats, and handwriting were nearly identical. The Jim twins lived apart but died on the same day, from the same illness.

I get the chills whenever I read about The Jim Twins. And while their case is extraordinary, it begs the question of what is nature and what is nurture. It doesn’t let parents off the hook – children do “live what they learn.” We have a billion examples of that. But we have, at the very least, tendencies to react to that parenting in different ways.

I’m so sorry my brother is going through this. If I only knew him ...

Temper, temper. Wednesday, January 5, 2011.

2011-01-05T11:32:00.000-08:00

“And so we know and rely on the love God has for us. God is love. Whoever lives in love lives in God, and God in him.” –John 4:16

Dear God,

I haven’t talked to you much in a long time. Since I went through my really hard time, I haven’t been so sure that you’re there. Other times, I feel like you’re there, but that you don’t really like me.

I pray to you at church, but mostly I just feel sad when I do. I try to pray at work or before bed and my mind just goes blank. I’ve heard of “the dark night of the soul,” but I don’t know how long it’s supposed to last, or how to get out of it. Maybe you can help me.

I’m praying to you now because I feel really bad for losing my temper with my Dad a couple of days ago. You know that I’ve been trying to make arrangements for him to be able to stay in his rest home, and there’s been lots of paperwork and financial stuff involved. You know that he’s autistic, and so it’s been hard to communicate with him all my life. And you know that on top of the autism, he’s developing dementia.

So I promised myself as I was driving over to the home that I would keep his autism and dementia in mind and that I wouldn’t get frustrated with him. After all, he’s a tiny, 85-year-old man in a wheelchair. He’s sharp as a tack in many ways, but in other ways, he’s clueless and can’t help it. You know that, and I know that too.

But Lord, a half-hour meeting turned into a 5-hour, complicated mess, and Dad is resentful of me taking over his affairs. He doesn’t comprehend that I’m trying to keep him from being evicted for forgetting to pay rent, and that I’m trying to protect his health by letting the rest home take over his blood pressure and cholesterol medications. He’s not cognizant of the fact that he is forgetting whole conversations a few minutes after they happen, or that he’s too confused to keep track of his checkbook.

Instead, God, he’s pissed. He thinks the County and the doctors and the rest home are just nosing into his business. One minute, he’s asking for my help and thanking me. The next minute, he’s resentful and angry and he’s shouting at me. Finally, I lost my temper and shouted back. I shouted so loud I’m surprised that the nurse didn’t come running!

I told my Facebook friends about what it was like to have an autistic father. Lord, you know better than anyone that my feelings about my dad are really mixed up. I don’t know if I love him, or hate him, or both.

When I feel angry at him, I’m not just angry at that immediate situation – I’m angry about all the times he hurt my mom and me, even though he never meant to. I’m angry because I learned a lot of dysfunctional things from him, and it’s taking me decades to unlearn them. I’m angry that I didn’t have a “normal dad” who would have been there for me when I needed the reassurance that only a father can provide. I’m angry that I have to parent him when he really never parented me.

Lord, you know all of that – and you also know how terribly, terribly guilty I feel for being mad. My father loved me as best he could, especially when I was a little girl. He provided for me. Unlike many fathers, he never laid a hand on me. And he can’t help being autistic or having dementia. Being angry at him for not communicating or for being confused is like being angry at a rock for being hard.

I have a sense that he won’t be around much longer. Only you know when that will happen, God, but it seems we fight every time we talk, and I’m so scared that he will die and our last conversation will have been an angry one. I don’t want that to happen. I need your help.

I’m going to try to talk to you more often, God. I hope you’re listening. I really miss you.

Amen.

Alizah.

Good grief. Monday, January 3, 2010.

2011-01-03T11:00:00.000-08:00

“When you are sorrowful look again in your heart, and you shall see that in truth you are weeping for that which has been your delight.” –Kahlil Gibran

My dear friend Abrihet lost her beloved mother at the end of September. I wrote about Mama’s unexpected death and about Abrihet, who is the most amazing woman I have ever known. Do I worship the ground on which Abrihet walks? Well, almost. At the very least I see her as one of the strongest, most capable people I’ve ever had the good fortune to have as a friend.

It’s been a hard few months of Abrihet. Her mother lived with the family, and the two were like best friends, so the loss of Mama in Abrihet’s daily life is palatable for her. The first few weeks after Mama’s untimely passing was a study in cultural differences for me. Abrihet and many of her friends are from Africa, where it is customary to put a very public face on one’s sorrow.

As one website on African traditions put it, “Females of the family of the deceased and their friends may undergo mournful lamentations. In some instances they work their feelings up to an ostentatious, frenzy-like degree of sorrow.” One of only a very few Caucasian Americans at the memorial, I witnessed that kind of emotion, and as Abrihet wailed in her native language, my heart was ripped open. I could barely stand it.

Still, it made sense to me – in a way, more sense than our silent and restricted ways of grieving in America. Rather than stuffing their grief, as so many of us do, the Africans let it all out; the bereaved are encouraged to scream and cry loudly to express their sorrow. Americans, in contrast, tend to expect the bereaved to mourn silently and get back to the business of living as soon as possible.

But Abrihet straddles two worlds. She’s lived in the US since she became an adult, and is as “Americanized” as can be. Abrihet is a medical researcher and an emergency room RN. She’s raising four children, and running a non-profit organization raising aid for Africa. Life in America is complex and busy, and it doesn’t allow for mourning time.

For a few weeks after Mama’s death, Abrihet looked positively ashen. Already tiny, she had lost weight, and she had dark circles under her eyes. She could not smile or laugh. As time went on, though, Abrihet began to return to her usual self. Her color returned, she looked less emaciated. Her face began to soften, and eventually I saw her beautiful smile again. Make no mistake: she was a different Abrihet, an Abrihet without Mama. She would never be “the same.” But I began to recognize my dear friend again.

Over the weekend, I participated in a fundraising event for Abrihet’s non-profit organization. Abrihet’s familiar smile and mannerisms were there. But as I was getting ready to leave, she pulled me into another room. She wasn’t doing okay, she confided. She was still crying a lot; she was still having problems sleeping. Mama’s loss was constantly on her mind. A friend of hers had suggested she try antidepressant medication. What did I think…?

Abrihet wasn’t asking a medical question; she’s a medical professional and knows more than I do. She was asking a spiritual question, a moral question, a social question: Is it wrong for me to still be grieving? Is there something wrong with me?
Some people here on FB seem to believe that because I take medication, I believe there’s a pill for every ill.

Let me say once again for the record that I do not believe this is so. I’ve written about the difference between sadness and clinical depression. I’m not in favor of drugging small children or feeding 20 different meds to grandpa. And while I’m no doctor, when it comes to Abrihet, I see bereavement and not clinical depression. They are different things.

In Africa, when someone dies, the family stays together in a room for a week or two and all activity stops. In the United States, we get two “bereavement days” off work if we are lucky. In Africa, death is seen as an entry to another life. In the United States, despite the fact that many people consider it a “Christian” nation, the spirituality of death has been sanitized away. We’re encouraged here to get past the business of death as quickly as possible.

Abrihet is trapped between these two worlds. And while she knows that she cries in private, I know that in public her “self” is on its way back. I don’t see how antidepressants could do anything to help her that her brain and body are not doing naturally already. She needs to be patient with herself as she goes through this transition.

I told Abrihet to speak to her physician about the antidepressants. It’s my sincere hope that he suggests bereavement therapy instead of prescribing medication. Painful as it is, Abrihet is experiencing a good grief, and someday, she’ll be on the other side.

To begin again. 2:13 a.m., January 1, 2011.

2011-01-01T00:50:00.000-08:00

“An optimist stays up until midnight to see the new year in. A pessimist stays up to make sure the old year leaves.” ~Bill Vaughan

Dear Diary,

I just got home from a little celebration to welcome this new year. A million people have gathered in Times Square tonight to celebrate the Earth’s orbit around the sun. Around the world, almost everyone on the planet is merrymaking. It’s the biggest party there is.

A year ago tonight, my husband, son and I were at a public event. I remember that night well. It was the first New Year’s Eve after my suicide attempt, and even though my attempt had happened earlier in the year, I was still quite depressed.

At first, being surrounded by children with balloons and adults with hats and noisemakers just seemed kind of irritating. But at some point, as I was watching people dance, I felt something inside me shift. Maybe, I thought, this could be a new beginning. Maybe there was hope after all.

If there is one word to sum up the emotion of a New Year’s celebration, it’s optimism. For one night, the vast majority of human beings join together as if to say, “We can begin again, and we can do it better this time around.” If you think about it, there would be no other reason to celebrate a particular passage of time. The point is that things are new and fresh, and there is opportunity and hope. Like the birth of a baby, the beginning of a New Year symbolizes possibilities.

Part of that optimism is reflected in the concept of the New Year’s resolution. When my son was 7 or so, I explained New Year’s resolutions to him, let him think for a while, and then asked, “So what is your resolution going to be this year?” “To learn more about roly-poly bugs,” he announced. For a 7-year-old, learning about a bug just might be considered self-improvement.

Actually, he kept his resolution, which is more than can be said for most adults who vow to quit smoking or start exercising. But part of the importance of a resolution is simply recognizing an area of one’s life that needs to be changed. That’s a big chunk of the battle.

This year, I resolve to do one thing: to continue to recover. I’ve already come a long way from that big celebration a year ago, and my “support group” on Facebook is a huge reason for that. I’ve taken other actions as well – getting proactive about my career options, reaching out to be closer to old friends and to make new ones, and finding a new therapist. Despite dark clouds of economic doom, despite some legitimate fears of what the future will bring, I still feel more optimistic tonight than I did one year ago when I first felt that tiny wave of hope.

Tonight, I’m hopeful that I’ll continue on my upward trajectory of healing. I’m hopeful that my loved ones will have a safe and happy year. And I’m hopeful that the dear friends I’ve met in the SAS group, some who have become like family to me, will continue to make a decision each day to stay in this world.

It’s the first day of a new year. We can begin again, and we can do it better this time around.

Goodnight,

Alizah.

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

2010-12-30T17:37:00.000-08:00

“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.

The fight club. Monday, December 27, 2010.

2010-12-27T12:20:00.000-08:00

“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?

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

2010-12-23T10:59:00.000-08:00

“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.

Great bodily harm. Wednesday, December 22, 2010.

2010-12-22T13:53:00.000-08:00

“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.

The Suicidal Trance. Friday, December 17, 2010.

2010-12-17T10:54:00.000-08:00

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.

With no warning. Wednesday, December 15, 2010.

2010-12-15T10:08:00.000-08:00

"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.

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

2010-12-09T11:59:00.001-08:00

“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.

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

2010-12-08T15:46:00.000-08:00

“(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.

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

2010-12-07T11:07:00.001-08:00

“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.

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

2010-12-06T15:42:00.001-08:00

“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.

Worth more dead? Saturday, December 4, 2010.

2010-12-04T13:42:00.000-08:00

“[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.

Suicide Awareness Friday. Friday, December 3, 2010.

2010-12-03T10:31:00.000-08:00

“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).

COMMON MISCONCEPTIONS

WARNING SIGNS

SUICIDAL THOUGHTS: WHAT TO DO

Seeing red. Thursday, December 2, 2010.

2010-12-02T10:48:00.000-08:00

“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?

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

2010-12-01T16:36:00.000-08:00

"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.

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

2010-11-30T11:50:00.000-08:00

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

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

2010-11-29T15:44:00.000-08:00

“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.

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

2010-11-28T14:53:00.001-08:00

“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.

Greed Friday. Friday, November 26, 2010.

2010-11-26T11:53:00.000-08:00

“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.

Attitude of gratitude. Wednesday, November 24, 2010.

2010-11-24T07:57:00.000-08:00

“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.
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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.

Peace/Love,

Alizah.

Breathing in time. Monday, November 22, 2010.

2010-11-22T13:12:00.000-08:00

“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.

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

2010-11-21T06:43:00.000-08:00

“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.

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

2010-11-20T08:15:00.000-08:00

“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.

Peace/Love,

Alizah.

Putting on boots. Wednesday, November 17, 2010.

2010-11-17T15:45:00.000-08:00

“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.

Sticky-glue. Tuesday, November 16, 2010.

2010-11-16T11:51:00.000-08:00

“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.

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

2010-11-15T11:56:00.000-08:00

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.

Smile, dammit. Friday, November 12, 2010.

2010-11-12T11:27:00.000-08:00

"Are you annoyingly happy? Despondex could be right for you." - The Onion

How did it escape my notice? Last fall, Pfizer – the world's largest research-based pharmaceutical company, which brought us Zoloft and Xanax – introduced a new medication to the market: Despondex.

Despondex, a “depressant,” has been shown to be effective in treating excessive “perkiness,” as the TV commercial shows. The advertisement sounds promising: “Are you annoyingly happy? Despondex could be right for you … If you have a persistent positive outlook on life you should ask your doctor about Despondex … Now you too can waste a night sitting on the couch with your friends or family watching a TV show no one enjoys.”

Bwaa-haa! Yes, Despondex is a joke, brought to us by America’s Finest (satiric) News Source, The Onion. But Despondex has taken a life of its own. A Google search on “Despondex” results in 23,400 hits, including references in dozens and dozens of blogs (soon to include my own). You can even buy a Despondex T-shirt or coffee mug!

So why is the idea of Despondex such a hit? Because even though your mother told you no one wants to be around a sourpuss, it’s also hard to be around super-duper happy people – particularly if you’re depressed.

If a friend, co-worker or relative has ever told you to “Smile! You're on Candid Camera!” or “Cheer up!” when you’ve been down, you know that nothing sinks your mood faster. Some people seem to have been birthed by the Good Luck Fairy. These are usually the same people who tell everyone else, “Be happy!”

Certainly, there’s nothing wrong with happiness in and of itself. It’s the self-centeredness of the “perpetually perky” that gets to us. Have you noticed that people who are inordinately happy all the time don’t really know what’s going on? Do you think their ignorance protects their mood?

One excessively cheerful acquaintance of mine doesn’t watch television or read newspapers. When discussion touched on the misfortune of a mutual friend who was laid off, he was surprised to hear that we are in a Recession. Something about that doesn’t seem fair. The rest of us have to live in the Real World. Why not him?

The same folks are also unlikely to ask you what is wrong if you’re not smiling enough for them. That’s because, quite frankly, they don’t want your mood to bring theirs down.

And I’m not assuming that you are like Eeyore – with an exhausting, consistently negative attitude and your own brand of self-centeredness. Nope, I’m thinking that you might be feeling down for a legitimate reason. Your father dying of cancer? Your son in trouble with the law? Your job being downsized? Don’t approach one of these people hoping for support. He’ll quickly change the subject to something a little lighter – like his own recent good fortune.

There is a different kind of happy person. This person has a positive outlook on life as well, but she’s been on the other side – and she hasn’t forgotten that. This person is thankful for any good fortune she may experience, but also realizes that many others are not so fortunate. She wants people around her to be happy, and if that means getting her hands a little dirty – providing volunteer help in her community, or a sincerely empathetic ear for someone in pain – she’ll do it.

Has someone ever made you laugh when you were crying? That’s the kind of person I’m talking about. She doesn’t just instruct you to “Be happy!” so that you don’t bum her out. She wants you to be happy because she knows life can be hard, and she sincerely cares for you.

“Despondex” is not for her. She’s the kind of happy friend you want to hang on to.

Justice unserved. Thursday, November 11, 2010.

2010-11-11T11:36:00.000-08:00

"My daughter did not get any justice." June Justice, Samantha Kelly’s mom

"I told him, 'You're hurting me. Stop. You're hurting me, and I want to leave.'" Samantha Kelly, age 14, said that she made her wishes clear when 18-year-old Joseph Tarnopolski forced himself on her.

Joseph, a popular senior who shared Samantha’s math class, ignored her pleas and did as HE pleased. So the Detroit-area girl contacted authorities and pressed charges against him: statutory rape.

But the students’ classmates took sides, and they began to taunt Samantha. They taunted her so much she began to miss class. Three weeks ago she OD’d, but survived for still more taunting. So two days ago, Samantha hung herself.

Samantha’s death results in two tragedies: heartbreak for her mother, June Justice, and her other loved ones; and the fact that the Huron Township Police had to drop charges against Joseph.

You see, without a victim, no one can be charged with rape. Those accusations evaporate into thin air. Like they never existed at all.

To Joseph, who admits he had sex with Samantha but claims it was consensual, Samantha’s suicide doesn’t mean much. When interviewed, Jospeh made it pretty clear that he wasn’t too broken up about her death. He refused all but “a little bit” of responsibility for Samantha’s harassment, adding, "If she was getting ridiculed, it's not because of me.”

National Violence Against Women Prevention Research Center finds that rape victims are 13 times more likely than non-crime victims to attempt suicide. Clearly, sexual assault in and of itself is a risk factor for rape. But Samantha didn’t hang herself the day after the rape. She hung herself after weeks of teasing by classmates.

After she was assaulted, Samantha did exactly what authorities would have said she should have done – she pressed formal charges. She was strong enough to do that. That took courage. Guts.

But what Samantha couldn’t deal with was the re-victimization from other teens, many of whom had been her friends. If Samantha had hoped her suicide would elicit guilty feelings among her classmates or in Joseph, it didn’t work.

Instead, Joseph wins. He gets to carry on with his life. In a year or two, all but Samantha’s family will have forgotten this situation ever took place.

And if rape is something Joseph happens to enjoy, you can bet he’ll have more opportunities with other girls in the future.

I don’t think Samantha would have wanted that. Do you?

Happy, happy. Joy, joy. Wednesday, November 10, 2010.

2010-11-10T16:31:00.000-08:00

“If only we'd stop trying to be happy we'd have a pretty good time.” –Edith Wharton

A number of years after Prozac had arrived on the scene, introducing the SSRI and changing the face of psychiatry forever, Peter D. Kramer released the book “Listening to Prozac.” Kramer cited studies showing that even people who weren’t depressed underwent transformations upon taking Prozac. Their self-esteem bloomed and they became more successful. Kramer said that Prozac could make people “better than well.”

I don’t think Kramer’s testimony has stood the test of time. It’s true, I’ve argued that a mega-study purporting to show that antidepressants are no more than expensive placebos has been misinterpreted. I believe strongly that there is a place for pharmaceuticals in the treatment of depression – specifically severe, clinical depression. But the idea that antidepressants are miracle pills that make peoples’ lives euphoric and trouble-free is, well, nuts.

I assume that people have always wanted to be happy. But how have they defined happiness? Until the last century or so, most peoples’ lives were “nasty, brutish and short.” As recently as the early 20th century, life expectancy ranged from 30 to 45. And those 45 years would have been difficult ones indeed.

There were no cures for most sicknesses, women died quite often in childbirth, the death of a child was a common occurrence, and people had to work to support themselves until they died. The technologies that make our lives more convenient – electricity, running water, transportation – didn’t exist.

And yet books and art and poetry depicted not only sorrows but also joys. Dirty and smelly, perhaps sick, often exhausted, people still found a way to be happy. I, for one, wouldn’t have wanted to be alive during Biblical times – what with all those crucifixions and the throwing Christians to the lions and all – but the word “joy” appears in the King James Bible 155 times.

I’m just going to take a wild guess and say that people had a different idea of “happiness” back then. Life was full of suffering, but perhaps they found their joy in the whiff of violets, the brilliant colors of a sunset, the giggle of a child. Perhaps it was enough to have a roof over one’s head, even if that roof was leaky. Perhaps having enough blankets was something to be happy about.

In the United States, a major shift in the idea of “happiness” came in the 1950s, when postwar prosperity ushered in a new age of consumerism and “planned obsolescence” that required houses and cars to grow bigger and fancier. Advertising hit its golden age, seducing the world into seeing America as the place where anyone, if they worked hard enough, could buy anything their hearts desired.

By the 1980s, the idea was entrenched in Madonna’s “Material Girl,” but the means to the end was changing. Two-income households became the norm, the rich got richer, the poor found it harder to get ahead. Today, the American Dream has become a virtual nightmare.

To those who have had and lost, or to those who will never have, “Be Happy!” sounds trite – almost disrespectful. It’s a scary time for many of us. But do we have to give up on happiness? Or can we redefine it again?

Daddy’s little girl. Tuesday, November 9, 2010.

2010-11-09T16:42:00.000-08:00

“You must look into other people as well as at them.” –Lord Chesterfield

When I was a little girl, my Dad would tell me fantastic stories using my stuffed animals as actors. He loved cartoon characters and fantastical worlds. I adored him and he adored me. He would brag to everyone about his “Baby-girl” and he kept every single drawing I made for him. He was the perfect father for a 4-year-old. The problem was, 4-year-olds grow up, and my father stayed the same.

I spent most of today my now 80-something father, working to get him secured in his assisted living situation, which has become necessary due to his physical disability and worsening dementia that is complicated by Asperger’s Syndrome. Although, like most adults on the autistic spectrum, my father has never been diagnosed, my discovery of the syndrome in a book in the early 90s kept me from losing my own mind. At last, there was an explanation for his behavior (much of which I mirrored as a child and wrote about recently).

By the age of 5, I recognized that things weren’t quite right with Dad, and I was already trying to protect him from things that would scare him or change his rigid routine. By the age of 9, I was pleading with him to stop speaking to me in “baby talk.”

At 12, I was deeply ashamed when he demanded to hold my hand at a carnival in front of my friends; when I whispered I was too old, he began to sob. At 16, I was humiliated when my father – wearing only pajamas and socks – ran after the schoolbus one frigid morning, crying “Baby-girl! Baby-girl! You forgot to kiss your daddy goodbye!”

By the time my parents divorced when I was 16, a part of me truly hated him. On the one hand, he doted on me. I was, he told me so often, his “entire world.” He had worked hard and made a beautiful home for his Baby-girl, filled with toy horses and trips to Disneyland. He never once disciplined me (he didn’t really have to). He gushed over my art and writing projects, certain that I was brilliant and talented and very, very special.

On the other hand, he never looked into my eyes. We never had a reciprocal conversation; he would simply monologue in a flat tone, about camera parts or film animation – reciting the same facts for hours, month after month, year after year. His hug was bony and awkward and didn’t give me any feeling of security or safety.

He made jokes about my nose, my weight, my hair and my scoliosis, using words like “cripple” and becoming genuinely confused when that made me cry. He taught me that the world was a chaotic and dangerous place, where airplanes fall out of the sky and cars crash more often than not. He was filled with anxiety if I got home past dark, and once when I was 17, he threatened suicide because I refused to put on a raincoat. “You’ll catch pneumonia and die,” he said, “and without my Baby-girl I would have no reason to live.”

Strange body posture. Narrow, obsessive interests. No understanding of emotional or physical boundaries. Difficulty in making conversation. High levels of anxiety. Lack of empathy. Confusion about age-appropriate language and behavior. Inability to tolerate certain fabrics, lights or noises. “At least MY dad’s an alcoholic,” said my best friend in high school. “He has as reason to be weird. Your dad’s just weird. It sucks.”

Then I stumbled upon “Shadow Syndromes” in the bookstore. It was as if someone turned on a bright light. It wasn’t all in my head. My dad wasn’t a bad person, and his behavior wasn’t my fault – or my mom’s. I Xeroxed the chapter on Asperger’s and mailed it to my mother. She called me the night she read it, crying. “Thank God,” she said. “Thank God someone understands. Thank God there is a reason.”

Today my father is an old man, and he seems to be fading fast. I don’t think he’ll be around much longer. But after spending hours with him today, I’m reminded of how far I have to go. You see, I had soaked up his dysfunctional ways of dealing with the world like a sponge. I “took after Dad,” and have spent decades trying to unlearn those behaviors. When I hate myself, I hate him. When I hate him, I hate myself.

I know he has a neurological disorder that prevents him from experiencing the world as “NTs” (neuro-typicals) do. I’m in an online support group for people raised by parents on the autistic spectrum. I see that every day there are more groups and websites dedicated to people like me.

My father lives in a small room now, and among his few belongings are all the drawings I gave him as a child. He’s never thrown one away. Every time I visit, he beams, “Remember when my Baby-girl made these for me?” But his Baby-girl grew up, and for Dad, that was a betrayal.

I know it's not his fault. And I know that in his way, he loves me. But I’m angry. I’m angry I have an autistic parent; I’m angry that I once idolized him and now can’t stand to be with him, I'm angry at myself for being angry at him, I'm angry that I have never been able to have a true conversation with him and that he knows virtually nothing about my life.

And I’m angry my own father has never looked into my eyes.

Picky, picky, picky. Monday, November 8, 2010.

2010-11-08T11:01:00.000-08:00

“First we make our habits, then our habits make us.” –Charles C. Noble

I have always found it very therapeutic to manicure my nails, which naturally grow long and strong. Choosing the color to match an outfit, taking off the old polish, shaping the nails and brushing on a pretty new color gives me a lift.

Actually, I had started wearing polish when I was in middle school in order to quit chewing my nails, and it worked quite nicely. Unfortunately, my nail-chewing habit morphed into something new – compulsive skin-picking, or dermatillomania, around my cuticles.

I would pick constantly. I was able to pick while driving, while working on the computer, while reading a book. Much of the time, I didn’t even know I was picking. Sometimes it was painful, sometimes it wasn’t. Sometimes I picked when I was feeling anxious or depressed; often, it didn’t seem to matter what mood I was in, although I did notice it felt calming.

A couple of years ago I discovered there was actually a name for my habit, and that I was not alone. Dermatillomania is an “impulse control disorder” and is often considered a form of self-injury, like “cutting.”

It had gotten to the point where I was wearing Band-Aids on eight of my fingers. I was desperate to stop. I was already in therapy for anxiety and depression, but now I decided to make my “picking” a priority.

The assumption was that my skin-picking was due to stress. I underwent six sessions of hypnotherapy, and listened to the CDs faithfully every night. I wore a rubber band to snap when I felt the urge. I journaled about what I’d been feeling when I began picking. I wore gloves while relaxing at home or driving. I worked with a specialist regarding any anger issues that might be causing me to pick.

Nothing worked. I don’t care what the experts say SHOULD have worked. It didn’t!

One day when I was at the drug store, I stopped in the cosmetics section and looked at the artificial nails. What would happen if I cut my real nails short, and put these on? I decided to give it a try. Sure enough, with the acrylic extensions, I couldn’t get enough “torque” to pick.

I remembered something about a habit taking 21 days to break. I decided to double or triple that for good measure. I wore lovely, fancy, dermatillomania-preventing artificial nails for three months, when the damage to my own nails became too severe to keep using them.

A miracle happened. I had stopped picking! My brain had been re-wired. And I discovered what I’d suspected all along – that I had an anxiety problem, but the dermatillomania had little to do with it. In fact, during the period of time when I suffered my acute dysphoric mania, attempted to take my life, and recovered from the attempt, I didn’t pick at all.

So why am I writing this today? Because over the last few days, I started noticing that I was picking again. I’m not sure if there is a particular reason, but it doesn’t matter. I’m nipping it in the bud. I bought several boxes of artificial nails yesterday at the store, and I stuck a set on last night. I’m frustrated about having to go through it all again, but at least now, I have a remedy that works for me.

Sleep, glorious sleep. Sunday, November 7, 2010.

2010-11-07T15:36:00.000-08:00

“A good laugh and a long sleep are the best cures in the doctor's book.” ~Irish Proverb

Is there an invention more wonderful than sleep?

I like to sleep as much as I possibly can. I work a lot during the week; Friday I put in a 13-hour day at my job. But I make sleep a priority. I slept most of the day on Saturday, but after Friday, I feel like I had it coming.

Truth be told, I still feel sleep-deprived after my mixed mania episode a year and a half ago. One of the worst things about it was the relentless insomnia. Unlike “typical” bipolars in a “typical” manic state, I did not feel euphoria, I did not feel creative, and I did not WANT to be awake. Instead I lay in bed in a horrible state of anxiety, heart pounding, flying out of my skin due to the slightest noise. For months I eked out about four hours of sleep a night, and I don’t think it was deep sleep as I don’t remember dreaming during that time.

Even after I was put on the correct meds, it was a long time before I got back to “my” normal. I no longer view the bed (or the couch) as my enemy. I look forward to laying down, letting my body relax, and letting my mind tell me bizarre stories called dreams.

I’m lucky in that I don’t have a great many nightmares. My dreams are pretty neutral. Once in a while I’m being chased, and I’ll have to force myself to wake up. Occasionally someone has died, and I grieve not only in the dream but upon awakening.

In fact, I’ve noticed that often, the dream I’m having when my alarm goes off will set my emotional course for the rest of the day. Sometimes I don’t even remember the content, but I’ll wake up feeling confused or serene or angry or giggly or regretful, and I know it was my emotion in a dream – but I’ll still feel that emotion hours later. Does that happen to you?

Sleeping and dreaming are the subjects of study by many disciplines. No one seems to know exactly why we sleep, and even less why we dream. Theories abound, but the only thing everyone can agree on is that both are necessary physically and mentally. For the bipolar patient, sleep is extremely important because it wards off mania.

I took a nap this afternoon when we got home from church, and I relish the time because I don’t get to nap during the work week. When I was sick, I couldn’t nap – my body and mind were far too stirred up. So I’m incredibly thankful to be able to catch a few winks.

Romantic suicide. Thursday, November 4, 2010.

2010-11-04T17:32:00.000-07:00

“And it seems to me you lived your life / Like a candle in the wind / Never knowing who to cling to when the rain set in.” – Elton John, “Candle in the Wind”

When Marilyn Monroe was found dead on August 5, 1962, the world mourned. It was still early in the decade, and more celebrity deaths were to come, making Americans in particular feel disillusioned in the goodness of the world. But Marilyn’s death was so shocking because she was the very picture of joyful innocence and incomparable beauty.

People wrote stories, poems and songs about Marilyn’s death. Even though it would be revealed later that Marilyn battled depression, and even though her death of acute barbiturate poisoning was ruled a “probable suicide” by the Los Angeles Coroners’ Office, some people believed (and still believe) that Marilyn was murdered.

But many people who do accept her death as a suicide may find in that suicide something to envy. “She was so beautiful.” “We’ll never forget her.” “How can someone that happy commit suicide?”

Elton John wrote, “Loneliness was tough / The toughest role you ever played / Hollywood created a superstar / And pain was the price you paid.” Poet Sharon Olds wrote of the men who carried Marilyn’s body to the ambulance, “These men were never the same. They went out afterwards, as they always did, for a drink or two, but they could not meet each other's eyes.”

Everyone wants to be remembered when they die. People who are suicidal probably spend more time than others imagining what people will say at the funeral, or how the obituary will read. People who want to kill themselves because they feel they have been wronged may put a great deal of energy into romantic ideas of what people will say. “Oh, he was such a great guy. I feel so bad I was so mean to him.” “How tragic she took her own life. I guess I should have taken her more seriously.”

There’s only one catch.

They won’t be around to hear these words of love or regret.

In your mind, you might see yourself hovering over the funeral home or the grave, thinking “Finally!” or “Serves you right for dumping me!” or “This will teach you!” But in reality, you won’t be there. You won’t get the satisfaction. Dead is dead. And you’re not Marilyn Monroe.

High times. Wednesday, November 3, 2010.

2010-11-03T17:00:00.000-07:00

A special column in honor of the failure of Prop. 19.

“I was making frequent use of cocaine at that time … I had been the first to recommend the use of cocaine, in 1885, and this recommendation had brought serious reproaches down on me.” –Sigmund Freud

I tried pot in high school, and I wound up in the ER with a panic attack like I’d never had before. “If I were you, I wouldn’t use marijuana again,” lectured the doctor. Gee. Good idea. But I felt cheated by the whole experience. Wasn’t the whole point of pot to relax?

I’d already discovered alcohol, though – specifically, my parents’ supply of liquor, which I stole and covered my tracks by filling the vodka and gin bottles with water. I never really went out to parties – my parents were too strict. But somehow I managed to hide a pretty significant drinking habit, starting at the age of 14, right under their noses.

I wasn’t partying in a social way. I was, as they call it in psychiatry, “self medicating.” I was already dealing with significant depression and anxiety, and I had discovered that alcohol alleviated both problems (at least for a few hours).

I would soon be diagnosed with “manic-depression” (that’s what they called bipolar in 1980), but I would not be prescribed medication until years later. Alcohol, it seemed, calmed my frayed nerves and lifted my spirits (so to speak). (That I never became a raging alcoholic is probably due to the fact that my hangovers were so wicked.)

At least 50 percent of people with mental illnesses abuse alcohol or illegal drugs (this compares with 15 percent of those without a diagnosis). Substance abuse affects as many as 60 percent of people with bipolar disorder. And an astounding 90 percent of people with schizophrenia are heavy nicotine users. Self-medication seems to be the name of the game. But what might come as a surprise is that there’s nothing new about this.

People (mentally ill or not) have been “self-medicating” since our ancestors began walking on twos. Use of tobacco, marijuana, and coca date back to prehistory. More recently, during the two periods most associated with conservative values – the Victorian era (1830–1900) and the family-friendly 50s – drug abuse was rampant; it just wasn’t defined as such.

Hashish, absinthe, and alcohol were in common use in the 19th century. And opium and its derivatives were ubiquitous. Opiates were found in the over-the-counter “tonics” that filled every medicine cabinet, even in the most religious of homes. Doctors prescribed them for depression and anxiety. Godfrey’s Cordial was a wildly popular children’s elixir that mothers used to cure tantrums and crying spells; it was made of opium and brandy. Yum.

Sigmund Freud both used and prescribed cocaine. Coca-Cola did, in fact, contain cocaine – this isn’t an urban legend. From 1885 to 1929, Coke had coke (though in ever-decreasing quantities). Cocaine was also an ingredient in children’s’ teething medications. A list of famous Victorian drug addicts includes poets Samuel Coleridge and Percey Bysshe Shelley; authors Lewis Carroll, Oscar Wilde, Edgar Allan Poe and Charles Dickens; and even the President’s wife, Mary Todd Lincoln, who wound up in an asylum.

Then there was the 1950s. The post-war years ushered in an age of prosperity that Americans can only dream of today. For the first time, there was a financially-secure middle class, and the “American Dream” of a house in the suburbs, an automobile, and a yearly vacation was in reach for millions of Americans.

But along with that discretionary income (and an undercurrent of fears: the bomb, Communism) came an increase in the use of mind-altering substances. Alcohol was everywhere – it was not uncommon for people to drink in the office (anyone watch “Mad Men?” My mom says its portrayal is quite accurate), at lunch, and at “cocktail hour” at the end of the business day.

Virtually everyone smoked, virtually everywhere. (In my favorite “retro” photo of my mother, she’s at her baby shower, eight months pregnant with me, with a martini in one hand and a cigarette in the other! She’d cut way down on both habits during her pregnancy, however, even though her doctor assured her she didn’t need to.)

There were also “Mother’s Little Helpers” – Valium and Milltown, which were passed out to bored and anxious housewives like Skittles. Amphetamines were also used for weight loss with little consideration for their abuse and addiction potential. Studies of the era reveal a population that was “tuned out” a decade before the next generation would be condemned for using pot and LSD.

And while there is hullabaloo over the use of prescribed psychiatric medications, at least antidepressants don’t affect people in the way barbiturates or amphetamines do. It seems we’ve evolved a bit from that. In fact, while the use of alcohol and most “hard” drugs is associated with an increase in suicidal behavior, the use of SSRI’s has actually been linked to a decrease in suicide. (The anti-pharma people won’t like that, but it appears to be the case.)

The news today of California’s voting against Prop. 19, which would have legalized pot, saving law enforcement money and bringing in tax dollars, strikes me as ironic and silly when our nation faces its greatest threats to stability since World War II and Great Depression. Just as the poor will always be with us, so will mind-altering drugs. The question is whether their use will be considered a moral offense, or whether appropriate medical treatment will be available for those who self-medicate.

The Addiction. Tuesday, Nov. 2, 2010.

2010-11-02T11:14:00.001-07:00

“Just cause you got the monkey off your back doesn’t mean the circus has left town.” –George Carlin

Merriam-Webster defines the word “addiction” as “persistent compulsive use of a substance known by the user to be harmful.” Of course, that’s an incomplete definition. Modern psychology allows for the concept of addiction to actions, like sex and gambling, in addition to substances.

Why do people get addicted to substances or behaviors? Well, usually, because they feel good. They override negative feelings like depression and anxiety, at least at first. Usually, they release endorphins. (So does “cutting,” which is why it can be such a tough habit to break.)

Author Susan Rose Blauner (“How I Stayed Alive when my Brain was Trying to Kill Me”) adds something else to the ever-growing list of addictions: suicidal thinking. For 18 years, Blauner says, she was addicted to the concept of suicide. She was obsessed with the idea of her own death. She attempted to kill herself on numerous occasions and was repeatedly confined in psychiatric wards. She finally beat the addiction with a combination of meds and therapy, but she admits she still thinks of suicide from time to time.

Does labeling suicidal thinking “an addiction” seem far-fetched to you? It doesn’t to me. Actually, it makes a lot of sense. It’s been long documented that often, just before a suicide attempt, a depressed person suddenly cheers up – because they believe their pain will soon be over. If you’re faced with more problems than you think you can handle, thinking of “Plan B” can actually be comforting. Why wouldn’t this flood the brain with those endorphins? And if it does, why wouldn’t suicidal thinking be, literally, addictive?

A writer on the Suicide Project says, “I get this relief/joy/etc by thinking/phantasizing[sic]/dreaming/planning about suicide. When contemplating suicide I have control to some degree, I feel I can control the time and way of my death, and I can stop pain and fear.” For this individual, suicide is a way to exert control in a life of chaos, and the idea of death is actually soothing.

But the anonymous writer goes on: “Like with any addiction you need a stronger and stronger dose, and where phantasies [sic] once were sufficient, I now am at the stage where nothing is good enough but the real thing. This past weekend I very nearly killed myself, and I know I am capable of because I years ago I did a (very serious) suicide attempt.”

Some people aren’t just addicted to suicidal THOUGHTS; they’re addicted to suicidal ACTIONS. They OD or slit their wrists again and again and again. Family and friends may eventually develop compassion fatigue, and it’s common to say these people are “just seeking attention.” But I think it’s more than that. I think they have become addicted to suicidal actions; they’ve gotten accustomed to calming themselves and feeling in control this way. Their actions do more than simply antagonize the people around them: any suicidal gesture can be fatal, whether it’s “for attention,” an addiction, or whatever.

How do we heal from addictions? A good model is the 12-Step group. I wondered whether there is a Suicide Anonymous, so I Googled it, and sure enough, there is. Just like AA, SA follows the 12 Steps:

1. We admitted we were powerless over suicidal preoccupation that our lives had
become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God, as we
understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves, and to another human being the exact nature of our
wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed and became willing to make amends to
them all.

9. Made direct amends to such people wherever possible, except when to do so would
injure them or others.

10. Continued to take personal inventory of ourselves and when we were wrong
promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God,
as we understood Him, praying only for knowledge of His will for us and the power to
carry that out.

12. Having had a spiritual awakening as a result of these steps, we tried to carry this
message to those who still suffer and to practice these principles in all our affairs.

I think it might be a good idea to join. What about you?

The funny thing about grief. Monday, Nov. 1, 2010

2010-11-01T12:26:00.000-07:00

“Tears are the silent language of grief.” –Voltaire

A dear friend of mine lost her beloved mother suddenly last month. In our church we have repeated observations of one’s passing. We honored her “40th day” over the weekend.

My friend is still overwhelmed with grief. She functions for a while, as a wife and mom and employee, and then the reality of her loss hits her and she sobs. On Saturday, she was surrounded by friends and loved ones who held her, prayed with her and gave her Kleenex. Our society has a “built-in” arrangement for people who a bereaved. Funerals and memorial services serve the function of keeping caring people around the bereaved so they don’t have to suffer alone.

But it’s a funny thing about grief. We all expect that when someone dies, there will be grief. But there are other losses that cause other kinds of grief – silent losses, losses of intangible things, losses we experience but don’t label, losses we might sense but don’t officially recognize.

There is, for example, the loss of a dream. This can occur in many ways. It obviously occurs in the case of a divorce, the birth of a child with special needs, or the loss of a job. But it also occurs when you simply come to the realization that life is not going to work out as you had anticipated. You realize that your mother, your father, your children, your spouse, your job, or even your faith is not what you’d thought – and yes, there is a loss involved.

I had a “happily ever after” in mind. That train has been derailed, and I don’t know what direction it’s taking me in now. Things I’d taken for granted now appear far from certain. The world is a scarier place than I’d thought it was. I feel nostalgic for a period of time that existed only a few years ago.

My depression over the last couple of years has had a strong undercurrent of grief in it. At my very worst, I have felt loss as keenly if someone I had loved dearly had died. But I haven’t had that kind of “obvious” loss, like the death of a parent, spouse or child. So there are no ceremonies addressing my situation. If anything, I have been encouraged to just buck up and deal.

But I still feel the loss. And Hallmark doesn’t make any “Thinking of you as you’ve lost your dream” cards.

The scariest Halloween. Sunday, Oct. 31, 2010.

2010-10-31T06:53:00.001-07:00

“When did the future switch from being a promise to being a threat?” --Chuck Palahniuk

It was exactly two years ago today.

It was Halloween, a fun day at work. Most of the staff of our publication was in costume for our annual contest. (I was a black cat.) We were looking forward to the potluck and to the weekend. And then we got word that we were having an emergency company meeting.

What followed was surreal. A room full of ghosts, goblins, witches and worlocks was informed by management that after three years of record profits, our owners were now facing bankruptcy. A number of changes would be taking place at once: we would be losing our 401K match; there would be compulsory furloughs to lower our salaries, and almost half the staff – about 150 people – would lose their jobs. Trick or treat.

To be honest, the reality of the situation didn’t hit me right away. It was too big. I survived the first round of layoffs, which I knew I would; my position is not redundant. I went from doing the job of one person to doing the jobs of three. If anything, my position was even more secure. And we were able to survive that bankruptcy threat.

But as the weeks went on, and the US economy continued into freefall, things got scarier and scarier – and I got sicker and sicker.

Of course, I had been in a battle with anxiety and depression for many years; these were not new to me. But I had never faced this kind of stress before. Every week or so there was an article somewhere about how our industry – much like the automotive industry and the real estate industry – was failing, and every day at work people whispered in the halls about friends who had lost their jobs and homes.

Layoffs continued – always without notice. People would come to work in the morning to find their belongings in a brown cardboard box. And I began to feel like I was living on Death Row. Would my job and home be next? Would we be living out of our car?

As my anxiety spiked, I talked to my doctor about it. His answer was to drastically change my medication regimen – and then, in the worst timing imaginable, he was not able to schedule me for a follow-up appointment until the following spring. The new medications made me sick, and I had to quit taking them. I got sicker and sicker over the next few months. The rest, as they say, is history.

My counselor says there are many kinds of environmental anxiety, but financial anxiety is the worst. The loss of economic security, she says, can often impact a person’s mental health more than the death of a loved one. Although it will be at least two years before the data can be crunched and a firm connection proven, social scientists believe there has been an increase in suicides since Fall of 2008, when the Recession began. Unemployment, foreclosure, and bankruptcy are all risk factors for suicide.

It’s not about materialism. The idea of losing all our belongings – our “stuff” – isn’t what scares me, or, I believe, most people. “Stuff” can be replaced. It’s the fear of what happens next – where will we sleep? How will we be kept safe? What will we do about medical care?

And now it’s two years later. The Recession, they say, is over – but they call it a “jobless recovery.” That, to me, is no recovery at all. And people are still scared to death.

It’s been the longest Halloween ever. Boo.

Is this normal? Friday, Oct. 29, 2010.

2010-10-29T18:12:00.001-07:00

“To study the abnormal is the best way of understanding the normal.” –William James

Today was notable because of what I did NOT feel.

I did not feel depressed about anything in particular.

I did not feel angry.

I did not feel hopeless.

I did not feel anxious.

I had a lot of work for my job, but I did not feel overwhelmed.

I did not feel tired because of my meds. (This is a big thing.)

I did not feel speedy because of my other meds.

Today was a stellar day. I felt the way I used to feel. I felt the way I imagine “normal” people feel most of the time.

What will tomorrow bring?

Actually, I’m laughing WITH you. Thursday, Oct. 28, 2010.

2010-10-28T12:44:00.000-07:00

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."

Clearly, life has become hellish for the young man in this short film. He downs a whisky as he looks over the papers on his desk – a pink slip, a foreclosure document, bankruptcy papers, and a divorce order. He signs his “To Whom It May Concern” letter, tosses it on top of the pile, and walks out to his car.

After a long drive down unpaved roads, he locates an obscure clearing in the woods and parks his car. He then proceeds to connect a garden hose from his car’s exhaust pipe through the driver’s side window; puts on a pair of dark glasses to block out the sun; reclines his seat and prepares to die.

The screen goes black. Then, suddenly, it’s dusk. The young man wakes up with a start. He’s alive, his engine is off, and his gas tank is on E. What the …? The camera pulls back as he gets out to find a car behind him, with the garden hose now inserted through the other car’s window – and a dead man inside.

On the windshield is a note: SORRY ABOUT YOUR GAS. BUT YOU WERE ASLEEP AND I HAD A REALLY SHITTY DAY.

I watched this five-minute film at a film festival several months ago. I was sitting between my mom and my husband. I honestly don’t know if I’ve ever laughed so hard in my life. I was laughing so much, tears were running down my cheeks. I don’t remember if my mom or husband laughed; I’m sure they were uncomfortable. And so was I. But I couldn’t help myself. As a suicide attempt survivor, this little movie touched my funny bone.

Wiki defines “black comedy” as “a sub-genre of comedy and satire in which topics and events that are usually regarded as taboo, are treated in an unusually humorous or satirical manner while retaining their seriousness. The intent of black comedy, therefore, is often for the audience to experience both laughter and discomfort, sometimes simultaneously.”

I have always loved black comedy. Black comedy is part of what’s allowed me to survive two decades in a newsroom. Not everybody gets the joke. I once asked a new friend if she liked black comedy; she replied (in all seriousness) that she was only familiar with “The Cosby Show.” But at work, where we covered rapes and murders daily, we basically had the choice to either laugh or cry, and we often chose to laugh.

Of all the taboos, suicide (or attempted suicide) is probably the tabooist. “Heathers,” which I wrote about a few months back, is probably the most classic. There’s also “Harold and Maude,” “My Suicide,” “Little Miss Sunshine,” and “Suicide the Comedy.” But it’s a short list. Much more often, suicide is the stuff of depressing drama. IMHO, the best of the bunch: “Leaving Las Vegas” (with Nicholas Cage’s most brilliant performance, which practically made me want to kill myself!), “The Hours,” “The Virgin Suicides,” and “21 Grams” (thinking of this one still gives me goosebumps).

Since my suicide attempt I’ve been amazed by the number of times I’ve seen suicide depicted on television shows, such as “Law & Order” and “Fringe.” (Of course, it was always there, but it’s like when you find a spot on your carpet – once you know it’s there, you keep noticing it.) I’m more concerned about my loved ones that might be watching with me than I am for myself – it’s just a plot device to me.

But drama isn’t as cathartic for me as black comedy can be. The very act of laughing in the face of something so horrible says, “I’m not afraid of you anymore. You have no power over me.” It’s a form of closure for me, and I suspect I’m not alone.

Perhaps it’s time to dig “Heathers” out again. After all, “I knew that loose was too noose ... uh... noose was too loose.”

Unringing the bell. Wednesday, October 27, 2010.

2010-10-27T10:22:00.000-07:00

“Welcome to your life. There's no turning back.” – “Everybody Wants to Rule the World,” Tears for Fears

Western civilization breaks history into two parts – BC, or Before Christ, and AD or CD, for after. As I was going through the family photos saved on my computer a few days ago, I realize that I now break my own personal history into two parts – before my suicide attempt and after.

I found myself starting at my face in birthday and Christmas and vacation photos taken before my major depressive episode that started in the fall of 2008, wondering if that person could have foreseen what was in store for her. Of course, I’ve been battling bipolar since 1980, and I’ve suffered a number of lows and at least two dysphoric manias. My smiling face in a lot of these old photos belies my true feelings.

But there is no comparison between the way I felt back then and the way I would come to feel from late 2008 through the summer of 2009. I was so sick that I had no frame of reference. I couldn’t believe I could ever climb out, because I had no experience with being in that deep of a chasm. It was like comparing a case of tuberculosis to a case of the sniffles.

And because I took action in a motel room that morning, unfortunately, my “before” and “after” affects others, not just me. I rung a giant bell, and I cannot unring it. Once you have attempted suicide – especially if your attempt was potentially lethal and not just what some would call “a cry for help” – you can’t forget it, and neither can your loved ones. The damage is done.

The son of my mother’s best friend hung himself a few years ago. His act shattered his family. We spoke of the family situation last night, briefly, when we had dinner with my mom. Suddenly the conversation ended and the subject changed. The suicide of a friend or family member is no longer something that can be comfortably discussed in my presence. I cannot unring the bell.

The very small selection of friends who know about my attempt communicate with me periodically, and they ask, “How are you?” I know what they mean. It’s a different question now than it was before. I cannot unring the bell.

Thank God, my liver is in good shape due to the 24-hour drip of N-acetylcysteine I was given to combat my acetaminophen overdose (one of the doctors actually referred to the clearing of my liver as “a miracle”). And the deafness caused by my aspirin overdose went away. But I wear bracelets to cover the permanent scars on my wrists. I cannot unring the bell.

Damn it. I wish I could unring this bell.

Beside the fence. Tuesday, Oct. 26, 2010.

2010-10-26T12:34:00.001-07:00

“The hardest struggle of all is to be something different from what the average man is.” –Charles M. Schwab

Guess what? I was born into a dysfunctional family.

I guess I can pick a number and stand in line, because I only know a few families that are “functional” (and I’m judging them from the outside; I could be wrong about them).

Every dysfunctional family is dysfunctional in its own way. In my case, my father had high-functioning autism (also known as Asperger’s Syndrome). He has never been diagnosed – the diagnosis itself didn’t even exist until the 1980s – but he is what you’d call a “textbook case.” My father has never made direct eye contact with me; all of our conversations (from the time I was a child until now) have revolved around camera parts; and, lacking empathy, he said and did many things to me as I was growing up that were (inadvertently) abusive.

My mother drank to deal with the loneliness and frustration of having a spouse that could not connect with her emotionally on even the most basic level. She didn’t drink every day; she worked full-time and kept the house absolutely perfect. But when she did drink, I sensed a gulf between us. My father was an emotional vacuum; my mother became one on those occasions that she did drink; and I had no siblings to share my experiences with. Both of my parents loved me deeply, but something was askew.

For some reason I’ll never understand, I took after my father – so much so, in fact, that I believe if I had been tested as a child, I would have been placed on the autistic spectrum. I was adept at going inside of myself from the time I was 4 or 5. I preferred to walk along the fence and tell stories inside my head rather than play with the other kids on the playground. I was 6 when I decided I was going to be a writer (a solitary craft), and when I drew pictures of myself as an adult, I never included a husband or children; only a dog.

When I communicated with other kids, I monologued – an Asperger’s trait – often having memorized my side of the conversation ahead of time, because it never occurred to me that conversation was a give-and-take thing. And I shared all the startles and phobias my dad had (also an Asperger’s trait) – loud noises, bright lights, flying.

But at some point – I think around seventh grade – I began to do something my father could not. I began to notice that my behavior was unusual, and I longed to be part of the “in” crowd. I began to study the way people talked, moved, and dressed, and I began to copy them.

Unfortunately, it would be years before I got it right; it wasn’t until I got a degree in psychology, became a journalist and had to relate to people in a deeply empathetic way that I truly became “NT” (neurotypical). In the meantime, I could never fit in – and I desperately, desperately wanted to. I always sensed that I didn’t quite fit in, even in my own house, with my own family, in my own church, in my own workplace.

And this sense has never left me. It’s hard for me to imagine that someone knows how I feel, because I feel that my very molecules are different from other peoples’. Interestingly, I’ve been told many times that I’m “good with people,” and “fun to be with.” My own therapist thinks I should be a therapist.

But inside I’m still that little girl, walking alone beside the fence.

Of suppositions & sugar pills. Friday, Oct. 22, 2010.

2010-10-22T11:12:00.001-07:00

“My recovery has been an evolution, not a sudden miracle.” – Patty Duke

Like a nasty rash, it keeps spreading again and again – provoking confusion, hopelessness and even fear for people taking antidepressants.

A meta-analysis of meds’ effectiveness, published last winter in the Journal of the American Medical Association, seemed discouraging to say the least. The presses were rolling, and a three-word summary of the study – “ANTIDEPRESSANTS DON’T WORK!” – flooded the traditional media as well as the blogosphere.

Perhaps most visible was Newsweek’s cover story, “The Depressing News about Antidepressants,” with the subhead, Studies suggest that the popular drugs are no more effective than a placebo. In fact, they may be worse.

But that’s not what the results of the analysis actually said – and as a 25-year veteran journalist who also suffers from depression and bipolar, I’m going to call this journalism what it is: bullshit.

Don’t get me wrong. I’m no friend of Big Pharma. I resent the hell out of the pharmaceutical companies that charge outrageous amounts of money for these medications even as they spend billions to persuade TV-watchers to ask their doctors for Happy Pills that will solve all their problems. Not only that, but I’ve suffered extreme side-effects from taking the wrong meds. (Come to think of it, I’m not thrilled about the side effects of the right ones, either.)

But the meta-analysis didn’t say that meds don’t work. It said, “The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial (emphasis mine).”

Allow me to put this into English: “If you’ve got a case of the blues, antidepressants probably won’t help you. But if you are very severely depressed, antidepressants can be very effective.” I’d like to add, “And they can save your life.”

That’s what frustrates me every time I read a reference to the AMA report. I fear it can lead people to stop taking their meds. For someone who is mildly, or situationally, depressed, this will save them a few bucks. But for someone with severe, unrelenting, clinical depression, the result could be deadly.

What we really have here is not the wrong meds, but the wrong people being studied. No one would study a group of people without cancer, give them chemotherapy, and then announce that chemo doesn’t cure cancer. But that seems to be what happened with this meta-study.

Further, the abbreviated report simply increases the stigma people with the most severe depression already face. If meds can’t treat it, then your depression must not be a medical illness. If it’s not an illness, then it’s caused by your thoughts. If you try to change your thoughts and your depression doesn’t lift, you’re just not trying hard enough.

When I was experiencing what I would learn later was a mixed episode, I was determined to get better – without meds, and with Dr. David Burns’ Cognitive Behavioral Therapy. This therapy is ideal for situational or moderate depression – it works amazingly well. But – based on my own experience only – Dr. Burns’ assertion that CBT works as well as medication even for severe, clinical depression is overly optimistic. I filled up seven notebooks with my “cognitive distortions.” I’ve never tried so hard at anything in my entire life. And I wound up attempting to kill myself.

It wasn’t until I had been on several medications for a period of time that my mood began to even out. Believe me, I experienced no placebo effect. In the beginning, I felt hopeless that any medication would work for me; later, there were meds I had faith in that did nothing. In fact, the placebo effect is least likely to be a factor for those who are the most severely depressed.

You see, until we found the right “cocktail,” I was truly too sick to help myself. I respect those for whom therapy was an adequate cure, but please don’t judge me for needing meds as an adjunct. Perhaps now I’m ready for that next step – stable enough to try CBT again. But – for me – it’s medication that has brought me here.

Just because you’re paranoid. Thursday, Oct. 21, 2010.

2010-10-21T11:31:00.000-07:00

“Just because you’re paranoid doesn’t mean they aren’t after you.” –Joseph Heller

Does anybody else struggle with a credibility gap? Or maybe it’s just me.

In the cinematic masterpiece “12 Monkeys,” James Cole (Bruce Willis) finds himself in a mental institution, displaying all the symptoms of paranoid schizophrenia. He claims to be from the future, and is afraid of the people that are after him. He can be traced via a device implanted in one of his molars. Against his will, he’s drugged to incapacitation.

The problem is, Cole is entirely sane. He really IS from the future – he’s been sent back in time to locate a virus that will wipe out most of the population of earth. He’s also a prisoner, so a tacking device has been placed in his teeth. But when he tries to explain his situation to hospital staff, they don’t buy his story. Who can blame them? Eventually, Cole comes to distrust himself. After all, he’s a textbook case!

Two things happen when you are diagnosed with a mental illness. First, the symptoms you have suffered are put into a context, and finally make sense. That’s the good thing. The bad thing is that from that day on, you lose credibility. You continue to live your life, as everyone does, but suddenly it seems like everything is about your illness and not about your outer environment.

It can be a frustrating thing to have a “reason” for your distress. You might have a bad teacher or an inept boss. Your spouse or parents might be cold and uncaring. You might have a physical illness, like irritable bowel syndrome or myalgic encephalomyelitis. But now that you have depression, anxiety, borderline personality disorder or bipolar, the problem is suddenly inside your head.

It can be difficult to talk about your problems with a physician, counselor, or family member, once your diagnosis is out of the bag. After all, diarrhea can be a manifestation of your anxiety (even though you might have food poisoning). You know you’ve always been too sensitive (even though your work environment is toxic). Your credibility is shot. It’s all about you.

And the person with the most doubt isn’t necessarily your father, wife or co-worker. The person with the most doubt is you. That’s why it’s so important, when you are anxious or depressed, to try to be as objective as you possibly can. Really listen to yourself. Journal. Keep track of your moods and how they may be affected by various factors.

Does anybody else struggle with a credibility gap? Or maybe it’s just me.

Not OK to feel. Wednesday, Oct. 20, 2010.

2010-10-20T11:08:00.000-07:00

“They may forget what you said, but they will never forget how you made them feel.” –Carl W. Buechner

Do you remember two months ago when I wrote about a co-worker who was angry at me? Well, I learned today that she is still mad.

The nature of the problem doesn’t really matter; it’s my emotional reaction to it. And my reaction is fear, shame, and depression. This individual actually believes I’m being provocative, when actually the reverse is true. I’ve been walking on eggshells because I don’t want this person angry with me. Or anyone, for that matter.

One of my very earliest memories is of my parents telling me it was OK to be mad. I think I was about 4 or 5. I can only guess that in order for such a comment to come up, they must have seen me refusing to vent emotions in a healthy way.

Still, despite that memory, I believe I grew up in a household where it wasn’t OK to show emotions – particularly anger. Whenever I got angry at my mom or my dad, I was afraid to express it – out of fear that they would be angry back, or that my anger would somehow result in their death. (I’m 46 and I still have that “magical” belief that my anger, particularly in the case of my mom, will cause her to die.)

My first “real” job at a newspaper was on a staff where everyone yelled at each other like members of a big Italian family. At the time, I thought the environment was stressful, but looking back, I actually think it was healthy for me. I started to develop a thicker skin, and I had several opportunities to be angry without experiencing dire consequences.

Now I’m in a much quieter environment, working directly with only a couple of people. There is no way I can “speak my mind.” A single comment I made has taken on a life of its own and my teammate is holding a grudge. Several years of holding my tongue has been for naught.

It doesn’t seem OK to feel angry here. It doesn’t seem OK to feel angry at home, either. I think the only place I can feel angry is inside my car, if it’s parked. And that’s where I went over my lunch hour to cry. I don’t know what else to do.

Factor X. Tuesday, Oct. 19, 2010.

2010-10-19T10:34:00.000-07:00

"Suicide is a particularly awful way to die: the mental suffering leading up to it is usually prolonged, intense, and unpalliated. There is no morphine equivalent to ease the acute pain, and death not uncommonly is violent and grisly." – Kay Redfield Jamison

Lately I’ve been wondering what makes us unique. And by “us,” I’m referring to those of us who have attempted to end our lives.

The American Society of Suicidology exists to study people like “us.” They are able to name risk factors for suicide: mental illness, especially bipolar disorder and schizophrenia; low self-esteem; perfectionism; history of loss (unemployment, foreclosure, divorce); gender (women make more attempts, men complete the act more often); recent exposure to another’s suicide; old age or terminal illness.

But what they can’t seem to explain – what no one can – is what I call Factor X: that one quality that gives us the ability to ignore, and override, the brain’s overwhelming desire for self-preservation. You see, MOST people that have a mental illness, MOST people with low self-esteem, MOST perfectionists, and MOST people who have suffered a loss don’t take that action. There is something different about us. What is it?

As I continue on this road to recovery, this Factor X bothers me more and more, and I’ve been trying to find the answer. One researcher believes it is the willingness to undergo physical pain and detach from it, and had found a connection between people who self-injure or otherwise abuse their bodies and people who attempt suicide. People who are suicidal have a high pain threshold, he says.

This doesn’t ring true for me. Other than my battle with dermatillomania, there is nothing in my background or personality to suggest that I like pain, nor that I can handle it better than other people. In fact, I would suggest that the opposite is true. I’m a wuss.

Right now I’m reading “How I Stayed Alive When My Brain Was Trying to Kill Me” by Susan Rose Blauner, who made a number of suicide attempts before she decided she wanted to live after all. Blauner developed a system to overcome what had become an addiction to suicidal ideation.

This does sound like the way my brain thinks. I experience certain “triggers,” and my brain’s automatic response is, “I want to be dead.” Blauner says it’s actually OK to have suicidal thoughts – the task to learn not to act on them, and to substitute those thoughts with more realistic and nurturing ones.

But I’m halfway through the book and I still can’t find out why some of us have actually converted our thoughts into actions, when the vast majority of people who have suicidal thoughts have not.

I’ve heard many people say, “I don’t have the GUTS to commit suicide.” Is Factor X really some kind of courage? If so, why didn’t I go mountain-climbing instead?

Understanding leads to control. I want to understand what makes me different, because it’s frightening that Factor X is a part of me.

The Electronic Friendship Generator. Monday, Oct. 18, 2010.

2010-10-18T11:04:00.000-07:00

“There's a certain detachment involved when you're surfing the Web, sitting alone at the computer, facing an inanimate screen. But there are real people to be found on the other end of the ‘intertubes.’”-Anne Hammock CNN

“Your account has been blocked,” the message said. A virus, Koobface, had been detected in it. In order to run the program that would remove the virus, I had to choose which of five wall photos belonged to five FB Friends – and I could only attempt this once an hour. Uh-oh!

The first thing I did was check SNOPES, and sure enough, the problem was legit. (Damn.) Because I have a firewall at work, I had to choose the photos from my home computer – and the photos displayed weren’t of my FB Friends’ faces. They were of poems and puppies and kittens and sunsets. Ack! It took five long days for me to unblock my account.

Recently I was offline for over a week during a trip with my husband. But this time, the choice wasn’t mine, and I felt like I was grounded on the night of the Senior Prom! What was going on in Facebook land? What was I missing? I felt lonely, disconnected, and strangely sad. The lyrics of “FACEBOOK UNBLOCK ME” seemed to be written with me in mind.

So here’s the part where some people would say that I should “get a life.” I should get friends and activities “IRL” (In Real Life”) and not “waste time” on the “Electronic Friendship Generator.” My mom is one of those people who says she “can’t figure out why someone would want to sit at a computer when there is a whole world out there.”

Well, I have a real life, thank you very much. I have a full-time job that’s fulfilling and interesting. I have a husband and son who I love very much. I’m very involved in our church, and I participate in peace activities. I have, by most measures, a very full life. And part of that full life happens to include Facebook and the Friends I meet there.

For a host of reasons both professional and personal, I’ve chosen to limit the number of people who know about my bipolar disorder, and even fewer know of my suicide attempt. Perhaps I should be “fighting the stigma” by coming out of the closet – but I fear the ramifications to my job and family would be too great.

So there is a part of me – a big part of me – that’s known mostly in cyber-space. And that means some of my relationships with Facebook Friends are as intimate – or even more intimate – than many of my relationships “IRL.”

Right now, Facebook meets a need in my life. It provides the support group that I couldn’t find when I checked Google and the Yellow Pages. And I won’t be ashamed of it. I need all the support I can get.

Pass the salt. Tuesday, Oct. 12, 2010.

2010-10-12T11:52:00.000-07:00

“I like it, I’m not gonna crack.” –Nirvana, “Lithium”

Does it sound a little Brave New World-y to you? Bioethicist Jacob M. Appel wants to put Lithium Carbonate in your drinking water.

Actually, Lithium Carbonate is an amazing little substance. It’s actually a salt, not too far removed from the salt on your dinner table, and it’s used to process metal oxide – but you probably know it best in its psychiatric applications, where it is the number one treatment for bipolar disorder.

Lithium’s way different from other medications used in psychiatry. It has an amazingly long history, having been first discovered effective against mania in 1871 (you read that right). In 1886, it was discovered to be effective against depression. It took a century for the FDA to approve it, though, and in the meantime, people were given exceedingly high doses that occasionally killed them. Oops.

But once doctors learned to administer it properly – and to test patients’ blood periodically to make sure there was no toxicity – they discovered something about Lithium that makes it different from every other psychiatric medication: it seems to have an anti-suicide effect.

It’s not just about relieving manic/depressive symptoms; meds like Lamictal and Zyprexa do that too. But Lithium is extra special. In study after study, patients taking Lithium are less likely to kill themselves than those on other meds. One study, for example, at the University of Cagliari in Sardinia, found that suicidal patients were eight times less likely to commit suicide if they took lithium – and that the pattern more than reversed itself if they stopped taking their meds.

But the best-known evidence is the data collected from 27 Texas counties between 1978 and 1987, which demonstrated that the incidence of suicide (as well as homicide and rape) were significantly lower in areas with naturally-occurring Lithium Carbonate in the water supply. Last year, there was a similar finding in Oita, Japan. The amount of Lithium in the water was quite small – much, much less than one would get taking tablets; the stabilizing effects were seen not only in people who are diagnosed bipolar, but among the general public; and no adverse health effects were reported.

So, says Appel, maybe we should put Lithium Carbonate in everybody’s drinking water, just like we add fluorine to prevent cavities.

Whoa! Whoa! Whoa! People were already freaking out about the fluoride. And don’t we keep reading about the dangers of traces of pharmaceuticals that are making their way into our water supply? On the other hand, fewer suicides, rapes and homicides might be a good thing…

I took Lithium for many years. I stopped taking it for several, and bad things happened. I’m back on it, and so far, so good. I don’t mind the blood tests – although every time I get one, I’m reminded that this salt is a drug – and a powerful one at that.

Somewhere in my bookshelf, I have “1984,” “Brave New World” and “This Perfect Day.” Let me read those again, and I’ll get back to you on the question of whether I think that my drug belongs in your drinking water. Okay?

Against our will. Monday, Oct. 11, 2010.

2010-10-11T13:31:00.001-07:00

“I must be crazy to be in a loony bin like this.” –McMurphy, “One Flew Over the Cuckoo’s Nest”

Life had become a nightmare for Rebekkah. Her husband of 20 years was divorcing her, and was continuing a pattern of abuse. He was trying to get full custody of their 13-year-old daughter. And Rebekkah’s mother, who lived with the couple, had just passed away.

But the chaos going on in Rebekkah’s environment was nothing compared to what was going on inside her mind. I had been noticing Rebekkah’s decline over several months each Sunday she came to church – she was losing weight, looking unkempt and chain-smoking. But it wasn’t until she called and invited me to her apartment that I knew how bad things had gotten.

Grabbing her pack of Newports, Rebekkah ushered me out to the lawn where she whispered, “Be careful what you say. He can hear you.” “Who?” I asked. “My ex,” she said. “He’s got microphones in the trees and bushes. He’s very powerful. Last week I was late to an appointment at my lawyer’s because he called his connections to cause a traffic jam on the expressway! He knows everyone in town. He can do anything he wants.”

I suggested Rebekkah talk to a therapist. “He knows all the therapists,” she said. “He has contacted every one in town and told them about me. They try to give me pills, but he has put poison in them.”

Rebekkah’s mental and physical health continued to deteriorate. She began to forget where she lived, and would walk for miles in the wee hours in the winter cold, asking to sleep on friends’ and relatives’ couches. Her sister found her wandering in traffic, murmuring to herself. She was arrested twice for driving under the influence of Hydrocodone. And she began making references to suicide. A half-dozen people (including her daughter) came to me – as the minister’s wife – asking me to “DO SOMETHING.”

Finally one day after church, I did. I asked her to come with me in my car, where she could smoke and chat, and I drove her to the hospital. Of course, when we got there, she appeared quite lucid. She knew her name (Rebekkah), her race (black), the year (2007). “I’m not crazy,” she informed the staff. “My ex husband is telling people that I am, but I’m not.”

“What do you want us to do?” The doctor asked me (when it came out that Rebekkah lacked health insurance). “Can’t you just take her to your house and watch her?”

I explained that I worked full-time and had a family to care for, and Rebekkah needed round-the-clock attention to make sure she would not injure herself. I fought with the doctors and administrators for almost two hours. Finally I exploded. “If I take her home with me and she winds up dead,” I said, “It’s on this fucking hospital! And don’t even THINK there won’t be a lawsuit!”

Rebekkah was admitted – over her loud objections – for a “72-hour hold.” At the end of that time, her sister and I were asked to attend a meeting at the hospital, where we both presented testimony in favor of keeping Rebekkah there for a period of time.

Rebekkah was livid. “You’re turning against me,” she shouted at us. “My ex has gotten to you too! They’re feeding me poison pills in here! They want me dead. I’ll beat them to it!”

About two months later, my husband and I received a phone call from Rebekkah. She and her daughter had moved into a new apartment, and she was having a housewarming party. Rebekkah looked beautiful in her native African dress. Her hair was styled and her makeup was flawless. She talked about an upcoming voyage to her hometown in Africa, and not a word about hidden microphones. The old Rebekkah was back. “Thank you,” she said to me as she handed me an expensive bottle of wine. She didn’t have to say any more.

The decision of whether or not to hold someone in a psychiatric unit, or whether or not to require them to take medication, is a difficult one. I knew that Rebekkah was in a world-class facility; I was also very sure that she was likely to be injured or die without 24-hour care. But I had to risk her anger, and I had to take the chance that I was wrong.

I know a lot of people would still say I was wrong. But if I faced the decision again, I have no doubt what my choice would be. And I would hope that someone would do the same for me.

Blaming it on the devil. Friday, Oct. 8, 2010.

2010-10-08T14:44:00.001-07:00

“The devil made me do it!” – Flip Wilson

In 1968 (when part of the world thought the utopian Age of Aquarius was dawning, and the other part thought the world was going straight to hell), Mick Jagger and Keith Richards wrote the song “Sympathy for the Devil” for the Rolling Stones’ “Beggar’s Banquet” album. The Stones, already under fire for their sexually suggestive lyrics and stage presence, were now accused of nothing less than Satanism.

It didn’t help matters that 18-year-old Meredith Hunter was stabbed to death by a Hell’s Angel after pulling out a gun in December 1969 at the Altamont Free Concert. The incident took place while the Stones were performing “Under My Thumb,” but almost overnight the urban legend developed that “Sympathy for the Devil” had been playing. Hunter’s death was blamed on none other than Lucifer himself.

As a Christian and a Rolling Stones fan, I have to stand up for the song’s true meaning. While the song is, in fact, narrated by the Devil (just as C.S. Louis’ “The Screwtape Letters” are narrated by a demon), the song really isn’t about Satanic powers. It’s about human beings and the crimes we have committed throughout history – medieval wars, the Russian Revolution of 1917, World War II, and the assassination of Jack and Bobby Kennedy.

Humankind has done all of these things, but in the song, the Devil wants credit. He claims to have been present at all these atrocities. He’s puffed-up and self-important. "If you meet me, have some courtesy, have some sympathy, and some taste,” he says. “Use all your well-learned politesse, or I'll lay your soul to waste."

What the Devil in the song doesn’t realize is that all of these events would have occurred without his help, because they were committed by human hands. In reality, the Devil is powerless; he depends on human beings to do his dirty work. The listener doesn’t want to have “sympathy” for him, but rather pity.

I don’t believe in Satan as a personification of evil, as a sort of anti-God, or as a creature with horns and a pitchfork that rules over a fiery Hell. When someone commits an evil act and blames it on the temptations of the Devil, I think they are taking the coward’s way out. Like the Devil in “Sympathy,” some people want to believe that someone or something outside of themselves is to blame for their actions. I do not believe mankind is inherently evil, but the evil that does exist is there because we create it.

The strange thing about the evil we create is that it does develop a life of its own. Humans can become so deluded, so confused, so sick that powers outside their control seem to take over. No where is this more true than in the act of suicide. All of my life I have felt in control, except for that morning in the motel room, when I had the distinct feeling that I was watching from outside of myself, like an audience member in a movie theatre.

There might not be an evil man in a red suit, but there are evil powers that can entrap us. All of my life I will be praying that those evil powers never come near me again. And the best way to keep them away is to remember at all times that I am responsible for myself.

“The Web.” Thursday, Oct. 7, 2010.

2010-10-07T12:20:00.001-07:00

“Information on the Internet is subject to the same rules and regulations as conversation at a bar.” -George Lundberg

Two high-profile suicides took place while I was out of town. Rigoberto Ruelas, a dedicated teacher for 14 years; and Tyler Clementi, a freshman at Rutgers College, both jumped off bridges to their deaths. But their suicides had something else in common – both had been humiliated by information on the Internet.

I attended high school and college pre-Internet. Back then, as now, no one wanted negative information about themselves getting around. Gossip and bullies existed. We knew how it felt to walk into a room and find out that our privacy had been compromised, or that people had spread bad things around about us.

But that’s where it usually stopped – a room. Unless someone made photocopies of a photo or a page out of a diary and delivered them to hundreds of people by hand, rumors could only spread so far. In a worst-case scenario, we could attend a different school and start over fresh.

Not today. Because of the Internet, literally the entire world had access to a website claiming Ruelas was a bad teacher, and another one showing video of Clementi having sex with another young man. And because of the Internet, these are bells that cannot be unrung. Once something is “out there” in cyberspace, it’s out there.

So it’s a little ironic that the Internet is known as “the Web.” Because in many ways, it’s just like a spider web – grabbing things and holding them, so they can be devoured.

Anyone who knows me knows that I don’t see the media, mass or social, as the root of all evil. I don’t believe that a normal person will watch “Saw” or “Pulp Fiction” and choose to torture people as a result. People can blame antisocial behavior on a movie or a TV show (and they do), but plenty of people have blamed violent behavior on the Bible as well – and have for centuries.

At the same time, while it might feel reassuring to be able to blame one thing – the Web – for the death of these two individuals, the truth is much more complex. Los Angeles psychologist Kita Curry said that suicide is rarely the result of a single issue. "There's almost always an underlying (mental) illness associated with suicide," Curry says.

For these people, things build up until there is a tipping point: "People take their lives because suddenly they're going to lose their house or they've been arrested or their wife has left them," Curry said. "But if not for that, it would have been something else. Because the real problem is that they don't have the emotional resources to deal with it. There are others dealing with those same problems and they don't take their lives."

So how much responsibility do people bear when they post negative information about others online? Perhaps these individuals would have become suicidal anyway, because of some other problem. Nobody knows for sure. But there’s a good reason why your mother taught you that if you can’t say something nice about someone, don’t say anything at all. I don’t want to have blood on my hands. Do you?

The chemical straightjacket. Sunday, Sept. 26, 2010.

2010-09-26T14:40:00.000-07:00

“Welcome to my nightmare.” –Alice Cooper

Today I’m packing my suitcase, getting ready to fly cross-country tomorrow. And to be honest, it’s giving me the creeps, because I can’t help but remember the last time I did this…

It was a couple of months after I had begun my descent into true madness. I’d been undergoing a great deal of stress due to a potential bankruptcy at work. My doctor – who had been wonderful for the prior six years – took me off the meds that had been working and put me on an all-new regimen of drugs. He then informed me he would not be available to see me for five months.

One of the drugs he put me on was Haldol, a powerful anti-psychotic. I thought it was an anti-anxiety medication, an adjunct to the high dose of Valium he already had me on. Anyone who’s been reading my FB page or my blog knows that I definitely believe there is a place for pharmaceuticals in the treatment of mental illness, especially bipolar. But this time, I believe, my doctor made a mistake. A huge one.

The side effects of the Haldol started so slowly, it was like boiling a rabbit. My thoughts were becoming more confused by the day, and I noticed that things like walking and typing were becoming difficult; but I attributed it only to the stress, not to the medication.

Then came the morning of the scream. I woke up stiff, hardly able to move, while inside I felt like there were a billion ants inside me. I screamed for my husband, who used to work in the AODA field. “Your doctor didn’t give you Haldol, did he?” he asked. “Yeah,” I said. “Oh, my God,” he said. “You need to get off it. Right away.”

My husband wanted to take me to the hospital. But the phone rang. It was his sister. Their father was dying, and he was asking for the family to be there. We had to get on the very next plane out.

Since this morning, I’ve been trying to figure out how I can explain to you what happened next. But even though I’m a wordsmith, I simply don’t have the language. It was as if my mind and body had turned to oatmeal. My husband had to run to work, and I was left behind to pack. I tried to count out five pairs each of underwear and socks, but I had a problem counting to five.

The chest of drawers across the room was so far away, I had to lie down in a fetal position and sing nonsense songs to myself in between steps. “Please God, let me do this, la-la-la I can do this,” I sang.

By the time he got home two hours later, I had managed to pack a small suitcase. We called a family friend to pick us up in the middle of the night, and we were off to the airport.

I was walking with a shuffle, as if my pants were down around my ankles. We had to hurry, but I desperately wanted to lie down in a fetal position again. Most disturbing of all, though, was the sense that I was inside a glass cylinder. I could only stand to perceive what was a few inches around me. I had to look down at my feet as I walked; when I looked ahead, there was a truly horrifying mess of people and lights and sounds. My mind could not make sense of it. I had to hold on to my husband’s shirt as we negotiated our way through the crowd, terrified I would lose hold.

When I tried to speak, I found that I could not make facial expressions; I found out later this is known as Haldol’s “Mask Face.” I was completely terrified and overwhelmed, but I could not give outer expression to my inner experience. This, I found out later, is “The Chemical Straightjacket.” It’s the reason why patients in psychiatric wards often beg not to be given Haldol.

Somehow we got onto the plane, went cross-country, visited my father-in-law just before he passed away, attended his funeral, and flew back. These symptoms slowly abated, to be replaced with extreme anxiety that would last for two months until – then off all of my medications – I tried to take my life.

Perhaps you take Haldol. Perhaps you have found it helps you. That’s quite all right. There are medications that I take that help me, but make other people sick. Everyone’s body chemistry is different. But I’ve asked a half-dozen different doctors since then whether Haldol made sense for me, as an anti-anxiety med, at the dose that was prescribed. And they have all told me it did not.

I have a different doctor now, but someday I’d like to ask my former doctor just what the hell he was thinking of when he prescribed this drug for me.

And now I will go and finish packing for the airport, shudder at the memory of the last time, and be grateful that this time, it’s different.

The Good Mother. Saturday, Sept. 25, 2010.

2010-09-25T14:38:00.000-07:00

“All that I am or ever hope to be, I owe to my angel Mother." -Abraham Lincoln

My best friend, Abrihet, is from Africa. And she is the most amazing woman I have ever known.

Abrihet is a mother of four, including one child with special needs; she has a demanding full-time job in the medical field; she runs a non-profit organization to raise money for medical care in Africa; she is working on her Master’s Degree; and in her “spare” time, she runs marathons. She’s deeply religious, always smiling, and on top of it all she’s beautiful.

Abrihet grew up in one of the most impoverished areas of an impoverished continent. As a child, she witnessed and experienced atrocities and acts of violence that Americans only see in movies like “Hotel Rwanda” and “Blood Diamond.” These life experiences don’t even seem real to us, yet Abrihet lived them, and so did her mother, “Mama.”

In Africa, Mama lived a life of sorrow; she watched eight of her babies die, and only Abrihet survived. Her husband deserted her. When Abrihet and her husband came to the U.S., they were able to send for Mama after several years, and Mama lived here most of the time.

Although she never learned English, it didn’t really matter. Mama communicated with us through smiles, touches, kisses and hugs. Like Abrihet, Mama was always smiling, always showing concern for others. And Abrihet was always quick to attribute any of her own positive qualities to the way Mama had raised her. Both Mama and Abrihet could blame traumas in their lives for being angry, selfish, even violent people, but instead both were bestowed with huge hearts of love and a strong spirit.

A few days ago, Abrihet sent me a shocking e-mail. Mama had died suddenly during a trip to Africa, only a few days before her planned return to the U.S. Mama was only in her late 50s and had been in good health. Abrihet was shattered, and she and her husband were catching the next flight to her homeland in Africa.

Last night we held a memorial service for Mama at church. Everyone was sobbing. The absence of Mama was palpable, and everyone expressed their concern for Abrihet. “Abrihet lives her life helping other people,” said one. “And now the one who takes care of her has been taken away.”

Every day on the Suicide Attempt Survivors board, I communicate with people who want nothing more than for their lives to end. Some of them actively work to end their lives; others simply pray when they go to sleep at night that they won’t wake up.

There is an irony here, a mystery. Even if you don’t believe in God, you can still ask – why, fate? The universe? do people like Mama die, while others who believe they want to die live, despite overdoses and razor cuts? Many suicidal people have told me that when they see a deceased person on TV, they want to “trade places” with someone who is finally at peace. But being in the church, surrounded by weeping people, I imagined how much harder they would be weeping – how much deeper their pain would be – if Mama had taken her own life.

Both Mama and Abrihet were fortunate. Mama had a daughter she loved, and Abrihet had a mother she loved; this mutual love allowed them both to survive unimaginable emotional traumas. Now Abrihet faces life without her mom, but it’s clear her mom planted the seeds that will allow Abrihet to face whatever trials may come.

Twilight years. Friday, Sept. 24, 2010.

2010-09-24T14:23:00.000-07:00

“Hope I die before I get old.” –“My Generation,” The Who, 1965

You might be surprised to find out that the highest suicide rate is not among teens, but actually among the elderly. In America, white males ages 65 and up have the highest suicide rate of all – 29 out of 100,000 of them take their own lives. There are plenty of reasons for this, such as suffering from illness or loneliness and depression from repeated losses. But I fear that suicide is going to increase in this age group over the next 10 or 20 years.

On a discussion forum about the recession, someone wrote, “My retirement plan is a Smith & Wesson.” He’s probably not alone. While the poverty rate for today’s seniors is unacceptably high, the poverty rate for tomorrow’s is likely to be higher, and many millions of people won’t know what to do.

My father is in his 80s and reaped the benefit of being born at the right time as well as being lucky. He dropped out of high school, but he was able to get a steady blue-collar union job. Although my mother also worked, the two of them together had no problem covering the costs of a nice house in the suburbs, nice cars, vacations to Walt Disney World and a college education for their offspring.

Dad was able to retire at 65 with two pensions, significant savings, and no debt. Social Security was the icing on the cake. He was able to purchase a 3-bedroom home and a luxury vehicle; when it came time for him to enter a retirement home, he was able to liquefy his assets and go on Medicaid.

The younger wave of Baby Boomers and the older half of Generation X are looking at a very different kind of future. Few of them work for unions and fewer of them have pensions. Instead, they have 401Ks, most of which lost most of their value in the stock market crash of 2008 and have yet to build back up.

Many of them purchased homes as investments for retirement, but when the housing bubble burst their homes lost as much as 75% of their value, sending many mortgages “under water.” Many of these homes will never again attain their original value.

The same people have been hit by a one-two punch of stagnant wages since 1975, and now a recession that has one of 10 Americans totally unemployed and an additional 15% underemployed. Put those two numbers together and you’re not looking at a recession anymore, but a depression. Those who have been laid off at 50 and above, according to a New York Times article this week, face the very real prospect of never being employed again.

Add to that the runaway cost of health care – which has quadrupled over the past generation – and the possible decrease, or even loss, of Medicaid, Medicare and Social Security. The complete picture is that of two generations that will be facing retirement with little net worth and few safety nets.

America is America, and so of course there are millions of people who will have American Dream retirements full of trips to Hawaii and daily golf outings. But many millions of others will ask themselves the most basic questions: Where will I live? How will I afford my medication? What will I eat? And I fear that for many of these elderly, suicide may seem the only way out.

When health care was being debated earlier this year, some people said that the proposed plan would result in “death panels” for the elderly. This charge was never true, but I’m afraid that there are, in fact, going to be death panels of a sort. When seniors lose their jobs or must retire due to health problems, many of them will hear, “Sorry, you can’t pay off your mortgage by selling your home;” “Sorry, we cannot pay for your health care;” “Sorry, Social Security is no longer solvent;” “Sorry, there’s nothing in your 401k;” “Sorry, the food pantries are empty;” “Sorry, that medication costs $600 a month.”

To me, that sounds like a death panel. When survival is only for the fittest, our seniors will be among those who suffer the most.

Status: Dead. Wednesday, Sept. 22, 2010.

2010-09-22T10:38:00.000-07:00

“The more stories that appear about young people having killed themselves in your area, the more (suicide) might appear to you to be a reasonable response to a particular kind of crisis.” -Dr Jonathon Scourfield

A couple of days ago I read a Facebook status that listed 8 or 9 names and said, “At least they are all together now in heaven.” It was a collection of names of young people, mostly girls, who have supposedly taken their own lives recently.

The death of only one person is tragic. The death of a veritable baseball team of teenagers, all hooked up to Facebook, is, frankly, a little fishy.

Please understand where I’m coming from on this. I was involved when one FB member chose to disrupt suicide prevention boards by stalking herself under a different name, an alter-ego that was threatening to rape and kill her. So many people believed the ruse that they were putting jobs and lives on hold, desperately calling law enforcement.

The young woman finally came clean and admitted she did it for attention, but a few months later she was back, running her own suicide prevention group and at the same time sending private messages to vulnerable girls telling them to “just do it.”

Not long after, another FB member supposedly lost her baby daughter when her boyfriend reportedly beat the child to death. She picked the wrong person to try to manipulate; I happen to be in the media, and it’s my job to investigate things. I discovered irrefutable evidence that no such event had taken place, but plenty of people on FB continue to believe her story.

Where’s the harm, you might ask? After all, it’s just Facebook! Well, there is a lot of harm. You’ve heard, I’m sure, of “The Boy Who Cried Wolf.” Eventually, a wolf really did come a-calling, but by that time no one believed in wolves anymore. Conversely, people on FB do occasionally commit suicide, or lose family members. The fallout of the fakers is that when these things do happen, people don’t believe it. They have been stung before.

In the UK in 1998, there was a widely publicized rash of teen suicides attributable to Facebook groups. Even the Archbishop Vincent Nichols, the head of the Catholic Church in England and Wales, weighed in, warning youth that Facebook causes suicide. There was only one catch – statistically, there had been no rise in teen suicides, no “suicide pacts” identified. It was all a false perception.

But there is an even greater danger. There IS a statistical link between suicide victims and people that feel close to them, either in real life or virtually. One person commits suicide, and friends (or fans) of theirs are at great risk to do the same. These are called “suicide clusters” or “copycat suicides.”

One of the factors that goes into these “suicide clusters” is all the attention the dead person gets. I understand the need for mourning friends to put up memorial pages on Facebook, but in doing so, they might be giving that individual more attention in death than in life – sending a very risky message to others who are depressed and vulnerable. This is why I have said that if a member of SAS commits suicide, I will not put up an RIP page.

If you are someone who has “committed suicide on Facebook” to silently watch as people post loving messages to your profile, or you claim to have several personalities and must “kill” some (perhaps my discussion about Multiple Personality Disorder will come another day), please reflect for a moment about how you will feel if your stunt results in a real death.

We all need attention. But there are better ways to get it.

The gift of tears. Monday, Sept. 20, 2010.

2010-09-20T15:03:00.001-07:00

“Have you ever known the feeling, when you're too sad to cry? When no tears escape your eyelids, and you can't help but wonder why?” -McJunkie

I’ve been having crying spells lately. I get scared or overwhelmed or angry, and the tears come pouring down. Sometimes it’s just a few teardrops that dry right up. Other times it’s a sobbing cascade that requires me to be locked in the bathroom, where no one can see.

Given the choice, I’d much rather not feel down enough to cry. But I’ve lived through another reality – the absolute inability to cry.

When layoffs started happening around me, and whispers of a company-wide bankruptcy began to surface, I began to cry silently in my cubicle. I also began to cry more in general – at movies and TV shows, even at kind comments.

But then somehow, in a way I don’t think even medical doctors understand, I was hit with a mania and a depression at the same time – the dreaded “mixed state,” during which it is reported that one of two victims will attempt suicide.

Along with extreme restlessness, inability to eat, and insomnia, I had a peculiar symptom – an inability to cry, which actually is one symptom of a major depressive episode.

Frankly, it was a bizarre feeling. I had never been so sad, but all I could do was make guttural sounds. At the same time, I was physically and emotionally numb. It was this numbness that allowed me to tell my doctor in the hospital that I was so low, even the death of a loved one would not have an impact on me. And it was this numbness that allowed me to slice open my wrists and not feel it at all.

Today, a year and a half into my recovery, I see the inability to cry as a major red flag. To cry real tears brings some release. To be unable to bring forth those tears – to have hit bottom so far that even crying becomes impossible – is a very scary place to be.

So right now, if I need to cry I will cry; I have a lot inside me that needs releasing. And I see those tears as a gift, helping to wash my pain away.

Pleasure & pain. Saturday, Sept. 18, 2010.

2010-09-18T16:08:00.000-07:00

“I feel certain that I am going mad again. I feel we can't go through another of those terrible times. And I shan't recover this time.” – Virginia Woolf’s suicide note

You’ve seen the list. Vincent Van Gogh. Kurt Cobain. J.K. Rowling. Billy Joel. Ernest and Margaux Hemmingway. Sylvia Plath. Hunter S. Thompson. Virginia Woolf.

As long ago as the time of Aristotle, there was a noted link between mental illness and creativity. Major depressive disorder and bipolar disorder seem to be common amongst writers, musicians, artists, and actors.

No one really knows if, objectively, this is the case. The advent of certain ways to label emotional disturbance is a relative newcomer in human history. When we say that someone suffered from mental illness 300 years ago, we are guessing – applying our definitions on to reported behavior.

And certainly the alleys and homeless shelters are full of people with mental disorders who have not been able to function well enough to work or to create anything.

But when I consider the apparent link between mental illnesses and creative types – and especially the link between suicide and creative types – I do believe there IS a link, and I believe the link is causal. As a writer and a suicide attempt survivor, I was taken aback by this list of more than 400 writers who took their own lives. But I’m not surprised.

Writers (and other creative people) are in the habit of observing the world around them and reflecting on it. My husband recently made this very point. People who are intelligent, who notice things in their outer environment, and who spend time meditating on it may think too much for their own good, especially if they are noticing unpleasant things. These are people who see beauty and feel pleasure very keenly, but they also perceive pain just as keenly.

It’s also been my experience that creative people are very critical of themselves and their work. They’re rarely pleased or satisfied with what they have achieved. They constantly aim higher and higher, and they may reach a point where they can’t improve anymore – and they become depressed.

It’s also said that people with bipolar, in particular, are very creative because one of the effects of hypomania is a racing of ideas and a loss of inhibition. It’s not hard to see why this state would lead some people to be able to create fantastic things, and later suffer a crash and become dysfunctional.

After my diagnosis but before my attempt, I felt a certain romantic camaraderie with these depressed and suicidal creative people. I was bipolar, but as a writer, I was in good company. Now, I don’t feel so proud of the connection – in fact, it terrifies me. This is a trait I don’t want to share.

The other shoe. Friday, Sept. 17, 2010.

2010-09-17T11:36:00.001-07:00

“There cannot be a crisis today; my schedule is already full.” –Henry Kissinger

I just got off the phone with a colleague who is terribly upset. Her son, who’s only in his mid-40s, is having emergency quadruple bypass surgery tomorrow. A couple of days ago, one of my coworkers became a grandmother to a baby born two months premature.

Last week, another coworker was in her second car accident in as many months; neither was her fault. And yet another coworker is losing the home she and her family lived in for 20 years because their mortgage payment became unaffordable. She and her husband, their five children, a grandchild and three dogs need to find a place to live, pronto.

Shit happens.

There will be crises in our lives; of that we can be sure. We won’t know what or when, but they will occur. But for people who suffer from a mental illness, any crisis is like a double-whammy. We already feel anxious and depressed, sometimes even when things are going well. That’s our “default.”

So where are our energy reserves to deal with the big things? If our emotions are already in a bad way, what will we do when the other shoe falls?

I love the advice of so many books and websites that tell people with depressive and anxiety disorders to “reduce stress.” I can’t wrap my mind around that one. Who has an extra share of stress they can just freeze off like an ugly wart and flush down the john?

Who can tell their boss to make their work environment a little more peaceful? Or prevent their kids from being kids, or their mothers-in-law from being mothers-in-law?

And let’s say I can do those things. What’s to prevent the unforeseeable? My biggest concerns are around my job and finances. But what happens if my husband has a heart attack? If my mother’s cancer comes back?

I feel so brittle. I never handled crisis particularly well, but nowadays, I feel like I will shatter into a thousand pieces if something goes wrong. I feel like the top layers of my skin have been peeled off, leaving the raw nerves exposed.

It’s a scary feeling, being so vulnerable. I wish I could surround myself with a magical bubble-wrap that would prevent any disaster from hitting me or my family. Because when spilling a glass of fruit juice on the kitchen floor makes you sob for an hour, you get really fearful about how you’ll handle the big stuff.

Fuck bipolar. Thursday, Sept. 16, 2010.

2010-09-16T10:30:00.001-07:00

"Manic depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live." –Kay Redfield Jamison, author of “An Unquiet Mind”

Yesterday I sat in my doctor’s office and sobbed. I had been feeling better – not good, but better – but then I had started crashing again. I was dealing with side effects from the meds. Some changes I’d made that I’d been hopeful about hadn’t helped at all. And my life stressors were still the same. “I just want to feel normal, just for a day,” I told her, the tears running down my cheeks. “I’m so tired of feeling this way all the time.”

Three years ago I had lunch with a friend, Don, whose wife Sarah is severely bipolar. Sarah was in and out of the psych ward a couple of times a month. She alternated between being suicidal and being violent toward her husband and daughter.

My symptoms had never manifested in that way, but listening to him, I was so thankful. I’d been on the same medication combination for several years, and in general, life was smooth. I had recently requested that my doctor remove “bipolar” from my diagnosis. I was certain I had been misdiagnosed years before.

After all, I was only 16 when a doctor who barely knew me labeled me “manic-depressive.” I had felt pretty darn good for a long time, so obviously, the label was wrong, and I wanted it out of my records.

But later, all hell would break loose.

Today I finished writing a story for my publication about a group of women who have survived breast cancer. Every one of them fought for life, through disfiguring surgery and sickening chemotherapy. Each one of them looked forward to a day beyond their illness. They operated on hope that one day, they would feel better. And every one of them was grateful to be alive. They are proud to be labeled “survivors.”

Depression is a different kind of illness. Depression feels like “always.” Depression hides hope. Depression tells the victim that the only way to relief is death. Whereas people with potentially terminal illnesses do everything they can to survive, people with clinical depression feel too tired and discouraged to fight.

Fuck that.

I’ve had times in my life when I felt better. I’ve hit bottom, but I know there is a “better” out there, because I’ve experienced it. I want to be able to look back and say, “There was a time when I didn’t think I’d make it, but I did. And I’m glad.”

I want to wear the label of “survivor.”

Never been born. Wednesday, Sept. 15, 2010.

2010-09-15T13:02:00.000-07:00

“I sometimes wish I'd never been born at all.” –“Bohemian Rhapsody,” Queen

“I never asked to be born!” I yelled at my mother.

Maybe I was 12. I don’t remember what the hullabaloo was about. It could have been an argument about my homework or about keeping my room clean. Whatever it was about, I’m sure that almost every kid has pointed out this fact to his parents at least once.

Because it’s true. None of us ask to be here. Well, some people believe that our souls lay in waiting, choosing what body to be born in. But that doesn’t make much sense to me. I think we come into this world without anyone asking our preference or opinion about it. And when we become too old to be angry at our parents for bringing us here, and we’re in distress, we become angry at God for creating us in the first place.

I’d be lying if I said I never wish that I’d never been born. If I had never been born, I wouldn’t be dealing with bipolar, depression, anxiety, and suicidal thoughts. If I had never been born, I wouldn’t have needed to be hospitalized twice. If I had never been born, I wouldn’t have a job or finances to worry about. If I had never been born, I wouldn’t be a burden to my family. It all sounds so ideal. So what the hell am I doing here, anyway?

To answer the question, I have to step out of myself for a moment. I have to shut off the critical voice inside my head and the angry woman in the mirror that tells me that I’m a worthless waste of space, and try to be objective.

Let’s see. If I had never been born…

…My mother, who’d had several miscarriages before I was born and longed for a baby for many years, might have always sadly wondered what might have been.

…My father probably would have been divorced much earlier, and would have lived more of his life alone.

…Gigi may have been injured or died in a drunk-driving accident, because I wouldn’t have been at the party to talk her out of driving.

… Laurel may have married a boy she did not love, because I wouldn’t have been there to help boost her confidence.

…Dedree may have died in her dorm room, because I wouldn’t have been there to contact emergency services when she went into shock because of bulimia.

…A little boy whose name I do not know may have suffered more abuse, because I would not have been there to call the police.

…Several publications would not have won a number of awards.

…My husband might never have met his soul mate; our church might not exist; and our son would be someone else.

So I guess it’s good that I’m here, although it really doesn’t feel that way much of the time. The next time I wish I had never been born, I really need to remember the consequences of my not being here.

And the same goes for you. Most of the situations above were the results of something as simple as a conversation or a phone call. Whose life has benefitted by your birth?

Even-Steven? Tuesday, Sept. 14, 2010.

2010-09-14T10:52:00.000-07:00

“Life isn’t fair. It’s just fairer than death, that’s all.” ~William Goldman

Some years back, Rabbi Harold Kushner wrote a book, “When Bad Things Happen to Good People.” Kushner, whose young son had died of a devastating illness, asked the question we all ask when we suffer, especially when we did nothing to deserve it: Why me?

I’m waiting for a different book: “When Good Things Happen to Bad People.” Because I see an awful lot of that going around. Why them?

There are people out there who do bad things. They tell lies about others. They are greedy. They are selfish. Some of them even break the law and get away with it.

We can wait for the scales of justice to tip, but the truth is, it doesn’t always happen. Sometimes, despite it all, these people wind up with good jobs in lovely homes and with nice families.

One person tried for years to ruin my life and the lives of the people I cared most about. She told lies about me and my family, and her behavior affected every aspect of my life: my relationships, my job, and my finances.

It may seem petty, but I had always comforted myself with the thought that one day, she would get her comeuppance. One day, I thought, she would get what was coming to her. One fine day, she would suffer, and I would revel in it.

I recently heard how she’s doing, and my fantasy bubble has popped. She’s become quite successful. Her spouse didn’t leave her. Her career is going well. God didn’t even smite her! Where’s the justice?

To be fair, I don’t know what she’s like on the inside. She could be miserably depressed. She could detest her outwardly perfect life. I don’t know. I just know that she’s not wearing a sackcloth, living deserted and alone, like I’d pictured in my mind. And I’m ashamed to admit that I feel angry and depressed about this.

The Bible tells me to bless my enemies. The truth is I’ve had very, very few enemies in my life, and not a lot of opportunities to practice that commandment. I guess I have one now.

Nine-Eleven. Saturday, Sept. 11, 2010.

2010-09-11T21:32:00.001-07:00

"All of a sudden there were people screaming. I saw people jumping out of the building. Their arms were flailing. I stopped taking pictures and started crying." – Michael Walters, a freelance photo journalist in Manhattan

This photo shows the image I still have in my mind when I think of Manhattan’s skyline. A New York without the Twin Towers still seems unreal, nine years later.

Today, Sept. 11, 2001 seems like the beginning of my nation’s decline. As a result of this cowardly act, in which thousands died, America got tangled up in two wars that would go a long way toward bankrupting our nation and destroying the world’s respect for us. Our rights as citizens would be curtailed, and the majority’s tolerance for minorities, especially religious minorities, would evaporate. In some ways, sad to say, the terrorists “won.”

There are many haunting images from that day, but perhaps the worst are those of the people who had jumped from the building, falling to the ground below. Dozens of those who died that day were killed in this way. Try to imagine what went on in their minds in the moments before they leapt – as flames descended upon them, they had to choose whether they preferred to burn to death or smash into the pavement.

No one referred to these deaths as suicides – although, technically, they were. But these victims faced certain and immediate death either way. As a suicide attempt survivor, I cannot pretend to have the slightest idea what it would be like to have to decide whether or not to jump or burn; but I do understand what it’s like to believe that death is my only choice.

I don’t think anyone who attempts suicide believes they are making a “choice.” They believe that living is impossible because they believe that it is impossible to live without pain, and it’s the pain that they want to stop. In fact, it’s not so much death that they seek, but an end to pain. The phrase “Suicide is a permanent solution to a temporary problem” rings false, because they believe their pain will be eternal. So the “choice” they face is constant, lifelong pain – a sort of living death – or a final death.

In that way, people who attempt to end their lives are not so terribly different from the people who leaped from the World Trade Center. They faced an intolerable choice, and they wanted their pain to end quickly.

Objectively, of course, we know that their situations are different. The pain of someone who is clinically depressed or in a terrible situation might come to an end in a non-lethal way. They might be able to undergo treatment, or they might be able to find a way to change their lives, and six months or two years or a decade later, they might look back and be very thankful they did not die. The 9-11 victims would never have had that opportunity.

But from the vantage point of someone whose life feels, at that moment, like a living death, the question of fire versus pavement might seem eerily familiar.

Suicide Prevention Day. Friday, Sept. 10, 2010.

2010-09-10T05:48:00.001-07:00

“There is but one truly serious philosophical problem and that is suicide.” – Albert Camus

When I attempted suicide, I unwittingly joined a very large club. According to the World Health Organization, about 3,000 people worldwide commit suicide every single day – and for every such death, there are at least 20 attempts.

Some points to ponder today, World Suicide Prevention Day, from a variety of sources:

• 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.
• Suicide rates in the United States are highest in the spring. (It’s a myth that the highest suicide rates are during the Christmas holidays.)
• Over half of all suicides are completed with a firearm.
• Suicide is the third leading death for young people ages 15-24.
• Suicide rates among the elderly are highest for those who are divorced or widowed.
• 15% of those who are clinically depressed die by suicide. However, 80% of people that seek treatment for depression are treated successfully with medication and/or therapy.
• The highest suicide rate is among men over 85 years old.
• Suicide is the 11th leading cause of death in the U.S. (homicide is 15th).
• An average of one person dies by suicide every 16.2 minutes.
• There are four male suicides for every female suicide.

As we experience this day, let us reflect on our own pasts, on the fact that we are alive, and on working every day to maintain health so that we each have a future.

Peace/Love, Alizah. <3

Help Yourself. Thursday, Sept. 9, 2010.

2010-09-09T11:13:00.000-07:00

“The Lord helps those who help themselves.” – NOT in the Bible

If you have strep throat, you need to take antibiotics. It helps to drink a lot of liquids and get a lot of bed rest, but other than that, there’s not much you can do to help the healing process.

If you have clinical depression, or any other mental illness, it’s very different. The onus is on you. You can go to therapy, and you can take medication, but there is one hell of a lot of work involved in getting well – and complete recovery is seldom in the cards.

Maybe that’s why mental illnesses are so often viewed as moral failings. “If she only tried harder …” “He needs to help himself …” “Stop wallowing in self-pity…” “Happiness is a choice!”

The problem with such statements is there is some truth to them. Those of us who struggle with mental illness are correct in identifying our problem as an “illness” that is not our fault. But it doesn’t follow that we can be passive, waiting for someone or something to come along and “make us better.” There is no Wellness Fairy that can sprinkle us with pixie dust and take our depression and anxiety away.

This sucks. It’s why I have so often begged God to take my bipolar away and replace it with some visible, physical disease – something that no one can look down at me for having. Something with a simple cure that will disappear with the right injection.

That said, there is another problem with such statements: they are overly-simplistic, and often condescending and hurtful. When I was very sick, I was told that I was being selfish and choosing (even wanting) to look on the dark side of things. I wanted desperately to get well, so I sent away for several books on Cognitive Behavioral Therapy (“Mind Over Mood”).

The problem, these books told me, was in the way I was thinking. And fixing it was supposed to be simple – just replace negative thoughts with positive ones. David Burns MD’s books informed me that the chemical imbalance theory of depression is a myth. I filled up more than seven notebooks with my “cognitive distortions.” At one point I was writing in my cognitive distortions journal every half-hour.

I tried. I tried. I tried. I wound up in that motel room.

So is it my responsibility to get – and stay – well? Yes, it is. It’s my responsibility to see my doctor, be honest with her, take my medication, eat properly, get enough sleep, write my blog (which is part of my healing process), and – yes – work to keep negative thoughts in check. There is a place for cognitive therapy.

But there was a time when I WAS too sick to help myself. And I don’t care what anyone says – I did not want to feel like I did, I did not choose to feel like I did, and I was literally unable to change my thoughts and feelings.

Recovering from mental illness does require you to make the effort to climb out of your own hole. But sometimes, you do need help to find the ladder in the darkness.

It’s not OK to hit. Wednesday, Sept. 7, 2010.

2010-09-08T08:20:00.000-07:00

“The man who strikes first admits that his ideas have given out.” ~ Chinese Proverb

One of the earliest lessons we learn in life is that it’s not OK to hit. It’s not OK to hit mommy, or your big brother, or the dog.

But many of us learn another lesson at the same time – it’s OK to BE hit by someone bigger than you.

Confusing? I think so. Much as I don’t want to turn my blog into a soap box against spanking children, I just can’t ignore the connection I see between being hit in childhood and growing up to either hit others or accept being hit by them.

Certainly, it doesn’t happen all the time. Most people who smoke don’t get cancer; most people who drive without seatbelts don’t die in a wreck; most people who grew up with lead paint in their home don’t develop brain damage. It’s the “I grew up … and I turned out OK” argument.

But a significant subset of people who grew up being physically “disciplined” become men or women who either batter or are battered. Once hitting is justified, I believe, it becomes a slippery slope. Moreover, it’s unnecessary. It’s very possible to raise loving, thoughtful, well-behaved children without hitting them; it just takes a little more thought.

Someone I care about very much has been hurt badly by someone who claimed to love them. It doesn’t really matter whether my friend is male or female. Statistics actually show that women in relationships batter their partners at about the same frequency that men do; the difference is that men are larger and stronger, and tend to cause more severe injuries. And there is domestic violence in homosexual and lesbian relationships as well.

It doesn’t really matter whether my friend or married or single; a battered partner can feel (or actually be) trapped and unable to end a relationship for any of a number of reasons, whether or not there is a marriage certificate. The question “Why don’t you just leave?” can have very complex answers. And the most dangerous time in any relationship is when the abused person separates from his or her abuser.

It doesn’t really matter whether my friend “did something” to “cause” the abuse. Beating someone is never justified. We can argue about what constitutes “emotional” or “verbal” abuse, but once fist meets flesh, all of that is moot. It’s not OK to hit someone. Does someone provoke you? Walk away.

The Washington State Domestic Violence Fatality Review notes a strong correlation between domestic violence and suicide. Not only are abuse victims more likely to commit suicide than the average person, but so are abusers. Most tragically, the abusers often take their partner and children out with them when they go.

I hope my friend can find safety from the person who has hurt them. And I hope that person realizes that it’s not OK to hit. Maybe that person learned in childhood; I don’t know. But someone who abuses someone I care about abuses me as well.

Fatal self-attraction. Tuesday, Sept. 7, 2010.

2010-09-07T10:48:00.000-07:00

“The smaller the mind the greater the conceit.” – Aesop

Know what I think is weird? That some of the most beautiful, intelligent, talented people I know feel badly about themselves, while some of the most ignorant and boorish people I know have a little too much self-esteem. What’s that about?

One might think that if a little self-esteem is a good thing, a lot might be better. But it ain’t necessarily so. It is very possible to be deluded into thinking one is smarter than one is, more interesting than one is, more attractive than one is. I know this is true because I’ve met some of these very people. And the results can be devastating.

Parents who care about their children’s self-esteem may nurture it in one of two ways. They may help their kids to have a realistic sense of their importance, talents or abilities. Or, they may shower constant praise, shielding their kids from some unpleasant truths: None of us is more important than anyone else in the world. And we’re all good at some things but inept at others.

A friend of mine, Stefan, was born into a family of sisters – I think he had five of them. He was the youngest, and, I imagine, the prize their parents had been hoping for. When I met him, I was in high school and he was 10 years older than me. He became a good pal of mine – not a boyfriend; I found him too annoying.

Stefan was fixated on his appearance; he was cute, but by no means gorgeous. He was obsessed with his great intelligence; he was bright, but by no means the sharpest crayon in the box. He got fired from job after job, because the bosses he worked for, he believed, never appreciated him. He was the cat’s pajamas, or at least he thought he was.

Unable to secure long-term employment, Stefan finally went into the military. Basic training may have knocked him down a notch or two; I’m not sure, because I didn’t hear from him very often after that. Within a few months, he’d met a young girl out west, 15 years his junior, and married her only a few weeks later. In less than a year, he had a baby boy, and the girl had left him, disappearing with their son. Stefan disappeared too; his phone number was disconnected, and my cards to his address came back “UNABLE TO FORWARD.”

Around 2 a.m. one morning, my phone rang. It was Stefan, and he was drunk.

“You know the bitch left me, and she took Justin with her,” he slurred.

“I heard,” I mumbled, wiping the sleep from my eyes. “I’m sorry, Stefan. What happened?”

“I said. She was a bitch,” he spat. “She was a stupid bitch. And I’m going to find her. And when I find her I’m going to kill her. I’ve got a closetful of guns. And after I kill her, I’m going to blow my brains out.”

“Where are you living now?” I sat up, alarmed.

“You think I’m going to tell you that? Then you’re a stupid bitch too. This is the last time you’ll hear from me. Because we’ll all be dead. I hope you’re happy!” He slammed the phone down.

The next day I attempted to locate his family. This was in the days before the Internet, and I had few options for tracking people down. Many years have passed. I was never able to locate his parents, who had moved; nor was I able to find out where he was stationed (he had a very common last name). I had to let it go.

I never did find out whether Stefan killed the mother of his son, and/or himself. The only thing I know is that Stefan was up so high that when he fell, he had a very, very long way to go.

Labor Day. Monday, Sept. 6, 2010.

2010-09-06T10:28:00.000-07:00

“Oh, you hate your job? Why didn’t you say so? There’s a support group for that. It’s called EVERYBODY, and they meet at the bar.” – Drew Carey

Today, people in my country, the United States, celebrate a national holiday called Labor Day. Labor Day was founded more than 100 years ago by our labor movement, and is “dedicated to the social and economic achievements of American workers.”

It’s a bittersweet holiday this year, as our nation now has an official 9.6% unemployment rate – and that number doesn’t include people who have run out of unemployment benefits, who never had benefits in the first place, who have given up looking for work, or are working at a job far below their educational or experience level and still can’t pay the bills.

People who have crunched those numbers come up with a much higher figure – as of today, 21.5%. Essentially, we’re looking at figures similar to The Great Depression of the 1930s. And many of those people who are fortunate enough to be employed right now are like me – they’re worried about the future of their own employment as the Recession continues on and on. Or, they are trapped in jobs they detest, in bad working conditions, because they can’t find anyone else who is hiring.

All of this is scary news to people who care about suicide. According to John L. McIntosh, a psychology professor who researches suicide trends at Indiana University, “There is a link (to suicide) with circumstances that come along with a Recession, such as unemployment and home foreclosure … People who have lost their jobs commit suicide at rates two times to four times as high as those who are employed.”

In addition, health insurance is tied to employment in America. People being treated for depression, and perhaps being stabilized on medication, usually lose their health care when they lose their employment, making a bad situation worse and potentially more deadly.

Speaking of health care for those with depression and other illnesses, many American states lack “parity” laws, which means that many people can work and have health care benefits, but those benefits do not include mental health care. And once someone has been diagnosed with any mental illness, that illness becomes a pre-existing condition – which means that an individual might be unable to purchase health insurance at any cost. Some of these laws are changing, but not in time for people now in crisis.

It’s scary out there, in many ways. And it doesn’t look like things are going to improve soon. As we celebrate Labor Day this year, I ask anyone with a stable, secure job they enjoy to thank God for their situation. For those concerned about layoffs, or unhappy with their positions, I hope you can research other possibilities. And for those that are jobless, I pray that and that you find employment soon … and that you will hold on to life.

A precious life. Sunday, Sept. 5, 2010.

2010-09-05T13:38:00.001-07:00

“Life is too precious, do not destroy it. Life is life, fight for it.” – Mother Teresa

A month or so after my attempt, I was in the office when I heard my husband out on the patio saying, “I don’t know what to do. I don’t know what to do.”

I went through the patio door and found him bent over the bushes behind the house, looking terribly concerned. I followed his gaze, and there she was – the tiniest bunny I had ever seen.

She was all alone, and far from anywhere where there may have been a nest. It was obvious she had been abandoned, or had at least gotten lost. She was frozen in place, her heart beating so fast I could see it through her brown fur. She was about the length of my finger.

“I don’t know what to do,” repeated my husband. “I don’t want to leave her here. There are birds of prey all over.”

Instantly I was in love with her (and I don’t know why I call it “her” – she just seemed female to me). She had tiny ears and giant black eyes. There was a tiny star-shaped white spot on her back. She was the very picture of vulnerability, and I wanted to save her.

“Do we have any milk?” I asked our son. He checked and said we did. We don’t own an eye-dropper, so I asked him to pour me a small saucer full. I tried to give her a drop on my finger, but she wouldn’t take it.

“What about lettuce?” I asked. “No, but we have strawberries. Want one?” “Sure, bring one down.”

I put the strawberry in front of her, to see what her reaction would be. She nibbled on the greens – that was good news. After she nibbled a couple of them, I pulled the rest off and placed them in front of her, but she wasn’t interested in more.

My husband brought me a soft towel, and I picked the bunny up and put her on my lap. She tried to walk a bit, but she seemed either injured or very weak. It was getting windy out, but bringing her inside was out of the question – we had two cats, and even if we locked the cats up, the smell of the cats would probably terrify this little bunny.

I asked my son to check online to find out if there were any organizations or services that would take an abandoned bunny. He checked local shelters and animal rescues, and in each case the answer was no. Two of the sites also included warnings that infant rabbits almost never survive human captivity, no matter how well intentioned.

So I sat outdoors with this little bunny in my lap for hours. I stroked her tiny back and memorized her markings. I talked gently to her. At that time, her life seemed more precious to me than my own. I did not want her to die. I desperately wanted her to live a bunny rabbit life, stealing carrots out of our garden and hopping through our flowers.

When it grew dark, I put her back under the bush and came inside. The next morning I checked first thing, and she was gone.

Months later my husband was looking out into the back yard, and called out, “Look who’s back to visit you!” There was a brown bunny hopping around beside our garden. “It’s the baby!” I said, and my husband agreed, “I’m sure it is.”

Of course, we both know that most likely, our sickly baby bunny had met an untimely end in the claws of a bird or the paws of a feral cat. But I let myself believe that our visitor was THE baby bunny. Because her little life was precious to me.