As Winter Approaches

Just a few thoughts at the darkening of the year. This is a hard time for many of us. First and foremost, days are shortening. In America, we have exited Daylight Savings Time, so instead of the long slow dusk we’ve been used to all summer, it’s pitch black before we even get our dinner. The warmth is leaving, and the holiday season is coming with its heavy expectations. Those who have family or community that they feel good about can snuggle up to them right now, but many of us feel the lack of close ties or gifts or abundance; so the whole season registers as a reproach, a scenario we “should” be living up to but aren’t.

This is the time to pull out your whole wardrobe of anti-depression strategies, because you’re going to need them. There’s exercise, number one - which you actually need more of to balance all that comfort food and indoor hunkering. There’s finding access to light, whether you sit by a window or invest in full spectrum bulbs or just put Christmas twinklers on your mailbox. There’s music - not necessarily Christmas music (I think it’s too early, anyway), but something to stir the blood a little. And there’s color. Don’t retreat into a brown and grey world just  because Winter’s coming. Bring out sweaters or quilts or pillows in your favorite bright colors to spice up the days. Wear them, sleep in them, sprinkle them around your home. It doesn’t cost any more to buy a bright color than a dull color, and it gives an immediate lift to the spirits. Nature herself approves of this: She brings out the brilliant reds and golds the minute Fall hits. Your environment doesn’t have to be drab just because the weather is.

This is a good time to cultivate beauty of all kinds. Walk through a gallery or museum or a pet shop full of brilliant exotic fish or birds. Attend that movie that’s billed as sheer eye candy. Drift through a lot full of sleek shiny sports cars. Now is the time to find the indoor beauties we have perhaps been neglecting.

It’s time to cuddle up with a good book or audiobook, or your cat or dog, or your knitting or whittling or DVDs.Take up meditation or mosaics. It’s time to shift focus. That’s not bad. It’s just an effort.

And speaking of shifting focus, I had an experience today that I’d like to share. I hope I can do it without sounding like Pollyanna Purebread. Today was a bad day for me mentally until about 2 in the afternoon. I was angry, irritable, grim, emotionally in the bottom of the ashtray. There was no reason why (which suggests to me that it was purely symptomatic). At some point, driving my car, I said to myself, “I don’t want to feel this way. What can I do to feel different?” I had taken my pills. I had gone for a two mile walk. I had treated myself to tea at Peet’s. I didn’t know what else to do for myself.

Suddenly it occurred to me that my brain (and emotions) were insisting on telling me everything that WASN’T ideal, when actually there was a lot that was good about the day. I remembered an old 12-Step tool and started listing, out loud, the things I was grateful for, starting with the fact that I was in a car instead of on public transit. And you know, once I started listing things, I just couldn’t stop. There were so many things, tiny things and big things, that could have been worse. By the time I arrived at my destination, I felt great. It completely changed my outlook - so far, for the remainder of the day.

Now, I am the first person to roll my eyes when people urge me to “think positive.” There are times when life is not positive, there is nothing positive to think about, and I’m not going to force myself into an emotional lie. But I see that shifting my focus from things that are wrong to things that are right is a completely free and easy way to improve my state of consciousness. And as those of us with diagnoses know, state of consciousness is everything.

I make no promises, but this sounds like a method I want to add to my toolbox. I offer it to you, for what it is worth.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, available at Amazon.com, Kindle Editions, iBookstore, and other major vendors. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.

For Gals Only

I know I promised a further exploration of Anosognosia, but I’m taking time out for a medical heads-up. Ladies, menopause may be dangerous to your mental health, and going hormone-free might not be one of your viable options.

I noticed a couple of years ago that I was destabilizing rapidly and had no idea why. In a few months, it felt like I had been dropped back into hell - I was in total misery, as vulnerable to symptoms as if I were taking no medications at all. When I started feeling suicidal, my husband and I talked it over. We determined that the only physical change in the last few months had been the cessation of my periods. This meant a massive drop in hormone levels, which might reasonably be responsible for what I was experiencing. So I started on a small dose of hormone replacement therapy, and Bingo! Within two weeks my symptoms receded to previous levels.

Here’s the kicker: it looks like I may not be able to get off them. Just recently my new GP reminded me of the possible link between certain cancers and HRT, and asked me to cut my dose in half to see if I could tolerate it. Within days, I began to feel depressed and experience anhedonia. In less than a month, I was suicidal once more. So much for that experiment.

I know there are a lot of women who just don’t want HRT, or only for a short while at most. They may be justly worried about long term effects, or they may simply want to go the natural route. This may be a choice you will have to face: which do you want to preserve, your mind or your body? It is a very personal dilemma.

For myself, I would rather have cancer temporarily, at the end of my life, even if it shortens my life, than the torture of psychiatric symptoms in a healthy body for years on end. I would rather be in a medical hospital at the end of my life than in a mental hospital for large portions of my golden years. You may feel differently. That’s fine. But I am already accustomed to a permanent regime of pills that may be harmful to various parts of my body. I find that one more risk is acceptable to me. I made my choice long ago: I would rather be sane. No matter what.

I’m not trying to influence anybody in this decision. Just be aware that if you are female, and you live long enough, this choice may be coming your way. Hormones can have a profound effect on our mental condition. One way or another, expect some rocks in the road.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She is currently recording it as an audiobook and CD set.  Her books are available at Amazon.com, Kindle Editions, iBookstore, and other major vendors. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.

“I’m NOT sick!”

I’ve been out of town, which made this blog very late - but when I came home and checked my mail, I learned something very interesting. My monthly NAMI newsletter had an article on a mental health condition I did not know existed.

Whenever I speak in public, I am sure to meet at least one audience member who tells me a variation of this sad story: My son/sister/brother has been schizophrenic/bipolar for 20 years. He/she won’t take medicine or go to the doctor, no matter what we do. How can we get through to him or her? We’ve tried everything!

I’ve never had a good answer. I still don’t. But at least now I can tell them what’s going on. It’s a neurological syndrome called anosognosia. The name means “to not know an illness” and it is often nicknamed “lack of insight.” People with anosognosia have actual physical damage to one or more structures in their brains which prevent them from being able to understand that anything is wrong with them.  It is not denial, stubbornness, or fear of stigma. It is anatomical damage to one or more parts of the brain and/or the connections between them - specifically, the part that allows you to think about or observe yourself. And it is NOT caused by medications: it is caused by the disease itself.

Anosognosia is also a problem with other brain dysfunctions, such as stroke, Alzheimer’s, Huntington’s or certain brain tumors. A stroke patient with anosognosia will literally swear that nothing is wrong with him even though the entire left side of his body is paralyzed! This is not a new problem or a new finding; the only new element is acknowledging that it happens to the mentally ill, as a result of the many studies that have taken place since the late 1990’s.

The damage seems to be connected to the experience of psychosis. Current figures show that it affects 50% of schizophrenics and 40% of bipolar patients with psychotic features. That is a whopping percentage! And it explains a whole lot.

Think about it. All of these people are UNABLE to comprehend that they are ill, therefore they are UNABLE to consent to or carry out treatment. According to recent surveys, this condition is the number one reason for medication noncompliance, number two being substance abuse - not side effects or lack of access, which lurk somewhere around fourth or fifth on the list.

Naturally this has profound implications for mental health policy and practices, which I intend to take up in a later blog. It is enough to point out now that when patients are given mandatory medication, they are sometimes able to regain some ability to understand their illness. Stop treatment, and that benefit goes away. So where does that leave the debate on the unfairness of mandating treatment for people who don’t want it? What does that mean for the opponents of Laura’s Law?

I’ll leave you with a great website for more information, and add it to my links:
www.treatmentadvocacycenter.org/problem/anosognosia

Please check out this very enlightening series of pages.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She is currently recording it as an audiobook and CD set.  Deborah has also published two novels. Her books are available at Amazon.com, Kindle Editions, iBookstore, and other major vendors; or you can order them from your local bookstore. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.

Letter to the Editor

In the town where I live, on September 4, 2012, a Highway Patrolman, Kenyon Headstrom, was shot by a man named Chris Lacy. Headstrom later died of his wounds. Lacy died at the scene. It has since come out that Lacy was Bipolar, and local papers have treated this story as if  Bipolar Disorder made Lacy automatically violent; as if the shooting were inevitable because of his condition. This is my letter to the editor about the stigma engendered by that terrible event.

I am one of the mentally ill of Contra Costa county, and I am saddened by reporting that seems to assume that Chris Lacy killed that brave officer because Lacy was bipolar.  Yes, he killed. Yes, he was Bipolar. But the two descriptives aren’t automatically connected. People only hear about us when we kill somebody. This is the image the public has of mental illness, and it scares everybody without helping a thing. It adds terror and stigma to a tragedy that is surely bad enough already!

I have been bipolar for forty years; I own a gun for self-defense; I even have the bad temper that goes with my red hair. But I have never slapped or hit or shot anybody.  I write books that help others with their mental health. I sometimes speak in public for the National Alliance for the Mentally Ill, in their anti-stigma program, “In Our Own Voice.” This is how I contribute to society.

 Here’s what most people don’t know: the average percentage of violence among the mentally ill is lower than the average percentage of violence among the total population. For years I supported myself by reading to the blind; I read that statistic in the standard study guides that my mentor, Dr David Kallinger (clinical psychologist) used for oral exams he took before obtaining his PhD. This is not obscure information: it is available to every clinician getting ready to obtain his license. Dangerous criminals among the abnormal are the exception rather than the rule (Corrigan & Watson, 2005). Most of us turn our violence against ourselves, not against others.

But it doesn’t fit the public paradigms. If a person does something that awful, they MUST be crazy, right? Crazy is the only explanation, isn’t it? The frightening truth is that most violent crime is committed by individuals who have no mental illness. They are reasoning, ‘sane’ individuals who think this course of action makes sense.

That statistic wouldn’t sell any papers, though. So you won’t hear about it. As a psychology teacher of mine used to say, “Mental Patient Lives Quietly, Dies Peacefully” just doesn’t work as a headline.

It is true that some mentally ill individuals commit terrible crimes. We have seen two examples just recently. I cannot say how sad they make me. But there are terrible, violent, tragic crimes EVERY day, and most of them are committed by “normal” individuals. It is not sensible to think that anyone with a mental illness is automatically dangerous, and it simply is not borne out by experience or statistics.

When we think like this, we are assuming the worst of human nature. We are assuming that when  brain wiring goes wrong, its first order of business is to attack others. And that is just incorrect. Most of us are just trying to get through another day, and get the care we need from a reluctant mental health system. What society can do to stop crimes like this is stop being afraid and concentrate instead on making sure health systems are responsive, giving thorough and prompt help, instead of abandoning people to stew in their own juices, locked in the prison of their minds with no way out.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She is currently recording it as an audiobook and CD set.  Deborah has also published two novels. Her books are available at Amazon.com, Kindle Editions, iBookstore, and other major vendors; or you can order them from your local bookstore. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.

In Search of Silence

I am looking for silence. I have been looking everywhere for a long time.

Not the silence that falls between two people in the middle of a fight. That is fraught with unspoken words, prickly ones in the air like allergens, irritating all the psychic senses. It is a relief when someone finally snatches at the subtext and speaks.

And not the silence of Nature, though a quiet forest is a great relief. But that is a silence filled with living. That is beetles and boughs and rodents going about their business with no regard to the mute observer.

And not the silence of cities, the void that yawns beneath traffic noises and jackhammers, beneath change machines and coffee cups clinking, beneath jukeboxes and beer bottles - the sterile emptiness where no communication is going on, no one is really connecting.

I mean the deeper inner silence of the soul, something that could speak but chooses not to. I mean the silence of a peaceful mind. It is something the mentally ill seldom experience. I haven’t seen it since childhood, myself.

I remember watching dust motes as they danced peacefully in a window embrasure. I must have done it for minutes on end. Just looking, fulfilled and timeless, my mind suspended and turning slowly, like they were doing. Nothing else existed at that moment.

I remember sinking backwards beneath the bath water, eyes open to the wavering fairy light, ears reverberating with the amplified tap of my fingers on the tub wall.

I was not thinking then. I did not have to. Those were good days. But they ended with the advent of hormones, for me. I became bipolar at puberty.

The mystics say that the true center of every soul is a vast and spacious stillness, laced with stars and smelling of forever. I have lain in meditation time after time and tried to reach it, following my breath, counting inhale and exhale, shut off from everything else in the world. There comes a moment when that silence sidles up to me, nudges me softly and whispers, “Stop counting.”

Maybe, for an instant, I do.

Immediately the brain starts screaming in terror. “My God!” it says, “We’ll explode out of our body and disappear! Don’t do it!” And then the yammering starts again, the ceaseless yammering on any subject and none - the aimless, hopeless, pointless gossip of the mind that drove me to meditation in the first place.

I have looked for silence in anti-psychotics, but the moment I seem to grasp it, savor its  texture, I fall asleep. So I search for it in sleep, but I dream and snore. I have listened for it under great music, and sometimes heard it between two beats.

And I wonder if the brain is right, if I really would pull up anchor from my body and sail away if I found that still center. Leaving the chattering brain behind, all by itself in a jar, spinning wave after wave of spurious story, believing itself an ocean.

(Thanks to the women in my creative writing group, who nominated this piece for my blog)

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She is currently recording it as an audiobook and CD set.  Deborah has also published two novels. Her books are available at Amazon.com, Kindle Editions, iBookstore, and other major vendors; or you can order them from your local bookstore. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.
www.islandjourneycd.com

My Diagnosis

My astrology chart shows Neptune in the 6th House at the time of my birth. In other words, I was born to have a mysterious illness that would be difficult to diagnose. I was 26 when at last someone told me I was manic depressive.

My response was, “Finally! Something that makes sense!” Because I had known for a long time that the world I saw and reacted to was not the same as the one everyone else did.

Insanity, if one dares to use the word, is hard to pin down, hard to tell someone, and usually hard for them to hear, my experience not withstanding. Some people will be told over and over for the rest of their lives without ever believing that it’s true. Hardest of all, even if they do believe, is to get them to start treatment.

Why is this? Why do we find it so hard to believe that the world inside one person’s mind is not the same as that of everybody they are standing with?

I remember long summer gabfests between college semesters. We were always batting ideas back and forth languidly, like a ping pong game where nobody was keeping score. The only point was to stay out in the garage away from the ‘old’ people. Time and again the conversation turned on existence and perception: how do we know that anything outside us exists? How do we know that we exist? How do we know that two people who say “blue” are actually seeing the same color? Maybe their blue is my green, or puce for that matter. All we know is that we are giving it the same name, that we both perceive something.

I never found it much of a stretch to believe that my head was different. After all, I’d been told over and over again that I was too sensitive - that I was uptight - that I was too serious - that I was way too dramatic - no matter what the stimulus, someone somewhere would say my response was too big, too little, or flat out wrong. Yet I was only reacting naturally to what I saw and heard. Obviously they were seeing, hearing, feeling something different. Theirs was a blander, less upsetting world, without tricky double meanings and barbs in every casual glance.

With time, with medicine, I learned to react less, to pretend to be less upset and in pain. Within a few decades, I was able to convince the most exacting critics that I was no longer scary and abnormal. And now, with 40 years practice, I have come to understand that everybody’s universe is different, that no one lives on the same planet, that our entire lives are a holodeck geared to the needs of just one person. The miracle is that any of us see anything remotely the same. And language, a shaky tool at best, is often the only thing that allows us to think we have so much in common.

Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She is currently recording it as an audiobook and CD set.  Deborah has also published two novels. Her books are available at Amazon.com, Kindle Editions, iBookstore, and other major vendors; or you can order them from your local bookstore. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.

Info for the Bipolar

This week I just want to tell you about a resource, International Bipolar Foundation. They’ve been around since 2006, but they’re new to me. The website address is exactly what you would expect it to be: www.internationalbipolarfoundation.org. They are involved in supporting bipolar education and research, and enhancing various support services such as housing. Such enhancement includes support groups per se, if you happen to live near San Diego, California. They also list some interesting sounding online communities to check out.

I am impressed by their monthly newsletter, which is full of ideas, tips, news about bipolar people in the public eye, and updates on the latest research in the field (see my previous blog for a sample topic). You can subscribe at: http://conta.cc/eyK0ra.

They also have a book, Healthy Living with Bipolar Disorder, which you can get FREE as a pdf for the asking. It’s also available on kindle for $1.99 - there’s a long URL but if you type the title in Amazon’s book search box it comes up right at the top.You can also get a hard copy, but for that you need to pay shipping, which comes to $12 U.S. and $25 international. I’ve downloaded this book, and I have to say what I’ve read is quite factual. There is a good section on the drugs commonly used, how they operate, what their drawbacks are, and even how they work in the body if that is known. They don’t stint on including side effects, either. If what you want is solid information on standard treatment, this is a good place to start. And what can you lose when it’s free, right? (If what you want is more practical, how-do-I- LIVE-with-this advice, though, you’d be better off reading Is There Room for Me, Too? Just saying).

Here’s their snail address, and I’ll add their link to my list on the right:

International Bipolar Foundation
8895 Towne Centre Drive, Suite 105-360
San Diego, CA  92122

 They host lectures and post them on the website the following week, hold webinars, have a buddy program, speakers bureau and outreach and referral program, anti-stigma campaigns, and more. Seems to me with this much activity, they must have something you could use... if bipolar is your thing, check them out.


Deborah is a public speaker and the author of Is There Room for Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. She is currently recording it as an audiobook and CD set.  Deborah has also published two novels. Her books are available at Amazon.com, Kindle Editions, iBooks, and other major vendors; or you can order them from your local bookstore. Visit her web page at www.lafruche.net, or see her catalog at www.lastlaughproductions.net. She has also narrated a guided meditation CD with her husband, musician Robert Hamaker. Check out sound samples at www.islandjourneyCD.com.