Depressed about the economy? It's healthy.

Is it possible for a country to lose its mind? Go insane? Crazy? Mad?

Following the bizarre shenanigans to the south, I can’t help but think that if this was a movie, it would be either outrageous comedy or political-horror-disaster all wrapped up in one. No one would believe it.

No wonder several of my muses on the blogosphere are taking the day off, shutting down their computers, and trying to recharge. The economy is depressing them.

I won’t even mention their pathetic Republican Vice-Presidential candidate, who mangles the English language so masterfully the media don’t really know what to do with her. As far as I’m concerned, they’re all too kind.

It’s this business of becoming depressed over the economy.

Several weeks ago, in the venerable New York Times, an opinion piece by Ronald Pies, a professor of psychiatry at Tufts and the State of New York Upstate Medical Centre, suggested that normal sadness should be considered “clinical” depression and medicated.

That “normal sadness” – like grieving the death of a spouse – needs an injection of some chemical concoction to juice up the serotonin levels of the brain’s neurotransmitters to cheer people up. Sadness? Depression? Let’s just smooth them all out so everybody feels “numb and up.”

I’ll never forget what David Kendall told me once. He’s a brilliant journalist and a damn fine writer. We worked together for years at The Toronto Sun.  “The best writing comes out of sadness,” he use to say. I would venture to guess the best art comes from extreme emotion. Anger, rage, misery, despondency.

How would Van Gogh would have fared on Zoloft or Paxil. Would we still have “Starry Night” or just some lovely little landscape. Hemmingway may not have shot himself, but would he have written his tough, spare, piercing prose?

Years ago, before all these drugs had conquered psychiatry and quashed the fine art of psychotherapy, I went to a psychiatrist named Jack Birnbaum. He did group therapy. Dr. Birnbaum, who died two years ago, started out as a family doctor in the days when GPs made house calls.

When he found he was spending so much time sitting at kitchen tables listening to the emotional and psychological woes of his patients, he went back to school to become a psychiatrist.

He wrote many books, including “Cry Anger” and one of his philosophical underpinnings was that sadness was anger turned inward. We sweated it out in his group sessions hitting pillows with tennis rackets. The pillows usually represented people we were angry at but made us feel sad. It felt great whacking the hell out of them. Maybe it was the exercise that hiked our serotonin levels, but I think not. We were exercising our anger, something our society rarely gives us an opportunity to do – outside of a gym. We have to control our anger. So we get sad instead of mad. Not healthy. That was his contention, anyway.

Emotions are healthy. They make us human. Without them, we turn into robots. We die inside.

Understanding our emotions. Learning to live with them. Managing them is all part of being responsible human beings. I don’t want to lose my rages and my temper and my passion. Emotions are passion. Without passion, where is creativity?

It’s a question of cause. What comes first? The chicken or the egg? The depression or the Depression?

This week, Philip Dawdy introduced an amazing new blog – chemicalimbalance.org – on his blog Furious Seasons. Created by Jonathan Leo, an osteopath and dean at Lincoln Memorial University, and Jeffrey Lacasse, a psychologist at Arizona State University, “the pair are responsible for defangling the chemical imbalance theory of depression in a seminal paper in PLoS in 2005 and of another paper in which they document the media's reliance on incorrect or overstated (take your pick) chemical imbalance theories. The two are a bit of a SWAT team,” Philip wrote.

The tag line of their blog is “Science, Mental Health, and the Media.”

Take note and start considering not believing everything you read in the press about the chemical imbalance business. These two are collecting lots of solid evidence to prove otherwise.

As for the mood of our American brothers and sisters, I suggest they have good reason for feeling down and there isn’t a pharmaceutical on the planet that’s going to lift their moods.

It’s depressing. And it's healthy.

A Recovery Story

A little while ago, while I was blogging about one of the most hotly contested issues in mental health – electroconvulsive or “shock” therapy or ECT – a friend called me for help.

This happens a lot. I’m no professional. Just a fellow traveller. Yet people come to me thinking I have magic answers.

In this case, his father was in serious trouble. He lives in another province and has a history of serious depressive illness. Nothing has worked for him and his doctors are recommending ECT. “What should he do,” my friend asked.

As far as I was concerned, there was no question. Depression can be lethal, if it’s ignored. People can become so severely depressed, sometimes end up killing themselves. I explained my experience of ECT which was benign. It was years ago. Methods have changed. It’s safer now. I made sure it was being administered by experts in a good teaching hospital. It was.

“What’s the alternative?”

I heard nothing more. For a couple of months. Then he called again. His father had been talked out of the ECT by frightened relatives and he had attempted suicide. Now he had no choice. I wished his father well.

The ECT went well, but the patient was slow to recover. He was still down, though not suicidal. You should know, he is a sad person – a man with no job, little if any income and an unfinished life. There seemed to be reasons for his depression.

When his son called a month or so ago, he wanted to know if I could help get his father into an Ontario psychiatric hospital, where he could be taken care of because his doctors had washed their hands of him. There was nothing more they could do.

Why should they do anything more, I thought.

People must take responsibility for their own personal health recovery – physical and mental. They have to want to get better and must work at it. Let’s say you break a leg. You need rehab. You have to work at exercising that leg back to full functionality. If you don’t, you have pain and you limp for the rest of your life. Maybe you never walk again. Your choice.

The mind is no different.

To recover, you have to own your recovery and work at it. No one ever said it’s easy. Pills aren’t always magic bullets. They numb symptoms, and that’s about it.

Do you think for one moment that without 48 years of a variety of different psychotherapies, including group work, peer support, and many other healing activities, I would be the same person I am today?

Yet this man and his family wanted his father put away and taken care of — so he wouldn’t hurt himself. And they could rest a little easier. At the expense of the Ontario tax payer. Where psychiatric hospital beds are at a premium for residents of Ontario.

While we were talking, I quickly located online a branch of the Canadian Mental Health Association in this man’s town and province.

I suggested his son encourage him to go. What did he have to lose?

Guess what? I ran into my friend this weekend. He couldn’t thank me enough. His father is much, much better. He’s found a community of people to connect with at the CMHA. Lots of support. Activities. New friends. People who understand him. He goes there at least three or four times a week. His life is beginning to have new meaning. His financial situation hasn’t changed. He’s had to sell his house and move in with relatives, but he’s happier.

In recovery.

A Tale of Assumptions

Recently, I attended the wedding of a very dear friend. It was a very small, intimate wedding, perhaps 50 people. Because of my hearing loss, I sat close to the front of the tiny, dimly lit chapel so I didn't witness what I'm about to tell you.

My friend told me this and I think it's worth sharing.

Several of her guests arrived just as the ceremony was about to begin and seated themselves at the back of the chapel. Then they noticed a man wearing sunglasses. He didn’t take them off. They were offended by this, for some reason, but what really enraged them was that this sunglass-sporting man started to snore halfway through the ceremony.

They were apoplectic. They wanted to complain to the manager of the inn where the wedding took place. Obviously, they thought, this person was probably off the street, homeless, someone who had drifted into the chapel to rest or relax or grab a few winks. His behaviour utterly appalled them. It ruined the ceremony for them. They were disgusted.

Until everyone rose to leave. Then they noticed this man who wouldn't remove his sunglasses was blind, and his beautiful guide dog, a glorious Black Lab who had been reclining undetected on the floor of the chapel at his feet, had been doing the snoring.

How interesting, I thought, when I listened to my friend tell me this story.

Assumptions. We all make them. It’s human nature. Especially when people don’t do what you think they should do. Don’t behave “normally.”

When it comes to “craziness,” assumptions too often turn ugly.

You're walking along the street and someone puts out a paper cup, asking for change. You veer away, as if the man had The Plague. You never make eye contact. Or say anything. Even “Good Morning.” Or smile. No contact. You pretend he's invisible. You disconnect.

You hear someone talking to herself – although she could be having a conversation through the earpiece of her cell phone – but let's say she's hearing voices that you don't hear, and responding. Is she hurting anyone? No. But instantly, you’re frightened. Threatened. This person is different, crazy, you think. Not right in the head. Could hurt you.

Yet, in Great Britain there are many Hearing Voices societies and networks where people who experience auditory hallucinations, a symptom in some cases of schizophrenia, can find support and learn to manage their lives and their voices, without medication. They learn to live with their voices.

Someone partakes of the charity at one of the hostels around town that feed those who cannot afford to buy food, or have no where to live – except maybe under a bridge. Maybe they look a little different. An instant reaction is to be disgusted and to automatically assume that they're mentally ill or lazy or don't want to work.

I’ll never forget the acceptance speech a woman gave several years ago on the occasion of receiving her “Courage to Come Back” Award from the Centre for Addiction and Mental Health. She stunned me with her honesty and insight. Her life had gone bad. The details escape me, but she had lost everything. Her job. Her family. Her home. Human support of any kind. She ended up in a ravine all one winter. I remember her saying that she wasn’t crazy before she was left to survive the elements, living outside, scrounging for food. Without the protection of four walls and a roof, however, living outside, exposed to the blistering cold of a Toronto winter, that’s what drove her crazy, mad, out of her mind.

Then, somehow, she was able to find one empathetic person who was able to reach her. Eventually, after years of work, she recovered. Now, she’s fine.

We’re all different. Our minds have a myriad of ways to manage living and surviving. We’re very resilient. We can all recover. Especially if someone cares. Or we can all lose everything. It happens. Sometimes life goes out of control and you can't stop the downward plunge.

It’s not seeing is believing. It’s believing is seeing. Give people the benefit of the doubt. Try not to jump instantly to conclusions. Don’t believe the worst. Do the opposite. You might find yourself pleasantly surprised, just those appalled folks who thought a man was snoring during a wedding ceremony.

Questioning the Bipolar Child Conundrum

No doubt, you saw this weekend's Sunday The New York Times magazine cover story headlined “The Bipolar Kid” or "The Bipolar Puzzle" – take your pick.

I read it on Saturday night online and then cringed when I saw it on Sunday morning, in print. Years ago, I interviewed Dr. Harold S. Koplewicz, director and founder of the New York University Child Study Center. He edited a breathtakingly beautiful and touching art book, titled Childhood Revealed, Art Expressing Pain, Discovery & Hope (New York University, 1999).

Why don’t art directors do their homework? Look to children’s art to illustrate stories about their inner feelings and difficult behaviours, instead of the hideous imagery featured in this story. Interestingly, in the Koplewicz book, bipolar disorder is not mentioned.

There are chapters on Depression, Eating Disorders, Anxiety Disorder, Psychosis, Attention Deficit Hyperactivity Disorder, Learning Differences, Pervasive Developmental Disorder and Autism, Post-Traumatic Stress Disorder, Abuse, Divorce and Children and Physical Illness.

Each chapter features art by children who have been diagnosed with these conditions. The commentary is sensitive, humane and thoughtful and the art is used as a clue as to what is bothering the child. It’s the key to their behaviour, their pain, their perceptions of the world, the feelings they may not be able to express in words.

Curiously. There is no chapter on Bipolar Disorder. The Bipolar Kid hadn't yet been invented.

Back in the late 1990s, no one believed that children could develop Bipolar Disorders. These conditions usually surfaced in people in their late teens or early 20s. Childhood bipolar disorder hadn’t yet been documented or discovered. 

Drug companies weren't manufacturing and marketing psychotropic drugs by the dozens for every possible emotional problem under the sun, and psychiatrists weren’t shovelling pills into kids like they do today, either.

Other forms of therapy were used. Art Therapy, Music Therapy, Play Therapy. Ah, but who has time for that, when you can just pop a pill – or six.

Back then, the world was a different place and psychiatry-by-prescription wasn’t the standard therapy it is today, for adults or children.

I found Jennifer Egan’s story troubling.  Philip Dawdy gives an excellent 12-point analysis of the problems with the piece.

In my favourite, number 5, he observes that "the boy who opens the story, James, is 10-years-old and to me appears to be desperate for a place to put all his aggravation and impulses. What's remarkable to me is that there's no indication in the article of whether or not his parents had tried to stick him into sports of any kind. That's just odd. I'll go out on a limb here: I think kids like James should be forced to play football or hockey or learn how to box--some kind of intense contact sport--as part of their treatment plan."

Dawdy, who has a bipolar diagnosis himself, but no longer uses any medication at all, closely follows the ongoing controversy raging about whether bipolar disorders do exist in children, the psychiatrists who promote this notion and the drugs use to treat these kids, and the ethical troubles some of them have been getting into with the FDA. You should have a look at his critique.

As far as I’m concerned, parents should avoid having their children diagnosed with mental disorders and medicated for them, if possible. Keep their kids out of the mental health system and find other approaches for support.

It’s not healthy for the psyche of any child to be put into the mental health system. Who wants to be considered to have a "disability" of any kind. There's too much ignorance, fear, discrimination and prejudice around mental health issues, today. Kids don’t function well when their labelled in a way that makes them feel different. It makes them feel insecure. They feel deeply that there’s something intrinsically wrong with them. Those feelings run deep and last long. I don't know if they ever go away.

Who’s benefitting? The child? The parents? The teachers? I wonder.

I lost my kidney function and my physical health to Lithium, but the emotional damage was far worse. I am deeply insecure on some levels because of my 48-year-history of dealing with the diagnoses of several mental illnesses. It’s inevitable. It's also a bit of a Catch-22. I’m well adjusted to it, but still, the label did its dirty work.

People working in the Recovery movement constantly say much of their work with psychiatric survivors involves helping them recover from being labelled.

Sometimes, I wonder what would have happened to me if I hadn’t been sent to a psychiatrist at 12. But that’s fruitless. You can’t turn back the clock.

NOTE: In yesterday's New York Times, Benedict Carey reported the results of a new U.S. government study showing that many of the newer antipsychotic drugs used to treat children with schizophrenia – the same drugs mentioned in the Sunday Magazine story, Zyprexa and Risperdal, to treat children diagnosed with bipolar disorder – are no more effective than the older, and possibly safer, antipsychotics. One of the most serious side effects of the new drugs, serious weight gain, puts children (and adults) at risk of developing diabetes. "Half the children in the study stopped taking their drug within two months, either because it had no effect or was causing serious side effects, like rapid weight gain," Carey wrote. "As much as 15 pounds or more in eight weeks," according to one of the co-authors of the study.

When will this madness end?

Suicide

This summer two people died by suicide on my street.

The neighbourhood grapevine whispered, used the word “commit,” as if suicide is a crime. Once, tragically, it was considered murder, but that’s been off the books for years. Still, the word and the idea persists.

One of these suicides was understandable, but no less shocking.

A sweet, kind 57-year-old man hanged himself in his garage. He was very ill and lonely. He ached for a constant companion, but he never found her. He had lost the quality of his life to a form of brain cancer that was cured by surgery, but the cure left him with constant pain and an agonizing cacaphony in his head that wouldn’t be silenced. He couldn’t stand it anymore. He found his peace.

The other was less easy to reconcile. A 17-year-old boy hanged himself in his basement. I heard this but little else through whispers in the neighbourhood. Apparently his father discovered his son’s body.

No one dares speak out loud about suicide. It’s a taboo. Still.

Yet, among youth of both sexes between the ages of 10 and 19, suicide is the second leading cause of death in Canada and the U.S. It is a major public health issue, yet there are huge gaps of knowledge and far too little research devoted to understanding suicide and trying to prevent it.

There are a great number of assumptions made about people who die by suicide. The most prevalent is that they are depressed or have some form of mental illness – mainly depression. Were this true, then the suicide rates should have plummeted with the proliferation of dozens of different antidepressants that have flooded the market over the last few decades.

They haven’t.

There has been a slight decrease in suicide rates in youth between 15 and 19 years of age in recent years – from 13.8 per 100,000 to 12.9 per 100,000 – the use of antidepressants may account for a fraction of these.

Alcohol and substance abuse may have declined and there is a decreased availability of firearms.

As for the use of antidepressants, the relatively new SSRIs or Selective Serotonin Re-uptake Inhibitors in some rare cases may worsen suicidal tendencies. It’s still very controversial. No one knows if these powerful drugs developed for adult brains are safe and effective for young, developing, teenage brains.

To be perfectly honest with you, I don’t know if stamping a young person with the label of “Depression” – as in a mental illness – does much to brighten his or her mood.  Especially if this young soul is showing signs of angst and unhappiness that may appear more profound that what’s considered typical of the teenage mind and brain.

Labels stick. Do you want to put your kid “into the mental health system?”

What’s typical, anyway? I don’t know if the experts know. Psychiatrists take one point of view. That you’re sick. Some psychologists do, too. A psychologist who saw my 13-year-old stepdaughter for a few sessions was convinced she was severely troubled and needed long term care. It’s to their advantage. They get paid $150 per hour.

There are other strategies. Other therapies that are proving promising. Cognitive Behavioural Therapy, for one.

When we took a different approach, and her father and I went to weekly groups sessions with other parents of difficult children with Parents for Youth we found that my stepdaughter responded beautifully to the changes in our behaviour and the strategies that we learned. From other parents.

Today, at 21, she's perfectly fine.

Peer support for parents and kids can be very powerful and very healing.

People, young and old, internalize the psychiatric labels tossed around so easily, these days. Even though “depression” and “anxiety” are so ubiquitous, they’re considered almost normal.

Furthermore, what might “depression,” feelings of despondency and dejection and hopelessness be caused by? A chemical imbalance in the brain? (No proof of that, yet.) Perhaps emotional, physical, sexual abuse at home. Perhaps bullying at school. Perhaps overwhelming academic demands. Perhaps an undetected learning disability. Perhaps parental neglect. Perhaps a sense of disconnect between a young person and parents who are obsessed with their work and their obsessions for acquiring “stuff.”

I think that feelings of hopelessness can come from many external sources (and have nothing to do with a “mental illness"). Maybe it’s the inability of parents and teachers to cope. Their lack of strategies that can be learned. Perhaps it’s the school system and kids who simply learn differently. Who have artistic talents that aren’t valued academically at school. Perhaps it’s peer pressure.

There can be any number of situations that can cause a young person to feel a sense of despondency.

If ignored, that despondency can spiral out of control.

Surely, when a family doctor prescribes a medication that has to be monitored regularly, perhaps just having to see a doctor on a weekly basis, someone who has the time to listen and show sincere interest, might help. Is it the regular human contact, the sympathetic ear? Or the chemicals that might prevent a suicide?

Listening. Actively. Just being there to listen, I think, is healthier than a psychiatric label and a prescription for a young person who seems to show warning signs of trouble beyond the typical teenage angst.

Recognize the warning signals.

When a kid comes home exhausted from school. Won’t go to sleep at a reasonable hour and then cannot sleep. Isn’t communicating. With parents. Siblings. Friends. When there seems to be a disconnect, don’t just chalk it up to adolescent angst. Look at the big picture and seek help.

There are many different strategies. Possibilities for Recovery that don't involve psychiatry. Do your homework. Seek ways to help your child without branding him or her with a “mental illness.” Look for holistic ways that will encompass the family, school and other influences in your child’s world.

Don’t go looking for a quick fix and a pill to make your child right. There are many different holistic approaches to help families in crisis. And, if a child is in crisis, perhaps it’s a family issue.

Just don’t wait. Don’t ignore the signals. It may not be a phase. Do something.

School Daze and other stuff!

Happy New School Year! It’s been quite a week.

I’m back at school, teaching at Seneca College. Ten hours a week – two classes each of two courses. One, I’ve never taught. The other one, I developed last winter, and continue developing.

If you have children or you’re a student yourself, you know how stressful these days can be, for teachers, students, parents, not to mention everyone working in education.

Students face major problems, trying to arrange their timetables, not to mention arranging any special accommodations they made need.

In the comments to my last post, a lively discussion played out about accommodation and how asking for it on the job in “the real world” too often leads to being let go.

It breaks my heart because, besides the obvious injustice, these stories speak of discrimination and prejudice and ignorance.

Employers desperately need help.

They need it more than people with diagnoses of mental illnesses – or madness.

Far too many people in powerful positions will accommodate someone with a physical illness or condition – I don’t like the word “dis-ability” – yet dismiss people with mental illnesses or “mental health issues,” or more accurately, madness.

I ask you: Who’s mad here? A well-qualified human being who experiences very real stresses and anxieties or depression at work, for good reason, and asks for a bit of accommodation? Or a boss, who gives this person a few days off, and then gives them the boot – under the guise that they’re redundant or their job is redundant, or some other madness.

Name game

One anonymous reader commented that he or she was utterly offended by the name of this blog, “Coming Out Crazy.”

In 1998, Chatelaine magazine invited me to write a major first person feature about my life with my mental illness. The headline was Coming Out Crazy. I happily approved it then because it felt right. It still feels right.

“I find (the title) offensive in the extreme," Anonymous wrote. "In no way does such a stance lessen fear or avoidance. Worse, it implies that everyone, even those with occasional attacks of anxiety or depression, is somehow in the same boat as an individual with paranoid delusions and a history of bizarre behaviour. It's not the case.”

The opposite is true. The name may shock people into thinking about what's called "crazy." Think about being open and up front about it. That's the idea. A little shock is a good thing.

You know what? We’re all capable of craziness and “bizarre behaviour.” If you think otherwise, I believe you’re kidding yourself.

A Couple of Announcements...

My friend Krista MacKinnon, a wonderful and creative woman, a survivor and a dedicated, tireless worker at Toronto’s Family Outreach & Response Program (FOR) is looking for “Recovery Stories” for the organization's website.

A few weeks ago, Krista reminded me that I had promised her mine, but I haven’t had time to write it.

“I only have one so far. It's lonely. Won't you help me populate my website with more and more stories of hope? Even solicit some stories from your readers? See, it's so lonely."

Share Your Recovery Story

So, why not your story of recovery at FOR? It’s an amazing agency that  “supports and educates families and friends during the recovery process.” Krista and the other staff at FOR “build on the strengths and resilience of families to enhance their lives. FOR strives to work with a diverse group of families and especially with those who cannot readily access support.”

In the meantime, I’m going to work on my Recovery Story, Krista! Promise.

Finally, one of my favourite blogs is written by a fabulous woman, a gifted New Jersey writer named Susan. On her newly redesigned blog, If you’re going through hell keep going,  besides her own colourful and impassioned writing, you’ll find many links to other blogs by writers exploring  important, often touching, mental health issues. I am especially impressed with Susan's section called “Suicide is not painless.”

She has included “Coming Out Crazy” on her blogroll. Here's what Susan says about her choices: "Every one of those links have been picked by me, there is something in each and every blog that has moved me, touched me, touched my soul. I don't agree with everything on them, but I admire these writers and enjoy reading what they have to say and hope you will too."

Thank you, Susan! I’m thrilled and honoured to be on your site and in such good company.

I urge you to have a look. You’ll be amazed at the world Susan opens up for you.

School Daze! Take it easy! It's a journey of new beginnings!