"Schmoozing" with Ron Pies, M.D.

As many of you know, through this blog I've developed a friendship with Boston's Tufts University clinical professor of psychiatry Dr. Ron Pies. He's also a psychiatry professor and lecturer on bioethics and humanities at the S.U.N.Y. Upstate Medical University in Syracuse. Plus he's editor-in-chief of Psychiatric Times. 

Dr. Pies is a polymath.

He's written a novella based on the life of medieval physician-philosopher Maimonides who believed that "the physician does not cure the disease, he cures the diseased person."

As well, Dr. Pies has had several psychiatric textbooks published along with a volume of poetry, Creeping Thyme, a collection of short stories, Zimmerman's Tefilin, and Everything Has Two Handles – The Stoic's Guide to the Art of Living. 

This charming slim volume of essays weaves together the ancient wisdom of the Greek Stoics and many great Eastern and Western philosophical thinkers with his own insights drawn from years of psychiatric practice – case histories of real people. He demonstrates how Cognitive Behavioural Therapy – a psychotherapeutic approach based on rational thought and understanding the present – offers helpful tools in coming to terms with emotional difficulties. I've found his book to be endlessly re-readable and a great tonic for sleeplessness.

(NOTE: It's unavailable through Amazon.ca or Amazon.com. However, you can buy it online at Barnes and Noble.com and it sure beats medication.)

My psychiatrist Dr. Bob and Dr. Pies come from similar schools. Dr. Bob blends this rational approach and a psychoanalytical bent in his therapy with me. It works wonders.

Last night, I read the short chapter on "Morality and Self-Respect" and, to quote Marcus Aurelius – "I do my duty. Other things, trouble me not." 

Dr. Pies often illustrates the Stoics ideas with practical contemporary examples, in this case a woman who couldn't do enough to satisfy her mother – a problem I've had. 

Do I want to lose my soul in trying? No way. So, after reading Dr. Pies and the ancients, I fell asleep peacefully with the words of Epictetus ringing in my ears: "If you fulfill your duties, you have what belongs to you." Or as Dr. Pies suggests, "the only real possession to which we may lay claim is our own moral integrity. Everything else in life either belongs to someone else or is beyond our control."

How did Dr. Pies and I meet? Well, to be honest, we've never met. And until last night at 7:30 p.m., we had never even spoken on the telephone. I had never heard his voice, though I feel very close to this man. 

Our friendship began when I misinterpreted him in a September 26, 2008 post I wrote about an article of his in The New York Times on depression and grieving.

He commented, correcting me in a very gentlemanly way – very gently and thoughtfully. And I wrote back. Thus began our correspondence. 

On two occasions, I've written lengthy posts about Dr. Pies and his wit and wisdom. From time to time, he often enters into my posts with a thought, a nugget of wisdom or in many instances, the support he is so generous in giving. His words speak volumes because he is so wise, well-read, and open-minded. He also willingly acknowledges that modern, contemporary psychiatry may be losing sight of its roots – a belief to which I subscribe. Where other practitioners in his profession are blinded by their current intoxication with the neurosciences, Pies is not. He's endlessly curious and willing to learn and keep on learning – a real signal of wisdom.

Our correspondence has lasted for almost a year, during which he has opened my eyes to many truths about his world of psychiatry and psychopharmacology. I've learned so much from him. And I suspect that I, too, have given him some interesting perspectives to ponder. We don't always agree, but we can easily agree to disagree. With respect.

His post The "McDonaldization" of Psychiatry: Psychiatric Knowledge is Not the Equivalent of "Fast Food" in the Psychiatric Times blog The Couch in Crisis is a perfect example of this thoughtful self-analysis. It's a studied critique of today's psychiatric paradigm.I urge you to read it if you haven't already.

What better metaphor for the current "norm" in psychiatry than fast food and its "McDonaldization" – 20 minute diagnoses, 15 minute-appointments featuring a prescription pad more than a willingness to listen and engage in any form of talking therapy or psychotherapy. 

What I have never understood is why psychic healing is supposed to happen fast. We didn't become emotionally disturbed fast. Often, it takes years, especially if trauma is involved. I'm in no rush. My healing is going to take a lifetime. I'm always learning and healing – becoming more and more whole.

Also, and I love this in Dr. Pies. Like me, he is fascinated by etymology – the study of words. He pointed something out to me last night, during our pre-arranged telephone conversation. I've often said that there's a world of difference between "doctoring" and "healing." The words are interesting. Doctor means teacher. Healer derives from the  Old English or Germanic origin "heilen" which means "whole."

Have you ever considered the word "physician," he asked? 

No. I had not. He explained that "physician" means "a person qualified to practice medicine." I looked it up myself and found as well that it also means, "a healer, as in physicians of the soul." The origin of that word is from Old French – "fiscien," based on the Latin "physica" which means – "things relating to nature" or as he put it, "assisting nature."

I wonder if all these medications, these drug cocktails too many psychiatrists prescribe these days – the main tool in the modern psychiatrist's toolbox on this continent – are assisting nature or impeding it. 

What do these drugs do for the soul?

As I've often said, you'll find no insight in a pill bottle. I am not angry at psychiatry nor I do not believe in throwing the baby out with the bath-water. All knowledge is useful, depending on how you choose to use it and what you choose to use. Psychiatrist Sigmund Freud had enormous contributions to make, as did R. D. Laing and Philip Thomas who subscribes to "Critical Psychiatry."

I use one medication everyday. In 1988, it stopped, cold, my severe annual manic episodes. I take one 200 mg tablet of the anticonvulsant Tegretol morning and night. It stabilizes my manic mind. I can live without it, but I'm better with it. And it's perfectly innocent for me. I have no side effects whatsoever. It suits me. (Unlike Lithium, which for me, was toxic and destroyed my kidney function because my psychiatrist at that time neglected to monitor it. Be sure yours is monitoring you!)

But Tegretol hasn't given me insight or healed my soul. Dr. Bob has helped me to do that. And my loving husband, the first person on the planet who has ever loved me unconditionally.

I find other ways to peace of mind, too. Like reading Dr. Pies. Our easy and relaxed conversation will continue in the future. I'll keep you posted. 

Do whatever you have to do to wake up in the morning feeling happy to greet the new day.

All the best. Happy Canada Day!

"Hello from CBC Thunder Bay..."

I receive a number of emails each week from people who choose not to comment. Anonymity is the most common reason, but this week, anonymity was clearly not why Lisa Laco wrote to me.

The subject line of her message was "Hello from CBC Thunder Bay" and what followed was a touching and, at times, a rousing, even funny account of how she's learned to live with and decidedly not suffer from ... depression. 

"Let's get some facts straight," she wrote. "No, I've never been locked away. I don't think people tip-toe around me, afraid of my reactions. I haven't wandered the streets, mumbling to myself. These are just some of the images that accompany mental illness. But it's not that way. At least it hasn't been for me, or any of my family. And I have quite a family history of depression."

Lisa vividly recounted her mother's endless struggles with depression and all the painful treatments she had to endure, including ECT. Lisa comes by her depression "honestly," she stated. "Her mother, her aunts, her sisters have all been diagnosed with depression or manic depression. At one time, the accepted treatment included amphetamines. My mother, grandmother and great aunt were all at our house, remodelling. I think they managed to tear down walls, repaint and re-paper an entire house within a week. 'Speed' lets you do that!"

At the bottom of her long, bold face declaration, for that is how it felt as I read it, Lisa stated this:

"I'm the host of the morning show at CBC Radio in Thunder Bay ... I speak regularly here about the joy of living with mental illness ... thought I'd share a recent speech with you ... just to let you know you're not alone ... never alone."

The first thing I did was look up Lisa Laco on the CBC website. Her show is called The Great Northwest

and she's been at CBC in Thunder Bay since 1992. Her picture is on the website along with her bio.

I quickly sent her an email, asking if she would mind if I wrote about her. She responded quickly. "I would be thrilled as it might help someone somewhere look for help."

Then she called me a few hours later and left a message. When we finally touched base and spoke 24 hours later, she was more than happy to elaborate on her own story. 

About "the joy of living with mental illness," Lisa said, "How about acceptance and perhaps a joyful acceptance by knowing who I am – foibles and accomplishments – and accepting who I am. It's brought a certain joy, a peace, a calmness. I'm glad I have depression because it explains so much of my life. As a little girl, I always felt guilty, inadequate. I didn't deserve to be happy. Underneath, I was a failure, just waiting to be caught out. I thought this was a normal way of thinking." 

She was the eldest of six children, all under the age of 10. "I vaguely remember my grandparents saying that part of my mother's problem was her children – us, too many of us – and I think this could have been the genesis of my guilt, that just by being alive, around, I was a problem for my mom," Lisa said. 

Despite having these feelings, Lisa, now 52, was able to follow her dream of being in radio, like her uncle CBC's Harry Brown, one of the original co-hosts with Barbara Frum of the groundbreaking CBC radio show As It Happens. She started in private radio and ultimately ending up with CBC in Thunder Bay, where she's happily married a second time and has raised her two sons. About 12 years ago at a family reunion with her five siblings, she discovered that two of her four sisters were also struggling with depression.

Until then, she had never told a soul about her feelings of guilt and inadequacy. "That would not make me 'cool' and I was terrified of being found out as weird. I don't confide in friends easily. I'm more of a listener," she said.

"That conversation at a downtown bar in St. John's was a revelation. Of course, I had depression as well. Wow! What an emotional moment! It explained so much. I literally felt exuberant. What I had always been feeling was not a normal way to feel." 

Back in Thunder Bay, she immediately told her doctor that she needed help and she start taking "good old Paxil." It took a few years, but what a difference. "Night and Day. I could cope." Two years ago, she spent a year in Cognitive Behavioural Therapy with a psychiatrist developing additional coping "tools" to deal with her depression, in addition to her medication. 

Her therapist, Dr. Paul Mulzer of Lakehead Psychiatric Hospital, "once told me that it's okay to talk about any illness that affects you from the 'neck down' but from the 'neck up' makes people uncomfortable." But nevertheless, about six years ago, she felt confident enough to let some of her co-workers know about her depression. 

"I'd even joke about taking my 'happy pill' and no one seemed shocked. It was all matter of fact," Lisa said. "At that point, I realized I didn't care who knew and that's when I must have made a subconscious decision to go public. I remember talking to my boss at the time, and saying, 'I'm going to do this on air. I'm not going to be exploitive or maudlin. I'm going to be matter of fact. So it began."

She did a two-part interview with her Dr. Mulzer focusing on depression and the negative stereotypes, discrimination and prejudices too many people have about mental illnesses. 

"I'm known as an upbeat host. I have fun at my job. I'm energetic and I believe strongly that it's important for people to know that you can have a mental illness and function every day in society. Hold down a job and not a menial job, but a job with substance," Lisa said.

"Most importantly, to not be afraid of being known as the crazy lady down the street. I've participated in a public awareness campaign here in Northwestern Ontario. My face is on billboards. I've spoken at numerous events about this. I've never, ever had a negative reaction. I think honestly that people would be afraid to react negatively because I'm so positive about life. I'm happy. I sound happy. I can survive, but I never mention my own battle with depression when the occasion warrants it. If I'm doing an interview about this, I always make sure it's part of the interview, on air."

Lisa stresses that she talks quite freely about her depression. "I don't really care who knows. My family, my husband and two sons, know this about me and I think it helps them to hear me talk about it. The more I talk, the more they realize that they are not the cause. They are not the problem. It's 'my' illness. It's not their fault. That's my greatest concern. I don't want my children to experience what I did, spending years and years thinking it was all my fault."

Recently, Lisa has taken up running. "It's fabulous therapy. You cleanse your mind when you're running. It's just one foot in front of another," she said.

"When you run, you concentrate on nothing but your next step. You're semi-focused and it's simple. That's the joy of life, of living with a mental illness or living in any other way. Life can be complicated or it can be simple. It depends on how you deal with it. I now know I can simplify a lot of my emotions and feelings by asking the pertinent questions, questions from my therapist. Like, 'Where's the evidence of that?" or 'Why are you a failure? Where the evidence?'

"Break things down to their basic fears – emotions – and analyse where it comes from. One step at a time. One foot in front of the other. You can figure it out."

Lisa, thank you for so generously sharing these lessons for living and the story of your life. It certainly resonates with me and I'm sure they'll resonate for everyone who reads them. It's an uplifting story of recovery. Your recovery. 

I want to end this post with a quote from a book by my friend, Dr. Ron Pies, clinical professor of psychiatry at Tufts University in Boston at S.U.N.Y. Upstate Medical University in Syracuse N.Y. He sent me this book, one of many he's written, but this one is very special. It's called Everything Has Two Handles – A Stoic's Guide to the Art of Living (Hamilton Books). I keep it beside my bed and read it before turning out the light. Since I started this little ritual, I've been sleeping more easily and more soundly every night. Waking up more refreshed.

From his chapter on "Living in the Here and Now," Pies writes:"One of the great liberating ideas of Stoic philosophy is the concept of 'present contentment.' In effect, the Stoic says, 'I can't change the past; I can't really determine or control the future; so the best I can do is live a life of decency and integrity – right here , right now."

A Mad Miscellany

Hello everyone!

I am pleased to announce that I'm feeling much better. In fact, totally better. After five consecutive weeks of weekly therapy sessions with Dr. Bob and some time, reflection and a lot of "processing," I seem to have weathered the bumpy patch in my recovery journey and arrived at a better place – a more peaceful place. More self-accepting.

When I left his office on Monday, I felt light and buoyant. I didn't book another appointment for next week, but rather next month. I didn't make any notes and didn't have any homework. This latest layer of the onion has successfully peeled away. I've shed a few tears and now I won't be seeing him until the end of July!

The passage of time was very healing. And YOU had a lot to do with my progress, too. More than you know. I am very grateful for all your supportive and empathetic messages and comments. Though I was feeling very isolated and fragile, I knew I wasn't alone. This doesn't happen to me very often. Most of the time I have to grapple with the manic end of the spectrum. 

So, now I have a renewed sense of purpose. And a plan. No matter what happens, I am determined to carry on and succeed and I'm looking forward to either exigency – and prepared. 

Today, I'm simply going to share a miscellany of thoughts with you. A little grab-bag of ideas. A gallimaufry, if you will. I hope you don't mind.

1. The television show Mental is off my list. We are no longer recording it and I'm no longer interested in wasting my time watching it. Last week's episode, quite frankly, was so outlandish, I fell asleep. About a young boy who was obsessed with a video game show. Too silly for words. Too bad. It would be lovely to see a network television show, or better still, something on HBO without commercials, that focused intelligently on emotional and mental health difficulties. This one isn't it. 

2. I have been asked to participate or be interviewed for a documentary film called "The Bipolar Project" – that's the working title. I'm hesitating, though. I have done these filmed interviews before and I've found you're at the mercy of the filmmakers and their own visions and biases. They can make you look and sound like anything they want. Editing can distort any message.

Gianna Kali who has an excellent bipolar blog called Beyond Meds had a similar experience recently with 20/20 and she declined as well. For similar reasons.

My husband, a professional screenwriter and producer doesn't agree. That's okay. We can agree to disagree. Quite frankly, I'm not that anxious to "get my message out" when it will be in the hands of a couple of Los Angeles documentary filmmakers with whom I am not familiar and may not be "my message." Especially as I am anti-label, as you all know so well by now.

So, I won't be headed for stardom this time.:-) Also, and this is really the clincher. I am evolving all the time. If I say something on film in July, chances are I might have moved on by the film is completed and released in two years. You never know.

This blog has seen an evolution in my ideas. I think that's healthy. I welcome change and I'm always learning new things and exposing myself to new ideas and perspectives.

3. And speaking of labels, Mad Pride Week in Toronto is from July 13 to July 19, 2009 and it begins at 3 p.m. on Monday, July 13 with a DSM Bonfire:

According to the Diagnostic and Statistical Manual of Mental Disorders or DSM "we are mentally ill if we are addicted to coffee – Caffeine-Related Disorders, page 231. Having struggles reading – Reading Disorders, page 51. If we don't think we are crazy then we are suffering from Non-Compliance with Treatment, page 739.

Who else is there?

"Enough with the labels, bring on the marshmallows!" The organizers of this years Mad Pride Week invite you to a symbolic bonfire "where we burn labels and all words that limit who we are as human beings and celebrate our abilities."

Although there will be no real fire, there will be hot chocolate and a sing-along.

Have a look at all the Mad Pride Day Toronto activities planned for that week. Subscribe to the Mad Pride Toronto Blog and stay in touch with people through Facebook by searching for Mad Pride Day Toronto.

I'll keep you posted here, with notices of different activities during that week. Just mark your calendar! Stay tuned. 

Consider using the word "madness" and "mad"... it's quite common in Britain. Lately, I've been listening to Madness Radio – voices and visions from outside mental health. Have a look and a listen. You might find these weekly interviews by Will Hall, who has a diagnosis of schizophrenia and is in recovery, utterly fascinating. Gianna Kali was interviewed in February about her experiences coming off 30 different psychiatric drugs and last week's interview with Jacqui Dillon director of the England's Hearing Voices Network will open your eyes to ears to new perspectives and alternatives to traditional ideas about this challenging issue.

It will open your minds to new realities.

New possibilities.

Take care. And stay cool. Summer has finally arrived. Enjoy!

Alchemy

I'm on the road. Not travelling in any conventional sense. I haven't left my house in three days. You know what I mean. 

Every morning when my little Dandie Dinmonts scratch at the sheets on my side of the bed and yelp to be let out – always at 5:45 a.m. – I begin the day a little further ahead than when I went to sleep the night before. 

That's the magic of sleep. A strange kind of alchemy.

I'm not alone. At the moment, I'm travelling with a young shepherd named Santiago. He's a wise young man, educated and curious. We started in Spain where he had a flock of sheep and now we're in Africa en route to the Pyramids. He sold his sheep, worked for a year in Tangier and now, he's in search of his destiny, his Personal Legend and an alchemist. I am, too.

My alchemist isn't going to teach me how to turn metal into gold or lead me to the Pyramids or a treasure. That's not the alchemy that interests me. You know that, as well. I am in search of something else. I'm not sure what to call it.

I have always been impatient. I've always tried to make things happen. To hurry things along. Now, in the last few weeks, I have hit a couple of road blocks and I can't control what's going to happen. So Santiago is helping me to follow a trail and be open to possibility. To stay in the present.

*   *   *   *   *

A couple of weeks ago, a darling friend of mine who has retired in Mexico was in town for a visit. She has been instrumental in changing the course of my life. We decided to have lunch the day before she was to return to her new home and when I arrived at the restaurant, a few minutes late, a red bag stuffed with white tissue paper was sitting on the table.

The bag contained a small, slim volume called The Alchemist by Brazilian writer Paulo Coelho. "This is a book all about following your path," she said, as I unwrapped the book. Perhaps you've heard of Coelho and read this book, or the many others he's written. I had not. Immediately, I thought I'd be able to read it in one sitting, but that hasn't been the case.

Since then, I've been savouring every word. Right now, I've only read 100 pages. I rarely have time to sit and luxuriate in reading for pleasure, so it's taking me time to finish The Alchemist, but I'm in no hurry. I find travelling with Santiago like the path I've been on for the last few weeks because with every bend in the road, something happens that helps me to learn a little more about where I am and what I want to do. Or, more importantly, who I am and what I must do.

Most of all, I am learning to remain hopeful. No matter what. And to find my own way. 

 

Coelho is a year older than me. When I started looking into his history – and don't ask me why I sensed this – I discovered that when he was a young man, probably a teenager, he rebelled against the conventions of the Roman Catholic church and his parents had him committed temporarily to psychiatric hospitals on three occasions. While hospitalized, he had electroconvulsive therapy or ECT.

In 1970, he dropped out of law school and for the next two years, he travelled through South America, Mexico, North Africa and Europe. He returned to his home in Rio de Janeiro, wrote pop lyrics and in 1974, was imprisoned for a short time for alleged subversive activities against the Brazilian government. 

In 1980, after working for Polygram and CBS Records, he started travelling again, this time, walking the 800 km pilgrimage of Santiago de Compostela from France to Spain. With a rekindled interest in Catholicism he wrote his first book, The Pilgrimage in 1987 and the following year, he wrote The Alchemist.

According to his online biography, Coelho has worked as a theatre director, actor, lyricist and journalist. I felt a connection with him the moment I started to reading the introduction to his book, in which he writes:

"I remember receiving a letter from the American publisher Harper Collins that said: "reading The Alchemist was like getting up at dawn and seeing the sun rise while the rest of the world still slept."

I love mornings. I'm always at my best in the morning.

So, I'm writing about this book now because it is all about living your own Personal Legend. I love that phrase. My friend, who gave me this book, is wonderfully cavalier about what happens in her life. Whatever will be is meant to be, she says.  

And life is always about a journey. I've never been a great traveller, but there are many ways to travel. In the case of The Alchemist, the fable of a young shepherd named Santiago in search of a treasure, I'm happy to ride along with him. Thus far, he's found his treasure, in the form of love when he meets a beautiful young girl in an oasis in the desert. But that's long before he reaches his destination. I don't know what awaits him, but I sense I'll be taking this spiritual journey again and again. 

So, though I've been having a difficult time these last few days, I've know I have many treasures in my life. My husband. My friends. You. 

Without a blink of an eye you are here to help me simply by sharing your understanding of this universal journey that we're all on and by celebrating with me. You sent me songs and showed your concern. More than my own family. I've learned that I can choose my family and I have.

Like me, you knowing that you're looking for and, at the same time, creating your own Personal Legends. That is cause for celebration.

You have many gifts, treasures, and you shared them with me this week. You reached out and touched me with your generosity and kindness. 

That is pure magic. Alchemy.

A bumpy stretch on my recovery journey...

I've been working very hard lately. Not only here, but on other projects. 

And I'm exhausted. I don't know about you, but when I'm exhausted, it's difficult to write. And there are other problems, too. Life, at time, is all about processing problems. Personal problems. 

Processing isn't easy, but it's the only way I can overcome those problems and carry on with a light, free heart.  

For the last three weeks, I've been seeing Dr. Bob every week. We're working on a very challenging issue in my life. Another layer of the onion that's peeling off and really upsetting me. I sense we're getting close to the core. 

Dr. Bob has a huge painting in his office. I remember when he got it. It's a dark canvas, with purple and grey and silver and pink flowers. In the middle, in very large handwriting, the words "I need you" are written. This is the essence of therapy. We discussed these words recently. 

"At the beginning," Dr. Bob explained, "when someone comes to see a psychotherapist, it's because they feel they 'need' to be there, they need that person, they need psychotherapy. But after awhile, that 'need' changes and you come because you 'want' to be here," he said.

Right now, after 18 years of therapy with Dr. Bob, I want to be there. I want to conquer these issues. 

They have to do with self-acceptance.

I can't imagine how I would manage were it not for those 60 minutes with him every week, these days. Still, it's not easy. When I'm in his office, I take notes. He gives me homework. Things I have to keep reminding myself of and keep challenging myself to rethink. Ways I have to change and question my beliefs. When I come home, I write my challenges on Stickies and post them on my desktop. They are constant, right now. 

Questions I have to keep asking myself.

Because of my psychiatric history, at times my life can be very difficult. Not because of symptoms. Those I can handle easily. I know myself well enough for that. 

It's the people close to me that can create upheaval and these people in my life will not change. That's the killer. Other people don't change. I have to do the changing.

That's always the way it is. I've learned that people won't change unless they want to and most people don't even realize what they're doing needs changing or why they might consider some of these changes. So ultimately, in my life, I have to do the changing. That's the way it's always been.

This June is wedding seasons. Consider this. If you are planning to marry someone with the idea that person is going to change after you are married, or you don't really know the person you're marrying, you may run into trouble. 

Luckily, that is not the case with me. My husband and I are best friends and he's the perfect life-partner for me. He's a major source of support. He accepts me. He loves me exactly the way I am. But right now, he cannot do the processing that I am now working on doing. He cannot change the way I see myself.

That's up to me alone. And at times, it's a very lonely journey. Part of my recovery. No one ever said recovery is easy. At times, it's the toughest road you'll ever travel, but I know it's worth it. And I know that I'm always moving. Never standing still.

So, as I write, I'm am in the midst of revising and reassessing my world view with regard how I see myself. 

Wish me well.

Good news from "across the pond" ...

Several weeks ago, I started branching out to see how other countries approach mental health. 

Especially efforts to challenge discrimination and prejudice.

Through social entrepreneur Robert Ashton, I was able to contact several leading British charities that for more than 30 years have been working to challenge mental health discrimination, change public perceptions and help people with mental health difficulties in a variety of ways.

It's really important, I think, to know what's going on in the world. We, in fact, have a long way to go. Just read the comments to my post earlier this week on Women and Depression and you'll see what I mean.

England is light-years ahead of us and here's proof.

This morning, I received the June 12th issue of the Time to Change newsletter and an encouraging report.

Time to Change is "England's most ambitious programme to end discrimination faced by people who experience mental health problems" and works with two other major anti-discrimination charities, Rethink and Mind, to inform and educate the public about mental health.

Here are some highlights from this latest report:

• According to figures in a 2009 British Department of Health Report released yesterday, public attitudes appear to have changed towards mental health. "After 15 years where we have seen attitudes deteriorate and deep-seated prejudice, ignorance and fear thrive, there are now signs of improvement." People are more open to change.

• According to the 2009 Department of Health survey:

• 77% agree mental illnesses are illnesses like any other – an improvement of 3% on last year and up 6% since 1994. 

• 73% think that people with mental health problems have the same right to a job as everyone else, up 7% from last year.

• 78% judge the best therapy for people with mental illnesses is to be part of a normal community, up 8% from last year.

• 61% agree that people with mental illnesses are far less of threat than most people think, an improvement of 4% since 2008.

• Other findings were still alarming:

• 11% would not want to live next door to someone with a mental health problem – an increase from 8% in 1994.

• Almost a third of young people between 16 and 34 years of age think there's something about people with mental health issues that makes it "easy to tell them from 'normal' people."

• 52% of young people agree people with mental illnesses are far less of a danger than most people suppose – 17% less than people over 55 years of age.

• 22% feel anyone with a history of mental health difficulties should be excluded from taking public office.

• When the issue is brought closer to home – only 23% feel that women who were once patients in mental hospitals can be trusted a s baby sitters.

• 65% underestimated the actual prevalence of mental illnesses and only 13% were aware that 1 in 4 people will experience a mental health problem in their lifetime. 

I don't believe Health Canada tracks national attitudes on a yearly basis, although the Canadian Alliance on Mental Illness and Mental Health produced a Mental Health Literacy in Canada report published in May 2007. It gives a very detailed overview of attitudes and conceptions about mental illnesses and discrimination and perceptions of dangerousness. How accurate is it now? Who knows? This is just part one. I couldn't find part two. 

There are also dozens of smaller reports from other groups but nothing current from a federal government health agency or even from the Canadian Mental Health Association that outlines how the general population views people, like us, with psychiatric or mental health issues. We have no coalitions of major charities devoted to challenging mental health discrimination or working together to raise awareness. 

Certainly, from what I've read, the Canadian and American media need desperately to be educated and are responsible in a major way for the negative framing of mental illnesses in our culture. They are part of the problem, according to an article on the Canadian Mental Health Association website, titled The Role of the Media in Forming Attitudes Towards Mental Illness. The problem with this story, originally published in Moods magazine, is that it perpetuates negative stereotypes and there is no current research cited. 

On the other hand, Sue Baker, Time to Change director views the British survey positively: "Attitudes towards mental health issues are finally beginning to move in the right direction," she said. "Deep-seated prejudices are starting to shift and it's a further sign that we are heading toward a tipping point in England and there is a real appetite for change."

Other similar sentiments were expressed by the heads of Rethink and Mind. 

So, now is the time for us to demand change. Or at least some accurate and up-to-the-minute information about our national attitudes towards mental health. Here in Canada. How can we change them unless we know where we stand?

It's up to all of us to take action and demand this information. Approach your local Canadian Mental Health Association branch or better still, email the national CMHA and start asking questions. Is there any national survey to gauge attitudes here? If not, there should be!

The national CMHA office will start to listen if you start to make noise. CMHA Ontario publishes a quarterly magazine called Network and a weekly update called Mental Health Notes can be sent to your email address.

These resources are just a click away.

Raise your voices and let them be heard.

In the meantime, have a great weekend.

What do you think about "Mental"?

I'm really thrilled that mental illnesses are finding their way into mainstream entertainment – Broadway Theatre and especially television.

Two examples are the rock musical Next to Normal – which won three Tony Awards last Sunday – and the new television series Mental.

Here are some random thoughts...

When Alice Ripley won the Tony Award for Best Actress in a Musical on Sunday night, I was over the moon with excitement.

Perhaps that means that "Next to Normal" will continue its Broadway run, at least until mid-September. On Tuesday, fresh from watching the Tonys on television, my psychiatrist Dr. Bob and I were discussing this groundbreaking rock musical about a suburban housewife with drug-resistant bipolar disorder attempting to cope with her life, family and hallucinations. It feels more like an opera with so many traumatic moments viscerally exposing how mental illness reverberates within a family and expressed in song. 

Ripley is in 24 of the show's 32 musical numbers.  

It wasn't hard to convince Dr. Bob to trip down to New York for an artistic weekend to see this show and the new Tony Award-winning Best Play, "God of Carnage".

Between those two corporeal crawls through the innards of contemporary coupledom – in Normal, the circle broadens to include kids – a psychiatrist, especially mine with his psychoanalytic bent, can't avoid having the time of his life.

He seemed convinced and I can't wait to discuss his take on these two plays.

According to a terrific story about Ripley in last Sunday's New York Times, after every performance, she is mobbed at the stage door by a gang of admirers, "and one out of five people ... is bipolar. I meet them every night," she said. 

In researching the role of Diana Goodman, Ripley read extensively about depression and psychopharmacology, she said in the New York Times interview. She also relied on a favourite uncle and her personal assistant as real-life resources. Both are diagnosed with bipolar disorders.

Ripley makes a striking and hopeful analysis of her onstage persona – which is why this show deserves to run for a very long time. Even Sir Elton John clearly stated this when accepting his Tony for "Billy Elliot" as Best Musical on Sunday night. 

"I started by thinking of Diana as someone with a disorder and I look at her now, and there's nothing wrong with her. I think that tells me I'm on the inside."

No matter how anyone reacts to this show, I think it's a healthy and hopeful portrayal of a woman realistically struggling with her bipolar disorder diagnosis as it's handled by mainstream medical approaches. It's controversial and gets people talking – gives them the freedom and the courage to open up more than they did before seeing the show, or reading about it. 

It's liberating. Those of us who have ever felt marginalized and negatively stereotyped can see ourselves in this character and in other characters in this show, indirectly affected when someone close to us is grappling with a serious and complicated psychiatric problem. 

This show is also contributing to the public discourse about emotional trauma as it relates to the development of a psychiatric illness. It calls into question the way we, in North America, perceive mental illnesses and/or mental disorders.

Are they "brain diseases" or "emotional disorders"? Or both? Are they chronic diseases or can you recover?

These are not yet mainstream ideas because a long-standing yet incorrect "assumption" – that mental illnesses are rooted in brain chemistry – is generally accepted as true in the medical mainstream. It is not. There is no scientific proof yet. This is an increasingly debated issue.

No one knows for sure the causes of mental and/or emotional disorders. They are varied and differ with each individual. Causes can include genetic, intrauterine, biochemical, environmental, social, cultural, and psychological factors – or a combination of them.

And people do recover from severe mental illnesses. I'm one of them. 

Meanwhile, on the home entertainment front, my husband and I have been watching a new summer replacement every Tuesday night at 9 p.m. carried on Global and produced by Fox Telecolombia called Mental.

This show, shot in Bogota, Columbia is being vigourously debated among bloggers and others online and elsewhere, I'm sure. It's highly unrealistic, but dramatically intriguing. And also encourages people to start publicly discussing mental health issues more openly. In essence, it's helping to normalize mental illnesses and health issues, and it's broadening the public discourse. 

It has people talking.

Here's what I like about Mental.

It's lead psychiatrist – a terrifically appealing character named Dr. Jack Gallagher played by British-born actor Chris Vance – is highly unconventional. 

Gallagher is always getting himself into hot water in the mental ward of the L.A. general hospital where he's recently been hired.

He's obviously modelled on Dr. Gregory House played by Hugh Laurie in the multiple award-winning House, M.D., also carried on Fox – but with a more engaging personality. Gallagher is a creative and unorthodox problem-solver with a team of young shrinks-in-training assisting him with his bizarre cases.

Normal, run-of-the-mill people with diagnoses of psychosis, severe depression, bipolar disorders, anxiety or schizophrenia are rarely the focus of each weekly segment, which ends with a solution. How conveniently and conventionally "Hollywood"!

It would be nice if real-life patients received this supremely specialized care instead of the cookie-cutter treatment most of us receive when we're hospitalized and even as outpatients. In Canada, all-too-often, it's the proverbial "15-minute consult and a prescription."

Nevertheless, for once, psychiatric patients are not depicted as villains and murderers, but complex individuals, human beings, with reasons for why they may be acting out or catatonic and solutions for their potential recovery. This is a huge step forward for a mass-market television show. It's far from perfect, but it's hopeful.

And it's too early to tell. Next week's segment involves a young boy with bipolar disorder. 

Why not tune in and have a look. Give me your critique. Share your ideas and what you think. Do you hate this show like the very popular Philadelphia mental health blogger Liz Spikol? 

Or do you like it. Share your reasons.

Let's discuss it!

Women and Depression – Echo-ing with Hope

Yesterday I participated in a panel discussion at a one-day conference called "Conversations on Depression." 

It was the first major initiative of a new Ministry of Health and Long-Term Care agency called Echo – Improving Women's Health in Ontario.

Echo was introduced in August 2007 – and is so new, it's website is still under construction, but when it's up, I'll let you know. You'll want to know.

It's priorities are mental health and addictions, sexual and reproductive health and chronic illnesses. 

Ultimately, Echo's mandate is to promote equity and improved health for women in Ontario, collaboratively. Women will be listened to and heard, at the grassroots levels of their communities and, in the health system, through research and policy changes.

In other words, Echo is giving women's health needs long overdue attention and when it comes to our needs, our emotional and/or mental health needs especially are desperate for help.

Echo's Mission and Values are "to improve the health and well-being of all Ontario women and to reduce health inequities – Equity, Diversity, Inclusiveness."

Our "Conversations" were a real eye-opener. Very hopeful. But these are early days. 

Echo is partnering with the Canadian Institutes of Health Research-Institute for Gender and Health and front-line workers from agencies, hospitals and community mental health centres across the province to gather information about women's mental health issues and in this case, depression.

Depression is singularly the most prevalent and pervasive emotional health problem women experience. 

It is perceived as an "illness" with symptoms. But it can also be a soul-destroying symptom in itself of other very serious, complex, deep-seated personal and societal problems and challenges. It's tough to talk about depression. It's misunderstood. Often it doesn't look or sound or feel like what the word "depression" suggests. 

It's frightening. Steeped in negative stereotypes, prejudices and discrimination. 

By far, the biggest barrier to gaining help with our emotional and/or mental health needs, is that we, women, and men, find it so difficult to face our emotional pain and talk about it. Not only is it painful to process, it's complicated by deeply-rooted fears about how our words and our feelings and our problems will be received. The real repercussions – like being ostracized or isolated or abandoned or losing our jobs and our security. Our connections to the people we depend on and love.

About 40 community leaders attended this day of "Conversations" yesterday – a rich culturally, ethnically and racially diverse demographic cross-section of the population – rural and urban. Almost all women and a couple of men. Dozen of others watched and engaged in the discussion via an internet web-based interface.

I wish I could have stayed for the whole afternoon. What struck me most about this event was the focus on interactivity. This was a dialogue on many levels – personal and public. Every word spoken was heard, recorded and I sensed, taken seriously. How far it will go, remains to be seen. 

Over lunch, there were a few introductory remarks and a brief PowerPoint presentation by Echo CEO Pat Campbell – one savvy lady with years of senior administrative healthcare experience in urban and rural Ontario hospitals, including Sunnybrook. 

Campbell is also a superb "active and empathetic" listener. Initially, when I called her to decline her invitation to be a panellist – after all, I have never experienced clinical depression – she managed to let me talk myself into presenting on my perspectives on Mental Health Recovery. Not a popular perspective.

Panelists' presentations were short – 10 minutes. Here are their very brief thumbnails. All are heavy-hitters. Highly qualified professionals with stellar credentials. Extremely knowledgeable and dedicated in their respective fields. 

• Natalia Diaz-Granados, an epidemiologist with the University Health Network Women's Health Program presented a thorough 2006 literature review covering all the quantitative research on women and depression in Ontario – lots of statistics but very telling. 

• Notisha Massaquoi, the executive director of Toronto's Women's Health in Women's Hands Community Health Centre, discussed both the high incidence and the causes of depression in the racially diverse, predominantly black women her agency serves – the vast majority are victims sexual assault and/or domestic violence and are living way below the poverty line.

• Denise Cole, a health policy advisor and strategic planner at StrategyCorp with 25 years of experience working on public policy at all levels of government, discussed how change happens and why everyone must play a part in this process. She "suffers with depression," she stated, stressing that "suffer" is the appropriate word in her case. 

• Nazilla Khanlou, York University chair of Women's Mental Health Research moderated and took extensive notes during our presentations.

At the heart of this event were the Questions and Answers from the audience and online participants. Then, more intimate "Conversations" at each table and an on-line survey everyone was asked to complete. 

This was an information gathering event. I was asked to send in several questions based on my presentation. Where should research focus? I'm still thinking about that. 

I was very impressed with the spirit of this conference. At the beginning, it was very official. Too formal. But after the panel, the tone of the conversation began to change and open up. 

One of the most moving moments was when Denise Cole admitted openly and courageously that she was abused sexually and incestuously throughout her adolescence and that her depression stems from those constant assaults and a family who still cannot empathize or support her. No wonder she suffers.

How many women can speak so openly and publicly about the devastating causes of their depression? Notisha stressed that close to 80% of the women who use the services of her feminist community health care centre are sexually assaulted. Raped. 

You have no idea how many women I know who have disclosed to me that they were sexually assaulted. Date raped. Tormented by incest as young girls. It's rampant. 

Yet, Denise is also in Recovery. She is a prime example of so many of us who are out there, working and living meaningful and productive lives. She's active in the community and, ironically, among many other boards she's served, currently she's vice-chair of the Seneca College Board of Governors.

How many people speak up about their recovery journeys? They travel alone, or with the support of their therapists and their close circle of friends and family.

There's huge great Catch-22 in all of this. In our culture, emotional trauma and mental illnesses are blurred. Where does one stop and the other start? They are more than a collection of symptoms. And there's no effective quick fix. Certainly, not a pill. Drugs are only tools and there are many tools available, but how many are accessible?

I learned that with a doctor's prescription Mindful Meditation classes are covered by OHIP. What else is covered by OHIP?

Still you have to see a doctor to get a prescription. That, in itself, creates another real and challenging Catch-22. 

To receive Ontario Health Insurance Coverage for an emotional health issue, you need a medical or psychiatric diagnosis. Yet, once you have it, too often you internalize it. Unconsciously. You see yourself differently. Why? Because of what the invariably ingrained negative stereotypes of having a "mental illness" may mean to you. Those stereotypes need to change and are changing, but so slowly. 

Yet, as I stressed yesterday, "we're all 'next to normal'." 

There was also an insidious "them and us" mentality that crept into the language of yesterday's conversations at times. Denise bravely erased it when she spoke out. But some other participants did not.

I urge Echo to keep a careful eye this tendency. 

I stressed in my presentation that depression is a "human" issue, not only a "health" issue. In order to effect change in public policy, we need change in public perceptions. All of us have to own our emotional and mental health issues. Openly and honestly. They belong to all of us. Either indirectly or directly. I learned that lesson from seeing the Tony Award-winning Broadway musical "Next to Normal" last week in New York.

So, that means to me that a fourth value must be added to the Echo Mission – Empowerment.

In order to heal, we must make peace with ourselves and accept ourselves, emotionally and mentally, as we endeavour to change public policies and perceptions for everyone. Especially girls and women, whose voices are not heard often enough. 

The healthcare system has traditionally been a patriarchal system. Psychiatry has been notoriously male-dominated. Governments are male-dominated, too.

Education is the key. Doctors need to be educated. They're not gods. They must learn to be healers and to look at us as whole human beings. How else can we be truly healthy?

They need our help. Healing is a two-way process. How can anyone help you if you don't tell them where and how it hurts.

We must keep that in mind. Language is imperative in this process. Echo is all about partnership and collaboration.

And hope.

"Next to Normal" – Electrifyingly True!

I never felt so normal in the audience of a Broadway musical as I did on Wednesday sitting second row centre at The Booth Theatre on West 45th Street in New York watching the Tony Award-nominated Next to Normal with my husband.

Within the first 10 minutes, I felt like I was watching myself. 

It was a peculiar feeling. And I have to admit these feelings are really hard for me to process. Much more complicated than I thought they'd be because they resonated so deeply. It would be much easier to intellectualize about this electrifying show. As I've been struggling to write this post for the last 24 hours, I've found myself slipping into a different voice. My critical, reviewing voice. 

But I wasn't given two complimentary tickets to intellectualize or be a theatre critic and write a review. Next to Normal has received rave reviews. Critical acclaim. From the leading theatre critics in New York and Washington. For it's bravery, originality, spirit and sincerity.

I flew down to Manhattan on Wednesday morning – and was on the ground for all of nine hours – to see this show and react to it viscerally. Diana Goodman, the suburban housewife and central character in Next to Normal, and I share a very similar psychiatric diagnosis – bipolar disorder.

We're not identical – no two people with the same diagnosis ever are – but the way Diana is treated by her doctors, what she goes through on her odyssey to wellness is so close what I've gone through that it's almost uncanny. That's why I've been struggling and it's taken me so long to process my feelings. Her story cut me to the core.

Minutes after the curtain rises, sleep deprived and speedy, Diana is madly making her family's lunches. She covers the kitchen table, chairs and eventually the floor with slices of bread, lettuce and ham in a frantic attempt to get ahead. Until her husband stops her and they go back to her doctor, once again, for a readjustment to her psychopharmacological cocktail of drugs.

Diana is a victim of today's North American quick-fix, pill-popping, McDonaldization of psychiatry culture. Over a period of seven weeks, Dr. Fine, her psychopharmacologist, keeps readjusting her meds to gradually numb her symptoms, or rather the side-effects of all the powerful psychoactive pills she taking – until she admits "I don't feel like myself. I mean, I don't feel anything."

Finally, Dr. Fine is satisfied, as he pronounces, "Patient stable."

That was me 40 years ago, when there wasn't the same smorgasbord of psychopharmacological drugs available. The few that did exist – chlorpromazine and haldol, the "chemically-lobotomizing" antipsychotics – were primitive mind-bludgeoners compared today's offerings. I barely remember how I felt because I was knocked out, practically deadened by their force.

We've come a long way. Or have we?

It's just a question of degree. Diana Goodman's doctors approach her today in much the same way as my doctors approached me then. That's why this riveting rock musical is hard hitting. It hit me hard. Over the head.

Has nothing changed in all these years? Obviously not. 

Today, we're brainwashed into believing that we should be controlled. All be emotional "square pegs." Diana's profound emotional "differences" are harrowing for her family. Her husband is happier when she's more complacent and compliant. Calmer, more "normal" – even if she's dying inside.

I wasn't married when I was experiencing my most dramatic moodswings but my immediate family – my parents and sisters – mirrored exactly what The Goodman Family experienced. That was a revelation for me, watching this show.

My mother, like Diana's husband, Dan, was understandably happier when my manic episodes were tranquillized. The family functioned better, I guess. 

No one really knew how I felt inside except me. Years of my episodic emotional cycling must have been so emotionally trying, tiring and taxing on my family, I can understand why they were ecstatic when I met and married my husband almost nine years ago.

Ironically, one of my sister's said to me: "He perfect for you. He's a rock." 

I'm absolutely sure they're thrilled that he has taken me off their hands. More or less.

Watching the Goodman family dynamics play out in front me with its passionate and at times violent rock rhythms, for the first time I was able to empathize, not only with Diana and her family, but with my family, too. I've never been able to feel what they must have felt, until Wednesday afternoon. The process of writing this post has been cathartic for me. It's forced me to put into words a reality that I've never admitted before because I didn't have their point of view.

My relationships with members of family have been and, at times, can still be rocky. But until now I only perceived my own pain. Not theirs. I couldn't really empathize with them. I didn't have two-way vision. 

Diana's sixteen-year-old daughter, Natalie, could have been one of my sisters, when I was at the crest of one of my many emotionally and mentally turbulent times.

Like this beautiful, sensitive, searching young girl, they, too, must have felt invisible when one of my over-the-top outbursts overshadowed them and their lives. Or when my mother, like Diana's husband, Dan, was overwhelmed by a crazy-quilt of confusing feelings and guilt. They both navigated an arduous, uncompromising, and at times, horrifying medical system that can seem so cruel and inhumane.

There is no escaping collateral damage when one member of a family is struggling to live with a mental illness, especially given the still essentially regressive approach offered by mainstream medical practitioners. 

"Next to Normal" has nailed many of these truths in my consciousness for the first time. And, as a rock musical, it accomplishes this in a way that no straight play or movie ever can. The music is emotionally jarring, at times. Poignant and plaintive, at others. I bought the CD but it's hard for me to listen to because it's so provocative. Musically and lyrically, it's exploring a rugged emotional landscape that's been my experience. An experience no one wants to talk about. 

Diana decides to try a new psychiatrist. Dr. Madden, a psychotherapist, not just a psychopharmacologist. He explains that medication and psychotherapy work best in tandem. But when she hits a wall, he hypnotizes her, opening to her memory of the trauma she's buried for 16-years in order to survive. (It took me 14-years of psychotherapy to unearth the trauma of my adolescent sexual assault.)

Mind you, Diana's story is not exactly like mine. No two stories are. Nor is her diagnosis – Bipolar depressive with delusional episodes. Mine is Unipolar disorder with a vulnerability to mania. 

She misses the vibrancy of her emotions when she's medicated. The drugs mask the real reasons for her madness. She's wrestling with unresolved anger and grief. The pills aren't helping her with that. Pills don't unravel or clarify the causes of your psychiatric symptoms. All they do is fiddle with the chemistry of your brain. It's futile. Her depression would be considered "drug-resistant." 

And she knows it. So, understandably, courageously, she pours all her pills into the garbage. She's a brilliant, charming, vivacious and educated woman. Both she and her husband were architecture students when they met.

None of these exquisitely performed scenes by the show's magnificent ensemble seemed to make anyone in the packed Booth Theatre squirm. We were enthralled. Fascinated. Fixated. Touched. The satire pinched and pricked us. We rode with the pulsating waves of the music and with each character. And surely, all of us identified with at least one character in the show.

Who has not known someone like Diana? Loved someone like Diana? Or been someone like Diana?

We weren't uncomfortable. I didn't sense that. We laughed and cried. We were moved because what was happening was so real. So genuine. I had no idea that it would resonate with me so deeply. 

It's 2009. Diana reluctantly consents to a course of ECT or electroconvulsive or "shock" therapy treatments. They destroy the last 16-years of her memory. Wipe it out. This was not my experience in 1965, or again in 1967, or again in 1975. I had three courses of ECT, but my memory is intact. If I've forgotten anything, I have no idea what it is.

Diana's experience is extremely rare. But, it's mind-blowing in a Broadway rock musical. 

My knee jerk reaction, however, was one of anger. At first. Why portray such a rare scenario in such an otherwise authentic production? I know that ECT can be helpful in cases of drug-resistant depression. Won't this reinforce old stereotypes?

Writing this post, I've been processing my feelings about "Next to Normal." My mind has flooded with painful memories and distressing emotions. Forcing me to relive my own past. It's no sentimental journey, I can tell you. But I realize how enlightened and enlightening this Broadway rock musical is. 

And one thing it is not – is docudrama or medical research.

So I'm not angry anymore. Experiencing "Next to Normal" – watching it live – is a journey in itself because it's so real. When you see Diana's tears streaming down her face. They're real.

And so is it's ending.

On her own, sad, but hopeful, Diana leaves her family and returns to her parent's home, a safe haven for her, to begin to heal and recover. To start to live with an awareness of the trauma she's experienced. Understanding will take time for her to process. That will be her recovery journey.

Her husband and daughter will survive and recover, too. There's no doubt they'll grow stronger. And as the stage went black, I felt inspired and hopeful. It won't be easy for Diana, but mental health recovery isn't easy. It, too, has it's ups and downs. It's all about finding a meaningful way to live. It's different for everyone. 

This is such a rich, multilayered musical. Utterly unique. There's not a derivative minute in it. It has many truths.

For me, Diana's odyssey keeps on resonating. I cannot get her out of my mind. We're all "next to normal" because, after all, what's normal?

As far as I'm concerned, this show is a clear-sighted, and at the same time, empathetic critique of today's biomedical neuroscientific approach to psychiatry. It shows how little many psychiatrists, especially psychopharmacologists, know about the workings of the human mind – which is far more complicated than the brain. How frustrated and impotent they must feel. 

Brian Yorkey, who wrote the book and lyrics for the "Next to Normal" defines the difference between "treatment" and "healing" – and far too many modern medical practitioners simply are not being taught the tools to heal the "whole" person. This is a real tragedy.

He certainly reinforces a fact I have learned – having lost a kidney to Lithium toxicity. There are no quick fixes for the devastations of emotional trauma, which invariably play a huge role for so many of us diagnosed with so-called "mental illnesses."

Diana's recovery begins when the show ends. Perhaps she'll begin to find a way to live a life that's meaningful for her. Whatever that may be. Recovery is different for all of us.

We all jumped spontaneously out of our seats at The Booth to give the six-character ensemble a standing ovation. How they deserved it. This is not an easy show to perform eight times a week. 

Alice Ripley was astonishing as Diana. I'd put money on her winning a Tony Award on Sunday night. Next to Normal deserves to win one for Best Musical. You can watch at 8 p.m. on CBS. The Tony's are by far the most intelligent and entertaining televised award shows.

I left the theatre inspired and uplifted. Not flying high. But proud. I sensed that everyone felt the same way. People were talking about the show, exploring their feelings and voicing them. 

And there's so much to talk about.