Hello! I've missed you. I'm happy to report that during my break there was some action in the comments which always warms the cockles of my heart. Thank you. What a lovely gift they were and they kept me on my toes.
I hope you are well and thriving now that the 2009 holidays are history. I hope they were smooth and whizzed by without any major bumps. Now you can look forward to Family Day, our nice innocuous statutory holiday on Monday, February 15, the day after Valentine's Day this year. A real double-header. It coincides with Presidents' Day in the U.S.
For those who are given this day off, it will be a lovely mid-winter day to relax, recharge, go to a movie, ski, snowboard or simply snuggle up with a good book.
I feel in my gut that MMX, as the Roman's would say, is going to be an exciting year. As soon as it starts for me. Gut is the operative word here. Mine is not in terrific shape at the moment.
You see, it's been a long, hot (as in high temperature, mine) holiday in our house, mainly because I've been sick. Still am. You don't want to know the details, but let us say that "rest" is what the doctor ordered and "rest" is not one of my strong suits. In school, I would fail "rest" and I would ace multitasking.
Oh well. That's the story.
There is an interesting item in today's New York Times by one of my favourite mental health writers Benedict Carey. The headline says it all – Popular Drugs May Help Only Severe Depression. By no means a new story, it's based on a new report published today in The Journal of the American Medical Association.
It certainly supports the strong contention I have about quick-fix, pill-popping approaches to mental health recovery. For cases of severe depression, this report finds quite conclusively that antidepressants are substantially more effective in cases of severe depression than in cases of mild or moderate depression.
This has been debated for some time and now a large and wide-ranging randomized study has come up with some conclusive findings. I have always sensed this to be true and further, than when antidepressants are prescribed, psychiatrists should be monitoring their patients closely and talk therapy should be part of the healing regimen. It is no secret that pills without therapy are never as effective as pills in combination with therapy. And that doesn't mean "a 15 minute appointment and prescription." That's not psychotherapy.
Carey sites Dr. Erick H. Turner, a psychiatrist at Oregon Health and Science University, who says, "I think the study could dampen enthusiasm for antidepressant medications a bit, and that may be a good thing. People's expectations for the drugs won't be so high, and doctors won't be surprised if they're not curing every patient they see with medications."
Dr. Turner adds, "The findings shouldn't dampen expectations so much that people refuse to even try medication."
Turner's last comment intrigues me. Mental health issues like depression are treatable, yes. But curable? Such a curious word for what most medical doctors consider mental illnesses to be – namely chronic, "like diabetes." Oh, how I hate that comparison.
One can go into recovery through medication, therapy, peer support, the process of self-actualization through meaningful and fulfilling work and having a stable family and home life. Recovery is a process. Not a pill. Not a cure. It's ongoing. It means many things, as I have often written. Have a look at The 10 Fundamental Components of Recovery from the U.S. National Consensus Statement on Mental Health Recovery.
Among them: Self-Direction, Empowerment, Peer Support, Respect, Responsibility and Hope. Similar to those underlying fundamentals of recovery at The Krasman Centre in two locations just north of Toronto. These centres are staffed completely by people in recovery from mental health issues.
As I reported last year in my story about mental health recovery in The Walrus magazine, "Today recovery is a fully realized and internationally recognized approach to attaining wellness... Still, it's hard to pin down an exact definition of recovery.
"Tanya Shute, the executive director of Krasman and a survivor, describes it as 'a person's ability to self-actualize, with or despite one's mental health experience.' Elaine Amsterdam of Toronto's Gerstein Crisis Centres says, 'It's about living well,' adding, 'The meaning of that is different for everyone and can include a range of different approaches.'
"But the whiteboard that hangs on the Krasman Centre's kitchen wall (in it's Richmond Hill location) notes five key concepts in indelible black ink: hope, personal responsibility, education, self-advocacy, and support."
We must all find our own way and it is that processing that we can begin experiencing recovery.
As Carey stresses, in some cases certain antidepressant are very helpful, in severe cases of depression. In his story today, he concludes with the words of one of the team of researchers in this study which included psychologists "who favour talk therapy and doctors who consult widely with drug makers."
On is Dr. Robert J. DeRubeis of the University of Pennsylvania, who stated, "The message of patients with mild to moderate depression is, 'Look, medications are always an option, but there's little evidence that they add to other efforts to shake the depression – whether it's exercise, seeing the doctor, reading about the disorder or going for psychotherapy."
This is such a positive message. Depression which isn't severe responds to many different and very accessible approaches, not the least of which is knowledge and understanding, learning about depression, facing it plus, peer support, doing things that make you feel better which can be anything from reaching out to an organization like the Mood Disorders Association of Ontario or joining your local community centre and signing up for Belly Dancing classes. Taking a class in Mindfulness Meditation, perhaps, or knowing when the best medicine is a lovely warm bubble bath or listening to your favourite music or a walk in the park with your dog or with a friend or with your thoughts.
Recovery is within reach. As long as you're willing to reach out.
Isn't this going to be a good year? Full of hope.
Now, I'm back to my bed.
Speak soon and be well.
Happy New Year Sandy!
Hope you are feeling better soon. I have a head cold so am also trying to take it easy. That's hard for me to do also, so I am cleaning my place. Although right now I am taking a break and sending you this note. :-)
I love reading your blog- always upbeat and full of info. I recently watched this Youtube video of Dr. Robert Sapolsky- Prof of Neuroscience at Stanford... great lecture about depression:
http://www.youtube.com/watch?v=NOAgplgTxfc&feature=PlayList&p=510B28EDDCA82E40&playnext=1&playnext_from=PL&index=2
If that link doesn't work just do a search on Youtube for "Sapolsky" and "depression"
Also there's an interesting show on PBS called "this Emotional Life" and they touched on depression and how it affects the hippocampus area of the brain, and also the effect of antidepressants on the hippocampus. All very interesting.
May 2010 be a wonderful year! Mine is already off to a great start. I graduated and landed a new job!
All my best to you!!!
Cheers, Kate
Posted by: Kate | January 06, 2010 at 12:45 PM
Hi, Sandy!
Your comment today hit the nail right smack-dab on the head! Medication isn't always the entire answer. Having dealt with my depression for 16 years I have noticed many things. For me in particular medication really isn't the answer. Talk therapy has been good, but I still had numerous relapses - big ones! However, about 6 years ago I was fortunate enough to attend the Stillpoint program in Barrie which is a mindfulness meditation practice group and since then I have not had any serious issues with my depression. That is the longest I have been free from a serious episode. I am more aware of it hiding in the background of my consiousness so I can deal with it before it becomes an issue and I have learned through the graces of the people leading the program to be kinder and gentler with myself and that whatever I am feeling, good or bad is okay - it is my experience and this too shall pass. I may still have my moments, but fortunately for me I have not been knocked on my backside. My last serious episode took me almost 2 years to recover from - so being this healthy for 6 years is truly a blessing for me. Take care & be kind and gentle with yourself.
Gardener
Posted by: Gardener | January 06, 2010 at 07:58 PM
Dear Kate and Gardener,
Thank you for your patience with me. Today, at last, I began to feel "human" again and wasn't chained to the "loo" so I worked all day on my classes which begin on Monday.
Kate, I hope your cold is on it's way out. Today's sun, here, was so beautiful to look at. I hope you derived a bit a sustenance from the sunlight. You sound so happy. So upbeat and excited about life and I'm absolutely thrilled for you.
Although I have downloaded Dr. Sapolsky's lecture, as it is 58 minutes long, I haven't had a chance to view it or to see our recordings of This Emotional Life. Over the weekend, I plan to take breaks between my lesson planning and see them and him!
I am very optimistic about this new year, 2010 or MMX (I love that, don't you?) and I wish you all the best in your new job. I know you'll do brilliantly. I can feel it. Your ebullient tone jumps off the screen.
You sound wonderfully winning.
And Gardener, heartfelt thanks for your uplifting and encouraging comment.
Medication is one tool in a tool box stuffed with tools of all kinds, as you demonstrate to us. I cannot understand why so many people resist the other tools.
Wisely, not you!
Knowing how you've turned your life around with time and effort, education and self-motivation, determination, is remarkable. A great achievement and a brave and courageous one.
We all have "our moments" ~ that's life. I know no one who sails through without a bump. No one. Those bumps are so educational and insightful. Not at the time, but looking back...
Your Recovery is a joy to read about and you give me hope that my beliefs ~ and they 're evolving all the time ~ are sound in their basis. I have so much to learn, but I am utterly overjoyed to hear a bit of your story.
Thank you so much for writing and sharing with us.
All the best to you both. Bravo!
I'm sending lots of positive thoughts in your direction for your continued success in your recovery and gallons of lemonade, too. Though it's frozen, the Lemonade Gods understand.
Be well. Of mind, body and spirit. I'm convinced we're a total package and when we're functioning on all our cylinders, smoothly, we make our lives rich and fulfilling ~ we thrive.
Speak soon.
Posted by: Sandy Naiman | January 07, 2010 at 11:21 PM
Thanks, Sandy!
We all need those little pats on the back, it's what helps keep us returning to write again ;)
I was waking from a nap and my head became full of ideas that I wanted to continue to share with you - I don't know that I have the space here. Anyway, it is true that despite what the professionals think, we - the survivors - have learned far more from our experiences than they will ever learn from a text book or lecture. To compare it with diabetes - which I have also heard (isn't that interesting - they must have all received the same memo) is astounding to me, really. I have never met a diabetic who felt ashamed or fearful to admit to anyone that they were in fact diabetic.
Mental illness, whatever variety a person is living with, is isolating. Never have I felt so alone in this world as when I have been in the grips of a debilitating episode of depression. Why do we feel so ashamed to admit that we are ill? Should it really take all the courage we have to even admit that we are ill on a blog where we can remain anonoymous? It is almost as if the "disease" has the ability to take your voice away. Depression has a way of convincing us that we are worthless and we believe this voice to be true because it sounds remarkably like our own. The only problem is that it is not our voice - it is the voice of the disease. A disease that is relentless in it's pursuit to win the battle for your life. I had to look to anything I could to win that battle. I told it No, that I wasn't worthless and that my family did need me.
This is the part that society doesn't truly understand. They call it a disease yet they seem to think at the same time we are fully responsible for what we do under the grips of this disease. When I began cutting myself I would get looks from professionals as if they were asking (with their eyes) "why would you cut yourself - stop it." I could explain the "Why I can't " to you if you would like - just let me know. It wasn't actually me who was doing the cutting - it was my depression - but how do you seperate the two of you when you can't see it on an xray or MRI? They can't operate on you and remove the problem - what's there to fix? It is a very complicated place to be.
Anyway - to further explain my learning experience about the kind and gentle thing. The meditation practice was to close your eyes and think of the person most dear to you, spouse, friend, sibling, pet, who or whatever. Feel the love that you have for that person - now turn that love around and feel it for yourself. It was more detailed than that of course. It is a most powerful practice. I took it even further than that - I visualized myself at various ages in my life. I visualized myself at my age now driving up the driveway of my childhood home. There I was at 5 years, 12, 17 and 22 years of age. To each one of these younger "me" I gave a very big loveable hug to. I told each one of them how beautiful they were, how smart they were and what a wonderful person they were. This was a huge healing practice for me. I gave myself the love that my Mother couldn't. I forgave myself more easily too. I still practice this visualization from time to time and I tell the "girls" that they have incredible strength and so many possibilites await them.
Yes, I have come a long way, baby! But I know that this journey is not over yet and I am hoping and working at, staying healthy.
Thanks for allowing me to express my voice on your blog. It's been a long time finding it.
Gardener
Posted by: Gardener | January 08, 2010 at 07:02 PM