On Denial ...

Last week, I was in touch with my friend and mentor, Tufts University professor of psychiatry Dr. Ron Pies after the summer break. He mentioned that Elyn R. Saks had written a commentary called "Some Thoughts on Denial of Mental Illness" for the September 2009 issue of The American Journal of Psychiatry.

I can't download this journal article without paying a fee, so Ron kindly offered to mail me the piece, which arrived yesterday. As you may recall, I wrote a lengthy post about University of Southern California Associate Dean and Professor of Law, Psychology and Psychiatry Saks and her "memoir of madness" The Center Cannot Hold – back in April. 

What I didn't mention then was that I detested her use of language. It made me cringe. Saks is a fine writer, but her language screams with embarrassment, shame and for the most part, exposes her chronic denial of her florid psychoses and her lifelong battle with schizophrenia.

It took Saks years and years, far too many years, to be able to admit to herself that she had a mental illness. It was and is still clear in the way she writes that she's ill at ease and grappling with her diagnosis of schizophrenia. 

Her commentary is rational. Emotions are irrational. 

It seems to me that she is actually in recovery, but doesn't know it or doesn't want to know it – despite her extraordinary academic accomplishments and her meaningful and rich life. She's happily married and a highly respected academic.

Right now, I'm not going to challenge her rationale simply because I don't have time. Saks has degrees in literature and philosophy besides law. She is a brilliant woman, an excellent writer, and her "thoughts" are argued with the precision of a closing argument in a murder trial. 

It's Friday afternoon. I've just returned from teaching one of my classes. It's been a long week. My editor is leaving in an hour and a half, and I need to digest what Saks has written to challenge her ideas. But I will. 

For now, I will muse a bit about denial and mental illnesses on my own. This is a rich subject. I will leave my journalistic jousting with Ms. Saks for another day.

First, as you know, I am not in denial of my mental health issues or my mental illness – I always feel a little odd using the term "illness" when discussing the mind. I do not believe the much-hyped theory that mental illnesses are brain diseases caused by chemical imbalances in the brain. That's simply not been proven and it's too simplistic, as far as I'm concerned. 

I've never been in denial. I grew up believing, naively perhaps, that going to a psychiatrist to talk once a week was healthy and smart – like going to an allergist once a week to have allergy shots.

As an adolescent, I used to complain to my mother, "Why do I have to go to see Dr. McQuaid every week?" She would simply say, "If you had a broken leg, you'd go to a doctor who would put it in a cast to heal. Well, if there's something wrong with your mind, you go and talk to a psychiatrist every week and you feel better."

Coming from a predominantly medical family where everyone was either a doctor or a psychiatric social worker, I was socialized to believe that going to a psychiatrist was de rigueur even though I was the only kid I knew who did, back in the early 1960s.

I live my life out loud today because it never occurred to me that there was anything wrong with having a mental illness. I consider myself lucky. 

Over the years, people have always confided in me, but always in whispers. 

Several years ago, I was invited to speak to a group of women at the Ontario Ministry of Government Services. The event, which celebrates Women of Influence and Inspiration, took place during Mental Health Awareness Week in May. Linda Lane, the creator of the event who asked me to speak, selected me as one of that year's Women of Influence and Inspiration, but asked me to stay clear of anything that smacked of mental health. Instead, she wanted me to focus on my journalistic career and women's issues. 

When I arrived, there were more than 250 women seated in a large conference room. I started listening to the other speakers, all extremely successful, high-ranking women in government who had clearly broken through the glass ceiling. (I've always thought that glass ceiling was really a layer of men, but that's another story.)

As I listened, clearly, I knew I couldn't stick to my script. After all, I'm an advocate. Place me in front of an audience and I can't resist, especially during Mental Health Awareness Week. When my turn came, I started talking and slipping references to my mental illness into my speech. Funny references. Self-deprecating quips to show that having a mental illness doesn't mean you can't have a good life and a great career. It's all about having a positive attitude. 

The audience laughed in all the right places and seemed relieved that I wasn't talking about government business. Clearly, they were enjoying themselves. You could hear a pin drop.

After I finished to a resounding round of applause, there was a break. I had to leave and go right back to my office. As I slipped out of the room, a woman approached me. I'll never forget her. She was slightly hunched over. Her body language screamed out "Denial" – I knew what she was going to say. And I was right.

In a barely audible whisper, she said, "I have the same problem as you, but I would never tell anyone. I've had it for 16 years."

I listened to her as she told her story of loneliness and isolation. She spoke about how she kept it a secret. How she was afraid she would lose her job if anyone "knew"... and how hard it is not to be able to talk to anyone at work about it, especially when "I'm not feeling at my best."

You have no idea how many times I've heard this. And worse. Parents in denial for their children. Rather that seek the appropriate help, they take their troubled adolescents to every specialist in the world, except a psychiatrist or psychologist. In one case, when no "physical" problem could be found, a young boy of 15 was kept at home, out of school, far from friends, cloistered, and hidden away because his parents couldn't accept that perhaps he had an emotional or mental health issue.

That's one reason why the new website Working Through It so powerfully mitigates denial by showing that mental health issues are not only prevalent but treatable in a wide variety of ways and real people are doing the talking. 

Often, I'm told that I'm very open. This surprises people, this openness of mine. But I also find that when I'm open, others open up to me. They share the burden of their denial. And they feel better.

I'm convinced that there is no normal. That we're all "next to normal" and diagnoses can and often do more harm than good. Even in cases of psychosis and schizophrenia, there are so many people finding ways to recover.

And in recovery, they overcome their denial. 

Working Through It

Have I got a website for you!

Yesterday evening, an email arrived in my inbox from my longtime friend and mentor, Mary Ann Baynton – with this subject line: 

Finally! Here is the link to Working Through It. Please forward it to anyone who can use it or share it.

Mary Ann and I go back a long way, but that's another story.

For now, let me simply say that she has dedicated her life to changing the culture of Canadian workplaces – to help employees facing mental health issues and their employers. Most workplaces are pressure cookers of stress and anxiety, demands and deadlines. More so every day.

Some of us can be emotionally vulnerable to these tensions, triggers for our mental health problems. Some of us bring those issues with us, but secretly. Either way, the workplace can be daunting for everyone involved.

In Canada, that's been changing because of Mary Ann.

In 2001, she was developing an educational program to help equip employers with easy-to-learn skills and training strategies to appropriately accommodate their employees who may be facing mental health difficulties on the job. Touchy situations that Mary Ann, with her training and commitment knew could be successfully mediated. Especially if an employee can "coach up" and help a supervisor learn skills they've never been taught.

Through the Canadian Mental Health Association (Ontario) she launched Mental Health Works. Since then, this multi-faceted program has won awards and now is running in government, private companies and corporations in at least five provinces. It's a win-win-win. 

There is no question that healthier workplaces with mentally and emotionally healthier and more resilient employees improve a company's bottom line! This has been proven time and again. Education is the key and Mary Ann's Complex Issues. Clear Solutions training and tools enables management to function more effectively – to discuss sensitive issues, resolve conflicts, create accommodations and avoid discrimination and human rights violations in the workplace.

A few years ago, Mary Ann began branching out and consulting. Now, she's consulting with CMHA and Mental Health Works but she's moved on.

Her newest venture is far more ambitious and delves deeper into the collective consciousness of people living with and struggling with mental health issues. Last night, I managed to track Mary Ann down at her home, where she was busy entertaining her extended family. She explained that in 2003 or 2004, a woman named Mandi Luis approached her at her CHMA (Ontario) office. 

"She had to walk away from a 27-year banking career because of severe depression. No one was able to help her," and now she wanted to help prevent that happening for others who may find themselves in similar straits.

Mandi is now a peer support specialist – peer support could have helped her when she needed it most. 

Mary Ann suggested Mandi write an article for Mental Health Works, which she did, but there was a problem. 

"When I was really, really depressed, really sick, I wouldn't have been able to concentrate on an article like this. I couldn't focus," Mandi explained.

So what to do about Mandi's dilemma? How do you transmit information to people who are currently struggling and so mentally and emotionally stressed out they're not able to concentrate well enough to read? How do you reach them?

Mary Ann came up with a possible solution. How about short videos of people, real people, talking about their experiences? 

In collaboration with Mental Health Works and The Mood Disorders Association of Ontario (MDAO) with the funding of Great West Life, where Mary Ann is now consulting, a working group was formed and 10 people were carefully selected to share their experiences in front of a camera. 

That's how Working Through It came about. This is an encyclopedic resource. Amazing. In all 31 videos. Short, byte-sized, none are more than three or four minutes. Several are even shorter than that. You can come and go, visit for a few minutes and then come back. Easily digestible and extraordinarily engaging.

There are 15 major themes, featuring four or five different people comfortably sharing segments of their stories of how they have "reclaimed their well-being at work, off work and returning to work."

"We wanted to use broad language that was entirely inclusive," Mary Ann explained when I asked why the word "recovery" was not used.  

You'll meet and grow to know Gord Conley, Sean Miller, Phillipia Wright, Bonnie Pedota, Hazel Gabriel, Rose Pardham, Marvin Burr, Melonie Long, Donna Hardaker and Constantin Nastic as they open up their hearts and their hurts to you. Candidly, viscerally, they tell you about their lives with their mental health struggles and their triumphs.

Speaking out about tough stuff sometimes. But they are surprisingly comfortable in front of the camera. They talk about their deeply personal feelings, memories, insights and strategies. They share practical tidbits of life experience that they've developed in facing all kinds of challenges in getting well, staying well, and coping when they may not be well, all the time. Yes, they talk about what they do when things go wrong. 

They talk about how they wish they could turn the clock back. How they wish they had sought help sooner. How facing the reality of their issues earlier may have saved them years of emotional anguish. Implicit is a sense that they want to help you to be more open to yourself, more honest. To refrain from denial and speak out. Open up. Don't go it alone.  

"This can happen to anybody and it's very treatable if you recognize it," says Gord Conley. 

We're all changing all the time. Life happens. Nothing stays the same. We all have set backs and they talk about theirs, too. And how they cope. What they do to prevent serious setbacks from reoccurring. All their support systems and strategies, from exercise and watching what you eat to taking your medication or going to regular 12-step program meetings. Whatever it takes. It's up to you.  

They're tremendous likable people and I was overwhelmed by their generosity, bravery, sincerity and courage.

Why? Because they've been through it. They tell you about how they've worked through it, how painful at times this process it. 

Most of all, they tell you and show you how you can feel better. How there is help out there. 

They are the faces of hope. There are lots of different ways to get help and stay healthy. And most of all, they show you that you're not alone.

To be honest, when I first entered the sight, I didn't know where to begin. It's so comprehensive. Initially, you see a selection of titles including What is happening? Why is it such a struggle? and What should I say? and How can I manage financially? and How do I stay well? and more.

I've never been one to begin at the beginning of anything. Being perpetually backward, I chose to bypass the Introduction and instead, headed to the end, to the penultimate section called Never Give Up. That title spoke to me.

I pressed the little orange arrow. A screen popped up and a lovely, pleasant-looking gentleman started talking, followed by another, and then two women. They weren't edited. They were extraordinarily comfortable and easy to listen to as they talked their mental health problems. They looked and sounded liberated. Alive. Free. 

I urge you to click onto Working Through It to see for yourself. No matter how you're feeling. There's so much information for you. Not only from these exceptional people, but specialists. Psychiatrists, leaders in the community who work to provide access to all kinds of support systems.

There's something for everybody here. Whether you are experiencing a mental health problem right now or you know or work with someone who is. University of Toronto Professor of Psychiatry Dr. Anthony Levitt talks about some startling statistics about how many people find the "right" help.

If you take 100 people with depression or anxiety, only 50 of them will recognize that they need help. Only 25 of them will look for that help. They may be prescribed one of 22 different medications or perhaps be offered one of five or six different kinds of talking therapy. That's 25%.

But here's what shocked me. Of that 25%, only 10% will follow through and receive the right treatment. 

You have to work through it. And it's not always easy.

These videos are powerful gems of hope and inspiration. Melonie Long talking about how she cannot believe what would have happened "had I been successful in my suicide attempt..." and now "knowing what joy feels like," brought tears to my eyes.   

You will be able to identify with these people. And there are loads of other resources embedded in this website. It's extremely user-friendly. One of the most exciting online mental health initiatives I've ever seen and experienced, anywhere.

This is another beginning for Mary Ann. "Next, we want to find out how we can help people get the right treatment, the help and support they really need, the first time – whatever it is." 

Think of how revolutionary that will be. And how much needless suffering will come to an end.

Think of how healthy our society as a whole could be. Negative stereotypes will be smashed. Workplaces with thrive. More people will live meaningful productive lives.  

Because we'll all feel more safe and secure Working Through It ourselves, with our families, our friends, our colleagues, our doctors. Everywhere. We'll be more comfortable with ourselves. 

Bravo! Let's spread the word. 

Say "Yes" to Mental Health Recovery...

Yesterday a gentleman named Stephen Batson sent me an email. 

The subject line? "another country heard from" ...

It turns out that Mr. Batson is the Project Coordinator of the Michigan Recovery Center of Excellence, where "Recovery is the foundation of service delivery in the Michigan community mental health system," it states under Welcome to Michigan Recovery" on this website.

"The Michigan Department of Community Health (MDCH) has charged mental health providers, consumer leaders and other community stakeholders to work together to promote recovery-based service delivery models."

Stephen wrote to me because he liked my last post on – Coming Out In Class. 

(By the way, I'm happy to report that 15 students showed up in my class this morning. Earlier this week, I had seven students attend with nine registered. This morning, I had 15 attend with 20 registered. This, after I shared with them the fact that my community service is mental health advocacy and I have a long history of mental health problems. I even told them about this blog. Things are looking up.)

Stephen told me in his note that he found me on a blog that's been running since 2006 called The Recovering Life with the tagline – Observations on a Cultural Phenomenon – written by his friend Norm DeLisle.

Norman G. DeLisle runs a small, non-profit organization called the Michigan Disability Rights Coalition and blogs like a house on fire, posting five or six times a day. He's worked in disability advocacy for 37 years, has background in education, Montessori, and psychology. He seems to me to be a powerhouse who works tirelessly to raise awareness and make a difference. He doesn't miss a trick and his blog is well worth investigating.

It seems he posted my Wednesday entry on his blog and that's where Stephen Batson comes in. "Every story makes us feel good about our decision to live real and open ourselves to others," he wrote, inviting me to check out his site. I did. It's amazing.

Then he invited me to a Recovery Conference in Detroit on October 6, sponsored by the Detroit-Wayne County Community Mental Health Agency, a real going-concern when it comes to recovery judging by its publication, The Advocate News, which is devoted entirely to mental health recovery and hope. 

Stephen asked me if I knew Dr. Daniel Fisher of the National Empowerment Center, which he founded in Lawrence, Massachusetts, near Boston. "Talk about leadership," Stephen said. 

As a matter of fact, I do. Though I've never met him. I know Dr. Fisher's remarkable recovery story and his spiritual and healing approach to severe emotional trauma, often the root cause of mental disorders. Having hope is crucial.

I've read several of his books including "One Vision of Recovery" – his personal story – and "A PACE/Recovery Reader" – an excellent historical anthology of writings about psychiatry, mental illnesses and recovery. 

My psychiatrist, Dr. Bob, was the first person to enlighten me years ago about the bogus claims that mental illnesses are caused by chemical imbalances in the brain – a theory that has never been proven. Fisher elaborates in his writings. I'm reading stories from substantial sources that corroborate this all the time, but still, especially here in Canada, the biomedical model which is grounded on this theory seems to stand firm. Psychiatrists prescribe cocktails of drugs and insist on diagnoses that rarely fit the individual. And people are getting sicker all the time, when they could, indeed, recover and live meaningful lives. 

We have universal health care here in Canada, but we're in the dark ages when it comes to mental health recovery. We're the only country in the G8 with no national mental health strategy.

Dr. Fisher subscribes to "recovery at your own pace." When I interviewed him several years ago, he stressed that medications can be helpful but only as tools, in the short term. There are other tools. Toolboxes full of them. He stated that he has not taken any psychoactive medication for more than 30 years. Community, inclusiveness, helping people to feel that they are not alone, that there is hope are among his prescriptions for recovery.

His story is recovery story remarkable. 

Years ago, as a PhD student, Fisher became delusional, ironically while researching the biochemistry of the brain in schizophrenia. He was hospitalized several times, treated like an animal, shut away and ignored. His psychiatric diagnosis? Schizophrenia.

So demoralized, appalled and angry at how he was treated as a psychiatric patient, Fisher vowed, then, that if he ever recovered, he would become a psychiatrist to ensure that people with psychiatric diagnoses would be treated with dignity and humanity. 

He finished his PhD, went on to complete his MD at Georgetown University and his psychiatry residency at Harvard. He has become a leading Recovery advocate, as well as a clinical psychiatrist – one of a tiny handful of psychiatrists who "are out" and openly discuss their psychiatric histories.

His interview on January 20, 2005 in Medscape is fascinating. Fisher is the featured keynote speaker at the Detroit conference, called Redefining Our Roles in Recovery: It's Everybody's Business. Sadly, my teaching schedule prevents me from attending, though I'd do anything if I could, I told Stephen.

But I'm following the activities of the Michigan Recovery Center for Excellence and Norm DeLisle's blog.

Then, this morning, when I came home after my class, there was another email from Stephen Batson.

"Hi again. I was thinking, on the way home last night, that we have recovery stories on this site. In fact, I will be spending the next seven days in Michigan's upper peninsula visiting drop-in and Clubhouses. While up there I will be video recording more stories to post on the site.

"I'm writing to you today because your article IS a recovery story. Perhaps not like the life stories many others have told, but yours talks about an important aspect of a person's recovery ... relationships' socially valued roles. So, I'm asking for your permission to include your story among the collection we have gathered."

Of course, Stephen. It would be an honour. My story is yours. As I tell my students, I have a mantra, one of several. "I live my life out loud. No secrets. No lies."

It's one way to find peace of mind.

Have a great weekend. I wish you the best, always.

Speak soon.

"The good life"...

I've been thinking about what it must be like to live on the street or beneath a bridge or in a shelter. About being homeless. 

I've written about people who have fallen into homelessness before. But not often enough. I guess because deep down I know that I could fall into homelessness. Anyone can. It frightens me, so I stay away. 

When I was reporting for The Toronto Sun, I spent several Thanksgiving and Christmas mornings at The Scott Mission where about 400 men and women and young people lined up for a warm Turkey dinner at 10:30 in the morning. I listened to their stories, those who would talk to me. Stories of lay-offs, family break-up, isolation, tough times, the dangers of the street. Often, mental illness, too.

But then I could walk away, go back to my office, write my story and go home. 

So you're probably wondering why I'm sleepless over homelessness now. As with many subjects I discuss here, it's pure chance.

Last week, I had a cup of coffee with a friend I hadn't seen in a long time and she mentioned that she's passionate about Mainstay Housing and active on its board. I had never heard of Mainstay and started asking questions about Ontario's largest provider of safe, secure, affordable supportive housing for people with serious mental health challenges. 

That was the beginning.

My friend suggested I call Brigitte Witkowski, executive director of Mainstay. I did. On Tuesday, I went down to meet with her. She's a petite firecracker bristling with energy, spark and excitement about Mainstay and the communities it's created and the people now "living the good life" because they have a safe place to call home. It's affordable. Rent geared to income. "If they have no income, we help them get an income – either through Ontario Works or ODSP (the Ontario Disability Support Program)," Brigitte said.

The first thing she did was show me, with obvious pride, a series of framed black and white photographs hanging on the walls of the Mainstay offices. Each picture showed a neat, nicely landscaped, pristine house or low-rise apartment building in Toronto. Mainstay has 867 apartment units housing and supporting about 1,000 people in single or family-sized units in about 40 locations across the city.

Within five minutes, as we walked to a charming new Queen Street West cafe, I discovered that Mainstay isn't about buildings. 

It's about people. With a staff of 13 supportive housing workers and a housing access coordinator – all highly skilled social workers trained to engage tenants in "narrative story-telling to determine what a person needs to access and maintain their housing. We ask tenants what will work for them." 

"Our ideal tenant is poor and living with a mental illness," Brigitte explained. "If they have an addiction or a physical disability or a developmental delay or they're socially isolated, this is a bonus for us."

The scope and potential for recovery becomes even greater in such cases.

In short, being members of a community and breaking out of patterns of social isolation so they can "create the good life for themselves" as Brigitte calls it.

She used a phrase I've heard before through The Clubhouse movement – Everyone needs "A home. A job. A friend." 

This is the first step toward mental health recovery.

For Brigitte, Mainstay is a hub, a cluster of bright possibilities for people. It's all about adult education, responsible living and community development, where tenants can reach their goals for a good life.

Then, something clicked. About seven or eight years ago, at a Centre for Addictions and Mental Health (CAMH)  Courage to Come Back Awards dinner, I heard a woman, an award recipient, speak about her life. 

Abandoned as a child and forced fend for herself, she had fallen into homelessness. For years, she was forced to fight the elements, barely surviving in Toronto's parks and streets. For years. Unable to read or write, she couldn't hold a job though she tried repeatedly. Eventually, struggling with a mental illness and a diagnosis of schizophrenia, the only homes she ever knew were either boarding houses or more often hospital rooms in psychiatric wards.

"If homeless people don't have mental illness when they start, they certainly do once they get out on the street," she said in her acceptance speech and I've never forgotten it. 

In preparing for my meeting with Brigitte, I came across Linda Chamberlain's story on the Mainstay website. Though we have never met, indirectly, our paths were crossing again.

Through one person, a caring psychiatrist who reached out to her and helped her connect with Toronto's Clubhouse called Progress Place, Linda was able to find a home in one of Mainstay's apartments where she still lives, has two part-time jobs, served on its Board of Directors for six years and helped start The Dream Team.

Mainstay changed her life.

That's how a person becomes a Mainstay tenant – through any of 23 different agencies in Toronto, including CAMH and the Canadian Mental Health Association.

What intrigued me most about Mainstay is its rights-based approach. The vacancy rate is low.

During Mainstay's last fiscal year – April 1, 2008 to March 31, 2009, there were a total of 5 evictions and 199 evictions prevented. "When one of our tenants is evicted, we track where they go and reconnect them back to mental health agencies.

"That means that 204 notices of eviction were given to our tenants based on failing to meet tenant responsibilities defined in the Residential Tenancies Act," Brigitte said. "Most of the failures were paying rent. We also give notices of evictions for interfering with your neighbours' rights or the landlord's rights. We believe we house citizens and adults, not patients. We believe in our tenants' abilities to solve problems. Things happen and people with support and knowledge can find solutions that work.

"We're ruthless about missed rent payments. We live by the Landlord Tenancy Act and serve our tenants with eviction notices immediately," Brigitte said. 

At Mainstay, a notice of eviction is an opportunity for follow-up and eviction-prevention, she explained. "We don't want our tenants to feel hopeless and helpless. We know how desperately they want their apartments, so we show them how to connect with their responsibilities and solve problems. We show them there are multiple opportunities and it's often a revelation to them that they can solve their problems, like setting up payment plans if they've missed a rent payment.

Many Mainstay tenants (not "patients" or "clients") may never have rented an apartment before and through respectful, dignified support they learn the responsibilities of tenancy and begin to build self-confidence and self-esteem through their "membership" in their building's communities. 

"I believe in adult education, knowledge transfer and community development," Brigitte said. "Everyone deserves access to the good life and if a rent payment is missed, we ask if this is a problem and then come up with a solution. Each tenant signs a housing contract. It's all about choices – and people."

Opportunities. Learning. Recognizing the enormous potential, skills and productivity of our tenants, she says. "We're taking it to the next level and supporting our tenants on their individual journeys of recovery and in their relationship with the mental health world and the social service world."

There are gardening clubs at 21 buildings engaging 112 members. Each club sets its own membership rules and decides what they grow – vegetables, flowers or both. Some share among themselves or with everyone in the buildings. Each club decides. In four buildings, there are food security groups involving 93 members who work with the Daily Food Bank. Some now volunteer there. As well, they volunteer at the Learning and Resource Centre in the Mainstay headquarters.

We ran out of time. I had to leave. But I did, knowing that this won't be my first experience with Mainstay. I'll be back. I want to learn more. 

I rushed off to my 3:30 p.m. appointment with Dr. Bob. He had never heard of Mainstay. It's too easy to dismiss homelessness. To close our doors on it. To lock it away. Not me. Not anymore. Mainstay's approach to giving people who have been homeless access to the good life is too good to stay so overlooked, so unsung.

I'll be back.

All quiet on the August front...

I'm happy. I'm free. For the next 13 days minus one morning, I am not a part-time community college teacher. I am a blogger. Full-time. Your blogger!

If I have not commented or responded to your recent comments, please forgive me. I read them. I wanted to respond, but I was under a huge gun. Thank you for them, for caring and being so tuned in to me and to each other. That's what community is and we, I believe, are a community. I want us to be.

But now, today, as of 2:40 p.m. this afternoon, the Summer 2009 term at Seneca College is officially over and I am me again, entirely. Not a split personality, driving madly between my life with you, thinking about you, and concerned about you, and my students, and their concerns – trying desperately to get them through my course. If you want a thoughtful and very insightful sense of my life as a part-time community college teacher, read this from The New York Times. My niece, a newly-minted PhD who began teaching today at Duquesne University in Pittsburgh sent it to me and in turn, I've sent it to about 12 of my part-time colleagues, all of whom agree that it was the story of their lives.

Not now, though. 

Right now, I have NOOOOOOOOOOOO students. Yipppppeeeeeee!!!!!!!

So, I want to celebrate. Here I sit, with not a thought on my mind. Well, not quite. I have two deadlines that are niggling at me and I'm going to do something about those. That's a good thing.

You know, it's interesting, but since everyone takes August off, it seems, nothing much is happening in the mental health world. I subscribe to about 20 psychiatry, mental health and bipolar blogs and right now the biggest news story is that Prime Time on ABC is airing a show on Mad Pride in a few minutes – the old violence issue will be a focus. You'd think an outfit like ABC News could come up with something other than this tired stereotype. 

You know what they say. Good news is snooze news, so it's easier to go after a sensational angle that represents a tiny minority of cases than find the real story. When the media does the diagnosing, as often happens with a sensational crime, I wonder how accurate those diagnoses really are. Well, I'm not going to think about it right now. It's borrrrring. 

I'll watch it tomorrow.

Other than that, nothing much is happening in the blogosphere around mental health.

I guess when the psychiatrists, psychologists, social workers and other psychotherapists go on vacation, "illness takes a holiday," too.

Helen Henderson's piece in this paper a few days ago about a British film called "Schizo, the horror story" was, as always, excellent. Have a look. The Brits are light years ahead of us in challenging mental health discrimination and working to end it. That's exactly what this new mini-movie, produced jointly by the British government and Time to Change, a leading mental health charity, is doing.

While the Mental Health of Commission of Canada is "Making the Case for Peer Support" with yet another cross-country, face-to-face consultation and focus group, we're still the only country in the G8 with no National Mental Health Care Strategy. They're still working on it. As if "peer support" is news. It's important. Very important, but I guess since it's August, nothing else is newsworthy. Please.

How many people are able to access Wellness Action Recovery Plan (WRAP) groups in this country? Or Pathways to Recovery? Does the MHCC even mention Mental Health Recovery on its website in any meaningful way?

But you know what? For the next few days, I don't care. I'm going to relax. Take care of business I've neglected. Doctor's appointments. Spend some time with my husband who doesn't recognize me these days. And my Dandies. Read anything that has nothing to do with what I'm going to be teaching in the fall. Go to a movie, if we can find one that appeals to us. And think about some intriguing material to share with you.

The Fall film line-up doesn't look all that promising, but I don't care. The Toronto International Film Festival is around the corner, and that's always intriguing to read about. Right now, though, this minute? I don't care about anything. I haven't a care in the world. Until September 8, when it's back to school.

On one sad but inevitable note. Senator Edward Kennedy has died. A voice for reason and compassion in health care, all health matters. Yes, especially mental health care. When you consider the madness that is exploding south of the border around securing  fair and equitable health care reform so all American people can receive the health care they need, Senator Edward's Kennedy's passing is a true loss and a great tragedy. His voice or reason will be missed.

Be well and speak soon!

Very soon!

More on "Mad Pride" and "Knowing Your Rights Day" ...

Happy Mad Pride Day!

July 14 – A Universal Day of Liberation from old stereotypical thinking about mental health and mental illnesses. To challenge mental health discrimination and prejudice. To educate and enlighten and declare ourselves. To celebrate who we are, educate ourselves and others and remember our history. To break out of denial. To stop being afraid. To end our silence.

To be proud.

Wow, is "Mad Pride" ever a red flag issue, though? At least on this continent.  

Not in England and other countries, where "madness" is an increasingly acceptable word to describe having a diagnosis of a psychiatric or "mental illness" and that's very significant. 

Just click onto the comments to my last post, In the mood for Mad Pride 2009 to see an intriguing discussion that took place over the weekend. Not quite a repeat of what happened in the comments to my post about 2008 Mad Pride Week. That really upset people. Big time. 

So, we're making progress. One step at a time.

This morning, I received a Facebook invitation from Mary Ellen Copeland of the Copeland Center for Wellness and Recovery to join her group called "Mental Health Recovery and WRAP© – Wellness Recovery Action Plan". Copeland is one of the leaders in the U.S. mental health recovery movement and she has a remarkable recovery story, herself. 

I met the Stephen Pocklington at a conference last year and posted all about WRAP. These eight week programs offered in Toronto and all over the U.S. Worth considering if you want to add more tools to help you with your recovery. It works!

There is a profound relationship between Mad Pride and Mental Health Recovery. As I see it, they go hand in hand, even if you choose not to describe yourself as "mad" and feel more comfortable with the term "mental illness." Whatever works for you!

My friend Tufts University psychiatrist Ron Pies, a valued presence here at "Coming Out Crazy",  suggests that being very specific is probably most helpful and healthy. 

Here's what he says: "As for how people diagnosed with so-called mental disorders ought to refer to their conditions, I think its often best to name the specific condition, such as 'I have an anxiety disorder' or 'I have bouts of depressions.'"

Everyone is different and should find their own "comfort zone" – and it's doesn't have to be carved in stone. You may find yourself changing and evolving. "Coming Out Crazy" is a process. It can take years.

These days, I don't run around town saying seriously that "I'm utterly mad." (Although, I do less seriously, in certain situations, among friends and people who know me.) What I usually say is that "I'm in recovery from a unipolar mood disorder. I'm not bipolar. I have never been clinically depressed. I get high. Very high. Not happy. Insane, crazy, nuts, mad!" 

I feel comfortable making a little fun of myself and playing with words and I can pull it off. I've been out all my life. I've had years of practice. It wasn't as easy when I was much younger, as it is now.

It depends on context, of course. Where you are. Who you're with. We're all different. I'll often add that, "This is a very rare, very serious mood disorder. I've been hospitalized about 20 times for mania. I get psychotic. It's no fun. Trust me! But I haven't had a major manic episode since 1988." 

When I talk about myself that way, more often than not, people are comfortable asking me questions. That's when I can self-advocate and educate. It's a win-win-win! That's how you can bring about change, one person at a time. It works. 

That's my brand of Mad Pride. Why don't you try to think about yours. Everyone feels differently. How do you describe yourself and feel about yourself? Why not comment about your brand of Mad Pride and if you don't have one, pretend you do. Put words to your thoughts. Brainstorm. Add your thoughts and comment on them, here.

After all, this is Mad Pride Week. It's the one week in the year when Madness is on a lot of minds. Have some fun with it. Think about some positives. Break out. Be a little optimistic. Cockeyed Optimistic! Think outside your box! Forget about the old resonating ideas for a minute. Just be free. Take a deep breath and for a moment, remember that you are you! There's no one on earth like you. Never has been and never will be. You have special gifts. Try to turn your thinking around. 

Be proud of where you are right now. If you're here, you're in a good, safe place. And we're all here together with you!

One last word – five really important words, actually – before I list highlight tomorrow's Mad Pride Week activities. 

These are the five key concepts for Mental Health Recovery according to Mary Anne Copeland.

• Hope

• Personal Responsibility

• Education

• Self Advocacy

• Support

Meditate about them, too.

Now them, tomorrow, Wednesday July 15th, is "Know Your Rights" Day during Toronto's Mad Pride Week. 

Here's what's on tap. Click here for an overview and details about location.

From 11 a.m. to 12 noon: The Dream Team, a group of "consumer survivors" who advocate for safe, secure and affordable house for people living with mental health and addiction issues will share their stories. Over the last year The Dream Team worked with various groups and communities across Ontario to explore the issue of discriminatory zoning. In this presentation members of the Dream Team will illustrate the concept of discriminatory zoning and the impact on people with mental health and addiction issues. 


At 12 noon to 12:15 p.m. The Parkdale Activity Recreation Centre or PARC Ambassadors Program is a remarkable grassroots community success story. This Parkdale Community consultation program engages, informs and consults with residents and stakeholders in the community in relation to their building development at Edmond Place. Nine Ambassadors, PARC Members, receive remuneration for their peer and member driven work, which incorporates and builds on the principles and values of the recovery model and PARC’s Mission – PARC – A Place Where People Rebuild Their Lives. 

When the Parkdale Activity Recreation Centre acquired Edmond Place from the City of Toronto to develop affordable, social housing for marginalized persons in our community there was extreme opposition to PARC by residents and stakeholders in Parkdale. Since the PARC Ambassadors Program's inception in September 2007 this inner-city community has evolved from a NIMBY (Not In My Back Yard) neighbourhood to a YIMBY (Yes In My Back Yard) neighbourhood. 

The PARC Ambassadors Program is proof positive that through community organizing and public relations, marginalized people have a commitment to their community. They have all the necessary attributes and capabilities to be productive, to contribute to their neighbourhood and to society. They can a do live a healthy, meaningful and fulfilling life. This is a powerful snapshot of recovery.

PARC Ambassadors will discuss their work at this presentation 

12:15 noon to 1 p.m. Lunch – light refreshments generously provided by The Raging Spoon

*RSVP: http://www.madpridetoronto@yahoo.ca

Special lunch time presentations featuring Laughter Yoga with Salimah Kassim-Lakha, and more!

1 p.m. – 2 p.m. – Presentation – Legal Jeopardy by Parkdale Community Legal Services (PCLS)

2 p.m. to  3 p.m. – David Carmichael

QUESTIONS, QUESTIONS, QUESTIONS

When it comes to treating your own mental illnesses, we often assume that doctors and other mental heal professionals always know what’s best. During this presentation, David will raise a few issues about scientific drug research and help you understand, based on his own experience recovering from major depression, how important it is for people living with mental illnesses to take responsibility for their own recovery and rehabilitation by asking their doctors and mental health workers questions, questions and more questions, and by becoming regularly physically active. 

David holds a masters degree in physical education and is the former director of national projects at ParticipACTION. After experiencing his first major depression in 2003 at the age of 45 and a relapse in 2004, he tragically learned the importance of good mental health and does not assume that doctors always know what’s best.

A Q & A session will follow.

3 p.m. – 4 p.m. Street Nurse Beth Pelton 

Beth Pelton is a registered nurse currently working with Street Health Community Nursing. Most of her nursing work has been in the community, and with people living with cancer. Her experiences have included working in medical and geriatric and psychiatric nursing, practising from a Harm Reduction Philosophy.

Mad Pride can help you on your Recovery journey. Go for it!

In the mood for Mad Pride 2009...

Since I started writing "Coming Out Crazy" 15 months ago, I've been on the steepest learning curve of my life. 

At least twice a week I sit down here facing a blank screen on my trusty iMac to muse and investigate issues around mental health and wellness that matter deeply to me and I hope to you, too. Particularly Recovery. Plus any relevant news. These days, there's lots of it.

Your comments are my only barometer, my only way know if I'm plucking at a few of your psychic chords. I live for your reactions, to hear your voices, to learn more about you and this community we've created.

Today, I am launching a short series on Mad Pride, which means many different things to many different people. I believe that Mad Pride is analogous to Recovery because they both share one very crucial quality. Hope.

Perhaps you'll think about what Mad Pride means to you. If you want to know the truth, I'm glad to be mad. I know I'm not normal and I wouldn't want to be. I'd rather be Next to Normal. I think everyone is. No one's normal. 

Being different and proud of it affords me enormous freedom, though I've worked hard to get here. Now, thanks to my psychiatrist Dr. Bob and his brand of talking therapy, I don't ever have to dare to be different. I simply am different. I like being different. That's part of my madness. I'm fine with it.

Some of you don't like the term "mad" or "madness" but perhaps you'll change your mind by next week at this time.

Anyway, here goes. A few annotated highlights for the first day or two of Mad Pride Week in Toronto.

• Mayor David Miller has once again officially proclaimed next week, beginning this Monday, July 13 and ending on Sunday, July 19 to be Mad Pride Week 2009. 

Incidentally, according to a PsychCentral 2007 post on its World of Psychology blog, July is considered Mad Pride Month.

And for all the folks of MindFreedom International, Mad Pride is central to its ethos as a "movement that celebrates the human rights and spectacular culture of people considered very different by our society."

For this "non profit organization that unites 100 sponsors and affiliate grassroots groups with thousands of individual members to win human rights" and alternatives for people labelled with psychiatric diagnoses, Mad Pride is a constant campaign – one of many.

NOTE: This year, due to the City Worker Strike, many of Toronto's week long Mad Pride Week Activities will take place at the May Robinson Auditorium at 20 West Lodge Avenue. That's one block east of Landsdowne and one block north of Queen Street. 

This year, Mad Pride Toronto is up to the minute electronically.You can follow our local Mad Pride Toronto events by watching them on YouTube. Or read the Mad Pride Toronto Blog. Or by following on Facebook.

Mad Pride is a cultural festival of arts, entertainment and heritage activities. Several activities honour and commemorate the contributions of men and women who lived, worked, struggled and died in the former Toronto Hospital for the Insane which was located at 999 Queen Street West.

Here are a few events that intrigue me:

• At 6 p.m. on Monday, July 13, you won't want to miss Geoffrey Reaume's unique historical guided tour of The Patient Built Wall, constructed in 1860 by unpaid patient labourers in what was then known as the Provincial Lunatic Asylum. The Centre for Addiction and Mental Health (CAMH) now stands there. Patients lived and died building that wall and Reaume, author of the landmark history Remembrance of Patients Past – Patient Life at the Toronto Hospital for the Insane, 1870-1940 is well-acquainted with their stories. Soft-spoken, thoughtful and profoundly knowledgeable, Reaume teaches a course in Mad People's History at York University, where he is an Associate Professor. He is also co-founder of the Psychiatric Survivor Archives of Toronto.

• At 8:30 p.m. a Candlelight Memorial will take place at the wall.

• Tuesday, July 14, is Mad Pride Day globally. It's celebrated from the United Kingdom to the United States and Canada and from Australia and New Zealand to South Africa. Celebrations vary, but often Mad Pride is an opportunity to challenge mental health prejudices, discrimination and negative stereotyping by raising awareness through community activities and the arts. Music, theatre, poetry, art and literature can transcend so many barriers, especially the unnecessary ones perpetuated by societal and media ignorance and fear.

• It's no coincidence that July 14th is also Bastille Day, the French National Holiday marking the anniversary of the storming of this Paris prison in 1789 that started the French Revolution. It's a universal symbol of liberation and, according to Mindfreedom, "when the Bastille was stormed, two prisoners with psychiatric labels being detained there for that reason were freed."

(I wonder what those psychiatric labels were, back in 1789, before there were psychiatrists.)

• The Honourable David C. Onley, Lieutenant Governor of Ontario, Ontario Human Rights Chief Commissioner Barbara Hall and MPP Cheri Di Novo will be attending the Opening Ceremonies at 11 a.m. on Tuesday morning to kick off Mad Pride Day.

• Following that, a virtual variety show of entertainment, song, poetry and readings is planned.

• At 1 p.m., York University's Geoffrey Reaume will be back to present an intriguing, no doubt healing and historically provocative program called "Hugging Our History: Why Psychiatric Survivors Need to 'Own' our Mad Past." This is a one-hour presentation I'm going to try to see.

• Wednesday, July 15th is "Know Your Rights Day" and features a presentation by The Dream Team – consumer survivors who advocate for more safe, secure and affordable supportive housing for people living with mental health and addiction issues. 

Next week, I'll continue with my Mad Pride series and some surprising information about how Toronto has led the world in the Mad Pride Movement.

The original organizers of Toronto's first "Mad Pride Day" was almost called "Crazy Day" back in 1993. Instead, they decided to call their event Psychiatric Survivor Day." But I'll leave the rest of that story until next week.

Finally, to get yourself into a "Mad Pride" mood, why not download some utterly amazing interviews on Madness Radio – "Voices and Visions from Outside Mental Health." 

Have a peek.

More of that next week, too. Have a "Truly, Madly, Deeply" sensational weekend.

Hugs,

sln

Musings on schizophrenia...

On Monday, I had lunch with an old friend. It all started because of last week's newsmaking announcement about so-called new findings about the genetics of schizophrenia.

I sent my friend a piece in The New York Times by Nicholas Wade which seemed to me to put a sober perspective on all the hoopla that followed. Well worth reading. Rather than a major breakthrough – for nothing would delight psychiatric researchers more than finding a cause for a varied group of disorders described as schizophrenia – what was reported was a big deal about information that's been known for years.  At best, a tiny little piece of the puzzle was confirmed by three new studies. 

The mysterious causes of schizophrenia are linked to thousands of genes, not just a few. There's lots of work still to be done.

It was this study that reconnected me to my friend. He often remarks that the word "schizophrenia" really describes psychosis – or, to be more precise, a number of different psychosis with several widely varying classes of symptoms.

At 89 and utterly brilliant, he and I met while I was writing for The Toronto Sun on one of my extended forays into psychiatric research and we remain buddies, although I do not see him often enough.

Yesterday, we wandered along College Street until we could locate a Japanese restaurant to our mutual liking and had an enlightening and, as always, fascinating chat.

He is a rare bird in the realm of psychiatry. One of the only people I know who launched his career as a psychiatric social worker in 1948 – the year I was born – after graduating from the London School of Economics in Psychiatric Social Work and studying clinical psychiatry with William Mayer-Gross at the Crichton Royal Hospital in Dumfries, Scotland. Dr. Mayer-Gross authored a seminal text called Clinical Psychiatry published in 1954, before the advent of the earliest antipsychotic medications.

After finishing his training with Dr. Mayer-Gross at the Crichton Royal Hospital, my friend moved to Canada to become director of social work at the former Whitby Psychiatric Hospital. Then he was named advisor in social work in the mental health branch of the Toronto Department of Health before taking the post of Associate Director of Psychiatry at the Toronto Psychiatric Hospital, which became the Clarke Institute of Psychiatry in 1964 and part of the Centre for Addiction and Mental Health (CAMH) in 1998. He finished his career at McMaster University as a research scientist, Professor of Social Work and Associate Professor of Psychiatry before retiring in 1990. 

His professional career in psychiatry spans 42 years from the pre-Chlorpromazine Age to the age of the atypical antipsychotics. He is one of the most knowledgeable and reasoned professionals I have ever known and this week, schizophrenia was on our minds.

My very first psychiatric diagnosis was schizophrenia. A rather dotty and dusty old-maid psychiatrist named Margaret McQuaid gave me that diagnosis back in 1960 when I was barely into my teens. I didn't know it then, but ah, those labels. How they stick!

About six years later, I found out about it in a brutal way. Another mad shrink at The Clarke Institute of Psychiatry – I cannot name him as he's still kicking around – decided he had cured me, so one day, he put me in a glassed-in cubicle on the eighth floor and handed me my chart to read.

There, in correspondence and other documentation, I discovered I had schizophrenia and then, a few years later, the word "catatonic" was added. Scary words for an 18-year-old to absorb. I remember riding home on the subway shuddering. I ran up to my room where my 1966 edition of the Random House Dictionary of the English Language sat above my desk and looked those two words up. 

• "Schizophrenia – a psychosis marked by withdrawn, bizarre and somewhat delusional behaviour and by intellectual and emotional deterioration. Also called dementia praecox, which means premature dementia."

• "Catatonia – a syndrome seen most frequently in schizophrenia, with muscular rigidity and mental stupor."

I didn't recognize myself remotely. Why were these words applied to me, I remember wondering. Can you understand why I detest these psychiatric labels and why language is so important to me? Yet, for the next seven years, through Seneca College and Queen's University, in the back of my mind, that diagnosis was there, though never in my entire life have I ever been "withdrawn." 

In 1975, that diagnosis was changed to manic depression.

"You know, this is the 100th anniversary of the word schizophrenia," my friend announced as we perused the $5.99 specials. His first statement has been well documented. According to an article in the American Journal of Psychiatry Paul Eugen Bleuler and the Birth of Schizophrenia, on April 24, 1908, Swiss psychiatrist Bleuler first coined the term "schizophrenia" at a meeting of the German Psychiatric Association in Berlin – as opposed to the earlier label, dementia praecox.

Without recounting all this history of labels, let's just say that the term schizophrenia simplified what had been a grab-bag of other labels. Too bad. I've always thought that huge catch-all categories are more dehumanizing than specific ones.

According to former Boston Globe investigative reporter Robert Whitaker, in his book Mad in America – Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, "Throughout the nineteenth century, physicians had conjured up a wild profusion of insanity types. Medical texts told of such ailments as "old maid's insanity," "erotomania," "masturbatory psychosis," "pauperism insanity," and "chronic delusional disorder."

Whitaker adds, "There was no rhyme or reason for these terms, and they provided little insight into what the future held for the patient." German psychiatrist Emil Kraepelin classified them into two streams – manic depression for those with psychosis and emotional disturbances, and dementia praecox for those with lack of emotion. The second group were given a less hopeful prognosis.

In 1908, Eugen Bleuler came up with the term "schizophrenia" which he viewed as a milder form of dementia praecox, according to my friend.   

Bleuler wrote a paper about his new term "schizophrenia" in 1911, so my friend considers 1909 – a point in between – as the true birth of the schizophrenia. 

Still, not much is really known about its causes today – probably because there are so many. I seriously doubt any one cause will ever be discovered. 

My friend announced that back in the 1940s and 1950s, close to 50% of patients who were diagnosed with schizophrenia went into spontaneous remission – complete recovery – with humane care and no medication. There were no antipsychotics back then.

"The prospects of lasting spontaneous remission are greatest during the first two years of illness," my friend quoted in an email from page 267 of Clinical Psychiatry (Cassell, London, 1954), co-authored by Wilhelm Mayer-Gross, Slater and Roth. "After five years of continuous illness they become negligible. If a series of patients whose illness have lasted a year are followed up, about half are found eventually to remit; if the illness lasts two years, the proportion is still about 45%. Thereafter it quickly declines."

My friend notes that with "effective community support, many former patients with longstanding schizophrenia were able to live satisfactory lives without or later with medication." 

Having a diagnosis of schizophrenia is not an easy one to live with and today, what we know about psychosis, no matter what you call it, is that early intervention is the key – especially for young people.

This also explains why so many leaders in the modern recovery movement – psychologist Patricia Deegan, Dr. Daniel Fisher and British psychologist Rufus May are three examples of countless people who have fully recovered from serious cases of schizophrenia and now live meaningful lives without medication. Others have succeeded brilliantly with psychoanalysis and medication, like law professor Elyn R. Saks, PhD. 

The question is, what about the other 50% who don't spontaneously remit? Why? And what about the standard contemporary biomedical approach that involves prescriptions of newer, very powerful atypical antipsychotics? Do they promote spontaneous and permanent remission? Or are they harmful?

A great deal in psychiatry has changed in the last 40 or 50 years, but not a great deal more is known about the causes of schizophrenia. Genetic testing and brain imaging will be studied in about 100 people with schizophrenia, bipolar disorders and depression at CAMH, the first hospital in the world to explore these newer avenues of therapy. 

We should be able to use all possible tools available for recovery. And recovery should be the goal. Not a belief that this condition is chronic. 

The word "schizophrenia" carries enormous baggage. The media hasn't helped. But, I think it's interesting to learn from the past. If many people diagnosed with schizophrenia, experiencing abnormalities in perception, hallucinations, delusions and disorganized thinking have fully recovered with humane support and care – that, to me is a reason for hope. And an approach to be seriously considered. Not isolation, hospitalization, drugging and other inhumane treatments. Instead, inclusion, respect, education, accommodation, empowerment and nurturing. Give people a chance!

Schizophrenia is probably not chronic brain disease, as so many people would have you believe. It involves the mind and the soul, the whole of a human being. There is no scientific proof that it's a disease of the brain.

Trauma can play a part in the development of the symptoms that suggest a diagnosis of schizophrenia, as can genetics, intrauterine factors, early childhood environment, psychology, neurobiology, social and cultural influences – even drug abuse.

Until we have more information, the jury is out and anything is possible, including recovery! It's time to rethink our knee-jerk reactions to this condition. See it not just a medical context but in an historical context. In a post-psychiatric context, too, and in the context of the recovery movement. 

Madness, a word I prefer to all the others, has many meanings. Love. Anger. Insanity. 

Let's open our minds to all them.

"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!