And now for something different...

Today, I'm taking a break from Electroconvulsive Therapy. I need it.

A QUICK ANGELA UPDATE

The last time Angela and I spoke was on Monday, when she said, "I'm holding my own." 

She sounded calm and relaxed while watching the Olympics. On Sunday, she admitted she was feeling a little bored. She had wanted to go snowboarding, but those plans didn't work out.

Over the last few days, she has punctuated our conversations with short bursts of laughter. Giggles, really. Her voice is sounding buoyant. I can always tell how she's feeling by the way she answers the phone and over the weekend, her "Hello" sounded brighter to me than it had sounded in the months prior to her ECT treatments which began three and a half weeks ago.

So today, I'm going to break away from Angela and her ECT and discuss my mood and one way I stay anchored.

This method has nothing to do with pharmaceuticals or psychotherapy, though it's therapeutic – healing.

SHINING LIGHT ON MY PERSONAL LIFE AND HOW I COPE

Today, I'm going to shine a little light into my personal life. The last few months, for me, have been more stressful than usual with the ominous possibility of a strike looming for all 24 Ontario community colleges and no resolution in sight. I am not good at "not knowing" even though, believe me, I am growing increasingly adept at enduring stress.

Three years ago, I walked away from a full-time job with full benefits and 100% security into an occupational abyss. I felt something would come along, but I also felt, even more, that I had to leave to survive.

My job may have had all the financial rewards and benefits, but the work itself was killing me. Things had changed. For my health and well being, I had to leave after 30 years. It was a huge risk for me but it turned out to be the best career move of my life. 

All kinds of windows sprung open for me. Ten days after I walked out of The Toronto Sun newsroom, The Globe and Mail published an op-ed piece I wrote in its editorial section. Two months later, on March 8, 2007, International Women's Day, I was hired on the spot to teach Women's Studies in the School of English and Liberal Studies at Seneca College. I graduated from Seneca in 1971.

Today, I'm teaching a course I was asked to develop called Leadership in Society. Seneca literally saved my life. I went on to Queen's University, Ryerson University, though it was a Polytechnic when I attended, then my 30-year Toronto Sun newspaper career and now I'm here at The Toronto Star – and loving it.

I'm learning more than I ever dreamed possible every day, between teaching and writing here. I love my blog, though it can be emotionally taxing, as my friend, mentor and polymath Tufts University psychiatry professor, clinician, writer, poet and fellow blogger Ron Pies empathized the other day, “'fighting off the Mongol hordes' (if that is not offensive to Genghis Khan’s people)."

I have an endlessly fascinating and adventurous life with my husband, Marty, and our two dogs, Lucy and Riley. We rarely travel, but we are never bored. Ever.

OURS IS NOT ALWAYS AN EASY LIFE

Ours is not an easy life. Marriage is a PhD in living – compromise, communications, acceptance, open-mindedness and all the challenges of inclusivity that culminate when two people over 50 join together, with three previous marriages between them, not to mention his two daughters. (One was 12 when we met and 13 when we married. She lived with us because Marty was a widower. His older daughter is a successful film producer, independent and now happily married.)

Here's what's best about my life and why I can cope. I respect my husband's values more than you can imagine. He is highly principled, generous, caring and compassionate – about all people who are oppressed. He's also excitingly political. I never knew anything about politics until we met and now I'm learning. His humanity is colouring mine, I'm happy to report. Also, living with Marty, I like to say, is "like living with Google," to borrow from my friend, journalist Cheryl Hawkes who has said that about her late husband, the brilliant journalist Bill Cameron. 

Besides being a film historian and teaching the History of the Cinema to aspiring film and TV actors at Humber College, Marty is an actor, screenwriter, TV writer, playwright and baseball fan. He has an encyclopedic memory and does the New York Times crossword puzzle in ink every Sunday. Best of all, he's a humourist. Almost everything that flows from his fingers is funny.

Nothing thrills him more than making me laugh and he's on a constant quest to do so. We share a passion for The New Yorker magazine, The Sunday New York Times, good coffee, old movies, great books, spectacular art, our darling Dandie Dinmont Terriers, a small coterie of dear, faithful, fun loving friends, and our bright little yellow house in Toronto's suburbs.

We both work hard, but we thrive on our work, and it is our work and these three significant "others" (my husband and my two dogs) that anchor me day-by-day. Marty, it goes without saying, has transformed me in many other ways. He loves me unconditionally, as I feel no one else ever has. My confidence and self-esteem has grown, though I'm still plagued at times with insecurity. (My other significant other is my psychiatrist, Dr. Bob.) 

Marty is rock solid, with a kind and gentle temperament that complements my madness. I'm emotional. Histrionic. Larger than life. Impatient. He calms me, just with his touch.

Do we have lots of money? Not by a long shot. We have more. Each other. Our routine. Our health, at the moment. Plus, we're both card carrying members of Weight Watchers.

WE LIVE IN THE MOMENT AND THINGS ALWAYS LOOK BETTER IN THE MORNING

Here's the clincher. We know we have enough. More than enough. We live in the moment. Marty has taught me the futility of worrying and that guilt is a waste of time.

So, that is how I live my life and how I can sit here and muse here about all aspects of emotional health and well being. I learn as I go and believe me, it's often really hard for me, like what went on last week. But I'm learning so much and ultimately, I know that we're all next to normal in varying degrees. I am stubbornly hopeful. I believe in recovery. It's hard work, but it's real. It happens. And it's different for all of us.

Feeling this way, knowing this, makes my life lovely to live, even when the living gets tough.

I have one little secret. Not a secret, really, but it helps me survive the rough times. 

Things always seem to look better in the morning.

Take care. Speak soon. Thanks for listening.

The way I see it ...

It's taken me a while to process my impressions and thoughts about Ethan Watters' provocative essay The Americanization of Mental Illness that ran in last Sunday's New York Times Magazine.

If you want to know the truth, I've been living with him – or it feels that way – all week. Initially, his article excited me, especially in its criticism of the way American psychiatry is "homogenizing the way the world goes mad."

Of course, this isn't entirely true. Nor is it new. Here's what I wrote in an article titled "My Life in Labels" in the Spring/Summer 2007 issue of the Canadian Mental Health Association magazine Network:

"Years ago, a diagnosis could depend on where you lived. In the 1970s, the joke among North American psychiatrists was that ''you could cure schizophrenia if you could fly to Europe,'" where psychiatrists there, using the tighter diagnostic criteria of the World Health Organization's International Classification of Diseases or ICD, would more likely diagnose you with bipolar disorder, which was more treatable. Here, where the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders or DSM is the standard reference, you would most likely get stuck with schizophrenia – then, much harder to treat and often considered hopeless. Now, such discrepancies are less likely as diagnostics have become more globally understood."

Watters essay was adapted from his brand new book Crazy Like Us: The Globalization of the American Psyche, which was published last Tuesday and which I haven't yet read. 

That, in itself, is a problem. 

Several writers have reacted to this story over the past week and there are links to their posts in the comments to my last post. I wanted to know how a Western-trained psychiatrist would react to Watters blistering critique of Western – read American – psychiatry and it's global reach. I fired off an email to my friend and mentor, Tufts University clinical psychiatrist and researcher Dr. Ron Pies.

A couple of points were of interest to me and Ron addressed them in a way that I found both wise and humane. After all, I take a holistic approach to health and well-being that encompasses mind, body, soul and spirit. The whole package. So does he. As does my psychiatrist.

"BRAIN DISEASE" VERSUS "MENTAL ILLNESS"

On the subject of "brain disease" vs. "mental illness" – here's what Dr. Pies wrote in his response to my email:

"I think this is a sterile debate that has plagued the field for decades, and is the baneful legacy of our friend Rene Descartes, with his mind/body dualism! My own view, which was anticipated by the late Robert Kendall, M.D., is that 'disease' is properly attributed to persons – not 'minds' or 'bodies.' As Kendall puts it in J. Schaler's book, Szasz Under Fire, p. 41)...

"Neither minds nor bodies suffer from diseases. Only people ... do so, and when they do both mind and body, psyche and soma, are usually involved."

Pies added, "The idea actually goes back to the great physician Maimonides, who said, "The physician does not cure a disease, but a diseased person." 

I am comfortable with the person I am, warts and all. Though I'm no cultural anthropologist, when it comes to psychiatry, in all honesty, I've been studying it from the inside for close to 50 years as a patient. No formal training, just one long extended, sometimes bumpy but endlessly fascinating field trip that began in 1960. 

In those days you rarely ever saw the word "psychiatry" in a daily newspaper or magazine. Psychiatry was almost unmentionable. It seemed to be more black magic than medicine. It was just a few years into its "chemical" age and just out of the age of the frontal lobotomy.

Also, I'm Canadian, with a slightly different take on some things, including psychiatry and medicine. I've grown up in a family of doctors, most of them specialists and academics. I've also learned that one's family culture, perhaps more than one's national, ethnic or even religious cultures, is astoundingly powerful in determining how you see yourself, your beliefs, your values and your personal outlook on life – especially if it is determined that you have a "mental illness."

Case in point. Until about four years ago, I really bought into the "Western Biomedical Model" of mental illnesses – hook, line and sinker. I was convinced that my mental illness was chronic, like diabetes (ugh!) and I was, indeed, deficient in some deep-seated way. I knew the chemical imbalance theory of the causes of mental illnesses is just that – a theory and unproven, according to Dr. Bob – still, I function best with a medication, one tool in many I use to stay as healthy as I can. (I have a large toolbox.)

Still, I believed that there was something wrong with my mind. This, despite a successful journalistic career, a wonderful new marriage and a good life. I believed that there was something terribly wrong with me but that through my therapy, I was righting it. 

INTERNALIZING YOUR DIAGNOSIS

Long ago, I internalized my diagnoses – and oh, what damage that does to one's psyche, let me tell you, especially when you're 18 and you discover have schizophrenia. It took another seven years to right that misdiagnosis. All this was part of my family's culture, too. After all, I am still seen as The Family's Resident Nut Case and recently, one of my relatives said, in a rather accusatory tone, "You've made a career out of your mental illness." 

Several things have happened to change that. Now, I know I'm okay. And I choose to believe that we're all "next to normal."

First, I was asked to speak to a group of psychosocial rehabilitation specialists and in doing my homework, I discovered the mental health recovery movement. 

This was an epiphany for me. A seismic shift in my consciousness. It was possible to be in recovery. I could recover. In fact, I already was in recovery. I didn't even know it. Can you believe how stupid I was?

I had known there were other non-psychiatric mental health models like Fountain House, which started the International Clubhouse Movement, but this time, the reality that you can recover from schizophrenia and bipolar disorder and other serious mental health problems and live a meaningful life – like mine – really sank in. 

So I started seriously researching.

Around the same time, my mother told me about a Benedict Carey story in the New York Times. "You must read it. It sounds just like you," she said. The headline – Hypomanic? Absolutely. But Oh So Productive! When I showed it to Dr. Bob, initially he resisted, but ultimately, he agreed and changed my diagnosis. After all, I've been manic, psychotic, but never depressed. I'm unipolar with a vulnerability to mania. Where's the bipolarity in that?

Though Dr. Bob wasn't enthusiastic about the idea of mental health recovery when we first discussed it, he's gradually changed his mind about its potential power and the way it transforms people's lives. I've grown increasingly recovery-oriented and also increasingly skeptical of the way the American biomedical model operates. For many reasons. Diagnosing young children with psychiatric conditions and prescribing powerful medications for them – medications untested for children – is criminal, as far as I'm concerned. There are other tools, other ways, other approaches. 

PEOPLE IN THE INTERNATIONAL RECOVERY MOVEMENT DEMANDING CHANGE

The point is, I started doing my own cross-cultural research about what was happening in other countries and cultures and I discovered that the American way is light years behind a significant majority of people in the recovery movement around the world demanding change.

Take Britain's Time to Change. Last week, this program to end discrimination "faced by people who experience mental health problems" (I love the language they use) announced another new ambitious community in Islington mounting a campaign to promote mental health equality. 

Community Mental Health and Recovery is a growing global movement in the world even though much of the medical establishment doesn't recognize it or simply pays lip service to it. Watters doesn't even mention recovery in his article, though he's right, according to Pies, "to call attention to the ways that culture and ethnicity can shape both diagnosis and expression of psychiatric symptoms." 

I guess the main problem I have with his essay is that I don't like generalizing about people and mental health and well being and diagnostics. Mental health is not a constant state for anyone, ever. Nor is having a mental health issue. We, individuals, are changing all the time. Our lives, our circumstances, our work environments, our relationships are in constant flux. We're all different, every day, and no diagnostic label is really 100% accurate. It's a ball park. A designation for a doctor to use. A place to start. Also, it's very useful for insurance companies. 

We're all unique, despite our diagnoses. As I've said for years, "I'm not my mental illness." Labels are for jars, not people.

MANY PROBLEMS PLAGUE MODERN PSYCHIATRY

There are many problems plaguing modern psychiatry. Every psychiatrist has his or her own approach. Even Watters' wife, who is a psychiatrist, and a very good psychiatrist, he says. There's the rocky modern landscape of psychiatry, influenced by new medications and new technologies. There's the pull of the neurosciences against and not always in concert with the healing powers of the psychotherapies. There's our quick fix, pill-popping culture. And there's the discrimination and negative stereotyping and prejudice that we must continue to fight with education. And open minds.

Lots to think about and to ponder. But I will add this. On his Psychiatric Times blog The Couch in Crisis Dr. Ron Pies posted about the Watters essay, too. It's worth a read.

I'm still processing. Today, I'm seeing Dr. Bob. We'll have lots to talk about.

Take care.

Speak soon!

Stresssssssssssssssss!

Until last week, I had no idea how mentally, emotionally and physically debilitating stress could be. Good stress. Bad stress. It doesn't matter. Stress is distressing.

"If you get the H1N1 virus, there is a very good chance you'll die," my kidney transplant coordinator told me on the telephone early last week. "It's so fast."

It wasn't available yet in Toronto. No one was dispensing it. 

"And the rules seem to be changing every day," she added.

Great. 

I couldn't talk my family doctor's receptionist into giving me the seasonal flu shot. At 61, I'm four years too young. 

Then I explained that I really needed to be vaccinated against H1N1 because I'm one of the high risk groups – I take three powerful immunosuppressant medications to ensure my body does not reject my transplanted kidney.

In 1991 I went into "iatrogenic" acute endstage kidney failure and lost the function of my only kidney because the psychiatrist who had treated me for 16 years for my mood disorder had neglected to monitor my Lithium levels properly. I had the kidney transplant in 1994. I have virtually no immunity to H1N1.

I made an appointment for the H1N1 vaccine. I'll have to wait until December to get the seasonal flu vaccine. This past Monday, right after my class at Seneca's Markham Campus, up in the northern end of the GTA, I jumped into my car and drove all the way downtown to Mt. Sinai Hospital.

Arriving at 2:50 p.m., I'd never seen my doctor's waiting room so crowded. All the receptionists were wearing masks. People of all ages were seated or milling around, including pregnant mothers with young children in tow. 

"We're running about 45 minutes late," my doctor's receptionist told me. "There's only one nurse and she's doing the best she can." 

Talk about stress. I couldn't wait to get out of there and within 20 minutes, I had my shot and was back outside, walking towards the underground parking garage. 

I live with a psychiatric diagnosis on the bipolar spectrum called Hypomania. In my case, it's rare and serious, but I handle it pretty well. I never get depressed, but wow, do I get high. To the point of psychosis. Mania. 

It can be frightening sometimes because I can tell when those curious little manic ideas slip into my consciousness. It takes me a minute to realize that I'm fantasizing, a little delusional. 

That's why I'm also in Recovery. I've worked so hard at processing my mind for 49 years in psychotherapy that I have spot-on "insight" that Dr. Bob admits he's rarely seen in anyone he's treated.

That doesn't mean I'm invulnerable to stress. Or that stress cannot trigger my grandiose thinking. Sleeplessness. Quirky judgement. The key is, I am prepared for it and work very hard to keep it in check.

On Friday, October 23, I had lunch with a colleague. It was my birthday lunch and we "dined" at the Flint 'n Feather, the modest dining room at the college's main campus. All during lunch, little delusional thoughts kept flickering in my mind.

"I bet she's planned a surprise birthday celebration for me... I bet the whole staff of the Faculty of English and Liberal Studies are going to burst into the dining room singing "Happy Birthday, dear Sandy... I wonder when... " This thought keep flickering in and out of my thoughts.

I couldn't concentrate on our conversation because of this intoxicating feeling that something wonderful was going to happen. 

It did.

My friend treated me to my salad and fruit!

At Seneca, a melting pot of more than 20,000 students – many from all over the world – you can sense everyone is a little on edge. More than the usual mid-term angst. It's filtering into my classrooms. This week, I've held two de-stressing sessions. Open dialogues. "Show and Tell" sessions. Opportunities for the students to "evaluate the teacher," for a change. 

Anything to help them unwind and, as my late father would say, "hang loose."

Lately, I'm not sleeping consistently. Sleep keeps me sane and stable. I'm bouncing around my mood spectrum from my normal, which is always slightly elevated to exuberant to flying around the rafters to back to my invigorating normal. 

That's why I'm seeing Dr. Bob every Wednesday for the next month. I saw him this morning.

There's so much going on. Stresssssss. I feel tingly. I have to go easy. I'm running up stairs instead of taking the escalator. I'm walking at twice my normal pace. I'm waking up two hours before the alarm goes off in the morning.

This is all stress. Good stress. Bad stress. It doesn't matter. It's debilitating. 

"Why worry when you have no information," Dr. Bob said this morning. "As soon as there's enough vaccine available so everyone can be vaccinated, things will die down. In the next few weeks. You'll feel better."

Right now, the H1N1 flu is great news story. There's an old saying about news.

"Good news is snooze news."

Too bad. We could use some good news right now. It would help ease the emotional and mental effects of this bad news story that feels more contagious than the flu.

Relax. Take a deep breath. Take good care of yourself. Sleep. Stay informed right here at Healthzone.ca.

Speak soon.

A Shared Reflection...

Hi, Hello, Good Morning, Good Evening, Good Day...

Today, I'm doing something I always ask my students to do, but I rarely do myself, anymore.

I'm writing a reflection on October 22, 2009.

Let's just say, for once, I'm taking some time to look inside my crazy mind. Writing a review. Critiquing one day.

It is also a gift to myself. We all need to give ourselves gifts. To take care of ourselves. So let's say that today, I am sharing with you, my team, my support, my inspiration, my "friends" – the community we've become – a gift I'm giving myself.

A moment of reflection. 

Yesterday was a landmark day for me. Not because it was my 61st birthday. Sixty-one isn't one of those typically landmark years ending in zero or five. It is, however, like 21, I think, a turning point because for me, it feels like I've arrived.

Aging is so interesting these days. I'm enjoying it. Another reason why I'm utterly mad. I'm enjoying liking the person I've become. It's taken 49 years of psychotherapy. This is a real milestone. I'm seeing my psychiatrist, Dr. Bob, next week for the first time in months. I think he'll be thrilled to hear this.

I didn't feel this way yesterday. Yesterday, my actual birthday, was a disaster. 

But this morning, when I awoke after six hours of solid sleep, I realize that it was probably one of the most extraordinary days of my life. I just didn't know it until a day later. My timing has always been a little "off."

To begin, I didn't celebrate in any traditional sense. I worked here, until 3 a.m. on the morning of my birthday, which happens to be the day after the anniversary of my father's death. Since he died, in 2000, two months after I was married, his death and my birthday are inextricably linked.

He had perfect timing in life, too. He also managed to die the day before his kid brother's birthday. A brilliant legacy.

I had a class at 11:40 a.m., so I continued my preparation. I wanted this class to be fun, so I was giving my students a Pop Quiz to help them learn to arrive on time and to read the text. I was showing them one of my favourite National Film Board of Canada documentaries – Race is a Four Letter Word – and I was giving them a basketful of Halloween treats to sweeten the experience.

All day long, birthday messages arrived from my Facebook "friends" – an unexpected surprise I found curiously stressful. As a Facebook neophyte, what is one supposed to do? Answer all of them individually? 

I tried. Time was ticking away.

My class didn't not turn out as planned, but I've learned my most difficult, challenging classes are actually my best classes. Teaching is learning. As an untrained teacher, I've learned to teach through experience. I've thrown myself into it headfirst. Learning as I go. No two classes are ever the same even if you teach the same course year in and year out.

This challenging birthday class yesterday, my first, ever, was a gift in disguise. I had to work hard after it ended to figure out how correct my mistakes – that took some complex processing, too. Especially as I break rules and engage with students on the phone if I sense they're struggling. I can't help it, but I do.

Dinner was simple. Celebration was a kiss on the back of my neck from my husband when I least expected it and a marvelous pin my sister Glorianne gave me. It says, "I've survived damn near everything." 

Best of all, she wrote on her card, "You are my hero." 

I thought of the title of one of my husband's plays, a line from the Old Testament, 2 Kings, 9:32. 

"Who is on my side? Who?"

 

On March 7, 1994, the day before International Women's Day, Glorianne, my youngest sister, gave me my life back by giving me one of her kidneys.

None of this really twigged until this morning, after I had six hours of sleep the night after my birthday. 

I desperately need sleep. My mind doesn't function with no sleep. I become manic so quickly, I have astounded my psychiatrists for years. Within hours sometimes. Sleeplessness is killing for me.

Yesterday, I was working on three hours of sleep. I forgot to take care of myself while being barraged with "Happy Birthday" messages. 

Sleep is the greatest tranquilizer in the world.

Last night, I slept. Now, I feel clear. Calm. Less crazy.

Thank you. You gave me the most intriguing birthday of my life.

And I survived it, too.

Take care. Be well. 

Speak soon!

xox

What "Mental Illness Awareness Week" means

This is Mental Illness Awareness Week.

Here at Coming Out Crazy every week is Mental Illness and Mental Health Awareness Week. 

If you're like me, every day is "mental illness awareness day." I am reminded of my psychiatric diagnosis and my 49 year psychiatric history when I take my 200 mg of Carbamazepine every morning and again every night. 

But, at the same time, I consider myself to be mentally healthy – in Recovery – most of the time. (There are many different perspectives on Recovery and mental health and they vary vastly. Hope must be a constant. Hope is one of the primary foundations of Recovey.)

Then there are those moments of madness. I believe we all have them. After all, and I've said this before, I am convinced we're all Next to Normal. Even if we try not to show it or deny it.

The point is, I'm human. Over the last two weeks, since my husband was rushed to hospital and I came down with a wretched fever and flu the day after he came home – which I'm still fighting – things are feeling a little more challenging than usual for me. 

We're fine. My husband's fine. I'm reasonably fine. It's just been one of those rocky stretches. And wouldn't you know... my psychiatrist Dr. Bob is on vacation. In France somewhere. Provence, I think. 

So I'm working without a net. When I'm writing here, I want to give you intriguing ideas to think about. That's why I'm musing about "Mental Illness Awareness Week" and what it really means. What it accomplishes. I'm really confused.

There's so much in life these days that's confusing. Although I don't live with depression, I can understand why our environment can seem really overwhelming and depressing.

On Monday, I received a book in the mail called "Depression is Contagious" by U.S. psychologist and hypnotist Michael D. Yapko.

I laughed when I saw the title. It's a clever marketing ploy. It's may even sell books. But is it furthering knowledge and awareness? Or promoting hypnotism as a treatment for depression? On the other hand, maybe hypnotism works for you. I tried it once and it didn't do a thing for me. But that's just me. 

The title also reminded me of the olden days when mental institutions were built out in what was then "the countryside" in the 1800s, so the "normal" citizenry, it was assumed, wouldn't be victims of the contagion thought to exist within its walls.

So they wouldn't catch whatever madness infected the "inmates" – like the flu. This was rumoured to be true of two of Ontario's Provincial Lunatic Asylums – The Toronto Lunatic Asylum on Queen Street West built in 1850 (now the site of the Centre for Addiction and Mental Health) and Lakeshore Psychiatric in Mimico, now Etobicoke in southwest Toronto, built in 1871. That latter mental hospital is now the site of Humber College where my husband teaches. 

That was the thinking back then. Mental illnesses or Madness was like the flu. Get too close and you can catch it. 

That was, I suppose, another way to explain the unexplainable. To talk about what was never talked about. The fear people harboured about mental illnesses and madness. Ignorance and Fear. The same fears and ignorance that Mental Illness Awareness Weeks are trying to combat. 

Through education. But what does that mean? Does that mean that the media is doing the educating about people, like me, who live with psychiatric diagnoses and are in recovery?

How much do you read in the mainstream media about mental health recovery?

Think about it. Do you ever read good stories about people overcoming serious mental illnesses and going on to live rich and meaningful lives? They do, you know. Lots of people. But too often, they don't live their lives out loud like I do.

You cannot catch depression like the flu. Depression can be caused by many, many things. It's still a mystery because every person's depression is specific to him or her. It's individual. But to the best of my knowledge, depression isn't a bacteria or a virus. It's not spread like a bacterial infection or a viral infection. Through sneezing. Or coughing. However, you can be affected by your environment, and with the "viral nature" of digital telecommunications, the title of Yapko's book – "Depression is Contagious" – a metaphor at best, I suppose, may have some meaning.

But, I think it's tenuous. We all have good days and bad days. Days that make us feel blue. That's not necessarily "clinical depression." Depression can be a very serious emotional disorder. Life-threatening. 

Yapko's title is more a marketer's ploy than a medical truism. I don't like it. I think it's misleadling. 

Just like I think "Mental Illness Awareness Week" is misleading. I don't know how educational it is and I question its validity when mental health and mental illnesses, like physical health and physical illnesses are a life-long, permanent concern for all of us, all the time.

We cannot be healthy physically if we're not healthy mentally and emotionally. 

What does "Mental Illness Awareness Week" mean? What does it do? Who is it in aid of? Who benefits from it.

Is it a promotion for psychiatrists? Many really care about their patients, but many others have lost their way and succumbed to the pharmacological, biochemical approach to treatment. They don't practice "talking therapies" anymore. And too many people want quick fixes. Demand them. I am highly skeptical about this, as you know. We're all different and we need to be treated as individuals. We need to work at our mental health and fitness, just like we need to work at our physical health and fitness.

(Have a look at the Mood Disorders Association of Ontario pro-active approach to mental and emotional fitness. Check Up from The Neck Up. It's never too late. Contact Kim Umbach at kimu@mooddisorders.on.ca)

I wonder. Is Mental Illness Awareness Week a way to help people overcome their denial and face their own personal issues and seek whatever help they need, be it psychiatric, psychological, peer support, community mental health, hypnotism or an empathetic ear? Someone who knows how to listen actively. Perhaps it's good supportive housing and employers willing to give people with psychiatric histories a chance to work, develop skills, achieve and develop the self-esteem and confidence that comes from real accomplishment.

Maybe it's more humane working environments and more empathy in those who don't live with mental illnesses. Maybe it's a wake-up call that it's time for psychiatrists to re-examine what they're teaching medical students about psychiatry. About those of us deemed to have emotional issues that affect our thinking and our behaviour, our minds.

I keep on writing here because I want to see change. I believe change is possible. I know it's possible. I've seen it in my lifetime. I remember when you never ever read the word "psychiatrist" in any newspaper or  magazine. Psychiatry was like black magic. Maybe it still is, but I believe that a lot of what psychiatrists have learned and are still learning and trying to do can change and improve our collective mental and emotional health. I believe that psychiatrists who listen and practice psychotherapy and see beyond neurosciences to the individuals they attempt to help, are creating important changes.

And there are all kinds of other routes to mental and emotional health, too. Everyone needs to be open-minded and educated.

Physcians need to be educated just as much as the media and all of us. Medical practitioners need to accept that emotional and mental illnesses and health are not a "them" and "us" duality. We're all in this together. And talking is the key. Not only talking therapy, but talking out loud and talking to each other.

Honestly. Candidly. Without arrogance. With humility.

That's education. That's why I call this blog "Coming Out Crazy" and because "coming out' with who we are and how we feel and what we see and perceive is all valid and part of the educational process.

Medications are just tools. Minor tools, if you ask me. Useful at times. But there's more you must do to heal. You need to talk.

You need to have your medications very carefully monitored if you take them. Trust me. I lost my only kidney and ended up on dialysis and with a transplant because a psychiatrist I was actually seeing regularly neglected to monitor my Lithium levels.

It doesn't matter what "diagnostic label" you have. Don't allow anyone to define who you are. Don't internalize a label and believe that it changes who you are. It doesn't. Unless you allow it to.

Over my lifetime - and I'll be 61 in less than two weeks - I've spent months and months and months as a psychiatric in-patient in four different Toronto psychiatric hospital wards. My family, primarily my mother, instilled in me a basic belief that I was "me" first. That I was talented, ambitious and smart, even if I was also histrionic and emotional and even, at time, manic and psychotic.

I was never just my 'illness" or "disorder". I was me.

That's what Mental Illness Awareness Week should be about, I believe. About how special we all are.

You are not your "illness" - you are you! Multifaceted. With so many qualities and characteristics that make you the unique individual you are. You are special. You have potential. And you must believe that. That's recovery, that's hopeful. That's your responsibility. That's self-determination.

No matter what any psychiatrist tells you. I've had so many diagnoses - schizophrenia, catatonic schizophrenia, manic depression, bipolar, hypomania.

They are just one small part of me. I'm also energetic and passionate and excitable and larger than life.

As for labels, I accept only two for myself. 

One is "human" and the other is my name - Sandra Lee Naiman, qualified by my date of birth. Just in case there's another "human" named "Sandra Lee Naiman" kicking around. :)

You're human. Now then, besides any "diagnostic" label you've been given, ask yourself, who am I?

And have some fun considering all the intriguing qualities you have, your skills, your talents, your abilities, your hobbies, your passions, your interests. All those special uniquenesses of yours that have nothing to do with any mental illness.

Everything about you that makes you, you. The only "you" in the whole world. The only "you" who's ever lived. How remarkable you are.

Speak soon!

Grading...

Right now, today, I'm living in a nightmare. My own personal trial by fire. It's an ordeal. A struggle. I agonize over it every time I am faced with it. It never gets any easier. I think it becomes more difficult. Maybe it's character-building. I don't know. But it's unquestionably one of the most challenging tasks I ever have to face. 

I'm grading my students. I genuinely like my students. As I grow to know them, more and more. My job is to help them succeed. I tell them that. Again and again. Grading them seems counterproductive to me.

I do not like assigning "final grades" to people. Period. Isn't that what a eulogy is for? Or an obituary? 

How can you put a final grade on a work in progress – a student. I can't pin them down with a final grade and I don't want to. What if I'm wrong? It's possible. I'm human.

My mostly young college students are very vulnerable. They take their marks terribly seriously. They do not yet have the life experience to realize that it's not the mark that really counts, but what they've learned. What they take away with them. What they can apply in their lives – at work, at play, in their personal relationships with the people they know and meet.

"You know, in 20 years you probably won't remember the mark you receive in this course," I always tell my new classes of students in an attempt to defuse their initial concerns about a new course and a new teacher. "But I bet you'll remember what you've learned." 

(I can attest to this. I have no idea what my transcript looked like when I graduated from Seneca in 1971, but I have full recall of what I learned. I can visualize my most outstanding professors and the important lessons they taught are still with me.)

My students look at me incredulously. They don't buy it.

Sadly, for too many of them, marks determine their future. And they're so arbitrary.

A single mark never seems entirely right. It never seems to say enough. It seems unfair.

Do we assign a letter or numerical grades to our sisters, brothers, parents, friends, colleagues, employers and acquaintances? 

"I have an A++++ boss. What about you?" 

"Oh, mine only rates a C+/B-. But she's improving. Maybe next term. We'll see."

Take our politicians. Voting is grading I suppose. Winning or losing is a mark of success or failure. But what does a winning number of votes say about an individual? Other than more people voted for him/her than the other person in the race? I'm a little naive when it comes to politics, I know. But I'm very nervous when I have to apply either a number or a letter grade to a human being. I can't help it.

I don't like competition. Never have. Not when it comes to human beings. (I'm not a sports-buff, so I'm not referring here to games people play. That's different. That can be character-building, depending on the sport. Boxing doesn't fly with me, though. I prefer team sports. But not violent ones. Or golf. Or tennis. I like baseball, too.)

Grading what students learn when they've just finished a course seems rather premature. They should be graded when they've been able to put what they've learned into practice in the real world. A year or two or three later. After they've graduated. And worked for a while. A job is the acid test. A profession.

It would be nice if students could receive a grade of "complete" or "incomplete." But that wouldn't help them in the big picture of their lives – if they want to continue with their education. The post-secondary education system simply doesn't work that way. Too bad. Ultimately grades are for administrators.

So I'm left with my trial by fire every term. I agonize over my eternal conundrum. Is it possible to appropriately and accurately grade or categorize or classify or place a value on a person you see only three hours a week for 14 weeks? Especially the students I teach. Often they're 17 years old and from other countries. International Students. This past term 99% of my Women in Canada students spoke English as a second language. Only one other person besides me in my classroom spoke English as a First Language.

Bear with me for a minute and imagine this. You're going to study at Peking Community College. It doesn't exist, but for the sake of argument, let's assume it does. 

You walk in on your first day and everything is printed in Chinese. Every sign. Everyone speaks Chinese. You are automatically enrolled in a 14-week term of "Chinese as a Second Language" and for 12-hours a week, that's all you do. Study Chinese. 

Then, Bingo. You begin classes where Chinese is spoken and written and everyone around you either speaks Chinese as a First Language, or another language that you don't speak as a First Language – a language other than English.

That's how my students from China, Japan, Pakistan, Russia, Iran, Iraq, India and many other countries feel. My heart goes out to them. You wouldn't believe how hard most of them work and how well they manage to do.

Grading students who are just forming and developing and learning about life seems almost immoral. Unfair. Meaningless. It's a form of pigeonholing that can really be damaging, depending on the individual student.

Isn't that one of the major issues around mental health and psychiatric labels? 

Bipolar Disorder. Anxiety Disorder. Schizophrenia. Hypomania. Depression. 

If I tell you my psychiatric diagnosis is Hypomania, and that's all I tell you about me, what do you really know? About me? Other than the fact that I have no trouble telling you about my psychiatric diagnosis.

A grade is a rating, a classification. A pigeonhole of sorts. Can't the same be said for a psychiatric label or disorder? Yet with psychiatry, where so much is still unknown, the label can be very damaging.

And in psychiatry, once you're pigeonholed or labeled, that's it. Labels stick. You're in the system. Someone may give you another label, too. You'll believe it. You'll internalize it. And that can be very damaging, especially if you begin taking medication. Too often, even the medication may not work for you, because you are unique. Special. An individual with your own experiences, your own body chemistry, your own uniquenesses.

And ultimately, psychiatric labels are for insurance companies, I suppose. Administrators. 

By definition, a label or classification is restrictive. But labels are often inaccurate, and in psychiatry, this is all too commonplace. How many of us have had multiple diagnoses? After all, you're dealing with diagnostics in an imprecise science. They're far more imprecise than a grade in college which sums up a student's classroom performances and behaviour over more than three months. Their assignments, class activities, interactions, attendance and punctuality, questions, concern, tests, exams.

As well as, you can learn a great deal about a student's individual complexities, their extraordinarily diverse cultural and personal perspectives and their backgrounds in the learning laboratory of a classroom.

Why, compared to giving a human being a psychiatric diagnosis, grading a college student seems like a walk in the park.

In school, you can at least change your Grade Point Average or your letter grade with hard work, if you really apply yourself. You can raise it. Improve your prospects. Often there's lots of help available to you.

"I've got a 3.5," one of my former students told me the other day. "Not very good," he said, sounding dejected. Confused. Lost.

Like someone who says, "I have bipolar disorder."

Whether it's a grade or B+ or C+ or a label like bipolar disorder or depression. What does it tell you about an individual? I ask you.

Does that tell you what this person has learned about life or a particular subject? What this person loves to read? Does it reveal their personal ethics and morals? Does it tell you who this person loves and cares about and cherishes? What this person likes to do in his or her spare time? What she or he wants to accomplish in life? What his dreams are? What her hopes are?

If you have a GPA of 3.9 it means you're a good student in a specific course. You write exams well and know all about how to do academic research papers. You have a set of skills at which you can perform in a classroom. 

But what about meeting deadlines in the real world? About respecting your co-workers and their concerns? About being a good citizen?

Does a 3.9 GPA indicate you'll be successful in life? Read Malcolm Gladwell's Outliers for an intriguing perspective on that question.

The same goes for a psychiatric label. It's a pinpoint on the course of life, a judgment made by an individual psychiatrist based on a collection of criteria – the DSM-IV and soon the DSM-V. People write the DSM criteria. Psychiatrists may have their own agendas. 

We are all human. We make mistakes. We're always changing. Evolving. Growing. Learning. And surprising ourselves and others. I'm always curious about people, waiting hopefully to be pleasantly surprised. Often I am.

Our outside appearances may not change all that much. But our minds are constantly in flux. Like kaleidoscopes. Beautiful fleeting refracted images of coloured glass that are never, ever repeated. Never the same. Unique. Like us.

That's why grading is so painful for me.

Shhhh! Wanna hear a secret?

(Editor's note: this has been modified from the original version to correct an error.)

I wear hearing aids!

It's no secret, really. I started wearing them in December 2005 after my sister Elayne turned to me at a big, noisy social function and said, "You know, you really should look into wearing hearing aids. I'm having trouble communicating with you. Why don't you go and see Jerry?" 

She was right. I had been in denial. I knew I had a problem with my hearing. I just didn't want to face it. Now, I decided to. Head on. Am I ever glad I did.

Jerry, Elayne's husband and my brother-in-law, happens to be the head of the ear, nose and throat department at Toronto's Mount Sinai Hospital. So I bit the bullet and made an appointment with him for a hearing test, which I flunked. Big time.

Turns out I had 20% of my hearing in my right ear and 70% in my left. It was so uneven, Jerry sent me for an MRI. He thought I might have an acoustic neuroma, a benign tumour that can cause hearing loss.

I didn't.

But as it happens, my maternal grandmother had a similar kind of hearing loss. She died when I was a kid and Jerry never knew her. My hearing loss is hereditary. On both sides of my family. My late father wore little inside-the-ear hearing aids and his "kid" brother, my Uncle Laurie, has had two cochlear implants.

I am very lucky. My wondrous audiologist Leslie Garbett assures me that I will never need a cochlear implant. My hearing will never get that bad. I will always have problems with clarity, but new hearing aid technology will to continue to improve my hearing. Isn't that good news?

With my very lopsided hearing, one of my hearing aids is twice the size of the other. 

All this is really no secret. (Nothing in my life is a secret, it seems. No one would ever describe me as a woman of mystery, except my husband. Maybe. He often finds me difficult to understand.) 

I've written about my hearing loss. My first story – headlined Hear! Hear! – appeared on pages 10-11 of the Summer/Fall 2007 issue of "The Sentinel," the Seneca Retirees Association magazine. It was reprinted from the Mount Sinai Hospital's Spring 2006 issue of "Your Health Report."

Another, Hearing is Believing on pages 14-16 in the Fall 2006 issue of "Network" magazine, published by the Canadian Mental Health Association (Ontario). Quite a different slant. 

What's really important is that every time I walk into a new class (or I make a speech, for that matter), I trumpet my hearing loss. I announce to my new crop of mostly very young Seneca College students that they'll have to speak up for me to hear them clearly. 

Here, we know all about "speaking up," don't we?

"Speaking Up" and "Speaking Out" is what Coming Out Crazy is all about. Advocacy. All of us are or can be advocates for change by using our voices. That's all it takes.

In class, I whip off my brilliantly coloured big, behind-the-ear Widex Inteos to show people what they look like. 

No tiny little nude-coloured hearing aids that fit neatly, almost invisibly inside your ear for me. Nope. They're not strong enough. I need the big guns, so I wear a bright, cherry-red coloured one on my right ear. And a magnificent deep turquoise-blue coloured one on my left.

Red-Right. Blue-Left. The nautical approach to hearing aid wearing. It makes them easier to tell apart, too.

I wear my red and blue hearing aids like fashion accessories. Like you may wear eyeglasses. Today, they've become fashion accessories, whether your eyesight is fine or you need corrective lenses. Either way, eyeglasses are facial fashion and these days, there's nothing particularly bothersome about needing glasses.

Unless you take Dorothy Parker's "News Item" seriously:

"Men seldom make passes
 at girls who wear glasses."

That might be "news" to you and it still may be true today, but I doubt its validity, especially if those glasses are sunglasses! Designer sunglasses – prescription or not – are mega-high fashion.

The bottom line is, whether their lenses are tinted or clear, it's all in the way you look in them and what you see or choose to see.

Furthermore, it's how you wear them. I sport vintage frames for my prescription glasses – for sun and shade, reading and distance – in wild colours or big black dramatic classic shapes and sizes. I always receive compliments. It's fun to turn a liability into an asset. 

That's my philosophy. It's another version of my favourite hobby – turning lemons into lemonade.

I apply this maxim to almost everything. Especially my unique brand of madness and my hearing loss. I'm me. I celebrate my differentness. I enjoy who I am. You can, too.

Depends on how you look at it. Your point of view. Your lens on life.

By the way, I am not deaf. I have a hearing loss. There's a huge difference.

Whenever I talk on the phone, I don't use my hearing aids. They don't work for me. I use my good ear. My iPhone has a fabulous sound system because it's also an iPod. I don't store music, but I love talking on it. It's better than any other phone I use, anywhere.

Hearing loss is like any disorder or difficulty. It's not objective but subjective. Peculiar to each individual. There are many kinds, causes and varieties of hearing losses just like there are many kinds, causes and varieties of mental health issues, disorders, difficulties, challenges. 

Madness. (Such a nice simple compact yet all-encompassing word. That's why I like it so much.) Difference. That's another way of looking at it.

Hearing loss could be viewed as difference. I don't like the word dis-ability. I've never felt dis-abled by either my mania, my hypomania or my hearing loss. I've always felt that "labels disable." So I've learned not to take the labels too seriously. I'm lucky that way, but I've worked hard at it. This fall, I enter my 50th year of psychotherapy. Dr. Bob remarked the other day that he doesn't know of any psychiatrist who's been practicing for 50 years. 

Anyway, hearing loss and psychiatric disorders or madness have several things in common. 

They're relatively invisible. They're most misunderstood and frightening to too many people – ignorance and fear go hand-in-hand with prejudice and discrimination. They're part of the human condition. Hearing loss is inevitable as we age. In our youth-obsessed culture, no wonder people deny needing them.

Consider some stats. 

• 75% of people who could potentially be helped by some form of intervention do not receive it – be it recovery-oriented, peer-support, community mental health and what clinical social worker Ron Unger likes to call the "Life Model" or some form of biomedical approach, according to Queen's University epidemiologist Dr. Heather Stuart, who has consulted with the Mental Health Commission of Canada.

• 90% of people who could potentially be helped by some form of hearing aid either will not wear them, cannot afford them or are in denial about their hearing loss, according to Krista Riko, Director of Audiology, Speech Language Pathology and Hearing Aid Dispensary Services at Mt. Sinai.

I remember telling a friend about being fitted for hearing aids in the fall of 2005. "Oh really?" she said, sounding shocked. "I thought hearing aids were only for old people." 

I quickly discovered that not only is noise-induced hearing loss affecting younger people these days because they crank up the volume of the music they listen to, but hearing loss has long been deleteriously stereotyped. Linked inextricably to an image best summed up in the insensitive, erroneous and archaic phrase "deaf and dumb." 

Not unlike the phrase "mentally ill", an adjectival phrase I never use. I hate it. It colours a whole person and we are all so complex. So multi-faceted. We may have challenges, difficulties – who doesn't? But, we are all human beings first. People first. Individuals first. And the way we use language colours the way we perceive the world. That's why I try to be so careful.

I know so many people my age wearing hearing aids and desperately trying to hide them. Most musicians and DJs have serious hearing loss. Famous people, too. 

I don't hide mine. What's the point?

Hearing aids are just that - aids. If you don't let people know you have a hearing loss, they won't take the time to slow down or speak up. I tell people that. Even though I'm a brilliant lip reader, when someone takes the time to accommodate my hearing loss a little, it beats my saying something inane or insane-sounding because I haven't been able to aurally process it correctly. It's terribly isolating when your hearing loss shuts out conversation.

It's often embarrassing, although nothing embarrasses me anymore. I just make a joke of it. I whip out my trusty little Widex remote control and adjust the volume controls of my hearing aids and the mode in which they process sound.

"I'm a bionic woman," I quip. Dazzling people with my smile. Humour is a great way to diffuse embarrassment. Most people grow curious and start asking questions. Opening their minds as a dialogue begins. Then I have an opportunity to do a little on-the-spot advocacy. One person at a time. That's how social change happens.

That's what we're doing here. You and I. Social change. Together. 

Thanks for listening. Let me know your thoughts and feelings about all this. I'm curious. In the comments, please. That way we can all join the conversation. No one will be left out.

Have a lovely meantime and a sensational weekend.

Speak soon!

A Postcard from the Edge*

Hi there. I wish I could say I wish you were here, but you wouldn't want to be where I've been for the last week or so! Quite frankly, I don't know if the fish were biting or not.

Here's the story.

You may recall, about 10 days ago, I decided I needed a break. So I signed off for a week, hung out my Gone Fishin' sign, and signed off.

I wish. 

The next day, my iMac froze. Completely. Off it went to my Apple specialist where it stayed until Saturday and I had to do all the other things I do in my life without my computer.

Believe me, there are a lot of other things I do demanding my computer to help to keep this ship afloat.

So, it meant I had to use my husband's computer. We're hitched and so are our iMacs. A wireless network.

That meant that he had to put his life on hold for a week for me. He's a writer, too. 

Every time I started to walk into my office, which I do automatically, I saw my empty desk. Sans computer. Sans external backup. Just my sleek but orphaned Chiclets-style Apple keyboard lying on my desk, its wires straggled amidst papers and pens and my dead little white mouse.

A sorry sight. 

Meanwhile, my "other" life carried on. I had to continue teaching my Seneca College women's studies course sans computer. Lesson planning. Emailing with my 18 students. Marking their online journals. I had to write their final examination. All sans my computer.

I was not entirely handicapped. I have an iPhone, so I could read my email. On my husband's computer, using his identity, I could respond. I could Skype, being him. (Talk about an "out of body, out of mind" experience.)

I was able to work, but every time I went into his office, he had to leave. It wasn't the relaxing week I had planned, although he was absolutely darling about the whole affair.

Want to test your marriage? Share your spouse's computer for more than a week. Especially when your spouse doesn't like you fooling around with the configuration of the files on his desktop. 

Mind you, he has more than 6,000 opened emails in his inbox and I had access to them, to all his correspondence. That didn't bother him a bit. Talk about trust. We have two rules in our marriage:

1. No secrets. No lies.

2. I cook. He cleans.

And now a third. Computer Sharing.

We have a blissful marriage and will be celebrating our ninth anniversary in exactly 18 days. 

But living without my computer was no fun for either of us. I couldn't read any of my RRS feeds. I subscribe to about 55 blogs and other websites. I felt cut off from the world. I do more reading on line than in hard copy. I don't yet do much reading on my iPhone – I'm still learning how to use it – so the only advantage it had for me, besides email, was having my calendar at my fingertips.

To the best of my knowledge, I didn't miss any important appointments.

I don't Facebook on my iPhone, so that part of my life died until yesterday. I don't Tweet on it either.

Now my iMac is home and once again fully functional – or almost – there are still a few little glitches.

That's to be expected with a new hard disk. 

That's what happened. My hard disk died. My computer needed a heart transplant. 

It wasn't a very happy time, last week. I was stressed out every day, calling the hospital, checking on its progress. 

Two complete backups were needed. Diagnosis was difficult. Finally, the problem was found. It wasn't software, but definitely hardware and in the hard disk. Couldn't be fixed. The whole hard disk had to come out and be replaced. 

With what model? The same one it had or an upgrade? We decided on an upgrade, but the one we wanted wasn't available, so we went with the top of the line. One that had to be removed from one of my computer doctor's other Apples. A double transplant. Not brand new, but tested and working well. A better option.

Meanwhile, I wasn't allowed to visit and for long stretches of time couldn't even locate the doctor. He's busy. I had to be patient.

Have I ever told you that I'm not patient? That's not one of my virtues. Doesn't exactly fit with my perennially hypomanic mindset.

So. For more than one week, my fishing trip was aborted, but I was gone. Really gone. Out of cyberspace, practically.

All this to let you know that I'm taking this week off, too. I need a week of relaxation. I don't know where I'll be. Just away.

I hope you'll understand, but I feel I need a little more time. Just one more week. After all, its summertime – and the livin' is supposed to be easy, isn't it?

Hugs,

sln

* Postcards from the Edge 

 

Yesterday, I lost my mind ...

Yesterday, I woke up exhausted. I neglected to take care of number one. Me! 

So here's what happened.

I forgot to take my medication until 2:50 p.m. I neglected to brush my teeth all day. I didn't get dressed. I didn't brush my hair. I grabbed unhealthy food and gobbled it down without tasting it. Like a robot. Just to fill a void caused by frustration.

I was struggling with a post for this blog. Inspired by you. It was driving me crazy.

Ideas were flooding into my mind. All day. I had trouble focusing. I was hitting dead ends and desperately turning around re-routing my thinking.

This went on and on and on until 12:14 a.m. this morning, when I gave up and went to bed with a couple of 0.5 mg tablets of clonazepam – which I take only when needed. It helps calm my mind and turn off my thoughts when they're running wild.

No. I do not get depressed. I get the opposite. I get revved up. I cannot turn off my brain. I cannot stop my thoughts. Ideas in words and pictures flood my consciousness. Crazy quilts of ideas. Conflicting ideas. Picture fragments. Images. Blasting away the cerebral quiet needed to fall into sleep.

I don't have the switch that most people have when they get overtired. That's what's wrong with me. That's the root of my "mental illness" and there really isn't a name for it, other than chronic hypomania with a vulnerability to full blown mania if I don't ensure that I sleep.

Sleep is the antidote for my sanity. Everyone's really. But I cannot do it without a little help. Maybe I should learn to meditate, mindfully. But I don't have time. 

That's why I'm better on medication. Including my mood stabilizer. 

That's what I've learned.

I slept, dreamlessly. Deeply.

At 6:15 a.m. I was awoken by my dogs nipping at my side of the bed and wanting to be let out.

This morning, after five and a half hours of sound, deep, fast sleep, I woke up and guess what...

My mind was back.

Miraculous.

Anyway, that's the miracle, the blessing, the healing of sleep!

Go figure.

Anyway, I want you to know that I'm working on a couple of amazing posts for you. Inspired, as always, by you. 

However, I need a break. So today, as it happens, while my husband is having a colonoscopy, I'm going to be spending a long overdue hour with... guess who?

DOCTOR BOB! My wondrous shrink. After spending an hour with him, always, without exception, I leave magically transformed. Always better, more calm, more at peace with myself, than when I did at the beginning of that hour.

Feeling better than when I did.

So, I'll be back tomorrow. With the post I wanted to finish and see up today. I need a break. I need to take care of myself. We all do! 

This is the first and most important lesson of a life lived well. 

Have a great day!

Speak soon!

sln

Edging a car out of my parking lot...

Last summer, my psychiatrist Dr. Bob recommended I read The Center Cannot Hold – My Journey Through Madness by Elyn R. Saks.

This was a first. We've been together since 1991.

The only other book we ever discuss is the Diagnostic and Statistical Manual of Mental Disorders. He even gave me a little pocket edition called Quick Reference to the Diagnostic Criteria from DSM-IV – published in 1994. I treasure it.

Back to the Saks memoir. I've discovered a number of peculiarities about it. Though it was number 34 in the "Also Selling" section on the New York Times best seller non-fiction list in September  2007 – it was never reviewed and its author is mentioned only once. Saks is briefly quoted, but not about her book or herself.

Compared to the other notable psychiatric memoir I've read – An Unquiet Mind, A Memoir of Moods and Mania – published 10 years earlier by Kay Redfield Jamison, there are stunning differences.

Saks is cited twice in The New York Times archives.

Jamison, 561 times.

Saks has schizophrenia diagnosis. Jamison, bipolar disorder. Or manic depression, the term she prefers.

Both are married. 

Saks to a good, kind, supportive, rock-solid man – Will.

Jamison, to a Richard J. Wyatt, a renowned schizophrenia scientist about whom she has written her sixth book – Nothing Was The Same, a memoir – to be published in September 2009. For Jamison, a brilliant writer with an M.A. in English Literature, her second memoir is an elegy on her 20-year marriage that ended when Wyatt died of cancer in 2002 at age 65. 

Saks is a PhD in philosophy, a professor of law at the University of California, an adjunct professor of psychiatry at the University of California, and a research clinical associate at the New Center for Psychoanalysis. She prefers research. Dislikes lecturing. She's had a number of important scholarly books and papers published about her area of expertise – mental health law.

Jamison is a PhD in psychology, a professor of psychiatry at the Johns Hopkins School of Medicine, a clinician/researcher and one the leading authorities on bipolar spectrum disorders. She's written several medical texts, plus five books for non-clinical audiences. All about mood disorders. All wildly popular.

Among them – Exuberance – about hypomania. Touched With Fire examines manic depression and the artistic temperament. Night Falls Fast – about suicide – is still the first of its kind. Meticulously researched and breathtakingly written by a clinical psychologist who came perilously close to dying by suicide before being prescribed Lithium Carbonate in the mid-1970s. (Then a revolutionary pharmacological treatment for manic depression, it saved her life and successfully stabilizes her mood swings.) 

Saks' book is barely discussed. Rarely reviewed. Problematic, perhaps, it is extraordinarily compelling – the only memoir I've ever read by anyone with wildly delusional and psychotic episodes of schizophrenia yet her primary treatment was and remains psychoanalysis. She takes medication now, but for years she fought her diagnosis and often refused to stay on it.

Here, I stop. The rest of this post goes back into the parking lot. To be continued next time. 

You'll notice my posts are shorter, as they should be. This one is 561 words. I've written 1,500 word posts. Too long. I'm not writing for a magazine here. You should be able to read these on Kindle or an iPhone.

Let me know your thoughts on this. Does "length" matter?

Speak soon.