How my dogs safeguard my emotional health...

In May of 1966, when I was 18, my mother decided having a dog would be good for me. 

I had just been discharged from Toronto's Clarke Institute of Psychiatry (now the College Street site of the Centre for Addiction and Mental Health known as CAMH) after a seven-month hospitalization. 

Around Halloween of the previous year, I had become psychotic for the first time in my life. My diagnosis was schizophrenia, though I was unaware of this, as was my family. I have very vivid, colourful memories of my behaviour at that time, what I was doing and saying, and why I was admitted, but I'm not going to describe them right now. It would take too long. Another time. 

After all, this is a dog story.

HOW DOGS HAVE HELPED TO KEEP ME EMOTIONALLY AND MENTALLY STABLE

More importantly, it's a story about how dogs have helped to keep me emotionally and mentally stable for many years. Still do.

Around Christmas of that seven-month hospitalization – my longest ever – I became catatonic. I have no recollection of anything from one evening, when I was supposed to go on a tour of the Christmas lights with a group of patients until Easter of the following year. Four months are gone. Blank! 

During March and early April of that blank period caused initially by the catatonia, I had my first course of Electroconvulsive Therapy. It snapped me right out of my catatonic state and brought me back to life. I recovered quite quickly, and in May, I went home – but I was very emotionally fragile.

So my mother decided that it would be therapeutic for me to have the responsibility of taking care of a dog. We had never had a dog in our family. I am the eldest of three girls, but my father wasn't very fond of dogs. Somehow my mother convinced him that the care and feeding of a dog would be a positive focus for me. I had lost a year of school. I remember feeling lost and out of sync with the world. Reluctantly, my dad agreed, as long as this dog was small.

We didn't know very much about dogs. My mother had grown up with them. That's all. My sisters were not terribly interested. So, my mother and I went to a dog show to case out different breeds. I remember that show well. It was northeast of the city in a huge arena. We didn't watch the show. Instead, we wandered about the huge area where all the breeders were set up to groom and ready their dogs for their individual competitions.

I FELL IN LOVE WITH A ONE-YEAR-OLD MALE YORKSHIRE TERRIER

After much browsing and chatting with dozens of breeders, we decided upon the breed for us – the Yorkshire terrier. One breeder's Yorkies seemed more beautiful than all the others. I can't remember the breeder's name, but I'll never forget her helmet of wild, frizzy, bright red hair. She seemed a little odd, a little eccentric, a little obsessive (as I've learned all good breeders usually are) but she took time to talk to us, while brushing and combing her exquisite little wards. She gave us her card, inviting us to visit her kennel in Oshawa. 

Within a week, we were there. First, we noticed how immaculate it was. Then, I fell in love with a one-year-old show dog. He weighed about seven pounds. He was perfectly sweet. Gentle. A darling little toy. Reluctantly she sold him to us. 

We called him Derrier because he had a silky, tan and black coat made his front look like his behind, but he was always called Derry. He was my first dog and my mother's instincts proved right. I researched the breed and learned to bathe him and groom him. I walked him and fed him. Most of all I adored him. 

Fast forward a bit. We thought Derry would enjoy a companion, so we bought another Yorkie from the Frizzy-Red-Haired breeder. A puppy. He was tinier than Derry and quite assertive. My father named him Fang. After that, we bought a third, Yorkie, a darling and quite daring little female. We named her Kismet, but she was known as Kissy.

Caring and loving these dogs had done its magic with me. I returned to school the following September and stayed relatively healthy for a number of years. Eventually, I went Seneca College, then Queen's University in Kingston, Ontario, and finally Ryerson, excelling all the way.

By 1977, my parents decided to move from our house to a condo. I was still living at home, but had just been hired by The Toronto Sun, so I was ready to move out on my own. Luckily we found a retired couple who doted on our little Yorkies and spoiled them unceasingly. 

I missed having a dog to care for and love. Living on my own, I felt it unfair to leave a dog alone for eight hours a day while I was at work, so I repressed the craving. 

From 1977 until 1988, I was hospitalized 11 times, often in the month of February, for between one and three months at a time. In 1989, I broke down and bought an eight-week-old male Shih Tzu-Poodle-cross, a Shih-Poo. I named him after my favourite journalist, Murphy Brown.

Murphy was the most remarkable dog I've ever known. My "significant other" for 10 years, sharing my bed, until I met my husband, when we became a crowded ménagerie à trois in my double bed. 

MY LITTLE DOG MURPHY NURSED ME THROUGH ALL MY ILLNESSES

He nursed me through all my years of iatrogenic endstage kidney disease (caused by Lithium toxicity), dialysis and transplant. He needed me to walk him and care for him. The routine kept me going. He was also a St. John's Ambulance Therapy Dog, the tiniest in his class and for years, we visited the adolescent and adult psychiatric wards at Sunnybrook Health Sciences Centre. No one else wanted this assignment, but it was perfect for us. Murphy looked forward to our visits and loved nothing more than to lie down on the floor to have his tummy rubbed or to be cuddled in anyone's arms. He seemed to know he could calm and brighten the spirits of those he served.

When I had to put him down at 13 years of age on December 8, 2003, I thought I would die. He was suffering from lymphoma –  losing weigh, not eating and his gums were bleeding. 

After three months of grieving, on February 13, 2004, we brought home our first Dandie Dinmont Terrier puppy, 13-week-old Riley. I adore the terrier breed, always have, but this particular terrier breed is like no other – and it's endangered. 

Riley is every inch a terrier – gorgeous, mischievous, playful – but he's also deliciously sweet and cuddles like a baby for hours, with his head on my shoulder making soft contented little sounds. He is gentle and loyal, with an immaculate pedigree. He became a Canadian Champion in 2005, the fourth top Dandie in Canada that year.

I groomed him, walked him daily and lost my heart to him. He is my dog. My constant companion. And my hobby, too,

In the summer of 2005, a little over a year later, my breeder gave us eight-week-old Lucy. We agreed to give her two litters. Lucy rules this house, though I'm utterly enchanted with her, as is Marty. She's the Alpha Male and a typical younger sibling, although these two dogs are actually cousins. 

She is the friendliest dog I've ever known and having two dogs is a part-time job, but I find the grooming calming and bonding, as I did with my first dog, Derry and every dog since. I had no idea what it was like living with a "bitch" who goes "into heat" every six months. She drives poor little Riley mad with desire. 

MY DOGS ARE A LINCHPIN OF MY EMOTIONAL HEALTH

For about 14 days of her 28-day cycle, Lucy and Riley must be kept separate at all times, a real challenge in our open-concept house. This will be her last season. The market for purebred dogs is shrinking. After one litter in August 2008 – remember little Auggie, – we haven't been able to breed Lucy and this spring, I am planning to have her spayed with my breeder's blessings, as the market for purebred dogs is shrinking.

Still, as always, the routine of all my dog-related activities and care, plus all the love I receive in return, keeps me emotionally anchored. I love holding a dog in my arms. I always will.

Marty helps enormously with our routine, but I do all the grooming and daily tooth brushing, much of the feeding, organizing and health care. With the dogs, I'm essentially in charge. 

They're a linchpin of my emotional health, in addition, of course, to my husband – the heart of my life. 

Since 1988, I've never had a major manic episode. 

I cannot imagine living without my dogs. They keep me in recovery. They keep me sane.

ANGELA UPDATE – "I SLEPT THROUGH THE HOCKEY GAME!"

Today, Angela is having a very good day following her seventh ECT treatment yesterday.

"Oh, I think there has been progress," she said, with a spring in her voice. "Last night I fell asleep and missed the (Olympic) hockey game!" She's a fanatical hockey fan. "Without my sleeping pills. And I slept through the night until 6:30 this morning. I haven't done that in, oh, at least two years. Maybe more."

A note from a friend made her feel even better. She read it to me on the phone. 

"I just happened upon Sandy Naiman's blog... and I have even more respect for you now than before," her friend wrote in an email. "I'm really wishing for great breakthroughs for you."

I think we all are!

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.

An apology and Angela's "voluntary" ECT...

One of my goals as a blogger writing about mental health and wellness is to use "the language of respect" at all times. I am not perfect and sometimes I err, which I did, unwittingly and unknowingly, in my last post. 

I inappropriately referred to Darby Penney, an ex-patient and long-time activist in the movement to protect the human rights of people with psychiatric conditions, as "a well-known anti-psychiatry activist who vehemently opposes ECT." 

I thought I was accurately describing her. It never occurred to me that I wasn't. But I was wrong. She was quick to inform me that I had "misrepresented her beliefs" and "defamed" her. She stated that she does not believe she is "well-known" and that she is neither "anti-psychiatry" nor "vehemently anti-ECT."

THE LANGUAGE OF RESPECT 

She stated that she is "pro-choice, especially pro-informed choice" and she stressed, "I believe people should be free to make their own decisions about any treatment as long as they have full and accurate information about its risks and benefits."

I would like to apologize to Darby and to anyone else I may have offended by misinterpreting Darby's point of view. I was insensitive. I became emotional and, unfortunately, defensive. ECT is a highly emotional and political issue. As a result of our private exchange, Darby educated me as to why the terms "anti-psychiatry" and "anti-ECT" were offensive to her. Henceforth, I will be extremely careful when using them. 

Darby, I hope you will accept my sincere apology. I'm sorry that I misrepresented you and upset you. Thank you for taking the time to explain why my statements were so hurtful and for educating me on the nuances of "the language of respect." 

"COERCIVE PSYCHIATRY"

In one of the comments to this last post, the term "coercive psychiatry" was used. Angela's ECT is by no means "forced" or involuntary. She chose to have electroconvulsive therapy independently. She asked me "what do you know about ECT" one evening, out of the blue. We had never discussed it. She discussed it with her psychiatrist. She did her own research. 

She is having outpatient ECT and she's had six sessions over the last three weeks, although she said last night that she "wants it to be done." She has another five weeks of treatment, and possibly more. Perhaps 12 weeks in all.

"I'm feeling tired, but not depressed. Just a little down," she said last night at about 8:30 p.m. She has to get up at 6 a.m. on the days of her 7 a.m. ECT treatments. "And my hand looks like a pin cushion."

She sad that during her treatment yesterday morning, she had "a nice psychiatrist and a female anesthesiologist who was very good." She admitted that she had a "tiny bit of confusion," right after the treatment when she got home. "I couldn't remember where I keep the popcorn or where my little Crystal Lite juice packs were, but I took a minute or two and it came back to me."

This morning – we just spoke – she said she's feeling better than she was last night. "I'm about a seven," she said. My call interrupted the "work-out" she does every day, using a computer program. She saw her psychiatrist today and said, "Everything is good." This weekend, she'll be glued to the TV and The Olympics, but we'll be connecting each day.

"WE DON'T HAVE INVOLUNTARY ECT IN ONTARIO" 

I asked my psychiatrist Dr. Bob about Involuntary ECT yesterday. Here in Canada, health policy is provincially legislated (as it is by individual states in the U.S.) and in Ontario, we don't have involuntary ECT, he said. 

Everyone must sign a consent form, except in cases where a person may not be capable of making that decision. I remember, when I had my first course of ECT treatments in 1965, I was hospitalized because I was psychotic. At that time, my diagnosis was schizophrenia. During that seven-month hospitalization, I became catatonic and ECT was recommended because nothing seemed to be helping me. My parents signed the consent forms. 

In 1975, shortly after I left my first husband, again I was hospitalized for psychosis. My diagnosis was still schizophrenia. I wasn't depressed. I was clearly manic with psychotic features, though my diagnosis wasn't changed to manic depression – the term "bipolar disorder" wasn't in use yet – until later that year, when I was prescribed Lithium. This time, my estranged husband and my parents gave consent for the ECT course of treatments that was recommended by my team of psychiatrists. I remember that distinctly.

In cases such as mine, when someone isn't capable to make an informed decision or give informed consent, in Ontario, there is a hierarchy of people or "substitute decision makers" who are asked to make this decision on behalf of the patient, my psychiatrist explained. First, a spouse or partner, then a parent or child who must be age 16 or over, then a sibling, and then any other relative. If none of these people is available, then the Public Guardian is consulted.

This decision is based on one of two criteria. If the patient made it known that s/he wishes not to have ECT, for example, that wish must be respected by law. If there is no prior known wish, then a decision must be made on the "Best Interests Principle" which is defined in The Health Care Consent Act. 

In Ontario, this is true for any medical procedure. Yesterday, I had to sign a consent form to have my dog Lucy's teeth cleaned. She had to be anesthetized. Last year, I had to sign a consent form to have periodontal surgery, though I did not have any anesthesia.

I had planned to tackle controversy swirling around the Newsweek cover story on antidepressants this morning, but as you can see, things sometimes derail my best-laid plans. I'll try to get to it next week.

HAVE A WARM AND RELAXING "FAMILY DAY"!

On Monday, Angela's regularly scheduled ECT treatment is cancelled because in Ontario, it's Family Day – a three-year-old and much-needed, mid-Winter holiday. It's also my stepdaughter's birthday, so we'll be celebrating that, too. If anyone has helped to support me and safeguard my sanity over the last 11 years, it's been my new immediate family. My darling husband, Marty, and his youngest and most spirited daughter, Maya, who will be turning 23 on Monday and grows sweeter and more adorable with each year. His older daughter, Rebecca, doesn't live with us, yet, she, too, is extraordinarily kind and considerate of me, always caring and compassionate. We're hoping she will celebrate with us.

I hope you have a family to celebrate on Monday, family in the broadest sense. Whether it's your father or mother (mine is extraordinary) or siblings (also pretty special to me) or your extended family, and your "chosen family" of friends.

Here's to a great weekend and a lovely, warm and relaxing Family Day!

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!

Here's to a hopeful 2010!

Did you have a good Christmas? I hope so. Now, you're probably recuperating. Relaxing or Boxing Week bargain-hunting. Having fun. Movie-going. Just hanging out with friends. 

Meanwhile, I've noticed that traffic is very light here right now. It died down on December 23 and it's stayed quiet. Commenting has fallen off completely. I think that's a good sign. Better to spend time with people you care about, people who love you, going out and about in the "real" world" instead of staying glued to the "virtual world" of your computer.

And you know what? I'm exhausted. I've been flying off the handle at Marty lately and he doesn't know why. Exhaustion. That's why. It's more insidious than sleeplessness.

Considering that I taught all last year (2008-2009), finished a book during my two months off in May and June 2009, taught all summer and then started again in September and as you know, had a disastrous marking period this term.Then there was Christmas. Now, I'm simply running on empty.

Utterly worn out and worn down.

So, I've decided to take a wee break. I feel I need it. I'm bone-tired. With New Year's Eve looming and another late night, my body and my mind are desperate for some real rest, relaxation, recharging, refreshing and recuperating. 

I call those the five "R's" of holiday recovery. (Yes, recovery has many facets.)

I've learned to be able to hear my body and to recognize its signals of potential exhaustion. Lack of sleep is a serious trigger for me. But what causes the sleeplessness? That's the key. I must understand that, too. It takes insight. If I ignore those signals and those reasons, I can run into real trouble. Mainly mania – big time. Better to prevent than to treat. Head it off at the pass. Call Dr. Bob. But psychiatrists need a holiday, too. So I'm taking it out on my closest substitute. My darling husband. We've talked about it. 

Also, I've learned never to make New Year's Resolutions. They're too breakable. (Although last year, I did make one and I managed to keep it about 99.9% of the time. I resolved not send "forwards" – you know, those cute emails saying or mildly threatening that if you don't "forward" this to 2,500 of your closest, nearest and dearest friends in three seconds flat, you'll wake up dead tomorrow, or some such.)

Well, this past year, I didn't. I ignored them. And guess what? I'm still here!

Mind you, this was a pretty stressful year for me, but I really learned a great deal from all the major mistakes I made, so I suppose all that stress was worth it.

Anyway, that's one resolution I enjoyed making and keeping. But the others, like losing 400 lbs. by mid-April, or working out 17 times a week. I didn't make those resolutions and I'm doing fine without them. And without the guilt that goes along with them.

Speaking of which... I want to share with you a few little things I've learned in 2009. I've learned to stop doing two things:

1. I've stopped worrying. It serves no purpose and it's a waste of energy.

2. I've stopped feeling guilty. For the same reason.

My husband rarely ever worries or feels guilty and he's a most calm and peaceful human being. A veritable rock. My rock. So, after nine years of marriage, I thought I'd try it and it works. Instead of worrying, I've learned to make lemons out of lemonade. Gallons of it. 

If I find myself feeling guilty, I remind myself that this completely wasted emotion can be resolved if I try to do something about it.

Apologizing is a great way to start. I've learned how to apologize with meaning.

Not just saying, "I'm sorry." If you listen to The Last Lecture by the late Carnegie Mellon University professor Randy Pausch, you'll discover that a good apology has three parts:

1. What I did was wrong.

2. I feel badly that I hurt you.

3. How do I make you feel better?

Try it.

And now, I'm going to end this post with my wishes for you.

Try to ensure that, not like me, you give yourself the greatest of all gifts. Time. To refresh, recharge, rest, relax and recuperate. Not just now, but throughout the year.

Enjoy that time. Feel good about it.

As for 2010, I sense it's going to be a good year. I'm going to try to make it good. And I wish that goodness for you, too. That desire and that determination to participate and partner in the goodness that 2010 is going bring. If you help it along, you can almost bet that you'll have a good year.

One never knows for sure, but taking action and doing things to bring about change cannot hurt.

Most of all, I wish you health. Without it, what else is there?

Have a healthy 2010. Be safe. Be well. I'll be back next week. Now, I'm going to relax for the rest of the day. I'm not going to do anything. No work. No shopping. No nothing.

For the next week, nothing. Nothing at all.

Finally, I want to thank you for all you have done to make Coming Out Crazy live. Without you, we wouldn't be here. You've shared so many wise and thoughtful insights here, enriched what begins as a monologue and turned it into an ongoing dynamic dialogue. You're honest and candid and courageous. You help to heal everyone who reads you. You inspire me. You challenge me. You keep me in my thinking and growing and evolving.

I couldn't write here week after week without you and I want you to know how grateful I am.

Here's to continuing your journey of recovery. Here's to a hopeful 2010!

xox

sln

Hidden Homelessness: One woman's story...

I often say to my students that "teaching is learning" and the same is true of journalism and perhaps even more, of blogging. There is a visceral connection between you and me in the blogosphere, often it grows beyond a virtual connection, too. It's very affecting and inspiring. 

This is the story of one of those times.

On Saturday night, I had a tough time falling asleep. My mind was whizzing. 

The day before, on Friday, while achy, feverish and sleeping most of time, felled by some sort of bug, I received an email from a member of our community here at Coming Out Crazy named Sandra Dawson.

She was clearly upset and for good reason. Through a series of emails and then a five-hour telephone conversation on Saturday evening, I discovered that Sandra's recovery journey is nothing short of miraculous. 

"When I was eight, my depression started. For no reason. I became glum, sad, moody cranky, often during the fall and spring. It was biological. I wasn't diagnosed at all until years later," she said. 

Sandra grew up in a comfortable and "privileged" military family, and as she was moving all over the country growing up, her behaviour began changing along with her moods.

"When I was about 10, I wrote a Christmas play and my teacher decided that I could direct it, but she fired me as the director because I was too bossy," she said, laughing at the recollection, perhaps a harbinger of the more exuberant moods she would experience later.

Initially, her mood swings were characterized by short episodes of increasingly severe depression, and occasional suicidality – her first attempt was when she was 11 years old, in school, with a pair of blunt, round-edge scissors. "I just knew I wanted to die," she said. A schoolmate spotted her and called her "Freak!" Nothing else happened. 

"We didn't talk about it in my family," she said. "We were repressed and didn't discuss our feelings or our emotions."

By the time she was in her early 20s, she was beginning to experience wildly euphoric manic moments as well as depression. Sometimes the two extreme moods occurred coincidentally, with "mixed episodes of mania/depression and hypomanic/euphoria. Depression with spikes of mania," she said. 

Eventually, Sandra started seeing a counselor, to no avail, then a psychiatrist who prescribed medication. "I was misdiagnosed as being depressed," but because of her own ignorance and fears about mental illnesses, her prejudice and discrimination, her negative stereotypes, she wouldn't take those drugs, even though she was suicidal.

She never went back to that doctor.

Sandra is now 42. She has been hospitalized approximately 35 times, calling herself a classic 'revolving door.' Most of those hospital stays, she stresses, were for relatively short periods of time – from a few days to two months.

"There were many times when my doctors didn't know what to do with me," she said from her home in Vancouver. Sometimes, they still don't, she added. 

Between these episodes, she typically has much longer periods of independence, emotional stability and productivity. 

At 27, a GP misdiagnosed her again and prescribed Prozac. This time, Sandra decided to take the medication, but it was disastrous for her. "It made me more manic."

Coupled with the death of her father, insecure living arrangements, travel, and another serious manic episode, her life started spiraling out of control. Suffering from Post Traumatic Stress Disorder, unable to work, for the first time in her life, she experienced hidden homelessness.

Four out of five (80%) homeless people in Canada don't live on the street. Most are improperly housed or on the verge of eviction, far too many are children. Women who earn less than men are more vulnerable to homelessness. The hidden homeless live in cars, couch surf or find temporary shelter in church basements or abandoned factories. 

Over the decade between 1994 and 2004, Sandra became homeless – but only four times. Years apart. Those episodes were short. She stayed in shelters for abused women, hospitals, or on friend's couches. She also lived in marginal housing like rooming houses and Single Room Occupancy hotels.

"I've been lucky," she said. "I've never lived 'on the streets' as in the stereotypical sleeping bag on a sidewalk. I am considered high functioning by my psychiatrists. Although my disorder is severe, I can look after my basic needs. Low functioning people need more help, but high functioning people can and do fall through the cracks and become homeless or at risk." 

These experiences were so searing, they turned her into a crusader, a passionate advocate, working professionally and within the community as a volunteer to help to understand, enlighten and fight hidden homelessness, and to ensure that more supportive housing is available especially for people with mental health issues.

She has a steady part-time job on the Mental Health Commission of Canada as a consultant, a person with lived experience of hidden homelessness, working on its newly launched, national multi-city study called At Home/Chez Soi.

Sandra is also on the board of Vancouver's Marine View Housing Society, a licensed and supportive housing project that began in 1975 and owns residential buildings in Vancouver for people with mental health difficulties. For years, she has also volunteered with her local arts community in several capacities. 

"It's so important to me. It makes me feel useful," she said.

Her work with the Mental Health Commission of Canada is one of her passions. 

On Sunday, Sandra was a presenter at a major national Vancouver conference on homelessness called Into The Light, which winds up today. She participated on a National Consumer Panel of peers with lived experience of homelessness and/or mental health issues involved in the At Home/Chez Soi project. These panelists represented cities of all sizes and discussion focused on pressing local issues in their respective areas. 

So why was she so upset when she wrote to me last Friday? 

When this four-year Housing First study was launched at a media event last week, Sandra bravely spoke out, telling her story about her own experiences with homelessness. She gave an interview to the press. Somehow, she was misrepresented and her story was badly distorted, so much so that she feared her credibility would be damaged and her reputation besmirched.

So she reached out to me and I'm so glad she did. I knew virtually nothing about hidden homelessness. It wasn't on my radar screen. Indeed, it was hidden. Invisible. Buried under the stereotype of the homelessness we see. I have started to scratch the surface. I will keep digging. 

Best of all, I've become acquainted with Sandra Dawson, one of the most courageous, generous-hearted people I have ever had the honour to engage with... and I sense we are more than acquainted. We have made a connection. I hope it will continue. There is so much more to share about the nature of homelessness – visible and hidden – especially among children and youth.

I have so much to learn. 

Thank you, Sandra.

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

My newest truths about food and mood...

Okay. I know what they say. Diets don't work.

If you take the "t" off the word "diet" – what you have? Die.

Anyone who's struggled with his or her weight all their lives knows all these cutesy cliches. We now know our weight is genetically predetermined, but that doesn't help. We still have to lose weight to be healthy. Genes or no genes.

The bottom line is, if you want to lose weight to be healthy you have to consume fewer calories than you burn.

That means either continuing to eat they way you like and spending 23 out of 24 hours seven days a week working out ... or cutting back on calories. 

And if you want to live long, it helps to eat a healthy diet. As Susan, a friend and one of my regular commenters mused yesterday:

"Why is it that all the good things in life are fattening, and stuff like carrot sticks, eewww."

It's not fair, but as my psychiatrist, Dr. Bob, often reminds me: "Life isn't fair." 

So, I'm now on Day Six of my first week of Weight Watchers. I'm dieting. They call it a lifestyle, but not yet for me. Right now, it's a diet.

I know I'm not going to lose weight on a diet of toasted whole wheat baguettes slathered with sweet butter. Or egg white omelettes loaded with melted cheddar. Or chocolate covered almonds. I'm feeling a craving coming on. 

The point is I'm in the midst of changing my habits. It takes a long time.

A lot longer than they tell you at a Weight Watchers meeting. 

My friend psychologist John M. Grohol found a new source of information about changing habits "across the pond" at University College London – from scientific psychology researcher Jeremy Dean and his PsyBlog. 

In a recent post, How Long to Form a Habit? Dean says it takes on average –  66 days to change a habit – with no guarantee this new habit will stick. He cites a July 2009 study in the European Journal of Social Psychology. 

It's complicated. Depends on the habit. Eating habits are probably among the hardest to change permanently along with quitting smoking and giving up alcohol or breaking a drug addiction. (What's the difference between an addiction and a habit, I wonder?)

If I could abstain from food altogether, it would be easier than moderating what I eat. One chocolate covered almond is harder to eat than none at all. 

At Weight Watchers they tell you it takes 31 days to change a habit. Marty will love this news. According to Dean, we're in for another 60 days of struggling to change our eating habits. If I announce this at my Sunday meeting, I'll be pelted with two-point snacks.

Here's my problem. 

I take one (1) 200 mg tablet of an anti-convulsant called Epival/Tegretol/Carbamazepine twice daily to stabilize my manic tendencies. It works for me. 

I also take eight (8) other different drugs, including three (3) different immunosuppressants, to keep me alive with my transplanted kidney. 

My complex daily cocktails of drugs don't exactly ease the weight loss process. 

Monica, pointed this in a comment to yesterday's post: 

"It could be your med making you hungry. I gained 100 lbs. while on Epival/Depakote, and I met a man in a bipolar support group who had the same experience. He lost it all when they switched him to Topamax. Me, I'd manage to lose 20 or 30 lbs. but then I'd start a new med and gain it all back. 

"Since I started Truehope and got off all my meds my appetite has plummeted. I eat a fraction of what i used to eat. I just am not hungry all the time any more.

What works for Monica would kill me. I need my drugs to survive. 

We're all as chemically different as we are emotionally different.

I'm going to struggle to lose my weight and reach my goal, again. 

For 60 more days – to change my habits – and every day after that.

Life isn't fair. It's life. That's the point.

Speak soon.

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!