In Pursuit of Happyness

By CARONAE HOWELL, From the New York Times, dated July 20, 2009

To fly away

I’m the kind of woman who spends entire days thinking of nothing but birds: woodcocks, goldfinches, kingfishers. I look for loons everywhere I go. Sometimes I find herons in Central Park and they are mysteries. There is one thing in this world that I envy: the hollowness of bird bones. In the three milliseconds of liftoff, a bird separates itself from its problems. The sky is the freest part of the world.

I have always been depressed, and I have always wanted to fly — not to emulate Superman or to travel faster. I want to fly because of the elation. In my dreams I am a butterfly or a fairy or a honeybee. Depression, for me, is when you want to be a bird, but can’t.

There is a specific moment in which I became a woman. It was February — always the worst month with its aching light and its slip-induced bruises. I had been trying to fall asleep for at least four hours. At 3 a.m., I found myself sobbing and shaking and confused, sitting on my metal dorm bed in the bird-with-a-broken-wing position. I dug my fingernails into my forearms, leaving shell-shaped trenches behind. I have the kind of skin that refuses to heal, just stays eternally raw and mottled. It was five weeks into my fourth semester.

In late January, a freshman hanged himself in my old dorm. I found myself asking, really, how hard is it to suddenly find yourself perched on a sink, rope around your beautiful neck, ready to fly? How hard? My dad drove through four states to pick me up the next week. On the way home I had tea and ice cream. He asked me if I remembered the time he took too many of his antidepressants. I did not. Nor did I remember my uncle’s suicide (gun to the cerebrum) or my sister’s delicately sliced arms and hips. These were things I had only been told. The space between my skull and my irises hurts sometimes — hurts like the shatter of a tiny bird that has fallen midflight.

And so it was that sour February night that I took the delicate step into the adult world: realizing that I was too depressed to stay at college was realizing I had not only lost my flock; I had fallen from the air entirely. Michigan has many birds. My favorite might be the wood duck, with its banded neck and flat little wings. When I watch birds take off, I hold my breath. They always make it to the sky.

Every Monday morning at 9 I see my therapist, mug of green tea and honey close at hand. I take new pills now. I have a routine: oatmeal in the morning, Wednesday nights with my father. I tell my therapist about Toni Morrison’s “Song of Solomon.” Who isn’t searching for their people? I arrange my thoughts. (No, I have never been in love and I am, in fact, afraid of men; I panic in Times Square; I grow attached to almost everyone I meet.) I have feathers and questions.

I moved to New York City for college in 2007. School did not grow me into an adult, nor did voting for the first time or doing my own banking. These things were not confrontations. How did I arrive at the place where I could look at my disease and say, “Yes, you are here, but I will not let you take the joy out of looking for birds”? I like to think it was New York, or my newfound discipline, but it was a more internal revolution. I acknowledged my traumas: I was not crazy, just damaged. I was molting. Columbia gave me many new things: a copy of the “Iliad” with a note saying the first six books should be read before orientation, a job in the oral history office, a sense of time management.

But without my sanity — without joy — these things had little value. I knew nothing until I knew I was hardly living. Hobbes and Locke and all the philosophers in the world could not matter when each day was insurmountable and burning. In my year and a half at Columbia, I began to learn how to love myself. I tell my therapist about my earliest memories and the bizarre geography of my family. I’m anxious and I have no self-esteem. But I am mending. Fifteen lost credits is a small price to pay for happiness. Perhaps I am learning how to fly. My bones may not be hollow, and joy will never come easily, but the beauty is in the struggle. The birds are everywhere.

Caronae Howell, Columbia, class of 2011, history major

Jan 6 2012

Out of the Blue: The Remarkable Role of the Caregiver

~Dedicated to my lovely wife Lynn, who cares for me so well~

How can I help a friend or relative who has bipolar disorder?

If you know someone who has bipolar disorder, it affects you too. The first and most important thing you can do is help him or her get the right diagnosis and treatment. You may need to make the appointment and go with him or her to see the doctor. Encourage your loved one to stay in treatment.

Your touch can make a big difference

To help a friend or relative, you can:

Offer emotional support, understanding, patience, and encouragement
Learn about bipolar disorder so you can understand what your friend or relative is experiencing
Talk to your friend or relative and listen carefully
Listen to feelings your friend or relative expresses-be understanding about situations that may trigger bipolar symptoms
Invite your friend or relative out for positive distractions, such as walks, outings, and other activities
Remind your friend or relative that, with time and treatment, he or she can get better.

Never ignore comments about your friend or relative harming himself or herself. Always report such comments to his or her therapist or doctor.

Support for caregivers

Like other serious illnesses, bipolar disorder can be difficult for spouses, family members, friends, and other caregivers. Relatives and friends often have to cope with the person’s serious behavioral problems, such as wild spending sprees during mania, extreme withdrawal during depression, poor work or school performance. These behaviors can have lasting consequences.

Caregivers usually take care of the medical needs of their loved ones. The caregivers have to deal with how this affects their own health. The stress that caregivers are under may lead to missed work or lost free time, strained relationships with people who may not understand the situation, and physical and mental exhaustion.

Stress from caregiving can make it hard to cope with a loved one’s bipolar symptoms. One study shows that if a caregiver is under a lot of stress, his or her loved one has more trouble following the treatment plan, which increases the chance for a major bipolar episode. It is important that people caring for those with bipolar disorder also take care of themselves.

Jan 3 2012

Jamison and Steel: Interviews on Suicide

NAMI’s Interviews With Danielle Steel & Kay Jamison

Last year, Steel published His Bright Light, a memoir of her son, Nick Traina, who committed suicide at age 19 after a life-long battle with bipolar disorder (manic depression). More recently, Jamison has published Night Falls Fast: Understanding Suicide, combining research, clinical expertise and personal experience to explore one of the world’s leading causes of death.On February 8, the Senate Appropriations Subcommittee on Labor, Health, Human Resources, Education & Related Agencies will hold a hearing on suicide prevention that will include testimony from best-selling author Danielle Steel and Professor Kay Redfield Jamison, author of several academic and popular books on mental illness.

Interviews with Steel and Jamison have appeared in “Spotlight,” a special supplement to The Advocate, the quarterly publication of the National Alliance for the Mentally Ill (NAMI). Conducted by NAMI executive director Laurie Flynn, they offer a possible preview of Steel and Jamison’s testimony on Tuesday. Excerpts follow below. Full interview texts are available on request.

……………………………………………..

Dr. Kay Jamison

NAMI’s Interview with Kay Jamison
Spotlight (Winter 1999/2000)

NAMI: What do we know about the linkage between suicide and mental illness?

Jamison: The most important thing to know is that 90 to 95 percent of suicides are associated with one of several major psychiatric illnesses: depression, bipolar illness, schizophrenia, drug and alcohol abuse, and personality disorders. These are obviously treatable illnesses. Another thing people don’t think about enough or emphasize enough is that because cancer and heart disease hit older people, they are seen as lethal illnesses. Because the age of onset for mental illnesses is very, very young, people don’t tend to think of mental illnesses as the potentially lethal illnesses they are. It’s important for people to understand that they have an illness to begin with and then that they get good treatment for it.

NAMI: You have spoken specifically of suicide and college students.

Jamison: Yes. Suicide is the second major killer of college aged kids. It’s the second leading killer of young people generally.

NAMI: You also have pointed out that, worldwide, suicide is the second leading killer of women between ages 15 and 45. These statistics are staggering, yet most people don’t seem to be aware of it.

Jamison: Absolutely. Across the world. There are almost two million suicides a year worldwide. I think people just don’t have any sense of the enormity of it. Suicide unfortunately has been so individualized and, because of the early suicide movement in this country, so separated from mental illness. People working in the field of suicide concentrated on existential factors and vague sorts of things, when in fact the underlying science is very clear that they’re associated with a few mental illnesses.

NAMI: Knowing what we do about illness and its treatability allows us to be able to discuss preventing suicide.

Jamison: Right. [U.S. Surgeon General] Dr. David Satcher’s emphasis has been very strong on three fronts. One is public awareness. Secondly, intervention and all that’s involved in making doctors and others more able to ask the kinds of questions needed to uncover mental illness. And then, thirdly, to support the science that’s necessary to study suicide.

NAMI: What else can policy makers and public officials do?

Jamison: I think we have to have public officials talking about it. When you have someone like Jesse Ventura out there saying these outrageous things-I think it’s really beyond the pale-we’ve got to have the president of the United States saying look we’ve got a real epidemic here, and there’s something we can do about it. People are dying from not gaining access to treatment-or from having three days in the hospital, and then going out and dying.

…………………………………………………

Danielle Steel, Author

NAMI’s Interview with Danielle Steel
Spotlight (Winter 1999)

NAMI: “His Bright Light” is a very personal story about a very painful subject, the mental illness and death of a child. What did you hope people would learn by sharing your story?

Steel: I hoped first of all that people would come to know my son, and learn what an extraordinary person he was. I wrote the book to honor him, and to share with people what a remarkable person he was, in spite of his illness. I also wrote it to share with people the challenges we faced, so that they feel less alone and less isolated with their pain, in similar situations. I wrote it to give people hope and strength as they follow a similar path to ours.

NAMI: What did you learn from this painful tragedy?

Steel: I’m not sure yet what I learned from the tragedy, except that one can and must survive. But from his life, I learned a great deal about courage and perseverance, and love.

NAMI: Lots of people in America might be facing signs of a mental illness in one of their children. What about Nick’s behavior made you realize that it was more severe than just the normal growing pains of a child?

Steel: Nick was different. Always. His moods were more extreme. I sensed from early on, that despite his many wonderful qualities, there was something very wrong. I knew it in my gut, as I think many parents do.

NAMI: How long did it take for Nick to be diagnosed as manic-depressive and receive treatment for that condition?

Steel: Nick was not clearly diagnosed as manic depressive until he was 16, a good 12 years after we began the pursuit of the causes for his ‘differences’. He received no medication until he was 15, and did not receive the most effective medications until he was 16. A long and very painful wait for all concerned!

NAMI: Prior to knowing of Nick’s manic depression, what did mental illness mean to you? Did you associate stigma with mental illness?

Steel: I don’t think I realized, before Nick, that one could still be functional, or seemingly functional, if mentally ill. I thought of it as something totally incapacitating, and of people who were shut away. I don’t think I realized how intelligent and capable mentally ill people can still be. I’m not sure I did associate a stigma with mental illness. It just seemed like a sickness, and not necessarily a shameful one. I just thought of Nick as sick, whatever it was called, and wanted him to be cured.

NAMI: How did Nick deal with the knowledge that he had a mental illness?

Steel: For a long time, Nick himself was in denial about his illness. And eventually, he accepted it. In the last year, he told people he was manic-depressive. Before that, when he felt ‘normal’ on medications, he believed he was cured. He had a hard time accepting at first that he would be manic-depressive all his life.

NAMI: Are schools able to cope with the mental illness of a child?

Steel: In most cases, I don’t believe they are. It is a huge challenge for all to meet, and certainly hard on the other kids to have one child acting out. We were very lucky, in Nick’s high school years we finally found a wonderful school that understood the problem, accepted him as he was, and was willing to work with him in a framework he could cope with. They were remarkably flexible and creative. But for most schools, it’s asking a lot to expect them to adapt to a mentally ill child.

NAMI: If you could tell a family member who is caring for someone who is mentally ill one thing, what would that be?

Steel: Never give up. Get the best help you can. Keep trying, keep loving, keep giving, keep looking for the right answers, and love, love, love, love. Don’t listen to the words, just listen to your heart.

NAMI: What do you think support groups like NAMI can do for families coping with the mental illness of a loved one?

Steel: I think groups like NAMI can provide support, both emotional and practical—the knowledge that you are not alone. And resources, where to go, who to talk to, what works. You need all the information you can get, and it is just about impossible to do it alone.

NAMI: Stereotyping the mentally ill as violent and dangerous is pervasive in America. How do we change this perception?

Danielle: Information. Obviously there must be some mentally ill people who are violent and/or dangerous. But I suspect that most are not. Nick certainly wasn’t either of those, he was gentle, loving, smart, funny, compassionate, extremely perceptive about people, and very wise. I cannot conceive of Nick as ‘dangerous,’ although ultimately he was a danger to himself. But for the most part, I think the turmoils of the mentally ill are directed within and not without.

NAMI: What do you think the average American should know about mental illness?

Steel: I think most people should know how common it is…I also think people should know how serious it is when it goes untreated. And how potentially lethal it can be. It is vitally important to get good treatment, the right medication, and good support. If you let a bad cold turn into bronchitis and then pneumonia, without medication, it can kill you. If you do not treat serious diabetes, it can kill you. If mental illness goes untreated, it can kill you.

NAMI: We know that having “hope” is important to battling any disease. What hope do you see for people with mental illness?

Steel: I see a huge amount of hope. The medications today can give people whole, happy, productive lives. There are lots and lots of people with mental illness holding down good jobs, even with important careers, happy family lives, and doing great things. It is possible to lead a good and happy life if you are mentally ill. If those who are doing just that would speak up, it would give great hope to all those who are still groping their way along in the dark.

NAMI: What is Nick’s legacy?

Steel: Nick’s legacy is the love we had and have for him, the word we have spread of what a terrific person he was. In his lifetime, he touched countless lives, with his warmth, with his mind, with his music, with his words. Through his experiences, others have and will learn. Through the Nick Traina Foundation, hopefully we can bring help to others, in his name.

For more information or assistance, please contact NAMI at: http://www.nami.org/

Nov 25 2011

Dipped in Shame

“All day long my disgrace is before me, and shame has covered my face.” Psalm 44:15

Some of us truly understand shame. It’s like we have been dipped in it, we have wallowed in it and things are sticking to us. We live out our lives in disgrace and in the sense of nasty embarrassment which we can’t truly resolve. And it affects all that we do, even in those rare moments we are not aware of it.

I honestly wish I was “teflon.” I would love to have a ‘non-stick’ heart. There is however, a constant sense of being totally insufficient as a person. It is a very deep awareness of being defective and unworthy. Many of us feel this way all the time. It is welded to us, and we keep trying to figure how to break that dark bond that’s on our hearts and minds.

Mental illness lives on that blackness. Depression feeds on that stuff, it seems to cycle through us. Our pasts become its nourishment, and at certain times it flourishes. Sometimes it explodes in our minds, just like when you give your roses a dose of “Miracle Grow” (but in a bad way.)

I read recently, that chemists are trying very hard to develop a drug that would erase bad memories. The thinking is that people suffering from PTSD will find freedom from very ugly events. Many of us, at certain points in our lives, truly absorb the evil. Some of us end up in prison, others are addicted, and a few go ahead and commit suicide. Shame when its at its best can completely incapacitate and destroy a person.

Most end up with a mental illness, and because we are so complex, it is difficult to view it as a simple ’cause and effect.’ It really is much more complicated than that. Mental illness has many layers. But if we look at our issues from a different view point we can see things we might never see.

Shame is a monster that is constantly tracking us. At times we can put some distance between us. But occasionally it leaps up on our backs and drags us down. We are humiliated with our guilt. That is precisely when we should scream out for help.

There are pastors and psychiatrists, therapists and friends who are most helpful. Practicing prayer and soaking in worship can drive the monster away. Meds can very often provide a respite. All of these have helped me. But in all of this, we must be patient.

We are dealing with guilt, and there are spiritual issues that trump everything else. Human beings were never created to bear guilt, we don’t know what to do. Shame is vigorously parasitical and consuming. If it runs amok through your life it can and will destroy you.

“You know my reproach, and my shame and my dishonor; my foes are all known to you.” Psalm 69:19

“…in whom we have redemption, the forgiveness of sins.” Col. 1:14

“To the Lord our God belong mercy and forgiveness, for we have rebelled against him.” Daniel 9:9

God has made an incredible provision for your guilt. Your sin, though it is crimson red in its intensity and very obvious, it can become as white as snow. Your shame and guilt can be erased.

“Do not fear, for you will not be ashamed; Neither be disgraced, for you will not be put to shame; For you will forget the shame of your youth, And will not remember the reproach of your widowhood anymore.” Isa. 54:4

It was Mark Twain, who once said, “Man is the only animal that blushes, and the only animal that needs to.” We are ashamed, are we not, of things we’ve done in the past? Nobody is free who is unforgiven. Instead of being able to look God in the face or to look one another in the face, we want to run away and hide when our conscience troubles us.

Bad Memories (brokenbelievers.com)
Guilt and Shame (ekahileo.wordpress.com)
Shame and Guilt (ladybugkisses.wordpress.com)

Nov 15 2011

Depressed Women

Depression Fits the Hearts of Women

Women experience twice the rate of depression as men.

Women have twice the chances as men

Everyone experiences disappointment or sadness in life. When the “down” times last a long time or interfere with your ability to function, you may be suffering from a common medical illness called depression.

Major depression affects your mood, mind, body and behavior. Nearly 15 million Americans — one in 10 adults — experience depression each year, and about two-thirds don’t get the help they need.

Women experience twice the rate of depression as men, regardless of race or ethnic background. An estimated one in eight women will contend with a major depression in their lifetimes.

Researchers suspect that, rather than a single cause, many factors unique to women’s lives play a role in developing depression. These factors include: genetic and biological, reproductive, hormonal, abuse and oppression, interpersonal and certain psychological and personality characteristics.

Symptoms of depression include:

Little interest or pleasure in doing things
Feeling down, depressed or hopeless
Trouble falling or staying asleep or sleeping too much
Feeling tired or having little energy
Poor appetite or overeating
Feeling bad about yourself, that you are a failure or have let yourself or your family down
Trouble concentrating on things, such as reading the newspaper or watching television
Moving or speaking so slowly that other people could have noticed or the opposite in that you are so fidgety or restless that you have been moving around a lot more than usual
Thoughts that you would be better off dead or of hurting yourself in some way

Women may be more likely to report certain symptoms, such as…

anxiety
somatization (the physical expression of mental distress)
increases in weight and appetite
oversleeping
outwardly expressed anger and hostility

Stay close to your friend

Helping a Woman with Depression

People with depression aren’t the only ones who suffer. Their friends and loved ones may experience worry, fear, uncertainty, guilt, confusion or even be more likely to go through depression themselves.

The situation may be especially trying if your loved one doesn’t realize that she is depressed. You can help by recognizing the symptoms of depression and pointing out that she has changed.

Recognize even atypical signs of depression. Women may be more likely to report certain symptoms, such as anxiety, physical pain, increases in weight and appetite, oversleeping and outwardly expressed anger and hostility. Women are also more likely to have another mental illness-such as eating disorders or anxiety disorders-present with depression, so be alert for depression if you know a woman with a history of mental illness.

To point out these changes without seeming accusatory or judgmental, it helps to use “I” statements, or sentences that start with “I.” Saying “I’ve noticed you seem to be feeling down and sleeping more” sounds less accusatory than “you’ve changed.”

Talking to a Woman with Depression

If a friend or loved one has depression, you may be trying to figure out how you can talk to her in a comforting and helpful way. This may be difficult for many reasons. She is probably feeling isolated, emotionally withdrawn, angry or hostile and sees the world in a negative light.

Although you may feel your efforts are rebuffed or unwelcome, she needs your support. You can simply be someone she can talk to and let her share her feelings.

It’s important to remember that depression is a medical illness. Her symptoms are not a sign of laziness or of feeling sorry for herself. She can’t just “snap out of it” by taking a more positive outlook on life.

Helpful responses include, “I am sorry you’re in so much pain” or “I can’t imagine what it’s like for you. It must be very difficult and lonely.” Instead of simply disagreeing with feelings she conveys, it is more helpful to point out realities and hope.

A woman with depression often expects to be rejected. You can reassure her that you will be there for her and ask if there’s anything you can do to make her life easier.

If your loved one is not diagnosed or not in treatment, the most important thing you can do is encourage her to see a health care professional.

*Never ignore statements about suicide.* Even if you don’t believe your loved one is serious, these thoughts should be reported to your friend’s doctor.

http://www.nami.org/Content/NavigationMenu/Mental_Illnesses/

Depression/Women_and_Depression/Women_and_Depression_Facts.htm

Symptoms of Depression in Women (robertlevine88.wordpress.com)
The depressed helping the depressed (ask.metafilter.com)

Aug 30 2011

When is Suicide the Solution?

The Contemplative Suicidal

There are times, difficult times when we are maneuvered into a place where we start to think that suicide is an answer. There is a certain mechanism to it, almost an art, which has a limited “air-time.”. But I have several suicide attempts to my credit. Once in a psych ward (and being watched 24/7) I cut my wrists on the broken shards of the clock over my bed. (Looking back, it was pretty innovative the way I did it.)

I’ve intentionally overdosed a couple of times. My last effort was to duct tape heavy training weights to drown myself in Kachemak Bay, off a pier. Numerous times I have slashed my wrists trying very hard to die.

I suppose that for these many attempts there was a distinct and desperate cry for help. When I went into the cycle of wrist cutting, I did not have a full and an aware understanding of what I was trying to do. But when I attempt to drown myself, I most definitely did. Perhaps there is an understanding of the two different concepts of suicidal depression. ( But I don’t intend to figure it out.)

Although there is room to be alarmed by the first kind. There is reason to be mega-concerned with the second approach. I guess there is kind of a morbid graduation from one phase to the next. (I may speak brazenly, but I know it is a dark thing we talk about.)

To commit suicide is perhaps the ultimate act of vengeance that we can do. It is final and speaks in many tongues. It also is a hard statement to all we used to love. Family, and friends. I guess we often can’t inventory or enumerate those we touch. So many people will be affected by my suicide. I can’t overstate this. There are literally thousands of people who will be rocked by what I have done. I will destroy many when I try to destroy myself.

The pain of the mind of the suicidal depressive is awful. It saturates all that I think and everything I do. The suicide person is in a difficult agony. It’s like being soaked in gasoline and looking around for a match. There is a fearfulness about it all. If we were not so enamored by ‘self-murder‘ it would shake us to our core.

So very many are on the edge. It really wouldn’t take much to nudge us over. There must be an understanding that there is a spiritual element to all of this. The enemy of our souls would delight in our destruction. He salivates over our confusion and lostness. He is a dark cheerleader in support of our self-destruction.

We must work things out, even with our dark issues. We really need to “regrip” and refocus. Often a good nights sleep and a good meal will incrementally move us through this moment. This may be trite, but resisting suicidal thinking will often turn on small things like this.

To be honest, patience seems to be the main factor to recovery. It seldom is a dramatic leap forward. It seems that certain nuances will push themselves against dark thinking. As you are led by the Holy Spirit, you will discover exactly how to drive against this strong momentum of the Flesh. Know this though– the Lord is actively at work on behalf of your loved one. This should give you a honest peace and assurance. You will survive, and bring Him glory.