Fountain of Too Much Going On

Hello Friends:

So usually when I take a series of long writing breaks, it's because I am too depressed to write.  I'm happy to say that my long absence has been due more to having too much going on, rather than nothing going on (for a change).  The year has been overflowing (like a fountain, see pic :) although there has been both good and bad, it's mostly been good.

Yet, it's always unsettling to go back to the blog and keep trying to blog, no matter what has been blocking the writing.  It's tough.

It's been an anxious year.  I've had a lot of health concerns I've been trying to nail down, as well as lots of travel.  I haven't been able to really get out and see friends, so I've been sort of isolated.  And the kicker is that I've been trying an experiment to see if I can get back into 'real' work, at least part time.  Very anxious.

It isn't as if I don't have oodles of ideas for posts.  Since there has been so much going on, there has been lots and lots of fodder for posts.  I just have to get the stuff down on 'paper' and get it, you know, posted.  And I have a lot of catch-up reading to do on all of your blogs, as I get myself back into the swing of things here.  Or try to, once again.  Which is also an anxious sort of thing.

Up until about December or January I was pretty down, and I think getting out of that can be credited to adding some Abilify to the med mix.  Celexa and my many supplements just weren't cutting it alone.  I'll also give some credit to my light box as a good 'brightness fix' in the winter months.  If you are like me, and feel down in winter, you might want to consider one of these.  Mine is pretty effective.

So to wrap up this rambling post, I'm not going to promise too many more posts too soon, although I'd really like to get some of these ideas down.  I've just been too sporadic over the last year.  But as I try again to get back into other activities that put me into the world, I'm going to keep on trying.  I look forward to reading up on your blogs!

Your Hostess With Neuroses

Image credit/info:  Picture of a fountain, on Flickr via Creative Commons CC 2.0.

Learning How to Say Goodbye

Hello Friends:

There on my sidebar of blogs is "Toddler Planet."  It has not been updated for year because the author passed away one year ago today on Feb 6, 2012.  I haven't yet been able to bring myself to remove the link, but I think the next few days will finally see that happen.

I've been watching it slowly fall lower and lower on the list, wondering why I couldn't remove it.  Wondering if this was me in denial, or some kind of weird homage, or what.  Grief is a strange thing.

Sue died of inflammatory breast cancer, and left behind a husband and two children, as well as a legacy of friends, coworkers, her blog, and much more.  It is so cliche to say 'inspiring' but if you take a look at just the last few posts on her blog, you'll see what I mean.

She had a very realistic view of chronic illness that I'm sure a lot of us understand all too well.  She didn't candy coat the difficulties, the pain, the sense of loss.  But she was able to maintain a sense of healing and hope that resonated with me.  We know how tough it is to be sick, but the truth is that healing is always there, even up to the very last minute of the very last day.  There is healing that happens.

I am daunted by the incredible flood of responses she received both towards the end of her life and after she passed.  It brings the pain and loneliness of illness into stark relief.  Mental illnesses (say depression in particular) drive us into isolation, away from friends, and into our homes and sometimes bedrooms, not to emerge for who knows how long.  We desperately desire to know that there are others out there who still know we exist, and still care, but we lack the ability to reach out.  Sue's life poses a challenge to keep trying even when the pain is severe - it is inspiring, but the challenge remains daunting.

It is my only real homage to be able to say to her that I still think of her, and that how she lived, and died, makes me want to keep on trying.  I do think she'd be honored by that.  I would be honored should anyone ever be able to say that of me.

Your Hostess With Neuroses
 
Image credit/info: Susan's avatar picture, taken from her blog "Toddler Planet"

Depression Continues to Suck, and Advertising is So Manipulative

Hello Friends:

I can't believe it, I'm posting again.  Wow.  That is about the longest time away from posting since I started this blog.  Depression is a nasty, nasty beast.  I'm still feeling pretty down, but things are improving.  Case in point - here's a post.

Thanks to everybody for sticking with me, here.  I hate it when my crazies make it hard for me to post.  Worse, I hate that first post after a long time away.  This post.  I get this idea that by being away I've somehow 'broken' my blog, or made it messy or less useful or what have you.  I know those thoughts are depression having its way with me.  I have them every single time.  But I really love this blog, and the community of bloggers (you) that I've met through it.  There are so many great blogs out there, and even if I'm not writing, I'll still try to keep up with my reading as I can.

Okay, so here is my topic for today - punchline - why do we let advertisers tell us what is beautiful?

Note the loaded picture on this post.  Someone on facebook posted this comparison image of two different advertising campaigns.  The poster's comment was a bit of a knee-jerk reaction, sort of with a "top image bad and lower image good" feeling.  But that's not at all how it strikes me.  Instead, it makes me irked at advertising in general.

It is hard to look at this comparison image and not immediately pass some kind of judgement, good or bad, and usually on ourselves.  The Victoria's Secret campaign is much like all of their other campaigns - their models have a very uniform look.  The Dove campaign is actually also much like other Dove campaigns.  They have a lot of products, and they all try to appeal to a desire to look a certain way.  You would think the "Real Beauty" campaign was different from the VS "Love My Body" campaign - after all, there is more variation in body type in the lower image - but in many critically important ways, it is just the same as any other advertising campaign out there.

They want to sell us stuff, and they will show us whatever they think will get us buying.

Women who look like the VS models, or want to look like that, will respond positively to the VS campaign.  Women who look like the Dove models, or who want to look like that, will respond positively to the Dove campaign.  Yet each of these would suggest that, at the least, beauty requires great skin.  Even the images from the "Real Beauty" campaign have been touched up, which isn't a surprise unless you've forgotten their point is to make us buy their stuff.

So I'll reiterate my punchline which is, why do we let them manipulate us with images like this?  Why do we let them tell us what is beautiful?  Why do we allow comparisons like this to tweak us into deciding what is or isn't how a woman should look?  Why does Dove get to define "real beauty?"  Why does VS get to tell us how to "love our body?"  All these women, both in the upper and lower picture, have their own beauty.  So do we, even if we are not in an advertising campaign.  I'm tired of having them tell me how big/little, old/young, tall/short, or whatever/whatever is the right ratio for beauty.  I'd like to just be healthy.  And I don't want them to tell me what is healthy for me or for someone else, either.  Only that particular woman knows what is healthy for her.

Do pictures like this tweak you as much as they do me?  I know next time I see images like this, or any kind of advertising image, I'm going to think first of how I am reacting, and why.  How do the images make me feel about the women pictured?  About myself?  And then, what is it I now feel like buying?  (Or how does it affect what I then go and eat?)  I know these are questions I'm going to ask myself a lot more often.

Your Hostess With Neuroses

Image credit/info: VS and Dove advertising campaigns

Giving Grief Some Space

Hello Friends:

A question came up on a forum - what have you lost or missed out on in life because of your mental illness?  I usually avoid these questions, because I want to be 'positive' all the time.  Yet I know that some of that inclination stems from a dysfunctional need to avoid the past.  I do not like to allow myself to grieve.  I can't stand the sensation of loss, so I repress loss and grief mercilessly.  I know it would be a good idea to put down what I've lost to MI, and honor that grief.

So here are a few things.  Not all of them, but at least some that I can articulate at the moment:

-   I did not get to be a child.  I was scared every moment of my childhood that additional abuse would come my way.

-   I did not have parents.  There were ostensibly two people there, and they did give me a home and enough resources to survive.  But with my parents both having untreated MIs (esp my Mom) and addictions (esp my Dad) they were not really parents.  (And now, having fully estranged them, I certainly don't have parents.  But that's been a necessary part of setting boundaries.)

-   I missed out on having a good sense of self.  Other people don't hate themselves, and I do.

-   I missed out on more social events than I can count.  Weddings, parties, casual gatherings, everything.  So much.

-   I lost about five years of my life.  It wasn't all at once - it was about 3.5 years during one depressive episode and then another 1.5 in another.  During that time I did almost nothing at all.  Completely wasted time.  Five years, poof, gone.  I was so depressed that except for the pain I hardly even remember them at all.

-   I lost the career track I worked so hard to build.  It isn't impossible that I might get it back someday, but the loss stings.

I feel compelled, however, to mention what I didn't miss.  This might be me being dysfunctional again, already turning aside from the hurting place, but I can't help it.  I found a great spouse, and we've been married for almost 14 years.  I got my BS and then my PhD in the subject I really wanted.  I can't work in that field right now because of the MIs, but I do have the formal background to do it.  I've been able to do a lot of writing, and it's been very rewarding and fun.  I've gone on a lot of business trips to amazing places.  I have a small number of very good friends who are supportive when I need it.  I've been able to develop empathy and a deeper understanding for suffering than most of my peers.

Do you have something you feel you need to grieve, but that you haven't really given the space?

Your Hostess With Neuroses

Image credit/info: Girl Young Woman from photoexpress.com

Feeling Bummed Out n Ugly

Hello Friends:

It's turning into a tough day.  The major symptom of which was the recent thought "I am really amazingly ugly.  Wow."  I mean, on normal days I hardly think I'm beautiful, but don't generally find myself actually repulsive.  Today - repulsive.  It occurred to me that I could combine features from some animals and come up with a pretty good representation of my face.  Start with over large hawkish nose, frog-ribbiting double chin, and then fill in the rest with pudgy pink pig.  Egads.

So, being mindful of where these sorts of emotions come from, I have looked back to the hour or so before I thought this.  Three things, wedding related, that threw me.  First, I found a wedding invitation from some years back - a wedding we attended of very good friends.  Just now going through their divorce.  Sigh.  Then worse, another invitation from good friends, again a wedding we attended - the bride passed away last year.  So painful. 

So I figured I'd try to focus on the positive, and checked out some pictures posted of a wedding we attended just a few weeks ago.  And OMG, there I am, in profile.  My second chin really is like a frog.  Nose is huge and sort of bent in the middle.

And I've been trying so hard to get in shape.  I've had a lot of success with eating well, getting in my treadmill time, and doing flexibility stretching.  You'd think seeing this would really put a fire under my butt.  Instead it has completely taken the wind out of me.  Like, why bother, too far gone.

I know that part of me isn't really upset about my looks.  I'm focused on that because I had a lot of negative messages about my looks growing up.  That plus my general self-hatred leads to really hating my reflection in the mirror on a regular basis.  So, it's not that as much as being down about my friends, I think.  Hard to draw the line between what starts you feeling bad, and then where it leads.  The workings of depression can be so bizarre.  So often, it isn't what we are thinking now that is the real "problem" but some other trigger, some other incident, that may have gone nearly unnoticed at first.

I'm still avoiding mirrors and pictures for the rest of the day.

Your Hostess With Neuroses

Image credit/info: Sad Girl by raymaclean on Flickr via Creative Commons, CC 2.0

Making the Choice to Keep on Going

Hello Friends:

Wow, I am pleased and happy - after four years of blogging I have received my very first blog award for Adventures in Anxiety Land!  The award is the "I Choose to Live" award, given by Jen Daisybee at Suicidal No More.

The text describing the award says "Awards will be given to bloggers who have lived through a period of suicidality, due to a mental illness or an addiction or eating disorder (or combination of the above), or other reason, yet chose to fight to stay alive, and combat their thoughts of suicide. The purpose of this is to spread awareness that there is hope for people living with mental health problems and feeling like they have no reason to go on. There is hope, and it's important to hold onto hope. Things do get better with time, and especially with appropriate treatment. The award recipients listed here have chosen, and continue to choose, to deal with their problems, whatever they may be, without giving up. They are resilient and determined."

Or in my case, just plain stubborn, but that works, too.

There was a time before I made this choice.  A time when there was still a "Plan B" for when things became unbearable.  But I have already borne so much over the years.  I finally came to realize that I could go on bearing it.  It would be hard.  It would suck.  But I could do it.

It feels strange to have given up on "Plan B."  I remember when having a "Plan B" gave me some relief, knowing I could just check out if things became ... well ... unbearable.  But now being determined and committed to living is a new, and better kind of relief.  This is a promise, a great vow you make with yourself, that you will not give up on yourself.  As I am fond of saying, as we live, options remain.  It hurts to live, much worse than those who do not suffer from MI will ever understand.  But I've made my promise to myself.  My sacred vow.  It makes me feel empowered.

And if you don't follow Suicidal No More, give it a look see.  Jen Daisybee is the kind of person who offers real, concrete hope for people with MI.  Here are some lines she wrote about herself, taken from a recent post.  (Go read the full thing, it's amazing.)

I was the young woman who drove her mother's car to the top of the Sunshine Skyway Bridge at top speed and rammed into a guardrail, trying to drive over the edge to die because the voices told her to do so. 
 
I was the young woman who thought she was a Manchurian Candidate with a microchip inside her body that the CIA was using to monitor her whereabouts and control her thoughts. I was the young woman who tried to cut the microchip out of her leg with a broken glass.
 
I was the young woman who lived in three different homeless shelters at three different times in three different years. 

I was the young woman who was hospitalized in psychiatric units more than 25 times in her life.

I was the young woman who thought she had no talents or anything to give to the world, who believed she was worthless, who cut her flesh out of the anger she had at herself.

And now........................

I am the woman who knows what reality is, who doesn't have delusional thoughts about being people she isn't, who knows who she is, and who remembers what it was like when life was not this good.

I am the woman who graduated with her A.A. degree with honors in 2010 from a college she first attended in 1993.

I am the woman who visits her psychiatrist each month, gets an injection of medication every two weeks, and goes to therapy regularly because she wants to be well and live.

I am the woman who speaks to the police every year during their Crisis Intervention Team trainings and tells them what it's like when the police come to take you away in handcuffs, so they can understand how to approach people in crises.

I am the woman who did an internship last year at the same crisis center where she was a patient seven years ago for months.

I am the woman who spoke at the Southeast Conference on Homelessness and Supportive Housing in 2010, the Directions for Mental Health training conference of 2010, Bayside High School during The Great American Teach-Ins of 2010 and 2011, and other community groups to open up a dialogue about mental illness, in the hopes that she could have a positive impact on at least one person's life.

I am the woman who loves to laugh.

I am the daisy that blossomed in spite of the cement that encased her.

How can these words not inspire us to keep on living!

Your Hostess With Neuroses

Spring Beauty Right Out The Front Door

Flowers growing in my own
postage-stamp of a front lawn.
Not sure how they got there.

Hello Friends:

I want to say "thank you" again to everyone who read and especially those who commented on my last blog post. It is amazing to get that kind of support, and I appreciate it more than I can say. First of all I just feel better for myself, feeling more understood, and secondly I feel a little better for those people who were directly affected by that tragedy, since there are now more people who are aware of it and can hope/pray for them (or whatever it is you do).

I am finally getting out of the darkness of this winter - and it is such a wonderful thing. I'm feeling better emotionally, I'm over my nasty ear infection, I've had some processing time on those other tough issues I've mentioned, and I have some plans for travel coming up that really are exciting.

Of course, to travel, one needs to be able to leave the house.  These days, just leaving the front door is a real coup. But I am working hard to focus on the positive.  The air was so perfect today that even I felt compelled to take a tiny walk around the complex, braving all the things I dislike about the outdoors.  (Like, why do there have to be dirt, insects, and rodents out there?)  In light of that, and in light of the arrival of spring, and in light of the literal increase in the amount of light at my latitude, I offer some pictures of flowers from my modest jaunt.

It amazes me sometimes how much beauty can be so very close. I took all of these pictures myself, and each subject is not more than a thirty second walk from my front steps. I live in a simple, very cookie-cutter townhouse complex in typical suburbia. You'd think there would be nothing so special to look at here, but I was wrong about that.  It is a good lesson for me, to focus in closer and see what is right under my nose. It's so easy to think you need to go someplace else to find what you need.

If you know more about these flowers than I do (which isn't hard) do please enlighten me!

Your Hostess With Neuroses

Image credit/info: All mine! Wanna use? Link to this blog and credit Blue Morpho.

Um, some pink stuff.  Sort of like Mountain Laurel,
but I think this is something else.

Daffodils!  These are some of my very favorite flowers.

I don't know much about the kinds of
flowers that grow on trees. Is this a
kind of faux cherry?

More flowers on trees.  Dogwood, maybe?  Nice and fluffy.

This purple stuff is literally thick on the ground out here.
Not bluebells, so I'm out of ideas.

Someone has some great tulips out here, mixed in with
some red spiky flowers that I have no clue about.

Okay, this is that ground cover stuff that is all over, but I
really think it is pretty.

So this is what I think of when I think of blue bells, but I
know that's not quite right.  Still pretty.

One perfect dandelion.  I love dandelions.  People who care
about their lawns think of these as weeds. Given that I don't
really have the mindset to deal with my lawn, I think of
these as free yard ornaments.

Dealing with Dark Waters

Hello Friends:

I mentioned in my last post that I had a whole dang list of things to write about and what with one thing and another, I hadn't manged to get my act together.  Far be it from me to suggest my act is actually coalescing, yet here is a post.

One of the reasons this winter has been so tough is something that happened early on, in December.  I'm feeling a little better about it, now, having had some time and some tdoc sessions to deal with it.  But I still feel a touch haunted, literally and figuratively.

We went on a cruise for the holidays, and overall it was a great experience.  We left on Christmas Eve, had dinner, did some partying, then went to bed.  We were not asleep.  I remember the moment when I felt something shift in the movement of the ship.  It was just after midnight, Christmas Day.  Then we heard an announcement in the hall using some kind of code.  The feeling was like a tingle of static energy, subtle, but my hands felt cold.  My feet numb.  Part of my mind recognized it immediately as a shock or panic reaction.  The other part said, clearly, to the rest of my mind, "Someone is overboard."

About ten minutes later, there was another announcement in the hall.  I know now that people who were asleep at the time didn't hear it at all.  But we were awake.  I was wide awake, in fact.  This announcement said clearly that there was a "man overboard situation" and the ship had moved into a search pattern.

We got up.  I went out onto the balcony, not because I thought I could see anything from ten stories up in a massive cruise ship at night.  I went out because I felt compelled.  The sea wasn't high, but neither was it calm.  We could see the lights of the coast maybe fifteen miles off, and another cruise ship searching in a wide circle, as we were.  It was hard to get your mind around.  Inside my head it said, "Someone is in that water."  I felt in my heart that the person had jumped intentionally.  It would have happened just at midnight.  The ship was not lurching.  I didn't think they had fallen by accident, although I had no proof or evidence either way.

I was so, so sad.  Am sad.  No matter how suicidal I have ever been, jumping into the sea has never been one of my options for offing myself.  Incredibly despairing and sad, to see a dark, yawning ocean and wonder at the mind of someone who leaped right into it.  I was in pain for that person, and for myself, knowing that feeling of empty grief.  All night long, the ship moved in a large circle.  It made the boat sway in a fashion I had not yet felt on a ship.  For the rest of the cruise, whenever the boat turned, it brought the feelings back up in an instant.

Nine hours later, there was another announcement.  It was at breakfast, and this was how most people learned that someone had gone over.  The Captain claimed that a staff member jumped overboard, and after nine hours, the Coast Guard had released the cruise ships from the search.  You could see helicopters still circling, but the ships were now moving away.  The Captain said that three orange life rings had been thrown over, and all three had been recovered.  But not the person in question.  And that was about it.

The way the incident was ignored on board for the rest of the trip was disturbing.  I was more disturbed by how hard it was to learn anything about it at all, even after we got back.  I ended up on some cruise watchdog sites before I even found the press releases about the incident.  I also found posts from family members of the woman who was lost.  Her family was absolutely certain she would not have jumped - she had a one year old child, was married, her husband was also a staff member on the same ship, they had just been shopping for presents, etc.  Her family was outraged at the 'accusation' that the woman had jumped.  The company was saying they had an 'eye witness.'  But no witness had come forth, and the company was apparently not releasing the tapes they have of everything that goes on everywhere on a ship.  I'm pretty convinced they must have caught it on tape.  The company would want it to be a suicide, since that would absolve them of any responsibility.  The family would want it to be an accident, for a million reasons, of course.

This was the point at which I was finally able to get together with my tdoc (recall I was really sick with a combined ear/sinus infection for weeks).  I still do not know what has come of this situation.  My tdoc helped me to see that obsessing over it, when it was unlikely to ever come to a resolution, was not a really good use of my time, or of my sanity.  But I remain distressed.  First, by the idea that a person drowned on Christmas Day.  Second, and more tangled, is this idea that justice has not been done.  Or found.  Or achieved.  Or something.  Why can't the family get some kind of closure from the cruise company, one way or another?  Why can't I?  How frustrating.

Frustrating that the chance we will ever know what happened is about zero.  And still haunting, that sight of an ocean - dark, abyssal, open caverns of arching waves.  It's another in so many kinds of incidents that ask me to accept and move on.  No answers.  No formula.  No meaning or reason. 

I am really tired of these sorts of lessons.

Your Hostess With Neuroses

Image credit/info: Waves by Mados on Flikr via Creative Commons, CC 2.0

Derailed by the Rains of Winter

Hello Friends: 

I had all sorts of nifty ideas for this post.  I've been out of circulation, first for holiday vacation, and then for a month dealing with a combined ear and sinus infection.  Yee haw.  That and some 'fun' times at the pdoc and tdoc have given me plenty to write about.

But I've been derailed.

I've lost another friend to cancer.  Another colleague.  I'm just too sad and angry to write about anything else.  I want to throw up my hands at the universe and say "Enough!"  I know the reality.  I'm not a kid anymore, far from it.  So my contemporaries aren't kids, either.  Statistically speaking, every year that goes by means ... well ... it's obvious what it means.  I just don't want to deal with this fact, that each year more and more people will leave.  I have enough abandonment fears already, okay?

I don't want to rant or harp on this too much.  No point, really.  It just hurts.

Instead I'll say something about how she approached her cancer, and how it gave me some help dealing with my own chronic illnesses, of the mental kind.  She felt that pressure a lot of us feel, that same pressure to put a good face on, to smile, even through terrible pain.  I'm sure you know what I'm talking about.  She made a point of saying that facing an illness with courage did not mean never being sad, angry, or irritable.  It helped me feel more at peace with the idea that it is okay to show the pain and confusion of illness, healing, and recovery.  The process of living with illness is messy, and hiding that fact is a disservice.  Sometimes you smile, sometimes you frown.  That's okay.  That's life.

So I'll say I am not feeling very okay right now.   

Your Hostess With Neuroses

Image credit/info: Rain on Window, teresaphillips1965 on Flikr via Creative Commons, CC 2.0

Depression in December - A Holiday Challenge

Hello Friends:

Long time no blog - well, a month, anyway.  I always forget how crazy the end of the year can be.  November is particularly sneaky since I try to do a lot of writing, but also have to clean up from my usual huge Halloween party, and then suddenly it is time to get ready for Thanksgiving.  Then the month is over.  And with the MIs, time does not seem to go by at a steady rate, anyway, with some minutes and some weeks feeling like the same length.  I'm sure you know what I mean.

Plus, okay, I've been feeling crappy.  I always get extra down at this time of year, along with many other people.  I've been spending a lot of time over at my favorite mental health forum, Crazy Boards, where, with the holidays on hand, there have been plenty of people posting about how depressed they are.  It really twists my heart, since I relate so strongly.  I wish I could write a note to everyone who feels depressed right now and say something that would actually help them.  (And me.)  Something that would actually be uplifting.  No words really help when you feel that rotten.

But I am tenacious, and I've decided I'm going to try anyway.  I was inspired by this really excellent holiday ornament.  I love snowflakes as a symbol, anyway, and this one is made of silver people all connected together.  A great image.

So here's the challenge, to myself, and to you if you want to join in.  I'm going to pick ten blogs from folks with MI, and I'm going to leave a message in the comments to try to lift their spirits a little.  Like a little online holiday card without the expense or generic verse.  I can't send holiday cards anyway since the pressure of not missing anyone makes me freak out.  In this case I've given myself a small, realistic goal.  Just a little something, a gesture. 

I have an ulterior motive, too, I'm afraid.  I think that writing these little messages might make me feel better.  I mean, I read a lot of blogs, and follow the lives of a lot of people online with MI.  It has made a huge difference for me, knowing I'm not alone.  Having people read my blog and leave comments here has helped to make me feel more validated, and more in touch with others.  It's all good.  So I think a few messages are in order.

As for the messages, well, already knowing that words barely make in impact on depression - what to write?  Well, that I enjoy and get something out of their blog.  That I hope they see how far they've come this year.  That I hope the New Year brings more healing for them.  Hmmm.  Not sure, but stuff like that, depending on the person.  Righto.

I have a few other ideas for making the Holiday more bearable, but that's for another post.  First, I have some messages to write!

Your Hostess With Neuroses

Image credit/info: Our First Tree by Tiger girl, on flikr via Creative Commons, CC 2.0.

Even More Sane Than Ever

Hello Friends:

As you know by now I love online quizzes, and I love talking about the crazies.  So pretty much nothing can beat an online quiz about the crazies.  My favorite for the last two years has been The Sanity Score at PsychCentral.  I've mentioned before that I don't think it is terribly diagnostic, but given that I've taken this exact same test five times now over the last two years, it has proven an interesting way to track my perception of my own mental health.

And has given me data.  Which I also love.  'Cause you can graph it.  Like so.

I left off some of the points I had on the last time because now there are five lines, and the whole thing can get to be a little difficult to read.  Many points haven't changed at all, and as I mentioned before, the scores for things like Mania and Dissociation do not seem to really work well.

To recap, lower scores mean better mental health.  Overall Score is from 0 to 288, while all the other subscores are from 0 to 100.  For the Overall Score, I think anything below 50 is probably pretty normal, assuming nobody is perfect.  For subscores, anything below ten or so is probably just 'normal life' and not something most people would seek treatment for.  An issue at 25 needs help, and something at 50 needs lots of help.  Over that, the situation is probably pretty dire.

So my analysis of myself.  The general good news is that almost everything has improved, if only a very little bit, since the last time I took the test six months ago (I hadn't blogged about that.  My last blog post on this topic was a year ago.)  This heartening to see.  I'm especially happy to see that General Coping continues its slow improving trend, including amazingly (if more subtly) Self Esteem. 

About 3.5 years ago, I went into a bad depressive episode.  Too depressed to even do online quizzes.  It wasn't until I had started getting additional help to get out of it that I found The Sanity Score and started tracking.  By that time, my depression was down to simply 'bad' with a score of about 50.  The next six months saw it drop markedly, and it has been slowly improving since then.  My depression is now at a level where it still bothers me, but isn't ruling my life. 

PTSD also went down in severity the first six months, but then didn't move for a year.  Now finally after 1.5 years, it has moved down a tiny bit.  It is still too high, probably because of questions that ask about recurrent nightmares and intrusive thoughts about past events.  These still bother me a great deal, but perhaps not to the extent the score would suggest.

Anxiety took an extra six months to make a steep drop, and then has held steady for a whole year at about 25.  OCD also dropped a lot in that first year, but now isn't going anywhere, and is up around 35.

So what does it all mean?  Overall good, but there are indications that I'm not making much progress in some areas that really need to improve.  I think this might be an indication of a need to bump up the meds, but I'm not sure.  I know my pdoc is thinking we might go up a little, but I've been hoping that my other techniques like yoga, meditation, exercise, and better food would close the gap for me, here. 

Of course, I'm not doing those things like I should.  I talk a good talk, but I need to actually get into real habits before I'm going to see if they will be enough, or not.  Stay tuned ...

Have you tried the Sanity Score? 
 
Your Hostess With Neuroses

Image credit/info: Happy Flowers by rkrichardson from Flikr via Creative Commons, CC 2.0

A Ridiculous "Hello" from Halloween

Hello Friends:

So there I am, in my kitchen, trying to make something to eat.  No, this story is not about mice.  Much.  Other than to say you know how hard it is to cook in a kitchen that has recently been visited by varmits.  I still do not have them out with certainty, but it's been five days since they've been sighted.  Heard one in the walls last night, but it did not enter the actual house.  Traps are empty.

Okay, I said this wasn't about mice.  It's about me trying to make lunch.  I'm having a very down day, with a bit of bad news, feeling overwhelmed in general, and dealing with my mice-heightened kitchen OCD issues that are not fun at the best of times.  And I know I am supposed to eat lunch, if I don't, I feel much worse as my sugar drops.  I struggle with myself, and finally settle on something I think I can force down.

I usually eat lunch as quickly as possible, with as little fuss as possible.  I am just not a 'lunch' sort of person.  I don't like lunch food, like sandwiches.  So I end up making either dinner or breakfast for lunch.  I knew it would be more work that I was quite up for, but I chose to make some pasta with red sauce and a good dose of cheese for added protein.  I knew that would hold me through the rest of a busy day.

Cook pasta.  Stand around.  Stir pasta.  Turn on fan above stove because steam is all over the place.  Right.  Stand and stir.  Feel hungry and bummed out.  Pasta finally done.  Drain pasta and put in small serving bowl.  Return pot to burner and dump in sauce, onion, garlic, and pepper.  Feel less bummed out since sauce smells good.  (One pot is always the way to go ...)  Stir and simmer.  Starting to actually want to eat this stuff, and hunger is pretty bad.  Dump pasta back into pot with sauce.  Stir.  Get cheese from fridge.  Sprinkle pasta in pot with healthy dose of cheese.  Then ...

Yeah.  It's like a sitcom around here sometimes.

Then ... a SPIDER, a big hairy black SPIDER drops on a line from the oven hood, inches in front of my face, and nosedives it right into the pot!  I $hit you not.  I about peed myself.  And get this.  He doesn't immediately croak because he is a big cuss and happens to have landed right on a bunch of cheese that just came from the refrigerator.  I am gape mouthed, and just starting to yell, when he seems to realize he is in MY POT OF BOILING SAUCE and starts reeling himself back up out of the pot!

The story ends here for the spider, because I hate them.  I'd have killed him even if he wasn't just spotted in my LUNCH.

I return to my pot.  I shut off the heat.  I sort of stare at it a moment, feeling bad for myself because there is just no way in heck I can eat this now.  And then I start laughing.

Because I am about to die of an irony attack.  I've spent the last two days decorating for Halloween, which is a holiday I love.  I do up the house like a vampire's lair, with fake spiderwebs and the whole shebang.  In fact, I have a bag of over 100 spiders I can put in the webs and scatter over the tables.  They really creep me out, which is sort of what I want on Halloween.

So what am I supposed to do?  Get all pissed off with the universe for giving me a good scare?  Too hypocritical.

Doesn't mean I was able to eat lunch, but I did get a serious laugh out of it.

Your Hostess With Neuroses

Image credit/info: Spiders on Flikr via Creative Commons, CC 2.0

Accommodating Mental Illness in the Workplace - A Little Goes a Long Way

Basic Office - No Touchy My Chair

Hello Friends:

The theme for World Mental Health Day this year is "Investing in Mental Health." With the wide variety of options for interpreting this theme, I finally chose to highlight the need for accommodations, particularly in the workplace. A little investment in time and energy, and much less investment in actual money, would improve the workplace conditions for many people who suffer with mental illnesses. In the process, conditions could be improved for everyone in the workplace.

In the US, certain mental illnesses fall under the Americans With Disabilities Act. This act requires that reasonable accommodations are made for otherwise qualified employees. You have a right to ask for changes to your workplace environment that will make you a happier and more productive employee. Of course, the kinds of accommodations needed by those with mental illness can differ radically from those with physical disability. We don't necessarily need ramps, elevators, or water fountains placed within easy reach. Instead, we might need a dedicated 'quiet' space to cool off, feel safe, or meditate, for example.

I first learned about possible accommodations by reading the materials at the Job Accommodation Network. Since the kind of accommodations we need can be seen as strange to others, you can't just go into your boss or HR department and say, "Make my life better." They might want to help, but have no idea how. You need to think of the concrete changes that you want, and consider how they can be implemented.

I started by making a list of everything in my work-day life that triggered my OCDs, GAD, phobias, and the rest. I tried to be as specific as possible.  I thought of ways to mitigate these situations, then went and discussed some specific ideas with my boss. He thought some of my request were odd, but did his best to grant what I asked.

Some things were easy.  I wanted a chair no one else would use. My OCD's make it difficult to use items that are 'public.' When we had big meetings, chairs would be pulled randomly out of peoples offices and dragged around the table. Even if you were not present, your chair might be appropriated. When I would come to my office and find my chair moved, I wouldn't be able to sit in it until it had been 'decontaminated' which can be a lengthy procedure. The same was true for other items, like my desktop computer.  He agreed that I alone had access to my chair and computer, unless IT had to do maintenance.

Some were more difficult.  The commute was very hard on me, over 1:15 minutes, and most of that on public transportation.  I have a very difficult time dealing with the GAD and OCD issues that come up on public transport.  Since I could see no way to change that situation, I asked to be able to work from home two days a week, so I could have a break from the stress.  He couldn't do more than one day a week, given the schedule of meetings.  But even that was a big help for me.

Mental illness, like any invisible illness, is very difficult for others to perceive and understand. The stigma remains - if you don't *look* like you need an accommodation, then you are taking up resources unfairly.  When I asked to have a chair of my own, some of my co-workers acted poorly.  Even though it was a small change, it was a noted change in office culture.  A few times people used my chair for meetings even knowing they were not supposed to.  I knew they were confused and some people interpreted any change as me trying to get attention or be 'special.'  They have no idea how badly I wanted to be 'normal.'  Some people were actually offended, wondering what was wrong with them that I wouldn't share my chair with them.

So the resources that have to be applied are mostly the time and energy to educate ourselves, and have our workplaces educate themselves, on what mental illness is, and what appropriate accommodation means.  Money is not usually the issue.  If we want people to be productive at work, we need to make the workplace as non-threatening as possible, and management needs to ensure and enforce accommodations and provisions so the requester does not feel like they are being outcast as other worker try to adjust.  Everyone needs to be educated.

Offices that begin to make accommodations or provisions for those with mental illness often find that it improves working conditions for everyone. Morale as well as physical wellness go up in environments where people are treated as whole people, not just workers.

Your Hostess With Neuroses

Image credit/info: My workplace, CC 2.0, Flickr via Creative Commons

Investing in Ourselves - Treating the Whole Person

Hello Friends:

The scientific literature for anxiety and depression continues to amuse, entertain, and on rare occasion actually enlighten.  I'm not even sure why I read the journals, since for the most part my only comment is "no duh."  But my psychologist continues to remind me that there is a difference between something being obvious to me as a sufferer of mental illnesses, and having actual metrics and research to back it up.  At least we have more and better ways to explain how crappy we feel.

But I don't want to actually get too down on it.  As a scientist I love research and data, I just wish these papers I read would say something really surprising.  I wish they would offer a jolt of realization, a truly new idea or approach.  Instead they say things like, "The people with GAD in this study felt bad, and the people with GAD as well as other diagnoses felt really bad."  In spite of everything, I keep hoping to spot that magic formula, that golden key that will unlock the mess that is my mind and make everything come together.

One advantage of reading over and over things you could have told the researcher yourself is validation.  There is now a lot of research backing up what many of us have been saying for years.  It gives me more faith in myself and my perception of my own situation.  And in spite of my belly-aching, the fact that I do keep reading the journals must mean I am enjoying it to some extent.  It's hardly required reading.

Anyway, here is something that caught my eye in the April 2011 issue of Depression and Anxiety.  (Yes, I'm behind in my reading.)  Hollon wrote a report entitled "Cognitive and Behavior Therapy in the Treatment and Prevention of Depression."  Here is an interesting quote about ADMs (Antidepressant Medication) "A recent reanalysis of the FDA database for all registered trials for a dozen of the more recently approved medications (including the bulk of the SSRIs) found evidence of substantial publication bias.  Trials that produced positive findings almost invariably found their way into the literature, whereas trials that did not either were never published or were published in a manner that made the target medication appear to be efficacious when it was not."

This is sad, but not unexpected.  Null results are always harder to publish, and large drug companies that fund many studies are not going to promote a paper that shows their drug is mediocre.  The reason I honed in on this is because I am a strong advocate for multiple kinds of therapy being used together - an integrated, holistic approach to treating people as whole people.  In my case, that means both meds and talk therapy, as well as other things.  I've known too many people who chose to treat depression with meds, and nothing else.  Hollon goes on to say, "Finally, there is no evidence that having taken ADM does anything to reduce risk for subsequent symptom return and standard practice has evolved over the last several decades to keep most patients who respond on medication indefinitely."

And, well, some of us may need that.  I'm not sure I'll ever be in a position to go off the meds completely.  I had four major depressive episodes that were completely untreated, and that carves quite a biochemical path through the brain.  Still, I do not think this means everyone needs the meds forever, as is the current trend.  I also think that concentrating on just meds means that a lot of people who need deeper intervention never get it.  There are people who would improve and take control of their lives in a whole new way if they had the right combination of treatment.  Some talk/cognitive/acceptance type therapies DO have evidence to show a reduced risk for subsequent symptom return.  And that is certainly some data that shouldn't be ignored.

I think as patients we need to be sure we advocate for the treatments we need - what we know works for us as individuals and complete people - rather than what is the trend of the moment.  Research is great stuff, but in the end, bias shows up in the literature the same as it does in any human endeavor.

The literature can point us all over the place.  I advocate that the investment we need to make in ourselves is to treat ourselves as whole people, who need a host of things like good food, sleep, and social interaction.  Our minds and bodies are working with the same chemistry, and are the same electrical system.  We need all kinds of options, like meds, CBT, ERT, talk therapy, DBT, yoga, meditation, acupucture, and more, to create a therapy program that really moves us forward in our healing.

Your Hostess With Neuroses

Image credit/info: [F]oxymoron, The Chemistry of Inversion, Creative Commons via Flickr CC 2.0

Learning More About Grief, the Hard Way

Hello Friends:

I lost a friend a few days ago.  I had intended to blog about it immediately, but was still sort of in shock.  Or denial.  Definitely denial, since I can feel this "how can this person not exist anymore" sensation.  I had known for several months that she had cancer, something with a bad prognosis.  But the last report just a week or so ago was that she was in treatment, battling hard, still writing papers and grading tests.  And then this.  She was 47, and as full of life and willpower as anyone I'd ever met.

I am really tired of people dying.  In the last several years I've lost my father-in-law, a grandmother, a grandmother-in-law, several science colleagues ... it's a bit of a list.  Some were older, and had been ill for some time.  That doesn't help, but facing the stark inevitability of someone elderly passing away is at least vaguely comprehensible.  Some were younger, like my friend.  This is not comprehensible.  Not computing.

I've written before on the problem of grieving past losses.  I know part of the healing process is looking back on an abusive and traumatic past and learning how to grieve what never was.  Not that I'm particularly good at it.  It's just too hard, and seems sort of optional.  Who wants to go digging, even if you know you need to deal with that loss eventually?  It seems ignorable.  Easy to focus on other "more pressing" issues.  And then something like this happens, and grief and loss come and slap you in the face.  There is no escape from this.

You can feel the echoes through your whole psyche - it feels too familiar - and you realize your interior tapestry is largely woven from sadness, grief, and loss.  That past is the fiber inside of you, and this new grief is catching on the threads, caught, tangled.  You have an inclination to grab a pair of scissors and cut it out, every spot of grief and pain.  But you get some semblance of sanity, and realize you'll end up with an inside full of more holes than you already have.  You can't cut your memories away without cutting yourself out along with it.  It is so much harder to try to darn and re-weave, but that's the choice.  Hardly profound, but facing facts is one of those things I'm trying to get myself to do right now.

I don't want to forget my friend.  It hurts, but I want to go on remembering.  It's important.  She deserves to be remembered and her life deserves to be celebrated.

Not that I feel like celebrating at the moment.

Your Hostess With Neuroses

Image credit/info: Sky Cries Mary by frantikgirl on flickr via Creative Commons, CC 2.0

Words Through the Walls

Hello Friends:

I am, this very moment, hearing my neighbors arguing.  I live in a townhouse with reasonably thick walls, but yelling, loud music, and such can be heard pretty clearly.

This couple has a loud argument about once a month.  They have done this for the last three years.  Usually I immediately play music to drown it out, leave the house, or start up with an engaging video game until they are done.  Usually lasts 15 minutes to half an hour, and then they seem to wind down.  I try to avoid hearing them because (1) I really don't have any interest in knowing what my neighbors are doing, I am not nosy or gossipy by nature, but more importantly (2) hearing the sound of yelling in an argument makes me really, really uncomfortable.  Scared.  Angry.  Sad.  Confused.  Then scared again.  These arguments really, really upset me.  I get a sensation that I'm going to freak out, and can't move fast enough to find a way to drown it out.

This is hardly a huge shock, given how I grew up.  The yelling at us kids for stupid things.  And worse, the yelling between my parents that would always be turned on us once they got tired of yelling at each other.  I was raised in a chaotic environment where verbal abuse, loud and otherwise, was commonplace.  And having been raised that way, it is again no surprise that I repeated this pattern of self-abuse by living with an emotionally and occasionally physically abusive boyfriend for five years.  So I am understandably very touchy when it comes to couples yelling at each other.

The thing that makes this argument different is that I am intentionally not tuning it out.  I've chosen to practice my mindfulness in this really uncomfortable situation.  I'm going to sit here and listen to this.  I'm going to feel what I feel.  I'm not going to judge myself or try to keep from feeling unhappy.  I'm just going to sit with this discomfort.  I'm going to think thoughts, ask questions, but I'm not going to avoid anything.  No avoidance.  This is really hard.  There is a rock in my stomach.  My palms are sweaty.

And it is still going over there.  Loud and scary.  I can hear, actually hear, the sound of my parents arguing in my head.  I feel like I am being yelled at, personally.  This is a bad one even for the neighbors.  It has already been a half hour.  Why does a woman stand there and let a man call her a *uk#ing idiot?  Why does a man stand there and let a woman call him a lazy bastard?  These are somewhat rhetorical questions, since as I said I was in an abusive relationship, and at the time I thought I deserved the abuse.  That I wasn't worth anything better.  That I could never find anything better.  I was also afraid to leave.  I was afraid he would stalk me, hurt me.  So yes, I get why people might do it.  But ... but really.  Now that I'm out of it, no, I don't get it.

Good grief, he is actually mocking her now.  Mocking.  A sing song voice.  The tone makes me want to tear someone's eyes out.  Wait.  Now they are yelling about who is at fault that each one of them no longer has friends.  Their words through the walls are loud and perfectly clear.  I'm choking down pained laughter.  If they would actually listen to themselves, the 'lack of friends' would be less of a mystery.  I sure have no interest in them.

My husband and I never yell at one another.  Not now, not ever.  Not once.  We've had a few heated arguments in the 17 or so years we've been together, but never yelling.  Part of the reason, of course, is that I can't abide it.  He is much less sensitive to it, given the normal volume of conversation in his house growing up was yelling, even when people were perfectly happy.  But even so, he agrees it is much more pleasant without the constant noise.

Okay, now it is so loud it is garbled.  Um.  He's saying "You are an a$$hole to me.  You haven't changed at all."  She is too shrill to be understood.  I realize I am actually afraid of ... of him doing something like ... well ... firing a gun.  I have this image of a gun going off, and a bullet flying through the wall and killing me.  How ... bizarre.  I ... you know, I have that thought every time they yell over there.  Somehow ... somehow I see their arguing as a direct threat to me.  A threat to my life.  Well, of course I do.  But now that I think about it, that's me doing ...

Oh, for heaven's sake, I'm having a flashback.  Of course I am.  I don't mean to say I've been shot at.  It's not that literal.  I have Chronic PTSD, not trauma from a single event.  When I flashback, I find myself caught in an amalgam of events; a mix of memories, some clear, some vague.  So it takes me 45 minutes to realize I'm in the middle of a flashback.  It does usually take a while since I don't have any visual symptoms.  I don't 'see' the past.  But I can hear it, smell it, even feel it.  My eyes see 'now.'  The rest of me is perceiving a blur of events from long ago.  My heart is pounding, I can hear my parents yelling, at each other, at me.  I am ... I am a little girl hiding in a corner.

And as soon as I started writing the above paragraph, I started feeling more normal.  Realizing it wasn't 'real,' wasn't 'now' helped it go away.  I have no evidence that things next door have ever gotten physical.  Just yelling.  There is no indication or evidence that any kind of violence has or will happen over there.  My fear of being hurt is completely unfounded in the 'now'.  It is entirely the past.  I'm there, living it as if it were the present.

It's been an hour.  They are finally done.

That sucked.

Was it worth it?  Hmm.  I'm an experimentalist, so it's hard to say an experiment was useless.  Even a null result is a result.  I didn't actually freak out.  I had a flashback.  I probably always do and never realized it before, even when I turn up the music, since I am always rattled for hours after they shut up.  Running from it did not make the fear stop.  I can't say confronting it made the fear stop, since I feel like total crap right now.

But if nothing else, I did just prove to myself that I can live through an argument.  The yelling alone can't kill me.  I did not 'freak out' any more than usual.  And I also have some more proof about how tough it can be to tell the difference between a PTSD flashback and a nasty GAD anxiety attack.  They seem so similar on the surface, but a flashback is more insidious.  Darker.  Deeper.  Tangled.

Whatever.  I deserve a reward.  Chocolates.  I know I shouldn't use food.  Too bad. 

Your Hostess With Neuroses

Image credit/info:  The Sun Goes Down, gideon_wright on Flikr via Creative Commons, CC 2.0

Back with More Acronyms, and Some Frustration

Hello Friends:

Back after another hiatus.  It is starting to get easier to come back and try to take up where I left off.  Less guilt about having been away.  Which was, admittedly, always kind of silly given that anyone who reads this blog already knows all about mental illness and the problems it causes.  So I'll say I'm glad I'm up to writing today, that I hope I'm back on track for posting, and it's nice to see you all again and catch up on your blogs!

BUT the motivation to write today does, indeed, come from a point of frustration.  For the last two weeks I've been arguing with my psychologist, saying that no, I do not have Seasonal Affective Disorder, I just really hate the holidays and need lots of time to get over them.  Then my psychiatrist entered the fray, and I finally had to admit to the weight of the evidence. 

Scientist = Objective x Irony

So now I have another disorder to add to my list at the top of this blog.  I'm running out of room.

Why does this make me so angry?  Usually, I feel validated when I get a diagnosis.  I feel that my 'issues' have a name, a reason, and more importantly, a treatment.  I usually feel some hope that there are new avenues to try, new options to explore to feeling better.  But I strongly resisted this diagnosis, and now am angry I have a new disorder.  I have enough to deal with ...

Then a semblance of rationality flits across my brain.  Whatever has been going on during the winter months - either SAD, or family issues, or simply how much I hate snow - it has been and still is going on no matter what it is called.  Reality has not changed because my 'winter blues' have a new name.  I've been dealing with this all along.  Naming it helps.  Yes.  Focus on that.  Yep.

Still angry.  Okay.  Need some more time on this one.  Did you get angry when you got a diagnosis?  How about if you got like three of them?  Five?  More?  Do you feel better with an acronym to your problem, or worse?

I know that eventually I'll focus on the positive, since that's what I've done before.  But right now ... frustrated.

Your Hostess With Neuroses

Image credit/info: Zach Klein, from Creative Commons via Flickr  CC 2.0

Gratitude and Thankfulness

Hello Friends:

I wasn't going to add to the many lists of thanks out there, I really wasn't. But after reading all the well-thought-out and moving expressions of thanks on your blogs ... well ... I felt an urge to express some of my own gratitude to the universe.

So I went looking for a neat picture to express my feelings, and found something absolutely perfect. I love the image and so made it bigger than I usually do to show off the amazing detail. Here is what the artist has as text associated with the picture.

"The stained glass ceiling inside the Thanksgiving Chapel spirals upward to 58 feet in a crescendo of color, harmony, and form. It is called the Glory Window and designed by Gabriel Loire of Chartres, France, one of the greatest stained glass master of the 20th century.  Gabriel Loire describes this progression: '...to express all life, with its difficulties, its forces, its joys, its torments, its frightening aspects. And then bit by bit, all that falls away and your arrive finally at a burst, an explosion of gold; you arrive at the summit.'"

The part that resonates with me is the idea of connecting the difficulties with life with the glories of life. I don't happen to buy into the imagery of climbing stairs to reach a summit of perfection - I do not see that as a helpful metaphor. I prefer to imagine our lives and our understanding as a flower blooming or a cocoon opening, each revealing the beauty that was there all the time. Still, this is so gorgeous, and somehow was a perfect expression of gratitude for me this year.

And here is some of what I am thankful for ...

1.  Being alive. This is a stretch for me, since there are still times I wish I hadn't been born so I wouldn't know about pain. But I no longer want to check out now that I am here. I feel more brave. Or maybe just more stubborn, although that's much harder to imagine. In any case, I am glad that I have the options that life brings, the greatest being the chance to know what it is like to deeply love another person.

2.  My spouse. The person who makes my continued healing possible, and gives me great reasons every day to want to keep at it. Constant help, love, and support. And lots of tea.

3.  My family. Especially a sister with whom I am very close. Since I've had to part ways with some members of my immediately family, I cherish even more the connections with those I can maintain, and which are mutually edifying and beneficial.

4.  My projects. I am glad to be well enough to really get involved in several creative endeavors that I have always enjoyed. Writing, making jewelry, doing crafts of all kinds, blogging, and so much more. These are the day-to-day things that give me the chance to be me.

5.  The necessities of life and more. A safe home, plenty of good food, clean water, nice clothes, and fresh air.

6.  My support network, mental and physical. Psychologist, psychiatrist, general doctor, physical therapists, acupuncturist, obgyn, spouse, family, friends, stuffed animals, and everyone who reads my blog, too! And a good network would not be possible without good health insurance - which I wouldn't have if my spouse did not have a good job. Really a blessing in tough economic times.

7.  My friends. From close confidants, to beer buddies, and onto folks I chat with only occasionally, it is great to have all kinds of friends. Every moment they spend on me is a miracle, life is so short. Each of those minutes is a gift.

I could go on and on. Which is very, very nice to consider.

Your Hostess With Neuroses

Image credit/info: Heaven and Soul Connection by alicia-lee-07 on Flikr via Creative Commons

Continuing Improvements in Sanity

Hello Friends:

When you don't know what to blog about, time to head on over to The Sanity Score and see what your latest numbers are. As I've mentioned before (see post in April, Apparently I'm Getting More Sane) I occasionally take the sanity test at PsychCentral just for jollies. Okay, not just for jollies. I take it because even though it isn't a terribly scientific instrument, it does provide something of a benchmark for changes over time. And because I love online quizzes.

And because now that I've taken the quiz three times over the last year, I now have enough data to make a graph. God I love data.

So I took the test the first time in December of last year, then about 4 months later, and then another seven months after that. The data is pretty interesting to me. It would suggest I feel better overall since December '09. And I do feel better - maybe not quite as much as this shows here, but still, it is consistent. (Remember, low numbers are good. And again, not all the subscores are on my graph, just the ones that I thought were most interesting.)

So my Depression score didn't move much, not a surprise, since it dropped a lot in April. But my Anxiety score plummeted from 48 (reflecting a major problem) to 27 (reflecting a moderate to minor problem). I don't think this is really shows how I feel. I feel less anxious, but not quite this much. So I predict the next time I take the test it won't move, or maybe will even be higher. Still, it is an improvement.

I left the Dissociation score in to bring up another point about the test. Just like the Phobia questions, the Dissociation questions don't seem to be written very well. I definitely suffer dissociation whenever I have a flashback triggered, and it is bizarre and uncomfortable. But that symptom does not seem to be captured here very well. I'll note my PTSD score hasn't moved, and still indicates one of my major issues. So perhaps some of the dissociation is represented there. Hard to say.

So my average overall score is now 55.  Fifty-five is definitely a sane person (a person with issues, but still a sane person).  As I said before, this is starting to look like I have the "resilience, skills, and resources to cope and manage." Odd. But I do almost feel like that. Almost. I do feel more capable, more in control, and less overwhelmed. I hate myself a little less, as reflected by the Self Esteem score, yet self esteem is still one of my major problems. And it is one of the areas which there as been the least amount of change. I will hazard to say that many of the other areas for sub-scores relate to symptoms, and that Self Esteem is more of a core issue. If I can see some improvement there, I might actually believe this isn't just an interim period between major depressions, but instead a real change in my worldview.

As I said in my previous post, "I continue to bemoan the fact that I did not take the test when I was at my worst." Naturally, I hope I never feel that way again. But if I do, I will try to see the bright side of it - that'll be some really good data.

Your Hostess With Neuroses

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Book Review: The Mindful Way Through Depression by Mark Williams et al.

Hello Friends:

This book gets four out of five 'wings' from your Adventure Hostess.

As you know from my previous posts, I've been trying to include meditation and mindfulness regularly in my life. I got the idea from reading about BPD (Borderline Personality Disorder) and DBT (Dialectical Behavior Therapy). I don't happen to have BPD - I exhibit only a few of the characteristics, but I do exhibit some of them. And I was raised by a person with BPD. So I figured I would plumb the workings of DBT and see if there were pieces I could successfully apply to myself. The mindfulness component struck me immediately as portable to therapy for almost any mental illness (or really to anybody for any reason at all).

I promised to review this book over a year ago, I think.  So here, finally, is the always-glorious, never-trivial, certain-to-be-mind-bogglingly-useful review.  

The Mindful Way Through Depression by Mark Williams et al. was published in 2007, and spans 273 pages. It presents the reasoning behind, and the basic course for, MBCT (Mindfulness Based Cognitive Therapy). MBCT was developed by Zindel Segal, Mark Williams and John Teasdale, working from Jon Kabat-Zinn's already existing MBSR program (Mindfulness Based Stress Reduction). 

Mindful Way, as I am going to call it in this review, appears to be the popular level incarnation of a previous book, Mindfulness Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse, that was published in 2001. This earlier book was directed more towards psychologists and such, including discussion of the research supporting use of MBCT in the arena of depression.

Some of What's in the Book

This book falls into four sections, and includes a final list of resources and an accompanying CD.  The sections are "Mind, Body, and Emotion", "Moment by Moment", "Transforming Unhappiness", and "Reclaiming Your Life". The CD has guided narration for six practices, including "The Body Scan" at 29 minutes, and "Mindful Standing Yoga" at about 11 minutes.  Overall, the CD is more than 77 minutes long.

The first section describes the authors' ideas behind the connection between mind, body, and emotion - how our moods and feelings are influenced by thoughts - and how becoming more aware and mindful can make a difference. The second section details the meditation focus points, such as the body and breath, and how to become more mindful of them. The third section is anchored by the passages that point out how our own thoughts are creations of the mind, are neither 'true' nor 'untrue', and that they do not define who we are. The final section brings together all the points from the book and tries integrate them into a coherent plan. This includes a breakdown of the full eight week program, with exercises, worksheets, and meditations on the CD.

The time commitment for the full program is substantial, as much as an hour a day some weeks, to do the required meditations, worksheets, and whatnot. Much of this is the Body Scan meditation, taking almost a half hour.

What I Liked

The authors recognize that we can't begin to think in new ways without new tools. Using what you have always used, you'll get what you have always gotten. Their eight week plan is designed to provide the necessary tools, by way of a step-by-step immersion into the world of meditation and mindfulness. This is a huge improvement over other CBT approaches, since mindfulness really does alter your perception of the world, and your place in it. And the authors offer their program as a way to manifest this opportunity.

For a systematic approach, I feel like all the pieces are in place. Specifically, the included CD makes it trivial to follow along with the specifics of what they want you to do. While you might wonder if the therapy is "working" you won't have to wonder what it is you are supposed to be doing today to be on track.

The personal anecdotes from people who have done the program are very useful, and show a good range of possible reactions to each stage.

Some of what they present helped me to make sense of certain things for the first time. While I disagree with some of their cause-effect reasoning, at least in two cases I was struck with a new idea that helped me a great deal. The first was one I have written about before, the idea that avoiding something is exactly what makes it impossible to avoid (Suppressing Does Not Work Part I and Part II). This is the whole "spend a minute and don't think about a white bear" thing that makes it clear you will spend that minute thinking about nothing but white bears. Mindful Way helps the reader to understand that engaging painful thoughts with a gentle curiosity is actually better at getting rid of them than trying to avoid them completely.

The second thing that grabbed me was the discussion of a list of automatic thoughts of those who are depressed (Kendall and Hollon, 1980). Although the list is a classic in the literature for depression, I simply had never considered the implications. They present this list of thirty automatic thoughts, like "What's wrong with me?", "I hate myself", "It's just not worth it", and "I can't finish anything." The program participants are asked how many of the thoughts they believe right now, and how many they believed in the middle of their last deep depression. The book goes on to say, "When they all answer 'Yes - all of them' ... something remarkable happens. A moment of realization that, 'This is depression, not me.'" I had the same realization when I read it. My negative thoughts are actually the symptom of an illness, and all depressed people have them. This list a chance to stare directly at that truth, and it was liberating.

What I Didn't Like

I am so, so glad I read Brach's book Radical Acceptance before I read Mindful Way (here's my review of Radical Acceptance). If I had read Mindful Way first, I think I would have looked at it as just another self-help book, with another five or eight or ten week course of stuff, another worksheet to fill out, and another eight steps to follow to cosmic enlightenment or optimum turbo libido or whatever (okay that last is just me being snarky). Either way, I'm sick of those kinds of books.

Fortunately, I had read Radical Acceptance, which artfully presents meditation, mindfulness, and compassion in a way that feels whole, connected, and meaningful. Radical Acceptance successfully walks the line between the mysterious/spiritual side of mindfulness, and the practical/daily side. In comparison, Mindful Way feels sterile. It presents only the clinical aspects of meditation, broken down into the authors' idea of a workable course/schedule. It cuts out much of the more compelling, mysterious, and motivating context to be found in Buddhism, and thereby saps the practice of an integral source of vibrancy.

I do not agree with some of the authors' ideas about the relationship between mood-thoughts-feelings-body. They very nearly fall into the whole trap of "you are depressed because you keep thinking depressed thoughts, so depression is your fault." They try to avoid this by blaming rumination and such on the "critical thinking part of the brain volunteering for a job it can't do",  and by admitting that thinking new things is really hard.  Yet it is still thinking = depression.  Too close to "it's all in your head" for my taste. I shouldn't be surprised, given the CBT roots of this kind of therapy, and even some of the worksheets that go with it.

They could have missed this near-accusation entirely had they included the important aspects of brain chemistry in the book. They say they recognize the existence of thinking ruts, patterns, and habits.  But they miss the opportunity to say how this manifests in brain chemistry, and how that in turn links directly to overall body chemistry. Thinking is, after all, nothing more than biochemistry. It is hard to think in new ways because our old thought patterns are actually "burned" in biochemically by past trauma, trauma responses, and years of repetition. Early childhood trauma can even inhibit development of certain aspects of the brain. These things are not mentioned.

Yes, we can change the path our thoughts follow from more negative ones to more positive ones by working for extended periods with the variables that alter brain chemistry.  Over time, this allows new preferred thought pathways to be electrochemically "burned" into our brains.  Successfully making those changes requires a complex combination of many possible approaches, including: good nutrition, stable sleep, social connections, support networks, talk therapy, meds, exercise, meditation, body knowledge, somatic therapies, massage, and on and on.  While I personally believe that mediation is a hugely powerful tool, this book presents it too disconnected from all other possible sources of an integrated plan for mental wellness.  The old CBT message of "just think your way out if it" remains, and I am very wary of that message.

Summary and Final Comments

Overall, this is a very good book. I would not recommend it as the first book to read about meditation or mindfulness. Read Radical Acceptance first if you are new to all of this, then Mindful Way. I just think Radical Acceptance is more robust, more compassionate, and more meaningful. Meditation and mindfulness are great, but not everyone is going to approach their practice in the same way. What Mindful Way offers is one possible plan for integrating mindfulness practice into your life. It is systematic, and tailored to those who have suffered at least one major depressive episode. If you respond well to structure, then the one presented here could be very helpful. If you do get the book, make sure the CD is included, since it is critical to the program. Mindful Way underscores the idea that mindfulness is a life-long practice, not an end goal, and offers some new options for developing the tools for dealing with the mental struggles of daily life. Anyone might benefit from reading the book and doing the program, but there is some evidence that for those with depression, it really might prevent another deep episode, or at least help limit its length and severity.

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