The Gifts of Salad and Sunlight

I went through a fairly significant depression in my early thirties. I’m sure I could write a book describing the journey and the hell, like so many have. But two of the memories that stand out most significantly for me during that time are not painful ones.

For the first few months, I had a very hard time eating. Not only had I lost my appetite, which, believe me, was VERY unusual, but the idea of solid food actually made me sick. There were few foods my stomach could tolerate, so I survived on soup and toast, as much as I could, for at least a month. I lost over 10 lbs. in that first month, which was significant on my 5’ tall frame.

About 3 months after what I call “the initial meltdown,” I was back to eating normal foods, but my appetite hadn’t really returned. I was at my internship eating a salad I’d brought from home. I remember it so well – green leaf lettuce, crumbled gorgonzola cheese and honey Dijon salad dressing. I have this very clear memory of sitting at the table in the kitchen, it was dark and cold out, and I realized I was enjoying my salad. It tasted GOOD. Not just adequate and not just less than nausea inducing, but GOOD. I was ENJOYING it. It was literally the first time in those three months that I was aware of enjoying anything. I’d been hanging on by my fingernails, coping and functioning (minimally), but the realization that I could enjoy something again felt like a gift from God. I actually got tears in my eyes sitting in front of that salad. The gift of feeling positively about something was huge.

The second memory happened about 6 months into the depression. I’d started medication and the really difficult periods were fewer and farther apart, but I still felt fragile and rocky. I drove to work that morning after about a week of very rainy, gray weather. The clouds had parted and the sun was shining. The sunlight streamed through the trees as I drove down Euclid Avenue in Berkeley, and it was one of the most beautiful things I’d ever seen. I’d never paid much attention to the weather before, so the effect the sunlight had on me surprised me. I can still see in my mind the corner I was stopped at, the houses that shone in the light and the green leaves filtering the bright streams of light.

I would say these two events are two of the most profound in my life – and the reason is precisely because they were such ordinary events that, in spite of being so ordinary, produced euphoria. I expected my wedding day and the days my children were born to be important, and they were. I did not expect a salad and sunlight to become my symbols of rising out of darkness, and it’s the very ordinariness of their existence that make them so potent.

For me, depression was a transformative experience. Two small things, a salad and the morning sunlight, had such a profound effect on me that I never forgot them. Since then, I’ve been so very aware of daily blessings. The fact that the freshly washed sheets feel soft and clean when I get into bed is a blessing. The sound of the rain on the roof while I’m in my cozy bed is a blessing. Finding a Tikka Masala that isn’t too hot for my bland-Irish taste buds is a cause for celebration (FYI, Trader Joe’s is perfect).

For me, chronic emotional pain was the opening to happiness, because once I really let myself fall into the depression I’d been staving off for years, I was finally able to appreciate not being in pain – when it finally happened. I’m so grateful for every day I’m not depressed. I’m so grateful for all the gifts that my post-depression life has brought me. There are definitely times when I’m more tuned into the blessings of pleasure than others. But I try very hard to not forget how wonderful the ability to feel pleasure is, especially since I’ve experienced losing it.Depression actually made my life richer by letting me see the sacred in the everyday.

Jump Starts

In cars, a jump start creates energy in a dead engine. Every once in a while, I need a jump start. I start to feel sluggish, slow in mind and body, and it feels like everything is too tight – finances, my jeans, my family’s demands. I knew I needed a jump start when I posted on my Facebook page, “I could really use a weekend at a hot springs right about now.” Planning a weekend away is just not in the cards right now, so I thought about the smaller things I could do to get my mojo back, and two things came to mind almost instantly:

1. Exercise

2. Organize something

Exercise creates energy. Any time I’m feeling overly tired, I know I haven’t been exercising enough. I remember a doctor on the radio commenting that if they could put exercise into a pill, it would relieve the symptoms of most ailments better than any medicine available. That always stuck with me and if I ever feel like my physical well-being is less than optimal, I try increasing my exercise before checking in with the doctor, and most of the time, I feel better pretty quickly.

De-cluttering, for me, is another powerful way to increase energy. I find that the act of clearing away or organizing an area makes me feel productive and clears the way for new ways of seeing things. In Feng Shui, de-cluttering is a necessary step to inviting new energy into your life. My life gets cluttered very easily. I tend to keep things I don’t need, or might feel sentimental about, and then I get overwhelmed with the clutter and ignore it. My natural way of being is not simple and clutter-free, so for me, de-cluttering has actually become kind of a spiritual practice that I need to continually practice.

My husband agreed he’d be responsible for the boys that afternoon, which gave me a few hours. If I hadn’t been intent on creating energy, I probably would have taken a nap or done office paperwork. Which is fine, but I knew in my heart that I needed to stoke the fire a bit.

I would have preferred a walk outside, but it was raining buckets, so I pulled out the Wii Fit, informed my sons that it was Mama’s turn to use the Wii, and no, I wasn’t going to do a 2-person game so the 5-year-old could just put down the extra remote. (He parked himself next to the board the entire time, so I just told him this was my time to exercise, and reminded him that he was capable of getting a drink himself or he could ask his dad.)

I felt better quickly. The Wii Fit isn’t exactly running a marathon, but it’s fun and I know which activities I have to do to work up a sweat. I did about 45 minutes, which was enough to remind my body that it could do more than sit in a desk chair.

Then I put my earbuds in my ears, pulled up “This American Life” on my iPod, and went to work in the bedroom. In about 2 hours I’d cleared out four large garbage bags of sweaters, jackets and pants that I kept because they were good quality, but I never wore. I took photos of all of them (for tax purposes – we always itemize our donations and keep careful records). They will be delivered to a local clothing bank within the week.

There are a lot of things on my to-do list that I haven’t gotten to, and that’s fine. I needed to prioritize those tasks that would help me gain momentum and propel me into this week so I could tackle it with energy.

Look at your to-do list. Which of those tasks will create energy, instead of deplete it?  Sometimes it’s important to put aside that which is urgent and focus on that which is essential.

Charlie Sheen: Mental Illness is Not Entertainment

One of my guilty pleasures is celebrity gossip. And I have to admit, part of my fascination is pure schadenfreude – when I’m struggling to make ends meet or balance my kids, work and other commitments, and I think, “If only I had an extra pair of hands, or a housekeeper, or a personal assistant, or more money, life would be easier…” it’s kind of reassuring to see that people with far more money and resources than I are also messed up and probably not very happy, even with their perfectly highlighted hair and designer clothes.

I’d been very peripherally following the Charlie Sheen saga, and knew he had issues with drugs and women. On Monday, I heard about these interviews he’d initiated in which he defended his actions. So I tuned in that night and watched his Today show and GMA interviews.

As I watched, I became increasingly uncomfortable. This wasn’t a hedonistic rock star who knew the consequences of his actions and was still choosing inebriation. Now, I obviously am not going to diagnose him on the basis of a television interview, but I will tell you that as I watched, I had flashbacks to every adult I’ve ever hospitalized in an unmedicated manic episode. Grandiosity, flight of ideas, pressured speech…it was all there. Of course he’s high on Charlie Sheen – it’s fun to be manic. And when you’re manic, you think you’re going to stay manic forever and it will be fabulous. Of course he can be sober now – his brain is providing a natural high. (Another disclaimer – I don’t know that he’s bipolar or in a manic phase – this is simply my impression based on his televised interviews).

But what about when he crashes? That’s when some people with bi-polar disorder turn to stimulants to try to keep the high going. That’s why so many people with mood disorders have co-occurring substance abuse issues. Their brain chemicals are not working right, so they’re trying to self-medicate to even out those chemicals.

I’ve seen more calls for the media to stop enabling him, and I hope it sinks in. In my opinion, they’re not just enabling him, they’re using his mental illness for entertainment value. Mental illness is not entertainment.

I do hope this ends up raising awareness for what mental illness can look like. People who are mentally ill are often unaware that their minds are playing tricks on them, but they also are smart, talented, and able to function in other ways. It can happen to anybody, and it doesn’t have to ruin lives. So please, stop laughing at him.

I Take Anti-Depressants Daily, and I’m Not Embarrassed to Tell You That

To me, telling clients that I take anti-depressants is like a cardiac specialist telling his patient he takes a certain heart medication. Clients are often nervous about taking medication, and I’m telling them, hey, I have some personal experience with this. I can relate, and I understand the worries.

When I first started taking Prozac, back at age 30, I was advised not to tell my boss, and I didn’t. Part of the reason I feel freer now is because I work for myself and I stopped judging myself for taking Prozac a long time ago. I’m 45 – I know my brain. I know my brain off Prozac, and I know my brain on Prozac, and believe me, my brain works a whole lot better on Prozac.

I was depressed as a child, a teen and a young adult. When it finally reached a breaking point and I couldn’t eat or sleep, I reluctantly saw a psychiatrist. She looked at me at the end of the interview and said, “If I felt like you do, there’s nothing I wouldn’t try to feel better.” Because I SO wanted to feel better, I tried Prozac. And damn if my brain didn’t turn “normal.” I could not believe how fabulous “normal” felt. I still am amazed at how wonderful “normal” feels. I have ups and downs, but my goodness, they’re within a “normal” range. I’m not struggling to keep my head above water. I can relax and enjoy myself. It’s not taking all my energy to go to work and maintain friendships.

People call psychotropic medication a “crutch.” “I don’t want a crutch,” they’ll say. I respond, “If you broke your ankle, and couldn’t put any weight on your foot for a week, would you refuse crutches?” “No, of course not,” they laugh. “Would you feel like you were somehow more deficient than the average person because you needed a crutch to walk?” “No, but that’s different…” they say.

I’m saying it’s not all that different. Crutches are to help you when you need a crutch to keep walking. I take allergy medication too, daily, because my nose is ridiculously allergic to anything that can float in air. Do I feel it’s a character flaw that I’m so allergic? Of course not. My brain needs more serotonin than it produces without medication. That’s not my fault, it’s not a character flaw, and it’s only an obstacle when I don’t treat it. My willpower is not going to change my serotonin levels.

I do admit, there are a few people I wish I hadn’t told that I was on anti-depressants. There are a few people in my life who continue to hold the view than depression is a mind-over-matter issue and I’m just not trying hard enough or am not strong enough to persevere without the “crutch” of medication. I’ll have to live with that, because now they know and although I’ve tried to educate them, they’re going to think whatever they’re going to think and apparently I’m not going to change them. That’s on them.

Some have even counseled me that I shouldn’t be revealing this to my clients. Maybe some prospective clients will read this and decide they shouldn’t seek my services because I may be flawed. It shouldn’t be news to anyone that we’re all flawed, including therapists. The fact that I am on anti-depressants is a much smaller flaw, in my profession, than my inability to return all phone calls in 24 hours (I’m working on that one, believe me. By the way, I’m faster with e-mail).

I refuse to walk around afraid that someone is going to find out I have Prozac on my medication shelf. It’s not all I do to treat my depression (which, by the way, I haven’t had a relapse of in 8 years – I had a short issue with PPD after my first child was born and treated it). I also exercise, nurture my relationships, seek spirituality, watch my sugar intake and try to live the best life I can. But taking Prozac has been a big part of my journey and if I, a mental health practitioner, can’t be comfortable admitting that, than how can I expect my clients to seek treatment without shame?

Thoughts on the Arizona Tragedy

The shooting in Tucson, AZ of Congresswoman Gabrielle Giffords and 19 others, six fatally, has provoked much discussion on the current climate of aggressive and negative rhetoric in the media and by politicians.

I’ve heard very little about what I think is the real lesson from the shootings – we have a mental health system that is broken. Reports of Jared Loughner’s bizarre behavior are coming out from former teachers and classmates. His behavior was so frightening, he was told to leave Pima Community College and not to return until he had a mental health evaluation. In this post, I’ll be referring to mental health issues such as chronic schizophrenia and schizoaffective disorders, which affect an individual’s ability to function in society. I’m not talking about the many people who struggle with other disorders, such as depression and anxiety, but are still in touch with reality. I also want to be clear that people with mental illnesses are no more likely to be violent than anyone else. That’s important.

Jared was an adult, 22 years old at the time of the shootings. As an adult, he has the right to refuse treatment for mental illness. What do we do when a symptom of the illness is that the afflicted doesn’t think they have an illness? To the patient, it makes complete sense to refuse treatment and it’s easy to see those who insist that the patient take mysterious pills or get shots as persecutors. To the friends and family of the patient, it’s another hurdle in a long line of hurdles facing them and their loved ones.

We don’t know what kind of help his parents tried to get him, and confidentiality laws prevent any local professionals from revealing whether or not he was treated, but I’m guessing he wasn’t very cooperative and didn’t agree with the college’s suggestion that he seek treatment.

People who have long-term chronic mental illness are not always easy to deal with. They burn bridges, get evicted, don’t follow the rules of housing alternatives. They go off their medication. They usually can’t work and live off long-term disability. Many of them develop substance abuse issues as well, complicating the treatment picture.

I used to have a job where I evaluated people for involuntary hospitalization. I was threatened with all manner of lawsuits and called many names by the people I was trying to help. They saw me as taking away their basic rights and they were right – I was taking away their right to refuse treatment. If I determined they needed to go to the psychiatric hospital, and they fought that decision, they would be handcuffed and restrained. One particularly searing image that stays with me was a terrified, very psychotic woman in her 80’s, screaming as she was wheeled out on a stretcher “I’m being kidnapped! Kidnapped! Someone save me!” The terrified look on her face haunted me. She really believed she was being kidnapped.

Parents looked at me in horror when I explained that yes, they’d need to stop paying their psychotic daughter’s rent and let her become homeless before we could force her to go the hospital, because her behavior, while bizarre, wasn’t dangerous enough yet.

Mental health budgets continue to be cut all over the country. It’s expensive to take care of these members of our society. The care we do give them is substandard. Ever been to a SRO? Unless it was brand new, I don’t think I’ve ever been to one that didn’t reek of urine and wasn’t dirty and worn. The staff who work with the chronically mentally ill have a very difficult job and are not paid well.

We have no safety net for these people. We offer them very basic care, try to keep them housed and safe and stable. We can’t do much more for them. Trying to offer some kind of quality of life is out of the question, because there is no money for it. We as a society don’t want to deal with the mentally ill.

I’m certainly not saying that what Loughner did wasn’t heinous. What I am saying is that it’s not as easy as, “Hey, this guy creeps me out. Let’s put him in the hospital.” Maybe he did go to the hospital and while being evaluated, told the staff, “I’m fine. Really – I live with my parents, I eat and shower daily, and I don’t need medicine.” That would probably be enough to get him discharged into his parent’s care.

What’s the answer? I wish I had one. Taking away a person’s rights is serious and needs to be considered carefully. But by focusing our efforts on protecting those rights, are we abandoning a large segment of our population?

(edited 1/14/11 to correct the shooter’s name)