Will This Trauma Never End?

I found this video while trying to survive the cluster f*ck of misdiagnosis, antidepressants, mixed episodes, and a psychiatrist and therapist who didn't know what they didn't know, so it must be me and maybe I had borderline personality disorder - the go to diagnosis for patients that the professionals are tired of.

OK Go - This Too Shall Pass. And in fact, it did. I survived to... today? I offer it to everybody who is trying to survive the current COVID cluster f*ck in the US.



I don't know what it will look like on the other side. We are not going back. But we will go forward.

Meanwhile, do what you can today to build community again, to take responsibility for yourselves and your neighbors, to learn about strangers so that you don't have to be so afraid of what you do not know. The Way of Love is the way forward.

That's it. That's the post. Bless you.

To Write Love - Hope for Depression, Addiction, Self-Harm, and Suicide

There is power in a story. You tell me your story. You are seen, heard, affirmed. I tell you my story. You know that I am for real. We are not alone.

To Write Love on Her Arms (TWLOHA) harnesses the power of story to offer hope to people struggling with depression, addiction, self-harm, and suicide.

The organization itself began with a story, a young woman who was suicidal but could not be admitted into a treatment program because she was also addicted and they couldn't bear the liability of her detox.

Yes, if you think you're done after you tell your suicidal friend or family member to get help, read that sentence again. Trying to get treatment can be enough of a nightmare to push us over the edge.

But that was just the beginning. A group of friends took it upon themselves to create a safe place and treatment program for this young woman for the five days it took to detox. The treatment program was admittedly unorthodox. She stayed with friends. In rotating teams they supported her, kept her safe. They also took her to concerts, Starbucks, and church. They prayed. They smoked cigarettes. They were her hospital.

Mostly, they listened.

On the last night, she handed over the razor blade that had been in her possession the whole time. Anticipating a difficult night before going back to the other "real" hospital, she thought she shouldn't have it on her.

Her life began again from there. And TWLOHA was born. As the website says, We often ask God to show up. We pray prayers of rescue. Perhaps God would ask us to be that rescue, to be His body, to move for things that matter. He is not invisible when we come alive.

TWLOHA came alive. Today it publishes the stories of people who have survived these things, who are recovering. It "exists to encourage, inform, inspire, and invest directly into treatment and recovery."

I once was working on a novel that included the concept of "Hospice for Suicide" as a suicide prevention strategy. But I'll have to mine that concept another time. For now, story.

Today a psychiatrist on my Twitter feed tweeted about a time when he was suicidal. If you told me then that I would recover, qualify & receive a standing ovation from 1000 people at a conference in Lisbon for sharing my story, I would never have believed you. How differently I hear his words than those of another psychiatrist who tells me there is always hope.

TWLOHA's website is filled with stories. You can submit yours. Let's not walk this road alone.
photos by author and Helen Keefe

Mental Illness Podcasts: Teaching and Tickling the Mind

I have to move a lot to manage my anxiety disorder. So why did it take so long for me to discover podcasts? I can do research and fold laundry at the same time! Here are four of my favorites:

My therapist recommended The Hilarious World of Depression, hosted by John Moe, a few years ago. And I recommended it to you as part of my Giving Thanks series last November. A depressive himself, John interviews comedians, musicians, and other celebrities, asking the question, Is depression funny? Not everybody thinks so, but that's my brand. The show was recently cancelled. Sigh. But with five seasons, that's a lot of bingeable laughter to come your way. And you can often find Youtubes of the featured comics to extend your pleasure. So have at it.

I should mention that John has just published his memoir by the same name, for when you can sit still and read.

I discovered Beyond Well, hosted by Sheila Hamilton after reading her memoir about her husband's undiagnosed bipolar and subsequent suicide. It is the cautionary tale and not so funny version of my book. Well, she wrote hers first, but I don't want to say I wrote the funny version of hers. It's not always funny.

Sheila is an award winning journalist in the Portland, Oregon area whose career turned to mental health journalism after her husband's death. Her guiding principle is: We are all on a spectrum of mental health and everyone will struggle at some point in their life. Beyond Well is here to listen, affirm, and share stories to help you feel less alone in the world. And that does describe the effect of listening in on the conversations that Hamilton has with professionals and people with lived experience - to feel less alone.

Both Moe and Hamilton are included in the resource section of Prozac Monologues: A Voice from the Edge. The following are discoveries made after my project manager refused to accept any more revisions.

Kimberly Berry's Being Unnormal is like having coffee with a friend, a powerful, dedicated, and smart friend, my favorite kind of friend, who does not mince words and is a mother tiger when it comes to her kids, and then talking about the stuff that matters to the both of you: being queer, being adhd, being bipolar, being black and traumatized... Oh, and she invited an expert to join the conversation. You laugh, you feel, you think. And you show up next week to find out who shows up next.

Berry is the mother of one daughter with bipolar, another with ADHD. She is the founder of Being Normal, a coaching and consulting group that assists people navigating the world of mental health and companies to create mental health focused policies.

And then there is Gabe Howard, who hosts the Not Crazy Podcast on PsychCentral.com, along with his former wife Lisa. Not Crazy advertises itself as the mental health podcast for people who hate mental health podcasts. This is a more reflective podcast than most, if I can use that word for heated conversations about controversial issues. Reflect: consider issues from a number of angles, rather than simply educate on a topic. They take a perspective, or Gabe takes one and Lisa challenges it. Then they wrestle it into the ground, often trading positions in mid argument. The anti-psychiatry movement, mental illness humor, the role of religion in treatment... Two people with mental illness (Gabe has bipolar,Lisa depression) arguing passionately about the things that interest people with mental illness. It works.

Personally, I love it. Their conversations remind me of late night debates in my college dorm. Okay, I went to Reed College. Maybe that's not what you were doing late nights in your dorm, but it's what me and my buddies were doing in ours. Gabe's bipolar makes me feel like I am with my tribe, loud, bright, passionate.

Gabe also hosts a more conventional mental health podcast, the Psych Central Podcast where he reins in the intensity "to break down complex topics in simple and understandable ways.

I haven't read his book yet, but I post it here, because I think he puts out a quality product. This guy has been at the mental health advocacy gig for fifteen years and has earned his street cred.

So what about you? What are you listening to? Who should I add to my list?

book covers from read.macmillan.com, Amazon.com, and gabehoward.com
graphic from beingunnormal.com

COVID Mask Resistance and the Death Wish

Why won't people wear masks? If their answers don't make sense, maybe we need to listen more deeply.

Truth be told, I want to respond with name-calling: selfish, anti-science, "drank-the-kool-aid"... I am tired of dodging the maskless in the street and the grocery aisle. I resent being confined to my home to protect myself from my fellow citizens. I grieve the slow, and now not so slow, decimation of the population of the United States, my native land, hurdling toward third world status as our health care system collapses, our food chain folds, and our future generations head toward long-term disability.

Side comment/serious question: There is such variation world-wide in leadership and results. Some countries have got this pandemic under control. Who benefits, who is the one who gains by our abysmal mismanagement and consequent destruction of the United States of America?

But 1) name calling is not helpful, 2) I actually care about some of these people, and in general, 3) I commit to the Way of Love. So I am stuck with listening more deeply.

Is It Time to Call a Therapist?

There is a difference between feeling depressed and having depression, which makes it hard to figure out what we need right now when - doesn't everybody feel like crap?

Pride Month Report: What Parents Can Do for Their Trans Daughters and Sons


1.8 million LBGTQ youth (13-24) in the US seriously consider suicide each year. The numbers for trans people in particular are even more staggering. According to the UCLA Williams Institute report, 81.7 percent of those surveyed by the National Center for Transgender Equality had seriously thought about killing themselves in their lifetimes, and 48.3 percent had done so in the last year. 40.4 percent of transgender people attempted suicide sometime in their lifetime.

Suicide happens when pain exceeds resources for coping with pain. This report adds evidence to that assertion. The following statistics are pulled directly and paraphrased or quoted from this report.

Mental Health Innovators Ponder the End of the COVID-19 Honeymoon

Dear Mental Health Innovators: The COVID-19 Honeymoon Is Almost Over.

The title of a recent PsychiatricTimes.com article caught my eye. Honeymoon? Then I realized it was dated May 19, so perhaps the authors could rewrite the title with the "Almost" removed.

The authors identify predictable stages of psychological response to our current pandemic. Unbeknownst to those whose education was really less education and more training for their future jobs (so things like history were deemed a waste of time), the human family has lived through past disasters, including multiple pandemics. There are patterns to these things.

Heroic Stage

Care of the Soul and COVID-19

Ronald W. Pies is a psychiatrist, bioethicist, and professor emeritus at SUNY and Tufts. His writings often tend to the philosophical, which keeps me reading his work and occasionally engaging with him in cross conversation between Prozac Monologues and PyschiatricTimes.com, where he served as editor-in-chief 2007-2010.

Pies' recent post is one such example where our respective disciplines come along side each other, Care of the Soul in the Time of COVID-19. He identifies five assaults on the soul made by the pandemic: impotence, grief, loneliness, mistrust, and displacement. While underlining that one solution will not work for all, he proposes cognitive therapy, gratitude, and the arts as strategies for healing.

Therapy and Spiritual Direction

As a physician, it is natural that Dr. Pies would write of problems and solutions. I too have been thinking about the larger implications of the COVID pandemic. However, I do less pastoral care these days. My thinking has been more in the realm of spiritual direction. Spiritual direction is as likely to trouble the mind as soothe it, raising questions to ponder rather than soothing manifestations of distress. So my care of the soul focuses on the questions that COVID raises about identity, values, and purpose. 

Identity

Misconceptions about Suicidal Thoughts

My publicist seems to think people have a lot of misconceptions about mental illness (she's right), because many of her questions go there. You are very open about discussing your own struggles with suicidal thoughts. What do you think are the biggest misconceptions about people going through similar experiences? So today's post will focus on suicidal thoughts or suicidality.

Suicide is not a choice


The way people talk, you'd think we sit down and make a list, pros and cons of suicide. Then based on our calculations, we make some kind of decision. She chose to end her life. Or, How could he have been so selfish.

This is called the volitional theory of suicide, suicide as an act of will. The suicide prevention approach that addresses it is to weigh in on that list of pros and cons, like Jennifer Michael Hecht's book, Stay.

You know -- Suicide is a permanent solution to a temporary problem. Or, Think of what you'll miss out on. Or, whatever. In other words, how dumb or short-sighted or irresponsible or selfish you must be to decide to kill yourself.

What People with Depression Need to Hear

Depression is one tough condition. Contrary to those cheery ads on tv and friends who want you to get over it, it is not easy to recover. Doctors also, in their eagerness to get you to do something that will help, sometimes oversell their solutions.

Chris Aiken's recent article in Psychiatric Times presents a more helpful picture.

Five Things to Say to People with Depression

You can expect, and do deserve, a full recovery. Aiken's point is that people with depression have a hard time believing we will ever feel any differently. (This is true. Boy, is this true.) Nevertheless, chances are, we will feel better. There is a rub here however. Most people get to full recovery, not all. As a patient, I'd like to hear up front that even if it comes back, chances are that things will get better again. So many of us feel like failures when depression recurs, when actually both remission and recurrence are part of the natural course of the illness.

Misconceptions about Therapy

Continuing the press kit-inspired series...

No, therapists aren't like friends that you pay

Therapists make you work. The work you do depends on the kind of therapist you see. Interpersonal therapists get you to examine your relationship patterns. Are they working for you? Are you sure? Social rhythm therapists make you track your schedule. For people with bipolar, an off kilter schedule results in an off kilter brain. (The chart I use is here.) Cognitive behavioral therapists even give you work sheets! Mostly this homework involves learning to examine your thoughts. Just because your brain tells you something doesn't mean it's true.

No, therapists don't give advice

Misconceptions about Antidepressants

What do you think are the most common misconceptions about antidepressants?


Prozac Monologues: A Voice from the Edge is at the press kit stage with Q&A in development. My publicist wants me to answer questions that interviewers might ask. My responses should be in the three to seven sentence range, she says.

Three to seven sentences are not my forte. I am doing my best and taking comfort that in an interview format, there might be a follow-up when I can say more.

They are good questions and worth a blog series, I think, where I can expand to three to seven paragraphs. Mostly seven. Maybe more. Plus, you know, pictures. So that's what you get for a few weeks.

No, antidepressants are not happy pills

Trauma, COVID-19, and Cutting Yourself Some Slack

Are you failing to build your abs while social distancing?
Or learn that new language?
Or clean out that closet (you know which one)?

Are you utterly exhausted while getting nothing done and beating yourself up for it?



STOP. Just stop.
And read on.

Frazzled Cafe and Ruby Wax - Yes, I am a Fan


Ruby Wax is the founder of Frazzled Cafe, a peer support group for anyone who is overwhelmed by the stresses of modern life. As Ruby says, our brains just don't have the bandwidth. If that describes you, check it out. But bring your own coffee. The meetings moved online, a Zoom meeting on account of... you know.

Ruby is an American-born long time television personality in Britain and comedienne whose career pivoted when mental illness caught up with her. She went back to school to study the brain and got a masters from Oxford on mindfulness based therapy. Since then she has written books, toured, lectured, using her prodigious brain and her comic chops to entertain and educate about brain health.

The End of Miracles - A Review

What is it like to have depression with psychotic features?

What is a day like inside a psych ward?

What is the psychiatrist thinking?

Sometimes the best way to explore questions like these is in a story. So here is Prozac Monologues' first review of a novel.

Monica Starkman is a psychiatrist at the University of Michigan whose expertise includes psychosomatic disorders, stress, and women's issues around fertility, miscarriage, and obstetrics. In her debut novel, The End of Miracles, she turns her clinical experience to the story of one woman, Margo Kerber, a long-infertile woman who finally conceives, tragically miscarries, and then... unravels.

Covid-19 and Coping - The Humor Version




So, we've all been coping as best we can. My best varies from hour to hour, as I imagine yours does too. And if you have hung around Prozac Monologues for long, you know that humor is one of my go-to tools. It takes a different shape, depending on the topic and the need. This is my Covid-19 version, the gentler one.

Of course, some things have not changed for me. You might say, I am in my zone.


Major Depression and World Bipolar Day

Your diagnosis is major depression. So what does World Bipolar Day have to do with you?

I mean, what a relief to just have major depression, right? Isn't bipolar another level of crazy? Well. . .

First, a reality check. Whatever level of crazy you are now, you can call it whatever you want, your mental health struggles will not get worse if your diagnosis changes. Actually, you might get better. I'll get back to that.

Where Is My Therapist?

I could have talked to my therapist yesterday by phone. She's not on vacation. But this week I decided to forgo an appointment. That may have been a mistake. . .

So I turn to a rerun from eight years ago, For When Your Therapist Goes on Vacation. I think I'll be focusing on humor for the next few weeks. Keep coming back! If you've got any good jokes, put them in the comments (click on the little envelope icon at the bottom.)

Normal/Not Normal at Prozac Monologues

How are you all doing?

Me, I am trying to imagine that at least some things will be sorted by the end of summer in time for publication of Prozac Monologues: A Voice from the Edge. So here I am, working in my New Normal Coffee Shop to meet my next deadline, a deadline that COVID-19 has not erased.

This stage is called "first pages." In the photo I have in front of me a printout of the design people's first version of the book pages, the interior of the book. I am working at the dining room table, my current coffee shop in the new normal, because my office doesn't have a table.

Social Distancing and Sabbath


Pandemic

What if you thought of it
as the Jews consider the Sabbath—
the most sacred of times?
Cease from travel.
Cease from buying and selling.
Give up, just for now,
on trying to make the world
different than it is.
Sing. Pray. Touch only those
to whom you commit your life.
Center down.


Early Praise for Prozac Monologues

While waiting for willgoodfellow.com to come online, here is an early opinion:

Willa Goodfellow has written a clear, compelling, and helpful guide for people experiencing clinical depression. Ms. Goodfellow's book is, at once, a vividly written personal narrative and a kind of Baedeker (travel guide) to the often confusing territory of mood disorders. She is especially helpful in describing "bipolar spectrum" disorders, and the risks of using antidepressants for these conditions.

Mental Illness Humor - A Manifesto

Is mental illness funny?

Depends on what you mean and who and you ask.

If it's not, well there goes my career. And indeed, in some corners, my career never got out of the gate. But here's my story.

Humor serves several functions for us loonies. The first for me was as a coping mechanism.

Under Construction

This sight is a work zone this week. Pardon my mess during the remodel.

Meanwhile, here is Stephen Fry, The Secret Life of a Manic Depressive.

Also coming soon: WillaGoodfellow.com, with lots of info about Prozac Monologues: A Voice from the Edge, to be published by She Writes Press, August 25, 2020.


Neuroscientifically Challenged - Check it out

Yay! When I found a new (to me) website, Neuroscientifically Challenged, I rewrote the resource section of the book. Given that Prozac Monologues is in proofreading stage, my project manager was not as pleased as I was. But it's now a better book.

Mark Dingman started blogging in 2008 as a way to explore his interest in neuroscience. That interest morphed into a PhD program, then a new career, and now his continued work on a website where he can learn, draw, teach, and talk about his favorite topic, the brain. Take my eclectic blog, focus on the brain part, turn it into a genuine resource, call it Neuroscientifically Challenged.

The website features two-minute videos each with a bite of information. Okay, Dingman has to talk kind of fast to get it done in two-minutes, but really, what do you want? Here is a sample:

A Common Struggle - A Review

In A Common Struggle, Patrick Kennedy tells the story that only he can tell.

There are many memoirs of depression, bipolar, co-morbid substance abuse, families that keep secrets, and recovery. Lately there are memoirs that combine a personal story with a cause: get help, get the right diagnosis, find people who can support you, advocate for better treatment.

Kennedy's unique perspective is the insider's view on the long-term national political work of improving mental health care.

How to Stay Sane

Shock, rage, fear, despair, depression, hopelessness, apathy, or even how about - drinking the kool-aid, surrender. Do we have a better choice?

Robin Chance, behavioral specialist and therapist, did a little therapy for the nation three years ago with her article, How to stay sane if Trump is driving you insane: Advice from a therapist. She offered a better choice.

Two questions: (1) How do we integrate this crisis into our understanding of the world? and (2) what do we do now? Now that the crisis of three years ago is our new normal, it seems time to revisit her words.

Mental Health Care as our Institutions Fail

There are twelve psychiatrists in Zimbabwe for a population of 16 million people. When Dixon Chibanda, one of the twelve lost a patient to suicide because she could not afford the $15 bus fare to get to her appointment, he did not blame her for breaking the appointment. He came up with another system to deliver mental health care. He trained grandmothers.



Prozac Monologues - A Book is Coming


The life of an author - this author anyway:

Mornings I work on finding my peeps. Twitter has been a revelation to me. I resisted it for years until I discovered what was possible. It's not all politicians and celebrities! I thought I was supposed to do Twitter because that's what you do when you want to sell books. That made me feel icky.

But then somebody reframed it for me:

There are people out there who have a question, a need, a pain point. Can I address their pain point? If so, how do they find me?

Six Ways to Heal the Holes in Your Head


Do you ever feel like you have holes in your head? Actually, you do. Ventricles are the spaces between the grey matter (brain cells) and white matter (wiring that connects the brain cells) in your brain. Depressive episodes, manic episodes, and psychosis all burn up brain tissue, leading to bigger ventricles. (Image: Effects of Western diet on the brain. See companion image, Effects of Mediterranean diet below.)

This loss of brain cells hits the hippocampus (in charge of memory and emotion regulation) particularly hard. In the early years after my last mental health crisis, I talked about my “Swiss cheese brain.” At my worst, I lost bills, I lost words, I lost everything my wife said to me on the way out the door in the morning. She took to writing down what I said I would do before she got home, never more than two items.

I lost the list.

New Year's Resolution - Eat Chocolate! Or Maybe Not...

Long time readers may know of my over-a-decade-long effort to get the sugar monkey off my back. I can report that I am reasonably  successful. I don't know if it has made an ongoing difference to my mood. But a shared dessert at a restaurant will get my arthritic shoulder burning. So I keep it up.

Or maybe I have taken it too far. It's all about costs and benefits, you know. And recent research suggests maybe I should lighten up, or rather, darken up.

Chris Aiken of Bipolar Not So Much fame, also Wake Forest University School of Medicine and The Carlat Psychiatry Report, says to my sugar fast, Not so fast. At least as far as dark chocolate goes.

Will This Trauma Never End?

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