Gratitude - The Prozac Monologues Publication Edition

Fifteen years! From the hypomanic first draft of Prozac Monologues on a yellow legal notepad to a published book, and the nail file that inspired it all.

The book was officially released into the wild this week and will be celebrated in two launches, one sponsored by Paulina Springs Books in Sisters, OR, and the other sponsored by Prairie Lights in Iowa City, IA.

It's a good time to talk about gratitude. Forgive my self-indulgence. It is a day to reflect.

First, people have asked whether it was hard to write about such dark times in my life, if it retriggered some of those emotions. Occasionally, it did. Occasionally I would have a sleepless night remembering, in particular, difficult encounters in treatment. One can forgive sincerely. One can forgive over and over. Still, the brain remembers. I don't harbor resentments, but I can't always hop off the time travel machine that is my brain, how it repeats the tracks laid down by past traumas.

For the most part I kept that time machine in idle with two techniques. One is reframing, putting the experiences in a box and pronouncing the "Riddikulos!" spell over them, transforming them into humor. It has to be outrageous humor, not a simple chuckle, performing the spell like I mean it. And I do. Prozac Monologues is, frankly, hilarious.

The second technique was to place myself even further outside the frame by refocussing on exactly the right word in exactly the right position in exactly the right sentence. I practiced my craft. These experiences became the raw material on which I performed the writer's magic.

But there were other experiences in those fifteen years that I could allow myself to experience fully, feeling fully -- gratitude.

The doctor who tried so hard to help when nothing was helping -- she even took the risk of talking to an irritable priest about prayer.

The therapist who changed her dinner plans in a heartbeat when she saw the look on my face.

The psychiatrist who showed up for my guerilla party to celebrate suicide prevention week held in the hospital lobby. Complete with cake. And boy, what a cake!

The psychiatrist/researcher/professor/writer/mensch who has engaged with me and my work, supporting and promoting it when he agrees, taking it seriously even when he does not.

The publisher who believes in this book, whose own life mission is to give voice to writers whose stories need to be heard.

My wife of twenty-four years. Oh my gosh, what can one say about the ones who say the words, "For better for worse, in sickness and in health" and then stick around to keep those vows?

Batshit Crazy Support Group, where I had permission to speak the unspeakable.

Batshit Crazy Book Club -- oh, the places that our books take us!

I could go on for a while. I will go on for a while. But I will end this post (not the gratitude) with:

My dear sweet Mazie. Sometimes she knew she needed to pull me into a faster pace on our walks to improve my exercise. Sometimes she knew that my depression was too deep, that creeping was the best I could do. So she adjusted her pace to mine. And always she provided a gentle way to interact with others in the neighborhood.

Amazing Grace -- her full name was inspired by what everybody said when they saw her run, "That's amazing!" Mazie had three legs. She didn't need a fourth. She ran like the wind. She came to us that way, a stray.

We both were lost. I am so grateful that we both are found.

photos by author

A Better Suicide Prevention Month

CW: Cynical Warning.

Anybody else cringe all through Suicide Prevention Day/Week/Month? Anybody else roll their eyes at the "Ask for Help" messages? Or search the lists of "Warning Signs" to make sure you're covering your tracks?

Are you a potential helper and confused by that paragraph? Did you design this poster? Let me explain it to you. The psychiatrist doesn't accept your insurance. The psychiatrist who does accept your insurance doesn't treat your issue. There isn't a psychiatrist. The therapist is available six weeks from now. Or later. What's the point of therapy anyway, the therapist isn't going to pay your rent, if you could make rent you could manage your mental illness just fine, thank you very much.

If you call a help line, what if the cops arrive to handcuff you in front of your neighbors to help you enjoy your free trip to the ER? That's the only thing that will be free. If you go to the ER, you may or may not be admitted. Either way, the bill will leave you homeless.

When the naive, new-to-the-world-of-suicide-prevention person actually asks for help and goes through the demeaning process of not receiving it, it's like that outstretched hand, the one on top, turns around and pushes down the head of the one who has been reaching up.

Now look at this poster carefully. It claims to be addressed to the suicidal person. Your story isn't over yet... Speak up. But read the topics covered. The role of depression. Warning signs, risks, and stressors. Protective factors. Resources and tools for communication. Are any of them addressed to the suicidal person? No, they are not. This is not a conference designed for suicidal persons. It is designed for would-be suicide preventers. Whose story isn't over yet?

This will be a theme. There will be youtubes posted of somebody tackling that suicidal person on the edge of the subway track, pushing him back from the edge. I suppose this youtube encourages people to keep their eyes open in subway stations, ready to prevent a suicide.

I'm glad his life was saved. Truly I am. When I am on the edge, will I make sure a would be hero is standing by, or will I wait until I am alone?

And now to those risk factors and warning signs. Really, risk factors have nothing to do with prevention. They are about who do you (the nonsuicidal person) need to keep an eye on? That's such a warm fuzzy feeling, you know, being scrutinized. Nobody is watching the bully in school. They are watching the victim. It's the victim who is at risk for being yanked from school and placed in a special program. 

And the warning signs - like I said, these lists are very helpful for telling those of us who have plans what we can and cannot say and do in order to keep these plans concealed.

Boy am I being difficult. All you helpers out there just want to help. Here's a hint. Ask us what would help.
Following my own advice, I am asking. Not what would help? That is a later post. I am asking people who are or who have been suicidal: 

How would you, somebody with lived experience of being suicidal, design a suicide prevention campaign? What messages would you like to see? What do you want to have happen in the month of September to prevent suicide?

Give me your ideas. I want to hear from you in the comments below. Let's do something different this year.

Because the truth is, most suicides are prevented. We prevent them ourselves. It turns out, we are the experts in the field. If anybody out there is listening.

Circadian Rhythms and Fixing Bipolar's Wonky Clock

When nothing else worked, Social Rhythms Therapy got my bipolar under control. That's why Ellen Frank is my mental health hero. She invented it.

A few years ago, I spent four weeks summarizing Frank's book, Treating Bipolar Disorder: A Clinician's Guide to Interpersonal Social Rhythms Therapy. My goal was to create a patient's guide. Here is the link to Part Four. It includes links to the earlier posts.

Frank describes Interpersonal Social Rhythms Therapy like this: IPSRT [is] a treatment that seeks to improve outcomes that are usually obtained with pharmacotherapy alone for patients suffering from bipolar I disorder by integrating efforts to regularize their social rhythms (in the hope of protecting their circadian rhythms from disruption) with efforts to improve the quality of their interpersonal relationships and social role functioning.

Circadian rhythms are at the core of IPSRT. People with bipolar have difficulty maintaining the stability of our circadian rhythms, because our internal clocks, governing everything from sleep cycles to blood sugar levels to body temperature are, well, wonky.

Social Rhythms Therapy basically is a strategy to keep resetting the clock throughout the day by making sure key events (clock setters) happen the same time each day. For me that means getting up, greeting my wife, eating, beginning to write, and going to bed, each at the same appointed time each day.

People who do not have bipolar don't need to reset their clocks on a daily basis. Their brains accommodate little variations in schedule. But even they occasionally knock their clocks off the table: jet travel across time zones, changing work shifts, sleeping in on weekends. These knocks may not precipitate a mood episode. But they do have other deleterious effects.

Here is an explanation of circadian rhythms and, in particular, how they affect metabolism for all the rest of you.

So it turns out, while I have been simply trying to not go crazy, I also have been controlling my weight, taking care of my liver, and improving heart health too.

I hope you can learn the same lesson without paying the tuition I have paid!

book cover from
flair from Facebook

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.

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