Showing posts with label hope. Show all posts
Showing posts with label hope. Show all posts

A Book Review: Loving Someone with Suicidal Thoughts

  • I just don't want to live anymore
  • If only I could fall asleep and never wake up
  • One well-placed bullet would solve all my problems
  • You'd be better off if I were dead



Oh my gosh, words you don't want to hear from somebody you love. It is tempting, so very tempting to say something that will get your loved one to take it back.

Getting My Brain Back -- I'm Still Excited by BDNF

Learning has been fundamental to my mental health recovery. It started with this blog itself. I wanted to know What the hell happened to my brain?!!! So I read the research and used ProzacMonologues.com to keep track of my notes.

For a while I added piano to my recovery regimen. Not for music therapy, but for brain development. Okay, I didn't keep at it. I can sort of play Desperado. But it did get me a few more miles down the road.

Lately I am learning a new language. Five minutes a day of Irish on Duolingo -- I don't expect to be fluent any time this decade. I don't need to be fluent. For those five minutes a day, I am building my brain.

Which is always a good thing.

I did a search in my blog for BDNF. And found something I wrote in 2011, right after I wrote that review of Ellen Frank's Treating Bipolar Disorder. Now you, kind reader, have no idea the struggle it took back then to write these paragraphs. I am proud of it both for the accomplishment and for the content itself. I present it to you again:

Getting My Brain Back -- In Praise of BDNF


Interpersonal Social Rhythms Therapy: Good, Bad, and Ugly (Mostly Good)

Following #bipolar on Twitter for the last few years, I am often dismayed. So many people seem to spend so much time struggling with their medications and so little time focused on anything else that could help.

Don't get me wrong. Medication is an important tool for managing bipolar disorder. But it can't do the whole job. Education and life style changes are crucial for getting off the roller coaster of constant med adjustments to address the episode du jour.

I decided it was time to revisit my 2011 review of Ellen Frank's Treating Bipolar DisorderIt was a four-part review. The last three posts describe the treatment itself, Interpersonal Social Rhythms Therapy, IPSRT.

Part I laid the educational foundation, describing the relationship between circadian rhythms (our interior physiological clocks) and mood disorders.

Part II outlined Frank's Social Zeitgeber Theory and the treatment that proceeds logically from it, a process of establishing regular daily rhythms that set our interior clocks and keep them running on time. (Zeitgeber means timekeeper.)

Part III explained how work on interpersonal issues helps people reduce stressors and prevent disruptions to their social rhythms.

This last post will pull together my appreciation, my reservations and my hopes for future directions.

Social Zeitgeber Theory


How Does Interpersonal Therapy Help People with Bipolar Disorder?

Ellen Frank - Treating Bipolar Disorder, Part 3

Lately I have been reposting my 2011 review of Treating Bipolar Disorder by Ellen Frank. It was originally recommended to me by a friend who was researching hypomania. Part I described the basis of Interpersonal Social Rhythms Therapy (IPSRT) in circadian rhythms that control the many physiological symptoms of mood disorders. Part II outlined the Social Zeitgeber Theory and described the early stages of the therapy process, history taking and stabilizing social rhythms. Today I pick up with the later stages, interpersonal therapy and maintenance.


Interpersonal Social Rhythms Therapy came to Ellen Frank in an epiphany on her birthday, July 14, 1990. Personally, I like that. I especially like that it was the day that she participated in a conference for people with bipolar, and listened to them.

Frank and her colleagues were already using interpersonal therapy for people with recurrent unipolar depression. Their theory was that certain life events, particularly losses could result in lost social zeitgebers, (timekeepers), with subsequent disruption of circadian rhythms, leading to eventual relapse into another episode of depression.

IPSRT took up from there as an adaptation specifically for people with bipolar disorder, integrating the work on issues (as in, you've got issues) with greater focus on behavioral changes to achieve and maintain daily rhythms, time of rising, time of first human contact, work, main meal, etc. The purpose of IPSRT is to help people achieve stability and then to avoid relapses into either depression or mania/hypomania.

Why Do People Relapse?

My Holiday Wish for Us All - Trip the Light

In my darkest bleak midwinter, I find the following. And I believe again. I do believe we can get back to this. And if the video were made again, with everybody in masks, it would not detract from the joy. It really wouldn't.

PS - While you are watching, dance!


If all the days that come to pass
Are behind these walls
I'll be left at the end of things
In a world kept small

 

Travel far from what I know
I'll be swept away
I need to know
I can be lost and not afraid

 

We're gonna trip the light
We're gonna break the night
And we'll see with new eyes
When we trip the light

Remember we're lost together
Remember we're the same
We hold the burning rhythm in our hearts
We hold the flame

We're gonna trip the light
We're gonna break the night
And we'll see with new eyes
When we trip the light

I'll find my way home
On the Western wind
To a place that was once my world
Back from where I've been

And in the morning light I'll remember
As the sun will rise
We are all the glowing embers
Of a distant fire

Come on and trip the light
We're gonna break the night
And we'll see with new eyes
When we trip the light

Music: Garry Schyman©
Lyrics: Alicia Lemke and Matt Harding©

Source LYBIO.net

What Happened to My Bipolar Brain and How Do I Fix It?

The most troublesome statement in Goodwin and Jamison's Manic Depressive Illness may be this: "Complete symptomatic remission does not ensure functional recovery." This is no small problem. For some 30% to 60% of patients with bipolar disorder, simply treating their mood symptoms is not enough to help them return to a full life.

There’s a third pole that needs to be addressed for that to happen: cognitive symptoms. These often persist even when patients are euthymic, and they range from problems with memory and attention to more subtle deficits such as picking up on social cues and making wise decisions. 

Chris Aiken's article, Eight Ways to Improve Cognition in Bipolar Disorder, opens with these paragraphs. Ironically, what Aiken calls troublesome, I find immensely reassuring. My experiences are real!

Confessions of the Good Suicide Survivor Story

I was suicidal. I nearly killed myself. I am glad I didn't do it. Because I got better.

Moral of the story: You will, too.

That's it. That's the good survivor story. Hopeful. Virtuous. I have told that story, and when I do, I get all kinds of strokes, including publication of my writing on other websites.

Some of it is true. It did get better. For me. For now.

For now.

There is more to the story. When I tell the more, I do not get publication. I don't even get acknowledgement that my submitted piece was received. I guess I am submitting to the wrong websites, to places that have one story they want to tell, the good survivor story.

And like I said, it's true, some of it. According to David Conroy, there are 50 million people alive today who have struggled, are struggling, or will struggle with suicide. 45 million of them will die of... something else. That's success, right? 90% of us will find another way.

But that's not the same as the good survivor story. Because for the 45,000,000 of us who survive, we have all kinds of stories.

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.

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.

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.

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

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.

Suicide Is Not a Choice

I peered over this very overpass on the Eisenhower Expressway. Years ago, there was no the fence along the top, just a rail. It was pie that brought me there. Yes, pie. It was Thanksgiving night, and the holiday was ending without pie.

Of course, it wasn't a reason to commit suicide. Of course, suicide is a permanent solution to a temporary problem. Don't treat me like an idiot with your clever lines.

No, pie brought me there, but that was not why I would jump. Pie was a match, a tiny little three letter match. My problem was a brain filled with gasoline. And one tiny match, that I should have been able to snuff with my fingers, threatened to ignite it and send me over the edge. The shame of being powerless over one tiny match poured on more gasoline.

Trip the Light

I have noticed, people who are buying more guns seem to be more scared than the rest of us.  It is about pattern formation, the anterior cingulate cortex.  It can be your friend, or it can be your enemy.  Come on, people.  Have you forgotten Christmas so soon?  We can do better.  Like Matt here --



If all the days that come to pass
Are behind these walls
I'll be left at the end of things
In a world kept small

Travel far from what I know
I'll be swept away
I need to know
I can be lost and not afraid

Ring The Bells That Still Can Ring

Liturgical Christians, Catholics, Lutherans, Episcopalians keep a season called Advent, four weeks before Christmas.  It is a difficult practice, because it calls us to be thoughtful.  Thoughtful?!  You mean making a list and checking it twice?  No.  Advent is a time to acknowledge the truth that we hide from, behind our shopping lists and party schedules, the truth of emptiness and brokenness, in ourselves and in the world.  We are surrounded by Ho Ho Ho.  Advent says Hmm.

Advent says, Yes we will rejoice, because the baby, The Baby is born.  And yet.  And yet...

This has been a hard week.  Our defenses against the darkness have been found wanting.  And yet.  And yet...



Neuroscience of Meaningful Work

Fourteen years ago, I was offered a new job, Missioner for Ministry Development.  What's that?  Sometimes I said, I consult with organizations undergoing paradigm shift.  Other times I said, I do what Paul did.  Depended on the audience.

The details don't matter.  What does matter is that I got up every single morning rejoicing at what I felt privileged to do that day.  I considered it the job I was born to do.


Well, yes and no.  It combined my burning passion for advocacy, my deep appreciation of small congregations, and my abiding love for the highways and byways of Iowa, Beautiful Land, as the native inhabitants called it.

On the other hand, it gave me intense fourteen hour work days, conflict with long time friends, people across the state who piled their hopes, dreams and desperations on my back and the resistance of those who value certain aspects of an institution that others can no longer afford.  When we mixed all that with second generation antidepressants -- Keep trying, the doctors and my therapist said -- my bipolar II went into hyperdrive.  I was both madly productive and plain old mad.  It was beautiful.  It was ugly.  It didn't last.

Ellen Frank says that people with bipolar need to deal with grief for the lost healthy self.  It's one of the interpersonal issues that sabotage our adherence to the regimen required to maintain recovery.

Stages of Recovery - AKA Hope

It gets better.  It really does.

People who get tired of the Chemistry Experiment go off their meds.  Why?  Because the meds don't work.  Or they make us sick.  And the doctor doesn't hear us, because the doctor has one tool in his/her toolbox.  [Hint: It's not an ear.]  And he/she thinks that the solution to our problem is compliance, because there isn't time for listening and problem solving.

When you walk into a hammer store, they will try to sell you a hammer.  Fair enough.  If you are trying to rebuild the life that your illness took from you, chances are you will need a hammer.  Chances are you will need some other tools, as well.

The doctor doesn't have those other tools.  But they are out there.  And so is the map.

You are angry that the meds promised what they could not deliver.  Get over it.  Pull out the map.  Or the toolbox.  Mixed metaphor.  Whatever.  Get over it.  Get to work on your recovery.

The Recovery Map

Seventeen Keys to Recovery

Margalea Warner is one of my partners, along with Carol Porch, for a Mental Illness Awareness Week presentation in October, Recovery: Rewiring the Brain.  Margalea is active in the Mennonite Church in Iowa City.  They have been supportive on her journey in recovery.  She says there were some years when she was hospitalized so often she bankrupted their flower fund!

This week I am reposting her recent contribution to ADNET, Anabaptist Disabilities Network.  Margalea's story is one of those lights I hold up when things get dark.  I hope it shines for you, as well.

Keys to Wellness and Friendship -- by Margalea Warner

On August 12, 2012, a group of my friends gathered at the home of my friend Becky for a celebration of two major life milestones.  My friend Sherry had achieved twenty-two years of being clean and sober.  I had reached the milestone of seventeen years outside the locked psych ward.

Is Recovery Possible? - Kayla Harrison Continued

A few weeks ago I published a video interview with Kayla Harrison, USA's first gold medalist in judo.  The story was dated before her win, and showed her determination: if not London, then Rio...  (The source is the Boston Globe.  Kayla didn't make NBC's radar screen until after she won.)

Lots of shots in the gym.  A young lady you wouldn't want to mess with.

Except, her former judo coach did, starting when she was twelve years old and for three years.

Today, her former coach is in jail, and she has her gold.

Well, of course we love this story.  It follows the USA's favorite narrative arc: misery, struggle, justice, triumph.  We will listen to this story, read this book, watch this movie every night of the week.

Some of us will ponder it a little longer than others.  I expect Kayla is one.

Get Over It, Already

Kayla Harrison Survives Her Way to Gold

She's calling me out of sabbatical.  Damn!  She's calling for a series.  I'll have more next week.



Note added on 01/02/13 -- Links to other posts in this series are below:

Is Recovery Possible? - Kayla Harrison Continued August 25, 2012 -- The judo champ's story introduces the concept of recovery.
Seventeen Keys to Recovery August 30, 2012 -- Guest blogger Margalea Warner describes her journey in recovery in schizophrenia.
Recovery - The Medical Model September 7, 2012 -- Introduces the doctor's agenda, covers the first half of the story.
Recovery - The Medical Model Continued September 14, 2012 -- It was a great idea.  If only it worked.
Recovery Redefined September 21, 2012 -- People with a mental illness have our own definition of recovery.
Recovery - From What? October 1, 2012 -- You have to know where you are going if you want to get there.
Stages of Recovery - AKA Hope October 5, 2012 -- We recover in stages, and need different tools for each stage.
Neuroscience of Meaningful Work October 10, 2012 -- Oh goodie!  Here come the dendrites!
Hope for a Cure? Or Not? October 18, 2012 -- We finish the series with questions left unanswered, like, What is a cure worth?

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