Tuesday, December 23, 2008

TO WRITE: Holiday Ups and Downs
So how do you really feel about this holiday season? It can be confusing. Family, friends, partners and mall stores may all expect bliss; magazine articles on SAD and newspaper editorials on the economic downturn may feel like harbingers of depression. Not an easy time for folks with mood disorders. I know I can feel up one minute and down the next for no apparent reason. So perhaps our goal should be to maintain some sense of stability, equanimity, groundedness. But how?

Play with this. . .
Write continuously for 20 minutes on: What helps keep you on an even keel at this time of year? Write as if you are sending this to a friend who needs your advice. For me, writing itself -- including being alone and quiet for 20 minutes -- helps a lot. So do occasional naps (even short ones), eating protein instead of too many Christmas cookies, not watching too much TV or surfing the net too much, and giving charitable gifts in honor of family members instead of just buying gifts for the sake of buying. What helps you?

This holiday period is likely to have both ups and downs for each of us. I wish all of you moments of joy, periods of peacefulness, and the awareness that life will likely settle down some soon, so persevere even if it gets tough.
With warm regards,

Saturday, December 06, 2008

Amazing New Treatment Approved to Treat Depression
It really can be amazing! I know personally. . . .

What is it? The US Food and Drug Administration has now approved the use of a technique that uses strong magnets for "treatment resistant" major depression. This is great news for anyone who has not responded to at least two antidepressant trials and who would prefer not to be treated with the main alternative, ECT (electroconvulsive therapy or "shock treatments"), which can damage memory and carries some additional risks.

The new treatment is TMS or transcranial magnetic stimulation. It involves placing a device that generates a strong but precise magnetic field against a particular site on the left side of the skull, and delivering magnetic pulses for 20 minutes, five days a week for two to four weeks. The patient is conscious during the procedure, which can be done in a psychiatrist's office. What does the patient feel? Not a thing. What side effects are there? None reported at all except occasional mild headaches that respond to over-the-counter meds. No memory loss!

TMS will soon become more widely available, which I feel is fabulous news. You see, TMS completely turned my life around -- after many years of requiring a series of ECT treatments when a suicidal depression struck every few months, I was allowed to try the experimental TMS. Now, I'm technically diagnosed as bipolar, though I mainly experience depression, so my TMS targeted a different area of the brain, this one on the right side. Nonetheless, my treatment was a resounding success, as the newly-approved one has now been for many with depression in clinical trials. By the second week of treatments, the profound depression lifted and I was merely very depressed, but functional. By the end of week four of the five-minute treatments I was well! Really well -- back to baseline.

Now I needed to repeat this four-week series every few months for a couple of years as the depression returned, but the intervals between series gradually grew longer. And I'm delighted to report that I have not needed TMS (or ECT) for over two years! I've had no serious depression symptoms, and I've gotten my life back after 14 years of being unable to work or have kids. I wrote a book last year (see profile), I published it this spring and have been promoting it and, most important, my husband and I adopted a child this summer. Obviously I'm a huge TMS fan.

I know that no treatment works for everyone, but I believe that having more alternatives to try is the key for those of us who've been through every drug trial and don't know where to turn. This is great news.

Wednesday, November 26, 2008

Thanksgiving May Decrease Your Depression
It's true! And I'm not talking about the dopamine levels in turkey. In the last few years the new science of "positive psychology" has repeatedly shown that, "People who practice gratitude are more optimistic, report fewer physical symptoms of illness and pain, and lower levels of chronic stress and depression," as one researcher summarizes.

Sounds great, doesn't it? But note that you need to "practice" gratitude -- and that means writing it down. Aha! The key seems to be that we'll feel gratitude's positive effects not by thinking or even speaking about things for which we are thankful, but that these things must be written down.

The Thanksgiving season is the perfect time to start writing a daily list of three things for which you are grateful. They may be huge or tiny. I find it most helpful to write these as three sentences, "I, Beth, and grateful for...." You don't need to make a lengthy list or write for 20 minutes on any of these, although we sometimes do this in my classes. Just write down three things that make you feel thankful inside. To me, that feeling -- even if I can hold it for only a few seconds -- is incompatible with depression. So take three minutes and do it... now! A peaceful and joyful Thanksgiving to you all. --Beth

1) I, Beth, am grateful that I at last became a mom this year.
2) I, Beth, am grateful that it's raining out right now -- we need the water, and it smells fresh.
3) I, Beth, am grateful that I know that I'll have food available for dinner.

Monday, November 10, 2008

TO WRITE: Coffee, anyone?
If you are living with a mood disorder, I'm betting you have a special relationship with caffeine. Depressed? You may down coffee, tea and colas all day long trying to get an energy boost. Bipolar? You may need to avoid the stuff like the plague to keep it from nudging you up into hypomania or mania. And what about the large numbers of us who just can't sleep reliably, or who sleep too much, or who feel sedated by meds? Chances are you have thought deliberately about your caffeine intake. I've certainly pondered mine over my third cup of java.

I've always assumed that caffeine helps me stay more alert and focused, especially when I haven't had all the sleep I need. But a new study of coffee's effects says: NO! A new study in the Nov. 3, 2008 Human Psychopharmacology journal tested people taking caffeine or a placebo, both when they were rested and when they were sleep deprived. While some brainwaves did look different, they concluded: "The findings do not support the use of caffeine as a means for enhancing human function or as an antidote to the negative effects of sleep loss."

Are the effects of caffeine different in those of us with a mood disorder? We don't know. And that placebo effect resulting from our common assumption that it helps or hurts may play a role too. But it's worth considering all the evidence.

Play with this. . .
Write continuously for 20 minutes about your sleep patterns and your alertness and how you cope with any sleep or alertness problems. Have you found practical solutions? Share them! This is a big factor in improving and maintaining our health.

Friday, October 31, 2008

TO WRITE: Alternatives to Discrimination
I've been listening closely to advertisements for haunted houses this Halloween season. Last year an organization whose name I've gladly forgotten got national attention for creating a scary experience in what they called a mental hospital or psych ward, and for using numerous terms derogatory to the mentally ill, as well as trying to frighten people with the ideas of straight-jackets and unanesthetized electroshock treatments. Probably without thinking about what they were doing (I'll give them the benefit of the doubt here), they were painting mentally ill people as frightening, violent and dangerous. We are none of those things. Fortunately, after many letters and much protest, the group changed their theme entirely.

We've all probably felt some stigma around mental illness -- the comments from others that you should pull yourself out of your depression, or the dismissal of one's symptoms and oneself as "psycho." Very sadly, the worst result of the stigma around mental illness is that it causes many people to NOT seek treatment that could help them.

Play with this. . .
There are three sections to this exercise. First, write continuously for 10 minutes about any stigma you've been the object of for any reason -- your gender, race, ethnicity, sexual orientation, height, weight, age, etc. Then write for 10 more minutes on stigma you've experienced or observed pertaining to mental conditions. Finally, write for five more minutes on what you could tell yourself or that stigmatizer that would make you feel better about the situation -- perhaps pointing out to your boss or relative that you are coping with an actual illness and you are working hard to get well, or perhaps giving yourself a positive affirmation or self-talk to counter an uninformed or unkind comment.

Thursday, October 23, 2008

TO WRITE: Are you "bogged down"?
An email crossed my screen recently with a question that was attributed to, or arose from, Oprah's discussion of Eckhart Tolle's ideas: What makes you feel less bogged down?

That phrase "bogged down" makes me think of swampy muck tugging at my rubber boots; it makes me think of the poem Picture of Depression by Jo Bobbie in my book (p. 89). Both evoke good heavy images and feelings of depression -- ones that could help non-depressed people ("neurotypicals," as one student calls them) get a clue about how a real depression really feels.

Play with this. . .
Consider that weighty feeling of being bogged down, then consider its opposite -- feeling buoyant and agile and free to move and be yourself. Now write continuously (without stopping to think a lot about what word or idea is coming next) for 20 minutes on what lifts you from one state to the other; what makes you feel less bogged down? It might be a healthy meal, a chance to sit in nature and just think, a new part-time job, running a marathon, talking to a friend, counting your blessings or writing in your journal. You might be able to generate a list you can turn to later when you really need it. After you write, determine what one thing you can do for yourself right now to feel less bogged down, and do it.

Friday, October 17, 2008

TO WRITE: What would you love to buy?
Economically, times are looking very grim for most of us right now. And, whether we want to face it yet or not, the holiday season -- with all it's frenzied buying and extra expenses -- is fast approaching. Does all this money talk sound overwhelming? Today I invite you to set aside those stressful issues and think about you.

Play with this. . .
Write continuously for 20 minutes on the question: What would you love to buy if you could? For me, an eagerly awaited new book is a favorite treat, so I might simply purchase more books if I had unlimited shopping resources. Your tastes may run to larger items -- a new house? car? a tropical island? Or perhaps you'd like to buy a gift for a loved one?

After you write, reflect on why this item is important to you. Is it something you really could go out and acquire today? If so, go for it, and see how wonderful you feel. If it's unattainable until you win the lottery, consider why you'd like it and brainstorm on whether there's a smaller alternative that could provide the same pleasure.

Thursday, October 02, 2008

TO WRITE: Are Women and Men REALLY Different?
Gender differences have been discussed, and sometimes enforced, for eons, continuing in this election season, including tonight's VP debate. How real are these differences? More crucially, how important are they?

I'm observing all sorts of interesting things in this arena now that I have an 11-month-old daughter. Friends tell me they couldn't affect their girls' love of princess dresses even though they tried; men seem less likely to ask to hold the baby even when they beam contentedly when the offer is made and they reach out; strangers with a kind comment for the little one are unsure how to deliver it if s/he's wearing gender-neutral clothing below her short baby hair.

Play with this. . .
Write continuously for 20 minutes starting with: The real difference between men and women is... Or start with the differences between girls and boys. What differences have you observed recently? What conclusions have you drawn? Do you treat women and men differently? Do others role-cast you, and how does that feel? Is it advantageous or problematic to have differences? And do gender roles have any influence on your depression?

Thursday, September 18, 2008

TO WRITE: The Power of Peers
I returned this week from the national conference of the Depression and Bipolar Support Alliance, held in Norfolk, Virginia. The theme of the meeting was "The Power of Peers," and the lectures I attended, the response to the one I presented, and the conversations I had with fellow attendees all underlined for me the importance of this concept. Many at the conference were leaders of local DBSA chapters around the United States; some were peer counselors, peer trainers or peer advocates for mental health parity. Most were also living with depression or bipolar disorder themselves, or had a close family member with one of these illnesses.

I was impressed. I heard from people who focus on reducing the stigma around mental health, from a comedian teaching others with mood disorders to do stand up too, and from good souls who have managed to get Medicare to cover peer counseling for mental illnesses in some places. It felt good to be among so many who have a lot on their plate just dealing with their health challenges, but who then go further and help others who are struggling too. Keynote speaker, renowned author and Johns Hopkins psychiatry professor Kay Redfield Jamison proclaimed to great applause: "If you've survived mental illness, you have an obligation to give back."

Play with this. . .
Part 1: Write continuously for 15 minutes on how your peers help you. Do you attend a support group and feel listened to each week? Has a neighbor or friend-of-a-friend ever reported that she has depression too, and that you can call if you need to? What have you read that supported you in understanding your illness and gave you coping ideas (perhaps Jamison's An Unquiet Mind, for example)?

Part 2: Write continuously for 15 minutes again, but now look at how you help your peers with a mood disorder. For example, I'm encouraging people to begin their own writing groups more and more lately, as I've benefited so much from leading mine for these last 10 years. But simply sharing your writing with a peer can provide an enormous support too -- discovering we're not alone in our experiences offers powerful support and healing too. Are there other ways you "give back"?

Thursday, September 04, 2008

TO WRITE: What are you looking at?
I'm discovering that what everyone told me is true -- being a mom is a non-stop job. But, oh, are we having fun! And even when a break presents itself, like naptime for baby (when Mom can write a quick blog posting) or when Dad arrives home from work (and plays with baby) I'm finding it hard to stop watching her. After dinner the other evening, as daughter played happily on the floor by herself, Dad and I thought we would take an opportunity to have an adult conversation; instead we realized we were both silently staring at her with smiles on our faces, intrigued with her games.

Play with this. . .
Write continuously for 20 minutes starting with: My eyes were glued to. . . Write a memory of a time you couldn't stop watching something, or write some fiction, creating a short story of someone's visual obsession.

Then, at several times during the day, consider where you focus your attention. Are these the places you'd like to be staring at, or would you like to home in on other, perhaps more "positive," images?

Wednesday, August 27, 2008

TO WRITE: The Youngest, the Oldest

OK, so I've got babies on the mind. . . humor this new mom. (See earlier post today.) As my beautiful little one seems to do something new everyday -- she is soooo close to crawling -- I'm terribly impressed by her rapid developments. Our accrued learning over a lifetime is amazing.

Play with this. . .
Describe the youngest person or the oldest person you've known. What stories do you recall about this person? What have you learned from her or him? My paternal grandmother, who I knew well, lived in reasonable health to 97 years of age. In China we met a 96-year-old man who was fascinating in his physical flexibility and apparent health. He said daily tai-chi was his secret. On the other hand, the youngest person I've known well since I've been an adult is definitely my new daughter, just turned 10 months old. I'm adoring watching all the changes she's made in just the month we've known her, and I know I'll learn a tremendous amount as we evolve as a family. I think that reflecting on all three of these people will be a help when I'm feeling really low.

After a several-week hiatus on two continents, I'm thrilled to be back in the blogosphere . . . and delighted to report that my husband and I are now proud parents of a 10-month-old baby girl! We spent two weeks going through the adoption details in China (after three years of going through adoption details in the U.S.), then made our way home just as the Olympics began there. All three of us are adjusting well and snuggling a lot, playing on the floor a lot, and dealing with wakings at 2am. Couldn't be better, even with having to just snatch a minute here and there to answer email, write blogs, take a shower. . . .

A few years ago I would not have thought there was a chance in the world that I'd ever become a parent as I had hoped. I was in the hospital too much, getting too much ECT, obsessed with harming myself; I was seeing and hearing things. I was too ill with my depression to work, study, or function very well socially, much less be responsible for another person's life too. And then there were all the issues around how my meds might affect a pregnancy, and how a pregnancy might affect my moods. But, lo and behold, a solution arrived as my recovery progressed these last three years or so. I feel tremendously grateful to the Universe for this opportunity, and it makes me want to say to everyone that there IS hope for better things, even when your health is very poor. Persevere, educate yourself, try different things and remember you are valuable. And write -- for clarity, understanding, peace and planning your recovery. Write.

Wednesday, July 16, 2008

TO WRITE: How Does Writing Save YOU?
I make a big claim in my book: Writing saved my life.

Other things saved my life too when I was going through years of life-threatening depressions: Medical treatment (a supportive psychiatrist, lots of meds, lots of ECT, experimental transcranial magnetic stimulation, hospital stays) also saved my life. . . and good people (my husband, my mother, a couple of great bipolar friends) saved my life. Without all three, I'm not at all sure I'd have made it.

Author Alice Walker has also been rescued by writing. She says, "Writing saved me from the sin and inconvenience of violence." Clearly, writing can aid many of us in surviving of life's most difficult trials. Some use writing to touch their spiritual core, some use it to recover from pain, others use it to plan their recovery.

Play with this. . .
Writing continuously for 20 minutes, reflect on why you write. Go deep. What would your life be like if you never did any personal writing such as journaling or crafting poems for yourself? Even if you don't find life-altering reasons for writing, you may find that writing helps you organize your thoughts and plan your day, or perhaps writing allows you to calm and soothe yourself after a difficult experience.

After you've written about writing's importance in your life, go ahead and give yourself 10 more minute (at least!) to write on what you need to write on today. . . . What's happening in my life? How am I feeling? What do I remember? What am I looking at right now? Have fun with this, and remember, this writing thing can help in very profound ways.

Wednesday, July 02, 2008

TO READ: What If Writing Hurts?

A reader commented recently that sometimes writing about difficult experiences or issues left her feeling as though she were reliving that awful time. Is this ever true for you? What can you do to make your writing experience both productive and positive? Lots of suggestions follow.

First, let me reiterate my three "rules" for writing to ease depression (These are discussed in more detail in Writing through the Darkness). Boiled down, they are:

1) Write continuously for the whole time you've allotted yourself. (10 or 20 minutes to start.)

2) Write for yourself. (Perfection and careful arguments are not required.)

3) If a topic feels too threatening, don't write on it today.

About #3: As you write more often, you'll learn to challenge yourself while still retaining safe boundaries. If something feels overwhelming, wait. Write on something else less charged for now. You may want to talk to a therapist or close friend about the issue and digest it before trying it again next week or next month when it feels less scary. Trust your instincts and be safe first.

Other thoughts on writing on tough issues (Again, loads more on this in the book). . .

-- It's most useful to write about both thoughts and feelings in a single session, not just one or the other.

-- Try writing about the event in the form of a story: A character runs into a problem; the character tries (perhaps several times) to solve the problem; the character somehow solves it or resolves the situation (even if that means deciding to wait for now).

-- Don't let yourself ruminate endlessly on one particular problem if you're not making progress with it. Let it go for now and write on other topics and come back to it in a week or a month.

-- Talk with a therapist about the issue to see if you can break the logjam in your thoughts and find some new perspective.

--Always try to end a tough writing session with even a few minutes on a positive topic -- try three quick minutes on the most relaxed you've ever felt, what you would do with $100 if you found it on the street today, or the most soothing image you can imagine.

Good luck, and remember to follow your instincts and make caring for yourself the number one priority with your writing.

Tuesday, June 24, 2008

TO READ: Is Exercise the Answer?
If it wasn't clear to me before that the obesity-depression relationship is a big issue for many of us, it is after your comments on my recent post on the topic. But what do we do about it?

As everyone knows, diets can be very tough. And if you're already depressed, you may be fighting with low motivation to eat more healthy stuff and less junk food. You may also be one who turns to comfort food when your mood drops, despite knowing that those calories add up quickly. It's not easy for me today, but earlier in my life I diet easily, drop a few pounds, then forget about it. Now, with bipolar disorder (mostly depressions) and its attendant medications, I'm really struggling. I still haven't gotten off all my Clozaril pounds, despite being off of that drug for years. Sigh. But. . .

Then there's the other side of the issue: exercise. Unfortunately I nearly stopped my exercise program last year as I focused on writing my book. And boy could I feel it. Several weeks ago, however, I got back on that horse, joined a small women's gym near home, and I've been taking exercise classes there. The classes work for me because they obligate me to be there at a certain time, so I can't procrastinate the entire day long. After the first two, I came home, sat down, and literally didn't know if I could get up a few minutes later. But, those sore exhausted muscles at least told me I was doing something.

The exercising is getting a bit easier now, and those jeans are in fact fitting a little better already. But can it really help me overcome my weight gain? And do I have to diet too? Hundreds, if not thousands, of studies demonstrate that regular exercise is the key to preventing and healing nearly every ailment. And we all know that those endorphins it produces are mood-lifting. We know we should do it, but it's still tough when you're depressed.

What do you do about exercise -- and how does exercise interact with your depression and your meds? Does it help you lose or maintain weight? Does it help you feel less depressed? More energetic? Proud of yourself? Let me know what you think -- I can use all the opinions I can get as I still have to push and push to get my shoes on and get to those aerobics classes three times a week.

Friday, June 13, 2008

TO READ & WRITE: Shockingly Great News!
We're still stunned. But happily stunned. My husband and I are in the very, very long process of adopting a little girl. . . .

As you may have read here in early April, our hearts were broken when, after receiving an assignment to a lovely 18-month old whose photos we fell in love with immediately, we learned that her medical report showed that she was not healthy, as we had been led to understand. Instead, she was at serious risk of severe health and developmental problems and in fact should have been considered a "special needs" child. We were neither trained nor authorized for an SN child. Our adoption agency very firmly recommended that we not accept this assignment. And after days of research, multiple medical experts' reports, counseling and soul-searching, we made the gut-wrenching decision to refuse the assignment. We did this with the understanding that she would be quickly adopted by a special needs family. (And we remained at the top of the list for a new referral.) We continue to mourn her -- she will always be in our hearts.

Now, two months later, we have received a new assignment. On Tuesday we learned that her file had arrived; on Wednesday morning it had been translated and completely reviewed and approved by the adoption pediatrician; at that point only were we ready to make the dash to San Francisco to see the file and the precious photos of our new daughter-to-be. She's gorgeous! She's eight-months-old and looks healthy and alert.

We are very, very happy. And we are still feeling stunned too. Parts of our hearts are, even now, guarded until she is in our arms at home. It's been an unbelievable 72 hours in our house. But shock that after three years this could really come true, and that we could possibly be so fortunate, is slowly ebbing -- and joy is rising, pure and clear.

TO WRITE: Shocked!?!
I've just written about the amazing swirl of emotions I've been in in the last few days since receiving our adoption assignment. Shock has been a big one. After three years of working toward this and waiting and waiting and one serious problem, our wish seems within reach. We hope we'll have our little daughter in our arms within the next couple of months. Yet I'm surprised.

I suppose I've guarded my heart and turned off a lot of feelings over this time, just in order to write my book, keep my mood stable, and basically function. But still, I'm rather shocked at how shocked I am, and I'm slowly working this through so that I can focus more completely on more important emotions, like being thrilled.

Play with this. . .
Write for 20 minutes about a time you were shocked by something. It may have been a good big surprise, or something less welcome. How did you feel at the time? And were you still feeling it later? How have you processed it, or is it still a pressing issue for you?

Saturday, June 07, 2008

TO READ: Depression and Obesity. . . and Depression

"Theory and research suggest that obesity and depression may be causally linked," says the summary of a new study in the journal Clinical Psychology: Science and Practice. If you are living with depression, chances are that you've already made that connection on your own -- after all, while some of us tend to eat (and sleep) less when we're depressed, there is also a substantial proportion of us who tend to eat and eat and sleep and sleep to try to ease the pain.

I happen to be an eater and sleeper; I especially crave carbohydrates (i.e., cookies and scones from Starbucks) when I'm way down. And, despite being a healthy weight until taking an atypical antipsychotic (which shall go unnamed) a few years ago when absolutely nothing else was helping, I'm now 20-30 pounds above where I'd like to be. It was much worse for awhile -- I gained 80 pounds in less than a year on this stuff. Very fortunately, when I finally got off of it to try a newly-released alternative, 40 pounds evaporated on its own. I've dieted to get rid of some of the rest, but it comes and goes and comes and stays -- and it's somewhat "depressing." And it often does feel like there's a chicken-and-egg quality to the situation.

So when I saw this research study suggesting that depression can lead to obesity and obesity can lead to depression, I took note. Long-term studies show that obesity predicts later depression. The authors propose that this may be due to either health or appearance issues. Meanwhile, there's some data showing that depression increases the risk of obesity, likely due to lack of exercise, negative thoughts or lack of social support. The suggestions for treating both of these include, not surprisingly, "behavioral activation" (diet and exercise) and cognitive-behavioral therapy -- but the scientists emphasize that no one's really studied how to treat both together yet.

What do you think? If you're living with both these conditions, which came first, and to what do you attribute the other? If you've recovered from one or both of these, how did you do it? I myself consider my bipolar disorder (mostly depression) well-managed now, but when I'm even slightly down, I judge myself harshly for my excess pounds. I can imagine these problems going either way.

For more info: Clin Psychol Sci Prac 15:1-20, 2008.

Monday, June 02, 2008

TO WRITE: Waiting and waiting. . . and waiting

I just spent a good five minutes on hold with a national company I do business with before hanging up in disgust. (I know, I know, you've spent 15, 20, 30 minutes in such situations. Still, I say anything over 10 seconds starts to get miserable.) And why don't they just play some dignified classical music instead of old Neil Diamond hits of the '70s?

Waiting can be tough, whether its for customer service or for something much more serious -- getting a call about an adoptive child (We're still waiting!) or a hint of relief from severe, chronic depression symptoms.

Play with this. . .
A writer friend of mine recently challenged her students to write on the question: What are you waiting for? Take 20 minutes to answer that one, writing continuously without stopping to edit yourself a lot.

Are you waiting for the confidence to register for that class you've been wanting to take? Is it the nerve to ask him or her out to dinner? Is it the energy to pick up your pen and write? Are you waiting for that last 20 pounds to disappear? After you've written, take five minutes more to consider what you might be able to do to either make the waiting end sooner or to better get through it. In my experience, my mental health depends upon this.

Thursday, May 22, 2008

TO READ: My Internet Radio Interview

Here's an email I sent out to friends, family, colleagues and students about my radio interview -- which is today! If you'd like to join my mailing list, please send your name to: EMSchaefer@aol.com. Thanks!

Dear friends,

I'm thrilled to announce that thanks to the help and support of many of you, my book, Writing through the Darkness: Easing Your Depression with Paper and Pen, has been released and is now available!

If you've wanted to learn more about how writing can ease depression, I invite you to tune in to a live, nationally-syndicated Internet radio show today, Thursday, at 3:20pm PST. I will be interviewed on World Talk Radio, which is accessible through the Internet at
http://www.modavox.com/WTRStudioA/. If you are not available at that time but are interested in getting a podcast of the presentation, you will be able to do so following the show by clicking http://www.modavox.com/WTRStudioA/HostModaviewForWTR.aspx?ShowId=440&BroadcastId=31517&ScheduleTime=15.

Many of you have already witnessed the power of writing. If there are others who you feel would be interested in this message, please forward it to them so they can tune in to the show or visit my website at

Thank you and be well!

Monday, May 19, 2008

TO READ: My Book is Available!
I'm delighted to let you know that my book, Writing through the Darkness: Easing Your Depression with Paper and Pen, is now widely available, both online and in bookstores. (If your bookstore doesn't have it, ask for it!) The official publication date is not until June 1, but lots of folks are telling me that they're finding it at various locations -- one chain bookstore I visited this week told me they'd already sold out of it and were ordering more, which of course does a new author's heart lots of good. To order online, go to my website, www.emschaefer.com, and click on the "order this book" button. Or, just go to www.Amazon.com.

Writing through the Darkness is a practical guide to using creative writing to help heal depression. For over 20 years I've coped with severe depressions due to my bipolar disorder. I've tried at least 25 medications, years of psychotherapy, over 100 electroconvulsive (shock) therapy treatments, transcranial magnetic stimulation, as well as acupuncture, herbs, energy adjustments, meditation regimens and more. But I discovered that writing was my friend, companion and, at times, my savior, through it all.

I've been leading a creative writing group for people with depression, bipolar disorder and other conditions for ten years now. Along the way I've studied the research on how writing can help us emotionally and how other authors and poets have naturally been drawn to it to cope. Writing through the Darkness is my offering of this healing tool to you. I hope you will find it encouraging and informative as you learn new ways to ease the pain of depression. Please let me know what you think!

Thursday, May 15, 2008

TO WRITE: Your Gang
What organizations or informal groups do you belong to? If you're like me, you can name quite a few. I'm a member of NAMI and DBSA, several writing associations, a gym, charitable organizations, alumni associations, on and on.... Then there are the less formal groups: two writing groups, a group of church friends interested in multiculturalism, my old high school gang of four close friends, a book group, and, of course, my family and my neighbors.

It all looks a bit daunting as I start to list them here. But I think most groups I am a part of do offer some benefits. Some provide a sense of camaraderie, a sense of shared purpose, educational opportunities, or -- most critically -- friends and support.

Play with this. . .
Take about three minutes to quickly jot a list of groups or organizations to which you belong. Then take three more minutes to list those you've belonged to in the past -- remember, your fifth grade class counts, as do any religious or business affiliations you've had. Now write continuously on one to three of these items, considering what your emotional experiences are or were there. Did you feel uplifted and aided in a depression support group? Did your softball team provide friendship when you needed it? Did your high school graduation class offer enjoyment, or was it all a burden?

Finally, how could you improve your life in terms of the groups you belong to now? Could you audit a class or find a few folks who like museums? Personally, I'm feeling stretched way too thin right now, so I'm trying to take leave of a few volunteer activities and focus more on things like the writing group I lead and the one I write in. I'm also realizing there may be times in the future when I'll benefit from a mood disorders support group again -- one of my saviors in past times. Try to be creative and keep all your options open.

Wednesday, May 14, 2008

TO READ: Unipolar and Bipolar Depression -- Differences
Many of us, psychiatrists included, tend to assume that a depression is a depression -- whether it's a unipolar one (ie, "major depression") or due to the depressed phase of bipolar disorder. But a recent report says that's not so.

British researchers compared 593 people with major depression and 443 with bipolar disorder, looking at their depression symptoms and the course of their illness. The findings showed several distinctions. Bipolar depressions tended to more often have:

* the presence of psychosis (ie, delusions or hallucinations)

* daily mood variation

* hypersomnia (sleeping too much) during depressive episodes

* more shorter depressive episodes

These are all features you may want to keep an eye on and discuss with your mental health care provider because treatments for the two illnesses do differ.

For more information: The British Journal of Psychiatry (2008) 192:388-389.

Friday, May 09, 2008

TO WRITE: Coming Out the Other Side

Thank you to all the kind souls who offered sympathy and solace in response to my recent "What a Disappointment" posting. Today's news: It's getting better.

We're still waiting for a new adoption assignment, which could anytime. I'm still a bit sad and fatigued from it all. But -- I am not having a depression. Hurray! My fears that this situational depression would trigger a severe neurochemical one that would take me to a hell hard to escape from have not materialized. And now even the situational depression is gradually healing, and I'm slowly finding myself able to look forward more easily.

A very wise person pointed out that I may need to pay special attention to doing physical, sensory activities during this time, and that has paid off. Rather than letting myself stare into space or sleep too much, I've been pushing myself to journal about the situation, to read for pure pleasure, to shop, to prepare simple meals, to talk to friends. It's grounding.

Play with this. . .

Write continuously for 20 minutes on what "grounding" activities could help you through your next difficult period. Could you exercise or just walk, paint or take photos, visit a bookstore or cafe, go to a museum? And what about writing? Research indicates that writing about a tough situation can help us organize it in our mind, get it out emotionally, and even change our behavior -- and can boost immune system function. Why wouldn't you include it in your box of healing tricks? Let me know what works for you.

Tuesday, May 06, 2008

TO READ: My New York Times Online Letter
Last week's science and health page of the New York Times (It comes out on Tuesdays and often has great brain, psychology, and mental health articles -- and it's free online.) had a book review entitled "Quieting the Demons and Giving Art a Voice." It described two new books on aspects of creativity and mental illness. I'm sure I'll read both soon, and likely enjoy them, but one of the conclusions drawn from both is that depression silences people's creative voice.

But no! My new book, Writing through the Darkness: Easing Your Depression with Paper and Pen (available online now; in bookstores June 1), provides evidence that in fact creative writing can be used to help work through even a deep depression. So I wrote back, and my letter appeared in this morning's NYT online edition: http://www.nytimes.com/2008/05/06/health/06weblett-ARTANDMENTAL_LETTERS.html?ref=science

Check it out, and you can also link from the letter back to the original article. I'd love to hear what you think. I believe it's crucial that people with depression, bipolar, or other mental illnesses -- especially those newly-diagnosed -- understand that this does not spell the end of their creative life. Although it certainly will present new challenges, I believe our creative life can actually be fed by our mental difficulties if approached correctly. And I believe our creativity can help heal us too.

Tuesday, April 29, 2008

TO WRITE: What a Disappointment
I'm back after a several-day hiatus brought on by a severe disappointment. As I described recently, my husband and I have been waiting for our assignment to a specific child we will be able to adopt very soon. The great news: We got darling photos and a report on an 18-month old little girl. The awful news a few days later: Her medical reports indicated she was at risk for very serious neurological and developmental disabilities. Our lives crashed.

Long story short: After days of research, second and third medical opinions, consultations, counseling and soul-searching, we declined to adopt the child. Our adoption agency strongly recommended that course of action, saying that she would very soon be adopted by a family trained and authorized for a special needs child, which we are not. Meanwhile, we'll be assigned another little one soon.

I've felt as depressed lately as I have in over a year, and my husband and I have been terrified that I'll really slide seriously. However, we got away from the Bay Area and spent several days hiking in the Sierras last week. Near a river rushing with melting snowpack, with wildflowers coming up everywhere, we created a small ritual, telling this child we'll never meet that we love her and won't forget her, and letting her go. And we began to heal.

Play with this. . .
Think of a significant disappointment you've faced in the past. Write continuously for 20 minutes, describing the situation and your thoughts and feelings about it. (Remember, describing both your thoughts and feelings has been shown to be more healing than just writing about one.) Then describe how you have coped with that disappointment. Did you talk with someone, take some concrete action, let time slowly soften the feeling?

Keep in mind too that you have survived and, by the very fact that you're here, it's clear that you've coped or you're coping with the situation. That thought has helped me lately. It hurts sometimes, but I'm still moving on. -- Beth

Tuesday, April 15, 2008

TO WRITE: Who are You on Meds?
This morning's New York Times features an essay asking: If you've grown up on antidepressants, or even been on them a long time as an adult, do you still have a sense of who you are?

I know my mood is dramatically better, my thoughts less self-critical and morbid and out-of-touch, on my medication. But after more than 20 years on the stuff, who am I? There are things I notice: It 's very hard for me to feel really excited happiness (perhaps due to my mood stabilizer?) and I physically am unable to cry except in the most extreme situations (Have all those antidepressants pumped me up that much?). But I wonder if there's more.

According to the article, by Richard A. Friedman, M.D., we know very little about the long-term effects of these medicines. The studies generally focus on people's reactions for only 4-12 weeks. The longest maintenance study so far has been on Effexor, and lasted two years. (It was better than a placebo at preventing relapses.)

Play with this. . .
Writing continuously for 20 minutes, compare what you notice about yourself on and off medicines. Consider your moods, your thoughts, your feelings, your bodily symptoms, and how long you've taken these drugs. Do your meds affect you ability to work or study, or your relationships? And do they affect your "sense of who you are"?

Hopefully, you'll conclude that you're heading in the direction that is healthiest for you. If not, talk with your mental health care provider.

Monday, April 07, 2008

TO READ: Genetic Testing for Bipolar
How would you feel if your psychiatrist could simply run a blood test to diagnose bipolar disorder? Recent research describes early studies that do just that. According to a National Alliance on Mental Illness (NAMI) press release, University of Southern California scientists have identified 10 specific genes involved in mood state. Using blood tests to determine whether each gene is active, and correlating this information with 29 bipolar patients' mood states, they found that eventually they could actually predict moods.

So what do you think? Is this what we've been seeking all along -- a definitive diagnosis that might mean more accurate and faster-working treatments? Or do you worry about that information falling into the wrong hands? And would this genetic information lead to more stigmatization (ie -- you're definitely "mentally ill") or less (ie -- it's clearly a biological issue, not a character weakness)?

According to NAMI, MSNBC.com did a poll of 10,000 readers and found that 83% thought a blood test would be a good idea since it could help patients get appropriate treatment. I suspect a poll of 10,000 people with mood disorders would yield much more mixed results.

Friday, April 04, 2008

TO WRITE: A Turn for the Better
I'll keep things short and simple and sweet today. . . I'm nervously listening for the phone to ring with a call from the adoption agency saying they've got our first photos of our daughter-to-be! At that point my husband and I will dash to San Francisco to get them. Today (hopefully, hopefully) will be one of the best days of our lives!

Which brings me to today's topic -- an optimistic one that my Stanford group wrote on this week. They wrote very briefly, but their responses were so powerful that I assigned them to write more on this as homework.

Play with this. . .
Here's the prompt: Life took a turn for the better when. . .

Quick! Write down the first thing that comes into your head. Write on it for just three minutes.

Then, write continuously and powerfully for 20 more minutes on this life-changing thing or person or event. And enjoy! (I think my life might just "take a turn for the better" today -- and you can bet I'll write on it!)

Wednesday, April 02, 2008

TO READ: Blogging to Beat Depression?
Millions of us blog these days. Among other things, blogging offers an opportunity to create a diary that includes emotions, as well as events, to share with others. But is blogging, like some other forms of writing, able to help ease depression?

Australian researcher James Baker of the Swinburne University of Technology says yes -- but for a surprising reason.

Baker has found that, in fact, people who begin blogs tend to be "more distressed emotionally" than others. As he told an ABC Online interviewer last month, new bloggers show "high levels of stress, anxiety, depression. They are also more likely to vent emotionally and self blame a bit as far as coping."

However, when Baker surveyed about 130 people, 60 of whom then started a blog, he discovered that two months later the bloggers had changed. They were "a bit happier overall . . . a little bit less distressed," he reported, "but the big difference was that people who actually started a blog felt more socially integrated." This feeling of connection comes from the fact that bloggers are making personal material public, receiving comments, and developing a sense of an online community.

He suggests that, ironically, perhaps people's private postings can help them become more connected to the outside world and, along with that, less depressed.

Sounds a lot like the findings I report in Writing through the Darkness: sharing what you've written is often an important part of the healing process. So, whether you're currently journaling, writing poetry, or, hopefully, doing the exercises suggested in this blog, consider sharing them, either online or person-to-person.

Thursday, March 27, 2008

TO WRITE: A Farewell
I'm reading Natalie Goldberg's new book on memoir writing, Old Friend from Far Away. (If you've been reading long, you know I'm a big fan.) As in many of her books, she offers lots of writing topics and ideas, and this one's from her today, with my paraphrasing.

Write a goodbye letter to someone. It could be after a divorce, when a friend moves across the globe or a relative dies. Tell them every last thing you have to say -- this is your last opportunity. You may have complaints, praises, specific awful incidents or glowing memories to share. Get it all out. As Natalie almost always adds: "Ten minutes. Go."

Then (and this is Beth again), consider how you feel. Stirred up, relieved, sad, glad, depressed, lighter? Are there other people, leaving or not, that you'd like to write to? Letters, of all different kinds, can be a powerful way of releasing pent up emotions and ideas. Let yourself go when you write them -- you can decide later whether to rip them up, burn them or send them.

Tuesday, March 25, 2008

TO READ: No Shame around Depression

I've always felt that the way to combat the stigma around depression and other mental health conditions is to talk about them. These are illnesses, not character flaws. So I was delighted to read this week that, although she unfortunately suffered depression in her 20s, Harry Potter author J.K. Rowling makes no apologies for it.

"The funny thing is, I have never been remotely ashamed of having been depressed. Never. What's to be ashamed of? I went through a really rough time and I am quite proud that I got out of that," the Seattle Post-Intelligencer quotes her as telling a British college magazine. Now that's the attitude we need see and hear more of.

Rowling, 41, said that after separating from her first husband and finding herself a single mom and struggling new writer, she experienced depression and suicidal thoughts. She reported that she sought treatment because of her daughter.

So take heart. As more and more of us are coming out with our mental health conditions, the world does gradually make progress at learning they are simply a no-fault part of life. As so many peers have said to me, no one would tell us to "pull yourself together" if we had heart disease or a kidney stone; why should a brain disorder be treated differently? Thanks for your example, Ms. Rowling.

Thursday, March 20, 2008

TO WRITE: Your Sleep Life
Sleep is a crucial, and often disturbed, part of life for those of us coping with depression. Whether problems are due to medications or the condition itself is not always clear. And the symptoms we experience can vary from slightly disturbing to exasperating to just plain weird.

I'm blessed in some ways, I suppose, because I rarely have insomnia. No, my sleep life leans quite the opposite way, leaving me wanting -- sometimes absolutely needing -- to sleep two to four to even six hours more than what most people consider a good night's sleep.

I've had many bizarre and unsettling sleep experiences when depressed, or even months after my mood has recovered. On one first-generation antidepressant, for example, I regularly sat up and opened my eyes during the night to watch amazing and often funny scenes play out in front of me. When I enthusiastically urged my husband to look at these hallucinations, he would have to talk to me or shake me a bit to wake me from my strange state.

Play with this. . .
Write continuously for 20 minutes about your sleep life. Do you have lots of wonderful dreams? An occasional frightening one? Do you need extra medicines to help you get a few hours of rest, or do you feel nearly narcoleptic when you're depressed? Do you find you have unusual thoughts just as you fall asleep or wake up? How does your sleep, or lack thereof, effect your mood? And how do you feel about all this -- angry, frustrated, bemused, relieved? Don't think too much, just let it rip and see where this topic takes you.
TO READ: "Against Happiness" ??
I was amazed to read that a new book, Against Happiness: In Praise of Melancholy, by Eric G. Wilson, actually lauds the experience of sadness or "melancholia" to the extent that it asserts that antidepressants should be used only for severe depressions, not for mild to moderate cases. He's got to be kidding, right?

Against Happiness, clearly titled as a comeback to Peter Kramer's book Against Depression, was reviewed in last Sunday's New York Times by National Public Radio star Garrison Keillor. According to Keillor, Wilson argues that America is so focused on happiness that melancholia -- which he believes is the the source of much great art, poetry and music -- is disappearing.

I've not yet read the book, and I'm not sure I will, for frankly I find this argument depressing. I've written about creativity and the writing-depression connection in my book, Writing through the Darkness: Easing Your Depression with Paper and Pen (to be released in June, 2008). Indeed there are correlations between bipolar disorder and artistic creativity, and much lesser correlations between depression and creativity. Who knows, maybe a lot of art and literature has in fact been born of low moods? So maybe, one can argue, melancholia (which Wilson sees as "turbulent," while depression itself is "passive"), has a certain benefit for society as a whole. (By the way, I know I've certainly had both passive and turbulent clinical depressions, so I don't buy this distinction.) But if it causes suffering that could be abated, I say get rid of depression.

If mild and moderate depressions are not treated, they can become severe depressions. And if a person wants her or his melancholia treated, and a qualified professional believes it appropriate, by all means it should be treated. (If a person is merely transiently sad, an antidepressant isn't going to do the trick anyway.) If a person doesn't want such treatment, and some artists don't, at least at times, I respect that. But to argue, as Wilson does, as cited by Keillor, "The greatest tragedy is to live without tragedy," is to romanticize depression. A romantic aura around what are biological brain disorders stigmatizes these conditions, and stigma contributes to many people's reticence to seek treatment.

Even if melancholia/depression does lead to some creativity, I can't believe it has cornered the market on human innovation. If human suffering can be alleviated, it would be very sad not to do it.

See: Eric G. Wilson, Against Happiness: In Praise of Melancholy (Sarah Chrichton Books/Farrar, Straus and Giroux); Garrison Keillor, Woe Be Gone, New York Times, March 16, 2008.

Wednesday, March 12, 2008

TO WRITE: Organizing Your Life
As I write this, I am surrounded by piles of papers covering my desk. Some are messy, some relatively neat; some are short, others tall; some were born today, at least one is a year old, I'm embarrassed to say. I've been meaning to straighten up, sort, file and toss -- really.

While I'm sure I'm not alone with my paperwork problem, we all have much larger things to organize too. Like our life in general. How are your priorities? (What are your priorities?) Are you using your time, money, talents and energies the way you'd like? Are there activities you're dreaming about but not getting to?

Personally, I'm trying right now to find more time for myself in my schedule. I'm leading my writing group, attending another, taking yoga classes, doing marketing work for my upcoming book, starting to prepare for the arrival of our adopted baby in a few weeks, trying to write, etcetera, etcetera -- and I'm spending way too much time on other volunteer work, especially the omnipresent meetings it involves. So, I'm getting out of a few things. I've felt reluctant, even ashamed, to say "No" to several things lately but, have discovered that it's actually empowering! I can decide how to spend my time and, frankly, the world won't fall apart without me being involved in every decision.

Play with this. . .
Write continuously for 20 minutes about something you'd like to organize in your life, whether it's one bathroom drawer or your entire calendar. How would it feel to just begin your organizational task? How could you break it down into manageable components? (I was intrigued to find recently that more than one person in my writing group proposed this topic on an anonymous suggestion sheet. I suppose we do tend to feel disorganized and out of control when we're depressed.)

Then consider how you would feel after organizing something. For me, a clean desk is like a new start on life. Maybe you too would feel empowered, free, or pleased to accomplish something tangible. If you're depressed right now, start small -- just delete three bulk emails you're not going to bother reading anyway, or toss out some junk mail that's accumulated on the kitchen counter. Voila!

Friday, March 07, 2008

TO READ: Antidepressants Don't Help Most Patients?
Could we have been misled by the "non-publishing" of studies that show poor results for common antidepressants? New research combining both the "good" and "bad" results of many studies on antidepressants' effectiveness suggests so. The new data says the medicines are no more beneficial to most patients than a placebo pill, and only help certain severely depressed people.

Irving Kirsch of the University of Hull, in the United Kingdom, along with colleagues from the US and Canada, studied Prozac, Effexor, Serzone and Paxil. They used a statistical "meta-analysis" to combined the data from all the trials submitted to the US Food and Drug Administration. Data from some of these studies had never been published, and some included what might be considered disappointing results.

The scientists found that patients with moderate depression responded almost equally well to the drugs versus a placebo. In addition, "Drug–placebo differences . . . are relatively small even for severely depressed patients." The severely depressed people seemed to respond to medicine somewhat better, but this was attributable to the fact that they responded worse to the placebo.

For additional info: see PLos Medicine (a peer-reviewed journal of the Public Library of Science) for February 26, 2008.

Tuesday, March 04, 2008

TO WRITE: Just Wastin' Time
Here in the U.S. many people feel that there's something "wrong" about just sitting and letting the mind wander for a while sometimes. There are things to do! This idea is so prevalent that many believe they shouldn't even do one thing at a time, but must multi-task. Now that I'm feeling considerably less depressed lately, I find myself succumbing to this thinking at times too. But honestly, if I stop to think, I feel that occasional time spent reflecting on the day and composing my thoughts or "spacing out" is a wonderful activity.

If you're depressed, chances are good that even accomplishing the simplest activities may seem overwhelming -- whether it's making it to the office on time or just getting your teeth brushed. When I've been in such states, I tend to chastise myself for not getting off the sofa and acting; I ruminate about what others are getting done. But from a now-healthy perspective, I see I should sometimes let myself relax and doze freely or flip through a magazine without guilt. I'm not arguing that we shouldn't fight like tigers to get well, but that now and then, guilt-free "wasting" time is healthy.

Play with this. . .
Write continuously for 20 minutes starting with "When I waste time. . ." You may want to consider what you do, when you do it, and for how long. How do you feel about it at the time or afterward? Would you like to adjust the amount or frequency of your "wasting" time, or perhaps your attitude toward it? (Maybe you want to go for a walk or stare at the wall for a half hour before you write this. . . .)

Wednesday, February 27, 2008

TO READ: Today's the Day
I'm very excited to announce to my readers that today my book, Writing through the Darkness: Easing Your Depression with Paper and Pen, went to press!

Copies will be in bookstores in June. If you find this blog interesting or useful, I think you'll find this book valuable. It's a writing guide that provides a menu of approaches -- freewriting, memoir, poetry and storytelling -- to help cope with the pain and confusion and stigma that surround depression. I also describe my own journey through bipolar depressions, and the exciting research that's been done on the writing-depression connection. Many of the wonderful members of my creative writing group for people with mood disorders that meets at Stanford University have contributed encouraging comments and samples of their work. I hope you'll check it out in June.

-- Beth
TO WRITE: Freedom
I'm reading The End of America by Naomi Wolf, and it's scaring the heck out of me. Wolf's studies indicate that there are ten changes that occur in countries just before they move from a democracy to a fascist state, and that the U.S. is going through all ten right now. Sound alarmist? I thought it would too, but her evidence and her arguments seem very strong so far.

Especially after having lived for several months in the Soviet Union when I was a teen, I value my American freedoms tremendously. For example, we're allowed to say and write what we want, basically. But there are lots of other types of freedom I value too. How about the freedom of spending my life outside of the walls of a mental institution, except under extreme circumstances, when I want to be there anyway? (Granted, we have short forced hospitalizations for those deemed to be putting themselves or others at risk -- what's known as a "5150" here in California.) How about the freedom to decide on how I'll treat my depression? How about the freedom to pursue what I want to do with my time and resources?

Play with this. . .
Write continuously for 20 minutes starting with: "The freedoms I have. . ." You might describe your freedom to wear the clothes or hairstyle you want, the freedom to read what you want, or the freedom to explore the entire Internet, if you are in a country that allows those things. Or you might explain your feelings about a freedom you feel you lack.

Then consider how your freedoms affect your psychological life. Does thinking about them make your life feel a little less confined? How do your thoughts of freedom affect the emotions and thoughts you allow yourself to feel and share?

Thursday, February 21, 2008

TO WRITE: Gimme a Hand
When we're depressed and it's hard to function, it's natural to wish for some help from our doctors, family and friends. That's one reason support groups for mood disorders are growing in popularity, and presumably one reason they've been proven to improve the course of members' depression.

But there's another aspect to this concept of people helping people. When we help someone else we tend to feel much better too. Think about it: How did you feel last time you held a door for someone struggling with packages? How do you feel when someone close says, "Thank you," for listening to their problems or assisting them with some task? I know I immediately feel good about myself -- the complete opposite of the way I usually feel when I'm depressed.

Play with this. . .
Write continuously for 20 minutes about a time when you helped someone else. Have you ever given information to someone newly diagnosed with depression, for example? Have you ever given a little money to someone who really needed it? Done any volunteer work?

Then describe how it felt. Maybe it diminished your depression for even just a minute? Is it something you'd like to try to do more of?

Wednesday, February 13, 2008

TO WRITE: It's a Secret!
Whether you want to admit it or not, you know you've got some. . . . Today I'm thinking of the new hiding place I found for the heart-shaped box of chocolates my husband's not supposed to see until tomorrow. (He recently discovered the behind-the-desk spot I'd used for birthday and Christmas gifts for years.)

Of course, you may have larger issues from the past looming unsaid, or you may have tiny guilty pleasures. You may have secret aspirations too. (Who says writers can't be superheroes or ballerinas on the side?)

Play with this. . .
'Fess up. Remember that this, like any writing, can be hidden, discarded or destroyed as soon as it's finished, so go ahead and let it all out. Write continuously for 20 minutes starting with In my secret life, I. . . .

Then read what you've written and see how you feel. Has a burden been lifted, or perhaps a new idea hatched? Or do you realize that you're really craving a pint of ice cream and an afternoon of soap operas? Let me know what you discover.

Tuesday, February 05, 2008


We've all got fears, large or small, significant or pretty trivial, relating to things likely or unlikely to occur. For example, while I'm fortunate to have no major phobias, I am not comfortable with snakes. I can touch, or even hold, someone's pet serpent for a moment, but the idea of suddenly coming across a snake when hiking makes me squeamish, even if I know it's unlikely to be a poisonous one. Still, I do hike, so it hasn't got complete control over me.

A much larger, more significant and, sadly, more likely object of fear for me is the possible return of my severe depression. I know how wrenching, debilitating and even life-threatening that can be. I try to guard against making too much of the issue, but the thought of its return, or the feel of just a small symptom, can strike terror in me.

Play with this. . .
Write continuously for 20 minutes about something you are afraid of. It might be a tiny issue or a life-altering one. What is it? How does the thought of it feel emotionally and in your body? Have you ever faced this thing head-on? Would you want to?

Then write for five more minutes, considering: If someone were to help you with this fear, what should she or he do? Maybe reassurance is what you need. Maybe someone to hold your hand on that plane trip. Maybe a therapist or psychiatrist could help you gradually acclimate to a scary situation. For me, an occasional reminder before hiking that most snakes really are much more afraid of me than I am of them is probably what is called for. Oh, and maybe sturdy hiking boots too.

Wednesday, January 30, 2008

TO WRITE: Dream a Little Dream
We have them multiple times every night, researchers say -- but what do we really know about our dreams? I agree with the standard wisdom about remembering more of those slippery experiences: keep a dream journal by your bedside and record whatever you recall immediately when you wake, even if it's just an image or a feeling. Indeed, when I've practiced this for even a few days, I've found that I begin to remember more and more of my nighttime adventures.

Then, of course, there's the issue of what to do with these often bizarre movies with emotions. Many types of psychotherapies use dreams in various ways, but I think it's really up to you to use these journeys as you see fit. They may amuse, frighten, inspire, explain, or call you to action. But usually -- usually -- I feel better after I've written a dream down and examined it.

Play with this. . .
Write continuously for 20 minutes about a dream you've experienced. It might be from last night or a long time ago; it might feel trivial or life-altering. Describe what happened, including all of the sensory details you were aware of. Then see if any connections or ideas occur to you.

For example, I often find that I dream about my life at the moment in the form of a house -- a simple or complex layout of rooms, a messy or tidy interior, maybe worries I should be spending more time in the office or the kitchen. There's the common dream theme about taking a trip too -- maybe the road suggests your life journey? But you may make completely different connections to these sorts of events and symbols, and that's what is most important for you.

After you've written about your dream and your impressions about it, write for five more minutes about whether there are any ideas about your waking life that you'd like to take away from this exercise -- maybe even insights about handling your depression or the happenings around it.

Tuesday, January 22, 2008

TO WRITE: The Poetry of Nature

As I write this I can see that the rounded line of hills that runs up and down San Francisco's East Bay region is changing color. Last week they were the color of straw. Then they looked like wet, dirty straw after several days of rain. And now they are a dusty green as they begin their annual transformation into glorious emerald green. I sometimes miss the Midwestern seasons I grew up with, but I treasure this metamorphosis each winter too.

Writing and poetry about nature is, of course, plentiful in our times and has been in many historical and ancient societies too. The Haiku form of poetry virtually always uses the natural world for its topics, in fact. (It's three lines long -- five syllables, seven syllables, and five syllables, respectively, in case you're trying to remember it right now.)

Play with this. . .

Choose a detail from the natural world -- you may want to go for a walk for inspiration, or even carefully look at a houseplant if you can't get out. Now write a list of at least ten words or phrases that come to mind when you think of this detail. (My list from the hills' color included: straw, emerald, dusty, trickling streams, blades of grass, tall weeds, my sneezing, the horizon, overseeing the bay, climbing rocky trails.)

Now use some items from this list to write a poem about the detail you originally chose. You may want to create a Haiku, or you might do a free verse poem by simply writing some sentences or phrases, and playing with where you "break" or end each line. If any analogies come to mind as you do this, you might include them too. For example, I might compare the hills' colorful transformation to my own recovery, or the seasons' inevitable return to my friend K's constant support.

Poetry can be a powerful means of expression and healing, and some people find it their favorite. Even if you're hesitant at first, give it a try and see what you come up with. Of course it's definitely fair game to alter it, adjust it and play with it later until you're happy with your poem. Just have fun.

Tuesday, January 15, 2008

TO WRITE: The Term "Mental Illness"

Many of us -- whether we live with depression, bipolar disorder or another psychological condition -- have strong feelings about being labeled "mentally ill." Personally, I'm OK with it at this point, twenty-plus years into my bipolar disorder. But there was a time when that term made me very defensive and conjured up images of complete non-functioning. Fortunately, most of us do function to some degree most of the time, yet this descriptor is often used, particularly by those in the medical fields, I find.

As one trained as a biologist, I think I may actually prefer being "mentally ill" because it indicates that my condition is physiological as well as psychological. That doesn't mean I'm excused from the hard work of striving for recovery, but it helps remind me that it's not all my "fault."

One member of my writing group at Stanford prefers that we discuss our "mental health" rather than our "mental illness," and I think this can be very helpful too, because it is so much more positive -- and because it is more inclusive of those suffering, for example, from a depression that is situational, but not clinical.

Play with this. . .
Have you ever had the term "mentally ill" used to describe you? How have you felt about it? If you bristle at it, do you have another suggestion? And how important do you think this language is in perpetuating or countering stigma?

I'm curious about what you come up with -- leave a comment if you like. And consider whether it might be helpful to discuss with your loved ones or doctor the language used about your health.