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. . . .)