TO WRITE: Changing Perspectives in Your Writing
In his book Writing to Heal, James W. Pennebaker reports that recent research demonstrates the importance of the writer's perspective or voice when writing about traumatic issues. People who derive the most benefit from writing on a difficult topic for several days in a row are those who can switch from writing exclusively about their own thoughts and emotions to writing about how others who were involved might have experienced and thought about the trauma.

This change in perspective can be accomplished by writing in the "first-person" voice versus the "third person" voice. (If these terms make you cringe about a failed fifth-grade grammar test, fear not. The first person uses "I, me, we," as in: I ordered a pizza for us to have for dinner. The third person uses "she, he, her, him, they," as in: She ordered a pizza for them to have for dinner.)

Play with this...
Think of an annoying event in your life -- not a massive trauma -- that you've been worrying over. Now write continuously about the event and your reaction to it for 10 minutes from your usual first-person perspective. ("I threw up my hands when...")

Now read over what you've just written. Then write on the same topic, covering the same basic information, for 10 minutes from the third-person. You'll sound like an outside observer. ("She threw up her hands when...")

Now read over your second writing and compare how these two pieces felt to write. (Writing in the third person may feel awkward at first, but does get more comfortable with practice.) Did it give you a sense of distance from the problem? Was that useful to you? This technique can be particularly helpful when you are later approaching a serious trauma through writing.
Beth

TO READ: Reading Books as a Depression Treatment
Bibliotherapy, also known as "guided self-help," has been studied for several years as a treatment for mild to moderate depression. In bibliotherapy, people with depression are assigned to read a self-help book such as David Burns' Feeling Good, instead of, or in addition to, treatment with psychotherapy and/or antidepressant medicines. The results are impressive.

Numerous controlled studies have been conducted and, in at least some, researchers have concluded that a four-week self-study period with an appropriate book was as effective as individual psychotherapy, participation in a cognitive behavioral therapy group, or taking an antidepressant -- and bibliotherapy worked faster. In a three-year follow up study, the beneficial effects of bibliotherapy were sustained.

Can reading really alleviate depression? There are some specifics to keep in mind. The book must contain real information on how to recover from depression. Typically the books used CBT-based approaches. (Peter Lewinsohn's book Control Your Depression was also found useful; Victor Frankl's Man's Search for Meaning led to no improvement.) In some studies the reading was conducted between psychotherapy sessions that reinforced the importance of the books and their exercises. Also, bibliotherapy has not been applied to severely depressed patients.

As you may suspect, bibliotherapy provides a vastly more economic way to treat mild to moderate depression. Some researchers have suggested that conducting bibliotherapy on the Internet may be effective, and cost effective, as well.

For more info, see: Smith, et al, (1997), J. consult. clin. psychol., 65, 2.
The Wall Street Journal, August 9, 2005, p. B1.
holisticonline.com/remedies/depression

TO WRITE: Focus the Power of Your Writing
For the past eight years, I've led a creative writing class for people with mood disorders, meeting weekly at Stanford University's Psychiatry Department. While we often explore our mental health issues through writing and sharing, we write on other topics as well.

Why bother writing about sand or your favorite meal or a photograph of a cheetah? Many reasons, I believe. For example, these exercises help us "warm up" as we begin a two-hour writing session; students report they are calming, clarifying, thought-provoking; and reading their pieces aloud helps validate writers' thoughts and feelings in a safe community. But these unusual topics also make us better, stronger writers by developing our use of techniques including: memory, the senses, and vivid detail. These three things are among those many authors (of fiction and non-fiction) emphasize when teaching others to hone their writing craft.

Writing about your family car when you were a child requires you to: Dig into your memory banks, which may lead you to long-forgotten stories as well. Describe the way the car looked and perhaps sounded as it backfired, felt as it hit a bump, or smelled of popcorn after a drive-in movie. And it encourages you to stretch yourself to come up with vivid details that will really bring the reader into your experience -- how Mom's beehive hairdo almost touched the ceiling, how big brother whined as he begged to be allowed to drive.

All these techniques help writers to better develop a narrative and to develop changes in perspective. Both these things have been found in studies to be more likely to effect health changes when writing about trauma -- something we're likely to address in the second in-class exercise of the day.

Play with this...
Write a description of your high school gym teacher. Try to use all of your senses as you look back to recall him or her. Use vivid details as much as possible to elucidate his/her character. What stories do you recall? Help an imagined reader really know this person.
Beth

TO READ: Could Depression Relief be "All in Your Mind"?
We've all heard it, or even thought it ourselves: You're not "really sick," your depression is just "all in your mind." Before you grind your teeth too hard, read about how neurofeedback, aka EEG biofeedback, has helped a few people ease their depression by training their brains.

It seems that in depressed people a particular type of brain wave, the alpha wave, is not equally strong in the left and right brain hemispheres, but is more active on the right. This distribution of alpha waves can be related to mood. Though the technique is highly experimental, and no controlled studies have been conducted yet, researchers at Northwestern University and the NeuroQuest Neurofeedback Center in Evanston, Illinois have seen some positive results when depressed subjects learned to balance the alpha waves in their brains.

After electrodes were stuck to spots on their face and scalp, depressed research subjects were trained in 15-30 minutes sessions to play a sort of game. In this rudimentary computer game, played simply by thinking, not using the hands, success was measured in changes in brain waves. When their alpha waves in the left frontal cortex grew stronger than in the right, they heard a note played on a clarinet. Their goal was to keep this tone playing as long as possible. The training worked -- at least for some people. One woman had outstanding results: After 12 years of recurrent depressions that were not responsive to treatments, she learned in just 35 hours of training to control the waves so that her symptoms decreased dramatically. Amazingly, she remained depression-free during the next six years as the scientists followed her case.

Brain training, as it's called, is being studied for many other uses as well: predictions of seizures in patients with epilepsy, treatment of ADHD, communication for those who cannot speak or move and, yes, even improving healthy people's cognitive skills such as memory, concentration and musical abilities.

For more info, see: Scientific American Mind, February 2006.

TO WRITE: What Are You Grateful For?
As the long weekend of family, food and crazed shopping ends, I'm reflecting on what it all means. What am I really thankful for, and do I ever truly stop and think about those things? Some recent psychological research suggests that the trait of being grateful is a particularly powerful one. The psychologists involved suggest the following practice for greater contentment: Keep a special notebook, and at the end of each day, write down three specific things for which you are grateful. These can be large or small things -- I was able to sleep six solid hours last night; I called my sister for support today when I felt really low; I felt engaged when reading the front page of the newspaper. Ocassionally look back at your notebook and see what things jump out at you or form a trend. Are these things you could strive to increase in your life?

Play with this...
Try the exercise described above for a week. Then reread your notebook entries and write consistently for 20 minutes on your findings. If you feel a sense of satisfaction, lightness or joy, continue the practice and see how your feelings evolve over time and how you might apply your discoveries day-to-day.
Beth

TO READ: The Creativity-Depression Link: Rumination
Science, as well as centuries of popular observation, has shown that there is a strong relationship between mood disorders and creativity. Artists, writers, musicians and scientists all have higher than usual rates of depression, for example. But why? Does depression lead somehow to creativity? Or are creative pursuits somehow depressing? Research now shows that there may be no direct link between the two. Rather, their connection may be the tendency to ruminate.

In the 1990s, one overview of research studies on creativity and depression concluded that major depression in writers and artists is 8-10 times higher than in the general population. Another study found that people working in the creative arts had a lifetime prevalence of depression of 50%, while scientists came in at 24%, and the general public had a rate of 9%. In particular, poets had a depression rate of 77%; fiction writers, 59%; and visual artists, 50%.

More recently, researchers at Syracuse University and Stanford University found evidence that the strong relationship between mood disorder and creative behavior is rumination -- having conscious thoughts about a particular topic that recur whenever the person is not facing immediate outside demands. This tendency to self-reflection increases the risk for depression, and it also triggers interest in and ability for creative activities.

The results suggest that depressed people, who tend to be ruminators, may turn to creative pursuits when they are feeling better in order to express their feelings and the content of that self-reflective thought. Also, rumination may allow the depressed individual to later generate more ideas, some of which are original and can be pursued -- though of course, the possibility of having repetitive negative thoughts about oneself is higher too.

From: Verhaeghen, et al. (2005). Why we sing the blues: The relation between self-reflective rumination, mood, and creativity. Emotion, 5, 226-232.

TO WRITE: Tell me what helps!
A recent comment left on this blog -- a request for help, really -- got me thinking about how easy it can become to focus on what makes our depression and other symptoms worse, not what makes us feel better. One of the many uses of support groups for those living with mental illness is that through sharing with others, we can often identify healing techniques, be they large or small. Writing can also trigger us to pinpoint what works for us, both as we put our finger on these approaches ourselves, and as we share them with others.

Play with this...
Imagine a person who has just been diagnosed with your illness coming to you for advice on how to ease the pain. What would you suggest? I'd include both broad approaches -- educating oneself through the links listed in this blog, seeing a highly-recommended physician -- and small, specific tricks -- holding my cat, coffee with a trusted friend, writing down my feelings of confusion. Writing continuously for 20 minutes, describe what you'd say to this new acquaintance who needs your help. And let me know what you come up with!
Beth

TO READ: Depression gene enlarges "negative" brain region
If you're clinically depressed, your brain's structure is probably different than that of your healthy friends. That's right -- while the use of biochemicals such as serotonin is undoubtedly different in depression, as we've heard for years, there are gross physical differences in the brain tissue as well. Several research studies have demonstrated that numerous regions of the brains of people with depression differ from that of non-depressed people -- usually certain areas are smaller in depressed people. Now, there's evidence that the "negative emotions" part of the brain is bigger in those with depression.

Last week in the journal Biological Psychiatry, scientists reported their studies of a particular gene, the serotonin transporter gene (SERT), which has two forms, known as short and long. If you have two short SERT genes (one from each parent), you're likely to have a bigger "pulvinar" in your brain. The pulvinar region handles negative emotions. People in the study who had depression had pulvinars 20% larger and with 20% more nerve cells than people with one or two long genes. Researchers believe about 17% of the population has two SERT genes.

The SERT gene also affects the nerve cells' use of the neurotransmitter serotonin. Prozac, Zoloft and several other antidepressants act by keeping serotonin more available for cells to communicate.

How does this new information help us? "The brain is wired differently in people who have depression, and probably from the point of view of treatment, we should try to identify these people as early as possible and intervene before the 'hard-wiring' gets altered," the lead researcher told Reuters.

TO WRITE: What makes you you?
When living with depression or any other mental illness, it's all too easy to lose sight of who we really are. We're busy taking meds or going through other treatments to help change the ways we think and feel, and underneath it all our sense of self can be seriously compromised. The following quote by William James has helped me on several occasions to connect to what I consider my core -- my unique abilities, character, desires, needs, goals.

"Seek out that particular mental attribute which makes you feel most deeply and vitally alive, along with which comes the inner voice which says, 'This is the real me,' and when you have found that attitude, follow it."

Play with this...
Write continuously for 20 minutes on "What makes you the real you?" Afterward, reread your piece and see if you can come up with ideas on how to "follow it."
Beth

TO READ: Migraines and depression -- What's the connection?
I want to report today on migraines, usually considered a neurological, not a psychiatric issue. However, I contend that for some of us there's a real connection. I say this because of personal experiences, and because of similar stories numerous others have told me about their illnesses. (See, for example, the comment from "Patricia" below the November 1 posting in this blog.) My ill health actually began, 20 years ago, as severe daily migraines that appeared suddenly for the first time, and made it very hard to work. After a year of trying various medicines, during which my depressive symptoms first appeared, an old tricyclic antidepressant took care of both ailments. At least it largely took care of the migraines; the depression has returned umpteen times. Of course, not everyone has even that much success, though medicines used have advanced a great deal.

Interestingly, however, there may soon be non-pharmacological treatments for migraine sufferers. The New York Times reports this week on two experimental treatments being studied in large trials for migraine -- ONS, or occipital nerve stimulation, and TMS, transcranial magnetic stimulation.

ONS uses electrodes implanted just under the skin on the back of the head to deliver electric current to a specific nerve. The electrodes are wired (under the skin) to a pacemaker-like device implanted in the upper buttock. The treatment sounds analogous to the VNS, or vagus nerve stimulation, therapy now used for treatment-resistant depression, where a device implanted in the upper chest is wired to electrodes in the side of the neck and delivers pulses of electricity. Very different nerves -- similar idea.

And TMS is already being studied for the treatment of both major depression and bipolar depression. I've previously described in this blog how fabulous TMS treatment has been for me. The idea in using TMS for migraine is similar. Instead of the side-of-the head stimulation I've gotten, here the back of the head is targeted. Again, a device pressed against the head provides brief magnetic pulses, which alter the electrical activity in a localized region of the brain. In neither case is it known exactly how the stimulation helps, and it doesn't help everyone. Also, the migraine studies so far are limited to those who experience an "aura," or a premonition period, before the migraine. Still, the idea of having more electrical -- as well as chemical -- treatment options for both depression and migraine is exciting. Stay tuned for more results.
Beth

TO WRITE: How do relationships affect your mental health?
All of our personal relationships are bound to affect us in myriad ways, and our mental health is definitely one of them. Think about the people in your romantic life, for example -- your spouse, partner, or a current or former relationship. Does that person know about your depression, bipolar disorder, or other mental health problem? Can you discuss it with him/her? Is that person supportive? Have you learned over time how to best handle conversations with her/him on this topic? What would you like to change in this area?

Writing about our relationships can be extremely fruitful -- and fascinating. For a great example of writing on changing romantic relationships, check out the essays on the blog of a writer friend of mine at: MovingInMovingOn.typepad.com.

Play with this...
Choose your current partner or a person with whom you had a former romantic relationship. Writing consistently for 20 minutes, describe how you relate(d) to that person on the topic of your mental health. Does reading what you wrote provide any insight into changes you might like to make in this realm, if any?
Beth

TO READ: Depressed? Keep trying new meds
The final portion of a large, six-year federal study of depression was published today in the American Journal of Psychiatry. The findings: While one-third of people were helped by starting on the antidepressant Celexa, one-third more got better if they were patient and added or switched to a second, third, or even fourth antidepressant, as needed. Thus, 67% of the 3,671 of the depressed patients studied reached remission by taking one or more medicines.

The downside of trying additional antidepressants, however, is that relapse becomes more likely the more drugs you try. Among those who achieved remission with the original Celexa prescription, 40% relapsed in the first year. For those who had to use a second, third or fourth drug, the relapse rates rose to 55, 65, and 70%, respectively.

TO WRITE: Getting the pink slip
In my creative writing class for people with mood disorders at Stanford I often use quotations as writing prompts. They may come from writers, philosophers, actors, scientists, politicians or even coffee cups. You may agree or vehemently disagree with them, but they often trigger new ideas and internal dialog that creates meaningful writing. Today I'll offer a quotation from the book Unholy Ghost: Writers on Depression, edited by Nell Casey. Though it may be discouraging to read when you're down, this is a fascinating collection of essays on depression from diverse, yet articulate, writers. I found it very engaging to read when I was relatively depression-free.

Play with this...
In a piece entitled Poodle Bed, a depressed Darcey Steinke, author of novels including Suicide Blonde, describes feeling disconnected and lonely as she watches people and mailboxes go by during an early morning ride to the airport. "I felt like I'd been found incompetent and fired from my own life." Write for 15 minutes starting with this sentence.

TO READ: Transcranial Magnetic Stimulation
Numerous friends and acquaintances with mood disorders have had lots of questions about a treatment I've been receiving lately which uses not medicines or electricity, but a magnet. Transcranial magnetic stimulation (TMS, also known as rTMS with "r" for "repetitive) is a relatively new technique now under study for the treatment of both major depression and bipolar depression. TMS is not yet FDA-approved, but I've been fortunate enough to have had several series of experimental treatments for my sudden and severe depressive symptoms, and it has helped me tremendously, with no apparent side effects other than an occasional moderate headache.

TMS involves stimulating the nerve cells in a specific part of the brain with a magnetic field. In my case, this has been accomplished through a very simple procedure. I sit in a chair in a regular office and a psychiatrist holds a plastic "wand" against a specific spot on my head, a little above and in front of my right temple. The wand is wired to a machine that creates a strong, focused magnetic field, and is controlled by a laptop computer. For 60 seconds, I hear a rhythmic clicking sound, one click per second, as pulses of the field stimulate a part of my brain just centimeters below the skull. All I feel is a sensation of someone "knocking" on my head, and occasionally a slight muscle twitch. After a three-minute rest period, I get another 60 seconds of pulses, and I'm done.

Although ECT (electroconvulsive therapy) has worked wonders for me many times in the past, it requires a general anesthetic and, in my case, has led to significant memory loss. TMS avoids both those things. No anesthetic is needed; I can drive myself home and resume normal activities -- or whatever activities the depression allows. The one slight downside is that my TMS regimen requires treatments five days per week for four weeks. A lot of driving to Stanford for me, but well worth it.

About two weeks after starting treatment, I begin to feel my mood improve and my energy return. When we stop after four weeks of treatment, I usually feel about 90% back to baseline. However, I continue to feel improvement for another week or so, which returns me to a healthy, non-depressed state. For me, this state typically lasts three to five months.

While TMS is not a cure, early studies show it helps 25% to 43% of people with depression who have not responded to medication. I know it has helped give me back my life -- with fewer depressed periods and no additional memory impairment, I'm able to work more and take on bigger projects in life than I've been able to do in years.

TO WRITE: Belonging to "Club Meds"
I remember the first time a doctor, who happened to be a neurologist, suggested I take antidepressants. It was not to treat depression, but migraines. It seemed an odd, unlikely idea, but my chronic daily headaches were making grad school very difficult, and no other migraine treatment had helped. I agreed to try them, quickly and arrogantly thinking, "Thank goodness I don't have depression to deal with; these are just for a neurological issue."

A few months later, after trying the little white pills for several weeks without any lessening of my migraine symptoms, then a few weeks off of them, something else was amiss. I noticed I was crying at the drop of a hat, sleeping all weekend if I could, and having to drag myself to my work in the lab each morning. My psychiatrist, who I had consulted just in case he could shed any new light on the headaches, quickly put two and two together. Those meds had been treating me effectively for something, it just wasn't my migraines: I was depressed. Now, as he suggested I restart the drug, my reaction was very different. "Who, me? Depressed? And taking pills for it? This can't be. I certainly don't need medicine to be happy! Or do I? Why can't I just change my mood by myself?"

Fearing I was on a slippery slope toward "crazy," I reluctantly went back to the daily medication. I didn't like it, even felt demeaned by the idea of it, but I also felt so lousy that I was cautiously willing to try this for some relief. The upshot: Within several more months, I was not only depression-free, but migraine-free as well. I became a believer.

Play with this...
If you take medication for your depression, bipolar disorder or other mental health issue, write continuously for 20 minutes on how you felt when you started it. Did you resist at all or welcome it with open arms? Why? Have your feelings changed at all over time? How does your attitude toward your meds affect you and your illness today?
Beth

TO READ: Stopping the Stigma Around Mental Illness
Today I spoke about mental illness stigma to clients at the substance abuse program at Highland Hospital in Oakland, along with other members of the Alameda County Mental Health Speakers Bureau. Our presentation identified and discussed stigma we sometimes receive from others concerning our illness: our personal strength and character; our need for treatment, including therapy and medication; our fitness for employment; and other things. It also discussed "internalized stigma" -- what happens we ourselves start to believe these negative messages about our worth.

I know I've felt stigmatized and discriminated against at times because of my illness. Even now, after writing and speaking publicly about it for years, there are times I meet a new person and hesitate, wondering what I want to say to the almost inevitable question "What do you do?" But I sometimes internalize it too. For example, my mind can ask nasty questions when I'm catching up with old friends and colleagues -- Why have I been out of the workforce for so long? Is my bipolar illness truly that bad, or do I not really want to get well? If I were stronger, would I need all these meds and therapy? Fortunately, at this point I can catch myself pretty quickly, or my husband or friends will help me correct my thinking. But it can be tough.

The program clients today had many questions about how reluctant they felt to "admit" that they might need therapy or even meds for depression, bipolar disorder or other mental illnesses. And the point I felt was most important to emphasize was that, while there might not be cures for these illnesses, one can recover and develop a meaningful life.

What does recovery mean? Recovery is a journey (not a destination) toward wholeness as a person, considering mental and physical health, one's spiritual self, and a role in life that one finds meaning in. That meaning could be the resumption of a high-powered, full-time career, but it is also meaningful to work part-time, create art, be a caring family member, do volunteer work, spread joy in the world, help another person, educate oneself. And we're all on a different journey toward recovery. For me, it requires, or has required, medicines, therapy, ECT, TMS (magnetic treatments), education, lots of writing, the support of my family and friends and peers, etc.

Where are you in your recovery? Even if you feel in the depths of despair, you're making a move in the right direction right now by reading this and learning of another consumer's ideas on recovery. You're educating yourself and perhaps feeling some solidarity or support. What can you do next? Check out the links listed on the right side of this page for information, encouragement, ideas on creating art and literature, and finding a support group, good doctor, or therapist. All of these resources can help you break out of the internal stigma you may be carrying. Then you'll be able to reach out and help confront the stigma and prejudice in the world around us. Bon voyage, and be in touch!
Beth

TO WRITE: "Go further" in your writing
One of the most wonderful writing teachers in the world, in my opinion, is Natalie Goldberg. Her book Writing Down the Bones is one I come back to again and again when I'm dragging and I need writing inspiration. I've also had the good fortune to study with her twice in Taos, New Mexico, where she makes her home. Natalie is a Buddhist, and that faith's philosophies and practices show up often in her approach. I should say too that Natalie is the first person I discovered who uses the "timed writing" approach that I advocate in my class and this blog.

That said, today I'm going to ask you to try to "go further" in your writing, as she puts it. After you've been doing timed writings for a while, you may be emotionally stopping yourself just as you reach the end of the prescribed period. Try now to make yourself really delve into the writing you're doing, even if you end up writing longer than you intended. You might just be getting to the good stuff.

As Natalie writes: "Push yourself beyond when you think you are done with what you have to say. Go a little further. Sometimes when you think you are done, it is just the edge of beginning. Probably that's why we decide we're done. It's getting too scary. We are touching down onto something real. It is beyond the point when you think you are done that often something strong comes out."

Play with this...
Write for 10 minutes starting with the phrase: In my opinion.... Then continue to write for 10 more. As usual, keep your pen moving and don't think too much, just write. Then continue for 10 minutes more. Repeat as desired. Later look back at your writing and see if you can identify where the writing was at its deepest or most meaningful. Remember this when you are writing anything. You may need to push a little more to get to the real issue you're writing about.
Beth

TO READ: Genetics of Depression, Bipolar Disorder and Schizophrenia
I recently attended a fascinating series of seminars at Stanford University's Bipolar and Schizophrenia Education Day. One lecture, given by Professor Doug Levinson, M.D., of Stanford, discussed what current research tells us about the genetics of these illnesses.

None of these mental disorders are as simple to follow through the family tree as, for example, eye color or blood type. The reason is that many different genes, not just one, combine forces to determine a person's susceptibility to depression, bipolar or schizophrenia. We don't yet know which of our 30,000 genes are involved. However, as scientists do "linkage studies" to physically locate these genes on human DNA, they're getting warmer. They are finding "peaks," or hot spots, on certain chromosomes for each of these three illnesses, though the peaks are at different places for each disease.

At this stage, it's clear only that these mental illnesses are caused partially by our genes, and partially by some aspect(s) of our environment. Studies show that bipolar disorder is 80-90% due to genetics; schizophrenia is 70-85% genetic; and major depression is 40-50% genetic. Furthermore, researchers have found that in the case of depression, people who have an early onset of symptoms (before age 20) have about a 50% genetic contribution to their illness, while those who have a single, later episode have about a 36% genetic contribution.

As further work allows us to eventually pinpoint a young person's genetic risk for such mental illnesses, perhaps earlier interventions and treatments will be able to avert, delay or lessen symptoms in those at high risk.

TO WRITE: The Stigma Around Depression
Even before you received your diagnosis of depression or bipolar disorder (or any other mental illness), you may have been labeled by those around you. "She's so moody." "He's just got an attitude problem."

But after discovering that you officially have a mental disorder, instead of finding those around you more understanding of your behavior and moods, you may also encounter stigma around your diagnosis itself. Have you heard any of these? "Depressed people are too self-centered; they should think of others." "People with mental illnesses should just try harder and they'd get well." "She has depression, so she'll never amount to much." "Only weak people have to take psychiatric medicines."

I speak to groups about mental health stigma on behalf of the Alameda County (California) Mental Health Board. According to that organization, stigma is "a brand of discredit or shame... a mark or token of infamy, disgrace, or reproach." And while stigma is hard to take from family, friends and colleagues, it can become internalized too. Giving yourself negative messages about who you are and what you can do can lead to decreased self-esteem and confidence, more isolation, and more difficulty leading a fulfilling life.

While all of us in the mental health community must continue to educate those around us about moving beyond stigma, there are techniques that can help you cope for now too. For example, I'm sometimes helped by reminding myself of what I have accomplished despite my illness, and by thinking about the places where I feel a sense of belonging.

Play with this...
Describe any stigmatization you've felt as a result of your illness. Who has is come from? In what form? How did you feel as a result? Then brainstorm to find things that might help you cope with this. Write continuously for 15 minutes.
Let me know what you discover!
Beth

TO READ: Hoping your antidepressant works may really help
We all know that biological phenomena (say, getting a bad cold) can affect psychological phenomena (you feel miserable). But now researchers are finding more evidence that the reverse happens too: Your biology, such as how well your antidepressants work, may change as a result of your psychological state.

Researchers at UCLA recently found that some patients with major depression had a specific brain activity pattern, and that this pattern correlated well with their positive response to an antidepressant they were later given. And it appears that this particular brain pattern was a result of hope or optimism (or perhaps simply from having positive interactions with the medical staff).

In the study, fifty-one depressed adults were given a placebo pill for a "lead-in period" of one week, and their EEGs were measured. Then half of the patients got an antidepressant while the other half continued on the placebo for eight weeks. The patients with the "hopeful" brain activity pattern were better responders to the antidepressant. (While those who improved on the placebo also had a distinct brain activity pattern, it was different than the one predicted by hope.)