TO READ: Writing Saves Lives
Many writers love to claim it: The act of writing not only helped my life, it saved my life. Author and teacher Louise DeSalvo begins her book Writing as a Way of Healing with this claim; poet, author, painter Natalie Goldberg describes "How Poetry Saved My Life," in Top of My Lungs; my students have made this bold statement; I use it in Chapter 1 of my book-in-progress, Illuminating Words: The Power of Writing to Ease Depression to illustrate one of the key aspects of my recovery from severe bipolar disorder.

In this week's edition of Newsweek (Jan. 22, 2007), writer Anna Quindlen's column is titled Write for Your Life. In it, she describes how the disadvantaged teens documented in the new movie Freedom Writers find connection and even pride when a young teacher gives them blank notebooks and says to write anything at all. Now I know that some writers, including Virginia Wolff, have said that a piece of writing is not truly complete until someone else has read it, but I disagree. I've seen it in my students when they report on their journaling; I've felt it myself. Even writing for oneself can be meaningful and healing.

"Writing is a form of personal freedom. It frees us from the mass identity we see in the making all around us. In the end, writers will write not to be outlaw heroes of some underculture, but mainly to save themselves, to survive as individuals," according to novelist Don DeLillo as quoted in Quindlen's article. I think he puts it very well. While writing intended for family, friends or publication is no doubt fulfilling and empowering, there is a place, a crucial place, for personal, private writing as well. And it even saves lives.

TO WRITE: Be Proud of What You See
I attended a retreat this weekend for writing and silent meditation. It was glorious. About 40 other women and I spoke only when we were meeting in groups to discuss spirituality, writing, and the role of "mystery" in our lives. Meals, writing periods and free time were all in silence - no small talk all weekend. In this freeing and reflective state, the sharing we did do in groups was especially meaningful. One comment that struck me was an older woman recalling how her father firmly told her and her siblings when they were children: "Every morning look in the mirror and be proud of what you see."

Play with this...
Try out this father's advice. Look in the mirror and consider what you are proud of in yourself. Then write continuously for 20 minutes on what you discovered. Personal traits, good habits, accomplishments, kindnesses? Even if you're feeling depressed today, try honestly to find areas of pride - at the very least, you are trudging through a lousy period and you're demonstrating bravery and persistence and modeling those traits to others... all things to take pride in. Now can you look in the mirror again tomorrow and be proud of even more?

TO READ: Should I Start Omega-3's?
A bipolar friend of mine was recently stunned to discover that along with my other meds I don't take an omega-3 fatty acid supplement. She claims great results from taking omega-3-containing fish oil pills - several grams of them - every day for her depression. So am I missing the boat here? I know omega-3's were hot news a few years ago, but what's the evidence say now? My psychiatrist and I set out to discover the latest conclusions on their usefulness.

Although omega-3's were previously widely touted (notably, in The Omega-3 Connection, a 2001 book by expert Andrew Stoll), the latest reviews of all the published studies in this field seem to reach the same conclusion: Maybe they're useful; the verdict is still out.

To summarize extremely briefly, people got very excited when population studies found that people in parts of the world where lots of fish is eaten have lower rates of depression than in regions where fish is a smaller part of the diet. The unsaturated omega-3 fatty acids found in high levels in fish oil could logically play a biochemical role in the brain, and some studies have indicated that depressed people have particularly low levels of omega-3's. Sounds promising in theory, but when psychiatrists around the world eagerly began to study the effects of fish oil supplements for their patients, things got complicated.... In 2006, at least three groups of scientists did careful statistical reviews, each of at least 12 published studies (see Am J Psychiatry 2006; 163:6, June 2006; World J Biol Psychiatry 2006; 7(4): 223-230; and American Journal of Clinical Nutrition, December 2006). Every one concluded the same thing: We don't know yet if omega-3's are really effective.

Yes, there are some quite positive studies, but there are others that contradict them, showing no significant correlation at all between omega-3's and depression improvement. And, the studies are not all easily comparable either - some look at major (unipolar) depression, some at bipolar depression, some at other psychiatric conditions; the doses used haven't been standardized; they use different lengths of treatment; and some used omega-3's alone while others used them to augment antidepressant therapy. All of these things require a good deal of further study before we can say with certainty whether and how to use these supplements.

So, what am I going to do? Well, no negative side effects have come up in my reading or talking with friends; my internist says I could start taking some anyway for general heart health; and I really, really don't want to have another serious depression coming my way.... So, yes, I think I'll give a moderate dose (a few grams a day) a try for a month or two. If I don't feel any problem with it, great; if I actually think I feel better or can prolong my remission, fabulous! Meanwhile, I'll keep an eye on the literature in this field and be open to altering my plan. Stay tuned.

TO WRITE: Picturing yourself
We carry visions of everyone we know; we can't help but recall the sparkling eyes of a lover, the tall frame and warm embrace of a friend, the boss's scowl even when you are on time for that big meeting. We hold pictures of their non-physical characteristics as well. Jill is such a talented mathematician, Matthew is arrogant, Lauren has a heart of gold.

So how do you envision yourself? This is a much trickier question. How do you really perceive your own size, shape, color? Your talents, skills and weaknesses? Your faith, maturity and sense of justice? The list goes on and on, of course, and for those of us living with depression or another mental illness, our self-image can be even more complex, and sometimes harder to access too. The illness's effects change who we are, and the illness can alter the way we view everything, including ourselves.

Play with this...
Imagine you are creating a character for a novel you're writing, and that character is based on you. How will you describe her/him for brand new readers? Write continuously for 20 minutes and describe this person - yourself - as objectively as possible. Consider as many aspects of yourself as possible, including the role depression plays in your self-image.

When you reread your piece later, look at whether there are things you'd like to adjust, whether by modifying something about yourself, or by simply deciding to look at something in a new light. The opinion of a trusted friend or therapist might be valuable if you're interested in making changes in your self-image.
Beth

TO READ: Genes May Predict Antidepressants' Effects
If you're reading this blog, chances are you've been there: Your doctor is prescribing an antidepressant for your unipolar or bipolar depression, then mentions the caveat - a big caveat - that this may take up to eight weeks to be effective, if it even is effective for you. When you're miserable, eight weeks is a very long time.

Once again, however, genetics may soon come to our rescue. I've written previously on the burgeoning use of genetics in other aspects of depression diagnosis and treatment (see 10/9/06 and 11/13/06), but now researchers are approaching the very practical issue of predicting "Which med will work for me?"

National Institute of Mental Health scientists screened the genes of nearly 2,000 people being treated with Celexa. They found variations in two genes associated with the treatment. One turned out to be linked to serotonin, one to glutamate, both of which are brain chemicals (neurotransmitters) involved in depression. It's only a start, but ultimately researchers hope to have a panel of genetic markers that can be used to predict which patients are at high risk of failure or side effects if the proposed medicine is used. Hopefully before long we'll see the end of the sometimes endless trial-and-error method of finding the right antidepressants for each suffering person.

For more info: WebMD.com for WebMD Medical News, 12/6/2006.

TO WRITE: Behind me and before me...
Welcome to 2007! After a short winter recess, WriteOutOfDepression is back, and I am looking ahead to the new year with a lot of excitement and a little trepidation too. Now that that busiest of seasons for many of us is over, where are you turning your attentions? In order to take stock and prioritize my ideas for the coming year (or at least the coming week or so), I have been making lists. For me, lists are a good way to trigger my sometimes sleepy winter brain, and they provide me with lots of options and ideas for further writing, something that always helps ground me in a new place or time.

Play with this...
Take a few minutes to quickly list 10 things that you remember about 2006. They might be personal, local or global. Choose one to write on continuously for 15 minutes, focusing on what that remembrance means to you yourself.

Then take about five minutes to list 10 things you imagine for 2007 - things you expect to occur or things you hope for. Look over your list and try to identify at least one small action you'd like to take to affect a desired item - or to hinder something you hope won't come to pass. (I, for example, would like to keep writing consistently on my book manuscript so that it's in good shape when I get a publishing offer; I also want to be more active in contacting my representatives about ending the war in Iraq.) Write continuously for 15 minutes on what doable action(s) would make you feel empowered in 2007.

May you find peace, good health and creative fulfillment in 2007,
Beth

TO READ: Great Books on Depression and Other Mental Illnesses
I've just finished reading a couple of terrific books on mental illness issues and want to pass my thoughts on, while hoping you'll let me know of other new ones or old favorites.

The Unholy Ghost: Writers on Depression (edited by Nell Casey with an introduction by Kay Redfield Jamison; 2001, Perennial) is titled for a phrase poet Jane Kenyon used to describe her deep depression in Having It Out with Melancholy. Though it's not brand new, it was new to me when I picked it up recently, and I've found it fascinating. The book is a collection of essays by noted writers who have dealt with the illness, either personally, or as a spouse or family member.

While these writers seek to describe what many of us find indescribable about our experiences, they also tell their own very engaging stories of despair. Some of them relate these periods to their ideas about their own creative work, wishing that depression should be abolished if that were possible, or arguing that the illness is actually useful.

The Creating Brain: The Neuroscience of Genius (by Nancy C. Andreasen; 2005, Dana Press) was an exciting read for me as a biologist and as one deeply intrigued with the relationship of mental illness to creativity. In addition to considering what constitutes creativity and how the brain creates, among other issues, it includes a full chapter on Genius and Insanity: Creativity and Brain Disease. Many of you will also be quickly drawn in, I suspect.

Building on long-reported connections, Andreasen's careful study of writers reveals a dramatically higher rate of all mood disorders (80%) than in a carefully matched set of non-writers (30%). No writers in this study had schizophrenia. She is now studying whether scientists, or their family members, have higher rates of schizophrenia. She reports that during periods of instability, poets and painters are generally unable to create, but that during remissions they can draw upon these difficult experiences in their work. Also discussed is the fear of some writers and artists that psychiatric treatment of any kind might stifle their creativity.

Both of these books offer unique, valuable and very interesting takes on illnesses that are being written about more and more, but not always with new insights. What are you reading?

TO WRITE: Spirituality's Role in Mental Health
In my way of looking at the Universe, we are all "spiritual" people -- not necessarily "religious" or even consciously spiritual in day to day life -- but spiritual just the same. We all have relationships with our self, with the world around us, with the mysteries life offers, and I believe that the way we face these things defines our spirituality. This is a very liberal use of the word "spiritual," I realize, but stay with me here.

Whether you are a Muslim, Jew, Buddhist, Christian, Hindu, agnostic, atheist or other, you have certain views about how the world operates and about what you most deeply treasure in that world. And, whether you hold truth, kindness or other principles as your highest values, whether your worldview is shaped by a traditional religious background or not, I argue that your mental health is affected by your spirituality.

The majority of psychiatric inpatients note that religion gives meaning and purpose to their life, according to several studies. In a general patient survey, 75% would like their doctors to address spiritual issues as part of their care. Clearly these are vitally important issues for many of us.

Play with this...
Write for 20 minutes on your spiritual views and how they relate to your depression or other mental illness. For example, does being an atheist ground you when you're ill? Does your belief in God help you to keep going despite your symptoms? And have your mental health experiences changed your worldview? Exploring spirituality with respect to your mental illness may make you more consciously aware of your beliefs and may even provide you with a lifeline when difficult thoughts and painful feelings strike.
Beth

TO READ: This is Your Brain on Therapy
Scientists are learning more on a daily basis about how the brains of people with depression differ from those without it. But can those differences be used to predict how best to treat depressed people? According to recent research, they can.

Using functional magnetic resonance imaging (fMRI), researchers at the University of Pittsburgh School of Medicine measured activity in two key areas of the brains of depressed persons while they responded to different words. The words were chosen to have negative, positive or neutral associations, and the patients were asked to choose words that reflected their feelings when they felt depressed. Then each person participated in a 12-week program of cognitive behavioral therapy (CBT) for their depression, and their depression levels were measured again.

The results seem strong: Among the nine patients with a particular brain activity pattern (a decrease in activity in the subgenual cingulate cortex) when responding to negative words, seven recovered during CBT. Among the five people who did not show that pattern, only one responded to CBT. The positive and neutral words produced no changes related to mood improvement in CBT.

So, even given this small initial trial, fMRI seems to provide a predictor of which depressed people will respond to CBT, a structured therapy that teaches how to control emotional reactions and rumination. Learning how to identify depressed patients who are likely to benefit from CBT versus some other therapy could provide quicker, more effective treatment for all.

For more info: Am J Psychiatry. 2006; 163:735-738.

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