11 Things Only Someone On Antidepressants Understands | Prevention

It’s time to stop treating antidepressants differently than medication for physical ailments.

Source: 11 Things Only Someone On Antidepressants Understands | Prevention

  November 30, 2015

facts about antidepressants
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There’s a spin class I like here in New York City, and the instructor happens to have diabetes. Periodically in the middle of class—sometimes barely even slowing her pedaling feet—she’ll check her blood sugar with a quick prick of her fingertip. Occasionally she’ll explain herself before or after class. Other times, no explanation necessary. I’m sure others like me who have worked out with her more than a few times hardly notice anymore.
Therapists and doctors and writers like to draw an analogy between the constant vigilance required of people with diabetes and that of people with depression. A person might need to be on insulin for the rest of her life, and there’s no shame in that. Depression, too, the thinking goes, can require lifelong treatment—why should our perception of that medication be any different?

Still, I can’t imagine this spin instructor popping off the cap of a bottle of Zoloft in front of 30 sweaty strangers.

It’s not a perfect analogy: We now know that depression is perhaps infinitely more complicated than the comparatively well understood fix for type 1 diabetes of replacing missing insulin. But it still makes the point so clear it nearly punches you in the stomach: We wouldn’t judge someone for treating a physical illness with medication, so why do we judge someone for doing the same for a mental illness? Diagnosing depression can be just as challenging as treating it. (Do you experience any of these nine surprising depression symptoms?)

I’m confident we’re (slowly) moving away from this stigma, but we’re not quite there yet. Whether it’s because a person on antidepressants doesn’t necessarily “look” sick or because we simply don’t understand the benefits antidepressants have to offer, it’s obvious we need more honest discussion of these meds and whom they work for and how. Considering the most recent data available suggests 11% of Americans over the age of 12 take an antidepressant—and that was in 2008!—we owe them a little more compassion and understanding.

In an attempt to help make things clearer and help us all be even just a little more accepting, here are a few things only people taking antidepressants truly understand.

Antidepressants are not a cure.
Depression is thought to be a noxious combination of genetic, environmental, and psychological factors that leads to profound feelings of sadness, hopelessness, pessimism, irritability, and fatigue, among many other possible symptoms. Antidepressants, the medications most commonly used to treat depression, affect a number of brain chemicals called neurotransmitters, which are thought to be involved in regulating our mood. While meds can make a drastic, sometimes lifesaving improvement in how a person is feeling, antidepressants don’t always mean the end of bad days—or even meh days, for that matter.

Freelance writer Lynn Shattuck, 41, likens antidepressants to her contacts. “I’m super-nearsighted; I need contact lenses to see,” she says. “Antidepressants aren’t a happy pill; they just clear the fog for me. They help clear my vision and enable me to be able to see a little more.”

She’s been on and off meds to help manage depression and anxiety for 2 decades. “My antidepressants are just one tool in my toolbox,” she says. “I don’t think any one thing for someone with depression is necessarily the answer.”

For Rob O’Hare, 34, an actor, comedian, and web producer who also happens to be my dear friend, antidepressants haven’t made negative thoughts vanish, but they’ve helped speed them along. “Without medication, I might feel devastated,” he says, “but with medication, I won’t feel awful, and then the feelings will pass—and that’s actually a drastic improvement!” He was first diagnosed with depression in 2003, and while he recognizes that he still harbors negative thinking patterns, “they have a chance to get better now with medication.”

You don’t have to be on them forever (but you might be).

 It can be tempting to take antidepressants for a month or two, feel like you’ve improved leaps and bounds, and figure you no longer need meds, says psychiatrist Michelle Tricamo, MD, an assistant professor of psychiatry at Weill Cornell Medical College in New York. “That’s not something we want to see,” she cautions. “Just like you want someone to finish the whole course of antibiotics to prevent relapse, we don’t want anyone to prematurely discontinue antidepressants, either.”

Typically, Tricamo says, your doc will want you to be relatively symptom-free for about a year before you talk about stopping the meds, she says, to make sure the changes in how you’re feeing are going to stick. What’s even more important than how long you’ve been on antidepressants is that you don’t try to go off them alone. A doctor can help you expertly taper your dose to wean you off with as few withdrawal effects as possible (we’ll get to more on withdrawal later).

After that weaning period, some people might carry on drug-free. Antidepressants can function like that ever-illusive perfect face wash that clears up your acne after a few weeks and you’re set, O’Hare imagines. “But for someone like me, depression is chronic,” he says. “I just have to manage it.”

If you do stay on them forever, it’s not because you’re addicted.
Shattuck says she was constantly establishing timelines in her head for when she’d be able to ditch antidepressants. It took years for her to come to terms with the fact that she might take them for the rest of her life. “I believe this is part of my genetic makeup and something I need,” she says.

Her attitude is key in understanding long-term antidepressant use: People who benefit from the meds are taking them because they still provide those benefits. There’s no high, and there are no cravings, Tricamo says. Antidepressants can cause withdrawal, which is probably where this misconception came from, she says, but it in no way means you can’t stop using them.

It’s not always an easy decision to start taking them to begin with.

There are critics out there who say antidepressants (and heck, countless other meds) are simply overprescribed. But the process of beginning antidepressants doesn’t start with some haphazardly written prescription. Docs frequently recommend therapy first, Tricamo says, which can result in significant improvements for many people with mild to moderate depression.

When she’s considering who might benefit from meds, Tricamo evaluates how much depression interferes with a person’s daily life. “If adults are unable to get to their jobs or leave their homes or can’t support themselves, these might be times to use a medication,” she says.

Some people still have hangups about starting meds, even if therapy hasn’t helped. “The biggest internal battle was the idea that I should be able to feel better by myself,” Shattuck says. “If I just did enough therapy or herbs or whatever, I could treat myself naturally.” Such defeating self-talk, she says, is a nonstarter because “depression is, in and of itself, a distorted way of thinking,” she says. “It makes it really, really challenging to get yourself out of that on your own.” We wouldn’t suggest that a person with a broken leg should simply pull herself up by her bootstraps.

Tricamo emphasizes the importance of working through these concerns and making the decision to try antidepressants a collaborative one. “They’re the ones taking the medication, after all,” she says of her patients. “You can’t force them, and since you’re not there to give it to them every day, you might not even know if they’re taking it.” Thoroughly explaining the risks and benefits can help a person understand why meds are important and how they might help. “If you don’t get them to buy in to treatment, treatment is going to fail,” she says.

Side effects can be harmless or hellish.

Anyone who has seen one of those horribly cliché staring-out-a-window-while-it’s-raining TV commercials for antidepressants knows that the accompanying long list of potential side effects is equally horrible. Many of them, like weight gain, insomnia, nausea, low libido, delayed or vanished orgasm, and diarrhea, to name just a few, sound entirely unpleasant.

Certain meds come to have a reputation for one side effect or another, but there’s no real way of knowing what you might feel when you start one or how long the side effects will last. Nausea, headaches, or a jittery feeling usually vanish within the first couple of weeks, Tricamo says, but weight gain or a dampened sex drive might be harder to cope with. “Unfortunately, it’s something we can’t really predict.” Side effects aren’t based on the dose of the med or really anything else measurable or adjustable, she says, although they are likely to be worsened by drugs or alcohol. While the unpredictability is certainly frustrating, it shouldn’t be prohibitive. “We can switch antidepressants, and we usually do find one that isn’t so harmful in these ways,” she says.

“It’s kind of a guessing game,” O’Hare says. He ended up in the emergency room after what was likely an allergic reaction to Lexapro when he first tried it in 2003. He’s since tried a handful of others with varying rates of success: Cymbalta and Wellbutrin both made his depressive symptoms worse, he says. Effexor made him feel something he can only explain as “medicated.” He gained weight on Remeron, but describes the experience as feeling like his body was no longer his own. He’s currently feeling some improvements on Prozac and is about to visit his psychiatrist for the first time in a month.

He’s stayed away from any antidepressants thought to mess with libido. He guesses everyone has their own threshold for tolerating different side effects. Some weight gain might not bother one person while it’s a deal-breaker for others, for example. “If a drug was going to diminish my libido, then I just wasn’t going to deal with that,” he says. “Among the drugs I haven’t taken are some I haven’t taken for that reason.”

But you’re not about to become a zombie.
The idea that antidepressants totally change your personality is understandable, Tricamo says, since they are tinkering with your brain. The persistent “I won’t feel anything” fear, however, is unwarranted. “Antidepressants are designed to help you return to your former demeanor,” she says, not transform you into some always-up or totally-out-of-it new you.

MORE: American Women Run On Prozac

“There’s some need to preserve a sense of your own identity or some kind of self-integrity or a version of yourself that being medicated might alter,” O’Hare says of this hesitance some people have to taking antidepressants. Of course, if you do feel like meds are “flattening” you, talk to your doctor, who can likely suggest another option.

There’s usually some trial and error involved before you find the right one.
When Shattuck first started medication, she went on Paxil and had horrible nightmares. Zoloft gave her heart palpitations and sent her anxiety through the roof. But just because one antidepressant makes you, say, sweat profusely, doesn’t mean they all will; it’s worth giving a few a try if nothing feels quite right at first, Tricamo says.

Even if you try one and feel nothing—no uncomfortable or dangerous side effects, but no real improvement either—don’t give up. With dozens on the market, odds are the first one isn’t the right one, O’Hare says, and frankly, it could take years to find one that helps. He was so frustrated by his experience with one drug in 2014 that he decided he wouldn’t try anything for a while. “I didn’t want to go through that hunt,” he says.

The process of starting a new antidepressant over and over again isn’t ideal, but it’s worth it to him. “It’s hard, but when you have major depression, after a while it’s just not worth being unmedicated or untreated anymore,” he says. “It’s so worth it to not feel the way you do when you’re suffering through major depression.”

Stopping or switching can be a Process with a capital P.
If only it were as simple as filling a new prescription. To avoid those aforementioned withdrawal symptoms—which can include anxiety, irritability, dizziness, headaches, muscle aches, and chills—doctors carefully and methodically wean patients off antidepressants when it’s time to stop or change meds. Shattuck says the last time took about a month to gradually taper her dose with her doctor. She felt flu-like fatigue, was more tearful than usual, and had what’s come to be called “brain zaps,” a feeling likened to an electrical current momentarily pulsing through the brain. Some people notice the effects of tapering almost immediately, Tricamo says. Some lucky others have no problems whatsoever.

Yes, yoga, meditation, and getting more sleep can help. That doesn’t mean antidepressants don’t.

Tricamo has a patient whose mother continually tells her she should quit the meds and take up yoga and meditation instead. There’s (probably) nothing wrong with any of the lifestyle tips offered up by your neighbor, your uncle, or that blogger you follow on Pinterest—but that doesn’t mean antidepressants are out. “Maybe she should be doing yoga and meditation, but that doesn’t mean she shouldn’t also be taking Zoloft and going to therapy every week,” Tricamo says. In fact, all these tools might work better together, if antidepressants are the “contact lenses” that clear the fog so you can actually get yourself to the yoga class.

MORE: 7 Reasons You’re Tired All The Time

Even if people mean well, this “just try yoga instead!” mentality is rooted in stigma, Tricamo says, against both psychiatric illness and its medical treatments. As long as there’s reason to believe there is a biological basis for mental illness, however, there’s reason to believe there is a biological treatment to go along with it. “If you have asthma and you can’t breathe, are you going to try to just meditate through it?” she asks.

O’Hare does his best to tolerate this kind of advice because he knows his friends mean well. “I’m not about to criticize my friends for whatever bits of helpfulness they’ve thrown my way,” he says. “I’m grateful for any and all of it, even when it is repetitive or bullshit.”

You can maybe even safely take them while pregnant.

Starting or growing a family can be a tricky decision for anyone, but women who use antidepressants have an extra layer of complication to decode. Questions about how antidepressants might affect a developing fetus have long been up for debate, and the most recent news is the meds don’t seem to have lasting cognitive or behavioral effects on children born to moms who use them.

Know what does leave a lasting impact on the lil guys? Moms who are depressed. “My midwives kept saying it’s not just the safety of my unborn baby that we had to consider but my safety and mental health,” Shattuck says. She stayed on antidepressants during both her pregnancies, a decision she calls “the most difficult part of my journey” with depression. Her son, now 6, and her daughter, almost 4, are both healthy. “They didn’t go through any of the scary things you find if you Google ‘antidepressants during pregnancy,’ ” she says with a chuckle. She was wracked with guilt, though, a feeling she doesn’t imagine she would have had if she had needed meds for, says, diabetes at the time. “A lot of people have to take medication during pregnancy for physical ailments,” she says. “I don’t know if I would be as hard on myself as I was about antidepressants.”

Sure, there’s a lot we don’t entirely understand about how they work. But they work.
You’ve likely heard the relatively straightforward theory that depression is caused by an imbalance of the neurotransmitter serotonin in the brain. If that were the case, drugs called selective serotonin reuptake inhibitors (SSRIs), which work by keeping more serotonin available in the brain, would obviously be an easy solution.

Unfortunately, it’s pretty clear today that depression is a much more complicated story than that: Serotonin’s not the only neurotransmitter involved, for starters, and we still don’t entirely know how antidepressants actually work. We know depressed people’s brains look different on imaging tests, but “we don’t necessarily have all the answers from science yet,” Tricamo says.

Whether we prescribe the meds, take them, or know someone who does, we’d probably all be more comfortable if we did have more answers. Antidepressant-bashing critiques range from there are too many people on them who don’t need them to they don’t work at all and patients only benefit from a placebo effect. “There are significant questions we should be asking about who needs antidepressants, why doctors prescribe them, and how the insurance industry approaches mental illness,” Maura Kelly wrote in the Atlantic in 2012. “But that, of course, doesn’t mean that antidepressants are dummy pills that have no real effect; and it’s crucial that depressives—many of whom are suspicious of medication—realize that.”

Shattuck is just glad they’re even an option. “Until really recent history, people didn’t have access to medication that could help them if they had depression,” she says. “I’ve come a long way from thinking, ‘Why can’t I do this on my own?’ to a place where I’m thankful I live in a time where it’s not quite as stigmatized and there’s access to help.”

Netflix series about teen girl’s fictional suicide raises alarm | The Seattle Times

In the month since the popular Netflix show “13 Reasons Why” was released, a rising chorus of mental-health experts, and worried parents, contend that too many of the show’s messages on suicide are inaccurate and potentially dangerous.

As a mom who lost her son to suicide in 2013, a Houston nurse became concerned when she heard about the popular Netflix show “13 Reasons Why.” By then her 15-year-old daughter had already binge-watched it.

In the series, the character Hannah Baker kills herself in despair, leaving audiotapes for the people she holds responsible, among them, her rapist, fickle friends and bullies. The tapes are part justification for her suicide and part vengeful accusation of her peers.

But in the month since the show’s release, a rising chorus of mental-health experts contend that too many of the show’s messages on suicide are inaccurate and potentially dangerous. Superintendents and school counselors around the country have issued warnings to parents that “13 Reasons Why” glorifies suicide and could lead to an increase in copycat behavior and self-harm among vulnerable students.

“We are concerned about our children watching this series without adult supervision because it romanticizes and sensationalizes the idea of suicide,” Lisa Brady, superintendent of schools in Dobbs Ferry, New York, wrote in an email to parents.

Its creators have defended the show, saying they aimed to make the drama helpful to struggling kids.

But for the nurse’s family, the show has been devastating. Her daughter, who found her brother’s body, has been working through depression and trauma ever since. With treatment and regular therapy, things got better — until she watched “13 Reasons Why.” Now the show has set off new thoughts of despair and suicide in her daughter, she said.

“If I’d known about the show beforehand I would have monitored her Netflix account a bit more,” said the nurse, whose name is being withheld to protect her daughter’s privacy. “If kids have a history of depression, self-harm or suicidal thoughts, I don’t think they need to watch it.”

On Friday, in a letter to parents, Robert Avossa, superintendent of Palm Beach County schools in Florida, reported that his employees have seen an uptick in self-mutilation and threats of suicide among elementary- and middle-school students since the show began.

The Netflix series, which may be renewed for a second season, is based on the 2007 young adult novel “Thirteen Reasons Why,” by Jay Asher. It includes a graphic scene in which Hannah kills herself with a razor. Its creators say it’s an unglamorous death, and they worked hard to make sure it wasn’t gratuitous.

Netflix has created an accompanying 30-minute documentary “Beyond the Reasons,” which includes the cast, producers and mental-health experts discussing some of the show’s more difficult scenes. In the documentary, Brian Yorkey, the creator of the series, said, “We did want it to be painful to watch because we wanted it to be very clear that there is nothing — in any way — worthwhile about suicide.”

In a statement, Netflix said the writers sought the advice of medical professionals while writing the script, and the show carries a TV-MA rating as well as a warning about graphic content. “Our members tell us that 13 Reasons Why has helped spark important conversations in their families and communities around the world,” the statement said.

Some parents have defended the show. Dawn Zawadzki, a paralegal from Fort Mill, South Carolina, said she watched part of the series with her 16-year-old daughter.

“Everybody is saying ‘it glamorizes suicide,’ but I don’t think it does,” she said. “It’s making us wake up and look at it.”

Not everyone agrees. Just before its March 31 release, a producer sought the support of the JED Foundation, a teen suicide-prevention group. “I think they were looking for us to say, ‘It was a great educational tool,’ ” or that “they handled the issues in a psychologically helpful way,” said Dr. Victor Schwartz, a psychiatrist and the chief medical officer at the JED Foundation.

Ultimately, he could not support what he called “one long revenge story.” The group issued a guide about the show, advising people who choose to watch it to view it with someone else and to take breaks between episodes rather than binge watch.

“It’s complicated, because they got a lot of important issues out on the table,” Schwartz said. But he’s concerned that students could think of suicide as a way to get back at people and worried that showing the specific way Hannah died would spur imitators. “The missteps are high stakes,” he concluded.

The problem, suicide-prevention experts said, is that even an ugly suicide can beget copycats. Research has shown that “someone else’s death by suicide can reinforce a vulnerable person’s motivation to die by suicide,” said Madelyn Gould, a professor of epidemiology and psychiatry at Columbia University.

On Instagram, Paris Jackson, a 19-year-old model who has tried to kill herself in the past, called the series, “extremely triggering.” “Please only watch this show with caution and keep in mind that it may put you in a dark place,” she wrote in a post that got more than 20,000 likes.

The National Association of School Psychologists has advised teenagers who have had suicidal thoughts to avoid the series entirely. They recommend that any teenager should watch with a parent who can make it clear that suicide is not a solution to problems.

The show’s fatalism leaves the impression that suicide can’t be stopped, experts said. In one concerning scene, a character agonizes that he could have done more to help his friend. A school counselor tells him: “If she wanted to end her life, we weren’t going to stop her.”

The statement runs counter to the advice given to teachers and peers about how to help at-risk teens.

“For kids, that action is staying with your friend, not keeping it a secret, and telling a trusted adult,” said Richard Lieberman, who coordinated suicide prevention for Los Angeles Unified School District for 25 years. Another option is to call the National Suicide Prevention line, 1-800-273-8255, or text HOME to 741741.

David Miller, author of “Child and Adolescent Suicidal Behavior: School-Based Prevention, Assessment, and Intervention,” said that children and adolescents often tell their peers about their suicidal behavior rather than adults. He said, “the way adults are portrayed as incompetent or clueless” is a major problem in “13 Reasons Why,” because he thought it would dissuade students from seeking critical assistance.

Although the creators of “13 Reasons Why” aspired to educate, the show itself never mentions a critical point: most children who die by suicide have a mental-health disorder like depression that is treatable.

26 Pieces of Advice That Have Actually Helped People With Mental Illness

With that expert’s list of ways to manage anxiety, the latest trendy mental health app and that “magical cure for depression” your aunt heard about on TV, it seems like everyone’s full of mental health advice these days.

Source: 26 Pieces of Advice That Have Actually Helped People With Mental Illness

 With that expert’s list of ways to manage anxiety, the latest trendy mental health app and that “magical cure for depression” your aunt heard about on TV, it seems like everyone’s full of mental health advice these days.

So, we asked our mental health community to share pieces of advice they’ve actually found helpful. These little nuggets of wisdom aren’t FDA-approved, but when used correctly side effects may include: self-care, acceptance and a little more patience with yourself.

Here’s some advice that’s actually helped people with mental illness:

1. “On a particularly difficult day, I was trying to fight through an anxiety attack and finish all the child-related tasks I needed to complete. My husband kept offering help, and I kept refusing. He pulled me aside in the laundry room as I was frantically folding another load and said, “Just let me help you.” It doesn’t immediately make the anxiety go away, but it’s helped me learn to let go.” — Maria Heldreth

2. “Don’t wait. See a doctor. Don’t be afraid to ask for help. Don’t be embarrassed. Chances are, someone knows exactly what you’re going through.” — Kristin Salber

3. “I have depression and anxiety (as well as other chronic medical conditions), and after the worst week I’ve had in a while, my doctor  said,“Find something you enjoy, and if you can’t find that, find the joy in something.” This really had an impact on me and still reminds me to look for a silver lining.” — Faith Merryn

Related: To the Husband With the Wife Who Has Depression

4. “I have generalized anxiety disorder, and I made friends with someone who’s extremely similar to me. She told me to always be myself and the people who truly care will stick around. It truly did help.” — Julia Ann Lange

5. “Words can hurt to say, but they need to come out. Write all those words down on paper.” — Melissa Cote

6. “A friend recently told me that no matter if I get a job one day or not,your life matters as long as you can make people smile. When I think of it that way, it’s easier to see my life as something of worth.” — Emma Wozny

7. “A great therapist I had told me to focus on ‘harm-reduction, not perfection.’ I felt like I was expected to magically ‘get better,’ and she helped me learn that starting with baby steps was totally OK.” — Jen Decker

8. “Someone said, ‘I’ve been here, I know a way out, I’m here to show you too.’ And, ‘It gets better, it may not leave, but it gets better. And it has.” — Tom Everman

9. “I have anxiety and major depressive disorder. This is going to sound ridiculous, but my best friend once told me, “When you’re sad, watch ‘The Simpsons.’” It actually works when I’m panicking, too. It gets my mind off whatever I’m obsessing about, and I usually end up laughing.” — Dawn Czarnecki Seshadri

10. “It wasn’t long after my diagnosis that I was told pretty bluntly: ‘This illness is has no cure. You’re going to carry this illness for the rest of your life. So you can either wallow in the weight of that, or you can fight for your only life and make it a good story.’” — Lyss Trayers

11. “My depression and anxiety stem from a traumatic childhood. Just hearing ‘it wasn’t your fault‘ from my psychologist was incredibly helpful.” — Kathrine Elise

12. “Don’t always believe what your brain is telling you.” — Kerri Lewis Brock

Related: 36 Things People With Anxiety Want Their Friends to Know

13. “It’s OK to feel sad. You don’t need to pretend.” — Allyson White

14. “The best advice: Treat yourself as if you were a good friend.”— Julie Jeatran

15. “Celebrate every accomplishment, no matter how small,instead of dwelling on all the things we perceive as failures.” — Jennifer Northrup

16. “I have post-traumatic stress disorder and bipolar disorder. When I was in intensive outpatient therapy, the counselor looked at us and said,‘It’s over. That moment is over. It isn’t going to happen again.’For some reason, that resonated with me.” — Nicole Hanes

17. “They told me this: ‘You are not broken; you are a whole person. You are just human. A human who is living, learning and growing. And learning, living and growing comes with bumps in the road. Remember that this is just a bump.‘” — Kallie Kieffer

18. “Your worst days will only be 24 hours.“ — Arielle Smith

19. “You wouldn’t skip a dialysis or chemotherapy appointment. Your therapy appointments are just as important. No excuses.” — Jennifer Davis

20. “‘I think you need to give therapy a try.‘ Thanks to that, I started therapy and I’m now on the path to recovery.”  — Julianne Leow

21. “Your struggles are your accomplishments in disguise.” — Katherine J Palmer

Related: 14 Things I Didn’t Expect to Learn at a Psychiatric Hospital

22. “Remember: Depression lies. Don’t believe it.” — Beth Brogan

23. “Always ask for help. There is never any shame in asking for help.” — Meghan Shultz

24. “Take life 5 minutes at a time.” — Stephanie Lynn

25. “You can’t give everyone else everything you have. You absolutely have to save a little of yourself for yourself.” — Shawn Henfling

26. I am a human being. Not a human doing. I just have to be.” — Michelle Balck

Answers have been edited and shortened.

By Sarah Schuster

More from The Mighty:

What the Starbucks Barista Didn’t Know When She Wrote ‘Smile’ on My Coffee

31 Secrets of People Who Live With Anxiety

I Have OCD. This Is What It’s Like to Be in My Mind for 3 Minutes.

What makes you happy?

recommended by a client today, so I put

it up here for all to find and use.

Rory

What makes you happy?

After I Was Diagnosed With Bipolar Disorder, I Decided to Move Forward

After I Was Diagnosed With Bipolar Disorder, I Decided to Move Forward

Posted: Updated: 


When I was 17 years old, I was diagnosed with Bipolar Disorder, something that came as no surprise, as my life prior to my diagnosis was fraught with behavioral challenges. At 21 years old, after years of battling uncontrollable moods, fits of rage, a myriad of body image issues, addiction and frustration with finding adequate medication I found myself in my first psychotic episode. This was no way to live, I knew I was capable of so much more as an articulate young woman with big dreams. At 5 o’clock in the morning on July 7, 2011, after driving through the night with a head full of racing thoughts in a mind that possessed zero ability to cope, I found myself collapsed on the porch of my father’s home manic, enraged and inconsolable. I was surrendering, I could no longer fight the battle my life prior to that summer had felt so unrelenting and inhibiting. After a brief rest early that morning, the first few hours of sleep I had experienced in days, is when made my decision to thrive. For years prior to that hazy morning, I had been urged by loved ones to receive intensive clinical psychological treatment in a formal setting, but I believe part of me was always resisting in denial and arrogance. It was at the end of my rope where I found my desire to change the trajectory of my life. On July 11, 2011, I made the first imprints in the path toward my new way of being in the world. I spent 90 days in intensive psychological care and healing treatment where I acquired invaluable “tools” that allowed me to move forward in the world, the woman I was on my father’s porch that July morning became a shadow of my former self and an unwelcome stranger in my future.

Almost three years later not a day goes by where I don’t draw on the lessons learned through my decision to thrive. I am currently finishing my Bachelor’s degree in clinical psychology and work as a peer counselor to youth experiencing their first onset of mental illness in Los Angeles, California. Everything I do comes from a place of gratitude for my demons and experiences that catalyzed my decision to forge the path I am on today. For I would be nothing without them just as I would be nothing without the boundless compassion, patience and support of the loved ones in my life who have championed all of my efforts.

I used to think the notion that people could change was a farce … until I did it myself. I am changing everyday, creating a more authentic self with every opportunity to do so, and within the beautiful chaos of it all — I am thriving.

Arianna has invited her Facebook followers to share their wake-up calls — the moments they knew they had to make changes in their lives in order to truly thrive and not just succeed — as part of a series produced in conjunction with the release of her book Thrive: The Third Metric to Redefining Success and Creating a Life of Well-Being, Wisdom, Wonder and Giving. You can read all the posts in the series here.

100 Ways To Motivate Yourself – YouTube

There is a multitude of free videos on YouTube  that can be helpful to assist in motivation and inspiration.
Here is just one.
Rory

100 Ways To Motivate Yourself – (Life Changer!) – YouTube.

100 Ways to Motive Yourself is packed with techniques for breaking down negative barriers and letting go of pessimistic thoughts that prevent you from fulfilling your goals and dreams. Whether you’re self-employed, a middle manager or a Fortune 500 executive, it’s easy to get stuck in a humdrum life and only fantasize about what “could have been”. Motivational speaker Steve Chandler helps you turn that way of thinking into what “will be”. His ideas will help you create an action plan for living out your vision in business or life in general. 100 Ways to Motivate Yourself is filled with proven methods for changing the way you think and developing self-creation. Chandler draws on the feedback he’s received from corporate and public seminar students to ensure that the methods work.

If you would like a free full Mp3 copy of this video, visit Our Website at http://insideabundance.com/ – Click “Free Downloads” and subscribe, and then download FREE OF CHARGE! .

Louise Hay – How To Love Yourself – YouTube

Louise Hay – How To Love Yourself [10 steps to loving yourself] – YouTube.

Published on 30 Jul 2013

Download Full Audiobook: Louise Hay – How To Love Your Self:http://worldbookonline.us/HowToLoveYo…

Would you like to be more at ease with yourself?
Do you sometimes feel that you are your harshest judge?
Would you like to incorporate more positive energy into your life?

If so, then this CD is for you! Louise L. Hay guides you through each of her ten steps to loving yourself. She discusses the concept of criticism, the power of meditation, being willing to change, what you believe you deserve, and much more. These ten steps are perfect for you if you’re looking for more realistic, practical ways to feel good about yourself. Louise closes the lecture with a beautiful and empowering meditation.

About the Author: Louise L.Hay
Louise L. Hay is a metaphysical lecturer and teacher, and the bestselling author of 27 books, including You Can Heal Your Life and Empowering Women. Her works have been translated into 25 different languages in 33 countries throughout the world. Since beginning her career as a Science of Mind minister in 1981, she has assisted thousands of people in discovering and using the full potential of theirown creative powers for personal growth and self-healing. Louise is the owner and founder of Hay House, Inc.

15 Things I Learned from My Nervous Breakdown…

very good list of things to meditate on . . .

Rory

 

15 Things I Learned from My Nervous Breakdown… and How They Can Help You Live Your Best Life – Calgary’s Child Magazine.

 

15 Things I Learned from My Nervous Breakdown… and How They Can Help You Live Your Best Life

I suffered a nervous breakdown at age 36 – and it turned out to be a breakthrough. Here are 15 important things about life and happiness that I have learned, and that I hope you will take to heart in the coming year.

I want you to do me a favor. Look to the upcoming year and ask yourself – realistically – what lies in store in 2012? If you’re like most people, a huge portion of your life will be spent anxiously plugging away at a job you may or may not enjoy with coworkers you may or may not like. Okay, yes, you work hard to build a better life for your family. But here’s the question: Will you have time to enjoy them? Will you be too exhausted to throw the ball with your son? And how many nights will you get home too late to tuck him in this year?

This pattern of stress and striving has to stop. We already live in uncertain and depressing times, and our lifestyles are driving us not toward new heights, but over the brink. And if you’re not careful, you may suffer the same fate I did.

When I was 36 years old, I was successfully leading my family’s auto parts business, I was well respected in my community, I had a wonderful wife and son… and I also suffered a nervous breakdown. Yes, at that point in my life, I enjoyed what I did and was truly proud of my successes, but I was also pushing myself too hard and prioritizing the wrong things, and eventually, it all caught up with me.

For months leading up to my breakdown, I suffered from a paralyzing depression and anxiety, and found it difficult to complete tasks as simple as deciding whether to order coleslaw or potato salad with my lunch. But I still consider myself to be very fortunate.

As horrific as it was, my breakdown was actually also my breakthrough. It was an in-your-face wake-up call that forced me to realize that I was driving myself too hard, and for the wrong reasons. I finally had to say, “Enough is enough! I am done destroying myself and ruining my life!” Admitting to myself that my former way of life wasn’t working was the beginning of my road to recovery and true happiness.

For the past decade, I have taken a closer look at what really makes people happy and unhappy, and I have seen most of my goals and priorities shift. In the same way, it’s in your best interests to shift your habits and focus in 2012. Call it a New Year’s resolution to simply be happy.

I have come to realize that how happy and fulfilled you are is largely under your control, and that it has less to do with success and accomplishments than you might think. I believe that most people are experiencing many – if not all – of the stressors that led to my breakdown, so please don’t wait until you, too, reach a breaking point to make changes in your life. I’m totally convinced now that true happiness is a possibility for everyone, so I’m asking you to take the lessons I have learned to heart.

If you’re ready to change the way you approach life before you drive yourself over the edge, read on for 15 life lessons that I have learned:

1. You have to choose and prioritize happiness – it doesn’t just happen. If you subscribe to the belief that your happiness is wholly dependent on what happens to you, you’ll always be dissatisfied. The truth is, your fulfillment largely depends on the choices you make: how you see the world, what you allow to influence you, what you focus on, and how you react to circumstances, regardless of whether they’re good or bad. In other words, it’s not what happens to you; it’s how you look at what happens to you.

If you want to make a dent in your stress levels, you have to make choosing happiness a priority every day. With all of the responsibilities on our plates, nothing is likely to happen unless we specifically focus on it. So make happiness one of the two or three priorities you absolutely must accomplish each day. To remind yourself, put a note where you can see it – maybe on the refrigerator or bathroom mirror. And if that sounds selfish, it’s not. If you’re extremely stressed or become depressed because of the way you’re living your life, you’re hurting many more people than just yourself. And what’s more important than teaching your kids to be happy? Always remember that children learn by example. If they see you living a harried, stressed life, that’s the pattern their lives will follow as well…and their children’s after them, and so on.

2. Striving for work/life balance is worth its weight in gold. Times are tough, and some of us are finding it necessary to work long hours to keep our jobs and livelihoods. Others have fallen into the trap of the work-ego addiction: over time, you become hooked on the “high” you feel when you accomplish something, get a promotion, etc., and you begin to spend more and more time at the office. Whatever the reason, if extremely long hours are becoming a habit for you, break it. No matter how good your intentions are, overloading on work will cause your relationships, mindset, and even health to suffer.

Prior to my breakdown, it was normal for me to work seventy- or eighty-hour weeks. In my personal dictionary, “rest” and “relaxation” were synonymous with “irresponsibility” and “slacking.” Boy, was I wrong. Working as much as I did is more than the human body is designed to take continuously. If you drive yourself that hard, you’ll eventually begin to run on fumes before you shut down entirely. Being firm about creating and maintaining a healthy work/life balance is no more selfish than prioritizing happiness – in this case, it’s about simple self-preservation! And if you’re still skeptical, remember this: no one looks back on their lives at age eighty and says, “Gee, I wish I’d spent less time with my family and friends and more time at the office.”

3. We are our own worst critics. If you’re like most people, you probably tend to focus a lot of your mental energy on the things you mess up rather than on the things you do well—even though most of us do a hundred things right for every one thing we do wrong. And although you may not realize it, focusing on that one wrong thing is very dangerous, because our thoughts are incredibly powerful. Until you give yourself permission to break free of the cycle of self-blame and negativity that causes you to be stuck demanding perfection from yourself in every situation, you’ll never have a chance to be a truly relaxed, content, and happy person.

It’s not easy to rewire your habitual thought processes, but you need to build yourself up more and beat yourself up less. I used to expect nothing less than perfection out of myself, which was delusional! We’re all human, which means that we’re going to make mistakes from time to time. That doesn’t mean that we’re in any way unworthy or undeserving of love. In fact, learning to love myself was at the core of my own happiness journey. If you aren’t satisfied with who you are, you’ll always be looking outside yourself for validation…and you’ll never be truly content. And like me, you might also push yourself beyond healthy limits in order to get accolades from other people.

4. It’s never too late to start living in the present. How often do your thoughts “live” in the present? More to the point, how often are they instead fixated on your “disappointing” or “disturbing” past or spent worrying about your future? If you are like most people, your percentage of time not spent in the present is way, way too high, and thus you’re missing out on life itself. If you’re letting what’s already happened eat away at you or fretting about what might come to pass, you’re not enjoying the blessings all around you. You’re exacerbating your anxiety and unhappiness by choosing to dwell on things you can’t change or control.

I used to spend a majority of my time rehashing my past mistakes and worrying about what might happen in the future, neither of which did anything for my peace of mind or self-esteem. In fact, these unhealthy and self-critical thoughts were a major contributor to my breakdown. Now that I’m making a conscious effort to live in the present, I’m actually enjoying all of the great things in my life instead of letting them pass me by unnoticed. Plus, I’m actually a lot more productive now that all of that mental space that used to be occupied with worries has been freed up!

5. Focusing on what you’re good at is best for everyone.
 If you aren’t good at something – especially if it’s work-related – chances are you’ll feel compelled to spend a lot of time and effort getting your skills up to par. It’s natural to want to shore up your weaknesses, but the fact is, this strategy tends to cause you a lot of stress for (most likely) mediocre results. Instead of trying to be good at everything, stay in your strengths as much as possible. When you’re doing what you’re good at, you’ll be happier and higher performing.

As I’ve said, I used to be a total perfectionist. I felt like I was a failure if I didn’t excel in absolutely everything I tried. It probably won’t be a surprise to hear that all I accomplished was making myself miserable when I failed to live up to my impossibly high standards. If that sounds familiar, I’d suggest focusing more time on a hobby or personal interest to start, even if you do it for only twenty minutes every other day. And if you determine that your career doesn’t utilize your strengths, start looking at online job postings or for local classes in your field of interest. It’s never too early—or too late—to start doing the things that make you happy.

6. Exercise is worth its weight in therapy.
 Yes, you’ve heard it (a million times) before, but exercise is one small change that yields really big, life-changing benefits. For starters, it will begin to make you feel more relaxed, stronger, and more capable of handling life’s challenges—also, it will improve your sleep, and it’s a natural anti-depressant that will help your attitude and outlook. In fact, exercise actually opens you up to future change by invigorating your mind and body.

I’m convinced that exercise is the single most important thing you can do to improve your life right now. Looking back, I believe that my breakdown occurred when it did because I had broken my feet and couldn’t work out. Before that point, exercise was essentially acting as a medication that helped to counteract the effects of the stressful lifestyle I was living, and after I recovered, it has continued to boost my energy and outlook. If working out is already a part of your life, great! If it isn’t, commit to walking just twenty minutes every other day to start out. You don’t have to join a gym, sign up for exhausting classes, and completely reorder your life to reap the benefits of this investment!

7. You need to feed your mind healthy ‘food.’ When was the last time you watched the nightly news and turned off the TV feeling positive and uplifted? If anything, hearing the headlines is more likely to be depressing and discouraging. Although many of us don’t want to admit it, the things we hear, read, and experience influence our own attitudes and outlooks, so it’s important to consciously “feed” your mind positive materials.

It may sound hokey, but over the years I’ve become a big proponent of motivational books, audio recordings, and DVDs. Whether we’re at work, talking with friends, or at home watching TV or surfing the web, most of us encounter a lot more bad news and predictions than we do good. No wonder we become negative and cynical! It’s important to seek out positive things that will counteract these influences and dispel unnecessary stress. Learn new, constructive things and expose yourself to fresh ways of thinking so that you don’t get stuck in a self-destructive rut.

8. Surround yourself with positive people. If you stop for a drink at the water cooler and find your colleagues griping about how much work they have to do and how unreasonable your boss is, you probably don’t think much of it. In fact, depending on how your own day is going, you might even join in. And although you may not realize it, your attitude will start to deteriorate. The fact is, if you spend a significant amount of time around other people who are negative, your own outlook will begin to mirror theirs.

It’s much easier for others to drag you down than it is for you to build them up. In terms of your attitude and happiness levels, you will be the average of the five people you spend the most time with, so you need to be around other people who share your commitment to happiness if you want to avoid unnecessary stress. I’m not suggesting that you completely sever relationships that aren’t entirely uplifting, but gradually, you need to gravitate more toward positive people and distance yourself from those who tend to bring you down. This might mean calling a positive friend and asking to meet up for coffee or a beer, or walking away from the water cooler when your coworkers begin to gripe and complain.

9. Invest in your relationships – especially your marriage.
 When we’re driving ourselves to the brink, personal relationships are usually one of the first things to suffer. After all, the more time you spend at work, the less time and energy you have to invest in friends and family. You don’t consciously realize it at first, but this gradual deterioration can leave you feeling unappreciated, angry, alone, and anxious. Remember, though, that loving, supportive relationships will majorly enhance your happiness levels, and that friends and family care about you and accept you in a way that your employer never will.

It’s never a waste of time to reach out to the people who are meaningful to you and tell them how important they are to you, or to try to address any unresolved grievances and apologize for the things you may regret. And there’s one relationship you need to focus on in particular: the one with your spouse or significant other. Put more work into this relationship than you do into anything else: your house, your car, or your job, etc. Celebrate your spouse every day. Tell her (or him!) all the time how beautiful she is and how lucky you are to have her in your life. Trust me: this can make such a great difference in your emotional health, your stress levels, and your overall happiness! I truly believe that I would not be as happy as I am today without the love of my wife, and I also believe that my breakdown would have been much worse without her support.

10. Take control of what you can. If you’re reading this, chances are your life isn’t exactly stress-free. It’s practically impossible to live in the modern world without a million worries ranging from work deadlines to bills to clogged gutters. While you aren’t omnipotent, you probably can influence at least a few of the things that are causing your anxiety. Try to eliminate or minimize situations that are stressors instead of constantly dealing with their effects. Often, it’s the little things that make the biggest difference when it comes to relieving stress.

Start by identifying the two or three things that cause you the most stress on a consistent basis – maybe having a messy house is one. Often, you’ll find that there are concrete things you can do to lessen or even eliminate the pressure. For example, you might have a frank discussion with your spouse and kids regarding chores. Or, you might finally hire a cleaning person to help you once or twice a month if you can now afford it. Also, if you can’t eliminate or change a stressor, such as a job you hate but can’t afford to quit, challenge yourself to handle it differently. Specifically, decide beforehand how you will react in a more enlightened way when certain stressful situations occur – actually visualize yourself handling them with poise instead of becoming outwardly or inwardly worked up. Having a game plan in place before the “beast” rears its ugly head really can reduce your negative reactions to stressors—big time.

11. Being friendly is a good investment.
 In our culture, it’s become a badge of honor to stride around with an air of importance and a stony face. After all, if you’re too busy to say hello, you must be important. Yes, it’s easy to become absorbed by your responsibilities – but you’re not doing yourself any favors by shutting out the rest of the world. Even if you don’t have time to answer all of your emails, you can still smile at people in the hall and say a friendly hello to the cashier in the grocery store. Making positive connections will bring more happiness to you and to others.

Have you noticed that although our society is more and more “connected” by technology, we interact less and less with other people on a meaningful, face-to-face level than ever before? Our plugged-in lifestyles aren’t doing us as many favors as we thought they would. Even when we’re not at work, we’re likely to be glued to our smartphones or laptops, which amps up our stress. Make a conscious effort to unplug and make a friendly connection with another human – even a simple smile or hello is great. The fact is, everyone on Earth is carrying some sort of burden. You can’t make their pain, stress, or grief just magically disappear…but you can be what I call a “lamp-lighter” – someone who makes others feel just a little bit lighter and happier on their journey, even if only for five seconds. When you make friendliness a habit, you’ll attract kindness and smiles in return…and you’ll feel great about yourself for making a positive difference in the world!

12. Helping others is the soul food of life. One of the (many) negative side effects of our busy lives is that we tend to think mostly about ourselves: how much work we have left on that big presentation, how we’re going to find time to take the kids to sports practice and pick up groceries, and much, much more. No matter how busy you are now, consider helping others to be an integral part of the healthy work/life balance that will help you to avoid unhappiness. This will give you perspective, make you feel good, and will prevent you from staying in the negative me-focused cycle that was making you unhappy in the first place.

Since my breakdown, I’ve become very involved in philanthropy. I’ve found that it really is better to give than to receive, and that reaching out a helping hand to someone who isn’t as fortunate as you tends to quash selfish impulses and highlight your own blessings. Giving of yourself doesn’t have to involve money, either – remember that your time, talents, and compassion are just as valuable as cash, if not more so. Consider visiting a disabled veteran at the VA, or simply rolling your neighbor’s trashcan up the driveway! And if you have kids, you’ll be setting a wonderful example for them. I promise you, whether you’re giving time, energy, money, or encouragement, being generous will build up your self-esteem, broaden your perspective, keep you anchored in reality, and connect you to your blessings – all components of a happy life.

13. It’s important to connect with something bigger than yourself. Yes, spirituality (much like politics) is a touchy subject. But believing in something bigger than yourself is essential to developing the kind of perspective you need to be happy. Whether you consider your Higher Power to be God, Yahweh, Allah, Buddha, Krishna, the Universe, or even just Nature or another entity, being willing and able to see and feel His (or Her, if you prefer!) presence in your life will enable you to move away from self-centeredness and focus your energy and concerns on the greater community. It’ll also provide solace and give meaning to unfortunate events and troubling life circumstances.

Personally, I’ve been connected to the Jewish faith for my entire life. But it was only after my breakdown that I really allowed my faith to grow. My personal belief that God exists and cares about me has changed the way I view the world—but you don’t need to espouse my beliefs, or even join an organized religion and attend services regularly. What I do hope you’ll do is make an effort to clarify your thoughts about faith and also make an effort to connect to your Higher Power, whether it’s through prayer, meditation, writing in a journal, doing random acts of kindness, or just spending time in nature. Eventually, I hope you’ll begin to see your Higher Power as a source of inspiration, renewal, strength, guidance, and aid – as I do.

14. A grateful heart is a happy heart. It’s very easy to take things for granted: the information your coworker emailed you, the fact that your car is running, and even the food you’re eating for dinner. The fact is, most of us have gotten into the habit of ignoring all of the good things in our lives. Instead, we focus our mental energy on being upset about what’s wrong and what we don’t have. Yes, cultivating an “attitude of gratitude” might be a clichéd concept, but the humility that comes from knowing you owe so much to so many others will, in turn, spur you to give back more often to those less fortunate than yourself. Plus, studies have actually shown that thankful individuals are 25 percent healthier than their counterparts, too!

To start tapping into the power of gratitude, just say “thanks” to the people who help you out during your day. And beyond that, try to notice all of the blessings in your life. If you live in America, you have access to great education, healthcare, and the freedom to worship and work as you choose. Those are huge things to be thankful for right out of the gate! We take these “basics” and much more for granted, and we often have others—whether it’s an ancestor of ours, a veteran, or a coworker—to thank for them. It’s extremely important to be aware of all of your blessings, and to honor and thank those whom you owe.

15. Asking for help isn’t a sign of weakness. All of the things I have learned from my breakdown will help you to cut your stress levels, and they’ll also aid you in cultivating a more balanced, happier life. But it’s also important to realize that feeling anxious, overwhelmed, or depressed are all very serious, and you shouldn’t expect yourself to easily “fix” these issues on your own.

If you feel that you’re in over your head, or if your best efforts aren’t working, please reach out and ask for help. I might never have recovered after my breakdown without the help of my friends, family, and medical professionals. This is all big stuff. You shouldn’t—in fact, you can’t—make big changes in your life alone. At the very least, you’ll need the support of those who love you.

Ultimately, I’ve learned that the quality of your life is largely up to you. If you’re anything like me – and if you’re honest with yourself – you’ll have to confess that a striving, stressful lifestyle is not making you happy. I’ll admit that many of the changes I’m asking you to make in order to avoid more unhappiness (and perhaps even a breakdown) go against what society says you should do if you want to be successful. But I have found out the hard way that a “successful” yet stressed out and unhappy life is certainly not, in reality, a truly successful life at all.

Todd Patkin is the Author of Finding Happiness: One Man’s Quest to Beat Depression and Anxiety and – Finally – Let the Sunshine In (StepWise Press, 2011, ISBN: 978-0-9658261-9-8, $19.95). The book is available at bookstores nationwide, from major online booksellers, and at www.findinghappinessthebook.com.

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Psychiatrist: I hate suicide but also understand it

Psychiatrist: I hate suicide but also understand it – CNN.com.


Film director Tony Scott left notes in his car and office before plunging to his death, a coroner's official said.
Film director Tony Scott left notes in his car and office before plunging to his death, a coroner’s official said.

STORY HIGHLIGHTS
  • Most people who commit suicide are losing a battle against major depression, psychiatrist says
  • These suicides can haunt and hurt most of all, Dr. Charles Raison says
  • Depression-related suicides cast a long shadow over relatives and friends, Raison says
  • Talking about suicide with someone can decrease the chance of it happening, he says

Editor’s note: Dr. Charles Raison, CNNhealth’s mental health expert, is an associate professor of psychiatry at the University of Arizona in Tucson.

(CNN) — I got a terrible shock when I heard the news that the famous director Tony Scott had apparently committed suicide by jumping off the Vincent Thomas Bridge in San Pedro, California.

Not because I knew Scott, and certainly not because it is a rare thing for people who seem to “have it all” nonetheless to kill themselves.

No, I got a shock because I knew the bridge.

For the better part of a decade, I trained and then worked as a psychiatrist in Los Angeles. For several of those years, I did psychotherapy with a young woman who drove over that same bridge every day. The bridge became almost a third person in our work together, because she talked about it constantly.

Dr. Charles Raison

Dr. Charles Raison

Every morning and then again every evening she faced huge anxiety as she approached its yawning span because it was all she could do not to stop her car and throw herself off it. Just seeing that bridge made all her pain and despair intensify, and it came to represent everything that was wrong with her life.

On the other hand, it’s a beautiful structure, in an industrial sort of way, and it also seemed beautiful to her because it was always there, silently waiting, always offering an easy out. When things were really bad, she’d drive 20 miles out of her way just to avoid that bridge and the terrible temptation to jump or crash her car off the side.

Director Tony Scott: An appreciation

Director Tony Scott dies

Scott called more ‘reflective’ recently

‘Top Gun’ director Tony Scott dies

Fortunately, my patient avoided Scott’s fate. She came to grips with a history of abuse and her depression eased. She married and left Los Angeles. I also left Los Angeles, but a few years ago, I returned to the San Pedro area to give a talk and crossed that bridge with a mixture of relief and distress.

It is that strange mixture of relief and distress that characterizes many of the responses to Scott’s apparent suicide that have been posted on CNN.com.

Many comments come from family members of people who have committed suicide, some defending the loved one’s decision, others decrying it as the ultimate selfish act. Although I’ve spent my life battling suicide, I find myself empathizing with both points of view.

Cornelius: ‘I am the face of suicide’

Perhaps the first thing to say about suicide is that people make suicide attempts for all sorts of reasons. Sometimes people want to die, or half want to die.

But just as often in my experience, suicide attempts are a cry for help, or a way to punish people they are upset with, or a means of controlling a situation. I’ve known more than a few married people who kept a husband or wife from walking out on them, at least for a while, by making a suicide gesture.

On the other hand, people really only kill themselves for three reasons.

Occasionally people will commit suicide because they are facing some incurable condition that promises a brief future filled with nothing but pain.

Although many mental health clinicians will disagree vociferously with me, I have seen suicides that I felt were in this sense justified. For example, I knew a grand old fellow who, in the midst of unbearable physical pain from inoperable cancer, took his life when he had a life expectancy of two to three months.

Occasionally people will commit suicide because they are psychotic and believe they must die for some reason that makes no sense to anyone else. I had a patient once who made a very serious suicide attempt because she believed that if she died, the mysterious private investigators who were stalking her would leave her family alone.

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These types of suicides are heartbreaking, because they are so futile and can often be prevented by appropriate treatment.

The vast majority of people who choose methods of suicide that are almost guaranteed to succeed — like a gun to the head or a plunge from a high bridge — do so because of they are losing a battle against major depression. These are the suicides that haunt and hurt worst of all, and that almost to a person are the most tragic.

I hate suicide.

I’ve been fortunate that suicide does not run in my family. But it runs in lots and lots of families and I’ve known — and known of — more people who have killed themselves than I can easily count.

There was the shy kid who shot himself in high school, the young punk who drove his car off a particularly bad curve, the wonderful hard-working father of the class valedictorian, and various in-laws across a couple of marriages.

And those are just people from my personal life. Like any psychiatrist who deals with the severely mentally ill, my life is littered with memories of folks who threw themselves off high buildings, hanged themselves in dark closets or slit their throats in dusky gardens.

Junior Seau’s death classified as a suicide

But as much as I hate suicide, I also understand it. One of the things people have repeatedly posted in comments responding to Scott’s death is that you can’t weigh in on why someone might commit suicide unless you’ve really had your life torn apart by an episode of major depression.

I agree.

Severe major depression is probably the most unbearable pain a human being can withstand for any protracted period of time. Many people who died of cancer have written eloquently about how the crushing pain from their tumors paled in comparison to the pain they felt when depressed.

With all other pain, most people can maintain some sense of separation between themselves and the pain. As horrible as it is, the pain is in their arm, or leg, or belly or head. But there is still a “them” that is separate from the misery.

Depression is different. Because it is at its essence a perceptual disorder, it causes one to see the entire world as pain. It feels painful inside, but it also feels painful outside.

When a person is depressed, the entire world is disturbed and distressed, so there is nowhere to escape. And it is this fact that makes suicide so seductive, because it seems to offer the one available escape option.

There are at least two reasons why suicide in response to major depression is so horrible and so tragic. First, although our treatments for depression are far from perfect, they are nonetheless effective enough to help the vast majority of depressed people feel well enough to forgo killing themselves.

Tony Scott’s cinematic contributions

And even when treatment is not particularly effective, depression often passes on its own accord. It is not an incurable cancer that offers a guaranteed foreshortened future of unbearable pain. Because of this, depressed people kill themselves over something that would have lifted had they just been able to hang in there.

The other reason depression-driven suicides are so tragic and terrible is because they cast such long shadows on families and other loved ones.

Children especially suffer. They grow up wondering why, and whether they could have done something, and whether they’ll have to struggle with the same urges.

I think of people I have known in this situation, and I have to think of something else to keep from tearing up as I write this. More than once I’ve “guilted” acutely suicidal patients into not killing themselves for the sake of their children and have done so with a clear conscience.

We may or may never know why Scott apparently killed himself, but we can be sure that his family and friends will spend many years wondering what they might have done to have protected him. This is part of the painful legacy left by suicide, and my heart goes out to them.

In fact, even psychiatrists have a difficult time predicting when someone is at heightened risk for suicide. In part, this comes from the fact that many people who really want to kill themselves keep their mouths shut about it and just go do it. In part, it comes from the fact that suicide is often an impulsive act driven by acute and unpredictable increases in anxiety and despair that one cannot predict in advance.

For families and friends worried about the suicidal potential of a loved one, there are a few useful pieces of advice I can offer from the research literature, such as it is.

Husband of Fukushima suicide victim demands justice

First, older men are more likely by far than other people to kill themselves.

Second, people who kill themselves often will tell someone ahead of time. Any such communications should be taken with utmost seriousness, and all efforts should be made to keep the person safe and get him or her to appropriate treatment immediately.

Third, even over the suicidal person’s objections, the means for committing suicide should be removed from the environment. Guns should be taken out of the house. Pain pills should be taken elsewhere.

Fourth, studies conducted over the last 20 years suggest that the biggest short-term risk for depressed people to kill themselves is the development of unbearable anxiety. If a loved one with depression begins to pace the floors or do other things suggesting that they are becoming consumed with terror, panic or dread, the risk for suicide shoots up.

Finally, it is not true that talking about suicide increases the likelihood it will happen. In fact, studies suggest the opposite.

So if you have a loved one with depression who is struggling with the will to live, one of the best things you can do — over and above getting them immediate health care — is to check in with them regularly and honestly and act if their drive to die intensifies.

Mindfulness Meditation: Effective as antidepressants for depression relapse

Mindfulness meditation found to be as effective as antidepressant medication in prevention of depression relapse.

TORONTO, Dec. 7 /PRNewswire/

A new study from the Centre for Addiction and Mental Health (CAMH) has found that mindfulness-based cognitive therapy — using meditation — provides equivalent protection against depressive relapse as traditional antidepressant medication.
The study published in the current issue of the Archives of General Psychiatry compared the effectiveness of pharmacotherapy with mindfulness-based cognitive therapy (MBCT) by studying people who were initially treated with an antidepressant and then, either stopped taking the medication in order to receive MBCT, or continued taking medication for 18 months.
“With the growing recognition that major depression is a recurrent disorder, patients need treatment options for preventing depression from returning to their lives.” said Dr. Zindel Segal, Head of the Cognitive Behaviour Therapy Clinic in the Clinical Research Department at CAMH. “Data from the community suggest that many depressed patients discontinue antidepressant medication far too soon, either because of side effect burden, or an unwillingness to take medicine for years. Mindfulness-based cognitive therapy is a non pharmacological approach that teaches skills in emotion regulation so that patients can monitor possible relapse triggers as well as adopt lifestyle changes conducive to sustaining mood balance.
Study participants who were diagnosed with major depressive disorder were all treated with an antidepressant until their symptoms remitted. They were then randomly assigned to come off their medication and receive MBCT; come off their medication and receive a placebo; or stay on their medication. The novelty of this design permits comparing the effectiveness of sequencing pharmacological and psychological treatments versus maintaining the same treatment – antidepressants – over time.
Participants in MBCT attended 8 weekly group sessions and practiced mindfulness as part of daily homework assignments. Clinical assessments were conducted at regular intervals, and over an 18 month period, relapse rates for patients in the MBCT group did not differ from patients receiving antidepressants (both in the 30% range), whereas patients receiving placebo relapsed at a significantly higher rate (70%). “The real world implications of these findings bear directly on the front line treatment of depression. For that sizeable group of patients who are unwilling or unable to tolerate maintenance antidepressant treatment, MBCT offers equal protection from relapse,” said Dr. Zindel Segal. “Sequential intervention — offering pharmacological and psychological interventions — may keep more patients in treatment and thereby reduce the high risk of recurrence that is characteristic of this disorder.
The Centre for Addiction and Mental Health (CAMH) is Canada’s largest mental health and addiction teaching hospital, as well as one of the world’s leading research centres in the area of addiction and mental health. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit www.camh.net.
SOURCE Centre for Addiction and Mental Health

Embracing the Dark Side

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Embracing the Dark Side:

Discerning the positive aspects of sadness, bereavement,
and other negative feelings.          by Jenna Baddeley
http://www.psychologytoday.com/blog/embracing-the-dark-side/201002/what-do-women-want-hint-it-isnt-prince-valiant

Renowned relationships and marriage researcher John Gottman has found that one of the characteristics of successful husbands – husbands whose marriages are long and happy – is that they accept their wives’ influence. This means honoring their wives’ opinions, ideas, plans, dreams. It means allowing their opinions and plans to be changed by their wives’ opinions and plans in large and small areas, from what to make for dinner to what kind of house to buy.

It is strange at first glance that wives’ ability to accept influence doesn’t predict marital stability. It turns out that this is simply because there is very little variation in wives’ willingness to accept influence. Indeed, wives are sometimes all too willing to sacrifice their own dreams in order to better fulfill their husbands’ dreams   . . . .

click on the link above for rest of article.