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  1. Phobiasupportforum

    6 Life Lessons I Learned Last Year

    Danish philosopher and theologian Søren Kierkegaard once wrote, “Life can only be understood backwards; but it must be lived forwards.” The beginning of a new year is an appropriate time to look back over the lessons learned from the mistakes and experiences of previous months. In 2018, I wrote two letters of resignation, grieved the ending of two significant relationships, and spent several weeks on a hospital waiting list for severe depression and weight loss. I fumbled, got lost, and confronted demons that I had been running from my entire life. The result is that I came away with a set of invaluable lessons that I take into the new year. Here are six of them. 1. Don’t measure your self-worth by your job performance or title. Once was not enough for me to learn this important lesson. I had to make the same mistake twice to appreciate why you should never measure your self-worth by the status of your occupation. In my first job, I lost myself in the pursuit of approval and acceptance of my co-workers. In placing too much of my self-identity into my work, constructive criticism felt more and more personal. I got turned around and forgot what I loved about the job. Trying to make up for the insecurity I felt at the first job, I arrived at my second job as an overly ambitious employee, setting an unrealistic pace I couldn’t sustain. As soon as I woke up to my limitations as a human being without superpowers, my self-esteem crumbled. Both experiences taught me that you absolutely must fill up your tank of self-love with things other than job performance and job title if you want a good shot at serenity. 2. Stress kills. Not investing too much of your self-identity into your job was the first of two lessons I learned at my second job, where I worked as an editor for a health website. The second lesson was this: stress kills. In my time editing hundreds of articles on a variety of chronic health conditions, I noticed that the one common denominator among all of them was stress. Every piece I produced on flare ups — in dementia, psoriatic arthritis, or eczema — included stress as a powerful trigger. Stress not only complicates diseases, it can make any condition life-threatening. Stress is what pushed my painful depressive ruminations of last year into intense suicidal thoughts that had me on the verge of hospitalization. Not until I made the necessary changes in my life at work and at home to reduce that stress did my ruminations become manageable. 3. Self-compassion is the path to healing. Some of us learned a message early on that the way to an improved self is to beat ourselves to death. We bash ourselves for every mistake we make; we push ourselves beyond our threshold; and we fixate on a picture of a successful self that is unrealistic and unattainable. The result is that there is nothing to catch the broken pieces of ourselves when we fall apart. I’ll never forget the doctor’s appointment last year when my physician told me that if I didn’t start to show myself some self-compassion I would end up in the hospital. Self-compassion was and is the most difficult and the most important lesson I will ever learn. Being okay with my imperfect self feels horribly awkward and uncomfortable. Relaxing into the truth that “I am enough” runs counter to the overachieving agenda that has pushed me for 48 years. However, my first steps toward this new mindset have already planted seeds of peace that I didn’t know was possible. 4. By identifying old tapes, you can rewrite your narrative. “There is no coming to consciousness without pain,” remarked the Swiss psychiatrist and psychoanalyst Carl Jung. “People will do anything, no matter how absurd, in order to avoid facing their own Soul. One does not become enlightened by imagining figures of light, but by making the darkness conscious.” I have sat on many therapy couches over the course of 30 years, but not until this year did I dig deep enough to uncover the source of the painful tapes that have played over and over again in my subconscious brain my entire life, driving much of my depression, anxiety, and dysfunctional behavior. In the safe sanctuary of psychotherapy, I was able to begin replacing the damaging and hurtful narrative that has become automatic with a message of loving kindness. It is never too late to try to identify the source of your damaging tapes and rework the narrative. 5. Marriage is an organic, evolving relationship. “All living relationships are in the process of change, of expansion, and must perpetually be building themselves in new forms,” Ann Morrow Lindbergh explains in her classic Gift From the Sea. “There is no holding of a relationship to a single form.” I used to be proud of the fact that my husband and I never fought. Friends and families put our marriage on a pedestal. This year I realized it had more to do with our fear of the kind of candid communication that is uncomfortable and at times hurtful. While we have always been loving toward each other, our relationship needed a dose of the brutal honesty that results in yelling and slammed doors. Such disruption is not a sign of demise. It’s an indication of growth. In marriage therapy, we pressed through the boundaries that had kept us safe, frozen in a single form, as Lindbergh describes. Now we are moving through the awkwardness of growth to a deeper intimacy. 6. Being yourself takes tremendous courage. “To be nobody-but-yourself in a world which is doing its best, night and day, to make you everybody but yourself-means to fight the hardest battle which any human being can fight—and never stop fighting,” wrote E. E. Cummings. Ralph Waldo Emerson’s version is this: “To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.” Last year I ran up against the temptation over and over again to become an imitation or a version of myself that I thought was more acceptable or likable to the world. As I wrestled with whether or not I should return to writing and work as a mental health advocate, I experienced many colors and patterns of fear. I didn’t know if I was brave enough to be me. Ultimately I decided to pursue my passion. I enter into this year with a renewed conviction to be myself, as uncomfortable as that feels on some days. View the full article
  2. I am a friend. Therefore, these words are my own stories, opinions, impressions, and thoughts on having a friend with depression in this moment. They are not concrete or bible or forever — they are my truth right now. I am a friend. I think a damn good one. That is all, but sometimes it is a lot. As I think back, depression was always a part of our relationship. But at 18, 21, 24 we didn’t call it that. We didn’t know it was that. It was “caving” or “winter blues” or just, “I need a break”. And as fast as our friendship began and as strong as it was, it ended — a couple of times over again. When we reconnected again as full-fledged adults, the “D” word was introduced. It was discussed, visible and fierce. There was no denying it and the impact it had on his relationships, his career — his life overall. It lived in him and therefore, it lived in our close friendship. Let me preface by saying that I screwed up dozens, if not hundreds, of times. At first, I was unaware of the magnitude of this condition and the effect it has on relationships. There was a learning curve that smashed me in the face numerous times. But somewhere along the way I decided I was not going to let mental illness define or destroy this friendship. I began to change my mindset and my ideas. I think of a yoga meditation, “Devote yourself to seeing, not being seen.” In hindsight that’s what I tried to do — see, really SEE what was going on for him. And now I realize that I have learned to see myself as well. My approach and strategy for dealing with his depression took on various forms and there was definitely a progression and evolution over time. I decided to learn more about how those on the outside and from afar (mind you, I live hundreds of miles away) can help. My initial thought is that talking about it is, and was, paramount. I remember countless text and phone conversations that were icky, but oh so real, about how being depressed really feels in the moment. He talks about it, and therefore, it gives me permission to talk about it too. Even when he can’t name it because he is too far in it, over time he has given me the language and the power to do it for him. With that came the hard part: I challenged myself with listening. I listen to understand, empathize, problem-solve, validate and encourage. In that moment, I am there. And after, I am thinking, processing, and replaying it all over again, so I can be more cognizant of it next time. Often I stop and ask myself: is this my real friend or is this the depressed version of my friend? I almost equate it to someone who drinks — while there’s certainly some truth in the words of a drunk, the tone and delivery are inevitably damaged and therefore, damaging. This was by no means easy to work through, especially at the beginning of the process. It doesn’t mean I ignore it and can move on instantly, but it has become a check that I issue after I am done processing the yuckiness. Also, I educate myself, and I allow him (when not all in it) to educate me too. I read articles (metaphors comparing depression to regular things in life, like snowstorms, make the most sense to me), I watch videos (the Black Dog series was one of our favorites), I peruse blogs and follow mental health organizations. But most importantly, after I read/listen/watch/learn, I share it with him and ask, “So what do you think about this?” so I can gauge if it resonates with him as well. This learning is new and scary and so very personal in that it affects someone I’m close to. But that is why it is so important for me to do. Lastly, I’ve learned to give space. Often he will say to me, “I’m sorry, but this is not about you,” and while it may feel like a rejection, it’s the truth. There are times when he needs to shut me down, and although I can get pissed, I understand that talking is not always the best option. We can come back to it another time — or not, and that’s ok too. I am not a perfect friend. And I will never truly understand what someone with depression deals with on a regular basis. But I’ve found from personal experience that by doing some of the strategies above to SEE what’s in front of me, we can work together to tackle this goddamn Black Dog one bark at a time. *NOTE: I have had my friend’s permission, blessing and assistance with this piece from the beginning. He is fully aware I have written it and has read it in its entirety. View the full article
  3. Phobiasupportforum

    I Was Dumped Over My Depression

    He found out by Googling me. I’ve been writing candidly about my life for as long as I can remember. I’ve never been able to pull off fiction, because my brain doesn’t work that way, but I’ve been able to, as Hemingway put it, “sit down at a typewriter and bleed.” Or, since it is the 21st Century, sit down at a computer and just let it all out. Maybe I’m a product of my 21st Century over-sharing generation, or maybe I just want others to feel less alone in their own struggles; some days, I’m not quite sure. But either way, the topics in which I choose to cover never fail to evoke a strong response, and I would never want it any other way. One such topic, from which I’ll never steer, is my depression. The 3 Best (and Worst) Things to Say to Someone With Depression I’ve been very open in many pieces I’ve written about my struggles dealing with depression, as well as being honest about my suicide attempt about nine years ago. That particular subject, I can say for sure, isn’t about over-sharing at all, and absolutely about providing a sense of comfort and solace to those who are learning how to deal with depression and possible thoughts of suicide. It has taken me a long time to get to where I am on the matter, to be free of shame, embarrassment, and judgment of myself, but since I’m still here, alive and kicking, I feel it’s a story worth telling. When I first started writing about that specific part of my life and my person, I was still single. I wasn’t an avid dater, as that’s hard to pull off in New York City, because — breaking news — this isn’t Sex and the City, but I did meet new people here and there, and sometimes, if the stars were aligned, a first date would lead to a second date, but it was rare. Dating in New York City has to be one of the most difficult things in the world. Despite this rarity, I actually met someone great, and not only did it lead to a second date, but a third and fourth one, too. I wouldn’t say we were “dating,” exactly, because no one likes to use that term too fast, but we were on our way there and it felt good. He was charming and funny, and we connected over things that are important to me like politics, religion, and of course, music. We had both been raised in New England and, thanks to that, we were extremely skilled in our Boston accent impressions. We weren’t soulmates or anything like that, but I could definitely see us heading into the direction of the whole boyfriend/girlfriend label, as much as I’m not really keen on labels of any kind. But then something happened a couple months into our seeing each other: He Googled me. When I first meet someone I almost always Google them, or at least try to find them on Facebook. I don’t do this because I automatically assume everyone out there is like Patrick Bateman from American Psycho (Or do I?!), but mostly because I’m curious. I also tend to meet lots of people in my field and like to see links to their work and read their writings. So when, let’s call him Jay, told me partway through dinner one night that he had Googled me, I wasn’t really surprised. Don’t most people Google? I mean, the majority of us are online all day long, so why wouldn’t we? At least as a means to procrastinate, if nothing else. But instead of singing my praises, as he should (I kid!), he decided to ever so slightly inquire about my depression and suicide attempt. I kindly explained that the attempt was securely in my past and that, yes, my depression is a very real part of my life, but it’s as under control as it can be — at least for the moment. It was then that he told me, in not so many words, that he “couldn’t deal” and “wasn’t up for the drama.” I thought this was a strange response since I know more people than not who are medicated, and about 50 percent of my friends also suffer from some form of depression and/or anxiety. Had this been 1950, I could have sort have understood, considering the stigma that was attached to mental illness then, but now, in this century? It seemed absurd. We continued to talk about it through the rest of dinner, a dinner we both barely touched, and by the time the waiter came to ask if we wanted coffee or dessert, it was quite clear that we were not going to be able to find a common ground on the topic. In his eyes, I was a drama laden woman who had no hope at being “normal” enough for him, and in my eyes, he was both an ignorant and smug twit, who probably should have taken at least one basic psychology class in college so he wouldn’t sound so clueless. I’ve long lived with the idea that I am broken. Although I have come to grips with who I am and the chemical imbalance in my brain, the fact that it’s still very much a part of my daily life, I still can’t help but think of myself as being flawed. Yes, no one is flawless and I think that’s a beautiful thing, but to be flawed in your brain, to have zero control over your thoughts and feelings, and to be completely dependent on drugs just to keep you alive and to prevent you from seriously hurting yourself, is an entirely different thing. Quotes That Perfectly Explain What Depression Really Feels Like My depression is what I hate about myself the most, even if I have learned to deal with it. Never before and never since that night has any man, or anyone for that matter, taken issue with my depression. I’m not saying the other men in my life were excited to be with a woman who suffers so deeply and so often, but their tolerance and understanding were in a completely different ballpark than that of Jay. Although we never got into the particulars as to why he felt the way he did, I could only surmise that perhaps he had lost someone he really loved to the disease. Maybe it was a past girlfriend, a sibling, or a parent whom he watched struggle, up close and personal, and he just couldn’t stomach doing it again. If that were the case, I would have been more than understanding. I would not wish on anyone the turmoil I have put my loved ones through when dealing with depression. But since I don’t know the reasons, all I can do now is look back and think ill thoughts about him. It pains me that someone could be so obtuse about the subject and not even willing to budge an inch, despite me having shown him just how great and healthy I was then. This guest article originally appeared on YourTango.com: My Depression Was A Dealbreaker For Him. View the full article
  4. Phobiasupportforum

    New Study Shows Most Americans Are Lonely

    If you are feeling lonely, you’re not alone. A recent study involving 340 San Diego County residents of various ages has found that loneliness is shockingly widespread.1 The study suggests that there is a 76% prevalence of moderate to severe loneliness in American society. This is a bombshell statistic. After all, our country has enshrined the pursuit of happiness in its constitution and prides itself on having a high standard of living (twelfth in the world), which apparently doesn’t equate with living well. What went wrong? The hopeful news in this study is that there is an inverse relationship between loneliness and wisdom. Those who possessed six components of wisdom experienced less loneliness — namely: general knowledge of life; emotion management; empathy, compassion, altruism and a sense of fairness; insight; acceptance of divergent values; and decisiveness — the ability to make quick, effective decisions when necessary. The authors of this study suggest that more research is needed. But it makes intuitive sense that the antidote to loneliness is to develop an inner life, which is the purview of Western psychology and Eastern approaches to spirituality. The American dream of achieving a successful, happy life clearly has some flaws. It appears to me that chief among them is the longstanding societal belief that the key to happiness is through external pursuits rather realizing that it’s an inside job. What We Want and How To Find It Dr. Dilip Jeste, the senior author of the study and a professor of psychiatry and neurosciences at the University of California, San Diego, has defined loneliness as “subjective distress,” that is, “the discrepancy between the social relationships you want and the social relationships you have.” We have a longing to be seen, understood, and accepted. We desire the pleasure of connecting, a sense of belonging, a tender intimacy with another human. Such meaningful connections are less likely without wisdom qualities that include empathy and compassion. If our personality has not developed in a way where it is natural for us to extend empathy and understanding toward people, they won’t be inclined to feel safe with us; they won’t come toward us. We may be left feeling lonely without realizing that we’ve become a person who doesn’t know how to soften and relax with people — generously extending our attention and caring, while also letting in others’ caring. Another antidote to loneliness is developing the wisdom quality of emotion management, which refers to self-regulation and self-soothing. This includes having empathy toward ourselves. We need to deal wisely with the instinctual fight, flight, freeze response when we get emotionally activated. Relationships trigger our deepest fears (of rejection), shame (not being good enough), and hurts (feeling abandoned). If we don’t know how to deal with the emotions that relationships and life bring up in us, we’ll either act them out (lashing out) or internalize them (shutting down and retreating). Not dealing skillfully with our emotional life contributes to our isolation. Sadly, our education system is not geared toward helping us develop emotional intelligence, although there are now innovative, research-based educational programs, such as the Toolbox, that address this serious gap. The longer we delay developing wisdom qualities, emotional intelligence, and a rich inner life, the more we set ourselves up for loneliness.2 We’re also prey to the well-documented health risks of loneliness, including high blood pressure, cardiovascular disease, depression, and cognitive decline.3 Old age is challenging enough. If we haven’t pursued Socrates wise dictate, “know thyself,” then we’re additionally challenged. Psychotherapists and philosophers (lovers of wisdom) have encouraged us to know ourselves, which fosters inner peace and provides the foundation for close, meaningful relationships. Investing in therapy or pursuing inner practices that help us connect with ourselves, such as meditation, yoga, Focusing, or other paths toward befriending ourselves can become invaluable resources to foster our physical, emotional, mental, and spiritual health. We all feel lonely sometimes. This is nothing to be ashamed of. It is heartening that research is confirming the obvious — that the best antidote to loneliness is developing an interpersonal life nourished by qualities that include empathy, compassion, and caring about others. Social Implications I’m curious about the social implications of this important study. One takeaway for me is that reducing loneliness, which is a step toward finding happiness, is not a matter of pursuing our own private pleasure or success to the exclusion of how we affect each other. As we know, many powerful business people and notable politicians who have competed, dominated, and “won” are among the most miserable, lonely human beings on the planet. They’ve gained the world, but lost their own souls. We might look good, but the important question is how good do we feel inside? If we’re honest with ourselves, are we fairly happy or dogged by a nagging loneliness, which we try to avoid through drinking, spending, or other addictive habits? Is maintaining the pure form of capitalism and hands-off competition the best system for achieving the happiness we desire? Or is it in our collective best interest to make prudent adjustments that include wise regulations and oversight? How can we create conditions for an economic, social, and political system that fosters qualities of compassion and kindness? Many people would accept that our society is dysfunctional, but what are steps toward a cure? Studies have consistently shown that European nations, which arguably have more concern for the collective welfare, have the highest levels of happiness. According to the UN’s latest Human Development Report, six of the seven happiest countries in the world are European. ((Here are the 11 best countries to live in around the world. (2017). The Economic Times. Retrieved from https://economictimes.indiatimes.com/slideshows/nation-world/here-are-the-11-best-countries-to-live-in-around-the-world/the-netherlands/slideshow/57875327.cms)) For me, this study raises vital, yet neglected questions: how can we create conditions where people feel more connected and less isolated? What needs to happen in our inner and outer lives so that we not only have the right to pursue happiness, but also have a fair shot at achieving it? Footnotes: Scutti, S. (2018, December 20). Loneliness peaks at three key ages, study finds — but wisdom may help. Retrieved from https://edition.cnn.com/2018/12/18/health/loneliness-peaks-study/index.html Goleman, D. (n.d.) Emotional intelligence. Retrieved from http://www.danielgoleman.info/topics/emotional-intelligence/ Gerst-Emerson, K., & Jayawardhana, J. (2015, May). Loneliness as a public health issue: The impact of loneliness on health care utilization among older adults. American Journal of Public Health, 105(5): 1013–1019. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386514/ View the full article
  5. Phobiasupportforum

    Can Humor Alter Your Brain Chemistry?

    “If I had no sense of humor, I would long ago have committed suicide.” ~ Mahatma Gandhi Do you know why everyone isn’t in a mental hospital? Because there isn’t enough room. Philosophers have long observed a dearth of happiness among humanity. Henry David Thoreau said, “Most men lead lives of quiet desperation.” John Stuart Mill observed, “Unquestionably, it is possible to do without happiness; it is done involuntarily by nineteen-twentieths of mankind.” Abd ar-Rahman III, who reigned as the most powerful prince of Iberia for half a century, had this to say about happiness: I have now reigned about fifty years in victory or peace, beloved by my subjects, dreaded by my enemies and respected by my allies. Riches and honors, power and pleasure, have waited on my call, nor does any earthly blessing appear to have been wanting to my felicity. In this situation, I have diligently numbered the days of pure and genuine happiness which have fallen to my lot. They amounted to fourteen. According to the most recent statistics, one out of every six adults will have depression at some time in their life1. The Centers for Disease Control (CDC) report that antidepressants are the third most commonly prescribed drugs in the United States.2 Where the natural world has failed to provide for our happiness needs, we have turned to man-made chemical assistance. However, humor offers an alternative means of attaining happiness, or at least relief from our misery, for far less money and with fewer side effects than antidepressants. Depression is caused by neurochemical reactions within the brain. Whether the original source of those neurochemical reactions is a traumatic event, long-term poverty, job loss, the break-up of a relationship or any other painful event(s), the illness itself takes form as a result of interactions that occur within and between different brain structures and neurotransmitters. It is therefore reasonable to expect that depression can potentially be reversed using the sufferer’s own self-induced neurochemical reactions. And humor can be a means of inducing those reactions. Neuroscientist Elisabeth Perreau-Linck of the University of Montreal carried out a study in which she confirmed that we are capable of altering our own brain chemistry. Perreau-Linck had professional actors self-induce a state of happiness or sadness and used a PET scan to measure the serotonin synthesis capacity (SSC) of their brains. SSC is an indicator of how efficiently the brain makes serotonin from its chemical precursor, tryptophan. The cortex and deeper brain regions showed significant differences in SSC activity for those actors who self-induced happiness and those who self-induced sadness. “We found that healthy individuals are capable of consciously and voluntarily modulating SSC by transiently altering their emotional state,” said Perreau-Linck. “In essence, people have the capacity to affect the electrochemical dynamics of their brains by changing the nature of their mind process. This is a kind of ‘positive emotion therapy’ that anyone can use to modify chemical functioning of the brain.”3 Perreau-Linck’s findings support the use of humor to intentionally alter our own brain chemistry and combat depression. It is within our power to control how we respond to the inevitable adversity and struggles we encounter in life. Although some pain and suffering is unavoidable, we do not have to endlessly dwell on it and languish in it and make a home there. The ability to overcome and rise above our suffering, even while deep in its midst, is within all of us. But doing so requires understanding that we are constantly being affected by what we give our attention to in ways that are completely outside our conscious awareness. Making a deliberate effort to shift attention from the sad to the humorous could alter your brain chemistry and all of the subsequent unconscious effects your environment has upon you. Exposing yourself to humor by watching funny movies, going to comedy shows or reading humorous books could retrain your brain. Reading any of the following books is a great way to begin using humor to deflate sadness, gain new perspective and self-induce more healthy neurochemical reactions in your brain — all with no ill side effects: My Depression: A Picture Book, by Elizabeth Swados Laughter Therapy: How to Laugh About Everything in Your Life That Isn’t Really Funny, by Annette Goodheart, M.F.T., Ph.D. Driving on the Wrong Side of the Road: Humorous Views on Love, Lust & Lawn Care, by Diana Estill When You Are Engulfed in Flames, by David Sedaris How Can You NOT Laugh at a Time Like This?: Reclaim Your Health with Humor, Creativity and Grit, by Carla Ulbrich Footnotes: Mental health conditions: Depression and anxiety [fact sheet]. (2018). Retrieved from https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html NCHS Dataline. (2012). Public Health Reports, 127(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268810/ E. Perreau-Linck, et al., “Serotonin Metabolism During Self-Induced Sadness and Happiness in Professional Actors,” program 669.3 presented at the 34th annual meeting of the Society for Neuroscience, San Diego, Calif., October 23-27, 2004. View the full article
  6. Phobiasupportforum

    Psychology Around the Net: December 22, 2018

    Happy Holidays, sweet readers! Regardless of which holiday you celebrate — or even if you celebrate one at all — you’ve no doubt felt a mix of pleasant and not-so-pleasant emotions this month (why does this read like a horoscope?) — especially if you celebrate Christmas as you now only have a few days to go! Take a look at this week’s Psychology Around the Net to learn more about how to handle the holidays when they aren’t the most wonderful time of the year for you, ways to navigate the season when it puts a strain on your relationship, and of course a bunch of other non-holiday-related goodies like studies on how your IQ affects your happiness, why it’s important to boost your EQ (and how), and more. Blue Christmas: It’s the Most Wonderful Time of the Year–But What If It’s Not for You? Often brought on by grief, illness, job loss, relationship problems, or just the overall stress and pressure the holidays can bring, the “holiday blues” — feeling lonely, isolated, or experiencing loss — can affect people with or without mental illness. Here are a few ways you can combat them before they start, or fight back if they’ve already begun. Can Intelligence Buy You Happiness? They say ignorance is bliss, but new research suggests the higher your IQ, the greater your well-being (or, at least, the greater your potential for having a greater well-being) because your smarts will enable you to acquire the educational and financial means to boost your quality of life. 21 Ways to Improve Your Emotional Intelligence (Using Just a Few Minutes a Day): OK, so now that we’ve covered IQ and how it can affect your happiness and overall well-being, what about your EQ — your emotional intelligence, e.g. your ability to be aware of, control, and express your own emotions as well as handle relationships? Mental Health Care Coverage Is Leaving Kids Behind and Families Reeling: Says Gene Beresin, the challenge is that “the treatment of children requires a village, and we don’t have a village. We have silos, and not all these silos are covered by insurance.” What to Do If the Holidays Make You Question Your Relationship: Some people start to feel a little weird about their relationships during the holidays. Often, this is just a side effect of the stress the holidays can bring. However, what if it’s not? What if it’s a sign of something bigger? Suggests Study: Depression and Anxiety May Damage Health as Much as Smoking and Obesity: According to new research, people who suffer from depression and anxiety might be at a significantly higher risk for serious health conditions such as heart disease — possibly risk levels comparable to obesity and smoking. View the full article
  7. Today, when it’s becoming harder and more expensive to see a therapist face-to-face, people are looking for alternatives. I don’t blame them. More and more therapists are ditching accepting health insurance for payment, because companies continuously put up barriers to receiving payment. The payments themselves can be incredibly low, making it difficult for many therapists to make a decent living. This has driven up the cost of therapy to consumers, all the while making it more difficult to access for those who can afford to do so. Could an app help you with something as serious as severe depression? New research suggests the answer is a definite “Yes.” What kind of app are we talking about? iCBT is its name (“Internet-based cognitive behavioral therapy”) and although I’m calling it an “app” here, it actually includes older self-guided websites too. Some of these sites have been around for more than a decade. That’s how well-established and robust these programs are in being able to deliver the gold-standard psychotherapy approach to treating depression — cognitive behavioral therapy. How do these interventions work? Here’s how the researchers describe them: In these interventions, patients complete interactive Web-based programs based on the principles of cognitive behavioral therapy with no therapeutic support, although sometimes technical support is available. The efficacy of these interventions can be enhanced by therapist support, although this effect may be smaller than previously thought (eg, standardized mean difference symptoms = 0.27). These types of interventions have typically been in the form of a website accessed via a laptop or desktop computer. But with the commonplace ownership of smartphones, they’ve been adapted for mobile use on the go. Some have also been turned into apps you can download from an app store. All of them are self-guided, meaning it is up to each individual to finish each module on their own. As motivation is a common problem among people with depression, this can be a challenge. Many apps try and address this with a reward system (such as daily points or rewards), or ancillary support services (such as group support or coaching services). Why are these types of interventions so potentially game-changing for both researchers and people with depression? The high prevalence of depression and the ubiquity of internet access and mobile phone ownership make self-guided iCBTs hugely promising in reducing the burden of disability associated with depressive symptoms, even if they were somewhat less effective than guided iCBTs. Since anyone can access and use them at any time — no appointment necessary! — they have the potential to be game-changing when it comes to the treatment of depression. Is iCBT Effective for Severe Depression? In a word, “Yes.” The current researchers (Lorenzo-Luaces et al., 2018) analyzed significant previous research done on these Internet-based interventions, looking at whether the study excluded patients with severe depression. They also examined how effective iCBT appeared to be in the treatment of any type of depression, including the most severe types. Their findings were counter-intuitive, as the researchers freely admit: The perception that self-guided iCBT will not be effective for cases of more severely symptomatic depression aligns with common sense but is not supported by research data. For example, Bower et al. reported that the effects of self-guided internet-based therapies were more rather than less pronounced among patients high in symptom severity. In our analyses, we found no evidence that the effects of iCBT varied strongly according to exclusions by high or low symptom severity. In other words, iCBT is an effective treatment to consider for clinical depression. And not just mild to moderate clinical depression, but also severe depression too. Even better for the iCBT studies, they tended not to use as many exclusion criteria for subjects as studies examining the effectiveness of psychotherapy or antidepressants did. For instance, many research studies will exclude subjects who have more than one diagnosis (not uncommon) or are also dealing with an alcohol or substance use problem. Because of this, it is likely that findings from past iCBT research are more robust and generalizeable to ordinary people suffering from depression than studies conducted on antidepressants or psychotherapy. The iCBT studies looked more like groups of real people, sometimes with multiple concerns outside of depression alone. If you haven’t tried an iCBT program or app and suffer from depression, I recommend giving one a try. There’s very little potential downside to trying one, and they can even be helpful as adjunct to psychotherapy (if you’re already seeing a therapist). Improving your depressive symptoms is a process that requires hard work and change. You have to put the effort into it, regardless of whether its an iCBT app or a psychotherapy session. Good luck! Recommended iCBT Apps to Try Any of the below cognitive-behavioral therapy-based programs below may be helpful to you. If one isn’t working out for you or making you feel any better, it doesn’t hurt to try another. For any platform with a web browser MoodGym – The granddaddy of all Internet-based CBT programs myCompass – Black Dog Institute For iPhone iCBT MoodNotes For Android Depression CBT Self-Help Guide Cognitive Diary CBT Help References Karyotaki E, Riper H, Twisk J, Hoogendoorn A, Kleiboer A, Mira A, et al. (2017). Efficacy of self-guided internet-based cognitive behavioral therapy in the treatment of depressive symptoms: a meta-analysis of individual participant data. JAMA Psychiatry, 74(4), 351-359. Lorenzo-Luaces L, Johns E, Keefe JR. (2018). The Generalizability of Randomized Controlled Trials of Self-Guided Internet-Based Cognitive Behavioral Therapy for Depressive Symptoms: Systematic Review and Meta-Regression Analysis. J Med Internet Res, 20(11), e10113. View the full article
  8. Phobiasupportforum

    OCD and Multiple Sclerosis

    Obsessive-compulsive disorder is a complicated illness, and the cause, or causes, remain unknown. Research has shown that OCD is seen more frequently than usual in those with various physical disorders, such as muscular dystrophy. An October 2018 study published in Frontiers in Immunology highlights a connection between OCD and another disease — multiple sclerosis. Multiple sclerosis (MS) is a debilitating autoimmune disorder, where the body’s immune system goes haywire and attacks healthy cells. It affects over two million people worldwide and has no known cure. Patients with multiple sclerosis and other autoimmune disorders are known to suffer from OCD, anxiety and depression. However, the relationship between these illnesses and the immune system has been somewhat of a mystery. In the above-mentioned study1, scientists found a direct link. They discovered that a class of cells that defends the body against invaders also triggers obsessive-compulsive behavior. In mice exhibiting symptoms of multiple sclerosis, the researchers noted that immune cells called Th17 lymphocytes induced behaviors characteristic of OCD. Th17 cells infiltrated the mice brains, and the researchers believe they likely disrupted nerve circuits involved in controlling obsessive behavior. Specifically, the researchers found that the diseased mice (with symptoms of MS) spent 60 to 70 percent more time grooming themselves compared to healthy ones. They also buried a greater number of glass marbles and shredded more of their bedding to make nests — signs that are suggestive of OCD, which is partially defined by uncontrollable, repetitive behaviors known as compulsions. To identify the trigger for such behavior the team focused on Th17 cells because previous studies showed they can penetrate the blood-brain barrier. They also play a key role in the progression of MS. The researchers infused diseased mice with Th17 cells and subsequently found an increase in the compulsive behaviors mentioned above. Moreover, brain tissue analysis in these mice showed that large numbers of Th17 cells were found lodged in the brainstem and cortex, which are involved in regulating grooming. The study’s senior author Avadhesha Surolia said:2 “For the first time, we are reporting a likely link between OCD and an important arm of cell-mediated immunity. Until now, we have looked at neuropsychiatric diseases as purely a neurological problem, ignoring rather completely the immunologic contribution.” Interestingly, when the mice were given an antidepressant such as fluoxetine which boosts the uptake of serotonin, their obsessive grooming reduced. This suggests that Th17 cells eventually disrupt serotonin uptake, giving rise to OCD-like symptoms. Researchers believe other neurotransmitters such as glutamate might also be involved. The team also gave the diseased mice digoxin, a molecule that inhibits Th17 development, and then found that the time spent on grooming was almost cut in half. This finding could be an important step in the development of medications that might be helpful for those with OCD and autoimmune disorders. As is the case with research, we are often left with more questions than answers. But thanks to dedicated researchers we are moving forward and slowly peeling away some of the complicated layers of OCD. Footnotes: Kant, R., Pasi, S., & Surolia, A. (2018, October 31). Auto-Reactive Th17-Cells Trigger Obsessive-Compulsive-Disorder Like Behavior in Mice With Experimental Autoimmune Encephalomyelitis. Frontiers in Immunology, 9: 2508. Retrieved from https://doi.org/10.3389/fimmu.2018.02508 Inacio, P. (2018, November 13). Inflammatory Th17 Cells Seen to Trigger Obsessive Compulsive Disorder in MS Mouse Model. Multiple Sclerosis News Today. Retrieved from https://multiplesclerosisnewstoday.com/2018/11/13/inflammatory-th17-cells-seen-to-trigger-obsessive-compulsive-disorder-in-mouse-model-of-ms/ View the full article
  9. Imagine a barking dog, a furry spider or another perceived threat and your brain and body respond much like they would if you experienced the real thing. View the full article
  10. My son Dan suffered from obsessive-compulsive disorder so severe he could not even eat. He spent nine weeks at an intensive world-renowned residential program where he learned techniques through the use of exposure and response prevention (ERP) therapy. These skills have allowed him to live a happy and productive life. Well, at least I thought it was an intensive program. At Haukeland University Hospital in Bergen, Norway, there is a treatment program for OCD that is truly intensive. And short. Four full days. There are many people who spend years of their lives suffering with OCD; it can be a cruel, insidious disorder. How much can four full days of intensive therapy help them? Apparently, a lot. More than 1,200 people have received the Bergen four-day treatment for OCD which is a concentrated form of exposure therapy designed by two Norwegian psychologists, Gerd Kvale and Bjarne Hansen. The results have been impressive and the program has gained international attention for its effectiveness and efficiency. In fact, the psychologists were named by Time as two of 2018’s 50 most influential people in healthcare. Avital Falk, a clinical psychologist who directs an intensive treatment program for OCD and anxiety at Weill Cornell Medicine and New York Presbyterian says: “It’s amazing that you can so get much done in such a small amount of time. OCD treatment regimens typically involve weekly hour-long sessions spread out across several months, but more clinicians are adopting concentrated therapy. Intensive treatment in general has been getting a lot more attention in different formats that can be anywhere from three hours a week. Ten to 12 hours a week, all the way to the Bergen method, which does everything in four days.” In June 2012 the first group of patients were tested and the results were as expected — immense improvements in the participants’ OCD. The Bergen method works in three stages: On day one, therapists provide patients with information about OCD and help them prepare for the exposure tasks they will engage in over the next two days. During the exposure portion, people face their fears head-on. For example, if someone is afraid of becoming contaminated, they would choose an object or surface that might trigger their anxiety and then force themselves to touch it. Kvale explains: “We encourage patients to pay attention to the moments when they feel the urge to start taking control to reduce anxiety or discomfort. And to use these as turning points for change.” The next two days can be best described as a single prolonged therapy session. Included with ERP therapy is the use of the LET- technique, which is a method of encouraging those with OCD to focus specifically on anxiety-eliciting moments. LET stands for LEan into The anxiety and forms the core foundation of the Bergen treatment. The format of the treatment is unique in that a group of three to six therapists work as a team with an equal number of patients. Kvale believes this setup is important because it provides tailored care for each individual while also letting patients observe others going through the same process of change. The third day is set aside for discussion and planning how to maintain the gains made during therapy. In August 2018, results from a long-term analysis of the treatment’s effects were published. It was reported that 56 of 77 patients remained in remission four years after treatment, and 41 of the 56 had fully recovered. More details regarding the results can be found here. There are already plans to bring this treatment plan to other countries, including the United States. While promising, there are lots of unanswered questions. Is this program effective for those whose compulsions are mostly mental? Can it be helpful to those who deal with recovery avoidance? The list goes on. As treatments for OCD evolve, one thing continues to be clear. More of the right kind of therapy is always a good thing. References: Hansen B, Hagen K, Öst L-G, Solem S, Kvale G. The Bergen 4-day OCD treatment delivered in a group setting: 12-month follow-up. Front Psychol. 2018;9:369. Oaklander, M. (N.D.). Bjarne Hansen and Gerd Kvale: Speeding Up Therapy. TIME. Retrieved from http://time.com/collection/health-care-50/5425089/gerd-kvale-and-bjarne-hansen/ Kwon, D. (2018, November 29). 4 days of intensive therapy can reverse OCD for years. Scientific American. Retrieved from https://www.scientificamerican.com/article/4-days-of-intensive-therapy-can-reverse-ocd-for-years/ Hansen, B., Kvale, G., Hagen, K., Havnen, A., & Öst, L.G. (2018). The Bergen 4-day treatment for OCD: four years follow-up of concentrated ERP in a clinical mental health setting, Cognitive Behaviour Therapy, DOI: 10.1080/16506073.2018.1478447 View the full article
  11.  Those of us with mental illness are asked many questions about our feelings. For a lot of us, the most difficult one to answer is, “Are you happy?” It’s a difficult question to answer because happiness isn’t an easily defined concept. Most people assume that in order to be in recovery from mental illness a person must be happy. But is that really the case? Listen in to this episode to hear our thoughts on happiness, regret, and even a side story about Gabe’s first marriage. SUBSCRIBE & REVIEW “People just want to be happy and normal, but there is no actual definition of either.” – Michelle Hammer Highlights From ‘Happiness’ Episode [1:00] Gabe & Michelle discuss happiness and mental illness. [3:30] The most annoying questions we have ever been asked. [5:00] Gabe’s story of never being satisfied with his life. [10:00] What makes Michelle unhappy. [12:00] What makes Gabe unhappy. [17:00] Do people try to ruin our happiness? – A discussion. [19:00] Michelle says she has confidence – but does she? [23:00] Dealing with mental illness and negativity. Computer Generated Transcript for ‘Can People With Mental Illness Be Happy?’ Show Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Announcer: [00:00:07] For reasons that utterly escape everyone involved, you’re listening to A Bipolar, a Schizophrenic, and a Podcast. Here are your hosts, Gabe Howard and Michelle Hammer. Gabe: [00:00:19] Welcome to A Bipolar, a Schizophrenic, and a Podcast. My name is Gabe and I have bipolar. Michelle: [00:00:25] I’m Michelle and I’m schizophrenic. Gabe: [00:00:27] You are straight up schizo. Gabe: [00:00:29] Apparently I am. That’s what the doctors say. Gabe: [00:00:31] Michelle, one of the questions that people living with mental illness get asked, pretty much ad nauseum, is, “Are you happy?” Do people ask you this? Michelle: [00:00:40] Yeah. I think so, yeah. Gabe: [00:00:41] There’s a bunch of them. “Are you OK?” “How are you feeling?” “Are you doing OK?”. Michelle: [00:00:45] I hate that one. “So how are you doing? Like on a personal level? Like, how are you personally?” You know. Gabe: [00:00:53] They’re asking if we’re happy. I’m not saying that’s necessarily a bad question. I mean, they want to know if we’re OK. And the way that we, as a society, gauge “okay” is if we’re content, if we’re happy, if we’re not sad. I mean, it’s not an unfair question, right? I mean, do we really want to get mad at people for making sure that we’re content? Or that we’re happy? Michelle: [00:01:13] I feel like people have ulterior motives sometimes when they ask you if you’re happy. Gabe: [00:01:18] Like what? Michelle: [00:01:19] They want to see if you could actually be happy. Gabe: [00:01:22] So you think it’s like a gotcha question? Michelle: [00:01:23] Sometimes. Gabe: [00:01:23] Really? Michelle: [00:01:24] They’re like, “Are you happy?” Gabe: [00:01:26] I feel like maybe you’re hanging out with mean people. Nobody has ever asked me if I’m okay or if I’m happy so that they can trick me. I mean how would that go? “Gabe, are you happy?” Yes. “Aha! I have fooled you, you none-bipolar liar!” That’s kind of weird, you have to admit. Michelle: [00:01:41] Whatever. Gabe: [00:01:42] One of the reasons we want to do this episode is because, 1) there’s, like, 5 questions that people with mental illness gets asked constantly. You know – “Have you taken your meds?” “Are you doing okay?” “How are you feeling?” “Are you happy?” The “are you happy?” one handcuffs me. Michelle: [00:01:56] Why? Gabe: [00:01:57] Because, I don’t know. I mean, how do you define happiness? You know our “Define Normal” initiative? Michelle: [00:02:03] Yeah. Gabe: [00:02:04] Where everybody gave a different answer for what “normal” was. Yet it’s something that’s thrown around by our society constantly. Michelle: [00:02:13] Mmm-hmm. Gabe: [00:02:13] I think if we asked a hundred different people what it means to be happy, we’d get 100 different answers. So when people say to me, “Are you happy?” I have no earthly idea. Michelle: [00:02:24] Good point. And do you think anyone would actually say, “Yes, I am happy” and feel like they’re telling the truth or feel like they’re lying? Gabe: [00:02:33] This is something that kind of keeps me up at night. Allow me to explain: Let’s say that you said right now, “Gabe, are you happy?” I would say, “Yes. My friend Michelle is here and our podcast is doing very well.” And then somebody would say, “Well, but I mean, how could you be happy? I mean, you have a debilitating disease and there’s so much suffering in the world? And I mean really! You’re happy with the homeless people that might die from coldness? And what about all the hungry children?” “Oh. Well, I’m not happy about that.” “Really? You’re not happy!?! Your friend Michelle was here!” Where does this end? Michelle: [00:03:10] The never ending nonsense circle. Gabe: [00:03:14] Michelle, how do you define “happy.” Michelle: [00:03:17] How would I define “happy?” Gabe: [00:03:19] Yes, that’s the question. Why do you keep repeating the question? Michelle: [00:03:21] I’m thinking of my answer for defining “happy.” Well, how would I define happy? Not being able to get rid of a huge smile on my face. Gabe: [00:03:32] Okay, so you’re never happy. You’re never smiling. You always look constantly pissed off. So I don’t think that’s true. I really don’t, because I know that you’re not constantly pissed off. You just have resting angry face. Michelle: [00:03:45] I don’t have resting angry face. That’s just around you. Gabe: [00:03:48] Okay. Well, you have Gabe angry face. Oh my God! You have GAF! Michelle: [00:03:54] Shut up. Gabe: [00:03:55] See, now you’re mean to me. So I’m clearly not happy now. Michelle: [00:03:58] Good. Are you happy? Gabe: [00:03:59] No. Michelle: [00:04:00] Did you take your meds today? Gabe: [00:04:03] One, yes- Michelle: [00:04:03] How are you doing? Gabe: [00:04:04] I’m good, I’m fine. Michelle: [00:04:06] Are you sure? Are you well? Gabe: [00:04:08] Well, there’s another one. Now hang on a second- Michelle: [00:04:10] How’s your work? Do you have a job? Gabe: [00:04:11] Ugh…okay. Michelle: [00:04:12] Wow, you have a job? Are you able to work? Gabe: [00:04:14] Oh, you’re killing me. Michelle: [00:04:15] Are you on disability? Gabe: [00:04:16] You’re killing me. No. No. Not that there’s anything wrong with that- Michelle: [00:04:18] Do you live with your parents? Gabe: [00:04:19] No. Michelle: [00:04:20] Do you have any kids? Gabe: [00:04:21] No. Michelle: [00:04:21] Do you plan on getting married? Gabe: [00:04:23] I am married. Michelle: [00:04:24] Really? Wow! Does she like you a lot? Gabe: [00:04:29] No, I’m bipolar. I think happiness has, like, moving goalposts. My Uncle Jack was a really cool guy. He passed away many years ago, but I really liked him a lot when I was younger. Because he talked to me like an adult. He recognized that I had intelligence beyond my years. So here’s this old guy, and he’s talking to a 14 year-old about, you know, adult subject matter. And a lot of adults were uneasy about this, but he wasn’t. And one of the things that he told me is that when it came to money, the perfect amount of money to make was 50 dollars more than you were currently making. And his point was that it didn’t matter how much money you had, you were always fifty dollars away from having something else. And when he said this to me, I thought, “You’re nuts.” If I have, let’s say, fifty thousand dollars. Now this was 30 years ago, but I thought, if I made fifty thousand dollars a year I would be happy. I would be perfectly happy with that kind of money. And then, when I made that kind of money I wasn’t happy with it. And then I made eighty thousand dollars a year, and I wasn’t happy with that. And then I made a hundred thousand dollars a year and I wasn’t happy with that. Michelle: [00:05:39] All that’s coming through, Gabe, is that you need to give me some money. Gabe: [00:05:45] That’s the takeaway? Michelle: [00:05:47] That’s it. The takeaway is that you need to give me some money. Gabe: [00:05:49] I think the takeaway is that I think that’s how happiness works. Michelle: [00:05:53] Well, happiness comes with money. Gabe: [00:05:54] No. No, I think that- Michelle: [00:05:56] Mo’ money, mo’ problems. Gabe: [00:05:58] Well, mo’ happiness, mo’ problems. Michelle: [00:06:00] What? Continue your story. Gabe: [00:06:08] Thanks, Michelle. When I was really, really, really sick – I mean really sick, like not showering for days at a time, laying in my own filth, not leaving the house, planning on dying, trying to will myself to death – I would lay there and I’d think, “If I could just get out of bed I’d be happy.” And I meant it, I wasn’t lying. It wasn’t a joke. I just thought that if I could just get up, if I could just take a shower, if I could just wash my hair, then I would be happy. But that’s not the mark of happiness. Now I get up every morning, I take a shower, I wash my hair, I get dressed, and I leave the house, and that doesn’t make me happy. That’s the lowest bar possible. That’s just an expectation at this point. But every time I achieve something – like remember when we started the podcast? We started the podcast and I was like, “Michelle, I’ll be happy when we have X number of listeners per week.” Do you remember that? Michelle: [00:07:08] Uh-huh. Gabe: [00:07:08] You were there, and I said, “That will make me happy!” Well, we surpassed that months ago and I’m still unhappy. I’m unhappy that we didn’t grow month to month. I’m unhappy that one episode dipped. I’m unhappy that one whatever. So, happiness is just this nebulous concept that you can’t put your finger on, and all of us are chasing it like it’s meaningful. Like it has meaning. We want to be happy, but none of us can define it. And even when we define it, once we get there we just redefine it. Michelle: [00:07:41] It’s just interesting that people just want to be happy and normal, yet there’s really no such thing as happy and normal. Nobody is happy and normal. Gabe: [00:07:53] I think that nobody is happy or normal because, again, there’s just no definition for it. I think that, depending on what the definition is, either nobody is happy and normal or everybody is happy and normal. Michelle: [00:08:06] Yeah, I mean, there’s always, like, things that can make you happy. But it’s not like a lifelong happiness. Gabe: [00:08:12] You know what makes me happy? Michelle: [00:08:13] Your dog? Gabe: [00:08:14] When you’re ready to record on time. Michelle: [00:08:15] OK. Gabe: [00:08:15] And my dog. I really like my dog. Michelle: [00:08:18] Yeah. I mean, your dog makes me happy, but I mean I don’t like and when he cries and stuff. It’s sad. Gabe: [00:08:24] Why does he cry? Wait, why are you making my dog cry? Michelle: [00:08:26] Your dog cries all the time! We walked in the house, and your dog was crying. Gabe: [00:08:29] Because he wanted you to play with him! Did you play with him? Michelle: [00:08:33] No. Gabe: [00:08:33] So you just walked in the house and ignored him and just went about your business. Michelle: [00:08:37] Yes. Gabe: [00:08:37] Wow! You ignored a crying puppy. Michelle: [00:08:40] He was in his crate. I didn’t want to let him out of the crate. Gabe: [00:08:41] You left him when he was trapped in a crate. Michelle: [00:08:44] You let him out of the crate, so shut up! Gabe: [00:08:47] I did let him out. Michelle: [00:08:48] You’re not funny. Gabe: [00:08:48] I’m a little bit funny. Michelle: [00:08:50] No. Gabe: [00:08:51] I’m not? Michelle: [00:08:52] Your jokes make me unhappy. Gabe: [00:08:55] Can you define “jokes?”. Michelle: [00:08:56] Nothing you say. Gabe: [00:08:59] That’s actually an excellent question, though. Because “jokes” has a definition. The word joke has a definition. It’s something that makes people laugh. Right? Michelle: [00:09:07] Uh-huh Gabe: [00:09:07] OK cool. So if I tell a joke and you laugh, but John doesn’t laugh, does that mean I told you a joke? But I didn’t tell John a joke? Even though I said the same thing to both of you at the exact same time? Michelle: [00:09:23] Well, maybe John didn’t think it was as funny. Gabe: [00:09:25] So it’s still a joke? Michelle: [00:09:27] It was a joke, but it wasn’t funny to everybody. Gabe: [00:09:32] So you can be happy with something but maybe somebody else who had the same thing wouldn’t be happy? Michelle: [00:09:37] Right. Gabe: [00:09:38] Is it possible that people like us, people with mental illness – especially people with depression side of it -, is it possible that we are happy? We just trick ourselves into thinking that we’re not? Michelle: [00:09:49] I think maybe we dwell too much on the things that make us unhappy. Gabe: [00:09:53] What are some things that you dwell on that make you unhappy? Michelle: [00:09:56] Oh goodness! Past experiences with people that just did not go well. Arguments, fights embarrassments, that just go around in my head. Where I wish I did things differently or I wasn’t sure what was going on. Basically just things I wish I could have changed but that I can’t change now just get under my skin. Gabe: [00:10:22] So you live with a lot of regret? Michelle: [00:10:24] Mmm-hmmm Gabe: [00:10:24] And you think that that regret is making you unhappy? Michelle: [00:10:28] Yes. Gabe: [00:10:28] Now, the things that you regret happened in the past. So clearly time travel is not a thing? Michelle: [00:10:34] Mm hmm. Gabe: [00:10:34] So you can’t go back and fix it? Michelle: [00:10:36] Right. Gabe: [00:10:36] So it’s ruining your present even though it happened in the past? And we’re going to assume that it’s going to ruin your future, even though it happened in the past? Michelle: [00:10:44] Right. Gabe: [00:10:45] So you’re literally wrecking your entire life because of something that you regret, that happened a while ago, that you cannot change or fix? Michelle: [00:10:50] Well, how do I get it to go away? Gabe: [00:10:52] Well, that’s a fair question. How do you get it to go away? Could you make amends? Michelle: [00:10:56] No. No. Gabe: [00:10:57] Like, not ever? You’re just stuck with it? Michelle: [00:10:59] Yeah. Yeah. Gabe: [00:11:00] What about radical acceptance? What about like thinking, “Look I accepted that I did this, I accepted it was wrong, and I accept it that I won’t do it again. And therefore I forgive myself?” Michelle: [00:11:10] Some things weren’t really my fault. Gabe: [00:11:11] Then why do you regret them? And why are you unhappy about them? Michelle: [00:11:14] Because things sometimes are just unfair. Gabe: [00:11:17] So you’re upset about things that aren’t fair? Michelle: [00:11:20] Yeah. Gabe: [00:11:21] So you’re unhappy about something that’s unfair, that you had no control over at the time, and you certainly don’t have any control over now? Because, again, time travel is not a thing? Michelle: [00:11:29] Yes. Gabe: [00:11:31] That’s nuts! Hold that thought, Michelle. We’re going to step away to hear from our sponsors. 2nd Announcer: [00:11:37] This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist, whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face-to-face session go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral. Gabe: [00:12:09] And we are back discussing happiness. Michelle: [00:12:12] Well, we just got to all the roots of my problems. Gabe, thank you so much. And I can’t change the past and it won’t get out of my head. Gabe: [00:12:22] I feel the exact same way. I’m still upset about how my first marriage ended. And I’m still upset about how my second marriage ended. I am now worried constantly about how my third marriage will end, because all marriages end. I mean, they either end in death or divorce. So there’s not good odds either way. You’re kind of SOL there. But the things that I did in my past, some of them I was able to make up for. As you know, my second wife and I – you know she’s my bestie. She’s my BFF, and I’ve apologized to her, and I’ve told her I was sorry. And we still fight about this stuff, because we’re very immature as people. But, I think there’s a level of forgiveness there. But my first wife will not forgive me. She – flat out. Michelle: [00:13:09] What did you do to her? Gabe: [00:13:09] Well I married her. That was bad. Michelle: [00:13:12] It was bad to marry her? That’s what she said? Gabe: [00:13:14] It turns out that women don’t really like being married to untreated bi-polars. I had no idea. Michelle: [00:13:20] Was it your fault for marrying her? She said yes. She said I do. How is that your fault? Gabe: [00:13:28] I… Michelle: [00:13:29] Didn’t she know that you were an untreated bipolar? Gabe: [00:13:31] No. Michelle: [00:13:31] She didn’t? Gabe: [00:13:33] None of us did. Michelle: [00:13:34] Oh. Gabe: [00:13:34] I didn’t get diagnosed with bipolar until after she left. That was one of the things that led me down the suicide path, her leaving. I wrecked my job, my marriage, my house, my home life, I was an embarrassment to my parents. She picked up and left and I was just like, “Fuck it! I want to die!” And I got lucky. I know that sounds weird, but me being suicidal and instituting a suicide plan and being so depressed and so messed up, that’s what led somebody see how sick I was and take me to the emergency room. Michelle: [00:14:07] She should forgive you, though. Don’t you think? Gabe: [00:14:10] I would like to think that she would, but she believes that I’m faking bipolar in order to con people for money. Michelle: [00:14:17] Are you serious? Gabe: [00:14:18] That’s not something you can make up. Michelle: [00:14:22] Okay, I don’t really like her that much anymore. Gabe: [00:14:24] I can’t feel that way. It would be easy if I could say that. I do think that she should consider everything that I went through, and should consider that I was in a psychiatric ward, and on, and on. Michelle: [00:14:35] Here’s what I don’t understand- Gabe: [00:14:36] I don’t know why she doesn’t believe in mental illness but she doesn’t. Michelle: [00:14:38] If she was with you, and she saw you acting like you were acting, so much that she left, and then you happen to end up in the psych ward, wouldn’t she have said, “Oh, that makes a lot of sense!”? Gabe: [00:14:53] No. She thought that I was faking because she believes that mentally ill people look a certain way. She believes that mentally ill people can’t be intelligent, they can’t hold down jobs. They rock back and forth and they drool. She believes in a very stereotypical version of mental illness. Michelle: [00:15:06] She’s a bitch. Gabe: [00:15:07] No, she’s not. And that’s the thing, I did hurt her. Do you know how many times I flew into a blind rage and just started screaming? I would be up for two, three, maybe four, days at a time and not come home. And I would just go out and fuck everything that moved. That not something that you can do to somebody and not give them long lasting emotional scars. I was her husband, and I let her down. I broke her trust, and we can discuss until we’re blue in the face that I did this because I had bipolar disorder, and some of that is true. But the bottom line is, she doesn’t want to forgive me. And that’s up to her, and I have to live with that. I would love to take your tact and just thin, “Yep, bitch!” But I can’t. I wronged her. The end. Michelle: [00:15:50] Do you want her in your life? Gabe: [00:15:54] No, I want her not to be mad at me. It would alleviate alleviate my guilt if she was no longer mad at me, because I feel like I have caused her pain and unhappiness that is going to span her lifetime. Because she spent five years married to me, and that’s a lot I would hate to think that because somebody knew me, their life was worse. And that’s what we have. Because she knew me, her life is worse. That’s hard. It’s hard to know that I made somebody’s life worse. And that makes me unhappy. Michelle: [00:16:32] I mean, I think I’ve given people challenges while they dealt with me. But I wouldn’t say I’ve made people’s lives worse. Maybe made it more interesting at times, I don’t know. Gabe: [00:16:47] I have certainly made people’s lives more “interesting” at times, as well. But the big regret I have, and something that keeps me from being happy, is the way that I treated other people. And while it is true that bipolar disorder played a part in it, it wasn’t all bipolar disorder. It factored in, but I was an asshole. Michelle: [00:17:09] I mean, at least now you know to apologize. Gabe: [00:17:11] Yes. Yes. Michelle: [00:17:12] You know, at least you’re not still on that track, yelling at her. Being a horrible person. You know to apologize. Gabe: [00:17:19] Yes, I was an incredibly bad husband. Michelle: [00:17:21] Do you ever think people are trying to ruin your happiness? Gabe: [00:17:24] That’s an interesting one as well, because, 1) yes, I absolutely think that people are trying to ruin my happiness. But I also think, just as strongly, that I am not happy. So that’s kind of messed up. How can somebody both be trying to ruin my happiness and I’m not happy at the same time? But yet in my brain that completely tracks. Michelle: [00:17:43] I feel like it’s very high school. Like when people try to ruin your happiness. Like, you might come in and you have the coolest shirt on and cool shoes. “Hi, guys. How are you doing? I like my new stuff here.” And everyone just kind of looks you and says, “Oh, okay, you got new clothes and new shoes? Oh, yeah. OK. Good for you.” Like they’re jealous. People get jealous of things. You know what I’m trying to say? Gabe: [00:18:03] I do. Michelle: [00:18:03] High school stuff. Like you when I get a new haircut and then everyone just has to say it’s ugly, you know? Gabe: [00:18:09] I mean, your hair is not great. Michelle: [00:18:11] I’m just saying. Gabe: [00:18:11] And also, that’s not a really cool shirt. And your shoes are kind of dollar store, but whatever, you do you. Michelle: [00:18:18] That’s what I’m trying to say, though. That’s my point. Gabe: [00:18:20] But does that pettiness bother you? Michelle: [00:18:22] People do sometimes try to ruin other people’s happiness to make themselves feel better. Gabe: [00:18:26] You buy new shoes and you are happy with the new shoes and then somebody says, “I hate those shoes.” Does it take any of your happiness away? I mean, honestly? If you’re being honest? Does Michelle Hammer get sad or lose happiness if somebody calls her shoes ugly? Michelle: [00:18:40] Me now? No way. Me 15 years ago? Absolutely. Gabe: [00:18:47] But there’s still stuff that people can say to you that hurts your feelings? Michelle: [00:18:52] Yes. Gabe: [00:18:52] I just find that incredibly hard to believe. Because when I see you, I see somebody with so much confidence. You have guts that I can not quantify into words. You once yelled out “cock ring” in the middle of a crowded hotel lobby. Dude, do you know how much guts that takes? Like, for real? It was just a ballsy thing to do. You were loud, and brash, and amazing, and I remember when we met, I thought, “Oh my God, she needs to a) stop and b) continue.” And that just, like, wrestled in my brain. And it’s one of the reasons that I wanted to work with you, because it was just so incredibly engaging. But the more that I get to know you, and the more that we talk, and the more we prepare for shows, do shows, write, travel etc.. You know, I’ve gotten to know you. Know the softer side of Michelle. Michelle: [00:19:47] The softer side (singing). Gabe: [00:19:48] But you actually kind of have a confidence issue, don’t you? Michelle: [00:19:53] I don’t have a confidence issue. I just don’t like when I feel like people are just giving me unsolicited advice. Gabe: [00:20:01] Well, but that’s what I’m saying. Iff you were 100 percent confident in your actions, you would just tune all of them out. It hurts your feelings, the things that people say. Sometimes people post comments on the Internet. Literal strangers, and you call me up, and you’re upset. You’re angry or you’re just like, “Well, what is wrong with them? Why are they saying this? Why do they say I’m not schizophrenic? How would they know? Because I have purple?” You were really really bothered by that. When that lady said, “There are too many colors. So you can’t be schizophrenic.” Michelle: [00:20:31] Because that just annoys me so much! Because then it makes me seem like a liar. And the last thing I want to be perceived as is a liar. I am not a liar. I don’t want anyone thinking that I’m a liar, and I don’t want anyone thinking that they can’t create art like mine because it is “too many colors.” That’s just a weird stereotype, or, you know, that’s a stereotype or that person just made it up. Gabe: [00:20:54] Are you really not going to admit that your feelings were hurt? Michelle: [00:20:56] I was just baffled and then my feelings were hurt. It was just kind of like, “Who is this idiot trying to say they know more about schizophrenia than a person who has schizophrenia!?!” Gabe: [00:21:06] Allegedly. Michelle: [00:21:08] Oh, yeah. Allegedly. It just, you know- Gabe: [00:21:12] Who hurts your feelings, Michelle? Like, whose opinion is so important to you that if they are negative toward you it ruins your whole day? For me it would be my wife. My wife, and my friends, and my mom. There’s like five people that what they think of me matters so intensely, that if I am happy and they say something mean to me it wrecks my whole day. Who in your life can do that? Who can take your happiness and just flip it upside down? Michelle: [00:21:40] No one. Gabe: [00:21:41] Really? So you’re telling me, that if your phone rang right now and your mom said, “God, you suck at podcasting!” You would just be like, “whatever” and it wouldn’t bother you one iota? Michelle: [00:21:52] I’d just tell her to stop listening. Gabe: [00:21:55] You lie. You lie so much. It would hurt your feelings. Michelle: [00:22:00] Does your mom say that to you? Gabe: [00:22:03] No! God, no! We have a great podcast. But, I’m saying if she did, it would hurt my feelings. Michelle: [00:22:08] Hmmmm. Gabe: [00:22:08] If my mom told me my podcast sucked, I would be sad. I would be upset for the rest of the day. Michelle: [00:22:12] I mean, she’s insulted me way more times than that. So it’s really not that big a deal. Gabe: [00:22:16] And it hurt your feelings! Admit it! Admit that it hurts your feelings. It’s OK that your mother can hurt your feelings. She’s your mom. I’m just trying to say that there are people in our lives whose opinions are so important to us that they can turn us on a dime. And I wish that those people would be more careful with our feelings, because we’re struggling with a lot. But we can’t control them. And that’s really what I’m trying to say – we can’t control their behavior. You can’t make your mom, and I can’t make my mom, or my friends, or you, or me, be nicer to us. We just can’t. So what I try to do is control my own emotions. I wish that I could be like the person that you’re pretending to be where I just don’t care that somebody insulted me. I don’t care. Fuck them. But I’m not. I’m not that guy. When people insult me, when people say mean things, it hurts me it hurts my feelings deeply and genuinely. And I will ruminate on it for days, it means that much to me. And I wish I could make that go away. And that’s what I work on every day. If there was something that I was still working on in therapy, it would be that. And I’ve gotten a lot better. We’ve gotten a lot better at cutting toxic people out of our lives, which we’ve discussed in previous episodes. I’ve gotten better at asking people follow up questions, so that way when they do hurt my feelings, I make sure that that’s what they meant. And I give them an opportunity to explain, because sometimes I just overreacted. And then I work really, really hard on just thinking, “OK, they didn’t like it, but that’s OK.” There’s a lot of different people in the world and just because they don’t like it, doesn’t mean that it’s not good. But mostly, I just curl up in a ball and cry. But I’m working on that, and I think a lot of our listeners feel that way too. Michelle: [00:24:02] Gabe, I think we need to understand that we have to learn how to make our selves happy before we try to be happy for other people. How happy are you right now? Gabe: [00:24:17] I am content. I’m content with my life. I feel safe. I feel secure. I love my wife. My family is good. I have a great show. I have a good career and my dog is nice. I would not say that I am happy. I would say that I am content and I think that’s the thing. I think from the outside looking in, a lot of people would be like, “Wow, if this guy isn’t happy with all the stuff that he has, he is never going to be happy” And that’s really my point. I think that a lot of us are really unhappy because we make ourselves miserable trying to get to some other mythical level. Or we need our medications changed and we need to work with our doctors. But I think that people with mental illness could be happier. I think we sabotage ourselves and I don’t know how to get out of the rut except by talking about it honestly. And I would venture to guess that a lot of our listeners feel the same as we do. They feel miserable, and they don’t know why, and that’s the point. If you don’t know why you’re miserable, then you’re probably not. You’re probably OK. You’re probably sabotaging your own happiness and that’s really messed up. Stop it there. We’ve just fixed all the depressed people Michelle, tell ’em to stop it. Michelle: [00:25:27] Stop it. Just just stop sabotaging your own happiness, I guess. According to Gabe, you are sabotaging your happiness. Gabe: [00:25:35] I think that it is something to consider. Michelle: [00:25:37] I think that I am happy. I don’t think I’m sad or angry. I don’t think anything like that. I mean, I know I’m not 100 percent happy all the time. But in my life, I’m much happier than I was five years ago ,for sure. Gabe: [00:25:53] Michelle, I always love debating happiness with you. So thank you, everybody, for listening to A Bipolar, a Schizophrenic, and a Podcast. Remember to review us on iTunes. Leave a comment. Share this episode. Make Gabe and Michelle famous because that is just so important! And we’ll see everybody next week. Michelle: [00:26:13] Happy! Announcer: [00:26:16] You’ve been listening to A Bipolar, a Schizophrenic, and a Podcast. If you love this episode, don’t keep it to yourself. Head on over to iTunes or your preferred podcast app to subscribe, rate, and review. To work with Gabe, go to GabeHoward.com. To work with Michelle, go to schizophrenic.NYC. For free mental health resources and online support groups, head over to PsychCentral.com. The show’s official web site is PsychCentral.com/BSP. You can e-mail us at show@PsychCentral.com. Thank you for listening and share widely. Meet Your Bipolar and Schizophrenic Hosts GABE HOWARD was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital in 2003. Now in recovery, Gabe is a prominent mental health activist and host of the award-winning Psych Central Show podcast. He is also an award-winning writer and speaker, traveling nationally to share the humorous, yet educational, story of his bipolar life. To work with Gabe, visit gabehoward.com. MICHELLE HAMMER was officially diagnosed with schizophrenia at age 22, but incorrectly diagnosed with bipolar disorder at 18. Michelle is an award-winning mental health advocate who has been featured in press all over the world. In May 2015, Michelle founded the company Schizophrenic.NYC, a mental health clothing line, with the mission of reducing stigma by starting conversations about mental health. She is a firm believer that confidence can get you anywhere. To work with Michelle, visit Schizophrenic.NYC. View the full article
  12. Phobiasupportforum

    Psychology Around the Net: December 1, 2018

    This week’s Psychology Around the Net takes a look at what you should ask yourself before you forgive someone, whether or not the #MeToo movement could hurt women’s health care, a new mental health care facility located in a Walmart, and more. Should I Forgive Him? Should I Forgive Her? Here’s What You Should Ask Yourself First: Forgiveness is often more about yourself than it is the person you’re forgiving (or not forgiving), and because of that, you might accidentally create a “problem” that doesn’t require forgiveness. Could #MeToo Hurt Women’s Health Care? University of Tennessee law professor Glenn Reynolds, referring to preliminary research by Dr. Sarah Perman of the University of Colorado School of Medicine, is sure to get a conversation going with this provocative question. Stuck in a Loop of Wrongness: Brain Study Shows Roots of OCD: A new analysis of brain scans of hundreds of people with obsessive-compulsive disorder (OCD) and people who don’t have OCD might help professionals begin understanding what drives those with OCD to do what they do and find more effective treatment, as the scans pinpoint brain areas and processes that are linked to the repetitive behaviors associated with OCD. Mental Health Clinic Opens Inside a Walmart in Texas: Many Walmart locations have some type of health-related retail space — such as vision care and pharmacies — but is a Walmart — or any retail location — an appropriate setting for mental health care? We, and Beacon Health Options, a behavioral health services company, are about to find out. National Anti-Smoking Campaign Helps Smokers with Mental Health Conditions Try to Quit: Back in 2016, the Centers for Disease Control and Prevention launched “Tips from Former Smokers,” an anti-smoking mass media campaign. One of the ads features Rebecca, a real person who agreed to speak about her struggles with depression and tobacco use. After survey analysis, researchers found that there was a greater intention to quit, and higher rates of quit attempts, among individuals who had more exposure to Rebecca’s commercials. How Culture Shapes Your Mind — and Your Mental Illness: Because culture plays such a huge role in shaping who we are, it makes sense that plays a role in shaping our manifestations of stress, emotions, and mental disorders. Modern psychology and psychiatry is even messier than most of us realize. View the full article
  13. Phobiasupportforum

    Out of the Closet with OCD

    I came out of the closet about my OCD shortly after the release of the film, As Good As It Gets, starring Jack Nicholson in 1997. I figured if a cool (but mean) character played by Nicholson could be afflicted, why not a nice guy like me? I hasten to admit that I don’t usually confess my predicament to just anyone; on the other hand, it’s nothing to be ashamed of. It’s pure hell, of course, but it’s nothing to hide. I have read that Obsessive-Compulsive Disorder often starts between 18 and 25, but my mine predates that period and, as I recall, was particularly exacerbated by Scarlet Fever (when I was seven) and reared its uglier thorns during my protracted bout with puberty. As OCD goes, my assorted checklist of symptoms isn’t anything to write home about. I would diagnose mine as mild to moderate, with ebbs and flows along the way, as well as occasionally difficult fluctuations. Some of my rituals have changed over the years, only to be replaced by newer ones. It’s an interesting fact that even so-called normal people may flirt with OCD when under stress, such as preparing for an important business flight — packing and repacking a suitcase to be sure the essentials weigh under 50 pounds. I like to think of my dilemma as a “blockage” between knowledge and emotion. For example, I KNOW that I have turned off the stove, for I have turned the dial to OFF. I also SEE the marker positioned under the word. I can FEEL that the dial cannot be turned any further. And yet, and yet… It’s a crisis of uncertainty! Would you leave the house if your gas burner were on? Neither would I. It’s not a matter of exaggerated fear. It’s a matter of doubt, of not connecting what you feel… with what you know. I KNOW that my gas burner is off; I just turned it OFF. However, I can’t leave the house, as long as I can’t FEEL that fact. So I repeat the action. Grip the dial harder. Stare closer at the OFF marker. Turn and align the knob. Rinse and repeat. There’s something about needless repetition, as senseless as it seems, that reinforces a sense of conviction. Perhaps it’s a matter of finding closure, of seeking reassurance in the fact that — what was done — was done. For me and for most OCD sufferers, repetition seems to be a major player in this illness. On the other hand, it’s not always about repetition, alone. During other situations, it can be about forging a sense of order. For example, I like to arrange certain objects equidistant from one another. The objects must not touch or be crooked. Nice parallel placements. Perhaps it’s a form of emotional superstition. Like a ritualistic rain dance while chanting. If I can establish a semblance of order, perhaps bad things won’t happen. Perhaps the carefully placed objects will be less inclined to fall. Perhaps they’ll be easier to sort through. Perhaps their organized arrangement will produce in me an ordered peace of mind. Harmony and tranquility will reign. The paradox of such stringent attempts at relief is that often they only lead to more frustration and pathos. What is the nature of this nemesis? Exploration into its possible causes persists. Perhaps a “fault line” between Conviction and Uncertainty lies in the anterior cingulate cortex, as well as other brain structures implicated in this disorder. Here’s a typical “highlight” from earlier today: I woke up and went to my bathroom, took some pills from my medicine cabinet. Returned the pill dispenser to its rightful place on the shelf. Studied its position on the shelf. Straightened out its position in minute detail. Adjusted its position again and again. Finally, closed the medicine cabinet door and sighed. Ah, done with that. For some reason, drawers and doors pose a special problem for me. When I close something, I need to know that the interior contents are safe. I must leave nothing to fate. Nothing must be disturbed. Life with OCD can be complicated; perhaps I compromise too often as a result. Unlike a hoarder, I find that the fewer things that are left hanging around the house, the less I have to worry about them. There’s less chance for disarray. I am a minimalist for that reason. References: At what age does OCD usually begin? (2014, January 10). Retrieved from https://www.everydayhealth.com/anxiety-disorders/experts-what-age-does-ocd-begin.aspx PANDAS-Questions and Answers. (n.d.). Retrieved from https://www.nimh.nih.gov/health/publications/pandas/index.shtml Bostan, S.N. (2018, January 13). Brain signatures of obsessive-compulsive disorder. [Blog post]. Retrieved from https://www.psychologytoday.com/us/blog/greater-the-sum-its-parts/201801/brain-signatures-obsessive-compulsive-disorder What is hoarding disorder? (2017). Retrieved from https://www.psychiatry.org/patients-families/hoarding-disorder/what-is-hoarding-disorder View the full article
  14. One of my life-long battles is to ensure that people get the most objective, useful information they can about mental illness and its treatment. It’s painful to me when I come across a popular website that misrepresents these illnesses or their treatment. So you can imagine my surprise when I reviewed the National Institute of Mental Health’s (NIMH) page on depression recently. This is a super-important page to get right, because it often appears as the number one or two search result in Google. It starts off well enough, but then devolves when it gets to a section entitled “Treatment and Therapies.” Biases can be in your face, such as when a psychiatrist suggests, “Take antidepressants for depression — it’s the only thing that works!” Or biases can be more subtle, even unintended. Treatment of Depression I’ve written enough words to fill a (small) book about effective treatments for depression. I’ve talked about newer therapies that show promise, including ketamine and rTMS devices. The main takeaway from anything I’ve written is that a combination approach using both psychotherapy and antidepressant medication is usually best for most people. Even if you don’t “believe” in therapy or don’t think there’s anything “wrong” with you, time and time again the research is super clear about the effectiveness of this combined approach. If you want to start feeling better as soon as possible, this is the method to use. So in a 904 word section on treatment of depression, why does the NIMH devote a measly 61 words — about 7 percent of the section– to psychotherapy? This is a perfect example of a subtle bias. It’s not in your face, but it’s clearly there. Of course, the section with the most words — and therefore the greatest focus — is medications. An astounding 414 words — over 45 percent — of the depression treatment section is devoted to talking about antidepressant medications. The NIMH also wants to be very clear it is only talking about FDA-approved (e.g., government-sanctioned) medications, because it devotes 118 words — more than the entire psychotherapy section! — warning you against taking herbal supplements for depression treatment. Despite there being a fairly robust consensus in the international community that things like St. John’s wort are generally okay to try for most people, and can have about the same clinical effectiveness as an FDA-approved antidepressant medication. The NIMH also writes far more about electroconvulsive therapy (ECT, aka shock therapy) than psychotherapy. In this section, 231 words are devoted to ECT — more than 25 percent of the treatment section! ECT is rarely prescribed as a treatment for depression in the vast majority of people who suffer from it. It’s estimated that less than 5 percent of people diagnosed with severe clinical depression will ever try ECT. And it comes with some potentially significant, serious side effects. Why This is a Problem We take the issue of treatment bias seriously here at Psych Central and always have. If the research shows a combined treatment approach that includes both psychotherapy and medications is best, then an article describing depression treatment needs to reflect that finding. Psychotherapy needs to be given the same amount of editorial focus in an article as medications. And it needs to be given far more focus than extreme, rarely-used treatments such as ECT. The NIMH article also fails to note that most people try to treat their depression on their own, using self-help methods and strategies first. This is, by far, the most common treatment strategy employed. For some people, it actually works and can be effective in treatment of mild depression. To be fair, the NIMH is not a clinical treatment center, nor focused on education about the treatment of mental disorders. It is primarily a research arm of the federal government. The fact that Google believes this is one of the best pages on the Internet for accurate, unbiased depression information (despite lacking author information or references) is not the NIMH’s fault. But they know — or should know — it is often the #1 result in for a search on depression. Knowing that, they should work with a team of science editors and writers to ensure it reflects an accurate portrayal of treatment strategies generally employed in clinical practice today. Because right now, the page reflects some alternative treatment universe divorced from the clinical reality on the ground. One where medications and ECT are routinely used to treat depression, and psychotherapy is just a footnote. View the full article
  15. Over the past year, I learned to never start a podcast with a schizophrenic. Honestly, it could be to never start a podcast with a New Yorker or a millennial, but since I operate in the mental health space, I’m going to pin this on my co-host’s mental illness. Which, of course, she’d correctly point out is exactly how stigma works. I learned that grandchildren, even the loophole variety, are time consuming and expensive. I figured out that, when you’re a traveling speaker, becoming TSA certified saves a lot of time at the airport. In addition, I learned that publishing a book is something that the government should consider as an alternative form of torture to replace waterboarding. In the 12 months since I turned 41, I completed a contract to deliver the same speech 26 times to 18,000 employees over six days, was on the front page of the Columbus Dispatch newspaper, and (perhaps most impressively) my wife and I went to Chicago to see the award-winning Broadway musical, Hamilton. How Does Bipolar Disorder Factor In? As you just read, bipolar disorder didn’t stop me from achieving great things on both personal and professional levels. I’m incredibly proud of the success of The Psych Central Show podcast, and despite my jokes that my co-host from A Bipolar, a Schizophrenic, and a Podcast is a handful, that show is growing at a record pace. Honestly, all my projects are doing extremely well, and my career continues to advance in a positive direction. So, naturally, I’m underwhelmed. I feel like a fraud. I just sit back and wait for the other shoe to drop. No matter how much I achieve, it’s never enough. It’s like ‘stinking thinking’ on steroids mixed with cocaine. I’m just not capable of accepting any success. I’m not an idiot. Intellectually, I know I’m successful, but emotionally, I feel like a failure. It’s just how my brain is wired and, while I can overpower those feelings with logic and coping skills, I still have to work at it. It’s not natural. I can’t just rely on how I feel. I’m constantly convincing myself that I’m not a garbage person. It does get easier with age. I’m almost 42, and I’m better at managing bipolar disorder than ever before. As I stated above, I know I’ve had a lot of success. I’m aware that most anyone would be envious of my achievements — mentally ill or not. My life, however, has never worked that way. I recognize I’m doing well, and I know the people around me are proud of what I’ve done with my life. Sometimes, in rare moments of clarity, I’m proud of myself, too. All I can do is keep trying and keep moving forward. For all I know, maybe 43 is the age a person living with bipolar needs to be to fully accept their positive qualities. Hopefully, I’ll let you know around this time next year. View the full article