Saturday, July 28, 2007

Yada Yada

They do it. All the time. You've probably seen them do it. I know I have. Even at church they do it, and they have no shame whatsoever. Now, some people claim that they are no worse than the males of the species, but my experience tells me otherwise. In fact, when I was a teenager and moved to a small town, one of them wanted to do it with me all of the time, and wouldn't take No!" for an answer.

It happens so often, that their behavior has become a joke. "A teen aged girl had been talking on the phone for 1/2 hour, and then she hung up. 'Wow,' said her father, 'That was really short. You usually talk for 2 hours. What happened?' 'Wrong number,' said the girl."

Teen aged girls and even preteens spend a lot of time talking. They talk at school, they talk on the phone, they text-message each other, and now, they use social networking to stay in touch. What a boy can say with "Yeah," a girl can say with 30 additional words. Boys don't pass notes, girls do. Boys don't win text-messaging contests, girls do. They get a lot of practice. "Yada, yada." That's why girls and women complain that we males don't talk much. By comparison, we are strong silent types for sure.

An article by Jennifer Warner and reported by CBS News, made this statement. "Teen aged girls who bond over gripe sessions and sharing each other's problems may be doing more harm than good emotionally. A new study shows that friendships based on complaining about each other's problems may raise anxiety levels among teen girls and potentially increase the risk of depression."

Amanda J. Rose, PhD, associate professor of psychology at the University of Missouri Columbia says, "These findings are interesting because girls' intentions when discussing problems may be to give and seek positive support. However, these conversations appear to contribute to increased depression."

Researchers say the study shows talking excessively with another person about struggles, such as rehashing and dwelling on negative feelings associated with them, can have both benefits and risks for people dealing with difficult issues. But boys of the same age didn't seem to suffer the same negative emotional effects of letting it all out. Probably because their disclosures consisted of an exchange of "Bummer" and "Yeah."

If you have a teenager in your household, you might want to track the amount of time spent communicating with her best friends. As already mentioned, time spent is higher than ever before. Teen girls are talking all of the time. In ways never dreamed of in the days of their mothers. When you consider all of the time talking at home, at school, at the mall, on the cell phone, through text-messages, and on their sites at YouTube, MySpace, FaceBook, MyYearbook, Piczo, Imeem, Bebo, and Tagged, it would probably astound the average parent or even teacher. And then, you have to consider the blogs, forums and chat rooms.

Juvenile depression is a reality. Now, parents and school counselors and medical professionals have to take into consideration this new dynamic. In addition to the negative exposure that teens find on the Internet, you have to factor in what could be negative exposure to friends. Technology is creating new addictions, and baring your soul may soon become one of them. I'm going to coin a new phrase. "Yada Yada Depression."

["I'm so low, I could do a ten minute free-fall off the edge of a dime."]

Tuesday, July 24, 2007

Head Bone Connects To The Body Bone

Do you remember the chorus to the children's song, "Dem Bones?" "The foot bone connected to the leg bone, The leg bone connected to the knee bone, The knee bone connected to the thigh bone, The thigh bone connected to the back bone, The back bone connected to the neck bone, The neck bone connected to the head bone, Oh, hear the word of the Lord!"

For me, bones and pain have been intricately connected. My broken bones include toes, ankle, ribs, sternum, fingers, thumb, wrist, elbow, nose and hip. Dem bones gonna hurt, when dey broke!! Add to that, three major operations (elbow, back and hip), several scars over 4 inches, twenty years worth of migraine headaches, and you can see that pain has long been a companion of mine. Like depression. In my particular case, though, I don't believe that there was always a direct connection. Perhaps some times, but mostly not.

The medical community has pretty much accepted the fact of a connection between the "head bone" and chronic pain. The discussion of this phenomena has caused a division of psychiatrists and pain management professionals into "egg" and "chicken" parties. There seem to be people from both professions in both groups. The major question is, "What comes first? Depression or pain?" The answer appears to be, "Yes."

The more open minded doctors and researchers see that, depending on the particular patient, either pain and depression can be a result of the other. In some cases, chronic pain (lasting more than 3 months) can cause depression to develop in the patient. Makes sense to me. I know that one year when I had daily migraines (5 out of 7 days), the pain alone was depressing. Severe pain that can't be escaped or alleviated just naturally causes a person to become depressed.

What is less obvious, though, is the manner in which depression might cause someone to develop (or feel) chronic pain. In a Newsweek article (10/27/07), James Bakalar writes that "depressed people suffer three times their share of chronic pain (and people in pain are at high risk for depression). Some studies suggest that if physicians tested all pain patients for mood problems, they might discover 60 percent of all undiagnosed depression. If you're struggling with either problem, there's a good chance you're suffering from both of them."

The connection between sensory pain and emotional pain is rooted in the nervous system. Both are governed by the same neurotransmitters (serotonin, norepinephrine, and substance P), and both are processed in the same parts of the brain. When the circuitry is working properly, pain and depression are self-limiting.

Treating chronic pain can often help reduce depression, and treating depression can, to some degree, reduce the magnitude or incidence of pain. The administration of antidepressants can sometimes reduce the pain felt. This is why the medical community is beginning to consider both problems in developing a successful treatment regimen. Dr. Matthew Bair, formerly of the Regenstrief Institute, says, "We believe that a treatment model that incorporates assessment and treatment of both depression and pain is desirable."

That makes sense to me. Even children know that the Head Bone is connected to the Body Bones.

["I'm so low, I could do a ten minute free-fall off the edge of a dime."]

Saturday, July 21, 2007

Good Web Sites

There are many great web sites with a wealth of information about depression and bipolar disorder. Here are a few of my favorites. If you have some good ones, email me. (ratings or reviews of drugs by patients)

["I'm so low, I could do a ten minute free-fall off the edge of a dime."]

Tuesday, July 17, 2007

Get A Job!!!

"Get A Job!!" Do you remember that old song by the Silhouettes? "Get a job. Sha na na na, sha na na na na. Every morning about this time, she gets me out of my bed, a-crying, 'Get a job.' After breakfast, everyday, she throws the want ads my way, and never fails to say, 'Get a job.' Sha na na na, sha na na na na."

But what if you can't get a job, or if you get a job, you can't keep it? How can people who are successfully employed understand the difficulty that having chronic depression or bipolar disorder creates for a job-seeker. How can they understand the embarrassment of having to answer that killer question, "Why did you leave your last job? And the one before that? And the one before that?" Over and over.

You can't help but wonder at what point the prospective employer will begin to think that there is a problem. Red flags waving. Knowing that he is formulating a plan to turn you away without letting you know that he will never hire you. No way. You can't really blame him. If you were the employer, in all honesty, you would see red flags too. The only difference is, you know what colored the flag red.

We live in a society where the most likely introductory question will be, "What do you do?" That's a question that I most hate to hear. I know that it's coming, and I get all stressed out while I'm waiting for it to come. I've tried to think of something safe and strategic to say. "I do mostly what I want to do." "Nothing that I can get out of." "Oh, this and that." "I read and walk and shop and fish and sleep and eat and watch TV and..." No matter what you say, the interrogators will never let you off the hook. They persist, "No, I mean what do you do for a living?" You can't even satisfy their relentless questioning by saying, "Well, I'm a mostly retired preacher."

"Mostly-retired" is a euphemism for mostly unemployed and mostly depressed and mostly feeling helpless. The reason that job seekers are advised to diligently look for employment is that counselors know that they will eventually begin to feel worthless, if they don't find a job pretty soon. For most of us, self-esteem is tied into our ranking in the employment hierarchy. If we are not a fully functioning member of the club, then we lose our self-respect. Even if we know that we would choose to work, if we only could.
You have no idea how hopeless and helpless a person feels when he can no longer use his education, his skills and his experience to benefit society and care for his family. It's frustrating and heart-breaking to say good-bye to your dreams, and to the self-fulfillment that comes with full time employment.

In a Newsweek article on men and depression, Dr. James Siepmann is described as a example of the disappointments faced by people struggling with chronic depression or BPD. "Siepmann, a family physician and father of five, gave up his medical practice in 2000 when his depression got so bad he couldn't bring himself to get dressed in the morning. Despite numerous types of treatment, he spends most of his days at home and can only muster the energy to shave once a week."

I wonder how many times he's heard his mind saying, "Physician, heal thyself." I can easily understand the disappointment he must feel. All of his education, skills and experience are no longer utilized to do what he is driven to do.

I got a late start on my formal education. Ten days after I graduated from high school, I entered the military. After spending a year and a half in Viet Nam, and over three years in the Seabees, I was discharged and returned to the Oklahoma workforce. I was twenty-one. In the next four years, I hopped from job to job, town to town, and state to state. Finally, following a divorce, I decided to start taking some college courses while I worked a full-time job. An hour here and an hour there.

I took my first undergraduate course when I was twenty-five, and my last undergrad course when I was forty-five. Twenty years of hard work, sacrifice and expense, so that I would be able to say, "I'm a college graduate!!"' I jokingly tell people that I was a slow learner, but I have had a healthy measure of pride in my accomplishment.

What I have in common with Dr. Siepmann and with others who struggle with mental illness, is the inability to use what I've learned to do, to accomplish what I've been trained to do. He can't serve as a physician, and I can't serve as a preacher. Both of us are miserable, I'm sure. It's not easy to become reconciled with the probability that you will never again be the person that you once were. I was a skilled teacher and preacher. It was something that I loved to do. I envisioned my entire life being spent as a preacher, but now that flame has been doused.

Those of you who don't wrestle with this problem, thank God that you have been blessed with employment. Really. Please try to understand the grief that the rest of us have to deal with. In my opinion, it's easier to recover from grieving over the loss of a loved one than it is to stop grieving over the loss of a dream and the loss of your self-esteem.

None of us who are unemployed or partly employed want pity, but we do need understanding, support and respect. A dream would be good, also. We just want to ...Get A Job.

["I'm so low, I could do a ten minute free-fall off the edge of a dime."]

Tuesday, July 10, 2007


As I say, "I'm lower than a snake's belly." (awful depressed)

A Funny

Some aspiring psychiatrists were attending their first class on emotional extremes. "Just to establish some parameters," said the professor to the student from Arkansas, "what is the opposite of joy?" "Sadness," said the student.

"And the opposite of depression?" he asked of the young lady from Oklahoma. "Elation," she replied.

"And you sir," he said to the student from Texas, "how about the opposite of woe?"
The Texan responded, "Sir, I believe that would be giddy-up."

["I'm so low, I could do a ten minute free-fall off the edge of a dime."]

Wednesday, July 04, 2007


Many of us can remember growing up in an era when disrespect was not tolerated. My parents wouldn't allow it in the home, among friends, at school or in the community. Disrespect had direct and immediate consequences. Learning to treat others with dignity and respect was a part of the good etiquette program learned at my home. In fact, my parents often said, "If you see someone being picked on, ridiculed or shunned, then go and make a friend of that person." This is an ideal that I've tried to live up to my entire life.

Stigma is a type of disrespect that many people who are mentally ill (like me) have to deal with on a frequent basis. It comes in many forms, both subtle and overt, but it usually is manifested by prejudice, discrimination, fear, distrust, and stereotyping. Many people might avoid socializing, working, and living near to or with someone who has a mental disorder. Stigma is primarily about disrespect. Unfortunately, everyone who is guilty of it can't be spanked.

The Language of Stigma

When I began my research about this problem, I was amazed to learn how stigma has been incorporated into much of our common language. The following is a list of words and phrases frequently used to ridicule those persons who are mentally ill. Those of us who have a mood disorder may have used these words ourselves.

(1) Around the bend; going bananas; batty; bonkers; certifiable; cracked; crazy; cuckoo; delusional; demented; deranged; disturbed; harebrained; haywire; his elevator doesn't go all of the way to the top; insane; irrational; loco.

(2) Loony; lunatic, mad; madness; maniac; men in little white coats; put you in a straight-jacket; he's mental; nuts; nutty; off your rocker; of unsound mind; he's paranoid; psycho; psychotic; schizo; raving mad; retard; screwy; screw loose; he's touched; wacko.

If you circled all of the above that you were familiar with, how many would it be? Society and we have become so used to these words that we don't even consider how hurtful and disrespectful they are.

On the bright side, on April 29th, 2002, President Bush created the New Freedom Commission on Mental Health, and declared, "Our country must make a commitment. Americans with mental illness deserve our understanding and they deserve excellent care." In addition to this commission, there is a Mental Health National Anti-Stigma Campaign sponsored by the government agency of the Department of Health and Human Services. This campaign is focused on motivating "a societal change towards social acceptance and decreasing the negative attitudes that surround mental illness."

In my opinion, stigma is a result of several factors. It is due to ignorance (lack of knowledge), fear, embarrassment, a sense of superiority, pride and disrespect. One of my personal goals is to provide encouragement, opportunities, and direction that will enable us and others to gain the knowledge necessary to understand depression and bipolar disorder. A lack of knowledge produces a lack of understanding. It has been demonstrated over and over again that a failure to understand something will often result in fear and disrespect.

Even when I've talked to church groups, I have often been approached by people who are embarrassed and reluctant to discuss the subject of mental health, especially if it is related to someone close to them. Embarrassment might even cause them to become angry and deny the reality of mental illness.

As I mentioned above, disrespect is now a national problem. We see it demonstrated by the interaction of adults, children in school, employers, and the community's attitude toward law enforcement officials and government representatives. I believe that our media makes a major contribution to these attitudes in their portrayal of parents, presidents and police persons. This all carries over into how the general public treats those of us who have some form of mental illness.

The Product of Stigma

We are not able to measure the harm that stigma causes, but in talking with others and measuring my own response, I have found that it results in (1) feelings of shame, (2) hurt, (3) fear, (4) isolation, (5) a feeling of being misunderstood, (6) loneliness and (7) secrecy. Of all of these things, I believe that we are most often self-stigmatized by secrecy. As long as we feel that mental illness is something shameful, and we make every effort to hide it from our acquaintances, we will continue to be subject to the painful effects of stigma.

How To Combat Stigma

Would you be surprised to learn that while this problem is discussed even on the Presidential level, little is written about what to do about it. Nationally, the solution is to educate (I agree) the general public, protect our rights through legislation, and force insurance companies to treat mental health problems in the same way that they would treat physical health problems. All of this is good, but what can we do about stigma?

I would suggest the following: (1) educate everyone who will listen to you. Education produces understanding, and hopefully, compassion. (2) Be assertive. There is no reason why we have to allow others to ridicule us publicly or treat us with disrespect. Assertiveness is not easy to learn. It has taken me many years, but there are some good books that will advise you on how to develop this in your life. (3) Get rid of shame, through counseling, if necessary. We have nothing to be ashamed of. We acquired this health problem through no fault of our own. (4) Do not hide your struggles. Secrecy is not the solution to stigma. The more you hide, the more disrespect you earn. Life is miserable when you have to keep a secret.

Ultimately, stigma creates a barrier to a happier life for millions of people. One in five people will have a serious struggle with depression or bipolar disorder at some time in their life. Unfortunately, of that group, only one in four will seek treatment. That is primarily because of stigma. I believe that the battle we face is not just for ourselves, but also for these others who are not living as happily and productively as they might, if they would only get the help available to them.

My friends, in my opinion, the better that we understand stigma and how to fight it, the better the rest of the world will come to understand us.

On a personal note, I have been deeply depressed for the last week. I'm using this mornings "window of opportunity" to write this blog. When I get behind, please don't give up on me, I will always return as quickly as possible.

["I'm so low, I could do a ten minute free-fall off the edge of a dime."]