Monday, August 31, 2009

Cognitive errors

Recent events - my friends' illnesses, looking back through my journals, and an incident with my sister - reminded me of the list of cognitive errors that I used to keep.

I read a bit about cognitive therapy of depression - including the book by that name by Aaron Beck - when I was diagnosed and trying to straighten out my thinking. The book lists a half-dozen or so errors in thought commonly found in depressives. The one I want to talk about today is "excessive responsibility." It's an idea that depressives often have - that we are responsible for everything negative.

Here's a small example of how it works.

One day I was sitting in the doctor's office crying away about something - probably sheer relief that someone knew what I was dealing with, and could help me - when I realized the tissue box next to my chair was empty. Doc got up to get another one from the closet, and I began to apologize. (Probably profusely, as I was upset to begin with.)

I was focused on the fact that I had interrupted our talk, and I had made him get up out of his chair (he was an older man - not old, but older.) He had to explain to me that, in a psychiatrist's office, people cry - it's apparently quite common - and as a psychiatrist it was his responsibility to keep supplies of tissues on hand, and if anyone needed to be apologizing, it wouldn't be me.

He was rather stern, and finished up by telling me that it was not necessary for me to apologize for living - something, I'm sure, that set me wailing again, as that was precisely what I had been doing for as long as I could remember. I apologized for everything.

Over the years I have gradually grown out of thinking that everything is my fault. I had to start hearing my own apologies, and then paying attention to what I apologized for, and to whether it was really my fault. And I'll give you an example of how that works.

This weekend my sister and I went to a concert, in my car. We left our purses locked in the trunk of the car - I picked up both of them, carried them to the trunk, and set them on the floor.

The next day she called me; she had lost an electronic key; would I go and check the trunk? I checked the trunk, and the floor where she had been sitting; there was nothing. I felt really bad; she had lost her key, and I couldn't find it. The feeling of being responsible for something bad was so familiar; it was only when I re-read the list of cognitive errors that I realized what was going on. I had, after all, picked up her things with care, and placed them in the trunk in the same way. I'd searched the parts of my car where she had been, and I shook out a blanket that had been in the trunk just in case something was caught in it. In the several square miles where her key might be, it was not in the six or so square feet of my car.

Her missing key was not my fault.

Even now, though, having figured out my cognitive error, there is still a tiny part of me that feels guilty...because my sister lost her key, and I couldn't find it.

* * * * * *

While looking the journals I found a remark from Doc - of course I can't find it now but he was warning me against setting artificial hurdles for myself. I used to be very good at that; I think I believed that if I set myself a task and accomplished it, then People Wouldn't Figure it Out. The mask would stay in place.

The first book on the "books I'm reading" box is "Anna Karenina." It's been there for awhile; it's going to stay there for awhile; it's slow going and I have about 350 pages left. I read it long ago but didn't remember much. Why am I reading it now? Because I ordered a novel called "What Happened to Anna K." by Irina Reyn. It's Anna's version of the story.

Why didn't I just sit down and read the new novel? Why am I spending weeks on "Anna Karenina?"

I'm setting myself unnecessary tasks. The good news is that I know it, and if the book wasn't interesting, I'd have put it away by now.

Excessive responsibility. It's a real pain in the ass; if everything is truly your fault then everything you do is wrong, and you are wrong.

My thanks to my gray-braided doc for the fresh box of tissues.

Sunday, August 30, 2009

The Glass Mountain

When I was a child, I read a fairy tale about a glass mountain. The evil king had placed his beautiful daughter at the top of the mountain. In order to win her the prince had to climb the mountain - which was as slippery as ice - and give her a golden apple.

The way I "work on" myself reminds me of that glass mountain. I make progress so long as I keep trying, but in order to keep trying, I have to remember that two steps forward and one back is truly progress.

I come up with theories, or plans, or ideas, or motivations, and I work with them for a week or two or four, maybe - and then they fade away. Fortunately, with each of these mini-efforts, I end up with the seed of a new habit or understanding. Each seed keeps that net number of steps on the positive side.

Right now I'm sliding back from the two-fruits-a-day and adequate exercise plan I've been on for a month or so. I've been through this many times, though. I know that what I have to do is find a little inspirational reading, get back on the elliptical machine, and buy some fruit before I go to work in the morning.

I've been eating ice cream and packaged, prepared food. That's a good sign to me that something is troubling me. (Years ago, I drank my emotional concerns/unrest - or they went up in tobacco smoke. Now, I eat them - literally.)

I think by writing this blog I'm making myself look at some things that I haven't thought about for a very long time. Overall, I think that's probably a good thing, even when it's not particularly comfortable. But I need to make sure I handle the effects intelligently - and a quart of ice cream does not qualify.

Writing here isn't always as easy as I thought it would be. It makes the glass mountain a little more slippery. But on the whole, that's good, it keeps me from getting lazy - and as I recall, that's part of what blogging was supposed to do for me.

Thursday, August 27, 2009


In the last few days I've had news from two friends - one an old friend who has been supportive of me for all the years I've known him; another a new, Interwebs friend. Both have recently spent time in psychiatric care of one sort or another - hospitalized for a few days.

I'll call them "OF" and "NF" - again, I won't abuse anyone's privacy on this blog.

OF taught me years ago to play my mental health cards very close to the chest - or, to be fair, I thought that's what he was teaching me; I may have got the message completely scrambled. But that's the lesson I learned, and one I have followed, with one exception (which I quickly regretted.)

NF simply announced, on the net board where his true name is known, that he'd been in a hospital for psychiatric treatment for nine days and he was glad to be home.

I was really quite surprised at his honesty. And he was well received, with comments about openness and trust and honesty, all of which were well deserved, and then a comment that openness "is the only way to go."

All of which I watched from deep in my own little Narnia, in my little mental-health closet, which seemed awfully small suddenly. It made me think about my own situation - some of that thinking healthy, some of it less so.

For example: as I read the conversations between NF and other members, I bent them a bit and reacted as though they were about me. That is, NF is brave and honest and open and therefore Julia is cowardly and dishonest and sneaky. Amazing how quickly the warped thinking comes back, isn't it? I finally convinced myself that the conversation was about NF, not me, and that just about everyone I know would understand my unwillingness to open the door of my closet.

It's also true that NF worked for himself for many years, and would be only too happy to do so again. I work for an employer, who would most likely not fire me if my history were known, but would certainly not trust me in the way I am currently trusted. And my field is a fairly incestuous one; word would get around unofficially, very fast, and my future earnings could be compromised. As a single woman of almost 50, I have only my own earnings to rely on. I'm not willing to put those at risk. So, although I found myself NF's ability to speak openly about his experiences, I'm glad I've never taken that step, and I'm happy for the lessons learned from OF - whether he taught them to me or not.

I also had to spend a bit of time thinking about the phrase "mentally ill." I will freely admit that I tend to avoid that phrase; for me it conjures up hearing voices and having a very slim relationship to reality - in short, people much sicker than I ever was (she says, praying that it was always true.)

I tend to think of myself as mentally healthy - as someone who was mentally ill, is now mentally healthy, will stay healthy as long as I take my medication, and will be mentally ill again if I stop. Even at that, I don't like the phrase "mentally ill." (Well, who does?) It just carries way too much baggage. While I don't mind choosing to stay in the mental-health closet, labeling it the mental-illness closet just seems to lock that door from the other side. I've never been hospitalized, and I want always to be in control of that lock.

Until society - more importantly, employers - have a better attitude about things, I'll just call it a salt deficiency. Lithium is made from lithium chloride, after all, and I wouldn't have to take it if I wasn't short of it, right?

Cowardly, maybe. Dishonest? I prefer "private." But I've been stable for 12 years, I'm still paying the rent, and I'm still putting money in the retirement account, and I'm not willing to give that up because other people are still hung up about words like "bipolar."

As for my old and new friends - I wish the best of health to them both, for a very long time to come.

Tuesday, August 25, 2009

Behind the mask

I've been thinking about this since I said it was in the works; the problem is that the further I get from thinking about the bad times, the harder it is to bring them into the present. The only way to get them to come to life again is to go back into the past and as we've already seen, that's not a good idea.

It's difficult to write about the isolation of depression, too, because to some extent we're all isolated inside our heads. I have no idea whether my own sense of isolation was greater because of my illness, or whether I was just like anyone else.

Given the situation, though, I think it unlikely that I was just like everyone else.

At its absolute worst, the mask was a visible (to me) gray screen between me and the rest of the world. It seemed to be two or three feet in front of me. But that was at the end, shortly before I was diagnosed. Before that, it was just a mask I wore that I hoped made me look "normal."

For most of my life, I had a strong sense that I was wrong - that I looked wrong, sounded wrong, felt wrong - I did not fit and I was trying to pass. The sense of wrongness started in grade school, but I think I was older, probably in high school, when I started trying to fake it. I hid behind the mask, knowing that if I dropped it, my wrongness would be visible; I would be found out.

I was living in a world of Miranda rights - I knew that anything I said could and would be used against me - not because people were out to get me, but because I continually felt I was saying the wrong things. Live like that for 20 or 30 years, and you slowly become afraid to say or do anything at all. (I just realized that I'm still a bit nervous when there are friends - or anyone - in my apartment; what part of me is showing, that shouldn't be?)

Or you say "to hell with it," and speak your mind - but your social skills are/feel so poor that you can't tell whether or not you even made sense. One too many times, and you lose your professional credibility. I tend to change jobs every 7 or 8 years; that's about how long it takes me to feel I've "screwed the pooch," so to speak.

I was at a family gathering this summer and heard my sister tell her daughter, "Poke me if I start talking too much." Shyness is a family trait, and in trying to overcome it, we all struggle with how much social chat is enough. I was surprised to hear her say that; I thought it was just me. That's when it struck me that I have no idea, really, how odd I am, how much of my self-consciousness is the scar from years of illness and how much is simple shyness.

I am getting better. I still hate large gatherings - I can never remember names or faces; I think it's from having spent so many years not looking people in the eye. That may never change. But I'm getting better at small gatherings and parties. In general, I can hold conversations and not be particularly anxious that I'm going to Expose Myself. But there's a sense of restraint - a sense that I shouldn't be too honest, or too open, or someone will know that something was wrong.

Now that I'm writing about it, it seems that I don't know any more about this than I did when I was ill; it almost seems as though I haven't advanced at all. But that's not really true. The level of anxiety is much, much lower, when it's there at all. I know that for the most part I'm as 'normal' and capable as everyone else, and most of the time I'm able to trust that.

And I no longer care so much about my place in someone else's view. It's far more important to me to be okay with myself in my own view, and I don't mean that in an "I'm Okay, You're Okay" kind of sense. I mean that most of the time these days, I like myself. I know where I've been and what I've come through, and I'm pleased with where I am. That's a huge achievement, and it gives me a place to stand. There will always be people who find me odd or unsympathetic or awkward - but that is more a matter of taste than anything else.

I've met a lot of people, and there are maybe a half-dozen I actively dislike. I'm guessing there are about the same number who actively dislike me. A half-dozen is not so bad. A half-dozen I can live with.

Saturday, August 22, 2009

Taking Responsibility

During the time I was sitting zazen at the local zen center, I learned several chants. This one is very short:

All the karma ever created by me from beginningless greed, anger, and delusion born through body, speech, and thought I now fully avow .

The first few times, I had real trouble saying it out loud. I think it was first referred to as a "vow," and I don't do well with vows - had, in fact, decided I wasn't going to take any more vows at all, ever, no thank you. I really struggled with that; if I was going to chant, I wanted to know what I was committing myself to.

Eventually, as I learned more, I began to chant it every day, and I need to start doing that again.

The meaning is fairly simple. "Karma" means "action." So the chant is saying that all of my actions, and the results of my actions, if they arose from anger, greed, confusion, or general wrongness of purpose -- whether I said them, did them, or merely thought them - these things are my responsibility. (Please understand that this is what the chant means to me now; I don't speak for the zen center, and I don't expect that my interpretation would match theirs.)

The chant speaks of actions that arose out of anger and delusion; it does not say anything about actions arising from good will. But I needed to learn to take responsibility and ownership for my actions, no matter their origin.

When I was sick I never knew whether the outcomes of my actions were good or bad; I felt at the mercy of judgments I didn't understand and couldn't predict. I lived a very defensive life, a life lived in reaction to illness and the world around me.

To chant the repentance vow with honesty means that I trust myself to understand the origin of my actions - to understand the difference between anger and illness and good will. It means I know which of my actions needed more thought. It means I know myself well enough to understand my own intentions.

The Repentance Vow taught me a great deal about myself. I didn't realize until I wrote this post that it is still teaching me.

Making plans

Deep depression made dealing with people incredibly exhausting. Being incredibly exhausted by social interaction for no reason I could identify (I didn't know I was depressed) made me feel incredibly inept, socially - so I struggled harder to be "acceptable" around other people.

Because of this downward spiral of energy and anxiety, it was very difficult to make any kind of social plans. In the months prior to diagnosis I reached a point where I would only accept a lunch invitation for the current day. I could be fairly certain how much energy I'd have in a few hours, but if you asked me on Tuesday to have lunch on Friday? Who knew what kind of shape I'd be in on Friday, whether I'd have the energy needed to make conversation?

For years, I fobbed off all social invitations with some version of "I'll see" or "I'll try." I generally ended up showing up, but I had to have that escape hatch.

This week I made reservations for a business trip, with a few days visiting friends tacked on at the end, and I realized I still have difficulty making plans. I'm much improved from the old days, but there are still areas where I hesitate, where commitment becomes difficult.

I have no trouble making plans for work. I think I've always been vividily aware that I don't really have a fallback for financial support - I am "it." (Even when I was ill, what reserves I had went to my job first.)

I have no trouble making plans for myself. I have traveled overseas, I routinely buy tickets for arts performances months in advance.

But social plans are still difficult. For nearly ten years I've lived less than 200 miles from my college roommate, and I've visited her once. (And on that occasion, behaved less well than I would have liked.)

I have dear friends who invite me to their home in the mountains every August and every Thanksgiving, and I have not been there in years. In fact, I decided on a whim to see them last year, not having thought things through, and had to cancel because driving for two days during the holidays to have a one-day visit just seemed foolish.

I need to work on this. I haven't been going out as much as I used to, and I think old habits of thinking have been sneaking up on me. The more I stay in, the more I will stay in.

Rather than jump in with both feet, and involve other people, I think I'll start making regular plans for myself - specific days, specific events, a week or more in advance. I've already started, by making plans to see a concert next weekend with my sister. Then I think I'll start making very specific plans that require me to be at a certain place, at a certain time, money in hand, ready to enjoy myself. Whether it's a movie or a meal or a play or an art exhibit, I need to remind myself that I can be relied upon.

But first, I need to make some hotel reservations for after the conference. As for my friends in the mountains - your turn is coming. I promise.

Friday, August 21, 2009

Coming Attractions

Friday is often my most productive day, which could be a little discouraging if I let it.

My weekend is free and I hope to add at least two or three new pieces here. If focusing on the past felt scary, or an invitation to illness, then focusing on the changes I've made appears to be energizing and uplifting. And who can't use more of that, right?

Here are some of the topics I want to delve into in the next several days:

  • When I was ill I lived behind a mask. Have I come out from behind that mask, or have I simply traded it in for a brighter one?

  • I'm making plans for a brief vacation in the fall. The years of illness left a very clear mark on my ability to make plans, particularly social ones. How can I make myself aware of that influence, and address it when it shows up?

  • I also want to read, think, and write about the ideas in "A Handbook for Constructive Living."

  • One topic that is a little further out on the horizon is coping mechanisms - the ones I used to rely on, the maladaptions I've tried to eliminate, new techniques I might need. Somewhere in relationship to those issues is a discussion of money and depression.

The counter is beginning to rise faster than my own obsessive checking could account for - someone is reading this, which is a truly amazing feeling. Thanks for that gift. If this is the end of your week, I hope you have a chance to put your feet up and sip a glass of iced tea. For me, it will be a scotch and water. But I'm looking forward to it, because I'll be able to be here.

Wednesday, August 19, 2009

Focus, Part 1

I have a terrible time with focus. I don't have ADD; I can concentrate on things I enjoy. Most of my focus problem comes with getting things done - and particularly at work.

Over time I've bought book after book on time and task management. They generally help, if only for a little while. Sometimes all I want is a tool or a hack or a technique that will work in the short run.

I work in software maintenance, which (in my case) means that nothing is truly finished. We also write a lot of trial stuff that ends up being abandoned. If you get your kicks from solving one problem and moving on to another, this really isn't the best place to be.

For me, it helps to break everything into pieces and tackle them one at a time. Unfortunately I'm on a project now where a lot of my tasks are backed up due to missing pieces in other areas. In short, the project isn't going well, and it's sapping my energy.

One thing I need to do is enable the screen saver on my office system, and set up a marquee that says "Chop wood, carry water." It's one of those very old, very well-known Zen phrases that may or may not be terribly obvious. For me, it's a reminder to do the work that is at hand and do it well; when it's done move onto the next task, doing that one also as well as you can. It's similar in nature, I think, to the Zen phrase "Just this." Just this; what is in front of me is what I need to do; what comes after will make itself apparent in its own time.

I left my copy of "Constructive Living" at work, unfortunately. I want to re-read it in a concentrated fashion. A major tenet of Constructive Living is to be aware of, alert to, your feelings, but to act, nonetheless. It's so easy to get tied up in planning and what-ifs. That's what's tying me up in the office right now. My supervisor told me very plainly last week to enjoy the process we're in because the result isn't really predictable, but I'm struggling because I want to know where I'm going - otherwise how will I know whether I've succeeded?

Oh. Because the project will be over and I will have my sanity, my fingernails, sobriety, etc. Because the project will be over and I will not have allowed it to "own" me. (And if I concentrate and work well at the office, the project won't have to own me.)

Those ideas - "Chop wood" and constructive living - are two different philosophies on how to proceed, of course, but either of them is more helpful than the complete lack of focus I've been struggling with. Whichever one helps me focus at a particular time, works for me.

As for hacks - small tricks - I've noticed that I work better, the more formally dressed I am. I work in a very casual environment, so dressing up tends to make me stand out - not always a good thing. But I think I'll have to dig through the closet and dress up a bit more than usual tomorrow. The more professional I feel, the more professionally I work - not always, but often.

These are exactly the kinds of things I mean by "Thinking Constructively." It's a process of identifying the discomforts in my environment and/or in my thinking, and then figure out how to make them less uncomfortable or less important. I can change behaviors and thought patterns that aren't serving me well. I have to know what they are, know their effect, and come up with a way around or through them.

Monday, August 17, 2009

How Happy Should I Be?

I've been thinking about the post I wrote a few days ago, about drinking a peach. I was a bit nervous about that one. It was a very good peach, but - how happy should I be?

It's very possible that I was on the manic side that day. Not likely, because it didn't last very long, and I've been sleeping just fine, but when you're bipolar, "How happy should I be?" is a real question.

Because my manic swings have been few and far between, I don't know the warning signs nearly as well as I do for the onset of depression. Mostly I rely on two characteristics: inability to sleep, and becoming fascinated by a single subject. While it's true that I've been buying a lot of books lately, they've been on a variety of subjects, and instead of trying to read them all at once, they're stacked on my desk, waiting for a long weekend.

There are all kinds of strange questions that I ask myself when I might be manic. Is whatever I'm smiling about, something that others - "normal" people - might smile about too? If Ifeel really good, have I been taking my medicine reliably? Have I been behaving in loud ways, or drawing attention to myself in any way?

If all those questions get the right answers, then I assume I'm just having a bright spot, and I try not to worry about it. But there is a part of me that switches into self-monitoring mode. Although I know that kind of "responsible" behavior is what makes me relatively tolerable most of the time, it's also, well, a bit like having to clean the chalkboard after school because your jacks game got too loud.

Sunday, August 16, 2009


I love to read. I started reading at 5 or 6 and, as a shy person with serious depressive issues, never stopped. Books were an alternate universe where I could live unselfconsciously.

I can't read as devotedly as I used to. Part of that is age, I'm sure; part of it is due to the fact that the world outside the book is more inviting, by far, than it ever was in the past.

Over the years I've bought a lot of self-improvement, self-help books. I've learned what I like and don't like, what helps me and what doesn't. I don't do religious (for me, Buddhism isn't like a religion). I don't do books that look for places to lay blame, or books that indulge any sense of feeling put-upon. (Some people learn from those books; I don't. It's a matter of what works for you.)

Dr. Al did me a huge favor when I first went to see him. He took a brief family history, as any doctor would do, and then he said "Now you get to choose. We can spend a lot of time digging over your family relationships and your parents - or we can get to work going forward into a healthy life." I was 37 at time. I chose to go forward, and I'm grateful to him for the hint.

A brief list of books that have helped me over the years - sometimes with only an idea or two, sometimes with more -

A Handbook for Constructive Living, by David K. Reynolds - the original source for the name of this blog.
How to Be Organized in Spite of Yourself, by Sunny Schlenger
Breaking Free from Emotional Eating, by Geneen Roth
Changing for Good, by Prochaska, Norcross, and diClemente

There are several more, and I'll mention them as time permits.

I should note that I seldom "buy" or adopt the full philosophy from any one book. If I can learn one or two things from a book, be spurred to one or two new habits, then I consider it a success. Sometimes it's not what the book tells me, but the thinking it prods me to do - "The Time Paradox," by Zimbardo and Boyd, set off a very productive thought train. And recently I read "Move a Little, Lose a Lot" by James Levine. I never made it past the second week of his plan - but I'm consistently exercising and more consistently eating fruits and vegetables, and that makes the book a winner.

I don't want books that patronize me, or "there, there, isn't it unfair" empathize with me. I don't have time for that. I want books that say "Here's a new way to look at an old problem," or "Here's a method that works for some people." I want a map. And over the years I've put together a fairly good atlas.


In a earlier post I wrote how I managed to turn an offer of help from my sister into a full-blown critique of my obvious failure in life. I was, pre-meds, notoriously over-sensitive.

I still have difficulty in this area; I don't have a good handle on it and it's not particularly predictible. Family conversations are not a problem; we don't criticize each other much, and it's almost always teasing, rather than any kind of attack. As my mother told me in a letter after I was diagnosed, my sisters spent a lot of years walking on eggshells, trying not to set me off. I'd guess it's habit by now.

I think the difficulty I have is in drawing the cognitive line between "you're doing that wrong" and "you, yourself, are all wrong."

When I lived with my illness on a daily basis, I knew I wasn't like other people, but I had no idea what it was that made me different. I was just wrong, somehow, and it was important not to let anyone else see it. I moved under a constant cloud of anxiety: something was wrong, something had been wrong, something would go wrong soon. I don't know anyone else who could conjugate error!

So when I am found to be wrong about something. my immediate reaction is that the disguise has slipped. The disguise is never, ever supposed to slip, so criticism - wrongness - is a major failing no matter how small the error might be.

These days, when I am directly criticized, I try to run through a number of questions/steps - the first one being to take a deep breath; the second is to think.

After that, and in no particular order, I ask these questions:
Is the criticism valid - did I get something wrong?
Have I done any harm? Can or should the harm be repaired?
Did I make the mistake out of ignorance? If so, can my critic enlighten me?
Did I make the mistake out of inattention or laziness? If so, is this a chronic failure?
Is this an error that I can avoid in future? (If not, stop thinking about it!)
How ashamed do I feel, why do I feel ashamed, is there any purpose or validity to it, and if not, knock it off!

And the biggest question of all, to which I almost always know the answer: Is this criticism a condemnation of me, as a person? It very seldom is. Once or twice I've received this sort of all-out-attack criticism. It's almost always made by someone who does not know me, and has no basis for attacking the whole Julia. After all, most people have enough redeeming qualities never to be rejected out-of-hand. So when the criticism is truly an overwhelming personal attack, I tend to believe it has much more to do with the critic than with me.
This really is an issue I haven't thought much about, but it's an important one.

This all sounds very logical and direct and well-adjusted. But the reason I'm writing on this particular subject today is that earlier this morning, I posted something on another site which may have caused a problem, which I corrected as quickly as possible. It was a problem I wasn't aware of so couldn't have prevented. Now I know how to keep it from happening in future.

That's good, and I'm pleased with the distance I've come. But...for a good hour after the incident, I felt tension, embarrassment, and an odd feeling like pebble loose in my ribcage. Those are pure emotional reactions based on an old thought process. They're not comfortable; I want to learn to change them.

It's really important to try to track down these errors of logic, these psychological limps, and build new paths. Part of the reason I left the local zen center is that learning there seemed to be based heavily on observation; one was to be aware of one's surroundings, and errors received sharp (but not particularly unfair) correction. I had spent a lifetime, not observing my surroundings, but trying to blend into them, and the thought of sharp public correction made me so anxious that all I could observe was my own failure to observe. When I have trained myself out of those personality traits, maybe I'll be able to go back to zen practice.

Oh. Today I finally decided to let a few chosen friends know about this blog. With an entry called "Criticism" at the top. It's a good thing I don't buy into Freudian theory.

Thursday, August 13, 2009

Pam's birthday (What's a "quit buddy?")

One way to explain the depths of depression and anxiety I lived with might be this: At least two doctors, over the years, discouraged me from quitting smoking. I was too anxious to be successful and they didn't think I needed the added pressure of failure!

I started smoking at 18, and continued for 25 years - at some point I counted 17 attempts at quitting, and then I stopped counting. Every time I'd make it to about six weeks, and start again.

About five years after I started taking lithium, I started toying with the idea of quitting. I did a little websurfing on the subject, and found an on-line support site. I signed up for it, thinking I could slowly talk myself into quitting - maybe over the next six months or so. I also found a reference to a rather cheesy-sounding book, Alan Carr's "The Easy Way to Quit Smoking."

I bought the book and began reading it one Saturday. I kept reading and smoking, reading and smoking, reading, reading...and I suddenly realized I had quit. Carr had convinced me that all my reasons for continuing to smoke were lies. By the end of the book I realized I was also furious with the tobacco companies who had kept me prisoner - a fury that helped me tremendously in the coming weeks.

I was smart enough, after 17 attempts, to know that help would be a good idea, so I went back to the web site and started listening and posting. No matter what time of day I was tempted to smoke, someone was online who would commiserate and console - and help me resist. It was a tremendous tool.

One of the informal tricks at that site was the pairing up of people who were quitting at about the same time. Pam quit about a month before I did, but we ended up as "quit buddies" anyway. We are not at all alike; Pam is outgoing and bubbly; hearing her laughter - which is nearly continuous - always makes me smile.

Pam is one friend I met through quitting smoking. There are others from that site who, like Pam, became real friends, with shared interests beyond tobacco. On the very rare occasions when I'm tempted to smoke again, I talk myself out of it because, really, how could I ever admit it to them? They are friends, they care about me, I couldn't possibly let them down.

For those who are considering quitting smoking but aren't quite there yet, the money and the improved health are only part of it. Here are a few other reasons to stop - reasons only a smoker would understand:
  • I used to know every convenience store on my route to anywhere. I'm rarely in a convenience store any more; there's no need, unless I'm on a road trip and I get hungry.
  • I no longer have to check whether I have lighter and cigarettes before leaving home, or whether I have enough cigarettes, and if not, do I have any cash and is there a place on the way to wherever I'm going.
  • I no longer have to search for a place to smoke at a party or other social event.
  • I no longer dread long plane flights or church services (okay, I do, but for other reasons!)
  • I no longer dig through my trash cans for long ends at 2AM
  • I no longer freak out \ when I develop a deep cough with a cold, or an odd bump on my tongue
  • I have an extra 20-40 minutes of every day that I used to spend smoking.
  • I don't owe anything - not my time, not my life, not my money, not my anything - to the bastard tobacco companies who sell poison for no other reason than that they can make money doing it.
One of the things I learned from Carr was this: That great feeling that comes when you [i]finally[/i] get a cigarette? It's not the nicotine making you feel good. It's the nicotine relieving the pain of withdrawal from your last cigarette. If you didn't smoke, you wouldn't need the relief from withdrawal and you'd pretty much feel good all the time because you wouldn't be "jonesing" in the first place.

The book doesn't work for everyone, but it's Alan Carr's "The Easy Way to Quit Smoking." And the website (which, when I was there, was nonprofit; it probably still is, but I'm not sure) is the Stop Smoking Center .

If you have tried to quit and failed, you are, as I was, a prisoner of tobacco. You can free yourself; they only want you to believe you can't. Quitting smoking was perhaps the most terrific gift I ever gave myself. I strongly encourage you to do so, if only for the sheer joy and freedom of it.

And for my quit buddy Pam - thank you for your help, both in quitting smoking and on that terrific shopping spree. I'm so glad you're in my life - happy birthday!

What a peach!

I've been making an inconsistent effort over the last few years to improve my diet. I'm not much for fresh fruits and vegetables, and I have to push myself; my current goal is two pieces of fresh fruit a day.

Last night, rushing through the grocery for some really bad food, I passed a display of white peaches. I don't often eat peaches - but the white ones are so beautiful, I picked one up.

I just ate it to finish off my lunch, and it was so juicy I wasn't sure whether I was eating or drinking. It was truly luscious.

One of the things I try to do for myself is to recognize the extraordinary (particularly sensory) experiences that come my way, and to enjoy them. To inhale deeply when I walk past the heavily-scented flowers down the street, to open the window during a thunderstorm.

To drink a peach.

I would never say that life is always good; Buddha tells us that life is full of discomforts. That's why it's so important to recognize the best bits. Some days I can get a lift just from sparkling surfaces in the bathroom, or from driving down the highway with the windows down, singing along with the soundtrack from "Once."

We don't have to be consistently joyous; we don't even have to act happy. But when gifts appear, savor them. They lift the spirits, the heart, and the energy. For those of us not used to looking up, it takes practice. But that peach has made me happy for a good quarter of an hour.

Monday, August 10, 2009

Better, today

A quick update: I am better today. more under control, less tired. I still feel a certain strain, and no good reason for it, but the kitchen is clean, I've eaten, if not completely intelligently, at least relatively so, and I spent 45 minutes on the elliptical machine.

This is really what I mean by "Thinking Constructively." It's recognizing the signs that something is amiss, and acting on them.

It's still very early, but I've done all I really care to today. Time to crawl into bed with a good book.

Sunday, August 9, 2009

Second thoughts

I'm not really sure this blog is good for me.

I've spent a lot of time intentionally not looking back, and I think that's a very good idea. But I'm writing this with the idea that others might read it, and that seems to require a bit of background.

I can't help but feel that "there, be dragons."

I have come a million miles forward from the blackness of depression. I don't think that I will ever build the kind of relationships and stability that others have; I have too much of a psychological limp for that. And that's okay with me; I just don't want to be where I was, ever again. I want to build a fulfilling life for myself, and since I'm relatively easily pleased in the way of material things, what I really have to work with - and on - is my mind.

I hate the idea that people who read this might feel sorry for me. I can't afford to slip, to lose my perspective and compare my life to others'. That's an unwise thing to do even when you've lived a "normal" life. It's extremely important for me to stay focused on my own life, my own goals.

I want to wrap this up with one final description of deep depression, and then end the looking backward, for good.

All the books say that when you're depressed, you don't really have feelings. That wasn't true for me. At its worst, depression meant that I wasn't thin-skinned; I was no-skinned. Everything hurt, in the way that air blowing across badly scraped skin hurts. I had emotions, but I spent a great deal of time and energy clamping them down, seriously afraid of what would happen if they broke loose.

At the end, just before I got the help I needed, I was living behind a gray screen. It wasn't a physical screen, of course, but it was visible, it was very real, and it was a few feet in front of me at all times. It separated me from the rest of the world and it was always, always there.

Nothing in my life since - not the death of my mother, not a marriage and divorce, not my father's fury at finding himself old - has been as painful as that life was, as just getting through a day behind that horrible screen. There, indeed, be dragons, and I will not look back any more. It costs too much, and it's dangerous.

From here on out, this blog will be true to its name. There are people who write about depression; that's not what I set out to do. I set out to write about building a life after depression, and that's what I'm going to focus on.

Friday, August 7, 2009

Who Do You Think I Am?

One thing I have real difficulty with still, and that is my place among other people.

There are some fine lines in this area; I'll try to be as clear as possible.

I am happy in my own company; I am somewhat reclusive but not, I think, dangerously so. I am terminally shy, something that seems to run in my family; all my siblings seem to be more comfortable with themselves than with others.

When I was sick, I spent a great deal of time trying to figure out how other people saw me. I was very, very bad at it, of course, but it meant a great deal to me. My perceptions of the world I lived in and the people who populated it were so bad that very little in the way of human relationships made sense to me, and I was constantly trying to figure things out, with almost no success.

As Doc put it to me: "Julia, any given situation can be viewed in one hundred different ways, and 99 of those are likely to be wrong." I had a lot of re-training to do.

Let me see if I can give an example.

Nearly 15 years ago, I was living almost a thousand miles away from my parents. I was working for a non-profit organization and not making much money. My older sister called to say, hey, I know you're not planning to come home for Christmas, but the parents aren't getting any younger, and I'd buy you a plane ticket if you'll come home.

I was stunned. I was furious. I was so upset that I cried, literally, for 15 hours, and then I called my sister back and read her a very incoherent riot act.

I now believe that she meant what she said, no more, no less. But my interpretation went like this: I know you're not planning to come home for Christmas because you're thoughtless and a loser and you're completely irresponsible financially, but the parents aren't getting any younger, and I'd buy you a plane ticket if you'll come home because God knows you don't have the money and wouldn't spend it on somebody else if you did. Since you can't run your life on your own, why not just do what we tell you, and after Christmas you can go back to pretending you're a grownup.

I was more than a little difficult to deal with.

These days, after a lot of work, I am better; at least I no longer assume that people know or think the worst of me. But while I no longer assume what others think of me, it's also true that I can't read the opinions of others well at all.

On the whole I think I would rather be uncertain than dead wrong.

This all came about because of a long meeting I had with my boss this afternoon. I've worked for him for almost five years. We get along well and I respect him. But on days like today I truly could not tell you whether he was sympathetic with the problem I was trying to solve, whether he had had a bad day, or whether he was sorry he had ever hired me.

With friends and even some family members, I find it difficult to know whether I am welcomed or tolerated as the odd aunt.

I tend to keep a certain distance in most relationships, as if to say "
I like me; if you don't like me, that's too bad - you don't know me as well as I do. If you did, you'd like me better; meantime, we'll both be happier in other company." I always know where the (emotional) door is. I seldom need to use it any more, but I still like to know where it is.

I call things like this - unhealed leftovers from the bad old days - emotional limps, and I'm really not sure how to fix this one.

Thursday, August 6, 2009

Fat and Happy

I am a large woman. Not stretch-pants-at-KMart large, but large, nonetheless. When I was diagnosed those dozen years ago, my doctor warned me that lithium tends to cause thyroid problems, and that I would probably have to struggle with weight.

Will the lithium work, I asked. Because I don't care about fat if it works.

The lithium has worked, and I am a good 50 pounds larger now than I was twelve years ago. I've finally started exercising regularly - may not make me smaller but I'm hoping it will keep me from being bigger.

Either way, I'm ahead of the game, because I'm alive and doing well. Without lithium, I'd have been dead long ago.

There was a joke, long ago - it might have been a "Sylvia" cartoon - that asked what the world would be like without men. "No wars," the answer went, "and lots of fat, happy women."

The men can stay, I guess. But I'll keep my lithium, thank you, and be fat and happy.

Tuesday, August 4, 2009

Exercise, or, "You Gotta Wanna*"

I'll say it over and over: depression is exhausting. All my life I've been a very low-energy person. I hoped this would improve along with my mood, but it hasn't, particularly. Some of that is drug-related; I have a friend who swears her antidepressants make her sluggish, and I know that a dozen years of lithium treatment have seriously damaged my thyroid.

I've known for a long time, at least at an intellectual level, that the way to make energy is to exercise, and I even understood it when I'd attempt exercise for short periods of time. But then something would come along, I'd skip the exercise, and I'd start to drag.

Finally, I think, this summer it is truly sinking in: my elliptical machine is a generator. My feet are generators, when I can use them.

I had yet another scattered, unproductive day at work today, so I swore to myself I would exercise when I got home. I start up an old tv sitcom, and move for 25 minutes. It's good for me.

It made me realize that I really have built a whole collection of techniques to manage my mood; writing this blog will help me identify them. Exercise is the most recent one, and very important. I hope I've finally learned that lesson.

* A George Carlin line - Thank you, Mr. Carlin

Monday, August 3, 2009

No Bitterness Allowed

The writing that I've done in the past few days has caused me to think about the bad times far more than I normally do. I decided very early (with some help from a wise doctor) that I needed to focus on building a new life. After all, that's not an easy task.

I also knew that it would be very, very easy to become bitter; to spend far too much time obsessing about what I didn't have because of the years of illness.

Writing the last few entries has sent my thoughts down a path I normally don't follow, and it's been troubling. I didn't think well at work today and that's disturbing.

I need to list some accomplishments here, to remind me that the past is past.

In the years since I started taking lithium, I have
  • Bought and sold a house
  • Traveled overseas alone and with a group
  • Become financially stable
  • Risked marrying again
  • Recognized a mistake and got unmarried again
  • Purchased two cars without anyone's advice
  • Learned to bid at an auction ("real" and Ebay)
  • Learned new techniques for my job
  • Begun winnowing out my possessions
  • Studied meditation at a zen center, and attended services for a year or so
  • Begun giving to charity on a regular basis
  • Quit smoking
  • Been a companion to my elderly father
  • Become a moderator for an on-line political discussion group

I'm sure there are other things that I can't remember, but this is a good start. It could be better, yes - and I think it will be - but it could also be a hell of a lot less.

Life is good, and I have a feeling I'll sleep better tonight, work better tomorrow, for remembering that.

Perception Check #1

Re-reading the piece "Low-Key Manic-Depressive" has pointed out one of the after-effects of illness: I don't trust my perception of myself.

It's very difficult to describe the experiences of 25 years in a few short paragraphs. It's even more difficult for me to evaluate whether I have over- or under-stated my illness. I try to tone down my writing because I want it to be believable; I re-read it and I think it sounds so controlled and disinterested that no one who read it would ever believe it was a real problem.

The evaluation process is made even more difficult because the "bad old days" are now twelve years in my past, and memories get fuzzy after a while.

I have a few things that help me to remember that yes, it was that bad.

I kept journals in the last years of my illness, as self-therapy more than anything else. Writing was a way to talk through whatever struggle I was facing (and I was always struggling; chronic depression is one long struggle.) I kept those journals, although I seldom look at them.

And: Twice in my life I've had my neck x-rayed. A normal neck is curved rather gracefully. I was surprised to see that mine is a straight line. I've never injured it. I think it's the result of 25 years of chronic depression - 25 years of keeping my eyes on the ground. My body has in some ways been shaped by mental illness.

Finally, in each of the last two years, in October, I have had the briefest of relapses - a couple of days, no longer. I think it might be triggered by the time change. Each time I have been pushed back into illness I have been filled with fear and anxiety and a desperate need to reach out to friends (a need I've been wise enough to indulge.)

What those two short episodes taught me is frightening enough to keep me taking my meds for the rest of my life. When I was sick, I kept going because I didn't know any other way to live. Now I know what it's like to be well. The contrast is stunning. I think that the way I lived for 25 years would kill me now, and kill me very quickly. I no longer have the tools necessary to survive depression.

I have "written through" my question: was it really as bad as I described? Yes, it was; I think it was really much worse.

That gives me yet another reason for this blog - to remind myself of all the tools I've developed, so that they are always available to me.

Sunday, August 2, 2009

A really low-key manic-depressive

Most of the bipolar people I've read about have really high highs and the really low lows. The high highs feel great, which is one reason people don't always take their meds.

My experience - my illness - is not like that. I do occasionally get "manic." I can tell I'm manic when I'm not sleeping, I've become fascinated by some subject, and I'm reading multiple books on that subject at one time. It doesn't happen very often, and except for the cost of the books, it's not really destructive.

The majority of the time, I was depressed - not all the time, but a lot.

I truly do not know how much time I spent in between the high and the low. I do know that my favorite songs as a child were all the songs on Simon & Garfunkel's "Sounds of Silence" , and James Taylor's "Mud Slide Slim" album, which came out when I was 11. I didn't understand what the songs meant, but they matched my world.

I got through high school with the support and laughter of my best friend, Tamara. I haven't spoken to her in 20 years, and I can't find a way to let her know it's only because I don't want to go back to those years. So my thanks to Tamara, and my apologies.

I married early, to a man I suspect was also a depressive. But I quickly realized I had no clue what I wanted to be when I grew up and didn't want to raise children while I figured it out. The marriage lasted about two years.

A few years later, a coworker/friend explained to me that I was chronically depressed; he'd been through it himself and suggested I get some help. I didn't believe him, and so I went through another fifteen years of pain and confusion. It gradually got worse until in 1995 I found myself fantasizing about ways to die, and spending my lunch hours in the car crying because I knew I didn't have the courage to kill myself.

I went to a psychologist, but by this time I had 25 years of practice at appearing "normal," and she had no idea what might be wrong - or whether anything really was. We talked for a few weeks, but all she could really see was that I was a fairly intense woman who probably had some unresolved parental issues.

I stopped seeing her, with her blessing, and then a few weeks later, I had one of those unexplainable shifts that sent me from barely hanging on to deep despair. I called the psychologist, who gave me an emergency appointment. She took one look at me and said "this is chemical. You need a doctor."

She sent me to an internist, who prescribed an anti-depressant and monitored me for some time. I felt better very quickly, then lapsed again. I remember asking him, much discouraged, whether I would ever really be better. He said "Julia, when you came into my office you were so far shut down that you might as well have been curled up in a ball under the table. You're already better. But your best days are like other people's 'blah' days. I'll tell you when you feel good, because you don't know how to recognize it."

I was better, truly I was - but not a lot better. After two years, I finally did what I should have done at the beginning - I agreed to see a psychiatrist.

It's the aftereffects of this illness that I want to write about, and the process of overcoming them.