Bonfire at Tamanend Park in Southampton PA

Just called the park and left a thank-you message for letting us use their pavilion for free. They grandfathered us in. Nice!

Was talking to my sister Amy in Eugene OR this morning while riding my stationery bike & mentioned I use an entirely different brain for writing than for talking. Amy's favorite mode of exercise is 'hot yoga' where you do your positions in a 104-degree room. Whew!

We all dressed warmly for the bonfire. It was quite chilly but there's nothing like a roaring fire to heat you up. I must say it's absolutely mesmerizing to watch the fire, you simply can't look away. At the end, we threw things in and watched em burn: such as marshmallows and pieces of Kleenex. Absolutely thrilling! Being there is its own kind of high.

My 3 favorite foods were:

Hot dogs - Helen got me the low sodium
Ada's brownies
hot cider
S'Mores
Pomegranate sparkling juice

Topics discussed at the Bonfire included: death by fire - the room fills with smoke and you can't see anything; arsonists (my adopted cousin, unfortunately I'd never met him, he smoked pot all day long; A Serious Man, the latest Coen Brothers film; ladybug infestions; the successful removal of a brain tumor for someone's psychiatrist.

Helen forgot to bring a poem to read, Little Orphan Annie. It was her dad's favorite.

Please pass the S'mores.

Quite a no. of times I was laffing hysterically. Nothing like a good laff. Or a good shit. The newly discovered Arnie is a riot. If something bothers him, he writes a letter. He wrote Waldfogel a great letter. Waldfogel told him he was OCD so Arn sends him a letter and never sees him again. The reason I laffed so loud is cuz I do the same thing.

I'd say for the first 20 minutes of the event people didn't talk shop. Then slowly this all-important part of our life insisted on sharing time between talk about gas fireplaces and solar panels and backyard swimming pools, maybe w/Carrie Fisher sliding home with her one-woman Broadway show Wishful Drinking, she gets maintenance ECT treatments, so we were in little groups under the covered pavilion while Larry turned the hot dogs on the grill and Helen stirred the hot cider on the Coleman stove (they're campers).

Marion brought a couple friends who waxed ecstatic about the bonfire. It was so good to hear total strangers praising the BF. It's like camp, they said. Camp for grown-ups.

Oh god did I feel like a grown-up yesterday. I got 7 new windows put in my house and a number of other improvements. They forgot their caulk and left it here. I hope I don't mistake it for toothpaste or cake icing.

I didn't bring up the windows at the bonfire cuz I haven't totally processed their appearance. It's like when you get a new car and you look at it with love and admiration. I'm in the early window-acceptance process as I lower it into my cerebellum.

Did you watch the NOVA show about the large Turkish family who walk on all fours? No one had seen it. That's a show you really wanna discuss w/someone.

As usual the conversation turned to the word Bonfire. I conceded that we don't really make a bonfire since we're not in the middle of an open field. It's really a campfire. When my kids were teens one of them used to have a friend who regularly made a bonfire. If you're a mom you're not allowed to attend these events as you might embarrass your kids. So I kept that concept in mind and then somehow when I discovered Tamanend Park, less than 15 minutes from home, I decided to try it.

That was 5 or 6 years ago. Massive organization on the part of Helen and Larry go into this. They work as a team. After everyone left for the evening, they sit in the folding chairs and burn all the logs they've brought. I never stayed with them before but did last nite. I knew Scott would be asleep by 10 pm so I could stay out as long as I wished.

Larry turned out the lights of the pavilion and we sat by firelight. When I returned from the bathroom behind my favorite tree, I reported there was a fine mist in the air. Not exactly rain. As we sat in our chairs Larry pointed at an opening in the ceiling where we could see the mist filtering down from the sky as a huge spiderweb swayed softly.

'I'm waiting for the officer to show up,' I said. When I'm not in a panic I don't call em cops but refer to them nicely. If, however, I'm driving or a passenger, I'm not gonna say, "Hey, you might wanna make sure you're obeying the rules, there's a police officer hiding behind the bridge abutment."

Finally a car pulls up and a man w/a flashlight heads our way. We figure it's about midnite, the time we said we'd be leaving.

What're you folks doing here? said the cop.

Larry and Helen spoke real slow, as if they were exhausted.

I told the cop we had reservations until midnite.

Did you reserve it for overnite? said the cop.

We didn't know what he was talking about until he left and we looked at our watches. It was 1:45 pm. We were shocked.

Driving home I took the beautiful backroads near my house. Fallen leaves had made a beautiful carpet on the road. Be careful of deer, I reminded myself. I was paying total attention to the beauty of the leaves and driving to the rhythm of the music on the radio. I was having major dopamine rush, or maybe it's serotonin rush. 80 percent of the serotonin in our body is produced in the stomach or intestines, hence the pleasure of eating?

Suddenly my car began to slide uncontrollably. Just for a second. Whew, that was close, I said to Jesus. Now drive slower, Ruthie.

At one point there were simply leaves all around, floating down from the trees in the misty rain, and on the road, and off to the side. I felt like I was in the Fun House at Euclid Beach Park back in Cleveland and my sisters and I were driving thru the Tunnel of Stars.

When I got home I removed the sign Bob's Home Improvement from the lawn. "I'm surprised you let him put it there," Scott said. "I didn't," I said. "He just put it there. He also went around the neighborhood advertising his services. That's how I found him."

The windows produce a deep happiness inside. Maybe I should join Iris's Happiness Group and advise people of the greatness of novelty in our lives.

Just put a sign on my front door. Remember, tonite is Halloween: Sorry, Gone Fishing.

I have no patience anymore for Halloween. I'm hiding out on the lower level of my house. How do you want to spend the evening, I asked Scott. "We could watch a movie and cuddle," he said.

You can't get much better than that!

My WorryList for the Cruise

This blogpost is an example of 'processing your emotions,' something I preach to everyone. My theory is that if I write these down they won't bug me so much when I awake in the morning and my mind turns on. Gong gong gong!

It was not until 7 this a.m. that I actually examined my itinerary and found out exactly when I leave - my daughter and I will leave from JFK Tues nite at 9:55 pm. We'll have 3 nites in Barcelona before boarding the Celebrity Cruise ship which'll tour the northern Mediterranean for a week. I emailed the ship my dietary regulations last nite - it was immensely difficult for me to do that - I included 3 kidney diet links and stated 'the one from scotland is the most liberal.'

My main concern is falling asleep aboard the cruise ship. The room will be pitch dark. No windows. I've packed a nite-lite. I'm worried about the sounds I'll hear. The lurching motor of the ship. The endless drone. Will it drive me crazy? Will I sit up in bed clutching my face?

No I will not take a tranquilizer. Mind-altering drugs are no longer my style. I take approx 12 different meds for my kidney problems. I threw out all my Klonopin long ago.

Before manic depression held me hostage for 20 years I was fearless. This is true.

PS - My fam doctor's office just called. I just hired him and am very pleased. Joanne said they just faxed over all my info to the Jefferson Kidney Transplant Dept. I thanked her generously and realized what a great choice of doctors I made. They faxed it immediately! Great service.

So, until the onset of bipolar I was just a regular gal, a prolific writer and newsletter editor for Art Matters, and then my brain drastically changed with the coming of the illness. Fear set in and stalked me day and nite.

Here's why I'm equating being on the ship to my illness. In the first few months after I got sick, I imagined I could actually feel the earth moving around the sun. I'd lay in bed at nite with the parking lots flicking over the living room which is where I slept on a couch and I'd feel this ever so slight movement of the world turning.

It was not a pleasant feeling.

Ya know something?As I'm writing this, I'm already feeling better about the ship.

Prior to the blog I imagined that when I closed my eyes in my state room I'd imagine I were an African tribal woman torn from her family and manacled with hundreds of others in the rank stinking quarters of the slave ship begging for food and water.

Oh, turn on your nitelight, Ruthie, to vanish such horrid thoughts.

Any other worries, Ruthie?

Actually they've been expunged by the very act of blogging. Is that possible?

My own bouillebaise or fish chowder

Good cooks know that fresh ingredients, not frozen or canned, make for the very best food. Sure, it's time-consuming to cut up all the ingredients even if you do have your very own bowknife like I do. I usually talk on the phone while I cook in my green Starbucks apron with my cordless phone tucked in the pocket and headphones covering my ears. Yes, I have been known to prolong phone conversations, easy to do with my mother who tells me all the dreadful health news she can think of, while I'm sawing away at the carrots and onion.

FISH CHOWDER

Make friends with the Fish Department folks at your grocery store. Ask about where the fish comes from. I buy fish on sale. Or is it on sail. They all take turns. I buy scallops by the number. "Five large scallops please."

In huge pot, braise your veggies in olive oil and butter. Our bodies do need some fat, ya know.

-carrots

-celery - I've just rediscovered celery and munch on it while cooking. In my youth I'd drink wine. Not a good idea. I'd need a nap after that.

- onions, of course!

- red peppers (they add vibrant color)

- mushrooms, wipe w/a wet cloth. Don't soak them or they'll become spongey.

When nicely browned and the aroma is overpoweringly delicious, add your CHICKEN STOCK. I use a low-sodium boxed brand from Nature's Promise. Rinse out the box with water and pour in pot.

Next we're gonna factor in ingredients according to their cooking time. Since this is a meal-in-one, we wanna get our starch in there. Remember, a meal consists of protein-starch-and carbs.

-Brown rice. Why brown? Because white rice is de-natured. The germ is removed as is the endosperm. Let's keep our grains intact, folks. None of this 'whites only stuff.' There are laws now, aren't there?

Add your FRESH VEGGIES as available at the market. Remember the macrobiotic-diet fads? I never subscribed but do remember you were only allowed to eat locally grown food which probly made sense, less chance of spoilage and disease. But w/modern refrig'n methods, we can get food - and fish - from all over the world.

I like:

-fresh shelled peas

-green beans

-corn on the cob (after it's cooked, remove & slice off corn)

Stir frequently making sure bottom doesn't stick.

During last 10 minutes add your fish. We don't wanna overcook the fish.

-scallops (after cooking, cut into bite-sized pieces with scissors or knife)

-salmon or your favorite fish or your fish on sale

Seasoning: A few shakes of cinnamon is delicious. I learned about cinnamon from Giselle Guerrero, who contrary to her married name, is from Lebanon, as is my kidney doctor.

Since I have bad kidneys I don't use salt tho your guests might like some. Fresh basil or parsley is a nice flavoring.

Ready, slurp!

His response came at twilight when the deer come in

Pardon me for eating while blogging but I get so darn hungry. The chicken is marvelous, juicy and flavorful. Ada told me they were having rotisserie chicken last nite so when I was in the supermarket today I bought some thighs. I baked it with fresh basil, carrots, mushrooms, and my raw egg & olive oil dressing. I was too lazy to add garlic. I was speaking on my hands-free phone to a former client of mine whom we'll call Andrea who calls me from time to time.

"Get thee to a new psychiatrist," I told her. She's been doctoring w/this one fellow for an entire year. She's substantially better but he doesn't seem to know how to medicate her. She's never been on Lamictal which is an obvious first choice for a woman who can't get out of bed in the morning.

I gave her Waldfogel's name, my current favorite.

When it comes to poets, my absolute favorite that I know personally, tho not well, is Christopher Bursk. Simply typing up his name conjures up my first meeting with the man maybe ten years ago when I worked as a therapist at Bristol-Bensalem. He came to meet me at The Atrium where I had this huge office, really the conference room, cuz they didn't know where to put me.

I was superstitious and refused to put up any nice decorations in my office cuz every time I did that, they'd move me to a new office, so I adorned the walls with old calendars. They simply hung on the wall, all these beautiful scenes, including a B&W calendar of Ansel Adams views. One day one of my clients discovered a trick I did with the calendars.

My job was to give a preliminary diagnosis before the psychiatrist saw them. There were so many codes. Instead of looking in my DSM-IV, I looked up at my calendars where in bold black Magic Marker I listed the most popular codes w/o their names. The only one I remember was - oops! - can't remember it. One of my clients discovered this and we laughed about it.

So there in the waiting room is Chris Bursk - ah, his long lean figure is towering in front of me right now - wearing that same long-sleeve thermal undershirt he wore when I met him. He was as confident & loose-limbed as a racehorse and I thought, Hmmmm, what a great new janitor we've hired. Of course, he was a professor at Bucks County College and a wonderful poet.

He returned to me a sheaf of poems I'd mailed him. Over the phone, he'd asked me how many poems I'd wrin. He wanted all of them. I lied and said I'd only written about 20 cuz I was too lazy to print out all 75 or so of em.

His writing was cryptic but I understood the STARS and EXCLAMATION POINTS he wrote on my papers.

Only yesterday, when a fellow poet mailed me a study showing that Verse Broadens Our Minds, I forwarded it to some poets I know including Bursk. He thanked me for it last nite and I took the liberty of emailing my latest poem 1921: Birth of a Son.

My heart pitter-pattered when he wrote me back just now. Here's what he wrote:

wow!!!!
powerful poem!
thanks for sharing it

Chris Bursk

WHEW! I passed muster.

A day or so ago I was driving down my street. If I could be known for anything in the world, I thought, it would be as a Poet.

Last nite I had a sensual experience in bed but I couldn't find any paper to write about it. I'll try to write about it to read at our Bonfire Friday nite. If no one likes it, I'll..........

New Directions' Supporters Checklist and WorryList

Written by Laurel Hoffmann of New Directions.

You cannot take care of anyone else unless you first take care of yourself. In extreme cases, if you are at risk you must take whatever precautionary steps are needed for your safety. For your support to be effective, you cannot live in fear.

GENERAL INFORMATION

1. Discuss the illness with the loved one. Ask him or her for help in determining how to make things easier. He knows his illness better than anyone else, including the professionals.

2. To help with compliance, put the medicines in trays, sold at drug stores. Color code: Use a clear or white box for AM, a dark box for PM.

3. If the loved one is agreeable, go in with him or her periodically when he sees his professionals. This is especially important on the first visit. When a person is severely ill, it’s also advisable. A diagnosed person may be very nervous during an appointment, and later be unable to remember what the professional may have said. Or he may not completely understand the instructions. It can also be helpful for the professional to have the supporter there as a source of additional, clarifying information. In very sad situations the patient, on his own, may not recognize professional incompetence.

4. Consider writing a history with the patient’s help. Include all medications the patient has taken and is currently taking. This helps both patient and doctor and you, their advocate.

5. If the professional doesn’t return phone calls within a reasonable time frame, consider finding another professional.

6. Many people with or without a mental illness are affected by light. A diagnosed person may become depressed during the fading light of autumn and darkness of winter. The loved one should sleep in the dark to foster production of the mind’s sleep chemicals such as melatonin. During the day they should soak up as much light as possible – blinds up, curtains open.

7. Many diagnosed people are eligible for Medical Assistance and Social Security. Young adults may receive more if still in their twenties, as theirs may be rated on their father’s income. Check it out.

8. That said, do encourage your loved one to participate fully in society as much as possible. Their psychiatrist and therapist should also do the same. People with mental illness are capable of meaningful work and should not be patronized or infantilized by professionals no matter what their diagnosis. Even if on disability, your loved one can still work a certain amount of hours or do volunteer work or take courses. Everyone wants to be a productive member of society.

9. Give the loved one reason to want to live. Praise anything genuine that the loved one does. We all benefit from praise. With support many loved ones can achieve full lives. Others can live fuller, more meaningful lives. Your support makes the difference.

10. Consider taking (1) the 12-week Family-to-Family NAMI education program and/or (2) Edie Mannion's Classes listed on the TEC Family Education website of the Mental Health Assn. Continue to attend New Directions Supporters meetings. See NAMI.org to find the nearest NAMI office.


CRISIS: PREVENTION, INTERVENTION

1. Initial prescribed medications may not work well, and often a series of medicines will be selected by trial and error until the right one or combination of meds are found. It’s not unusual for a patient to take an average of 3-4 meds for mood stabilization.

2. Be aware that drinking alcohol renders the meds ineffective. Your loved one should not drink except on very special occasions.

3. Get confidentiality forms signed when the loved one is stable, so as to have access to information from the professionals when the loved one is in crisis. Having confidentiality forms signed also helps with access to insurance information, making it easier to get financial problems straightened out.

4. For the severely ill loved one, consider getting a power of attorney, a durable power of attorney, and a health directive.

5. Sleep deprivation is often the first sign of an impending breakdown. But even when compliant and with no symptoms, a breakdown may not be preventable. That’s the nature of these cyclical illnesses.

6. If there is a crisis, it’s okay call the local police. Ask for an ambulance. Tell them the person in crisis has a mental illness. Plan ahead. Know where your loved one, in crisis, will receive the best treatment. Familiarize yourself with the best mental hospitals in the area. Ask the Supporters about this.

7. In crisis speak calmly, softly, and slowly so as to prevent upsetting the loved one. Do not get into a car with someone who is manic.

8. What a diagnosed person says in crisis may be very painful to hear. Try to let it go. Remember: it’s the disease talking.

9. Make sure YOU have support. Many supporters get their own counselors.

10. Your Supporters' Group is now led by Murray Weismer. Contact him at Murray@weismer.com or 215-934-7459.

SUICIDE PREVENTION

1. Because the disease is so difficult to bear, people with a diagnosed mental illness are at high risk for suicide. Ask the loved one if he is thinking of suicide. He will probably tell you. If so talk with him about how horrific this would be for all involved. Make sure he understands the impact this would cause for all. If in fact suicide is attempted, remember: it is the fault of the disease, no matter what the suicide note may say.

2. Teens tend to be impulsive. Impulsivity is a symptom of mental illness. That is why teens are especially vulnerable for suicide.

3. Make it clear that you care. People with a diagnosis know they present many problems. They are easily convinced everyone would be better off without them. Find a way to genuinely praise the person every single day, both saying “I love you” and showing it in innumerable ways.

4. Do not keep guns or weapons in the house.

5. Not everyone is equipped to be a good supporter but you can learn and you can do it! You and all supporters are VERY SPECIAL PEOPLE. We did not ask for this role in life but we do it out of the goodness of our hearts.

WORRY LIST

SUPPORTERS PROBLEMS & WORRIES

Worries:

1. Worry that the loved one will relapse.

2. Worry about money to pay if there is a relapse.

3. Expectations are now lower – disappointment.

4. Worry about finances in general.

5. Siblings worry that they might get it.

6. Concern or fear that the diagnosed member will become angry with, and blame the caretaker. No matter what, it is not your fault your loved one is ill.

7. Family concerned that another member may go off the deep-end next.

8. Loved one may be concerned that family might put her in a home.

9. Hard for the family or principal caretaker to help loved one emotionally.

10.Sibling may be concerned that he will become the caregiver.

11.Primary caretaker may worry that financial support and repeated bailing out of the diagnosed member may become a serious drain on caretaker’s own finances and limited energies.

PROBLEMS:

1. Loss of extended family who don’t want their children with the diagnosed family member.

2. Reactions of other parent – Non-supportive in some situations.

3. Overload with dealing with mental illness of loved one.

4. Diagnosed member blaming the mother.

5. Self-destruction aspect: e.g. Drinking, car accident

6. Shocking or humiliating aspects of diagnosed child’s behavior

7. The diagnosed person’s appraisal of her situation as compared with a healthy sibling or friend. Feeling left out of normal joys of life because of illness.

8. Emotional problems of diagnosed loved one.

9. Difficulty lowering the bar of expectations.

10. Depression of diagnosed family member with what he didn’t get or didn’t do in his life.

11. Need to be there for the others.

12. Other parent’s worries.

13. Physical stress from taking care of diagnosed members.

14. Various family members adversely affected.

15. Loss for the diagnosed

16. Having to repeatedly bail out their diagnosed family member in numerous situations including from jail, in money matters, at mental hospital, in making bad decisions.

ACTIVITIES THAT HELP:

1. Need a life of one’s own.

2. Helping others helps you.

3. Getting out with friends. Having confidence to leave the loved one home alone when it is safe to do so. Never leave home if a loved one is acutely suicidal. This is when they 'try it.'

4. Getting the house into reasonable condition.

5. Interaction with others in same situation – finding out that others are in worse situations.

6. Taking charge of situations to protect other family members.

7. Staying close with family members who are supportive.

8. Helping others in worse situations.

9. Work

10.Get involved outside the home.

11. Murray says: Have loved one take at least 4 grams of good quality fish oil. Very recent research shows significant benefits for both Depression and Bipolar. Many psychiatrist now suggest it.(Disclaimer: Check with your doctor before adding any supplements.)

REAL ADVICE:

1. Lower your expectations
2. Look for something worse.
3. Get a good disability lawyer early on and find out about social security.
4. No denial.
5. If your loved one is a drug addict let them know this is unacceptable. Attend Nar-Anon meetings for families of substance abusers.
6. Maintain a positive attitude which hopefully will rub off on the loved one.

Beautiful season, beautiful minds

That's the title I gave my latest article that appeared in last Sunday's Intelligencer newspaper, based in Doylestown, PA. Usually the editor picks his own title, based on space considerations, but he stuck with mine. Read the entire 900-word piece here.

Here's what's been keeping me busy since last we spoke:

- my kids n I went to my new kidney doc - let's see if i can spell nephrologist correctly w/o getting those horrible red wiggly lines of spelcheck - well, i flunked, seems like i spelt it wrong. sorry, microsoft, you big monopolist you! (actually during this post Dr Ghantous just called w/my latest test results. my GFR is 'acceptable' he said. these docs don't use superlatives cuz these are progressive diseases. i'll need dialysis or a transplant as soon as 6 mos to a year and definitely before 5. i've written it all down on the back of a huge brown envelope. as you can see i've come to accept this.)

- am getting ready for my mediterranean cruise the first 2 weeks of novembre. forced myself to go clothes shopping. you know, of course, i only shop at the most exclusive shops here in the delaware valley so after careful consideration i walked thru the doors of what used to be santerian's dept store in hatboro which is now impact thrift. why buy new when you can have somebody else's germs? i went on a nonmanic buying spree and am currently sitting here in my gorgeous fake-velvet purple zip-down shirt.

helene liked it so much when i went to her house to get my pants hemmed that she tried to bargain it off me. i told her and her hubby they MUST go see the Coen Brothers latest film A Serious Man. She called me the next day to say it was a work of genius and that she cried and laffed her way through. I'd seen it w/my friend Pam the psychiatrist after we'd eaten sushi at Ooka in Willow Grove. Scott will not eat sushi but when i told him raw fish is the consistently of lox, as in bagels n lox, he said he'd give it a try.

- had the kids over for my delicious fish chowder. thank god they liked it. they were worried cuz dan called in advance to ask about the ingredients. i also presented him w/his new bowknife which is particularly effective in cutting thin slices of homemade bread, lemon, limes and of course fingers.

- scott and i watched auto-focus which i ordered inter-library loan, the true story of bob crane of hogan's heroes who was brutally murdered (is there any other kind? who was gently murdered?) i thoroughly enjoyed this sex-blasted film made by paul schrader who was raised by strict calvinists and punished when bad by his mom who would stick pins in his hand.

my interest in hogan's stems from my client 'evelyn' who loves nothing more than to sit in her raggedy easy chair and watch some of the 138 episodes of hogan with me or all by herself. her fee to see me is being paid by an 89-yr-old relative who i'm trying to convince to put evelyn in a community home. she pays $10,000/year for evie to eat at area restaurants.

- i finally found a book i could sink my teeth into. it's by ann lamott. people in my online writing group had raved about her. it wasn't until sarah told me to read her 'how-to' on writing that i went to find her in the stacks of our library. i can't remember the title of the book but it's fantastic - about her conversion to christianity and her love of jesus. it's very moving.

i'd given up my search for god and concluded the universe was created exclusively by amino acids but my ongoing quest to find god will never be complete.

Her sudden and sodden illness

My well-read daughter Sarah told me about the author of Seabiscuit: An American Legend, composed while Anne Hillenbrand, was sick unto death with chronic fatigue syndrome. Hillenbrand no doubt has one of the worst cases ever documented. Despite this she managed to compose her masterpiece about the racehorse whose tragedies finally resulted in racing victories. Likewise, Hillenbrand triumphed over an illness that kept her bedridden and still does. There is no known cure from this virus, from which pianist Keith Jarrett also suffered. Recently, a persistent female scientist found the viral origins for this disease which doctors tell patients is "all in your head."

To read Hillenbrand's 12-page personal account of her illness, click here.

Guess who's coming to dinner?

Yes, my own dear friend Rob will be coming to dinner next week. In preparation I made a delicious dinner last nite which I'd like to share with you all.

I was in the mood for a fantastic meal yesterday having traveled back and forth to New Hope. Here's the meal I prepared which I served a delighted Scott. BTW, I write down the menu in advance so I won't forget any of the entrees. My meals are all in accordance with my kidney diet plan from the Giant nutritionist.

Baked salmon with a surprise topping
Fresh corn bought at a farmer's market in New Hope (Solebury High School)
Brown rice

Guess what the topping is made from, I asked Scott.

Mayo.

Nope.

Cheese? he asked. The topping was pale yellow and studded with green.

That's not it, I said with glee.

I give up, he said.

It's right in the fridge, I said. He looked inside and shook his head.

Third shelf, I said.

Apples? Walnuts? Limes?

You missed it, I said pointing to the box of cage-free organic eggs.

Eggs?

Sure, what's mayo made from?

I explained that I took a bowl and whisked together one egg, a couple tablespoons of olive oil, garlic, and fresh mint and parsley from my sister Ellen's garden.

And, that, Robert, is just one possible entre from when you come over next week. Rob is super-polite and will say he loves whatever it is I cook. He goes to all these fine restaurants - yes you do too, Rob! - so I'll simply do my best.

More from Arnie

ARN: Here’s something from the I Ching: “He who is conscious of danger creates peace for himself, he who takes things lightly creates his own downfall.”

RZD: Arnie, I always operate from a premise of danger. This is why I was only hosp'd once for manic-depression. My hosp'n was tantamount to being in hell. This is why whenever I drive at high speeds I imagine what it would feel like to fly thru the windshield. Don't they train soldiers to think of themselves as already dead? What a great concept.

I think this is also why I love reading good literature and poetry so much. It's a surcease from danger - even if you're reading about death - and a total immersion into the life of the mind, which is a place I love to dwell. I know you're a great reader, too. I think you concentrate more on books to help you live better, yes? Perhaps this is cuz your bipolar has never been well-controlled.

ARN: I read your blog and it's fine, however I would have preferred it if you didn’t mention that I was married three times. But it is the truth! Someone once said to me that, I at least had what it takes to try it three times (but when I look back on them, I see it as mistakes that I made). It’s just something that I’m not particularly proud of. But don’t fret, I’m okay with it.

It’s amazing the difference…the way I’m feeling now, since the Prestiq began to work. It’s been a couple of weeks now.

RZD: I'd never heard of Prestiq until you mentioned it. Wasn't it great that we had someone in our group who works for a pharm company? He explained that Prestiq is an isomer of Effexor, a "cleaner" type of drug, ie, less side effects. It belongs to the class of antidepressants called SNRI (serotonin-norepinephrine reuptake inhibitor). (I'm looking at my notes from the other nite.)

Stay well, Arnie! Oh, feel free to attend our Bonfire a week from today, Friday, Oct. 30, from 6 pm till midnite. Details on our ND website. I'll take a look at your newly painted van.

Dialogue with Arnie from The Northeast (Phila)

Arnie's been coming to the support group on and off for a no. of years. One of the things that impresses me most about him is his loyalty to his friends, many of whom have bipolar or related illnesses. They all have a great time and lots of laffs together. He's a retired small business owner having installed window treatments which he carried in his van. He survived bladder cancer, bipolar disorder and is still surviving giving up cigarettes 53 months ago (but who's counting?).

When he and I were standing in the dark parking lot after the meeting, he expressed concern about a no. of people he'd just met in the group. His kindness moved me. In our small group we had 3 people w/schizaffective disorder, a tougher illness to deal with than bipolar. Two do extremely well, the other one needs guidance in social skills. She'll join my Connexions Group when I get the funding to run it.

Arnie writes: I didn’t mention this, but my primary care physician is treating me…per my request. You may or may not know that I have many doubts about Psychiatrists and Psychotherapists, based on past experiences. Hopefully there are good ones out there but I have yet to find one. Don’t get me wrong…I had Psychiatrists that I genuinely liked; they just didn’t or couldn’t help me — for the long run.

The social worker at Fox Chase Cancer Center, recommended someone, but I just couldn’t bring myself to call her. Don’t know if she’s good or not, and if she’s on the list…her name is Rona Cohen in Feasterville. I have her info if you want it.

I have a theory about going to Psychiatrists and Psychotherapists. When seeing a Psychiatrist, but especially a Psychotherapist (as more time is spent with them) one’s behavior in their presence is generally positive and uplifting. There’s a feeling of a certain amount of happiness (this is based on my experiences, of course) as you are anticipating…expecting that you’re going to be helped, and there is at least some relief from the pain. However, after leaving and after a certain amount of time —but not much - sooner or later the reality of not having that professional support at hand, being alone again to deal with your pain, etc. allows for going back to what you were feeling before going. I hope this makes sense to you. I guess that what I’m saying is, as an out patient in a professional environment you’re feeling good…if only the Psychiatrist and Psychotherapist could observe their patients in thir own environment and surroundings. There is a difference. I know that this isn’t possible...or is it?

Let me know what you think.

PS: I am having such a strong craving for a cigarette. It’s at the second time this week.

RZ: yes i remember now your low opinion of psychiatrists. you're def'ly doing the right thing by seeing a physician and not a shrink. i believe you were treatment-resistant for a long time but are no longer. uncanny but our bodies do change.

your last point is well-taken about the therapist needing to see you outside the healing setting. we're definitely protected and loved when we're in there. then we face the cold cruel world. if we're doing well when we went in, we'll do well when we leave. the patient must figure out how to take these good feelings and be with them all day long. we must create our own field of happiness.

i think it's definitely harder for a man to be happy all by himself. you've been married 3 times, i believe, and know the comforts of having a partner. i think you're an attractive man - esp. after you take mary ann's nutrition class and drop the 40 lbs you gained after you stopped smoking - and could EASILY meet a woman.

ARNIE: You mentioned you have a good relationship with your 87-yr-old mom but it wasn't always that way. This made me think of something that I read a long time ago. After reading a certain part of this book, I went up to shower, and while showering and thinking about what I had just read, it caused me to burst in to tears. Upon getting out of the shower I called my mother and invited her out to lunch. Needless to say, I too had issues with my mom. This is the short version of this story.

The name of the book is; “If You Meet The Buddha On The Road, Kill Him.” (have you heard of it?) This book lead me to at least read some of I Ching.

RZ: wow, very powerful reaction, arnie, to thoughts about your mother. i believe the majority of bipolar folks have 'mother issues.'good for you for acting quickly on your good thoughts. you're a do-er! yes i've heard of kill the buddha book but never read it. same w/ i ching. thanks for returning to ND. you have a lot to offer.

Ye Olde Testament

Believe me, I'm not out to convert anyone, religion can be extremely comforting, but I stand with one of the Top Hundred Great Thinkers of Our Time, Richard Dawkins, in proclaiming, "There's probably no god."

When I told this to Scott he said, You mean you won't meet me in Heaven?

Well, I will, if there is one. And you'll have a full head of hair. And I'll have intact kidneys.

Scott is amazing. As a young man he gave the God issue a lot of thought and concluded, Yes, there is a God and an afterlife, and dropped the subject. Me, I'm a vacillator, having finally agreed on the No-Way theory.

One thing always puzzled me about my religion, Judaism. How could Abraham have attempted to sacrifice his son Isaac b/c God commanded him to do it? And why would this story be included in the Canon? Is this what we want to teach our congregation? Plenty of people hear voices to kill. Shall we heed them or medicate them?

So it was with great delight I read this photo-essay in the Times today by the wonderfully creative irreverent R. Crumb. Bill Hess, this is for you since you like the inclusion of my links. Click right here.

A Gift for our Guest Speaker

We had a fantastic meeting last nite. Just finished sending out emails to a couple new members welcoming them to New Directions. What I'm really doing, however, is welcoming them to the new world of mental illness. It's a very important job.

Last nite everyone in our small group worked in concert with one another to encourage people on their new journeys of life with mental illness.

Really, it's not so bad. Sure, major suffering required, but then certain alleviation of same. People say we feel life deeper than other people. Not sure I agree. What about artists? What about journalists? I'm reading a 5-part NY Times series on a reporter kidnapped by the Taliban. This man felt so deeply about life he exposed himself to the worst dangers a man possibly can and unfortunately fell victim to the crazed brainwashed world of these extreme Islamic militants.

The rigors of the terrain they live in seems to have seeped into their pores, their view of God and all of life. Their god is merciless and all-punishing as is their landscape, with its harsh climates - sunscorched earth and droughts. This is all they know. Is it possible to be any different in a land like this?

We all worked together last nite to congratulate members who had gotten promotions, returned to work, found a job, reunited with long-lost children or adult children, sold their homes for better homes, lots of victories.

I was not victorious however in selecting a good gift for our guest speaker. I'd erroneously thought he had 2 young children. Instead our corpulent speaker whom I'd never met has a 4-month-old daughter Haley Jo. At Kremp's Florist, with great aforethought and pacing round the store in deep thought I purchased a gift for the whole family: chocolate covered pretzels.

How those two kids will love the colorful pretzels I thought. I bought the worst ones, the ones I would definitely never eat: one choc-covered pretzel was covered with M&Ms (yuk! too sweet), another had tiny colorful jimmies (whoa! stick in your teeth), another had coconut (where's my dental floss?) and the fourth was the one I'd eat, slathered with caramel.

I know what you're saying: It's the thought that counts. Thanks for your support.

When I got home I made myself one of my delicious fried eggs and sliced a piece of homemade bread. I sat on the couch and munched away. Then Sarah came in, she's visiting from NY, and we attacked the licorice I bought on Sunday.

Mom, this is so good, she said, so moist.

I was popping em in my mouth nonstop. Then Scott came upstairs. He was exhausted.

Hide the licorice, I said, covering my eyes with my hand.

Hmmm. Wonder where he put it. Ever play Hide the afikomen? I ain't gonna look.

For all you coffee-lovers

How is it that I, who freely confess my addiction to the Times, only just now discovered the work of the brilliant German-born Christoph Niemann. Here's his blog on the great love of his life: coffee.

I dare you to read it and not reach for a cup of coffee.

My own love affair with coffee began as a lipsticked catseye-glasses-wearing teenager growing up in Shaker Heights, Ohio. Gramma Lily would take hers black. I couldn't stand the taste so doctored it up w/milk n sugar.

El Pico, Martinson's, Chock Fulla Nuts were some phases I went thru when I dripped my coffee in my yellow Stangl 2-cup brewer that a former boyfriend accidentally broke. I can still see it, its sides and bottom stained with lovely coffee stains.

I adore coffee stains b/c it reminds me of the clarity of thought coffee brings.

Why then did I give it up about 5 yrs ago?

I'll get to that in a sec. Remind me if I forget.

When I worked as a therapist at the now-defunct Bristol-Bensalem Human Services Center I'd drink the coffees that the various departments would make. Some were better than others and I decide to hold a contest among the various departments and have people vote on their favorites.

When I went into the Fiscal Department where Stephen Schwartz was the head, he said to me, "Who authorized you to do this?"

People needed approval for everything.

"I'll be right back," I said.

I flew down the hall to the Crisis Dept where my boss Jon Hartung worked. Is that his name? Sure, he said. Sounds like a great idea. It'll foster cooperation between the departments.

I raced back into the Fiscal Office where Schwartz terrorized the employees w/his iron fist. He was a handsome man w/a thick black mustache, unmarried, b/c no one was good enough for him. When I'd first joined the force, he lifted me up, after hours, and set me in a rolling cart that contained charts of patients and rolled me down the hall with me screaming for dear life.

Suzanne Schollaert who I reconnected with on Facebook awarded me a Certificate of Creativity for the Coffee-Tasters Sip-Off. She runs her own agency now in Pgh.

When I was about to wean off 16 yrs of Klonopin, or Klonny as Simon and I called our marvelous calming drug, I decided to go off coffee as a test. I succeeded with minimal headache to cure my lifelong addiction in 3 days. The Klonny took 5 weeks under the auspices of 2 psychiatrist friends.

It is so cool not to have a psychiatrist anymore. As you know, I'm cured from bipolar disorder, an act of magic.

Who's the magician?

Why is the Cheesecake in the Trunk?

The only thing to be done on a gloomy Sunday with a strong prediction of rain is to be in denial. Well, I said to myself and Scott, it hasn't started raining yet, let's get out and do something.

You know I like to stay home and relax, said Scott.

You relaxed yesterday, I said. You had a great time doing nothing while I went to my Coffeeshop Writers group and had a great time running around.

Why do you always do this to me, Ruth?

Cuz you're the best boyfriend I've ever had.

Why, thank you.

Once I get him moving he's fine.

Dyou mind if I invite Linda Barrett? I asked.

The three of us drove down to Styer's Orchard in Langhorne, PA, home of our own Peggela. Peggela, where art thou?

My kids n I used to visit Styer's regularly. Naturally I had no idea how to find it but did remember driving thru scenic Langhorne w/its b'ful houses.

Since the direx on their website were wrong I pulled into a Lukoil to ask directions. I always bring a pad of paper w/me. My printer gives me dozens of free pads. Lemme know if you want one. I have a couple saying I'm the superintendent of schools.

On we go. We learn the name of the street after we pass it so I have to make a u-turn.

As I begin the turn, Linda screams from the backseat, "For godssakes don't turn here, you'll get us killed."

She didn't see from the driver's vantage point so I safely made the turn & reassured her I'm a very good driver.

Crash! Later on, I ran over an orange hazard cone but more about that later.

Scott had predicted nobody would be out cuz it was a gloomy day. What? He doesn't go to work cuz the clouds are out and the sun is hidden?

Styer's was packed!

I couldn't remember a thing! They sell fresh produce from their farm. I wanted to buy some apples but they didn't have them displayed that well so I forgot all about buying apples and instead I concentrated on desserts.

Oh, I am so ashamed of myself. Well, semi.

You really don't know how they taste but I took a plunge and bought a whole apple-walnut cheesecake and a six-pack of licorice. Actually a container of black licorice.

It was cold and gusty outside. I wore my beret and Linda wore her warm wool cap. Scott wore his Ford motor jacket when he was a mechanic at the dealership. Boy could he tell you stories about how the mechanics were treated. He put a punching bag up in his garage and pretended it was his boss.

Hey, let's follow this road and see where it goes, I said.

You know me, always curious.

The road leads directly to the orchards. It's unpaved. I realize we're splashing thru mud so I drive real slow. I motion for cars to pass me. Let them get mud in their eyes, not me.

We pass apple orchards. The trees are small and a few apples lie on the ground. If it weren't so muddy I'd go and pick em up. Do kids really appreciate this? Or is it mostly grownups that are bedazzled by real trees w/fruit.

Pumpkins are everywhere. Linda is mumbling in the backseat, Boy that's a huge one.

As I proceed down the muddy road a huge vehicle is coming my way. There's not enough room for both of us on the road so I force him off the road into a ditch. Just kidding. I decide to turn around, check my rear-view, and back up onto the grass.

Cr-un-chhh! Something is beneath my wheels.

What the heck?

I pull back out and Linda says, You ran over a cone.

A cone, I say. How can I run over a cone?

OH, an orange hazard cone.

I am conscientious to a fault. I pull into a hay-covered parking spot, jump outa the car and run over to put the cone back.

Jeez, of all people to run over a cone, I think. I use these in my artwork. I love the little devils.

Then I go back in the car and say, Luckily it wasn't a kid I hit.

So. The cheesecake was delicious. I had one huge slice. The rest is in the trunk. YOU guess why it's in the trunk. I hate half the pack of licorice. Scott was sposed to take it home for safekeeping but he forget.

Voices in the Family w/Dr Dan Gottlieb

Apparently if you wanna call in to a talk radio show you should call in immediately. I waited 45 minutes until Dan announced his phone number for the second time. The first time I wrote down the wrong number. (Don't worry, kids, I sent the WHYY webmaster a note that he/she should prominently display it on the website. I spose it'll be about as effective as my writing Mr. Frick about offering education classes to newly diagnosed folks w/bipolar disorder.)

Here's what I did while hanging onto the phone for 45 minutes:

- Punched down my whole wheat bread into 2 nice round loaves and set the timer for half an hour to rise

- Opened my mail. The PECO bill wasn't that high, about $72 I think. I got a thank-you note from the Red Cross cuz I donated money for the flood in the Philippines. Reason is cuz I'd talked to my PayPal representative who lives there.

- Read a cute email forward from Bendesky about How to Cure Neck Pain when sitting at the computer. The email showed the writing SIDEWAYS. And that's exactly right. Neckercises should be done rolling your head around. PS -I don't do them. My neck makes horrid little crackling sounds.

- Used my pill cutter to cut my blood pressure pills in half. My druggist saves me money by giving me the huge horse pills & I halve them. I stole my first pill cutter from my friend Marcy with her permission. But I upgraded it recently b/c after 20 yrs the razor blade got rusty.

Then the WHYY man said to me, Ruth? Sorry but we won't be able to fit in your call.

Darn, I said. Thanks for letting me know.

Then I sat down and typed up an email to Dan Gottlieb also sending it to a couple friends including the GREAT Debbie Moritz of NAMI Bucks. One of her members was the featured guest of Dr Dan, along w/someone else whose viewpoint I disagree with in nearly everything he has to say.

Hi Dan,

Thanks for broadcasting this all-important topic. I also listened to Minds on the Edge.

I did call in to the show but unfortunately there wasn't enough time.

Mark Salzer was on my board of directors. I run the leading support group in the Phila area for folks w/depression, bipolar disorder and our loved one.

I would've made the following points.

1- There are numerous success stories for people w/mental illness, specifically bipolar disorder which I myself have. Your program highlighted the worst case scenarios. People need to know that perhaps a majority of people w/bipolar do well in life. Our support group has bipolar people who are lawyers, schoolteachers, business owners, journalists. A happy productive outcome awaits us if our illness is properly managed. Our support group teaches people where to get help and emotionally supports them in both good and bad times.

2- I'm totally in favor of mandatory involuntary treatment when a patient won't cooperate and is in danger of harming herself or others. It is absolutely necessary. In 1984 my mother had me forcibly hospitalized when I had my first manic-psychotic break and threatened to kill her and pushed her down on the ground. I knew not what I did and landed up in the hospital for the first time and was medicated with Haldol. I thanked her afterward. Since then, I was never hospitalized and took my meds religiously, and started my own support group. I always worked.

3- As Salzer said, the most important values to not only mentally ill folks but to everyone is a good job, an intimate relationship, and one other thing I forget. Fred Frese also emphasized the importance of work, no matter what lowly job we may have.

I WOULD ALSO LIKE TO BE INCLUDED, if I may, in future dialogues about mental illness. Thousands of people have passed thru the doors of our support group since our founding in 1986. I know bipolar folks very well. At my age of 63, I no longer suffer from bipolar disorder and no longer need meds. How many people know this? I'm sure you're surprised.

That's it, Dan. Keep up the fantastic work.

Ruth Z Deming, MGPGP - a degree I got at age 45 after I was diagnosed w/bipolar disorder
Director
New Directions Support Group
www.newdirectionssupport.org
215 659 2142

An afternoon with Betty Wms / Poem: 1921: Birth of a Son

Finally went back to Chico's to return my ridiculous $110 faux leather jacket w/no pockets. I'd worn it once, then threw it on the couch in disgust. "How can you buy anything so ridiculous?" I said out loud. Linda gave me a store credit.

Nearby is the assisted living complex Rydal Park in Jenkintown, PA. Or is it Abington? I went over to visit my friend Betty. Had some questions to ask her about two mental health advocates who recently died. Their main concern is: what'll happen to my mentally ill children when I die?

Betty and I sat down to dinner. I brought my own from Whole Foods and she got hers from the cafeteria. Ooh, just the word 'cafeteria' makes me hungry and think of pie. I do love pie. Apple, peach, blubbery.

Then I asked if I could use her indoor pool. Most assisted livings have these nowadays. Her pool is among my favorite. We walked over to the locker room where I changed into my new blue and white suit, we signed in so if they found our decomposed bodies they'd know who we were, and then we went into the warm pool room at twilight.

Betty sat and guarded my contact lenses which I put in her Pyrex bowl cuz I forget my case, while I climbed down the blue stairs of the pool and began my laps. Swimming is my favorite sport, other than eating.

On our way out, Betty said hello to lots of residents, including Bertie. I was hoping Betty would tell me how old Bertie was cuz she looked way older than anybody I'd ever seen. Petite with puffy white hair, she looked like a gust of autumn wind could knock her off her feet. She held onto a walker and her big blue eyes peered out of thick glasses.

I asked her if she was in good health and she said yes except her eyes were going and she'd get an operation in the spring.

"Bertie just turned 100 in July," Betty said.

We stood in the hallway admiring paintings that residents had made. Bertie praised two of Betty's watercolors including one of Abington Presbyterian Church which is where our support group meets.

I like being around old people b/c they remind me of my own mortality and that I need to do things NOW while I'm still in the prime of life. Rydal Park boasts very distinguished individuals who used to be somebodies when they were out and about.

Isn't it amazing what happens to us when we get old? Lemme go look in the mirror. Hold on.

I saw a woman with all white hair staring back at me w/ reading glasses on the top of her head. I have no idea who she was.

As for me, my writing group meets in half an hour. Under necessary deadline pressure, I'm finally writing the poem I named "1921: The Birth of a Son." I'll fork out some cottage cheese and homemade applesauce now which should give me courage to face my poem again. To get into a poem-writing mood I goggled my favorite poem At the Fishhouses and found a new poem Divers in the Wreck, a spectacular poem by the fascinating 80-year-old Adrienne Rich, mother of 3 sons, who lives with her female lover in California.

I wonder what will become of me?

1921: BIRTH OF A SON

in memory of my father

coming out
coming down the snug dark passageway
I anticipate nothing
the smell strikes first
so different from anything I have known
the snuffling of my small jewish nose
that later will grow like a crown
to bring me the women of my desires
and now the cold turns my lips blue
as I am touched for the first time with
feelers across what I’m learning is me
me
a new man shining with light

were I still alive
I’d haunt the streets in our town
eighty-eight years old
mind firm
discipline intact
peering through thick glasses
at the cities made without my consent
or influence
where is my importance?

I kissed my mother goodbye
when she left this kingdom of sorrows behind
I would have flown to her side
left the beds of women I loved
to be with Mama one last time
and arrived to stroke her soft rouged cheek
and caterpillar eyebrows
the hospital room was warm
glowing with sunshine
the two of us together once more
as I imagined my life without mother
strange frightened mama
whose soul roamed free in
the Carpathians she left behind.

mortality is mine.
o mortality
how I fought my death sentence
no appeals allowed
when cancer struck
nine months in bed
moving closer to the womb
vision narrowing
my glasses gathering dust
somewhere in the room
as attendants entered to bathe
and amuse me
motion impossible
a little clapping to show my approval
moving closer to the womb
eyes closed during the day
remembering the oceans of comfort
and unnamed bliss
that beckoned with
unflappable certitude
not even needing to say
wait for me
I shall be there.

- Ruth Z Deming

Open letter to George A Frick, CEO of Pennsylvania Blue Cross

LETTERHEAD STATIONERY

October 14, 2009

Joseph A. Frick
President / CEO
Independence Blue Cross
1901 Market Street
Philadelphia, PA 19101-9131

Dear Mr. Frick –

Clearly you value bold new ideas. My idea is simple. Offer education classes for the thousands of individuals in the Philadelphia region diagnosed like I am with bipolar disorder.

When I was diagnosed with diabetes 15 years ago, my health insurance paid for a series of 6 education classes plus 2 nutrition consults that educated me on this insidious illness. Within a year I had dropped 40 pounds and learned to eat right, so that I no longer needed my Glucophage and Avandia. Since then, I’ve been diabetes-free, though my bipolar disorder still raged within.

Let’s offer free education classes for folks with bipolar disorder as well, sponsored by the forward-thinking Independence Blue Cross.

As a Keystone Health Plan subscriber, I recently thumbed through your Healthy Lifestyles brochure and read that your Connections program treats every conceivable condition – asthma, cystic fibrosis, MS, Parkinson’s – with the notable exception of mental illness. I was shocked!

Mental conditions are undoubtedly more prevalent that all of the above illnesses combined.

This void is not only regrettable but totally mirrors and fosters society’s prejudice against folks with mental illness. This terrible prejudice is what keeps the majority of people from seeking help. As you know, insurance coverage for mental health had been greatly restricted in the past and finally, finally, through dedicated efforts of mental health advocates we got our “parity” legislation passed in the final days of the Bush administration.

What I am hoping, Mr. Frick, is that you might spearhead my plan of Education Classes to all people newly diagnosed with bipolar disorder. I myself have taught scores of such classes. In July, my Conquering Bipolar Disorder class was attended by nearly 50 at the Holy Redeemer Counseling Center in Meadowbrook, PA, affiliated with Holy Redeemer Hospital. Eighty people attended my program at the Doylestown Hospital Wellness Center.

I am as staunch an advocate for the rights of mentally ill people as they come. I’ve been recognized by generous grants from the Patricia Kind Family Foundation, Douty Foundation, and van Amerigen Foundation for my work and regularly write newspaper articles and letters to the editor on behalf of of the most vulnerable among us.

Who is it that said, Society can be judged by the way we treat our most vulnerable citizens?

In closing, Mr. Frick, I must confess that God has been good to me. At age 63, I no longer suffer from bipolar disorder. Seven years ago I was forced to go off lithium as it damaged my kidneys. I discovered, to my immense glee and surprise, the disease had fled. Like a fast train speeding through town, it rattled my brains for 30 years, and then left me in peace.

I look forward to hearing from you, Mr. Frick. Call me anytime at 215-659-2142 and if I’m not baking homemade whole-wheat bread, conducting a therapy session, or pedaling madly on my stationary bike, I shall triumphantly answer the phone and know you have heeded my call.

Sincerely,

Ruth Z. Deming, MGPGP
Director
Enc.

How a Friend might help a Depressed Friend

I tried to help my childhood friend Nancy over the phone. She lives in Columbus, OH, and I live in suburban Philly.

First I want to acknowledge how difficult life is when we're in the midst of a depression. The word 'depression' is such a weak, ineffective term to describe the immense psychological anguish a person goes through, not to mention their lack of energy and the way their thoughts go round and round unstoppable: rumination, particularly bad when in bed.

So, yes, Nancy, I do understand what you're going thru even tho my own depressions mercifully abated 7 years ago, when my own bipolar illness 'resolved' itself, as the doctors put it.

Confusion and indecisiveness are to be expected with your depression, Nancy. Those are cardinal symptoms of the disease. But here's what you can do to help yourself, and help yourself you must and are capable of doing, difficult though it may be.

Get a piece of paper, Nancy, I said. We're going to write down your daily schedule. FORCE yourself to do many of the things on your list.

Nancy would constantly interrupt me with, "But I don't want to."

I simply replied, "I know it's difficult. Just do it. You want to get better, after all."

She was leaving for the dentist in 10 minutes. Good! Naturally she voiced her 'what ifs' about what the dentist might find wrong.

Again, this 'catastrophising' is part of the illness.

"Don't think about it," I said. "Let's get on with our schedule."

I suggested she remain out of her home after her dentist appt. After all, the home is where a person regresses or feels so comfortable w/no one watching they can do things like lie on the couch all morning and allow the ruminations to course thru their brain.

We discussed some places Nancy might go after the dentist. She admitted that when she's out of the house she doesn't feel as bad. I suggested she buy some food but she said she didn't want to so I said Okay, I know food shopping is really hard, find something easy to do like going to the library.

And in times like these, it's okay to buy your food at a convenience store.

Nancy is an artist. She's currently not doing any artwork b/c of her depression. I suggested some light artwork as that's something she used to enjoy. She enjoys nothing now. Her depression has been ongoing since February - 8 months - the longest it's ever been. She's on ineffective meds and I suggested she have a consult w/another psychiatrist there in Columbus, OH. If she lived here in Philly I could go over our Top Doc list with her.

Her therapist is utterly incompetent. Nancy sees her to lean on her for strength as she was doing with me on the phone. So what does the therapist tell her? "I think you have OCD, Nancy."

How can that possibly be helpful to a seriously depressed woman.

Nancy told me a group therapy session is meeting tonite, the same time as a drawing class she'd like to sign up for. She doesn't 'want to' attend either and I suggested she try real hard to attend one tho not to excoriate herself if she decided to stay home.

I reiterated that once you're in house mode we tend to stick there like glue! Hence my telling her to stay out of the house.

I suggested she attend the art class so she doesn't keep wallowing in depression. I also suggested she go for an aerobic walk every single day.

"I feel lonely when I walk by myself," she said.

"Too bad," I said. "Do it anyway. You've gotta fight this depression and not let it swallow you up."

We said goodbye to each other over the phone, Love ya Nancy, I said, and wished her well. Next day I emailed her that she may wish to attend a partial hospital program or day program such as the fine ones at our local Horsham Clinic.

When I talk to depressed people I am kind but very firm. They need guidance like a blind person needs a seeing eye dog. I'm proud that I have these skills, formed in my own dozens of years of suffering from depression, till the powers that be - the forces of the universe - converged to set me free from depression and mania.

Vegetable Soup w/Fresh Flounder

Who wants to come over for dinner? Raise your hand and cry out loud.

In the chilly autumn weather, I love to make soup. My soups are so thick they're actually stews.

Into your large soup bowl, saute the following in olive oil or other healthy oil like peanut oil. Remember, fat is good for us as long as it's not a trans fat.

- onion
- celery (okay to munch on a stalk while chopping)- ooh, can't wait to chop w/my new bow-knife, see previous blog (I'm pretending that people read my blog.)
- mushrooms

Essentially just use whatever you've got in the fridge. I did forget we've got some green peppers still growing outside.

Add a box of organic chicken stock LOW SODIUM. I don't need to remind you that the American food industry is poisoning us with too much sodium. Check your food labels and moan out loud with me. Rinse out the chicken stock box w/water and pour into soup pan over sauteed onions, etc.

Add fresh veggies found in the supermarket:

- 3 corn on cob (remove when soft and cut kernels off)
- handful of green beans
- baby carrots - when soft, slice w/scissors

Hover round the kitchen, stirring so food won't stick to bottom of pot

When almost ready, add these quick-cooking items

- sliced zucchini if you're not sick of it from your garden. We didn't grow it this year b/c it took up too much space and we were mad at it

- FRESH FLOUNDER or other wild-caught fish that's on special. I could've gotten scallops or Cojo salmon but wanted to try something new.

NOTE on fresh flounder: I chopped it into bite-size strips but while cooking, it crumbled into tiny bits while cooking. What's that all about, Alfie?

The soup is scrumptious! No seasoning except fresh parsley from the pot on my mother's porch and fresh chopped scallions sprinkled on top.

A Knife for Danny

Sounds like the name of a children's book.My son Dan turned 33 thother day and I was looking for a great present for him. His late father used to buy him great books, mostly history or war books. I recently told Dan I watched the Bill Moyers Show and his guests predicted another recession, even worse than this one, in a dozen years. Make sure you have plenty of money tucked away, Dan, and that you're an expert in your computer field so if, god forbid, you lose your job, you can find another one. People don't listen to predictions, I said, cuz they're off in the future and see only what's in front of them, so please be forewarned.

BTW, I asked him, dyou ever talk about the recession at work?

Nope! he said. Except when I bring it up.

YOU bring it up? I asked. What's the reaction.

Basically no one's interested. They don't think about it.

But YOU do? Good for you, Dan. Well, you do love your history. You're probly one of the best educated people at your office.

I am, he said. I'm also one of the oldest. Dan is 33 and the others are in their early twenties, the computer geniuses! I told him I'm proud of him.

In Ocean City over the weekend there was an Arts n Crafts Fair with hundreds of merchants. A demo caught my eye. Jean-Pierre from The Congo was demonstrating a handmade bow-knife hand made by his wife's family company. I sliced a tomato, a potato and a bagel. Hmmm, I thought, this would be perfect for my homemade breads and slicing those tricky slippery onions and also the green peppers that are still growing outside.

Perhaps I could also get one for Dan's 33rd birthday. I told J-P and his wife Eileen I'd think about it while I visited other booths and then stop back. Actually on the way back I couldn't find their booth but I had their order form and called them today at their studio in Albany. J-P was at his job as a research scientist for NY State. I ordered two knives and mailed out a check.

I spent a ton of money in Ocean City. I've never paid a cent of interest on my credit card and never will. Instead, my credit card pays me. I got a half-price bathing suit as my current suit is ready for the rag bin. When I paraded in my new suit in front of Scott he whistled.

Find yourself a good boyfriend who appreciates you!

Tis better to have no man at all than a bad one.

Scott and I talk about everything.

"You actually have the nerve to tell me I sneeze too loud!" I said to him.

"Well, you do! You wake me up in the middle of the nite."

I told him I hadn't realized that and that I'd muffle it next time. And suffocate to death.

Christian Barth was sitting outside the Atlantic Books on the Boardwalk signing the book he wrote earlier this year: The Origins of Infamy.

Oooh, I said when I saw the book. Ted Bundy is my favorite serial killer.

Bundy, executed in Florida in 1989 at age 42, confessed to 30 murders tho doubtless there were more including 2 unsolved killings at the Jersey shore. Barth's book is an imaginative account in the form of a first-person narrative of Bundy's life as a Temple University transfer student and his trip to the Jersey shore to pick up girls.

I read half the book when Scott and I drove home from the same shore where Bundy may have murdered the unsuspecting women. After I bought the book, autographed, by Barth, I looked w/suspicion at all the possible schemes a good-looking fast-talker like Bundy could've pulled. I went to one of the public restrooms that was all by itself. Scott was nearby but as soon as I went in I was aware that someone could be hiding in the stalls. Bundy would do something like that. He was a sneaky voyeur and an exhibitionist. The author makes a great case for how his maternal grandfather, thru extraordinary meanness and cruelty, inadvertently trained Bundy and germinated the fires of rage that had been fuming inside since Bundy was a small child.

Are sociopaths born or made?

I love this book and recommmend it to anyone who likes a good crime novel. Its title is perfect: Origins of Infamy. Send me an E and you can borrow it when I'm done.

Dover Beach

Every time I go to the Jersey beach and see the ocean spread out before me I whisper the opening lines of Matthew Arnold's great nihilistic poem Dover Beach: The sea is calm tonight. For a full reading click here.

Now we are home. We missed you terribly, of course, but mummy and daddy just had to get away by ourselves, little lamb, but now we're back and have you once again in our loving arms.

I'm chomping on some fabulous licorice I bought at Shriver's Fudge House or was it Farlinger's. Anyway my teeth are black and I don't give a damn.

The ferris wheel was 90 feet tall and I forgot I was a grown woman - oh no! - and was riding all by myself. I clung to the bars, a side bar and a bar in the middle, and I watched myself shiver with fear. I knew I was in no danger but I clung onto the cold metal with great desperation. At first I enjoyed the ride upward and waved goodbye to handsome Scott who stood in his warm sweater and warm mustache on the ground below. I reveled at the magnificent view as we climbed higher and higher in the sky. A man and his tow-headed little boy were in the car in front but soon I lost sight of them and could see no one in front of me and of course there was no way I was gonna turn around to look behind me.

I think I'll finish the licorice now I'm so nervous writing this and rethinking the ferris ride. When I was at the top the machine stopped. I knew someone was either getting on or off. Oh shit, I said, this is killing me, I'll ask to get off.

Going down I thought, well, maybe I can ride to the finish but when I saw the young man who was delivering the ride I requested he set me free.

Your lips are white, said Scott putting his arm around me.

Two days in a row we went on the Go-Karts, life dream of mine. You can go as fast as you want w/o getting a ticker. The Go-Karts were a riot. We both loved em. We raced each other and I still can't figger out how Scott won.

This "Penniless Do-Gooder" in NY Times

A year ago, Times' business columnist Brent Bowers asked entrepreneurs to send in current challenges to publish in his In the Hunt column. "Why that describes me perfectly," I thought, "an entrepreneur. I never thought of myself that way." Calling myself a "penniless do-gooder" I was shocked to receive an email from Brent asking to interview me over the phone.

It was Brent who initially suggested we raise our donation fee from $3 to $5. I still feel guilty about it but people seem to believe it's worth the price. Of course, if a person can't pay the full fee, all we ask is they put something in the donation basket.

So I'm appearing again in Brent's very last column for the Times, as he's retiring and is already working on a new book. I'm listed toward the end of the article right here. I found out it was in tonite's Times from fellow blogger Andrew of St. Petersburg, FL, author of BipolarPorch Blog.

Here's what Brent wrote: Ruth Deming, who appeared in this column in April 2008 with the lament that her New Directions Support Group in Philadelphia for victims of depression and bipolar disorder was so cash-poor it was turning her into a “penniless do-gooder,” has also weathered the recession.

In addition to increasing rates to participants for attending meetings to $5, from $3, New Directions has been successful at winning grants, Ms. Deming, 63, said. Last month alone, it received $15,000 from the Patricia Kind Family Foundation and $3,500 from her county’s health department. It also obtained a $2,500 gift to keep its twice-yearly magazine, The Compass, alive.“We’re still going strong,” she said.

When Brent and I spoke, he told me his own father suffered from manic depression. He was a professor of literature, I believe.

We are everywhere!

My favorite Aghan restaurant

Driving home this afternoon I spotted a sign for Yalda, Afghan Restaurant, at 222 Horsham Road in Horsham, PA. In the front seat of my car was an envelope to mail at the PO, a grant proposal for my new Connexions group, to bolster communication skills for shy people, but I had hours before the PO closed.

I was curious to see what an Afghani restaurant looked like and how the food smelled. .

The owner, "Mo," short for Mohammed, greeted me warmly.

"I've never had Afghani food," I said.

"It's wonderful," said a married couple who were finishing their lunch. They mentioned they were bringing their 2002 Jaguar in for service, saying it was nothing but trouble. Of course I was interested cuz I'd recently driven a Jag when deciding what car to buy.

Mo's 21-year-old son, Omed, who helps his father offered to show me the menu.

It was filled with meat dishes. I told him I don't eat much meat but that I do like lamb. We decided on a brown rice, lentil, and lamb dish, which came with a scrumptious salad with yogurt dressing.

Do you mind if I eat standing up? I said. I carried my flatbread w/piquant sauces of hot raspberry relish and a cilantro dip around the restaurant as I looked at the artifacts from Afghanistan and newspaper clippings of all the papers that had given rave reviews to Yalda.

"My son went to school with a guy from Afghanistan," I said. "I doubt if you know him. His name is Afzali, short for AJ. He's a Volkswagen mechanic," I said.

"AJ!" said Mo. "He's my nephew. He moved to Albany and is studying to be a lawyer. He's the smartest of all of us."

It never made sense to me why he'd limit himself to becoming a mechanic so I was ecstatic to learn he'd used his considered intelligence and charming personality. He'd married a wonderful woman from Bryn Athyn and now had four children. AJ himself is one of 24 kids - his father was married twice. Afghan custom is to have lots of kids.

There was another puzzlement about AJ which I decided to bring up.

"He was a troubled kid," I said.

"He went nuts," said his uncle.

"Yes, exactly. They put him in a mental institution." From what I remember they actually diagnosed him with w/bipolar disorder. Fortunately he didn't listen to them and refused to take meds.

"Now, why did he go nuts?" I asked.

"His father died."

"Ah!" I said. "How old was his dad?"

"Ninety-one," said his uncle.

"Geez! It was time for him to die. But AJ couldn't handle it well."

Now he's at SUNY Albany with two more years of law school.

"He's the smartest of us all," said his cousin Omed. I was so pleased.

A newspaper article on the wall told the story of Mo's emigration to the US way back in 1973. He came alone, a scared 17-yr-old and began working at various restaurants in New York before opening his own pizza shop. Then he and his family moved to the Philly area where he became chief chef at the Highland Inn, all the while planning on starting his own Afghani restaurant called Yalda or "Let's celebrate!"

To me, its out of-the-way location is a real drawback. I found it due to its huge red sign and my own curiosity. I needed a nice antidote to the horrible war stories about the inland country of 28 million, an ancient crossroads of invading conquerors who wanted possession to ensure safe passage to the Silk Road.

"We are victims," said Mo. I asked if he watched the evening news. "Lies," he said. "It's all lies."

I got out of the political discussion.

"Are you Muslims?" I asked.

"We're Muslims. We pray to one god."

"Where's your mosque?" I asked.

"In the living room."

I was smacking my lips from all the delicious food I was eating. The salad dressing was particularly delicious. Actually, I learned, it was made from mayo, blue cheese, and spices. That was sure some salad dressing.

I told them to say hello to AJ for me. He graduated from Upper Moreland High School same class as my son Daniel. Dan is one of two children. AJ is one of 24. They're all in America thanks be to Allah.

Ruth Deming's Keys to Recovery from Bipolar Disorder

Here are my Keys to Recovery which I suggest you print out and make a part of your daily life. In time, they will become second nature.

KEYS TO RECOVERY

Take heart! In this, the twenty-first century, treatment options for people with bipolar disorder and depression couldn’t be better. Medication works in the vast majority of cases. Its effectiveness is far greater if used in conjunction with “talk therapy.” You will also want to incorporate “healthy lifestyle techniques” in your Recovery Plan.

When you teach yourself these common-sense Keys, you are training your brain just as an athlete trains her body to run a marathon. This is the marathon of life.

Did you know that people who suffer from depression say it is far worse than any physical illness they’ve ever had? Know that you are endlessly brave and tenacious in your struggle against depression. If you experience flare-ups, this handout provides techniques to gracefully endure it.

Planning ahead is crucial. Most people think of planning ahead when they think about taking a trip or getting married, not when they deal with a serious, chronic illness. Planning ahead is a requisite for living well with your mood disorder, as is discipline and vigilance.

The following Keys provide a roadmap for your journey to remain healthy and to avoid the “ups” and “downs” of the illness. For some of us, medication works just fine and we remain on an even keel. Others experience “breakthrough” episodes of either mania or depression as this is the nature of the illness. These cycles, caused by life’s inevitable stressors, can be resolved by learning to identify the onset of your moodswing and then take action by: adjusting your medication, discussing your current issues with a compassionate listener such as psychiatrist, therapist or friend, and taking a temporary respite from the stress in your life.

1) Get a good psychiatrist. A compassionate and knowledgeable psychiatrist is your lifeline to a successful life. To make the most of your painfully short appointment, come in with a list of questions you’ve jotted down between visits. Also come prepared with your version of a mood chart. You can create this on a spare calendar by marking your mood from 1 (worst) to 5 (best), accompanied by any life changes such as “got a new boss.” You can also print one out from the Internet.

Get medication parameters from your doctor. In other words, how much medication can you safely take on your own if, for example, if you can’t sleep or are becoming anxious or psychotic. Psychosis usually requires putting in a call to the doctor for much-needed emotional reassurance. Work with your therapist or support group members on EARLY-WARNING SIGNS OF MANIA or HYPOMANIA such as lack of sleep; the feeling that someone is watching you (paranoia); inability to stop talking (pressured speech); inability to shut your mind off (racing thoughts).

Crisis management. Discuss with your doctor how to get in touch with her should a crisis occur. It is important you realize the importance of calling her quickly. Keep her business card in your wallet in case of crisis and also for reassurance. Delay in contacting your doctor may result in hospitalization.

2) Get talk therapy. After your diagnosis, it’s helpful to have guidance from an expert in aiding you to live with your illness. You are the same person you always were but may need reassurance that you are capable of living a good life.

Positive brain changes occur when talking with a therapist. Therapy should include goal-setting, long and short-term, and a rudimentary training in cognitive therapy: thinking self-affirming positive thoughts and challenging negative thoughts.

The purpose of therapy is to grow as a human being and also to bring out the greatness inherent in every human being. Therapists help with issues like low self-esteem, anger management, accepting feelings of shame or sorrow from the diagnosis, assertiveness, choosing a healthy partner, grief over the loss of a relationship or job.

Developing a healthy relationship with your therapist is the prelude to establishing good relationships for a lifetime.

3) Medication. A mood disorder is a serious, chronic illness that, if untreated or only partially treated, will impair your chances for a productive, happy life.

Remain hopeful that your psychopharmacologist (a psychiatrist who specializes in medicine) will find a combination of drugs that work for you. Medication is your first line of defense against depression.

Take the least amount of medication possible. Make sure your doctor isn’t a pill-pusher. If he is, find a new one. All medications, whether for mood disorders or high blood pressure, have unwanted side effects. However, the benefits of taking meds heavily outweigh the cons.

Most people take more than one medication to stabilize their moods. This is because our brains consist of numerous neurotransmitters and hormones and each medicine targets a specific chemical. Three or four meds is not uncommon. Purchase a pill-box at your pharmacy to keep track of the dosing. You can also buy a pill-cutter.

Take an active role in learning about your meds. Learn the categories of medication. The impact of medication is highly individual. Write down every medication you have ever taken and keep it in a folder. This way if you change doctors, it will be readily available. Some antidepressants lose their effectiveness over the years. It is not your imagination!

Learn what category of medication you are taking. Categories include Mood Stabilizers – Antipsychotics (which are often also mood stabilizers) – Antidepressants – Antianxiety meds. There are also stimulants and drugs for side effects.

Lab tests are necessary when taking drugs such as lithium, Depakote or Tegretol. Make sure your doctor schedules lab tests once every six months. Clozaril (for schizoaffective disorder) requires tests every two weeks. Don’t forget the importance of weaning off a medicine to avoid painful withdrawal symptoms.

Explore the Internet to discover your favorite drug information sites such as PsychCentral.com.

Old vs. New Drugs. Thorazine, the first antipsychotic, came out in the 1950s, an era that produced a wave of new psychiatric drugs. Lithium appeared in 1970 and is still considered “the gold standard” for bipolar disorder. Due to its side effects, however, particularly on the kidneys, more modern drugs should be tried first. Lithium levels testing kidney function and thyroid function should be scheduled once every 6 months.

In the rush to use newer drugs, which were once thought to have less side effects - they actually have different side effects -the old stand-by’s are often forgotten. However, if the new antidepressants don’t work for you, there’s a chance the older ones will! Many people remain on MAO inhibitors such as Nardil. Or on tricyclics (such as Pamelor or Elavil).

YOU must be your own advocate and suggest these options to your physician if they do not.

Also, if meds do not work for you, consider the much-improved and, yes, much-maligned electroconvulsive therapy or ECT. Read the inspirational book “Shock” by Kitty Dukakis to find out how it helps this successful, busy woman. Because of the side effects of memory loss ECT is rightfully considered a last resort. But it works! For treatment-resistant cases, consider VNS - vagus nerve stimulation - where a device is inserted into your vagus nerve in the neck and bursts of electricity are sent to your brain.

Perhaps the best and most effective alternative treatment for depression is TMS - transcranial magnetic stimulation. A noninvasive device is placed on the patient's head and electrical "zaps" are administered thru the scalp. Reports indicate an 80% effective rate on people who have not responded to meds. Read about the New Directions' TMS seminar here.

There is always hope!

The anti-medication view. There are many valid reasons, chiefly the side effects, that people with mood disorders decide not to go on medication. Theirs is a difficult journey but many succeed. Read Gracelyn Guyol’s book "Healing Bipolar Disorder and Depression without Drugs."

4) Follow a schedule or a “To-Do List.” The human brain is wired to work, to keep busy. In the midst of a depressive episode, keep working if at all possible. Many people can pull this off. They may do less work than usual or find ways to postpone difficult projects until their depression lifts. Use your discretion whether or not to disclose your illness to your boss.

It is important you don’t blame yourself or feel guilty when your depression strikes. It is absolutely not your fault. Just accept it the way you accept getting the common cold. Like a cold, it will run its course and you’ll be fine again. All depressions come in cycles. They are self-limiting which means they come to an end.

Get in the habit of writing things down, getting ideas out of your over-stuffed brain and onto a piece of paper. If you are depressed and home during the day, make a list of easy tasks you can do. As you know, depression makes everything you do difficult. This is one way the illness manifests itself.

Decide which tasks are easy, which are hard. For some people, easy tasks include getting your child off to school, sitting at the computer surfing the net, reading the newspaper, doing the laundry. Hard tasks include bathing, house-cleaning, grocery shopping, meal preparation.

Keep easy-to-eat foods at home in case depression hits. Although you may not feel hungry, you need to remain nourished until your depression lifts. Drink plenty of water to hydrate yourself. Easy to prepare foods include canned goods such as salmon, sardines, corn, stewed tomatoes, baked beans, pineapple, soups or the nutrition supplement Ensure. Also keep on hand fresh fruit such as bananas and apples. Yogurt is easy to eat and very nutritious. Also have a stock of nutritious juices like V-8, apple juice, orange juice.

It’s fine to eat your canned foods directly from the can. Remember, easy is best. That way you don’t have to worry about clean-up afterward.

5) Contact with people. Here’s the irony. When depression strikes, you probably want to isolate yourself, stay indoors and avoid all contact with people. Your bed or your couch is your best friend, along with the droning TV which can lull you into a numb zone where you may temporarily forget about your depression.

Although it feels very comfortable to succumb to your isolating behavior, do everything you can to avoid it. Schedule events every single day to get out of the house. This is hard and takes all of your strength. Have a set time to get out of bed. Then avoid the temptation to return. Get dressed and get out of the house fast! As you know, by remaining in bed you are a victim of the terrible thoughts of the depressed: what a terrible person you are, how you don’t accomplish anything. The minute you get out of bed these thoughts recede, not totally, but you’ll get a break once you concentrate on doing an activity, once you take action and start moving, the very thing our brains are wired to do.

Stay out of the house for as long as possible. What might you do? Consider that you are recuperating from an illness. Visit friends or relatives. Go to the library, sit and leaf through magazines. Have a cup of hot chocolate in a coffee shop, go to the movies. Sit in a park. As you know, once you return home you’ll return to your depression mode.

Make a list of friends to phone to “cheer you up.” When you’re home and in a funk, call someone. “Do you have a minute? I’m a little down and just wanted to chat.” Or, don’t mention it at all. Simply call someone and start a conversation to get your juices flowing. Keep your list on your kitchen bulletin board or fridge. As you speak on the phone, your brain will be stimulated by each phone pal.

Be sure to phone people if you’re on a new medication which is taking time to ramp up in your brain. Your phone pals will bolster your spirits.

6) Learn to process your feelings. Bipolar disorder is what I call an “emotional processing illness.” We don’t process emotions like other people do. Many of us harbor secrets and don’t communicate well. Be aware of this quirk and work on it with the help of friends and a therapist. Although it’s hard to view feelings as concrete entities, they need to be nurtured and taken care of, not left to simmer untended in the brain.

If a bad thing happens, we must acknowledge it, and then share our observations with someone close to us, to “talk it out” and not sweep it under the rug. Otherwise thoughts will take on a life of their own and come back to haunt us in the form of depression, anxiety, anger, or mania.

Anger issues are common for people with bipolar. Again, although anger is invisible it is as real as a brick sailing through a window. If someone makes you angry, you must figure out how to deal with them in a tactful constructive way rather than letting the anger build and make you sick. The simple but difficult technique of “walking away” from the person – or “cooling off” – is very effective but requires discipline. You must hold back your impulsive desire to fight back.

For example, say you receive an email that makes you angry. Walk away from the computer or go on to something else before addressing the email. Then type up your reply, save it and send it after you have re-read it and feel it is appropriate. You may also wish to call a friend to discuss the email and your response.

This is good practice in dealing with potentially destructive anger and dealing with it in a healthy, assertive manner.

How about journaling? I myself kept a diary from age 10 until today. Every nite before bed I would write in my diary, no matter what. I never read it back.

Another unpleasant emotion is that of feeling overwhelmed, when it feels like you will never get all your work done. Take heed that our minds are capable of “compartmentalization.” This means putting different tasks in different sections of our brains so we can concentrate on one thing at a time. Write down all the things you need to do. You can also create folders or bins for each task. Just watching yourself organize your many projects may help you feel less overwhelmed. Then, of course, work on one thing at a time. Explain to your brain “I’m working on cleaning off the dining room table now. When I’m finished, I’ll tackle that letter I want to write.” Set a timer for an hour to work on each project. Then cross it off your “to-do” list to feel a sense of satisfaction.

Aerobic exercise, only 20 minutes a day, is great for relieving stress. Examples are a fast walk, stationary bike, swimming, the treadmill or elliptical machine.

Mindfulness exercises like yoga and meditation calm our minds and help us live in the present moment.

The above two life-enhancers take discipline to achieve. Challenge yourself to succeed in doing them.

7) Practice a healthy lifestyle: regular hours for sleep, regular medication times, meals, prayer and exercise. Routine! The body loves routine. Emulate the birds! They live a well-ordered life.

Change your diet. Avoid all junk food, processed food, and preservatives. Eat less meat, more fish for those valuable fatty acids. Eat plenty of high-fiber fresh fruits and vegetables, whole grain foods, olive oil, nuts. Visit EatingWell.com. Healthy foods are delicious foods!

Did you know that many psychiatric drugs are implicated in getting diabetes? Very true. Check this out on the Internet. By eating a healthy diet and by exercising and controlling your weight, you can avoid this life-threatening side effect.

8) Realize you a whole person, more than just a person with a mental illness. Develop hobbies and interests so you can grow healthy new neurons in your brain. In our complex American society many of us have a chance to live “many lives in one” whether it’s discovering a new career or a new hobby such as writing or painting. Begin a new hobby with the mindset “I’m not perfect. I’ll make some mistakes.” By freeing yourself from the idea of perfection, you give yourself freedom to succeed. Hobbies also allow us to practice mindfulness, to live in the present moment while we are writing or painting, and discovering a deeper part of ourselves.

9) Compliment page or drawer. Raise lagging self-esteem by writing down compliments given by important people in your life. “My boss said I’m intelligent and have a great sense of humor.” You may also have a drawer-full of things you’re proud of such as letters from loved ones, diplomas, awards, college papers, photos. Call on these souvenirs whenever you need to bolster your self-worth.

10) Recognize your triggers. A trigger is anything that can bring on a moodswing. Here is where your ability to know yourself and to plan ahead can avert disaster. What events or triggers have set you off in the past? Write these down. Naturally we can’t control all of life’s stressors but we can certainly recognize a few on the horizon and learn how to cope with them.

Plan ahead. Discuss in detail with someone you trust how you might ideally respond to upcoming events that may “trigger” you such as a family wedding, a day with old friends who will ask you what you are doing with your life (practice a “pat” answer for this), new duties at work, a fight with your significant other, getting divorced, moving to a new home, or returning to work after a hospitalization.

In addition to mentally planning how to avert a crisis, exercise is most helpful. Get on that stationary bike, pedal out your frustrations and feel physically strong.

Always be solution-oriented! Realize that for every problem there are dozens of solutions to choose from. Brainstorm with others to help you.

11) Good sleep is essential for good mental health. Poor sleep may be a prelude to mania or hypomania. Remember, though, not everyone sleeps through the night. Some people simply have odd sleeping patterns that work well for them. Most people get up in the night to go to the bathroom, a situation often remedied by not drinking caffeine after 3 pm, or not drinking too many liquids before bed.

Address sleeping problems by training your brain how to sleep properly rather than taking sleep medicine which can be addictive and will be yet another medication in your body. By taking your regular meds at night, your sleep may improve. Obviously if your sleep deficit is so severe, you may need sleep meds or train your brain per below.

Establish a bedtime ritual so your body knows you are slowing down and it’s time for sleep. We did this as children and should continue as adults. A bedtime ritual may include changing into pajamas, reading or watching TV in bed, then switching off the light and the television set. A dark sleeping environment allows our brains to produce more melatonin, the sleep chemical. Yes you can fall asleep without the TV! But you may have to train yourself to do so. It may take a month or more to learn to fall asleep the way you did as a kid.

Many people take a brief nap during the day which, contrary to popular thinking, does not impair their night-time sleeping. You know yourself best of all!

12) Your home environment should represent you! When you enter your home, whether it’s an apartment, a house, or a cardboard box, it should look inviting and smell inviting. Jazz it up with aromas from fresh fruit, cooking smells, scented candles, incense. Our moods are affected by aromas more than we realize. Open up the windows to aerate your place!

Live in as clutter-free an environment as possible. The state of messiness – or chaos – very much affects our ability to think straight. Hide things in closets or drawers until you’re ready to organize them. It’s a great feeling coming home to a neat house.

Don’t forget music! If you live alone, turn on your radio or stereo instead of the drone of the TV set. Listen to the radio while you’re doing hard work like house-cleaning or doing the dishes.

Lighting, temperature and color affect our moods. All mammals respond to the circadian rhythms of night and day. A chief problem of folks with mood disorders is our rhythms are out of order. Bring them back into alignment. In your home, observe the rules of the outdoors, of day and night. Since most people live a “9-5 life” we want to get on the same schedule as everyone else.

Decide where dim lights are needed as well as bright lights. Open your drapes or blinds to let in the sunshine, especially in the winter months. Keep a few easy- to- care- for houseplants around– and herbs such as rosemary and basil. And what could be better than to add fresh flowers that bloom indoors such as cyclamen or African violets. Their cheerful colors are infectious!

Many people with mood disorders cannot tolerate hot weather. It is definitely not your imagination if you feel awful during the heat. Cool off in air-conditioned facilities such as the local library, bookstore, movies, mall or coffee shop. At home, sleep near a fan.

Your home should be easy to move around in. There should be clear walkways with nothing to trip over to break your big toe. Read books on feng-shui, the Chinese art of object placement to ensure an unimpeded flow of energy.

Put anything unpleasant away from sight such as bills. Everything you look upon in your home should give you a sense of peace.

Remove from the premises anything that causes you extreme psychic pain like old love letters or letters of rejection.

13) Develop a crisis plan. Print it out and keep it handy. Then in a crisis take it out and read it over. The same is true for when you’re feeling suicidal. Remember that suicide is the most extreme symptom of your illness. Remember that you do not really want to kill yourself but the illness is urging you to do so. Here is the Crisis Plan and the Stop-Suicide Plan.

CRISIS PLAN

It is important to PLAN AHEAD should a crisis arise. Prepare NOW with your doctor and your support team. Plan a medication strategy with your doctor to get your all-important medication parameters in place or “how much is it okay to safely take” in case your mood worsens. You must work with your doctor on this. Never change medication on your own! That said, if you and your doctor have agreed on med changes in advance, then by all means, take the extra dose – or even a diminished dose to ensure the return to your good mental health.

During a crisis it’s best not to be alone. Have someone stay with you or go to someone’s home for safekeeping. You could even sit in the waiting room of your doctor just to be around people. Keep your cell phone with you at all times. It’s another lifeline and important security blanket.

Call your psychiatrist. The partnership you have with your doctor will ease your mind during a crisis. Leave a message on his voicemail. Again, have your cell phone handy for when he or she returns your call.

Call your therapist. The soothing sound of her voice – and her ability to help you remain calm and not panicky – will help you withstand this temporary crisis.

Leave home where your lethal weapons reside.

Be among people. Go to the home of a friend or a relative who treats you well. Go to a soothing place such as the library, the bookstore, a coffee shop, the mall. Be comforted that people do not know you are in a crisis unless you tell them. You can therefore remain “invisible” when you are seeking comfort at public establishments.

No need to interact with people if it’s too difficult. If you’re psychotic and paranoid, you may wish to avoid people and just wait around the house for your doctor to call. In this difficult state, you might listen to soothing music, watch TV if it doesn’t trigger bad thoughts or if it begins to “talk to you,” lie quietly with eyes closed, take a shower or bath, surf the Internet, look at “coffee table books.” You may wish to revisit your Compliment Drawer or to read over the Crisis Plan or “Strategies to Regain Strength” below.

Every single person has a strong survival mode which is at the core of our being and is serving us well at this very difficult time.

Check yourself into a hospital if necessary. Your safety is paramount. If you are suicidal, get thee to a hospital. You will be surprised at the relief you will feel. In the Philadelphia area, good hospitals include Horsham Clinic, Brooke Glen (formerly Northwestern Hospital), Bryn Mawr Hospital, Abington Hospital and others. Not every general hospital has a psych unit. Research this in advance, not at the time of crisis!

STOP-SUICIDE PLAN

Depression is not a fatal illness but when the illness flares, a depressed person experiences a distorted view of herself that propels her to seriously consider suicide. This is different from the common passive thought “I wish I were dead.” Suicidal thoughts may be constant, an urge to take action. They may emanate from powerful erroneous messages your brain is giving you: the world would be better off without you. I am a burden to everyone. They may even be triggered by your medication – something new you are taking.

The truth is the world would not be better off without you. It would be infinitely worse! The legacy of suicide flows like a tidal wave, first devastating your own family members, then hurting everyone else who knows you. The world will never be the same after you take this drastic action. This thought alone has stopped many people before they attempt suicide.

Know that it’s okay to fantasize killing yourself. Allow yourself a few moments to think what a relief life would be if you were not here. Then stop these thoughts and get to work on your Stop-Suicide Plan. In time, you won’t need the respite of your suicidal fantasies.

When you are well, study the “Stop Suicide Plan.” Have it handy should you become suicidal. Know that suicidal thoughts are common among people with mood disorders. It is the most difficult symptom of our illness and calls for all of our strength. Talk to understanding friends about suicide. Get it out in the open. Don’t dwell on it, but don’t keep it a secret either. Two helpful websites are Metamoia.org/suicide and Suicide.com.

Call your doctor. Call your therapist. Similar to the Crisis Plan above, let them know through the answering machine or secretary that “This is an emergency. I am feeling suicidal. Please call me back as soon as possible. My phone number is ……”

Call a trusted friend or loved one immediately! You must talk to someone to divert your mind from the constant pressure to kill yourself. Refer to your “List of People to Call.” Then go down the list until you get someone.

When someone answers, you may say, “I’m feeling really awful. Do you have a few minutes we can talk?” Or, if you don’t want to disclose your intense pain, simply make it a friendly call and listen to the soothing sound of the other person’s voice. There is also a national suicide hotline. Keep their number handy: Call 1-800-SUICIDE or 1-800-784-2433.

Your own home becomes an echo chamber of your negative suicidal thoughts. Just leaving home will diminish them considerably. Again, do not remain at home.

Leave home to remove yourself from lethal weapons and to be among people. You can visit a long-lost relative, a friend who is home during the day, or go to a public place like bookstore, library, park, mall, or coffeeshop. Be creative. Visit a YMCA or fitness center and ask for information about joining. Test-drive a new car but only if you’re not manic! Or drive around and sight-see.

Again, do not remain at home.

If you’re overcome with anger, it’s best not to drive until you’ve got your feelings under control. Fast walking is great to discharge anger. If you’re near a park with fitness equipment, avail yourself of this option. You need to get your aggressions out of your body. Bounce a basketball. Hit a tennis ball. Throw rocks in a pond or in the back yard. Do some gardening and pull out weeds. Walk quickly around the block. Punch a living room pillow or punching bag.

Suicidal thoughts are intense and truly horrible. We must rely on all our powers to resist their pull.

Talk or sing out loud. Counteract your hammering thoughts with chipper conversation with yourself. Tell yourself what you see. “I am now looking out the window at Nancy’s house across the street. She’s opening the door and taking the dog for a walk. “ This is a very effective technique to keep you calm and grounded.

Carry phone numbers of friends and loved ones in your wallet or on your cell phone.

When to go to the hospital. When your thoughts are bombarding you nonstop and you feel you can’t avoid the temptation to kill yourself, check into a hospital. Pack your bags including your toiletries and PJs and drive off. Realize that it will take hours and hours to get checked into the hospital but that is fine. You are somewhere safe and on your way to getting lifesaving help.


HOSPITALIZATION

When we’re at our worst we check into the hospital to stay safe and also to be under the care of a physician for a medication change. You will be with all sorts of people with all different diagnoses including substance abuse. It may or may not be pleasant, but your goal is to take care of yourself and get well.

Make the most of your hospital stay. Chat with interesting patients or staff. Avoid people you’re not fond of. Don’t feel guilty if you don’t like everyone. It’s impossible!

Hospital aftercare. Transitioning from your hospital stay to living at home again is often best done by attending a “partial hospital program” also known as a "day program." These structured programs for half a day feature wellness techniques that should help transition you back to life in the community.

Some people feel ashamed to have bipolar disorder or depression. Try to get over this sense of shame. It’s the main reason why the majority of people with bipolar or depression do not seek help. Imagine! Great help is out there but a person is too embarrassed to see a psychiatrist. They would rather live a life of misery than admit to having an illness.

Attending a good support group such as New Directions can be very helpful on your road to recovery. You will hear truly amazing success stories of people with your very same illness who have pulled themselves out of suicidal depressions and the depths of despair. Each person’s story is unique. You will feel comforted to know that other people have triumphed over their unwanted, unasked-for illnesses. A feeling of LOVE and DEEP CARING exists at New Directions. We can think of each individual person as a strong tree in a forest. Each tree is so different from the next but all arch upward toward the light and the sky, each seeking to share their love and beauty with one another.

STRATEGIES TO REGAIN STRENGTH

When you’re knocked down, these strategies will help you rise again. Keep these handy and don’t forget to add your own. Action or moving your body is the best antidote to a moodswing.

-Hang out with positive people. Limit the time you spend with negative relatives or friends. And don’t feel guilty! Your own welfare comes first.

-Aerobic exercise. Your brain endorphins will invigorate you better than a shot of caffeine.

-To alleviate anger, go for a fast walk. Use a punching bag or punch a pillow.

-To alleviate anger or sorrow, write an impassioned letter. Then let it rest. Read it to someone for feedback. Then decide whether or not to send.

-Take phone off hook when sleeping or napping. Or, when you need to concentrate or to eat your dinner. Phone calls can always wait but your dinner is hot only once.

-Keep a journal of your feelings. This is a way of processing your most difficult thoughts and feelings. As we’ve said, these thoughts must be acknowledged or they’ll develop a mind of their own. By acknowledging them to yourself through journaling, you are freeing your mind of the burden of carrying a heavy load.

-Affirmation cards. On an index card, write out your goals. “I will find a good job.” “I will find a way to pay for my college courses.” And “I will not kill myself.” Having written them, you are giving your unconscious valuable messages. At the same time, the direction of your life will head toward these important goals.

-Do artwork. Express your feelings through poetry or visual art such as painting or sculpting. Buy self-hardening clay available at craft stores and create little sculptures, bowls, or African masks. You can also create artwork with found objects. The joy and satisfaction in creating art is among the highest a person will ever experience. It’s called “self-expression.” Many people with mood disorders are artists. Achieve your human potential by nurturing the child within you by creating mature works of art.

THINGS TO KNOW

As we’ve seen, medication is only half the picture for your wellbeing. Also crucial in stabilizing your moods are lifestyle changes, therapy, choice of friends, choice of significant others, your home life, the way you organize your home and yard, and how you choose to spend your time. This will all become second nature to you once you understand its deep connection to your staying well.

Learn all about mood disorders after your diagnosis but then plunge into the joy of living. Be curious about this amazing world we inhabit. Meet new people. If you’re shy, hang out, for safety, with people at New Directions, but then widen your circle by going into society at large.

Know that any medication change may bring about a change in mood. Whenever you can’t figure out why you’re not feeling right, ask yourself, “Have I changed my medication or dosage?” Or, “Maybe I’ve forgotten to take my meds.” To prevent this all-too-common problem of forgetting to take your meds, buy a pill box and keep it visible!

Get plenty of light, especially in the winter. SAD (seasonal affective disorder) is as serious a form of depression as any other. SAD is treated with special lights. After researching and consulting with your physician, purchase bright fluorescent lights, different than your home lamps or your home fluorescent lights, and sit in front of them daily, usually for a set time in the morning. Read Winter Blues (rev. 2006) by Norman E. Rosenthal, MD.

Avoid the always tempting thought: I feel so good I’m going to go off my medication, or lower the dosage. Sad to say, you will most likely regret this as your symptoms may return with a vengeance.

Later in life, a mood disorder may have run its course. If you are in your fifties, research this and if you wish, come up with an Action Plan to safely go off your meds. Many doctors will work with you on this all-important project. You may need to re-train your brain to live without drugs. Again, it has been done by many!

Reach out to help others. People with mood disorders are unusually compassionate. Many are in the helping professions. Or they are particularly skilled at helping people in need. You are most likely one of these people. Notice how good you feel when you engage in active listening. You can feel the gratitude of the other individual which, in turn, makes your brain chemicals turn somersaults of satisfaction.

Courage, hope and tenacity will get you everywhere. And so will the words “Pursue the Wonderful!” Good luck!