Wednesday, September 24, 2014

Program at Doylestown Hospital Wellness Center in Warrington, PA - Keys to Recovery

My 'chauffeur' the talented Mr Bob Klein drove me to the 7 pm program. He never goes anywhere w/o his iced tea.

I enjoyed riding down in his Honda which made a loud buzzing noise when the door opened. You had to jump out during the buzz or else.

Since the Health and Wellness Center hadn't been able to advertise my event since I thought of it after the death of Robin Williams, we had to scramble to get folks out.

I was pleased with the turnout. As always, it was like a little New Directions meeting. Bob and I got to know one another during the half-hour drive down Easton Road.

His dad, who died as my dad did, from a brain tumor, but he was 71, was a decorated World War II soldier. Bob framed his medals, including a Purple Heart, and has them hanging in The Sun Room of his condo.

After we entered the Center, I saw the sign advertising my program. Bruce Uhrich, Ed.D, is very organized and efficient.

At the top of the stairs I peeked down and saw him sitting at the desk.

"Anyone here yet?" I asked.

"Yes," he said, and Bob and I carefully walked down the steps.

Bruce Uhrich, Ed.D. He has a year-old grandson in south Jersey. He comes from a family of educators. His son teaches at Ocean City, NJ high school. Scott and I passed it a couple of weeks ago on our vaca.

At the end of our program, someone asked me if Bruce and I were married.

Yes, I said, smiling at him.

No, we're not, he said, but we've known one another a long time.

Before the program, I asked Bruce if he'd shown his antique car in any car shows lately.

Yes, he said. In NYC.

Here's Bruce's 1955 Checkers Cab. Read more about the Newtown PA car show - and Checkers (woof woof, Tricky Dick Nixon's dog)  on my July, 2013, post. 

Aside: Just made my side dish for tonite's Rosh Hashonah dinner at mom's.

It's a diabetes-friendly warm bean salad. I never use salt. Ingredients: steamed green beans, green scallions, cuke slices, fresh basil and toasted pecans and sunflower seeds. Dee-licious!

 I asked "Leslie" to call me. "Harry" had left, as had "Danny," who attends our Daytime Meetings at the Giant.

Harry wanted to get info about his son who lives in Houston. Harry had a beautiful baritone voice. I always ask, "Is your son able to work." That indicates how healthy they are with their bipolar.

He is, said Harry, but he just got divorced.

He'll find someone else, I said, b/c he's porbly as charming as you are.

That's what my wife said, said Harry.
I looked really nice for the event and wore my sandals. After I began talking, the toes on my left foot went into a painful cramp but I said nuffin. I told the group that we often put on a mask w

When we're depressed and that's a good thing.

Was happy to see my friend Teresa "Tree" there.

Bruce kindly made copies of my short handout. I always love when people ask questions, which they did.

Talk at the Doylestown PA Health and Wellness Center
 in Warrington, PA on Tuesday, September 23, 7 to 8:30 pm
by Ruth Z Deming, MGPGP, Director of New Directions Support Group – 215-659-2366, ext. 4.

1) Find a good psychiatrist, one who listens well and is compassionate. He or she should be available in times of crisis. “Partner” with your psychiatrist and take an active role in your treatment. Ask questions. 
Since a “mood disorder” – bipolar or depression – is an illness that affects the whole family, include your loved ones occasionally in a visit to your psychiatrist or psychotherapist. They can help you discover when an episode is on its way and take action to lessen its effect. 

2) Find a good psychotherapist or “talk” therapist.

3) Take medication. The medication arsenal is ever-expanding. 

4) Learn what your diagnosis is. Most people with bipolar disorder do not know the difference between Bipolar One and Bipolar Two. Find out on the website for the National Institute of Mental Health.

5) Prevention. Stop a mania – or hypomania - before it gets out of control. Symptoms may include: lack of sleep, euphoria, inability to stop talking, inflated self-importance, feelings of being invincible, paranoia, increased sexual appetite, increased religious feelings, poor judgment, taking on many projects, risky behavior. 
Angry or irritable behavior.
Symptoms are observable to others but you can teach yourself to observe them yourself.

Depression and mania usually alternate. Symptoms of depression include lack of energy, lack of pleasure, lack of appetite, self-loathing,  feelings of hopelessness and thoughts of suicide. 
Your doctor may change your meds to lift you from depression. Also exercise – vigorously - if at all possible. 
If necessary, check into a psych hospital to stay safe.
Both depression and mania are “self-limiting,” meaning they will stop. Everyone’s “cycle” – or the time the mood swing lasts - is different. 

6) Meds. Learn what category of meds you are taking. Categories include Mood Stabilizers – Antipsychotics (which are often mood stabilizers) – Antidepressants – Antianxiety meds. There are also pills to counteract side effects.

7) Hard to treat depression. Try the older MAOI drugs, as well as the older tricyclics. Also somatic (nondrug) treatments such as electroconvulsive therapy (ECT) and the newer TMS – transcranial magnetic stimulation – and DBS (deep brain stimulation). 
Read Tom Insell’s blog, he’s the director of the NIMH about somatic treatments
8) Lab tests. Necessary when taking lithium, Depakote or Tegretol.  Your doctor should schedule lab tests once every six months. 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 

9) The anti-medication view. There are many valid reasons, chiefly the side effects, why people don’t take meds. Theirs is a difficult journey but many succeed. Read Gracelyn Guyol’s book "Healing Bipolar Disorder and Depression without Drugs." See her website at


Follow a schedule or “To-Do” List. You’ll feel good when you accomplish your daily tasks. 

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. 

To Disclose your illness or not. Best not to tell your employer since bipolar disorder carries a stigma. Less so for depression. However, you must disclose if you want accommodations from the Americans with Disabilities Act. View provisions online. 

Write things down. Get thoughts 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.

Help for depression. 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. “Ensure” may be helpful, as are canned items such as sardines, corn, stewed tomatoes, soups. Okay to eat right out of the can.  

Do not isolate yourself, although it’s easy to do. 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.

Phone people to “cheer you up.” 

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.
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. 

Go for a walk or a swim or bat a tennis ball or punch a pillow if angry. 

Mindfulness exercises like yoga and meditation calm our minds and help us live in the present moment. Regular practice provides a new sense of peace and calm. 

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 Or, for a lo-carb diet see Dr. Hyman’s online recipes. 

Cultivate new interests. Realize you’re 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. Take an inexpensive adult evening class in, say, jewelry-making, poetry, watercolors. 

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.

Recognize your triggers. A trigger is anything that can bring on a mood swing. 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.

Exercise exercise exercise!


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.

Call your doctor. Call your therapist. 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.”

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.

If necessary, call the National Suicide Hotline at 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, where your lethal weapons are.

Give away any weapons you have such as knives and guns. 

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.

Carry phone numbers of your psychiatrist, therapist, 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 may harm yourself, check into a hospital. When you are discharged, you may wish to continue treatment at a partial hospitalization program aka day program to slowly get you back into the swing of things.


Stay active. Keep on moving. Inertia will only drag you down again.
Hang out with positive people. Limit the time you spend with negative relatives or friends. 

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

To alleviate anger, go for a fast walk, swim, or bike ride. 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.

Journal. Get all thoughts and feelings onto paper. Not necessary to read them back. This is a way of processing your most intimate thoughts and feelings. As we’ve said, these thoughts must be acknowledged or they’ll develop a mind of their own. By recognizing them 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.

Creativity.  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.


Healthy lifestyle changes are important as we evolve through life. We may make new friends as we part company with others. Same with job changes. If at all possible, stay in the work force and do not go on disability. If you positively cannot work, do volunteer work so you are “giving back” to society. We all need a life of meaning.  

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 both meds and special lights. Purchase bright lights on the Internet. 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.

Depression and bipolar disorder are treatable illnesses of the brain. Have faith in your ability to recover. With a good doctor, therapist, and support group, you will!  

 Remember: The World is Your Friend.

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