Mental Health Discussions: What Can a Minister Do?

Recently, the amazing Glennon Doyle Melton of Momastery posted this to her Facebook page:

"Dear All The People,

Please, if possible- this:

Before doling out advice about medication for the mentally ill, pause to ask yourself these quick questions: 1. Am I a doctor? 2. Am I the doctor of THIS person I'm talking to?

If the answers are yes- by all means - carry on! If not, shhhh.

Also just a gentle and loving reminder to the pastors and religious leaders. Pastors (along with druggies and drunks and depressives) are MY PEEPS. LOVE YOU. But listen - if you are a pastor, you don't actually count as a doctor. Pastor and doctor are, like, two totally different careers. Different colleges and such. So- maybe no medical advice, please. Out of gratitude- I promise not ask my doc for communion.

Jesus loves Me This I Know, For He Gave Me Lexapro.

Love,
G"

As always, she gets right to the point and has great humor. I think she is fantastic and her book is a good dose of inspiration, humor, and is a great read for a spiritual practice. I even wrote a blog post for her Messy, Beautiful Warrior Project. 

I totally agree with her. Ministers should not give out unsolicited medical advice about medication. From reading the comments, it seems like what most people with mental illness get from ministers, is the belief that mental illness is not a true illness and you can just pray it away. I don't agree with that. As a Unitarian Universalist minister, belief in evil spirits as a cause of illness, medical cures through only a belief in Jesus, and prayer as a sole medical intervention, are just not things that are part of my theology. We understand the body, mind, and spirit connection, and we value the combination of science and religion. 

On the opposite side of what it seems like Glennon and some of her readers with mental illness have experienced, I more often get ministers telling me I have to take medication. I have been told it is morally wrong not to take medication. I have also been told that if I don't take medication I must not really have a chemical imbalance, not a "real mental illness." As if treating it only with medication is the thing that proves you have mental illness. (You might want to tell my many psychiatrists who diagnosed me that information, because they might need to know they, apparently, should to go back to medical school.) 

While I agree with Glennon, I want to be clear that I do not think ministers are unable to give counsel about mental illness. I don't think that was what she was saying in her post at all anyway, but many of her readers took it that way. Medical advice would be what medicines to take, shock therapy or not, and such treatment that a psychiatrist would give. However, people contact me all the time about mental illness and treatment because I talk about my mental illness publicly. I always say that each individual needs their own treatment team. That could be just a therapist and Psychiatrist, or include also a minister, spiritual advisor, nutritionist, etc... 

I do believe mental illness, like all illnesses, has physical and spiritual components to it. Please read this blog post for more explanation of what I mean.

Rev. Katie Norris. Copyright.

I don't want ministers to get the idea that we can not tell our own stories if we have mental illness. I also don't want people to think that ministers have no place in a mental health treatment plan, because they can. We just need to know boundaries. 

As a minister, I can give counsel about ideas for spiritual practice that can support treatment. I can be a pastoral ear and listen to the pain that most people in the world are unwilling to listen to. I can help families communicate better. I can advocate for a better understanding of mental illness, and help churches create a stigma-free environment. I can be the minister to officiate a funeral and walk a family through a death by suicide. I also can be a part of a person's mental health team. Many doctors and therapists suggest spiritual practices, like meditation, as part of a treatment plan. Which means that it also should not be assumed that doctors know nothing about spirituality and can not advise to bring that into a treatment plan.    

I can also tell my own story, which is not giving medical advice, but does let other people know more about different treatment options. Just like Glennon writes about her medication, I can write about my spiritual practice, sleep schedule, diet, and exercise which all help treat my mental illness. There is sadly not enough information about the varieties of types of treatment and the many, many things a good treatment plan needs. That is why we need more people with mental illness sharing their story about what manages their illness. When I read that someone else uses a mood tracking app to help manage their bipolar disorder, I might want to ask my doctors if I should add this into my treatment plan. 

Everyone needs their own mental health team, of their choosing. Unless you are on that team and have been asked for advice, don't give it. If you are someone with mental illness, don't change your treatment plan on your own based on what someone outside of your team tells you or what you read on the internet. Make decisions with your mental health team. 

Blessings,

Rev. Katie

UPDATE: Here is Glennon's Facebook response the day after the post above. See how great she is?:

"Yesterday, there were folks upset with me for telling depressives to “take their goddamn meds.” I was pissed that they were pissed. But I slept on it. And when I woke up, I had a softer heart about all of that. My friend Nadia Bolz-Weber calls this a heart transplant: when your heart of stone gets ripped out and replaced with a softer, open one. I think if we are not having heart transplants daily, we are really missing out. So anyway- I understand. It’s all confusing and murky. I know that we all want the best for each other. I believe that even more strongly in the wake of all the passion this week.

I’ve got some mental illness issues and chronic Lyme disease, and so my relationship with meds/no meds is windy and twisty and hurty. I haven’t been on any meds for a year now. I’m grateful for that. I’m also grateful that I had the meds when I needed them- they felt like a lifeboat for me. I’m insanely grateful to know that they are available if and when I’m in desperate need for a lifeboat again. And I just want other drowning people to feel less shame for climbing in whatever life boat is available. The fact is that I don’t write about all of this because I love meds. I write about all of this because I love people. And I love the lifeboats that save them. But I don’t have any freaking clue what you should do. I just want you to be okay. I just don’t want any of us to drown.

It’s been a tough freaking week. Just a TOUGH one all around. I feel rubbed raw. Do you? When I turned on the news before bed and saw the Ferguson crisis I just thought: the whole world needs a lifeboat. I guess we do, and I guess that lifeboat is love and forgiveness and grace- in all of its million forms. I don’t want to put anything out into the world today except for love and forgiveness and grace. I really love this ragamuffin crew. You are my lifeboat, too. Thanks for floating and bumping along with me.

Love, G"

Adventures in Acupuncture

Five weeks ago I started acupuncture to help with my bipolar disorder. It seems to be helping as I am finally getting numerous days in a row that do not end up in manic meltdowns. I am able to handle things a better and have more functional time during the day. I have actually been letting my husband sleep and not talking to him all night, which he is very happy about. It takes at least a few months to be sure a treatment is working, but this looks promising. Part of the actual experience of getting the acupuncture though was an adventure for me though.

I have no trouble with needles so I did not anticipate any issues with getting acupuncture. However, at my first appointment, after the practitioner put all the needles in me and left the room, I instantly panicked. For some reason it did not cross my mind earlier that someone who has panic attacks being in confined areas might have a serious problem with being basically pinned down and unable to move, at all.

I had one of my worst panic attacks that day because I could not get out of the situation I was in without serious pain and I could not do any of the little things I usually do to try and calm myself down. You can not really move any part of your body because the needles really hurt if you move. It's fine if you lie still, but I tried to wiggle my fingers to clench my hand, which I do when I am panicking, and it was extremely painful. Technically I could get up, with the pain, but really, what would I do then with no clothes on and tons of needles all over me? There is really no where for a human pin cushion to go.

Attempting to relax. Photo by J. Norris

That was one of the worst half hours of my life. I kept panicking, fearing I would get sick, unable to move, knowing I could yell for help but that would be extremely embarrassing.

Apparently, most people fall asleep during acupuncture and they find it very relaxing. I find it excruciatingly terrifying and I lay there doing anything to try and distract myself- singing songs in my head, counting, but mostly I kept saying over and over again in my mind "When is this going to be over?"

Until we can figure out how to get rid of my panic, I can not go to acupuncture by myself. So, my loving husband takes three hours out of his week to go with me (between driving there and back, meeting with the practitioner, getting all the needles put in, laying there, and getting everything removed.) It may sound odd that he would figure out how to go with me, but the acupuncture seems to work enough that it is worth all the time and effort.

Some days I am able to lay there quietly and we both get some meditation time in, which is nice and he finds that quite relaxing. Other times I am an anxious wreck and I have him talk to me to try and make the time pass faster.

My acupuncturinst is not quite sure what to do with me and the anxiety since he has not had anyone have acupuncture make them so anxious, every time. Then I realized though that most people who have severe anxiety over being confined would never get acupuncture in the first place.

I am glad I did not think this whole thing through and realize acupuncture would cause me to panic because then I would have missed out on a treatment that really helps me- better than medications have done. Even if acupuncture makes you nervous for any number of reasons, I would encourage you to try it because it might really help.

Blessings,

Rev. Katie

Why Having Fun Creates Better Mental Health

We have been trying to add different kinds of exercise, adventure, and fun to our lives. This is good for everyone's mental wellness, but it is especially helpful for people with mental illness. We chose some activities the other day that were inspired by a few of the principles in the book Running with Nature. We got outside, laughed and played, and had some adventure.

Research shows are many reasons why these activities help create mental wellness. Being outside gets us out in the sun, which elevates the mood. People with Seasonal Effective Disorder (SAD) and depression are often treated with light therapy. Too much darkness increases melatonin. Melatonin is needed for sleep, but too much of it can make people depressed and tired. Laughing and playing is proven to make everyone happier. Taking a bit of time each day for fun means we then have enough energy for the rest of our life such as work and it even helps us handle difficult situations better. It is also said that laughter helps us heal. Some hospitals and use humor therapy as part of their program and have found it reduces the need for medication.

Copyright, Jeff Norris

In order to get all of these benefits for us as a family, we decided to use the slackline that my husband Jeff bought on a whim a few months ago. Slacklining is basically balancing on a piece of nylon that is suspended between two trees. We also spent some time on our trampoline which is always fun. I often forget to do anything fun, ever, and I was reminded how important it is to my mental health and also the health of my family.

The slackline is basically a balance exercise, which means you need to be in tune with yourself. Balance exercises require you to pay attention to your body and really focus on what you are doing. This is never one of my favorite things to focus on because I am very self consious about my size and I often feel like a big bull in a china shop. I would rather forget I even have a physical body, but you can not do that when you are doing any kind of exercise that requires a focus on balance. Slacklining helped me be a little less upset about who I am as I started to just let go, have fun, and focus on learning to balance more. I found that when I started taking stronger antipsychotics a few years ago, my balance was severely effected and even though I stopped taking them, I have never gotten my balance back. I hope slacklining will help me reverse that.

I also found slacklining brings us closer together as a family. We were all encouraging each other and helping each other get across the line. We wanted to see each other succeed and we were all engaged in helping each other reach our goals. (My son is currently working on his best yet, four steps without help from anyone.) When we were on the trampoline, I commented that our neighbors must think we are so weird. Other people have trampolines, but we never see parents using them. Our son, while jumping high up in the air said, "You guys are the best parents and the most fun!" Seriously, how could you not feel happier after hearing that?

Copyright, Jeff Norris

As Jeff was helping me across the slackline I had this profound sense that we rarely are just present with each other. The longer partners are together, the less we remember to have any daily physical contact. You hold hands less and don't spend as much time really looking at each other. When Jeff helped me go across the line, I remembered how we still need to make time to be present with each other rather than just going through our daily lives. It is all too common for couples to loose connection with each other, especially when one of them is living with an illness. It can feel like all of your life is about the illness and everything becomes stressful. Spending time together having fun brought us much closer together and allowed us to appreciate each other more. All in just an hour.

They suggest one hour of play per day in Running with Nature and I can tell that the more we try and stick to that suggestion, the better off we will all be.

What will you do today that gets you outside, let's you have fun, and is a bit adventurous?

Blessings,

Rev. Katie

Book Review: Running with Nature

Running with Nature by Mariel Hemingway and Bobby Williams is, simply, a book that helps people live their best life. It's not a book specifically about mental illness, but a book about having a well rounded life.

Many of you know that I use many lifestyle initiatives in order it treat my bipolar disorder. I have researched what diet, sleep schedule, meditation techniques, exercise, etc... are effective in treating bipolar. While there is a lot of overlap in what works, I have also come to learn that exactly what works is different for each person. You really need to experiment and see what is your perfect treatment plan, knowing that it will need to change as you age and as life changes.

So, I have been looking for a book that speaks clearly and concisely about basic principles which create mental wellness while also giving room for discovering what works for you personally. Running with Nature (formerly The WillingWay), is just that book. This is one of those few books where you highlight and flag almost everything in the book and you read it over and over again so everything can sink in.

Each chapter talks about an essential element to living a well balanced and healthy life and achieving mental wellness. I will go through each chapter and highlight some of the main points.

Photo from Mariel Hemingway.com

Get Outside
This chapter is all about the benifits of being in nature which brings us closer to ourselves and the divine. One of the great suggestions in this chapter is a simple one: walk barefoot. We truly connect with nature when walking barefoot - it grounds us, and we feel the rejuvinating energy of the earth by walking upon it without rubber soles on our feet. Try it and I guarantee you will feel better in a few minutes.

Sleep Well
If you have read anything about treatment for mental illness, you will know that keeping a good sleep schedule is extremely important. This chapter explains why sleep is important and how to create an environment so you get the best sleep you can. They also talk about your natural circadian rhythm and how to honor it. Circadian rhythm is one of the things most disturbed by bipolar disorder so you have to get this on track. 

Breathe Consciously
This chapter explains the importance of breathing and also how to use breathing techniques for mental health such as alternate nostril breathing, which my therapist taught me. This technique helps balance the right and left hemispheres of the brain and helps you feel more balanced. This chapter is a great resource for quick ways to improve your mental state no matter where you are.

Live Silence
We rarely ever have silence in our technology laden, fast paced world, but without silence we can not tune into ourselves and get to know who we are. This chapter talks about different forms of meditation and their benefits. I am glad that they mention how during meditation deep emotions come up, so if you are experiencing depression, trauma, etc..., you should see a professional counselor to help you through the process. They also talk about the importance of prayer, which they define as asking our inner self, the Universe, and God (or what you find divine) for help. What I love about their prayer practice is that they say to always add at the end "For the highest good of all concerned in connection to the universe and the source of all that is." This means prayer is not about asking to get what you want, but asking for the greatest good of all. Another part of silence is turning off technology and they suggest turning it off for one day a week. This is something I want to try soon as I think it would help our whole family.

Eat Wholesome Food
An amazing chapter about how to eat good food, but not giving a prescription that everyone must eat the same way. They believe that each of us, if we pay attention to our body, can discover the right diet to maximize our wellness. I find this to be so true. While I know that the basics of a Paleo diet work best for me, there are things I need to modify for it to work best in treating my bipolar disorder. This chapter gave me the freedom to listen to myself and be my own expert. It covers such things as eating as local and organic as possible, the issues of pasteurized dairy, keeping an acid alkaline balance, healthy protein sources, gluten sensitivity, and the issue of sugar. Nothing in this chapter conflicts with what I have researched about a healthy diet for people with mental illness.

Drink Pure Water
Basically, pure water helps us in many ways by keeping us hydrated, clearing out toxins, and it gives you great skin. This chapter talks about how to actually make sure you are drinking pure water that will give you the most benefits for a healthy mind and body. I am glad they talk about the environmental impact of drinking bottled water and also some of the things you need to watch for in tap water.

Cleanse and Heal
I admit, I was a bit afraid of this chapter because there are so many detox and cleanse fads out there. Few of them are a good idea, most of them will set someone like me with an eating disorder up for increased disordered eating. Mariel addresses the issue of disordered eating and fasting, so thankfully this chapter explains the basics of cleansing and how to find what method is right for you. Too many "experts" recommend cleanses and fasting to people with eating disorders and that is a serious problem. There is a whole range of ideas from just eating mild foods for part of the day to give your body a break, to people who fast for a few hours a day. I also love that Mariel talks about the connection of food and mood, she says "I have a passion for making people aware of health, nutrition and lifestyle as it relates to mental well-being. When I eat unheathy food, I become mentally challenged and off-kilter." There is a lot in this chapter about mental wellness and food choices, it is a wealth of information.

Laugh and Play
One of the best chapters ever! As adults, we think we are not supposed to have fun and play, and we teach our kids that they need to play less and act more like adults. Mariel and Bobby quote Unitarian minster Rev. James Freeman Clark (shout out to my fellow Unitarian Universalists!) when he said: "The love of play and sport shows that amusement is evidently one of the original instincts of human nature." Having fun is essential to a well balanced life. Play games, find fun exercises, use a trampoline, laugh. Make a conscious effort to bring happiness into your life through laughter and play. This chapter has made such a difference in our lives, especially as a family. This has allowed us to focus more on finding time to have fun as a family, which also means I am participating in activities which combat the depressive side of my illness.

Adventure
This chapter talks about how adventure keeps us growing. This is also where they talk about the mental health benefits of exercise. Exercise helps combat depression and boosts cognitive ability. Keeping up with exercise means you need to pick something that is fun and adventurous, or challenging for you. Exercise is key to a good mental health treatment plan, I can not stress that enough. This chapter and the Laugh and Play chapter have really added to our lives. (Look for an upcoming post about Slacklining!)

Be Mindful in Your Relationships
Wow, a book about wellness that recognizes true wellness is not created in a vacuum! If you are in a partnership, you have to communicate well in order for both of you to maintain wellness. They talk about being honest with each other, having time together, and making time for yourself. They also talk about male and female energy, but not just that only men have male energy and women female. I acknowledge that not everyone feels there is male and female energy and so that part of the chapter may not speak to some people as much.

This is just a basic review'summary, and I don't feel it does the book justice! It has really changed the way our whole family lives, even to the point that my son told me today "Mommy, you need to get in touch with nature more" when he was asking me to play outside on this warm spring day.

Look for future blog posts that talk about the many ways in which we have implemented the principles of this book for better mental health by clicking on the Running with Nature tag/label on the right side of the blog. I am feeling so much better, with a more even mood and better ability to implement diet, exercise, sleep, and other lifestyle components after embracing the suggestions in Running with Nature.

Blessings,

Rev. Katie

Healthy Ways to Manage Bipolar Swings

I have been getting more and more off over the last week, feeling tired, disconnected, angry, and depressed. There have been triggers, but also something (we are not sure what) that is making the triggers worse than usual. So the theme of this week has been: What can we do to interrupt the downward spiral, or at least lessen the magnitude of it?

Cleveland Metroparks. Copyright Jeff Norris.

Last weekend on a particularly depressed day, my husband and son took me for a walk in the Metroparks. I was really resistant to it and it took a good half hour before I started to feel some joy again. They made sure we walked, but also had time to just sit in nature and hear the water rushing down the river.
 
We also made sure that I exercised at CrossFit three times last week. On Friday I was so angry when I woke up, and normally I would not go out in public, but Jeff got me to go to CrossFit anyway. I did feel better after the workout and it allowed me to manage later triggers in the day better because my anger did not skyrocket thanks to the exercise. Now today I woke up even more angry and also feeling physically sick due to all the junk food I ate yesterday. I finally got to CrossFit, assuming the same thing would happen as last Friday, but even just into the warmup, I could tell all my muscles were like lead and everything was just so hard to do. I got part way through the workout and stopped. I was pretty upset about that, but Jeff reminded me that even part of a CrossFit workout is normally a full work out for most people, and that I actually got there on a day when I usually would have stayed in bed. So, it is progress even if it is not as much as I had wanted it to be.

Right after CrossFit though, I felt pretty bad about ending my workout and was just an angry mess when we got home. So, Jeff talked to me, and got me to let him do the meridian work on my feet. He said the angry energy was literally burning his arms during the energy work. It did calm me down though, after I was done trying to resist it working. Then Jeff got me some food and tea and had also emailed my therapist. So, by the time my therapist called, I was doing much better and we could look at the situation and find out why it might have happened and I am looking forward to my appointment tomorrow.

Today I will still be lounging around a lot. I will make sure I don't go anywhere on my own because I don't want to end up getting fast food and making myself even sicker. I will have Jeff hide all the car keys tonight so I do not try and go to Dunkin Donuts in the middle of the night.

To some people these tactics might sound extreme or weird, but there are so many illnesses where you have to manage the symptoms, where you have to intervene to lessen the effects. What I don't think we talk about enough in mental health is that there are many non-pharmacological things you can do to stop or lessen a downward spiral. We also need to realize that we need understanding and compassionate people to help us because sometimes we can not do it on our own. If Jeff had not sat holding my feet even when I was arguing with him, I would not have been able to calm down. It took about five minutes of me trying to say this was not going to work until it did work. Even my workout this morning, I waited it out to see if it would help. And it did, because it kept me committed to my healthy lifestyle, got me out of the house, got me some exercise, and made it easier for me to calm down later in the day. Now, if I can just get in some family time, and meditation or art practice today, I think things will go even better.

Depending on the severity of your illness, managing it can be a full time job at times. It is not fun. It is tiring for everyone involved. You wish you could be like everyone else, but we rarely realize that everyone else has their issues too, we just don't know about them.

One of the things that has really been helping us add in simple things to help me is Mariel Hemingway and Bobby Williams' book Running with Nature (formerly The WillingWay). I will write a review on it soon, but basically it has many suggestions of how to calm your mind and feed your spirit, such as taking the time to sit and listen to nature, or meditation techniques. The book has made us much more mindful of the options we have for helping all of us be happier and healthier. 

So, just try anything healthy in order to help yourself manage the hard times. Even if you don't want to do it. Tell yourself you will try it for just five minutes and see what happens.

Blessings,

Rev. Katie

Movie Review: Running From Crazy

Last night at the 2013 Cleveland International Film Festival, we saw Running From Crazy, which is a documentary about Mariel Hemingway's journey to understand her family's history of mental illness. Mariel is an actress, model, and the granddaughter of Ernest Hemingway. There are seven suicides in her family, including Ernest and Mariel's sister Margot.

Photo from Running From Crazy's FB Page

This is a very good movie for so many reasons. First, there is footage from when Mariel's sister Margot was creating a documentary about Ernest Hemingway. In the footage you can really see the family dynamics Mariel speaks of from her childhood. You also hear Margot talking about her struggles, which hit so close to home for those of us with mental illness.

Second, this movie is from the perspective of one of the healthier members of the family, Mariel, trying to live within a dysfunctional family, find her own peace and her own way out to break the cycle of mental illness and dysfunction. I think it is important to hear not only from the voices of those with mental illness but from their family members as well. Mariel is so candid about her emotions concerning different family members and how she is working towards greater understanding and compassion. What is beautiful about the movie is that she is not insulting to her family, but truly seeks to understand them better and talk about the times when she may have been unkind to her sisters. She truly talks about the whole family system rather than blaming and shaming anyone. This shows in incredible amount of insight and spiritual work on her part. And she is honest that she is still working on some of those issues. She is not perfect, just like none of us are perfect.

For me personally, as someone with mental illness, I identified with much of this movie not only from Mariel's point of view but also in some of the things her sister Margot spoke of and her pain. It was healing for me to watch this movie and know I am not alone in some of my life experiences. This is why I think sharing our stories is so important. We tend to think we are the only ones stuck in a situation that is scary and we don't understand, and this creates a lot of shame. We need to know there are others out there in similar situations also striving to change dynamics, become well for themselves, and live a happy and healthy life.

Mariel talked a bit about her lifestyle as well, which she sees as essential to wellness. Rarely in the community of mental illness do you hear people talking about anything other than medication as a way to recovery. This makes it very hard for those of us who feel a different way is a better fit for them. People seem to think that I am required to take medication and I am irresponsible if I do not. Then again others say I must not really have a mental illness if I don't take medication. This is not true. I just believe that we have the ability to know what our bodies and minds need to be well and for some of us that means we need medication as well as a healthy lifestyle and for others we do not need the medication.

Our home brewed mango kombucha (fermented tea).

I loved seeing Mariel on the trampoline, being active, and talking about drinking kombucha and eating local foods. These are things that Jeff and I do, yet most people think it is weird and a very restrictive life. Mariel was also walking across a slack line, which Jeff bought a while ago and has been wanting us to try. I guess I have to try it now! It is all about finding the diet that works for you which heals your body and mind, getting out in the sun and nature, sleeping well, exercising, having fun, and having a spiritual practice in your life.

One of the hardest things about sticking with this lifestyle is that it is difficult to do if you do not live in a community that supports it. Mariel and her partner Bobby Williams created The Willing Way in order to help support other people who want a healthy lifestyle. This is important in terms of general community support but also, I find it difficult to find healthy living supporters who also understand mental illness. Many of these groups are quite unsupportive of those of us who can't just make a decision one day and stick with it forever. We are seen as weak and selfish. I think Mariel could be a great voice for understanding and acceptance for those of us struggling with mental illness who want non-pharmacological ways to reach recovery.

I recommend seeing this movie to give real insight into mental illness from a whole family perspective. It shows the reality of mental illness, but it also the hope that exists as well.

Blessings,

Rev. Katie

I Want an Off Switch!: Practicing Skillful Means in the Midst of Mental Illness

I won't go into explaining all the ways in which my bipolar is all kinds of whacky this evening- from depressed to angry and back and forth again. I will say, it feels awful. I will say that when it gets this bad, I can't hang on to all the things my therapist and I discussed such as meditating, eating well, going to sleep, using energy work to calm down.

Now, when I am not doing well, I tend to bug my husband in a myriad of different ways, and this week he is out of town. I was texting him frequently this evening, and of course he is trying to sleep at 3am so he can work tomorrow. So, he turned off his phone. This infuriates me. My irrational mind says he just does not care about me and he is a jerk. My rational mind tells me he has already responded about a million times and he is exhausted and needs to work tomorrow. I also know he is the best husband ever and is way more compassionate and helpful about my illness than most partners of people with mental illness are. It's good for him, and us really, that he turned off his phone because then there is less risk of us arguing. (Although I don't think he will like all the texts he finds on his phone when he wakes up in the morning.) When I get through this extremely bad time, my rational side will take over and I will not be angry at him anymore.

However, I was thinking that it must be so nice for Jeff to get to turn the illness off. With his phone off, he no longer needs to hear it, see it, or be affected by it. He gets to go to bed and leave it all behind. I am jealous. That must be so nice.

I don't get to turn my bipolar off. I have to live with it every second of every day and on the days when it is bad, that is excruciating. I want an off switch. I want to be able to calm my mind enough to meditate for even two minutes. I want to fall asleep. I want to be happy. I want to work tomorrow. I want to be a good mother. I would like to clean up the house so my husband comes back from his trip with no work to do. I want what every other person with most any illness wants, to be able to get rid of it.

I don't get that choice.

I do get to choose to go to therapy and keep working so that these terrible times happen less and then my bipolar will be more under control. It is not like I think I have no agency in my life. The problem is that sometimes when the illness gets so bad that it has completely taken over your mind, and in those moments you rarely have a choice. Or, the choice is to try and do the least damage to your life as possible. I don't think people without mental illness know that when we are manic or depressed, we are trying to make good choices and have agency in our life. We are trying to control it. In reality for many of us, what our brain is pushing us to do is way worse than what we actually end up doing.

It's like when you learn to ice skate and one of the first things they teach you is how to fall. It is a given that you will fall while ice skating, so if you have to fall, you learn to do it in a way that will produce the least amount of damage possible. Basically, that is what we do with mental illness. To use a simple example, I can not make myself sleep right now. My brain wants to push me to do really irresponsible things, so how can I "fall" and obtain the least about of damage possible? I try to scrapbook, watch funny movies, read something, basically do anything other than the normal manic behavior of driving all over the city at night or leaving home. (By the way, my son is sleeping over a friends house so there is no risk that I will be leaving him at home alone.)

While I don't get a switch, I know that I am lucky. It could still be worse. I have been living with this illness long enough to know how to fall without being so destructive that there is rarely ever no turning back. But I completely understand when people end up running out in the middle of the night driving to another state, or go downtown and jump in a fountain naked. Or when they drink into oblivion, or even when they commit suicide. I get it. We have no button that we can turn off and just walk away from the illness. Frankly, most people do not have access to adequate help which shows them how to fall with less damage.

Photo of Avalokiteshvara by Cea in Flickr Creative Commons

The "falling" is really what the Buddhists call skillful means. Simple put, this is the ability to adapt to your situation and be able to use whatever means necessary to navigate what is going on. My favorite Buddhist Bodhisattva is the Bodhisattva of Compassion. Kwan Yin is the female version of this Bodhisattva and the male version is Avalokiteshvara, the Bodhisattva often pictured with many hands. What most people do not know about the many handed Bodhisattva is that in each hand there is often a skillful means that he can use to help someone on their path to enlightenment such as musical instruments, bottles of ambrosia, flower, anything one might need to help end suffering. These teachings of Buddhism, skillful means, meditation, and being present in the moment is what has enabled me to learn how to fall with the least amount of damage. While I have no off switch, these Buddhist principles have given me more agency in my life even when my mind is too sick to give me much of a choice.

Blessings,

Rev. Katie

Unhelpful Advice from Professionals

Picture if you will for a moment, a doctors office. A husband and wife sit across the desk from the doctor and he has just told them that the wife has cancer. She will need surgery, weekly doctors visits, daily medication and he is not sure if the cancer is curable. This will be a long road for the couple. Then the doctor turns to the husband and says "You have a lot going on right now with work and managing your diabetes, there is no need to let your wife's issues add to your difficulties."

Now, you may not think that this doctor is all that compassionate or understanding. He basically told the husband that his wife's cancer is her illness alone and he should not be bothered with caring for her. You may think advice like this does not happen often, but it does, at least for caregivers of people with mental illness. 
 
I talk to people all over the country who are caring for a loved one with mental illness. Parents, siblings, partners, friends. The advice above is a fairly common from some people in the helping professions (ministers, counselors, therapists). I think is unhelpful at best, damaging at worst.

This advice is some form of: "Do not take on someone else's problems" or "You have enough going on in your life already, there is no need to let (your partner, child, etc...) add to your difficulties."

I understand that this is well meaning, as a way to help the caregiver put up some boundaries and make sure that they care for themselves in the midst of helping another person. This advice can also sometimes mean that as a caregiver you do not take on your loved ones insecurities, insulting behavior, or irrational thinking, if they have any of those symptoms. (By the way, having mental illness does not mean everything we do is irrational).

While the advice is well intentioned, it also comes with a whole lot of assumptions, stigma, and judgement. In fact, it is advice that I am pretty sure you would never give to a caregiver of someone with any other illness.

This advice, given mostly to caregivers of people with mental illness, assumes that mental illness is a choice. It assumes people with mental illness are just trying to make life difficult for others and that they are inconsiderate. It assumes that we have no community responsibility to care for people with mental illness, because they bring it upon themselves. This advice leads to caregivers loosing compassion and empathy for their loved one.

So, what can you say instead to get the message of self-care and boundaries across and not use a phrase that stigmatizes mental illness? How about something like: "Make sure to take care of yourself as you care for your mother and if you need help and are overwhelmed, ask for help." Then brainstorm a list of people they can ask for help when they need it. Or say: "I know your partner is saying unkind things to you, which is inappropriate. You do not need to take on their beliefs about your as your own." Suggestions like these do not assume the person with mental illness is a burden who has chosen to be a burden, and whom the loved one (who willingly entered into a relationship with this person) has no responsibility to help care for them. It is also a big assumption to think that the caregiver has no bad behaviors which might be exacerbating the situation, so don't blame it all on the person with the mental illness. You really need to look at the whole system to give good advice.

Often people argue with me that "If someone has mental illness and they have bad behavior, that is an extreme situation and unlike anything else, so you need to just walk away." Untrue. I hear couples all the time who treat each other terribly. Neither has mental illness, but they yell and scream at each other, they blame and shame. Parents call their kids "irresponsible brats" and make them feel unworthy. Parents feel overwhelmed at the daily caretaking of their kids. People with all sorts of other illnesses have bad days where they lash out at their loved ones caring for them. This is all about managing communication and environment to enable the best relationship possible so that the person with mental illness is cared for and loved and the caregiver is not burnt out and they also feel loved.

Blessings,

Rev. Katie

Movie Review: Silver Linings Playbook

Director David O. Russell and an amazing cast brought to the screen an adaptation of Matthew Quick's novel The Silver Linings Playbook. Briefly, this movie is about Pat Solatano Jr., who gets out of a mental institution after a court ordered 8 month stay. Pat has bipolar disorder, which we discover he has probably had most of his life but it was not until he caught his wife cheating on him and he beat up the man she was cheating with, that anyone truly noticed he had an illness. After Pat gets out, he lives with his parents and focuses on trying to get his wife back, but at the same time he meets Tiffany who struggles with depression and they form a friendship and ultimately fall in love. It is a serious, funny, and cute movie. Heartbreakingly sad at times, yet with enough humor and hope so as to not portray mental illness as completely tragic.

Photo from IMBD

One of the things I really liked about Bradley Cooper's portrayal of Pat is that he actually was able to accurately show how the mood swings and outbursts of bipolar are not something we do on purpose. There is a scene where Pat gets upset in the doctors waiting room and throws over the magazine rack. He then realizes what he did, says he is sorry and they have a close up shot of his face where you can see the pain in his eyes and the realization that he scared people and was acting out. He was embarrassed, ashamed, and confused. At another point with his therapist Pat says he is sick of his illness and wants to control it. Don't we all feel this way? The movie is just a real representation of how mental illness is truly an illness and not some behavior we choose. I should add that director David O. Russell made the movie for his son who has bipolar disorder. His son also has a part in the movie as a teenager who wants to interview Pat for a school report on mental illness.

I also liked the part where Pat thinks Tiffany is crazier than he is. When I was watching the movie I was thinking "I don't act like Pat does. I am not that crazy." But when we got home I asked my husband "Do I look and act like that?" and he said "Of course. Why would you think you didn't?" I guess it is always hard to see our own crazy.  

This is only a movie and so it can not get to all aspects of mental illness. The movie really captures one episode of breakdown, struggle, and treatment that ultimately becomes successful. There is what seems to be a turning point when Pat chooses to take his medication (which he was refusing to take before), as if just taking the medication and finding love with Tiffany was enough to cure him. This does not show the full spectrum of living with this illness and the fact that for many of us medication works for a little while, then doesn't, and even on med's there can be many relapses. While I like the love story, at the same time I always remember thinking, ever since I was a child, that if I found someone who loved me just the way I was that I would be cured. Well, I found the love of my life at sixteen years old, and have discovered that love alone can not conquer all. Many couples struggle with this issue and have to come to terms with treatment being long term. Even though love and care does help tremendously, it is not the ultimate silver lining. That is why I really like the musical Next to Normal because it shows the illness over a longer period of time and addresses the many issues with treatment. Of course, the ending of the musical is not as happy as the ending of this movie.

I do think the movie is very helpful for people who do not quite understand or who really need to emotionally experience mental illness. It helps combat the stigma against mental illness and shows people with mental illness as not just violent, scary, and hopeless. It shows how a community, a whole group of family and friends, really need to pull together to help someone with mental illness thrive.

The movie also shows that mental illness and the triggers for it are not only part of the patients brain, but profoundly affected by the environment around them. Pat's family is quirky with his father having some Obsessive Compulsive Disorder, anger issues, and superstition that clearly does not help Pat's illness very much. But they work with everyone's quirks and accept each other and try to help each other. In a way all of their "issues" make them understand each other better and come closer. The movie is a great example of how everyone has issues and if we recognize them we can go a long way to figuring out how to live a happy life rather than families who deny that they have any dysfunction going on at all.

Overall, this is a really great movie and I encourage everyone to see it. It is a more human experience of mental illness rather than a completely sensationalized view of it, which the media so often likes to portray.

Blessings,

Rev. Katie

Treatment Isn't Easy

Treatment for mental illness has been in the news quite a bit lately due to the Newtown, CT shooting and then a blog post that came out from a mother with a child with mental illness. There have been many responses from people with other children who have similar issues and the difficulties in getting treatment. Some say they can not get enough help, and then there is an issue brought up by one mother that we need to accept that medicaiton is a good option for kids.

I am glad we are having this conversation and I cannot say what treatments I think are the "right" ones. In reality, I think that treatment is different based on every person. And that is why I think it is important to speak to the fact that for most of us there is no easy solution to treatment.

I have had different mental health problems since I was 6 years old but did not start to receive treatment until I was 19. That means I have been at this treatment thing with psychyatrists and psychologists for 15 years. And clearly we know from my blog posts that I am not free from my illness. For many of us, treatment is just not that easy.

Photo by Jeff Norris

First there is the issue of medication. Many people think if all mentally ill people just received medication and kept up with taking it that we would all be free from our illness. You can see through many of my previous posts that medication has not worked for me and actually caused severe side effects. It is promoted by many doctors and the media that most side effects include things like weight gain, nausea, lack of libido, sleep disturbance, dry mouth, and other things that people say we can put up with in order to be free of our illness. First, unless you have experienced those side effects, you don't know that for many people they are pretty debilitating and life altering. Furthermore, most people don't tell you about those of us who have severe side effects like decreased cognitive functioning, organ failure, heart disease, and more. We can not present medicine in simplistic terms and assume it is safe and/or effective for everyone. There is always the argument from people who see better behavior in an individual on medicine and then get angry when the person goes off the medication. However, if the medicine were really working, we would keep taking it. Clearly it is not working well enough if we stop taking it. Either it is not controlling the irrational thinking enough so we think we don't need it, or the side effects are so bad that we stop taking it. Medication works for many people but we should not judge those for whom it does not work. And finding the right medication is hard. It may take 8-10 years at the minimum to find the right medications. We need to be understanding when the illness is not treated quickly and easily.

Second there is the issue of all the other lifestyle changes doctors suggest for treatment such as exercise, diet, sleep schedule, and meditation. Everyone I know, regardless of mental state, has a hard time keeping a balanced life at all times. For people with mental illness, it is especially hard to do so and we have less wiggle room for how much can get out of balance. In college, other people could barely sleep for a week and be just fine functioning. They would need a few days of extra sleep and could get right on back on track with life. For me, one night of bad sleep meant possibly weeks of worsening symptoms and I needed a lot of help to get back on track. Here again we need to be compassionate about treatment. If someone can not keep the perfect diet, keeps forgetting to take medication, has issues sleeping, etc... that does not mean they are not trying. The worst thing you can do for someone trying to make positive lifestyle choices is to argue that because they don't stick with it that they are failing and need to learn to make better choices, or that they just should not do it anymore because it is clearly not working. Our lives are worth fighting for.

Photo by Jeff Norris

Third, people also have co-occuring disorders so they may have many road blocks in their treatment plan. Such as for me diet is a huge help in my treatment but I also have a binge eating disorder which makes it very hard to stick with the right diet. If you have PTSD it can sneak up on you in times that you would not think have anything to do with a past traumatic event so watch out for that getting in the way. If you can find the link it is often something you can work through. What I really like about my therapist is that he looks at every "setback" as an opportunity to learn more about me and what we might need to work on in order to help me be healthy. That is different than the usual mentality that if you do not get better instantly you are not trying hard enough, make bad choices, and you won't ever get better.

Last, there is the inevitable "if this is an emergency dial 911" message on your doctors phone. Many doctors and other people think if you go to the psychiatric unit you will be cured, but that typically is just between a few days and a few weeks of treatment. It takes at least six weeks just to see if a medication has a chance of working for you. And there is little support for how to live life out of a treatment center. Honestly, most of us can't keep going back into the hospital and we need much more support in our every day life than most of our communities and insurance companies (if you are even lucky enough to have insurance) are willing to give us. You see a therapist and/or psychiatrist every day in a facility and then in regular life you might go to therapy once a week and see your psychiatrist once every six weeks. You have none of the outside stimulus, none of the people and situations that might contribute to your illness, and far less that can trigger you in a facility. Then you go back into the same life you had before and don't know how to manage. Going into treatment is beneficial to many people but the success rate could be even higher if we didn't just assume a few weeks in a hospital cured everyone and if we had better programming out of the hospital. Good care for a psych patient includes a plan after the hospital. A great start is if you have a loved one who is in a facility, to think about what changes you might need to make at home to help them keep up with treatment or how much assistance they might need with taking meds, eating, sleep, and exercising.

All this is to say, treatment is not simple and I don't know that we always have an understanding of how complicated it is. Some people ask me why I would write my blog if I am not "cured" or my illness is not under control. I write because my situation is much more common than we think it is. It can feel very lonely to look for resources on mental illness and often have it portrayed that there is a simple fix- if we would just take our meds and do what our doctors tell us. I wish it was not that hard. I wish there was a simple solution for everyone. Sometimes we have to just keep trying even if it does not work over, and over, and over again.

Blessings,

Rev. Katie

This Was Not Part of the "Package"

Over the last few months, a few people have asked me some form of the following questions:
Did you have your bipolar diagnosis when you married your husband?
Did he know that was part of the "package" when marrying you?

My husband and I met when we were 15 and 16 years old. We knew I was sad a lot and that I had really bad anxiety but I did not see a therapist and psychiatrist until I was 19 years old and we were in college. At that time I was diagnosed with only depression and an anxiety disorder so that was all he knew when we got married at 21. At that point I was on an SSRI and doing a bit better but then we moved out of town and I got a lot worse. I went back and forth on medications being treated for depression, not knowing I had bipolar and the SSRI's were triggering mania.

High School Graduation, 1996

Many people assume my husband has always been understanding of mental illness and supportive of my treatment but really neither of us understood what was going on and in the early years he still thought mental illness was a choice. He is a left-brained computer programmer and logic makes the most sense to him so having a wife that does not have a hold on reality was hard for him. He did not really read much about mental illness and did not go to doctors appointments with me in the beginning. We fought a lot and were not sure if we would stay together or not. We had many dark times.

We struggled like this for five more years until after our son was born and I was finally diagnosed correctly with bipolar disorder. At that point, after so many years of us struggling, he did start to do more reading and went to a few doctors appointments with me. As we went back and forth with treatment, he got more and more involved in helping me. He has always wanted to understand what I was going through but it is really hard for people who have control over their mind to really get what is happening to their loved one.

Today we still we struggle with treating my illness. (Sometimes It's Hard to Stay Together) Some days one of us is not entirely sure we should still be together. My illness was clearly not part of the "package" Jeff married. And honestly, he is not the same "package" I married either. The whole marriage "package" idea actually really bothers me. No one stays the same forever so thinking that you married a "package" is unrealistic. Both of us understood from the beginning that marriage is not perfect and the one you love will change a lot over the course of your lifetime.

For me, seeing my father go through serious illness and the other challenges my parents had, I knew that people do not stay the same forever and that marriage is hard. Life will throw sickness and many other horrific things at you, but you promised on your wedding/commitment day to get through those things together, in sickness and in health. I think the biggest problem with mental illness is that either the person with the illness does not think they have an illness and/or their partner does not believe it is an illness either. If one or both of you can not accept that this is an illness, then you do not know the correct way to manage it. You blame each other and think that you have a "deal breaker" in your marriage.

Wedding, 2000

None of us really has any idea what we are getting into when we marry/commit to someone. I have no idea why Jeff and I have been able to stay together except that when each one of us thinks about life without the other, it makes us sad. That sounds very simplistic, but it is what keeps us going. And it is not like we have not had times that absolutly would qualify as a "deal breaker" (as Dr. Phil says.) Jeff did not sign on for a wife who is sick, and will be for her whole life, with behaviors that negatively affect him.

We both agree that if either one of us was to hurt the other emotionally or physically and we were not getting help or did not admit we had a problem, that it would be wrong to expect the other person to stay in the relationship. We do believe in each other though. We believe that if either one of us is going through something, that we will take responsibility and get the help we need. The problem with mental illness is that it is extremely hard to treat so you have setbacks and you will not always be well. People with mental illness have high rates of non-compliance, which is not stubbornness or laziness, it is a symptom of the disease so it is not an illness that you treat and never have to deal with again.

In order to handle all of this, I encourage couples to go to doctors appointments together. Make sure everyone in the family is physically and emotionally safe and if they are not you may need to be apart until things are more stable but if the person is in treatment that does not mean you need a divorce. You really have to work closely with your doctors to decide the best options are for your family.

Two books that have really helped us are The Five Love Languages by Gary Chapman for general relationship help (given to us at a Couples Retreat at John Carroll University) and Loving Someone With Bipolar Disorder by Julie Fast.

Our best recommendations to couples are:  You HAVE to talk to each other. You have to see your doctor, together. You can't see marriage as a "package" that you bought and which stays the same. Don't have a big ego and either of you blame everything on the other person because both of you will make mistakes over and over again. Marriage/partnership is not easy and couples need help in order to make things work. ALWAYS ask for the help you need, and actually take the help given to you.

Blessings,

Rev. Katie

Vitamins for Mental Illness: Making a Responsible Decision

You can find all sorts of places that recommend different vitamin supplements to help with treating mental illness. Since I have had such a hard time taking regular medications, I have a new doctor who is adding in some supplements for me. I know the research really is not out there to prove the positive effects of supplements mental illnesses. The most recent studies have been done on the effect of Omega-3's on depression, indicating that it may be beneficial, but is is still not a widely used treatment. Overall, extensive research studies have just not been done on the many supplements people are recommending and doctors are really suggesting these things based on small preliminary research studies and evidence from what they have seen with their own patients. That is not to say supplements do not work, it just means we have a lot of research to do to prove, to our Western scientific satisfaction, that they do.

If you are working with a Psychiatrist that you have researched and trust who prescribes supplements, I think it is safe to try them. However, I think far more people take them on their own than really work with a MD and I think that is risky for a few reasons.

First, there is a misunderstanding that supplements and they are completely safe and both adults and children can use them because they are "all natural." That is simply not true. Supplements change the chemistry of your brain, that is why you would be using them to treat mental illness, so clearly they have an effect on you and it is possible the effect could be negative. You can take too much of a supplement and supplements can have dangerous interactions with each other and prescription medications. Also, even our doctors do not know how much is a "safe" dose of a supplement because there are really no regulations around them. 

Photo by Katie Norris

There is also a myth that supplements have no side effects. But really, anything you put into your body can have a side effect. We try supplements in order to make us better, which means they have an effect on our body, which means they can have negative side effects as well as positive. One supplement my doctor gave me to help me sleep did make me tired but also gave me extreme stomach pain about four hours after I took it, which lasted for about twelve hours. So, even though it helped me fall asleep, I woke up four hours later in pain, could not sleep, and then had to try and get through half of my work day with a chronic, sometimes immobilizing stomach ache. One thing you also have to be sure of with side effects of supplements is that many of the supplements are combinations of a few different things in  one pill. When you research side effects look up each individual ingredient to find more accurate information.

Lastly, one of the arguments against using supplements is that often some of the supplements your doctor will prescribe for you are supplements that they sell from a company they make money from. True, this could be a red flag, but at the same time, doctors also get rewards from the prescription medications they give you. I have had a few doctors that change my medication to the "latest" new drug, which often is not covered by insurance and not available in generic form often causing us to spend $600 for one drug per month. (But of course the first month is free due to the samples the doctor gives me brought to them by the drug representatives.) You really have to research your doctor to see if they are suggesting supplements because they really believe they work, or because they can make a lot of money off of them.

My point in this post is not to make you fear supplements. Obviously I think they can work as I am willing to try them. It is just to warn you from getting caught up in the hype that supplements are so natural that there are no risks in taking them and you can even prescribe things for yourself since you can go to any drug store and pick them up. If you want to try supplements, my advice is to only do so under the supervision of a Psychiatrist who takes a truly holistic and responsible approach to mental health. How do you find a Psychiatrist like that? It's hard. It takes a lot of research to find the one doctor of hundreds who truly understands and is willing to use both regular and non-pharmacological treatments.

Blessings,

Rev. Katie

Intuitive Service Dog

My Psychiatric Service Dog in Training, Rosie, is still full of puppy energy and just learning the basics of being a manageable dog. We have not even started her therapy task training and we can't really take her out in public much because she still barks at every dog she sees, but she seems to intuitively have a knack for being a psychiatric service dog.

Rosie has been very helpful to me lately, especially when my husband was in India for eight days and I was struggling a lot. She just seems to sense when I am manic or depressed and helps me out. When I am manic she usually sits right on my lap in order to help calm me down. She instinctively knows how to ground me. The weight of her body calms me down and she distracts me from my manic thoughts and behaviors.

When I am sad she licks me. Dog's lick for many different reasons but it seems telling to me that Rosie licks me when I am sad and dogs learn to lick from their mothers. It was a way to survive, a way for the mother to get the puppy breathing after it was born. When Rosie licks me she is showing me affection and helping me survive. It is like she helps me breath again.

Then the other day I was sitting on the floor doing the meridian work (meridians are channels that bio-energy flow through in your body and certain meridian points are acupressure points) my therapist had just taught me that day and Rosie came up and put her head in my lap. It was as if she knew that sitting with me would help me calm my system and balance the energy in my body.

Rosie helping me with my meridian work.

Rosie is very easy to train with all of her basic commands such as sit, place, etc... so I know her task training will be go well. Right now I am just hoping we can train her to be calm in public so I can have her with me all the time, which would be a huge help.

I have had dogs all my life and they have all helped me in many ways, but Rosie is the first one who seems to know exactly the right thing to do to help in the different stages of my illness.

Whenever I am having a hard time now, I go see Rosie or she comes to me, and that has made my mental illness a lot easier to handle.

Blessings,

Rev. Katie

Treating Mental Illness: The Mind and Spirit Connection

There is a line in my favorite musical Next to Normal, which is about a woman with bipolar disorder, that says:

"What happens if the cut, the burn, the break was never in my brain,
or in my blood, but in my soul?"

This is from the song "The Break" which is about how she has tried medications and treatments but none really work for that long and she has relapses of her illness. She wonders if maybe all of the treatment is not working because the illness is really mainly in her soul.

I named my blog "Bipolar Spirit" because I feel the body and spirit (what some call soul) are intricately linked together. (I guess I would not be a minister if I didn't believe that.) While I know mental illness is a chemical imbalance, I also believe it is an imbalance in the spirit as well.

I have been trying to manage my mental illness for fourteen years (I have been sick since I was six but only started getting treatment when I was 19) with medicines and talk therapy, and I have never really gotten better. Through all of this, I have always known that my mental illness really comes from a crushed spirit. The psychiatric profession calls it a trigger event (or events), as in a traumatic event happens and it triggers the chemical imbalance in your brain. I think the trigger causes a break in your spirit that co-occurs with the chemical imbalance. If our treatments only focus on trying to fix the chemical imbalance and not also on taking care of your spirit at the same time, I am not sure anyone really becomes well. 

I would add: "Help Heal Yourself."

I believe truly managing mental illness means possibly taking medication, going to therapy, and also becoming in touch with your inner spirit and the Spirit of Life that is all around us. I have finally found a medical practice that takes an integrative approach to medicine which will help my logical and my spiritual sides combine in order to treat my illness. While some people may think this is not a legitimate way to treat mental illness, I know it is the right way for me. I see too many people with crushed spirits to think differently. That is why my faith is so important to me, because it speaks of salvation in this life, through knowing you are loved just as you are and discovering who you are and your place in the Universe so you can live out your purpose in life. When you are able to do that, you are healthy and whole and can bring love into the world to make it a better place. Essentially, if you are out of balance, you can't really care for those around you. 

Blessings,

Rev. Katie

The Lifestyle Trade-Off

Yesterday I wrote about dealing with the trade-off between medication and side effects. Wendy, from the blog Depression Getaway, commented on my post and talked about the trade-offs not from medication, but from lifestyle changes and I realized I really should have included that topic in my post yesterday as well. As Wendy points out in her comment, lifestyle changes have a great effect on our illness and can be a treatment, just like medication is. Just like with medication though, the lifestyle changes come with trade-offs.

Some of the lifestyle changes that I have made to treat my illness and you have heard me talk about before are diet, exercise, and sleep. I also need to balance my schedule between overworking myself and having down time. I need to keep doing things that bring me joy like scrapbooking and knitting. I also need to keep up a spiritual practice which can be meditation, an art practice, journaling, etc... The trade-off to this lifestyle is that it works. My illness can be managed very well by doing all of these things. However, the other trade-off is that it is a lot of work to keep up this lifestyle.

It is very hard to find things that I can eat when we go out or are with friends. People then seem to want detailed information as to why I eat the way I do and then some people judge my choice. I also have to eat pretty regularly so might have to eat during a meeting which some people find rude. I always need to have back up food in my purse in case I can't find anything to eat. I can't stay out late at parties. Sometimes I can't travel or I need different accommodations at things like retreats which combine people in rooms because that just gives me panic attacks. I have to schedule exercise in the morning, no exceptions, even for meetings. I can't have meetings or events that last all day or late at night because I can't handle the overload of being in the public so long or I need to get to bed so I have enough sleep each night.

Taking an art break with Jeffrey. (Photo by Jeff Norris)

These are hard things to handle because it is hard to have the ability to stick with these things yourself and, in my experience, you get a lot of peer pressure not to follow through on these lifestyle changes. Whereas few people will tell you you are stupid or weird for taking medication. 

But these changes can make us better. These changes make me able to do great work, be a great Mom, and be happy and healthy. What we really need in order to help balance the trade-off of lifestyle changes being so much work is a good support system around us who helps us stick to these changes. Such as friends who exercise with us, a partner who will cook a healthy meal when we are feeling tired, people who on vacation help make sure we eat well and get sleep, workplaces that give people flexible schedules so they can work as productively as possible.

Lifestyle changes help manage your illness even when you take medication, it does not have to be one or the other. If you are not on medication though I always think you should still have a psychiatrist who you see regularly so that just in case you ever need extra help, you can get it.

So, take the plunge, make some liefstyle changes. It will take a lot of work but the trade-off is increased wellness.

Blessings,

Rev. Katie

I.C.E.: In Case of Emergency

Last night I had horrible anxiety. This weird extreme terror I have been getting for the past four months on my new medication. I was so scared and unsure of how to make myself calm down. I was having an emergency and I didn't have an emergency plan. So today I decided to make one.

Eventually last night I finally thought that instead of crying to Jeff about the intense fear and how my life might be over, I thought I should ask him to talk to me about something happy instead. The problem was that it took me forever to come up with that strategy. And, I completely forgot about my other strategy for dealing with anxiety, which is taking my anti-anxiety medication. You would think that after all these years I would know what to do when I am having a hard time. However, in the moment, you often forget what can help you. I figured in order to avoid this situation again, I should create an I.C.E.: In Case of Emergency plan.

I decorated an old cigar box with paper and then made smaller cards inside it with suggestions on each card of how to handle an emergency. I wrote down such things as: "Take my anti-anxiety medication before my anxiety gets bad." "Take a walk." "Play a simple game with Jeffrey." "Talk about something fun or happy."

Photo by Jeff Norris

My I.C.E. box is an example of the creative journaling I am hoping to share with other people with mental illness through the Finding You program which starts this coming Monday. There are all different ways that journaling can help us treat our illness either by reminding us of what our treatment plan is, or as a way to get our thoughts out instead of having them ruminate in our minds. If you are in the Cleveland, Ohio area I hope you can join me and find ways to help with your illness and create a supporting community for all of us.

What is you I.C.E. plan?

Blessings,

Rev. Katie

Fighting, Not Failure

Yet again, I have had trouble keeping up with my treatment plan. It all started with ice cream after dinner one day. It was a busy day and I said to myself that just one small bowl of ice cream is fine, I won't eat too much. Then I figured I could have a bit of dessert another day. Then Christmas came and I thought "It's Christmas, I will only have dessert today and that's it." It ended in many bowls of ice cream and dozens of cookies after a depression set it because I was eating poorly- and it was all down hill from there.

For a while I saw these times of struggling with my plan as failure. Failure to do what I need to be stable, weakness on my part for giving in to eating wrong, or spending too much money, or staying up all night. Now I know it is not failure, it is me fighting to have the life I deserve. No matter how hard it is and how many times I mess up, I will keep fighting to get better, it is the only option I have.

Now what I am coming to terms with is that I can not take a day or hour off of my treatment plan. I can't just eat a bowl of ice cream once, or stay out late because I am with friends, or skip a workout. It may seem strict to some people, but for people like me it is what we need to do to survive.

Due to my illness, I have many limitations on my life. The more I try to be "like everyone else" and have the same lifestyle other people can have, the sicker I get. Sometimes people around me see this as weak to need so many things to take care of myself and weak when I can't always follow the plan. Instead I see it as strong for continually fighting for my life.

I hope you all fight for your life as well, no matter how many setbacks you have.

Blessings,

Rev. Katie