Sunday: Forgive yourself.
Monday: Forgive your family.
Tuesday: Forgive your friends and associates.
Wednesday: Forgive across economic lines
within your own nation.
Thursday: Forgive across cultural lines
within your own nation.
Friday: Forgive across political lines
within your own nation.
Saturday: Forgive other nations.
Only the brave know how to forgive.
A coward never forgives.
It is not in his nature.
When life mugs you, robs you of what you hold most dear, leaving you for dead, how can you keep your hope alive? You can use your loss to bless someone else whose wounds are fresher than yours.
Plan twenty minutes — perhaps during a walk, after yoga or meditation, or even when sitting quietly in your home with a cup of tea.
• Think about people in your life who could use your support: loved ones, your child’s teacher, someone at work. Note that person (you can do this mentally or write it in a journal).
• Think of ways you can support that person in the next week, perhaps by having a conversation, making an introduction, gifting a spa treatment, or just letting him or her know you care.
• Over the next week act on your intent to support this person. Record your feelings as you embark on this journey.
• Having done that, and experienced what it means to give support, plan another twenty minutes to do the same kind of reflection about who can support you in your intents.
Give voice to your desire to let go of something. In your journal, write the following sentence: “I want to let go of …”
You may have a specific situation, feeling or recurring thought that is calling to be released. Write for as long as you need to, or do a series of journal entries over a week using the same writing prompt. Be willing to express the depth and range of your feelings. Trust that listening to your inner voice is a sacred and holy process, creating the receptive ground for surrender.
“Live to the point of tears,” said Camus.
That’s not so hard if you have treatment-resistant depression or any kind of chronic mood disorder. You learn to take Kleenex with you wherever you go. In the middle of a depressive episode, especially, it happens as naturally as sneezing or blowing your nose.
Two or three days of every month are tearful ones for me. Sometimes the crying is triggered by hormonal changes. Sometimes it is a release of stress. And sometimes I don’t really know why I’m crying. I just do.
Tears are healing in many ways.
They remove toxins from our body that build up from stress, like the endorphin leucine-enkephalin and prolactin, the hormone that causes aggression. And what’s really fascinating is that emotional tears — those formed in distress or grief — contain more toxic byproducts than tears of irritation (like onion peeling). Crying also lowers manganese levels, which triggers anxiety, nervousness, and aggression. In that way, tears elevate mood. In his article The Miracle of Tears, author Jerry Bergman writes, “Suppressing tears increases stress levels, and contributes to diseases aggravated by stress, such as high blood pressure, heart problems, and peptic ulcers.”
I like Benedict Carey’s reference to tears as “emotional perspiration” in his New York Times piece, The Muddled Track of All Those Tears. He writes, “They’re considered a release, a psychological tonic, and to many a glimpse of something deeper: the heart’s own sign language, emotional perspiration from the well of common humanity.”
But tears can also leave you feeling worse. Someone on my depression community, Project Beyond Blue, asked the other day: “Does anyone else experience a hangover from crying?”
The response was interesting. There were those that said once they start crying they can’t stop and feel emotionally exhausted afterward, so they try really hard not to start. Some wished they COULD cry, that meds have leveled out their emotions too much. One guy said that he can’t cry when he’s in the midst of a deep depression, so it’s a sign of recovery once he is able to shed tears.
There’s conflicting data, of course, just like there is with red wine, dark chocolate, and coffee.
Bergman catalogs the benefits in his piece mentioned above. However, the Journal of Research in Personality published a study in 2011 that found that shedding tears had no effect on mood for nearly two-thirds of women who kept daily emotion journals. Time magazine featured the study and included a quote by Jonathan Rottenberg, PhD, lead author of the study and an associate professor of psychology at the University of South Florida. “Crying is not nearly as beneficial as people think it is,” he said. “Only a minority of crying episodes were associated with mood improvement – against conventional wisdom.”
I tend to follow the wisdom of a fellow member of Project Beyond Blue who gives herself 20 minutes or a half-hour to cry. She sets a timer, and when the alarm sounds, she is done boo-hooing, and back to work. Of course, that’s easier said than done, but I think the wallowing is what depresses a person more than the tears.
Since I am a crier, and I generally feel better after a bawling session, I like to think of tears as numinous mist. Washington Irving writes: “There is a sacredness in tears. They are not a mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are the messengers of overwhelming grief, of deep contribution and of unspeakable love.”
Tears are messengers … I like that.
German study also found higher rates of schizophrenia in urban vs. rural residents.
WEDNESDAY, June 22 (HealthDay News) — People who are born and raised in cities have a greater lifetime risk for anxiety and mood disorders due to the impact that city living appears to have on two brain regions that regulate emotion and stress, a new international study indicates.
The findings may lead to new ways to improve the quality of life for city dwellers, according to the researchers.
Previous studies found that urban residents have a 21 percent increased risk foranxiety disorders and a 39 percent increased risk for mood disorders. They also have nearly twice the rate of schizophrenia compared to people who don’t live in cities, said study co-author Jens Pruessner, of the Douglas Mental Health University Institute in Montreal.
He and his colleagues in Germany used functional MRI to study the brain activity of healthy volunteers from urban and rural areas. They found that city dwellers had greater stress responses in the amygdala, an area of the brain involved in emotional regulation and mood.
The researchers also found that being raised in the city was associated with activity in the cingulate cortex, which is involved in regulation of negative mood and stress.
The study appears in the current issue of the journal Nature.
“These findings suggest that different brain regions are sensitive to the experience of city living during different times across the lifespan,” Pruessner said in a Douglas news release. “These findings contribute to our understanding of urban environmental risk for mental disorders and health in general. They further point to a new approach to interface social sciences, neurosciences and public policy to respond to the major health challenge of urbanization.”
Pruessner added that more studies were needed to expand on the findings.
Nine years ago I decided to wean off all my meds and take natural supplements instead.
One evening I was fixing a magnesium concoction, chatting with a friend. We were talking about my depression, and this new holistic route I was taking.
“You have everything you need inside you to get better,” she said.
Yeah, I suppose I do, I thought. I mean, why would God create you with some missing pieces?
A few months later my husband found me in our bedroom closet, in a fetal position, unable to move. I was horribly depressed and hiding from the kids. He begged me to change courses, to go to Johns Hopkins Mood Disorders Clinic for a consultation.
I was stubborn and wouldn’t budge. I was positive that I had everything within me that I needed to get better.
Then his voice cracked and he started crying.
“Please,” he begged me. “Do this for me.”
So I started taking pills again.
It was like the scene in the movie, “As Good As It Gets,” when Melvin (Jack Nicholson) takes Carol (Helen Hunt) out to a nice restaurant. Melvin says to her:
I’ve got this…what?…ailment. My doctor, this shrink I used to go to all the time…he says in 50 to 60 percent of the cases a pill really helps. Now I hate pills. Very dangerous things, pills. I am using the word hate here with pills. Hate ’em. Anyway I never took them…then that night when you came over and said that you would never…well, you were there, you know what you said. And here’s the compliment. That next morning, I took the pills.
Like Melvin, I hate pills. I hate them so much. I prefer looking for jewelry in my dog’s crap than taking prescriptions. However, the people I care about the most tell me that I’m easier to be around when I’m taking medication.
A few months ago, I was talking to my best friend from college. She has experienced 25 years of my mood swings, so her assessment of my mental health is extremely valuable to me. Our history allows her to place my meltdowns and freak-outs in a context that even my doctor and therapist can’t. Plus, her perspective is always interesting because she is no lover of medicine. She treats every ailment of hers and her kids holistically, with this kind of herb or that type of extract, which I’ve grown to respect.
I had just been to see a new functional doctor, who sent me home with a list of 26 supplementsthat would treat the underlying causes of my depression and anxiety. The plan was to start weaning myself off of my antidepressants and mood stabilizer over the course of the next six months, and rely solely on SAMe, Vitamin B-12, NatureThyroid, and some intestinal health support to treat my mood dips.
“But you seem good right now,” she said.
“I’m not that good. I still want to die,” I responded.
“But maybe you want to die less?” she laughed.
“I just need to get over my fear of not taking the meds,” I said. I was picturing the scene in the closet. There was a pause, which I didn’t really understand, because I know her philosophy on pills.
“Maybe you need to get over the fear of taking the meds,” she said. She went on to explain that, over the years, I have seemed more resilient when I was on the right medication combination, and that she thought my psychiatrist was very good, that I was okay to trust her.
I never thought of it that way: That I was afraid of taking the meds. I always presumed I was scared to NOT take the meds, to make that jump out of the plane — not knowing if my non-pharmaceutical parachute would work — that I was a wimp, inept at training my brain to think positive, and therefore had to take the synthetic stuff.
Obviously, the fear of taking medication is far more prevalent than the fear of not taking medication.
“I’d like to make the obvious point that I don’t think is made often enough,” said Kay Redfield Jamison, PhD, a professor of psychiatry at Johns Hopkins School of Medicine at the Johns Hopkins 21st Annual Mood Disorders/Education Symposium, “which is that it doesn’t do any good to have effective medications for an illness if people don’t take them.”
She went on to say that a little less than half of bipolar patients do not take their medications as prescribed.
I was never crazy about taking meds, of course. I fought my college therapist for 18 months before I finally gave in taking Zoloft. But moving to an affluent town on the East Coast (Annapolis), where people have the disposable income to throw at holistic experiments, has made it even more challenging. Aside from my husband and my psychiatrist, I don’t have anyone around me who REALLY believes there is such a thing as a severe mood disorder that can be life-threatening if you don’t treat it effectively, ideally with medication and other supplements (plus other things like exercise and therapy). Most folks here adhere to a philosophy that medication only masks the symptoms, and a person can’t really heal or get to the underlying causes of depression or anxiety until she is off the toxins.
Zoloft and Lithium, in other words, are lame Band-Aids.
Just the other day, for example, a well-intentioned friend approached me about seeing a healer-chiropractor who apparently can only do reiki if a person is not on meds.
“Any sort of synthetic drug blocks the energy so she can’t get through,” my friend explained matter-of-factly.
She is a kind woman with a good heart. I know she’s not trying to insult me. But those types of remarks pour salt on a wound that is forever fresh. Because part of me thinks she’s right. There’s a voice inside of me that won’t believe bipolar disorder is legitimate and that drugs like Zoloft and Lithium aren’t cop-outs.
A child psychologist I met with yesterday was explaining the two voices inside of every kid (and I add adult), and how it can prove very difficult to move forward until we totally abolish the “You suck” voice from our heads.
“Believing it just a little is going to elicit almost as much anxiety as believing it a lot,” she said.
Yikes. Really?
I think she’s right. My real battle does not exist with people on the East Cost (or West Coast) who don’t get depression or bipolar disorder. The war is within myself. I must kick the little self-doubting turd out of mind and believe that I am on the right path, that all of the sweat and tears and research and hard work of the last 43 years have guided me there.
I must believe in my own wisdom: That even though I can’t always feel the benefits of medication, that they must remain a part of my treatment plan for now.
I must trust my truth, as difficult as that can be when you live in a place like Annapolis.
Six weeks ago I woke up tired and depressed, like I have so often in the last year. All I wanted to do is go back to bed.
The negative intrusive thoughts began before my feet touched the floor.
You are so lazy, I thought to myself. You could never hold a REAL job. You can barely string together three sentences.
All I had to do that day was to crank out one quality blog before getting the kids from school, but every few paragraphs I needed to lie down.
Since I hadn’t been sleeping well for months and was used to feeling fatigued, I assumed my exhaustion and concentration problems were merely symptoms of my chronic depression.
But there was actually something more going on than depression.
“Your thyroid is not making enough thyroid hormone,” a new doctor told me over the phone that day. “That’s the first thing we have to work on, because low thyroid levels can affect a lot of things and make you feel very tired and depressed.”
As a physician who practices “functional medicine,” a science that engages the entire body to address the underlying causes of disease, she took a dozen vials of blood from me the week before as part of a comprehensive consultation.
The thyroid is a butterfly-shaped gland in the front of your neck that produces hormones that control how your body uses energy and a lot of other things, like body temperature and weight. When your thyroid is underactive (hypothyroidism), your symptoms might include:
When your thyroid is overactive (hyperthyroidism), symptoms include:
The interesting thing is that I’ve had my thyroid levels checked for eight years now, ever since an endocrinologist spotted a tumor in my pituitary gland. However, not until a comprehensive lab test was done did a doctor suggest treatment for low levels of both T3 and T4 hormones.
According to the American Thyroid Association, more than 12 percent of the American population will develop a thyroid condition. Today an estimated 20 million Americans have some form ofthyroid disease; however, 60 percent are unaware of their condition.
Many of those people will visit their primary care physician or a psychiatrist and report symptoms of depression, anxiety, fatigue, insomnia, and fuzzy thinking. They might receive a diagnosis of major depression, general anxiety, or bipolar disorder, and leave the doctor’s office with prescriptions for antidepressants, mood stabilizers, sedatives, or all three.
The drugs might abate some of the symptoms, but the underlying illness will remain untreated.
Dana Trentini, mother of two, was diagnosed with hypothyroidism the year following the birth of her first son in 2006. She was overwhelmed with fatigue. Her pregnancy weight was impossible to lose. Her hair began to fall out. And kidney stones landed her in the emergency room. She was treated by a leading endocrinologist and became pregnant again; however, her thyroid stimulating hormone (TSH) reached levels far above the recommended reference range for pregnancy and she miscarried.
In October of 2012, she launched her blog, “Hypothyroid Mom,” to help educate others about thyroid disease. “The mission of Hypothyroid Mom is clear – to drive awareness,” she writes on her blog. “The Thyroid Federation International estimates there are up to 300 million people, mostly women, with thyroid dysfunction worldwide, yet over half are unaware of their condition.”
Everyday Health featured Hypothyroid Mom in January 2014 for Thyroid Awareness Month:“How Mom’s Thyroid Problems Can Hurt Baby.” It is Dana’s life mission to bring about universal thyroid screening in pregnancy. “I will save babies in memory of my lost child,” she writes.
A friend led me to her fascinating post, “Mental Disorder or Undiagnosed Hypothyroidism?” In this post, she features a letter from one of her readers who was diagnosed with bipolar disorder and pumped full of meds, ready to undergo electroconvulsive therapy (ECT). The woman, Jana, writes: “Finally after four years of bipolar medications to the max, a close family member was diagnosed with hypothyroidism so my doctor tested me too. I have a family history of thyroid disease. I was diagnosed with hypothyroidism.”
And then Jana says something that makes me think all persons taking antidepressants and mood stabilizers should have their thyroid checked: “Every single time I attend a bipolar support group, I ask everyone if they are hypothyroid and every time half the people raise their hand and the other half have no clue what it is and they don’t know if they have been tested.”
Dana then highlights a few studies linking bipolar disorder, depression, and thyroid disease. As she mentions, the use of lithium to treat bipolar disorder complicates matters, because the medication can itself cause thyroid problems. However, plenty of research points to the connection between bipolar disorder and thyroid disease even in those who aren’t medicated with lithium, as well as the connection between different kinds of mood disorders and hypothyroidism. Dana mentions these:
A 2002 study entitled “High Rate of Autoimmune Thyroiditis in Bipolar Disorder: Lack of Association with Lithium Exposure” found that Hashimoto’s thyroid antibodies were highly prevalent in a sample of outpatients with bipolar disorder as compared to a control group.
An interesting study of bipolar twins versus healthy control twins showed that autoimmune thyroiditis is related not only to bipolar disorder itself but also to the genetic vulnerability to develop the disorder.
A 2004 study found a link between thyroid autoimmunity, specifically the presence of thyroid peroxidase antibodies (TPO Ab+), with anxiety and mood disorders in the community.
A 2005 study found that subjects with Hashimoto’s disease displayed high frequencies of lifetime Depressive Episodes, Generalized Anxiety Disorders, Social Phobia, and Primary Sleep Disorders.
For some people, thyroid treatment is straightforward and brings fast relief of symptoms. Mine has been more complicated because I take lithium for my bipolar disorder and I have a pituitary tumor. I’m extremely sensitive to medications that stimulate thyroid production: What should be a therapeutic dose for me causes insomnia. I am hopeful, however, that I will eventually find a solution.
If you suffer from depression, anxiety, or both, please get your thyroid checked. Read Dana’s post, “Top 5 Reasons Doctors Fail to Diagnose Hypothyroidism.”
An underactive thyroid can make you feel depressed, fatigued, and fuzzy brained. An overactive thyroid can cause anxiety and insomnia. If you fluctuate between the two, you will have similarsymptoms to those of bipolar disorder.
Thyroid disease may very well be at the root of your problem.
Oscar-winning actress Patty Duke died on Tuesday, March 29, at the age of 69.
“This morning, our beloved wife, mother, grandmother, matriarch, and the exquisite artist, humanitarian, and champion for mental health, Anna PATTY DUKE Pearce, closed her eyes, quieted her pain, and ascended to a beautiful place,” read a statement on her son Sean Astin’s official Facebook page. “We celebrate the infinite love and compassion she shared through her work and throughout her life.”
Duke’s agent, Mitchell Stubbs, said that the cause of death was sepsis from a ruptured intestine. Sepsis is the potentially life-threatening complication of any kind of infection in which inflammation in the body can damage organs, causing them to fail, according to the Mayo Clinic.
Duke rose to fame at age 12 in the Broadway hit The Miracle Worker, in which she played Helen Keller opposite Anne Bancroft as Keller’s teacher Anne Sullivan. At just 16, Duke received an Academy Award for best supporting actress for the film adaption of the play.
Her success extended to music and TV as well as theater and film. She starred in the popular 1960s sitcom The Patty Duke Show, and had radio hits like “Don’t Just Stand There.”
Despite her success, Duke was plagued by mental illness. In 1982, she was diagnosed with bipolar disorder, a psychiatric condition that causes a person to experience extreme shifts in mood and energy levels. She first opened up about her mental illness in her 1988 autobiography Call Me Anna. In 1992, she published another book, A Brilliant Madness: Living With Manic-Depressive Illness, in which she described what it was like to live with the disorder (which was later called bipolar disorder).
She became an avid supporter of mental health issues and collaborated with theNational Alliance on Mental Illness (NAMI) to create the Patty Duke Online Center for Mental Wellness, “a place of comfort, caring, and compassion.” Duke will be remembered as one of the first celebrities to encourage a public dialogue about mental illness.
Photo credit: Jesse Grant/Getty Images
Bipolar Support Groups.com blog 