Bipolar Off Meds Success

If it hasn't become apparent by now, I'm pretty much done with this blog. It served it's purpose, which was to get me writing again and to help me figure out just what it was I needed to do with that whole "bipolar incident".

I wanted to finish off on a positive note, though, and here it is:

A couple of weeks ago I went to my regular doctor for a "med-check", and as he was going through my records, the conversation went like this:

Dr. R: So are you still seeing the psychiatrist?

Me: No, I haven't seen him in three years.

Dr. R: And you're not taking any of the psych meds any longer.

Me: No, I went off the mood stabilizers and antidepressants five years ago…and I haven't taken trazodone in over two years.

Dr. R: And it doesn't look like you've had any mood issues in that time.

Me: No, I haven't. I've had fewer mood swings in the last three years than ever. I'm pretty sure they were caused by the aspartame in the diet soda I was drinking.

Dr. R: Really? Not the caffeine?

Me: I don't think so. I still drink tea, and it doesn't cause me any trouble. But the mood swings started when I was nineteen and started drinking gallons of diet soda a day to stay awake to study. When I stopped the diet soda, the mood swings stopped.

Dr. R: Wow. That's really interesting. So this bipolar diagnosis we have on here really isn't relevant any more. I'm going to take it off your records.

So that, my friends, is that. I am officially undiagnosed.

No prizes for guessing whether or not the psychiatrist would agree with that assessment…

I'm going to leave the blog up in the hope that it might help someone else in a situation similar to mine begin to ask questions and seek answers. While we all have to find our own answers, we don't do it in a vacuum. The people who helped me come to terms with what happened to me and helped me during the journey of figuring out just what that was all about are the authors of the blogs listed on the sidebar. Thanks to all of them, and thanks to the people out there who read my entries and asked insightful questions, provided comfort and support, and were just good blog friends in general.

Adios, dudes!

Medication Madness: A Recovery Story

Gianna first asked me to write this back in December for the Recovery Page at her blog, Beyond Meds. It was posted there about a month ago, but I thought I'd put it here, too, since this blog is kind of about reclaiming one's life after being misdiagnosed with bipolar disorder and buying into the bullshit for a while before finally seeing the light.

In retrospect, I find it interesting, tragic, and infuriating that a gp and a psychiatrist were able to take an otherwise healthy woman suffering from situation-induced anxiety with a history of two brief periods of depression probably caused by as-yet undiagnosed hypothyroidism, and parlay that into a bipolar diagnosis and a life-sentence of medication-or-else.

I'd always had ups and downs. As a child, I'd been very anxious and very creative. As a writer I'd experienced intense writing highs when I could write for hours at a time and get by with very little sleep, and I'd also experienced intense creative lows where my mind seemed to be mired in muck and I couldn't eke out a single sentence for weeks on end. It never occurred to me to medicalize of pathologize that behavior...it was just part of me and who I was and how I operated.

In the fall of 2003, I went to my gp to get something to help me sleep. I'd taken Ambien before, when I had my creative periods and just couldn't get the wheels to stop turning long enough to fall asleep, and figured that was probably what I needed. At the time, we had a very difficult, anxious family situation going on—my best friend, who was in the process of getting a divorce, had moved in with us, and had promptly met and began an affair with my then-married brother-in-law, putting me smack in the middle between her and his bewildered wife. When I lay down to sleep, I couldn't stop thinking about what was going on and how to fix it. When I went to see my gp for help, my regular doctor wasn't there, and I had to see one of his partners. I was running on maybe three hours of sleep a night for the past week, and felt like I had way too much energy for having had that little amount of sleep.

The doctor asked me if I'd ever been depressed. I recalled two six-week periods, on in 1999 and one in 2001 when I had felt really down, unmotivated, and exhausted. Each of these periods of "depression" resolved on their own without medication. Sure, I'd felt horrible, but I was a young mother stuck at home with two small children and no car (let alone no time to write), which hadn't exactly been part of my career-oriented game plan. The doctor decided that I might be bipolar and asked me how I felt about seeing a psychiatrist. I was a bit surprised, but figured she probably knew what she was talking about and said I would make an appointment. She told me it would probably be a number of weeks or possibly months before I could get in to see anyone and that she would prescribe something for me to take to "bring me down" until I could get an appointment.

She gave me Zyprexa.

She also drew blood for a thyroid test, saying it was possible that my thyroid levels were high.

I managed to get an appointment with a psychiatrist six weeks out. In the meantime, I thought it wouldn't hurt to do some research on bipolar disorder. What I learned did not make me very happy. I read the DSM laundry list of symptoms of bipolar disorder, and realized that I had had all of those symptoms at one time or another. I began going through my journals and noting times when I had been down and times when I had been unusually creative or energetic. No pattern emerged, but there were an awful lot of ups and downs.

A week after my initial appointment with the gp, the thyroid results came back, and I learned that my thyroid levels were low and that I would need to start taking Synthroid. This was no surprise, really, as my mother had been diagnosed with the same thing years ago. But I have to wonder now just how long that had been going on, and whether it might have played a part in those two periods of "depression" I'd experienced a few years earlier.

The Zyprexa took a week or so to kick in, but it did seem to help. By the time I went to see the psychiatrist, I was sleeping better and my anxiety levels had come down somewhat (former best friend had moved in with brother-in-law, so I wasn't having to deal with that situation on a daily basis), though they were still a lot higher than normal. When I finally went to see the psychiatrist, I believed I had educated myself about bipolar disorder, and was fully prepared for him to diagnose me and medicate me. After a 45 minute interview, this man whom I had never met before and knew nothing about me other than my answers to his standardized questions, diagnosed me with bipolar II and told me that I would need to start medication immediately and that I would need to take it forever.

He did not once ask about anything that might be going on in my life.

To his credit, he wasn't too thrilled that the gp had prescribed Zyprexa. "We don't like Zyprexa," he told me, "but I'm sure she was just trying to help." He prescribed Depakote for the mood swings and trazodone (an older antidepressant with the helpful side effect of making one extremely sleepy) to help me sleep.

In my research, I had read that many writers and artists who had been diagnosed with bipolar disorder refused to take medication because it stopped them from being able to create. I told him I was a writer, and I was concerned about my ability to write while on medications. He gave me a condescending look and said, "Depakote won't kill your creativity." I took my prescriptions and dutifully made an appointment to see him again in four weeks.

At my next appointment, I told him I was still feeling a lot of anxiety, although I was sleeping better. He prescribed Lexapro, an antidepressant, because he said it would help with the anxiety and that he was concerned that untreated anxiety might lead to depression.

I swallowed all the propaganda, hook, line, and sinker. I became a student of my moods. When I felt good, I was "hypomanic" and needed to call him and ask him to increase my Depakote. When I felt lousy, I was obviously becoming "depressed" and needed to have more Lexapro. There was no room for normal, human emotions in my illness, for any emotion I felt might be the herald of disaster. My doctor told me on every appointment that the medications were "saving my life" and that if I ever stopped them I would ruin my life.

My Depakote dose went up and up and so did my weight. Within six months I had put on sixty pounds, and within a year I was suffering from terrible pain in my feet from plantar fasciitis, which the foot doctor whose advice I sought told me had been brought on by gaining so much weight so quickly. He prescribed orthotics and stretching exercises, but also told me that it was likely that I would not find a whole lot of relief until I lost some of the weight. I tried the orthotics, I tried the stretching, I tried to lose weight, and finally I submitted to painful cortisone shots, which brought some relief, but alas, only for a few weeks, and then the pain would return.

Pain became my constant companion. It was so bad that many evenings I was in tears. I couldn't be on my feet for more than ten minutes without excruciating pain. Housework had to be done in fits and starts. Grocery shopping became a nightmare, and I had to strategically plan shopping trips that would keep me in just one area of the store for the minimum amount of time. I missed out on taking the children places like the zoo, the science museum, and the amusement park because I just couldn't be on my feet for that long.

Soon after starting the Lexapro, my moods began to cycle rapidly. During my first year on Lexapro, I experienced three depressive episodes and two hypomanic episodes. My doctor took this as validation that being on medications was the right course, because obviously my illness was worsening, and it was a good thing we'd caught it before things really went off the rails.

It never occurred to me that the medications might be the cause of the mood swings.

As the doses of medication increased, my mind started to shut down. Where once I had possessed a rapier wit, now it was all I could do to get the right word out without stuttering. My hands shook and I couldn't do the fine needlework I'd always taken pride in. And worst of all, my verbal abilities disappeared. I couldn't write. I couldn't remember things. I couldn't even find the right words half the time. I also lost all interest in sex, and I found myself unable to care about anything. Life just drifted by, and nothing ever seemed to touch me. In fact, the only time I really felt anything was when my moods cycled up or down.

But I had to keep taking the medications, right? Because if I stopped, I'd "ruin my life", and I was damned lucky that we had caught this problem before things got really out of hand. A doctor had told me so, and he was Educated and Informed, so he had to know what he was talking about, right? After all, he was a professional psychiatrist—an expert on mood disorders--and a professor at a respected university, to boot. I could trust him...right? And after all, my mood swings had become much more frequent and much more severe in recent months. All proof to me that I was doing the right thing.

As time went on I became more and more drugged and disillusioned. I couldn't write anymore so my dreams of writing and publishing novels for a living went down the toilet. By the fall of 2004, over-medicated and overweight, the future no longer seemed bright and full of colour and energy. It looked cold and numb, the colour of ash. And I had pretty much resigned myself to the idea that this is my life now. I have bipolar disorder and I'm lucky to have a life at all.

I tried complaining to my psychiatrist about some of this, but although he listened, I do not think he ever really heard me. And he had an answer for everything:

"I'm concerned about the amount of weight I'm putting on," I told him at one appointment. "When do the risks of carrying around this extra weight outweigh the benefits of taking the medications?"

"You are taking the best medications we have available," he told me, and his manner made me feel like an ungrateful child asking for a second helping of dessert.

"What about going off the medications for a while and seeing what happens?" I persisted, aware that weight loss wasn't going to happen on Depakote—I'd already been trying, and was having no luck.

He gave me a severe look and said, "You are an intelligent woman. Your episodes have been more frequent during the last year, and you know that if you stop taking your medications, you will ruin your life."

Eventually, in the winter of 2005, after months of me pestering him at every visit, he finally agreed to let me try Lamictal. I was very excited at the prospect, because I had read that Lamictal was not as sedating as Depakote—I might actually be able to think and write while on this drug—and it was weight neutral, so I might be able to lose weight as well. I was instructed to cut my Depakote down over a few weeks from 2500 mg to 1000 mg, and then start the Lamictal, then taper the rest of the Depakote after I was up to 100 mg of Lamictal a day. Within three months, if all went well, I would be off the Depakote entirely.

Unfortunately for me, I developed the dreaded Rash, and was told to stop the Lamictal immediately. Cold turkey. I was on 100 mg at the time, and stopped as instructed. A week later I came down with the worst "flu" I'd ever had and was in bed for six weeks with the worst fatigue I had ever felt. I was so exhausted I could barely get off the couch to stagger to the bathroom. I didn't have the energy to make dinner or do laundry, or anything I normally did. My husband had to take over pretty much all the household chores as all I was capable of doing was lying on the couch sleeping 18-20 hours a day. At that time I'd never heard of Lamictal withdrawal, and my doctor had not mentioned anything about the risks or symptoms associated with stopping it so abruptly, and so I assumed I'd had a rotten bout of flu. I know better now.

So the Lamictal experiment had failed, but I was down to only 1000 mg of Depakote, and was beginning to be able to think a bit more clearly. My memory was better and I didn't feel like I was groping for the right words all the time. The shakes had mostly gone away, although I still couldn't do really fine needlework. And I was starting to care about things again. I felt so much better on the lower dose that I told my doctor I wanted to stay there for a while. He agreed.

The turning point came that spring when my husband suffered a severe heart attack. In a cold, numb daze, I dealt with it. I called the ambulance, I called the neighbor to take care of the kids, I drove (with my terrible sense of direction and fear of getting lost) into the big city to a hospital I'd never been to before, and I held it together. I didn't cry. I didn't feel much of anything, actually.

Fortunately, my husband survived. He had a catheterization procedure done, which he came through with flying colours, and was out of the hospital within three days. But I still couldn't feel anything. I couldn't even cry, and I knew that wasn't normal.

At that point, I decided that I'd had enough of being drugged numb. I was completely unable to respond to normal human emotion, and I began to fear that I was not able to respond to my children appropriately. When I told my doctor that I was concerned about the fact that this traumatic, life-changing event had occurred and that I had been unable to react to it, his response was, "Well, the medication protected you."

Yeah. Thanks ever so, doc.

That was my last visit to him. Without having a clue what I was doing, I tapered my medications down over the next month, and by the summer I was off of Depakote and Lexapro. I was still taking trazodone to help me sleep, because I still believed I had bipolar disorder, and that I needed to do everything in my power to stay stable. I embarked upon a program of healthy living—excellent nutrition, supplements, regular bedtimes with trazodone to make sure I got my sleep. I even gave up caffeine. I'd been a regular Diet Coke drinker for years, but I knew that caffeine could mess up my sleep, and I'd had it hammered into my brain for the last year and a half that proper sleep could be the difference between stability and a manic episode. When I was on the medications, caffeine was often the only thing that allowed me to see through the drug fog long enough to get the kids off to school in the mornings, but with the dulling effects of medication gone, I found that I didn't need caffeine any more. For exercise, I started a simple yoga routine because that was about the only thing I could think of that didn't involve impact that would hurt my feet. I found that I enjoyed yoga a lot, and this naturally led me to an interest in meditation, which I added on to the end of my yoga program.

The first week completely off meds was rough. My emotions were all over the map. But I refused to pathologize them. I told myself that I'd had everything deadened for the last year and a half, and that I had to become accustomed to feeling things again. I told myself that I had a year and a half of chemically suppressed emotion that I needed to deal with, so I let myself cry, I let myself feel whatever it was I needed to feel, and embraced the fact that I could feel at all. After that week, things eased up and I began to feel more like my old self.

I began to lose weight slowly, and the yoga had an unexpected benefit—even before I had lost much weight, the pain in my feet began to ease up (although it did not disappear entirely until I had lost thirty of the sixty pounds I'd put on). Soon I was able to go back to my usual activities, and even take short walks.

I was still taking trazodone, and I still believed that I had become that most dangerous of creatures, an Unmedicated Bipolar. Months went by and I was still unable to write. I was afraid that something, either the bipolar disorder or the medications, had damaged my mind, destroyed my creativity. I tried everything to bring it back, but nothing seemed to work. The ability to write seemed to be intact, but it didn't move me that way it once had, there was none of the sparkle I recalled, and I lacked the drive to do the one thing that I had once believed to be my life's purpose.

A couple of years passed. I was still taking trazodone, and I lived in constant fear that I was going to have an "episode" and not be able to control myself. Eventually, the fear got to me and I decided that, knowing how long it takes to see a psychiatrist, it might not be a bad idea to have one on board, "just in case." I found one not too far from my house, and went to see him. Even though I had been stable off medications for nearly three years, he wanted to put me back on medication. I told him I would consider it, but I also told him point blank that I refused to take anything that would make me gain weight or make me stupid. He named three medications—Abilify, Lamictal, and Trileptal. I told him about my past Lamictal problems (the rash, at least, not the withdrawal symptoms, as I still believed it had just been a nasty bout of flu), and he suggested that if we increased the dose much more slowly and without Depakote present that things might go better. He told me to research the medications he had suggested and we would discuss them next time.

However. In my research I came across Phil Dawdy's Furious Seasons, and Gianna's Beyond Meds, and after doing much reading and thinking, I decided that this new psychiatrist had a hell of a lot of nerve suggesting that I ought to be on medication when I'd been completely stable on just trazodone for nearly three years. And in fact, I decided that I didn't want to be on trazodone anymore either, because from what I'd been reading, it just might be responsible for my lack of enthusiasm for writing.

My trazodone taper was a lot smarter than the others. It took me about four months to go from 200 mg a day to nothing. I had headaches for a few days every time I lowered the dose, and I had a couple of weeks somewhere in the middle where I'd have scary flashes of suicidal thoughts. But I persisted, because during this time, I was reading recovery stories and looking into alternative mental health solutions, and realizing that drugs might well have been part of the problem rather than the solution.

In my reading, I also came across some information about the artificial sweetener Aspartame being implicated in mood disorders. When I thought back over my own history, I realized that my mood swings had started in college, soon after I'd turned to diet soda as a study aid. I'd never liked coffee or tea, and didn't want the calories in regular soda, so Diet Coke became my drug of choice. More importantly, those mood swings had stopped when I'd stopped drinking Diet Coke.

As I write this, I've been off mood stabilizers for over three and a half years, and off of trazodone for about six months. My enthusiasm for writing seems to be returning, and I feel better and more stable than I have in years. The mood swings that followed me through college and beyond are gone, and I've felt neither depression nor hypomania since stopping mood stabilizers and aspartame. I am incredibly grateful to Gianna and others who have shared their recovery stories on her site, because if I hadn't found this resource, I might well have listened to that second psychiatrist last year, and allowed him to frighten me back onto the medication merry-go-round.

I no longer live in fear that I am going to lose control or that the Bipolar Monster is going to rear its ugly head and ruin my life. I no longer believe that I have untreated bipolar disorder. I accept the fact that I had symptoms of bipolar disorder, but as more and more time passes with no recurrence of these symptoms, I become more and more convinced that these symptoms were caused by a toxic reaction to Aspartame, and have nothing to do with bipolar disorder.

For a while, I was pretty angry. Angry that drugs like Aspartame could be put into the food supply because they were supposed to be "safe". Angry that I could be diagnosed with a major mental illness so quickly and easily by someone who had never met me. Angry that the diagnostic criteria for this life sentence left no room for life-circumstances and that the doctors I saw never asked about anything beyond those narrow criteria. Angry that my doctors saw medications as the only treatment options available and refused to consider alternatives. And mostly angry at myself, that I bought into the whole thing in the first place, that I listened to doctors without questioning. That I bought into mainstream media perceptions. That I was a sheep. Baa...

But you can't stay angry forever, and my yoga practice has helped me to accept what happened and to make peace with it. I had to go there to get here, and I like where I am now. That which does not kill us can make us stronger...and perhaps wiser, if we are open to learning from it.

Today, I've lost about forty-five of the sixty pounds Depakote packed onto me, and my feet no longer hurt—I can now do some of the higher impact activities I used to enjoy. I'm starting to write again, and rather than feeling angry, I'm starting to feel like I had a pretty lucky escape.

Hopefully reading my story might help someone else start to think and to question...and maybe give them the inspiration to stage their own lucky escape.

The Stories We Tell Ourselves

The stories we tell ourselves about ourselves have so much power over us. They shape our self-concept, mold our identity, because in the ways that count, we are what we believe we are.

So it's important for me to decide which story I want to believe about my "bipolar" adventure. That "manic" episode I had that was so out of control, that drove me to a psychiatrist and into chemical restraints...which story do I tell myself about that? Which one is my truth?

Do I tell myself that it was bipolar disorder? That the mood swings I experienced from ages 19 to 40 were due to that? But there is no family history of bipolar....depression, yes, but not bipolar. And I'm not even having mood swings any more...haven't had any for four years now...even my psychiatrist is calling me an anomaly. So I don't think that's the right story.

Do I tell myself it was just me letting off steam after having been trapped at home with infants for 7 years, and finally tasting freedom? A partying mid-life crisis sort of thing? But that smacks of complete irresponsibility, something I've never been known for. Knowing myself for what I have been for most of my life, I cannot quite buy into this story, either.

Do I tell myself that I had bipolar symptoms due to my ingesting large quantities of aspartame? That seems to make the most sense of any of the stories. But somehow there seems to be something wrong with this one, too...like maybe it's a cop-out, an easy way to absolve myself of responsibility for some of my behavior...

It all seems so clear in retrospect, doesn't it? I should have done this, I should not have done that...

I need to tell myself a new story that will not make me feel like crawling under a rock or beating my head on the ground for being so stupid...problem is that I'm still not sure what the real story is...and upon reflection, I'm not so sure it's about figuring out the story at all...because the past is immutable...what happened--happened. I can't change it now. What I can change is how I look at it. My perspective.

So maybe it's about acceptance rather than story...I need to:
* stop beating myself up...the past cannot be changed, much as I might like to change it.
* accept that I probably had a toxic reaction to chemicals I was putting in my body because I didn't know any better.
* accept that modern medicine--especially psychiatry--does not understand nearly as much about the human psyche as it thinks it does.
* accept that I did the best I could with the information I had.

Whew...that's a lot of acceptance there. But I think that's what I'm needing. Acceptance.

Why is acceptance so hard?

Writing Prompt: It seems that it is much easier to accept things about other people than it is to accept things about ourselves. What things in your life are you still trying to accept? What do you think makes acceptance so difficult sometimes? What can you do to make acceptance easier?

Knowing When to Slow Down

Part of being well and staying well is knowing how to pace yourself. Sometimes we load too much on our plates and then we get stressed out and don't do any of the things we're trying to do to our satisfaction.

My sleep is still disturbed after my trazodone withdrawal, and I'm trying not to take anything to help because I feel like then I'm just trading one chemical for another. As a result, I'm a little more tired than usual, and a little less alert.

I think I need to slow down and be kinder to my body and mind.

I am not doing well with coming up with anything to say today. In addition to it being summer and having the kids home all day and needing attention, I have a couple of other projects going--coming up with the curriculum notes for my journal class this fall, and working on a book about bipolar disorder and wellness strategies. I think I need to post a bit more sporadically...so I will try to get something up a few times a week, but I think I need to slow down a little...I'm running out of steam, I don't want to push myself so hard that I end up dropping the blog entirely. I'll still be visiting your blogs, but I don't think I can keep up the pace I've set so far!

Writing Prompt: How do you know when you are trying to do too much? What signals does you body give you? What signals does your mind give you? Do you listen?

Positive Feedback and Goals

One of the things that has helped me stick with my wellness routines--such as eating healthy, exercising, meditation, and sleep hygiene--has been the positive feedback I've received. And I'm not talking about positive feedback from other people--I'm talking about the positive feedback I'm getting from my own body.

Since I put these routines in place, I have lost 45 lbs, and the benefits of this are enormous--I no longer huff and puff going upstairs; I don't get a sweat rash on my thighs in the summer; my feet don't hurt anymore, and I'm actually finding that I'm able to do exercise involving some impact work, something I thought I'd never be able to do again.

I also have a lot more mental clarity. Some of this is due to stopping the psych meds I was taking, but I am convinced that a large part of it is due to my instituting a sleep schedule and being absolutely rigid about sticking to it. Getting the right amount of sleep is extremely important for your mind and body.

My moods are much more stable, and I attribute this to my stopping aspartame, stopping antidepressants, eating a much more nutritious diet, and getting myself into a regular exercise routine which includes yoga. I also have a greater sense of peace, and a greater sense of contentment. I think that my mental health is better now than it has been for most of my adult life.

The only problem with this scheme is that it has been slow to incorporate and slow to show results. The difference over time is amazing... but it has taken a long time for me to fully incorporate these wellness activities into my life, and a long time to see results. And I still have times when I backslide. I've been working on losing my Depakote weight for two years now, and I'm still not finished (I'm close, though! Fifteen pounds to go!). I know intellectually that losing weight slowly through a combination of sensible diet and exercise is the safest, most-likely-to-be-permanent way to lose weight, but it has not been easy, and I would like to see those numbers going down faster!

So while it's nice to have someone notice that I've lost weight, it's even nicer to be pain free and to feel happy and content most of the time. When I get impatient, I just have to think about all the positive feedback I'm receiving from my mind and body--and that's enough to keep me going.

Writing Prompt: Many things that are worth achieving take time, and in our culture of quick fixes and I-want-it-now, a lot of people don't have the patience to work slowly towards a long-term goal. Are there any long-term goals you have been putting off working towards because they look so big and so impossible? Reaching those goals is a matter of small steps, taken successively.

When I started losing weight, my long-term goal was to lose sixty lbs. Sixty! Even at a healthy two pounds a week, we're talking the better part of a year, and that was assuming I could lose two pounds a week. So I broke it down into smaller parts. I wasn't going to concentrate on losing sixty pounds, I was going to concentrate on losing the first five. Losing five pounds was a small amount that I felt I could lose in a reasonable amount of time.

What is a small, positive step you can take today towards achieving a long-term goal? Is it possible to break the goal down into smaller parts that don't look as daunting? What is a reasonable way to break it down?

Unsticking Yourself

Beyond Meds has an interesting post up today about a Newsweek article in which Dr. James Gordon is interviewed. Gordon is the author of the book "Unstuck: Your Guide to the Seven-Stage Journey Out of Depression."

I read the interview, and it really struck a chord with me because these are exactly the recovery methods I used to get myself off of bipolar meds and to stabilize myself: excellent nutrition, plenty of exercise, and meditation.

The fact that Gordon has had success working with people suffering from PTSD is particularly encouraging, as the number of people with wounded psyches coming home from Iraq increases.

Gordon's method sounds like plain old common sense to me, although I suspect it will be a hard sell to a culture that would rather pop a pill than do the hard work involved in a radical lifestyle change. Still, it's nice to see some alternatives to medication getting some press. It's important for people to know that there are other ways to get through depression than to take potentially dangerous medications.

Writing Prompt: What are some small, common-sense things that you can do to improve your quality of life right now? Remember, they don't have to be big things...some ideas: coming up with three things to be grateful for, or three things that you find beautiful, every single day. Taking a ten minute walk...or a five-minute walk, if that is all you can manage. Lighting a candle and sitting quietly for a few minutes watching the flame and centering yourself. These are all small steps we can take toward wellness...and even a journey of a thousand miles begins with a single step.

Identity Theft

One of the most insidious effects of my bipolar diagnosis was the way it robbed me of my identity...

I was not suicidal, nor was I psychotic, or even a whole lot out of control. I initially went to my GP because I couldn't sleep. I hadn't slept more than a few hours for nearly a week, and wasn't feeling tired, and I figured that wasn't normal, I ought to be exhausted...so maybe I better get this checked out. I was also under an enormous amount of stress, and my anxiety levels were sky-high due to some extremely stressful Family Bullsh*t that was going on at the time. Did anyone ask about that? No. Instead, I was asked if I'd ever been depressed. And since I said yes (although I'd never been diagnosed or medicated for it), I was sent home with Zyprexa and Ambien, and told I should call a psychiatrist.

This led to an ever-descending spiral of self-doubt. In my reading, I learned that my writing highs--those times when I could just let go and write for hours on end--were actually "hypomania". And those times when I felt like I just loved life and really enjoyed everything I was doing--that was "hypomania", too...so the last two or three years of my life, which had been wonderful, happy years in which I felt productive, and excited about my future, suddenly took on the sinister aspect of an "illness". Which must be "managed." I learned that if I ever felt that way again--exuberant and loving life--that I should talk to my psychiatrist immediately, because I urgently required a "medication adjustment." And that if I didn't have my medications adjusted, the hypomania could steamroll on into full blown "mania" in which I would be completely out of control and need to be hospitalized (even though I had never been close to being "out of control"). I also learned that if I felt just a little bit sad, I needed to consider that a "warning sign" and to talk to my doctor because I might be getting "depressed". Which would require that another medication or three be added to my "cocktail" in order to prevent me from becoming so ill that I might kill myself (even though I'd never really considered that seriously before). Overnight, my perception of myself went from creative, confident and happy to "very sick and in need of medication for the rest of my life."

For the next two years, I would be haunted by the question, "How much of my personality is me and how much is it?" The answer, according to my psychiatrist, was that a lot of my drive, my energy, my productivity, and my creative whirlwinds could be attributed to it. So I figured whatever was left over once the medications were working, that was probably the real me. And since I lost my ability to think, laugh, create, write and enjoy life once I was medicated, I began to think that the real me wasn't worth very much, was she? She was actually a hopeless, dull-witted, exhausted lump who couldn't even speak without stumbling over her words, and didn't want to do anything but sit on the couch.

Life was pretty dismal for those two years. I no longer had the capacity to enjoy life, and the medications I was taking actually made me more sick. My moods began to cycle, and within a year I'd had three "episodes" each requiring that my medications be adjusted (read "increased") and that new medications be added. My doctor pointed this out to me as proof of just how sick I was.

I am so glad that I retained enough clarity and sense of self to say Enough. Unfortunately, it took a near-tragedy to shake me back to my senses (my husband's heart attack and my inability to respond to it in any sort of normal way). But however it happened, I did finally see the light and realize that my misplaced trust in psychiatry was only making me sicker, and that there had probably been nothing wrong with me in the first place that a little therapy or education in stress management wouldn't have taken care of.

I stopped taking medications over a very short period, probably too short, but then I didn't have much in the way of medical support--my psychiatrist's view of stopping medications was that it would be "stupid" and that I would "ruin my life". He didn't say It would be a bad idea, but if you're hell bent on doing it, here's how to do it safely, no, he just said Don't.

When I came off of meds, I was a mess. I had no idea who I really was anymore. After being told that all the things I had loved about myself were due to my illness, my self-confidence had taken a serious hit. I was terribly overweight and out of shape and dreadfully ashamed of myself for having let myself get into that condition. It took a long time for the anger to fade, for me to accept what I'd allowed to be done to me. And in some ways, I think I am still working on that acceptance, because the anger is still smouldering away in there.

After I was off most of the drugs, my sense of self, my sense of humor, and my ability to enjoy life slowly returned over a period of a few months. It took a longer time for my creativity and my confidence in myself as an artist to return--after all, I'd been told that all of my artistic achievements were actually manifestations of my "illness". For a long time I wondered if my drive to create--to write and to "make stuff"--would ever come back, or if the medications had damaged my brain in some subtle way and I'd never be able to create again--or worse, even want to.

Thank goodness I took my life back into my own hands. I dread to think where I would be now if I hadn't. I certainly wouldn't be myself.

Writing Prompt: Has there ever been a time in your life when your identity, your sense of self, was threatened by a label, an event, or a person/group? How did you deal with it and in what ways did this experience change you? If you've never experienced a threat to your sense of self, what sort of event do you think it would take to do this? Where are your vulnerabilities?

Thoughts on Wanting Wellness

Susan, the Bipolar Wellness Writer had an interesting post up yesterday about wanting wellness. Her key question to people who are on medication for bipolar disorder or depression but who are not moving in the direction of wellness is "What are you doing besides taking medication?"

It's a good question because so many things feed into our health and well-being, and taking medication is only one of them. I have a friend who has been battling depression on and off for most of his adult life. He takes medication when the depressions come on but other than that has done nothing to change his lifestyle, which is incredibly stressful both in terms of his emotional well-being and his physical health. It is frustrating to watch him lose hope and lose heart when there is so much else that he could be doing for himself. But he is not willing to make any of the changes that might help him.

Or is it that he is not able to make those changes?

I am reminded of the place I was in three or four years ago. Bipolar medications made me so ill that I was unable to do the things I knew I should be doing. I had no energy, no motivation, no clarity of thought. The things that would have been good for my body--like eating more healthfully and exercising--were beyond me, as I literally had not the energy to do them. Planning healthy meals was an exercise that was beyond my mental capabilities...and cooking healthy meals was beyond me physically--because of the 60 lbs I had put on (due to the medications) I was suffering from painful tendonitis in my feet, and was unable to stand for more than ten minutes at a time. The things that would have been good for my spirit were also beyond me--I was too mentally dulled to do much of anything. Writing would have helped me a lot, as that is the way I process things and gain insight...but Depakote took that ability away from me.

I wanted wellness badly at that point. I wanted to have the energy and clarity to care for my family, I wanted to be able to do the creative things I'd always done. But I was not able to do any of the things that would have moved me in that direction. Because I trusted my doctor, I believed that the choice was medication or illness and chaos. There was no middle ground, and I was not encouraged to do things that might minimize the amount of medication he thought I needed. I was not able to make healthy decisions for myself until I decided to trust myself and stop the medications that were making me so sick.

I think that our doctors need to take more responsibility for making sure that we have the ability to pursue wellness. Drugging us into oblivion may make them feel safer, but it is not conducive to wellness.

Writing Prompt: The pursuit of wellness often requires us to make sacrifices. Sometimes it's something as simple as sacrificing some of your hard-earned free time to exercise when you'd really rather be doing something else, or perhaps sacrificing your favorite foods because you know they are not good for you. Sometimes these sacrifices have a far deeper impact, both on yourself and the people around you--like cutting toxic relationships out of your life or making a decision to pursue an alternative treatment for an illness that those around you may not approve of. What have you sacrificed in your pursuit of wellness?

Books

I know I said I wasn't going to post this weekend, but mother-in-law snuck out early this morning before I was even awake, and Little Mouse was so exhausted from the "sleep"over that she is still sleeping. It is quiet and I have thoughts...my own thoughts, even!

Books have played such an important role in my life. I have been an avid reader since I was very small. In our house, we don't have broadcast or cable television--our TV is used only for DVDs and video games, and even their use is limited. Many evenings will find all four of us sprawled across various couches, together, but each absorbed in their own book. I still read to my children every night before bed, even though my oldest is nearly thirteen, and they still look forward to this ritual very much, and are sad when circumstances do not permit us to do it.

Some books I adored as a child and read over and over again, like "The Swiss Family Robinson", and an old English novel by Ethel Noakes called "The House of Many Pages." It has been a joy to introduce my own children to these books, and to say reverently, "These books belonged to your grandfather when he was a little boy, so you must be very careful with them."

Books by Ray Bradbury, Sylvia Louise Engdahl and Octavia Butler opened my young eyes to the endless worlds of fantasy and science fiction, ignited the fires of my imagination, and started me down the path of telling my own stories.

Some books have come along at just the right time...Ann Maxwell's "Timeshadow Rider" came into my hands just after I broke up with my first love. It restored my faith in love eternal, and made me believe that my soul mate was out there and that I would one day find him.

Some books I feel I owe a lot to, given how they have changed (or even saved) my life. Pamela Peeke's "Body for Life for Women" and Julia Cameron's "The Artist's Way" got me off my butt and got my feet firmly on the path to wellness and health after I stopped taking my bipolar meds and needed to reclaim my mind, body and creativity.

Books by Marion Zimmer Bradley, Mercedes Lackey, and Lois McMaster Bujold are like old friends that I return to again and again.

Writing Prompt: What role do books play in your life? What books did you love as a child? Which books opened your eyes to new worlds and new possibilities? What books have you read that still haunt your dreams? What books have you read more than once?

Writing as Meditation

My friend Gianna over at Beyond Meds was up at 3 am last night writing out her anxieties over a trip she is taking this morning. Her post got me thinking about all of the times I have done exactly that--sat down feeling all wound up about something, scrawled my anxieties or pain or fear (or sometimes all three) across several notebook pages, and come out on the other side feeling, if not better, at least better able to handle the situation.

I don't think you have to be a writer or a long-time believer in the power of journaling to benefit from this sort of catharsis. I think that a torrent of words at the right time can have extremely healing and beneficial effects. I have used writing when I've been in the middle of a difficult situation. Writing helps me sort out what, exactly, is going on, and what, exactly, I'm reacting to. And it helps me figure out what I might do to ease my way through whatever it is I'm going through. It's something you can do, as opposed to just letting events take you where they will...and I'm all about doing something when I'm in the midst of a crisis.

And that's fine for those highly emotional moments when you just need to get it out. But what about for the everyday parts of your life? I have found writing to be an excellent form of meditation. Julia Cameron talks about writing as a form of meditation in the books from her "Artist's Way" series, which include "The Artist's Way", "Walking in this World", and "Finding Water", and also in some of her other books, including "Vein of Gold". Cameron calls it Morning Pages, and Morning Pages are three pages of longhand writing that you do every morning, first thing. They don't have to mean anything, they don't have to be about anything, they don't have to be pretty or spelled right, because nobody is going to see them but you. They are basically a brain dump. Whatever's on your mind, put it down, and you don't ever have to look at it again if you don't want to. It's about the process, not the product. My Morning Pages are usually pretty banal: I can't believe it's morning already. I wish I was still in bed. There is too much to do today and I don't want to do any of it: vacuuming, laundry, grocery shopping...I absolutely don't want to grocery shop because that means I have to figure out what we're going to eat and I don't know what we're going to eat because those kids won't eat anything...

Writing in this way, every morning, feels like meditation. It's part of my routine. It sets me up for the day. I come away from it feeling refreshed and ready to start my day. I suppose it does take a bit longer than your ten-minute mindfulness meditation... but for me, writing is how I make sense of my world, and so for me, writing is a perfect form of meditation.

Writing Prompt: Set aside twenty minutes or so and do a brain dump. Just write whatever is on your mind no matter how mundane or boring. Even if you have nothing to say, write that. The trick is to just keep your hand moving the pen across the page for twenty minutes. When you have finished, sit in silence for a few moments and ask yourself how you feel. Do you feel more collected? Less scattered? Consider whether or not a morning brain-dump might be a helpful thing to add to your arsenal of wellness tools.

You Are What You Eat

Naturalgal has been running a series on foods that are healthy and foods to avoid. Reading her work and talking with my psychiatrist the other day got me thinking...

I find it interesting that my psychiatrist has never asked me about my diet. Nor does he have any interest in which supplements I am taking. Now, admittedly I'm not taking anything exotic, but so many substances that are marketed as "supplements" have the potential to cause harm or interact with psych meds that I find it curious that he does not ask.

It strikes me that part of the reason most psychiatrists don't want to look too closely at diet is that the typical western diet is so bad for you that for most people, eating healthier would mean a huge lifestyle change. And let's face it, it's easier to get people to take a pill every day than it is to get them to change their habits.

But all of the brain chemicals involved in psychiatry's pet theory of chemical imbalance--namely the neurotransmitters like serotonin and dopamine--are made by the body from the materials it has at hand, meaning whatever has gone into the mouth recently. And so it makes sense to me (although I am not a biochemist or a nutritionist) that if you are giving your body junk for building blocks, the quality (and quantity) of the things it can make from those building blocks may not be optimal.

Looking at all the junk that's out there on the shelves at the grocery store, it amazes me that the average human lifespan keeps increasing. Our bodies are extremely resilient, and they'll keep running for a long time, even if we do fill them with crap. But damage is occurring whether we notice it or not.

Maybe if our bodies just balked and stop performing when we ate junk--like a car with a gas tank full of water--then we'd all be a lot more mindful about what we put in our mouths.

Writing Prompt: While our bodies need good food to run optimally, our minds/souls/spirits also need to be nourished. What things do you do to nourish your spirit and keep it healthy? Could you do more? Are there things you'd like to try but haven't? What things get in the way of nourishing yourself?

D is for Depakote

I've been visiting some of the websites that I have listed on the sidebar under "Resources", and I've been thinking about trying art journaling...pictures and words. I've collected a lot of art supplies and scrapbooking supplies over the years, so it's not like I would have to make a substantial investment to get started. I just need to get myself past the critic in my brain that says, in glaring neon letters, Yes, but you're not the least bit artistic. It'll be a Disaster. With bells on. You'll do it completely arse-backwards and They will all laugh and tell stories about it to Their grandchildren.

Well, last night, I said to the critic, "Yes, well, you're just a disembodied brain with bright red duck feet and horn-rimmed glasses. What do you know about Disaster? Especially Disaster with bells on?" And with that I took up my coloured pencils and began to colour my world. Or at least my thoughts.

So I thought then that I would try to draw my impressions of my whole bipolar nightmare. And I had all these clever, arty ideas about the whole manic/depressive dichotomy, black vs. light, light and dark, day and night, all very cliche, you understand.

So she puts pencils to paper and begins...

And what comes out is this brightly coloured amorphous creature of light and colour and movement trapped behind criss-crossing barbed wire, and everywhere that two pieces of wire meet there is that grey pill with the stylized "D" on it.

D for Depakote. D for Doped up. D for the Dreams and the Days lost. D for the Darkness in my soul. D for the Doctors and Drug companies that do this to thousands of people like me every day.

Wow. Um. Yeah. That was unexpected. So obviously I am still angry and still bitter and still not at peace with that whole chemical restraint and over-medication and doctors who think they know best thing.

And here I thought art journaling was just pretty pictures.

Writing Prompt: Creativity is one of the most powerful tools we have. It can aid us in healing and recovery, and it can brighten our lives and even become our life's focus. To what unexpected places has your creativity led you?

Putting Myself Back in the World

I feel as though I am at some sort of cusp or turning point. For the last three years--since The Chief's heart attack and my subsequent liberation from chemical restraints--I feel as if I have been curled up inside myself. In a state of hurt bewilderment, I've been laying low and licking my wounds.

But over the last year or so there has been a gradual opening up, a reclaiming of territory I once thought of as mine. Medication and several emotional wounds turned my beloved home territory into a dangerous, alien landscape...but slowly, it seems, I have begun to reach out. I took a chance and invited someone I met at a school function over for tea one afternoon, and over the last year, a deep and mutually beneficial friendship has blossomed. I started writing again, and trusting myself to just do it, like I used to. And although my interests have changed, the passion is still undeniably there. And today I mailed off my application to teach a journal workshop of my own design through our local community education program, and I feel like that is the culmination of all of that healing work I've been doing...putting myself back into the world, as it were.

The Journal Series: Some Thoughts on Truth

I really thought I was done with this series yesterday, but I guess not. I need to stop taking showers. I get too many good ideas in the shower...

Truth in fiction is the story's truth. It's what makes a story resonate with what you know to be true. Truth in fiction has nothing to do with make believe and everything to do with making us believe.

And then there's the other kind of truth. The one you sometimes have to ask yourself how much of you really want. This kind of truth is for journal writing. This is the kind of truth that can hurt people.

Truth can cut deep. Is your first loyalty in writing truth to yourself or is it to the people in your life whom you love/hate/want to protect? This is where privacy comes in. If you're going to write your truth, you need to protect yourself and others by making sure people who could be hurt by your words don't have access to them.

There is never only one truth to any story. Each of us has our own version of the truth, each of us puts a unique spin on a story that is seen through the filters of our own individual set of experiences. So your truth of an experience will not be the same as the truth of the other people involved.

Truth is what I try to write in my journals. But I'm well aware that what I'm writing is only my truth. Others experienced the same events completely differently. Their story is not mine. But my story is the only one that's going to help me find my way.

Truth is what you should aim for in your journals. Not someone else's truth. Not the truth you think or have been told ought to be yours. Not the politically correct truth, or the truth that isn't going to hurt anyone. The real truth. Your truth.

Even if it hurts.

The Journal Series: Distance

I was going to wrap up this series yesterday, with my post on resources, but a comment left on Sunday's post got me to thinking that there's more to be said. Well, there's always more to be said, but I thought this in particular, was worth saying.

On the subject of the Altered Point of View technique, Lynn had the following to say:

"For myself, I have found that trying to understand another person's point of view was not always healthy for me. I think that is because of whose point of view I was trying to understand. For me, it was a way to make excuses for other people's hurtful behavior and that blocked my access to my own real feelings about it. I was a mess without knowing the truth of my feelings. I think it was easy for me to do that, though, because the feelings were so unpleasant."

Lynn brings up a good point. Sometimes, I think, if we try to process experiences before we are ready, it can do more harm than good, and it's not always easy to know when you have enough distance from an event to write clearly about it. It's one of those things where you have to trust yourself, I think. And I think, too, that as you write more and get to know yourself better, you get a feeling for when you have enough distance from an event to really analyze it.

I find that when I am actually going through an unpleasant experience, my writing tends to be more cathartic than anything--whining and complaining and raging against whatever or whoever it is that has hurt me or made things difficult for me. At that point, and often for a long time after, I am too close to the event emotionally to process it in a rational way. So I let myself whine without trying to analyze too deeply.

Sometimes you have to let yourself whine for a long time.

I am only now coming to the point where I can begin to face and process the events that led up to my bipolar diagnosis (the Big Mania), and that was nearly five years ago.

So writing about things that have happened to us in order to heal isn't just about getting it down on paper the minute it happens--although that catharsis is very helpful. Writing to heal is also about examining those events and your reactions to them after you have gained some emotional distance. Time helps us heal, and it gives us perspective.

How much time varies from person to person, but I think that if you are journaling regularly, you are going to know when you are ready. It's a question of learning to trust yourself.

Please note that I am not promoting this sort of thing as a substitute for therapy. If you're trying to process something really traumatic, professional guidance is definitely a good idea.

The Journal Series: Some Resources

One thing I've found inspiring through the years is reading other peoples' ideas on journal keeping. I've read a number of books on the subject, and found them all to be helpful. Sometimes I pick up a new technique, sometimes I just gain some new insight into what I'm doing. What follows is a list of some of the books on my book shelf. I've checked on Amazon (but I'm far too lazy to put all the links in here!), and all of these are available, although some of them may only be available used.

The New Diary by Tristine Rainer (my favorite)

Writing the Mind Alive by Linda Trichter Metcalf and Tobin Simon

Write Your Heart Out by Rebecca McClanahan

Harvesting Your Journals by Rosalie Deer Heart and Alison Strickland

Notes From Myself by Anne Hazard Aldrich

Keeping a Journal You Love by Sheila Bender

One to One by Christina Baldwin

Writing Your Authentic Self by Lois Guarino

At a Journal Workshop by Ira Progoff

I've only recently started hunting down websites on journaling and on writing to heal, so I'm afraid I don't have much to offer in that department, but the following sites look interesting, and you might want to check them out:

One Year of Writing and Healing

Self Help Healing Arts Journal

I'm sure there are others out there, I just haven't put much time into hunting them down yet, but if you should find something good, shoot me an email or leave the address in a comment.

The Journal Series: Some Techniques

In this installment, I describe a few of the different techniques that can be used by journal keepers to get to the heart of the matter. Sometimes it's easy to write about what's bothering you...other times, it's harder to get a handle on your thoughts and get the words out. At these times, it can help to use a different technique than a straightforward free-write.

Unsent Letters: An unsent letter is just what it sounds like--a letter that you write to someone else, which you don't intend to send. This technique is valuable because it allows you to speak to that person directly without fear of their reactions. You don't even need to write an unsent letter to a person...you can write to yourself in the past or future, you can write to a body part that's troubling you, you can write to a situation...anything you can name, you can write to.

Lists: Lists can be a very powerful tool. When I'm feeling down, I have challenged myself to come up with a list of 100 things I love. As a self esteem booster, you can write lists of things you are good at or things people like about you. Or you can list things you'd like to do in the future, goals, dreams, ideas...even a simple to-do list for the day.

Altered Point of View: Sometimes, when trying to understand a situation involving other people, you run into difficulties because the only head you are actually in is your own. This is where writing from an altered point of view can help. If you are in conflict with someone, or trying hard to understand where they are coming from, try writing about the situation from that person's point of view. If nothing else, it will give you a fresh perspective.

Dialog: A dialog is a conversation between two people...or two things. You can write a dialog between yourself and someone else or between different parts of yourself. When I was in graduate school and feeling the pressure of two opposing forces within, the poet and the engineer, I wrote many dialogs between logic brain and creative brain, in an effort to seek balance.

Tomorrow I'll finish out the series with a list of resources--books and websites that I've found helpful.

The Journal Series: Getting Started

All you need to get started is a pen and a notebook. Or some form of computer software--you can use a word processor and password-protect your files, you can use Life Journal, software specifically designed for journal keepers, or, as Gianna suggested in yesterday's comments, start a blog and keep it set on private so that no one but you can read it. You can start a blog with blogger or wordpress, and I'm sure there are others out there, too.

For those who want to go the pen-and-paper route, there are many fancy blank books out there, some with lines, some not. Personally, I prefer a spiral notebook with a sturdy cover, so I can write with it balanced on my knee if I'm out and about. I don't spent a lot of money on my journals because I always feel if I've got this lovely, expensive leather-bound book, then whatever I write had darn well better be worthy of that lovely, expensive leather-bound book...and of course, it won't be, will it? In short, I get performance anxiety.

So grab a notebook that appeals to you and a pen that writes nice and dark, and moves easily across the page. Open the notebook, put the date at the top of the page, and start writing. Don't worry about quality--we're not writing a novel or poetry, we're not making art here, we're not letting anyone else see this stuff--it's for your eyes only. What we're doing here is letting out feelings, we're synthesizing input in an attempt to make sense of the world, we're whining about our problems, and maybe starting to make sense of them and think about solutions...

The most important part of this process, at least in the beginning, is to give yourself permission to write badly, to write ungrammatically, to write in whatever manner you need to in order to get whatever it is out of your head and onto the page.

But what do you write?

There's really no magic formula here: you write whatever happens to be on your mind at the time. But I'll give you some thoughts...

Natalie Goldberg ("Writing Down the Bones") suggests you write in ten-minute bursts (using a timer), and give yourself writing prompts: Write about a sunset. Ten minutes. Go...Write about your favorite food. Ten minutes. Go...Write a about a time when you were unhappy. Ten minutes. Go... Depending on what areas you want to explore, you can make up your own prompts to get you started.

Julia Cameron ("The Artist's Way") suggests Morning Pages, which are three pages of longhand writing done every morning. The idea is not to edit or put a lot of thought into it, but just write whatever comes into your head, and follow your train of thought as best you can, keeping the pen moving the whole time.

A professor I had in college liked the "Ten Minute Autobiography" exercise. You have ten minutes to write your autobiography. You can give an overview or you can focus on one specific event, or anything in between, but you only have ten minutes. I've done it a number of times, and I've found it amazing how my focus shifts depending on what mood I'm in and what's been on my mind lately.

I have used a method in which I pose myself a question to get me started, such as, Well, Jazz, why are you feeling so edgy today? and then I write about that and try to explore what might be causing that feeling and what I might do to help myself.

I usually start my day with Julia Cameron's Morning Pages. I begin by writing, It's Saturday (or whatever day it is) and we have way too much to do today...or It's Monday and I'll be glad to get these kids out the door... And it just goes on from there, a steady stream-of-consciousness sort of thing. Sometimes it meanders into something big that's going on in my life, sometimes it's just a sort of a game-planning session for the day, but regardless of what I write, I always come away from it feeling ready to start my day.

The Journal Series: Privacy

If you are going to do journal work that allows true healing to occur, then you must have a safe place in which to do it. And that safe place must be a place that you and those who may live with you know is inviolate. Self-censorship does not belong in the pages of your journal, because if you are afraid of your work being discovered, you will not write the truth.

Privacy is a touchy issue, but I feel that it is essential to have a sense that the work you do in the journal truly is for your eyes only. Privacy not only protects you, but it protects others--because if you are going to write the honest truth, there is always the potential for writing something that will hurt someone else. And truth is essential to the healing process.

So how do we protect our privacy? Sometimes trust is enough. I trust my husband not to read my journals. I've been leaving them lying around ever since we shared our first apartment twenty years ago, and he's never read them. (I don't think he's interested enough, to be honest...) I do not, however, trust the kids not to get into them. Children are curious by nature. So now that the children are old enough to read and begin to understand, my older journals are kept in a locked file cabinet.

But what if you don't have a file cabinet that locks, or you don't trust someone in your household not to go snooping? Or what if you live with someone who would be hurt if they thought you were keeping secrets of any sort from them? What if you don't feel that there is any way to keep your journals private?

Since the journal serves its most important role in allowing you to get rid of and process feelings, destroying what you've written is one way to protect your privacy. I tend not to like this method just because it can take more than one session to work through something, and it helps to have your earlier work to refer back to.

I think the computer offers the best solution to the privacy issue. Microsoft Word allows you to password-protect your files. This is not an ideal solution--I've tried journaling this way, but the file soon becomes huge and unwieldy, and it's difficult to find anything unless you can recall specific phrases you used. There is, however, software designed specifically for journal-keeping. I use a software package called Life Journal. Life Journal allows you to keep your work private with a password, and allows you to assign topics to entries, the way you can in a blog. In fact, I use Life Journal to draft my blog entries, because of that feature. It helps me find things in a hurry.

Having said that, I must also say that I have a strong preference for a pen-and-paper journal. Maybe it's because that's how I started out. When I started keeping a journal and writing, there was no such thing as a word processor. There was me and my notebook and my pen. And there is something about the physical act of writing my words down, having my thoughts flow from my mind to my hand to the page, that is therapeutic for me. So I still keep a paper journal. But...if I am doing work that I feel might be too intense, or work that I would never in a million years want anyone to see, I go to the computer and call up Life Journal. Because when I'm working in pen and paper, I do censor myself. No matter what I tell myself about trust and all that...I honestly feel safer working in a password protected environment. And if I don't have that feeling of safety, the tough work isn't going to get done.

The Journal Series: Why Keep a Journal?

Many people think of a journal as a diary. But journaling to heal ourselves isn't so much about leaving a record, as in a traditional diary ("Hot and sunny today. Beans for dinner again. Don't like beans."), but more about learning about ourselves and those around us by detailing and puzzling through the chain of events that makes up our lives.

Journaling with the intent to heal is more about process than it is about product. Yes, it is nice to have a record of where you've been, and reading over the things you've worked through can be helpful, if only to remind yourself of how far you've come. But my sense of it is that the journal serves its main purpose in the moment and then you move on to the next moment, hopefully having gained some insight to bring along with you.

The journal was where I first began to suspect that I had a problem with my moods. It was where I raged and screamed against my bipolar diagnosis. It was where I debated the pros and cons of going off of medication against medical advice. And it is where I continue to go every day of my healing journey.

I journal because it helps me make sense of my life. It gives me a lot in terms of self-knowledge and self-understanding...and if I can be honest with myself--not always easy, even in one's own private journal, to be truly honest--I get more insight out of my journal than I ever got out of therapy.

So...why journal? Because it can be cathartic--the journal is a place to safely release emotions and thoughts that may not be appropriate for those around you to bear the brunt of. Because it can help you gain insight--by examining your thoughts and feelings, sometimes it's possible to identify negative patterns that need shifting. Because it can give you a map of how far you've come, and help you figure out where you need to go next. Because it can help bring order to sometimes chaotic thoughts and emotions. Because it can be a place to brainstorm and problem solve. Because it is always there for you, and it is never judgmental. For all of these reasons and more, a journal can be a powerful tool for healing and a powerful adjunct to talk therapy.

In coming installments, I'll talk about how to start a journal, and about privacy issues. Then I'll present some of the different tools that can be used within the journal to gain insight. And if anyone's interested, I could list some specific journal exercises to get you started. Let me know.