Mental Health Archives 2008

A CONDITION TO LIVE WITH
(Bipolar Disorder)

Denial is the first and worst symptom.

Your doctor gives you the news.. you have a chronic disease. How do you react? Your heart catches. Air rushes out of your lungs. Your fists and throat tighten with emotion. But your mind makes all the noise. It silently insists, "no! You must be mistaken... sure I feel lousy, but it couldn't be that"
You have entered the first - and perhaps most dangerous -stage of your chronic disease: Denial.

You refuse to admit this disease is now a part of your life. This is a natural reaction - no one wants an incurable illness. It's difficult to believe that no pill, no operation, and no amount of time will banish it.
But you may be able to control this disease with your doctor's help, calm its symptoms and get on with your life - unless you flounder in denial.
What's so dangerous about denial? When you deny the disease, your self-care becomes erratic. You block the road to feeling better, you shut out your doctor, and your health deteriorates. You settle for a life of illness.
"You have a choice," says Nancy Sanders. "You can choose to control the disease, or you can let it control you. Either you can learn to cope or you can feel hopeless, guilty and crippled."

As for fear, Ms. Sanders believes it is crippling. "Knowledge erases fear," she says. "To move ahead you need to raise your expectations of what you can do...never accept mediocrity."
• Learn as much as you can about the disease.
• Consider counseling.
• Meet with other people who have your chronic disease.
• Laughter is always good medicine.
• Don't depend on your doctor to drag you out of denial. He'll try, of course, but denial is a personal enemy you have to meet yourself.
Condensed from Family Health Update/

The Key to Happiness
By Dot Holladay

TODAY

Today I smiled, and all at once
Everything didn’t appear so bad.
Today I shared with others
The love and hope I had.
Today I sang a joyful song
And felt my heart grow light.
Today I loved a little more freely
And complained a little less.
In the giving of myself
I found peace and happiness.

TODAY

Outside my window, a new day I see,
And only I can determine what kind it will be.
It can be busy and sunny, laughing and gay,
Or boring and cold, unhappy and gray.
My own state of mind is the determining key,
For I’m the only person I let myself be.
I can be thoughtful and do all to help,
Or be selfish and think of just myself.

I can enjoy what I do, make it seem fun,
Or gripe and complain and make it hard on someone.
I can be patient with those who may not understand,
Or belittle and hurt them as much as I can.
But I have faith in myself, and believe what I say
And personally intend to make the best of each day.

WAYS TO REDUCE STRESS

author unknown
thanks to Susan Grant

50 Tips On The Management of Adult Attention Deficit Disorder

. by Edward M. Hallowell, M.D. and John J. Ratey, M.D.

Editor's Note: You may distribute this content electronically or in print if you include the following statement at the top of the article so that it is visible to all readers.

Terms of Use: This educational material is made available courtesy of the author and Attention Deficit Disorder Resources, a non-profit organization based in Tacoma, whose purpose is to help people with Attention Deficit Disorder achieve their full potential. We have numerous materials as well as a quarterly newsletter for sale. Phone: 253-759-5085
Address: ADD Resources, 223 Tacoma Av S #100, Tacoma WA 98402
E-mail: office@addresources.org; Web Site: www.addresources.org

The treatment of ADD begins with hope. Most people who discover they have ADD, whether they be children or adults, have suffered a great deal of pain. The emotional experience of ADD is filled with embarrassment, humiliation, and self-castigation. By the time the diagnosis is made, many people with ADD have lost confidence in themselves. Many have consulted with numerous specialists, only to find no real help. As a result, many have lost hope.

The most important step at the beginning of treatment is to instill hope once again. Individuals with ADD may have forgotten what is good about themselves. They may have lost, long ago, any sense of the possibility of things working out. They are often locked in a kind of tenacious holding pattern, bringing all theory, considerable resiliency, and ingenuity just to keeping their heads above water. It is a tragic loss, the giving up on life too soon. But many people with ADD have seen no other way than repeated failures. To hope, for them, is only to risk getting knocked down once more.

And yet, their capacity to hope and to dream is immense. More than most people, individuals with ADD have visionary imaginations. They think big thoughts and dream big dreams. They can take the smallest opportunity and imagine turning it into a major break. They can take a chance encounter and turn it into a grand evening out. They thrive on dreams, and they need organizing methods to make sense of things and keep them on track.

But like most dreamers, they go limp when the dream collapses. Usually, by the time the diagnosis of ADD has been made, this collapse has happened often enough to leave them wary of hoping again. The little child would rather stay silent than risk being taunted once again. The adult would rather keep his mouth shut than risk flubbing things up once more. The treatment, then, must begin with hope.

We break down the treatment of ADD into five basic areas:

Diagnosis

Education

Structure, support, and coaching

Various forms of psychotherapy

Medication

In this pamphlet we will outline some general principles that apply both to children and adults concerning the non-medication aspects of the treatment of ADD. One way to organize the non-medication treatment of ADD is through practical suggestions or "tips" on management. Fifty such tips are presented below:

Insight and Education

Be sure of the diagnosis. Make sure you're working with a professional who really understands ADD and has excluded related or similar conditions such as anxiety states, agitated depression, hyperthyroidism, manic-depressive illness, or obsessive-compulsive disorder.

. Educate yourself. Perhaps the single most powerful treatment for ADD is understanding ADD in the first place. Read books. Talk with professionals. Talk with other adults who have ADD. You'll be able to design your own treatment to fit your own version of ADD.

. Coaching. It is useful for you to have a coach, for some person near you to keep after you, but always with humor. Your coach can help you get organized, stay on task, give you encouragement or remind you to get back to work. Friend, colleague, or therapist (it is possible, but risky for your coach to be your spouse), a coach is someone to stay on you to get things done, exhort you as coaches do, keep tabs on you, and in general be in your corner. A coach can be tremendously helpful in treating ADD.

. Encouragement. ADD adults need lots of encouragement. This is in part due to their having many self-doubts that have accumulated over the years. But it goes beyond that. More than the average person, the ADD adult withers without encouragement and positively lights up like a Christmas tree when given it. They will often work for another person in a way they won't work for themselves. This is not "bad", it just is. It should be recognized and taken advantage of.

. Realize what ADD is NOT, i.e., conflict with mother, etc.

. Educate and involve others. Just as it is key for you to understand ADD, it equally if not more important for those around you to understand it--family, job, school, friends. Once they get the concept they will be able to understand you much better and to help you as well.

. Give up guilt over high-stimulus-seeking behavior. Understand that you are drawn to high stimuli. Try to choose them wisely, rather than brooding over the "bad" ones.

. Listen to feedback from trusted others. Adults (and children, too) with ADD are notoriously poor self-observers. They use a lot of what can appear to be denial.

. Consider joining or starting a support group. Much of the most useful information about ADD has not yet found its way into books but remains stored in the minds of the people who have ADD. In groups this information can come out. Plus, groups are really helpful in giving the kind of support that is so badly needed.

. Try to get rid of the negativity that may have infested your system if you have lived for years without knowing what you had was ADD. A good psychotherapist may help in this regard.

. Don't feel chained to conventional careers or conventional ways of coping. Give yourself permission to be yourself. Give up trying to be the person you always thought you should be--the model student or the organized executive, for example--and let yourself be who you are.

. Remember that what you have is a neuropsychiatric condition. It is genetically transmitted. It is caused by biology, by how your brain is wired. It is NOT a disease of the will, nor a moral failing. It is NOT caused by a weakness in character, nor by a failure to mature. It's cure is not to be found in the power of the will, nor in punishment, nor in sacrifice, nor in pain. ALWAYS REMEMBER THIS. Try as they might, many people with ADD have great trouble accepting the syndrome as being rooted in biology rather than weakness of character.

. Try to help others with ADD. You'll learn a lot about the condition in the process, as well as feel good to boot.

Performance Management

. External structure. Structure is the hallmark of the non-pharmacological treatment of the ADD child. It can be equally useful with adults. Tedious to set up, once in place structure works like the walls of the bobsled slide, keeping the speedball sled from careening off the track.

. Make frequent use of:

lists

color-coding

reminders

notes to self

rituals

files

Color coding. Mentioned above, color-coding deserves emphasis. Many people with ADD are visually oriented. Take advantage of this by making things memorable with color: files, memoranda, texts, schedules, etc. Virtually anything in the black and white of type can be made more memorable, arresting, and therefore attention-getting with color.

. Use pizzazz. In keeping with #15, try to make your environment as peppy as you want it to be without letting it boil over.

. Set up your environment to reward rather than deflate. To understand what a deflating environment is, all most adult ADD'ers need do is think back to school. Now that you have the freedom of adulthood, try to set things up so that you will not constantly be reminded of your limitations.

. Acknowledge and anticipate the inevitable collapse of X% of projects undertaken, relationships entered into, obligations incurred.

. Embrace challenges. ADD people thrive with many challenges. As long as you know they won't all pan out, as long as you don't get too perfectionistic and fussy, you'll get a lot done and stay out of trouble.

. Make deadlines.

. Break down large tasks into small ones. Attach deadlines to the small parts. Then, like magic, the large task will get done. This is one of the simplest and most powerful of all structuring devices. Often a large task will feel overwhelming to the person with ADD. The mere thought of trying to perform the task makes one turn away. On the other hand, if the large task is broken down into small parts, each component may feel quite manageable.

. Prioritize. Avoid procrastination. When things get busy, the adult ADD person loses perspective: paying an unpaid parking ticket can feel as pressing as putting out the fire that just got started in the wastebasket. Prioritize. Take a deep breath. Put first things first. Procrastination is one of the hallmarks of adult ADD. You have to really discipline yourself to watch out for it and avoid it.

. Accept fear of things going well. Accept edginess when things are too easy, when there's no conflict. Don't gum things up just to make them more stimulating.

. Notice how and where you work best: in a noisy room, on the train, wrapped in three blankets, listening to music, whatever. Children and adults with ADD can do their best under rather odd conditions. Let yourself work under whatever conditions are best for you.

. Know that it is O.K. to do two things at once: carry on a conversation and knit, or take a shower and do your best thinking, or jog and plan a business meeting. Often people with ADD need to be doing several things at once in order to get anything done at all.

. Do what you're good at. Again, if it seems easy, that is O.K. There is no rule that says you can only do what you're bad at.

. Leave time between engagements to gather your thoughts. Transitions are difficult for ADD'ers, and mini-breaks can help ease the transition.

. Keep a notepad in your car, by your bed, and in your pocketbook or jacket. You never know when a good idea will hit you, or you'll want to remember something else.

. Read with a pen in hand, not only for marginal notes or underlining, but for the inevitable cascade of "other" thoughts that will occur to you.

Mood Management

. Have structured "blow-out" time. Set aside some time in every week for just letting go. Whatever you like to do--blasting yourself with loud music, taking a trip to the race track, having a feast--pick some kind of activity from time to time where you can let loose in a safe way.

. Recharge your batteries. Related to #30, most adults with ADD need, on a daily basis, some time to waste without feeling guilty about it. One guilt-free way to conceptualize it is to call it time to recharge your batteries. Take a nap, watch T.V., meditate. Something calm, restful, at ease.

. Choose "good", helpful addictions such as exercise. Many adults with ADD have an addictive or compulsive personality such that they are always hooked on something. Try to make this something positive.

. Understand mood changes and ways to manage these. Know that your moods will change willy-nilly, independent of what's going on in the external world. Don't waste your time ferreting out the reason why or looking for someone to blame. Focus rather on learning to tolerate a bad mood, knowing that it will pass, and learning strategies to make it pass sooner. Changing sets, i.e., getting involved with some new activity (preferably interactive) such as a conversation with a friend or a tennis game or reading a book will often help.

. Related to #33, recognize the following cycle which is very common among adults with ADD:

. Something "startles" your psychological system, a change or transition, a disappointment or even a success. The precipitant may be quite trivial. This "startle" is followed by a mini-panic with a sudden loss of perspective, the world being set topsy-turvy. You try to deal with this panic by falling into a mode of obsessing and ruminating over one or another aspect of the situation. This can last for hours, days, even months.

. Plan scenarios to deal with the inevitable blahs. Have a list of friends to call. Have a few videos that always engross you and get your mind off things. Have ready access to exercise. Have a punching bag or pillow handy if there's extra angry energy. Rehearse a few pep talks you can give yourself, like, "You've been here before. These are the ADD blues. They will soon pass. You are O.K."

. Expect depression after success. People with ADD commonly complain of feeling depressed, paradoxically, after a big success. This is because the high stimulus of the chase or the challenge or the preparation is over. The deed is done. Win or lose, the adult with ADD misses the conflict, the high stimulus, and feels depressed.

. Learn symbols, slogans, sayings as shorthand ways of labelling and quickly putting into perspectives slip-ups, mistakes, or mood swings. When you turn left instead of right and take your family on a 20-minute detour, it is better to be able to say, "There goes my ADD again," than to have a 6-hour fight over your unconscious desire to sabotage the whole trip. These are not excuses. You still have to take responsibility for your actions. It is just good to know where your actions are coming from and where they're not.

. Use "time-outs" as with children. When you are upset or overstimulated, take a time-out. Go away. Calm down.

. Learn how to advocate for yourself. Adults with ADD are so used to being criticized, they are often unnecessarily defensive in putting their own case forward. Learn to get off the defensive.

. Avoid premature closure of a project, a conflict, a deal, or a conversation. Don't "cut to the chase" too soon, even though you're itching to.

. Try to let the successful moment last and be remembered, become sustaining over time. You'll have to consciously and deliberately train yourself to do this because you'll just as soon forget.

. Remember that ADD usually includes a tendency to overfocus or hyperfocus at times. This hyperfocusing can be used constructively or destructively. Be aware of its destructive use: a tendency to obsess or ruminate over some imagined problem without being able to let it go.

. Exercise vigorously and regularly. You should schedule this into your life and stick with it. Exercise is positively one of the best treatments for ADD. It helps work off excess energy and aggression in a positive way, it allows for noise-reduction within the mind, it stimulates the hormonal and neurochemical system in a most therapeutic way, and it soothes and calms the body. When you add all that to the well-known health benefits of exercise, you can see how important exercise is. Make it something fun so you can stick with it over the long haul, i.e., the rest of your life.

. Make a good choice in a significant other. Obviously this is good advice for anyone. But it is striking how the adult with ADD can thrive or flounder depending on the choice of mate.

. Learn to joke with yourself and others about your various symptoms, from forgetfulness, to getting lost all the time, to being tactless or impulsive, whatever. If you can be relaxed about it all to have a sense of humor, others will forgive you much more.

. Schedule activities with friends. Adhere to these schedules faithfully. It is crucial for you to keep connected to other people.

. Find and join groups where you are liked, appreciated, understood, enjoyed.

. Reverse of #47. Don't stay too long where you aren't understood or appreciated.

. Pay compliments. Notice other people. In general, get social training, as from your coach.

. Set social deadlines.

He has shown you, O man, what is good;
And what does the LORD require of you
But to do justly,
To love mercy,
And to walk humbly with your God?

Micah 6:8

Advice for all:

What does God require of us in regard to ourselves, to others, and to God?

To do justly. This means we must think rational in the knowledge of God's word in order to know what justice is. We must treat ourselves and others justly. Irrational thoughts about ourselves and others, based on emotion, is self-abuse and abuse of others.

To love mercy. We must be kind and compassionate to others and forgiving. And we must be kind, compassionate, and forgiving to ourselves. It is a false belief system that everyone must be perfect, including ourselves. Yes, we must strive for perfection, but "all men have sinned and come short of the glory of God." All men lack the wisdom and knowledge they need for perfection and all men lack the self-control to achieve perfection. To expect perfection does not work; it's dysfunctional. It is a false idea that must be changed according to the word of God. (1) We must strive for perfection (2) Know all people have times of failure (3) Accept our failure (4) Learn from our failure (5) Make better decisions the next time around (6) Forgive ourselves and others (7) Don't dwell on it and move on.

Yes! This does take work especially when there is habitual learned behavior over a long period of time, but with exercise and hard work we can learn new behavior that is in line with justice and mercy.

-Pat

SHARPER THAN A TWO-EDGED SWORD

by Pat Gates

And he hath made my mouth like a sharp sword; in the shadow of his hand hath he hid me, and made me a polished shaft; in his quiver hath he hid me. Isaiah 49:2

Sharing personal pain with the brethren:

The writer said, "Most of all, I wish I could tell brethren my story without the fear of being ostracized as if I were unfit to be numbered among the faithful." (My disclaimer: Because I don't know who you are and your own personal history, I am going to respond to this on face value of what you wrote. If there are any other problems you have in regard to the church, that I am unaware of, this doesn't apply.) I agree, from my own experience, there are quite a few Christians who make it difficult to share emotional problems and inner struggles. This is such a shame because God wants us to be able to go to each other and edify one another. These same Christians will speak out against psychologists and emphatically state that Christians have no business going to these "ungodly" men and women, but at the same time, will not make themselves available to listen to others who are in great need of empathy and helpful advice.
I have found, however, there are other Christians who want to help; some have the wisdom and others don't know what to say but they will give a big warm hug and tell you they will put you in their prayers. Both are needed!
It's important for you to not give up on Christians because you've had some bad responses. Learn who you can share your thoughts and feelings with and rather than feeling anger towards the others, just chalk it up to ignorance.

For right now, I left off the "anxiety about the future." We'll talk about that later. This statement you made is so important for we are to gain intellectual knowledge of God's loving care, using this knowledge in discretion and wisdom, acting on what we know, and placing this knowledge on top of fleshly desires and emotions, thus creating proper responses, whether in action or thought.

Intellectual knowledge is indeed what we need and that is going to be what saves us from ourselves. Frankly too much emphasis is placed on how we feel and not enough emphasis on what we know. It is knowledge that prompts the right thoughts and actions and when proper reactions occur, that will take care of the negative emotions that lead to worry and despair.

There are two kinds of knowledge: (1) Knowing facts and (2) A working knowledge. The first one does no good. The second has great power but only if there is true belief in the power.

There are three kinds of "feeling" I would like us to think about: (1) Feelings that are produced as a response to outside stimulus, (2) Feelings that are produced from our own thoughts, whether those thoughts are accurate or unreasonable and (3) Feelings based on intellectual reasoning of Truth. The first is automatic and most often out of our control. The second is the outcome of our attitude and beliefs. The third is rational and controlled. It is this one we must exercise in order to gain discretion of which feelings are acceptable and which must be controlled.

On the chronic illness page there is an article on the power of the word of God that I would like to be read with this article. God's word is our foundation of rational thinking which will help us to control our irrational thoughts and feelings.

Rational Thinking:

Rational thinking is proper exercise of the mind; thinking that is consistent with known facts refers to logic or reasoning being involved in the thought process. It refers to providing reasons or rational behind thoughts or ideas. It adds an element of calculation and planning to a stream of thoughts rather then basing them on emotion or personal opinion. Rational thinking is going to be what changes us and this is what we are going to be talking about in the next few issues. When negative thoughts and emotions come, we need to allow our intellectual knowledge of God's word and the simple logic of reality to examine our thoughts and feelings

Rational thinking (intellectual knowledge) also produces understanding of God's loving care and that is what will transfer our knowledge of God's love into our life and into our ability to love life, love others, and love ourselves. We need to think rationally about love and the way to do that is to grow in knowledge of God's love and how He wants us to think and act. Let's read our Bible and concentrate on teaching ourselves the academics of love. Let's look at the Word of God afresh and learn what love is, even making a list of what we read, if desired. I know it may sound lifeless to just concentrate on the academics of love, but what it is doing is laying down a good foundation to build on.

I will continue to talk about love next month because many emotional problems Christian women have is a misunderstanding of what love is and they feel a great emptiness because they aren't feeling what they think love should produce in them. They worry so much about the phrase, "You must love yourself before you can love others," that they remain in depression because they don't know how to love themselves, therefore it's impossible to love others...therefore it's impossible to love life. Forget all that. That is one of those catchy phrases society has come up with that gives no direction and only burdens the individual with confusion and even more self-loathing because she doesn't know where to begin to start loving self.

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January - February 2012

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