Thursday, January 31, 2008

Respite for the Restless Mind

Kasey Cox

Every year, in the beginning of October, several health and mental health associations sponsor a “Mental Illness Awareness Week”. This past fall, I thought of writing a book review column highlighting books that help people who suffer from depression and/or manic-depression. I then learned that other advocacy groups promote a mental health awareness month in May. I decided to split the difference, and write about mental health for January, the time when many of us who live in our mountain homes struggle with some symptoms of depression from “seasonal affect.” Most of us have our techniques for coping with the confines of the bad weather or the doldrums from gray days. But some of us experience much more than minor symptoms.

When I was hospitalized for depression, a friend brought me a highlighter and 14,000 Things to Be Happy About by Barbara Ann Kipfer. It didn’t cure me; in fact, one definitive symptom of depression is that the sufferer doesn’t feel happy about things that would normally bring pleasure. Nevertheless, the highlighting session helped me remember happier times, gave a little wider perspective – something else depression often steals. It helped comfort me through a difficult time, which is why those who document their depression and mental disorders are so important to others who have the same disease.

In writing anything addressing mental health, I understand that those who suffer from these mental health issues are not just those who have been diagnosed with the illness, because certainly family, friends, co-workers – indeed, whole communities – suffer with those who are trying to deal with these slippery, chronic, and widespread illnesses.

In 2001, Andrew Solomon’s The Noonday Demon: An Atlas of Depression, won the National Book Award for Nonfiction, and was a finalist for the Pulitzer Prize. This surprised me at the time, because, in a culture where openly discuss everything from the sordid details of Hollywood’s addictions to the sympathetic spaghetti dinners we hold for a neighbor’s prostate cancer, we still whisper about mental illness. We talk about a person’s battles with schizophrenia or manic-depression the way people used to murmur about “the big C” in the 1950’s. For this article, I humbly follow in Solomon’s footsteps: “one of the aims” of his writing, he said, “is to remove the burden of stigma from mental illness” by speaking up about his experiences and cataloging others’.

Ironically, though, one of the difficulties in finding – and reviewing – books on mood disorders is not the lack of books. We may have a hard time disclosing our mental health difficulties to our community, as individual people, but as a whole, Americans want to tell their stories. Again, Andrew Solomon sums this up beautifully: “I have never written on any subject about which so many people have so much to say …. It is frighteningly easy to accumulate material about depression.” The problem is in choosing which books are best for you. It’s a question of finding the right match, much like medications or therapists.

This is where I recommend following the advice of doctors Michael Rozien and Mehmet Oz. You may know them better as the authors of the best-selling series of “You” health books, as in You: the Owner’s Manual, and You: on a Diet. For folks dealing with mental illness, be they “patient” or family, get yourself a copy of You: the Smart Patient. Perhaps the single most important thing you can do for yourself is to learn how to navigate the medical system – how to communicate efficiently and effectively with the medical staff you must interact with, how to keep accurate health records, how to research alternative medicine options, how to deal with insurance companies. This book will not solve all the frustrations involved in this often nasty process, but it will go a long way in smoothing the way.

Another very practical book for “consumers” of the mental health system – so labeled by some mental health advocates to remind “patients” of their need to take an active role in choosing which medical staff they will use – is a new classic of the “consumer-driven” mental health movement. Mary Ellen Copeland, who lives with both chronic pain and a mood disorder, has authored and co-authored several fantastic books which give step-by-step plans for living well with these illnesses. Now used regularly by therapists, group home managers, and social workers, alongside their clients, The Depression Workbook: A Guide for Living with Depression and Manic-Depression as well as Living without Depression and Manic-Depression: A Workbook for Maintaining Mood Stability are, literally, lifesaving guides.

As helpful as it is to have practical, factual information, there is a balm like no other in the validation one gets from reading firsthand accounts of others who have experienced similar circumstances. This is especially true in dealing with illness, which often isolates those afflicted. There are many memoirs written about living with mental illness, especially with mood disorders. The two that stand out and stand the test of time are Kay Redfield Jamison’s An Unquiet Mind and William Styron’s Darkness Visible.

Both of these authors are brilliant, accomplished people, who write from both spectrums of manic-depression. Jamison herself is an M.D., Ph.D., in psychiatry and in psychology, making her a much-sought-after psychiatrist with the education to engage in therapy and counseling with her patients as well as treating them medically. She wrote several of the standard textbooks used in medical schools for psychiatry, and worked as a doctor for many years before divulging that she, too, had bipolar disorder. Though Jamison’s experiences were more about the dangerous, near psychotic highs of pure mania, she has also dealt with shattering depression, and writes lucidly about both.

William Styron wrote Sophie’s Choice and the Pulitzer Prize-winning novel The Confessions of Nat Turner. In 1985, he suffered a crippling, life-threatening depression. The miracle is not just that he survived this – the statistics of those who have not are insidiously larger than most would believe, and Styron names a few famous predecessors who did not – but that he was able to write about his experiences afterward. I don’t think I have ever read such descriptions of depression that echo so resounding in my soul.

Looking to educate yourself? Try Lewis Wolpert’s Malignant Sadness. As a developmental biologist, Wolpert explains the physiological aspects of mood disorders, but with a great deal of human warmth and sympathy. If you are looking for warmth and sympathy, I recommend picking up J. Ruth Gendler’s The Book of Qualities. This lovely little book is one of my absolute favorites. Gendler describes each emotion and characteristic of humanity as though it were a person: Change wears orange socks; Despair has stopped listening to music; Faith is not afraid of Doubt, because she grew up with him. Every time I read this book, no matter where I am in my life, I am reminded gently of the beauty in my humanity, and that I am not alone in my experiences.

The bottom line, of course, is that books won’t cure you. I wish they could. They may comfort you, though, and serve as an important resource through confusing, troubling times. Most of all, I hope this article and some of these books empower you and your family to speak out, get help, and stop living in shame. Be well.

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