No reservations necessary



No reservations necessary!

GUEST SPEAKERS

Everyone is welcome at New Directions’ Speaker Programs. They are held the 3rd Tuesday of every month at our regular meeting place – Abington Presbyterian Church, 1082 Old York Road at Susquehanna, Abington, PA – from 7:45 PM to 8:30 PM. Our Small Group Discussions are held afterward. To verify that the speaker program hasn’t been changed, listen to our recording at: 215-659-2366 ext. 3. For directions, call Nick Breslin at 215-886-8628.

November 18… Becky Shoulberg, MSW, marketing outreach specialist, Eagleville Hospital, “Substance Abuse and Mood Disorders.”

December 16… Diane Allen, personal coach, “Learning Lessons from The Wizard of Oz” (rescheduled from earlier).

January 20… Betty Degnan, RN, MSN, and Reiki Master, “Mind/Body Integration,” Abington Memorial Hospital’s Integrated Medical Services.

February 17… Dr. J. Russell Ramsey, Center for Cognitive Therapy, University of PA, “How Cognitive Therapy Can Help People with Mood Disorders.”

EDITOR’S CORNER

by Ruth Deming

New Directions

A gigantic thanks to:

…. Janssen Pharmaceutica

The Compass would still be sitting in the editor’s computer – or, worse yet, in her already stuffed head - if it weren’t for the generosity of the folks at Janssen in printing up the Compass: Tom Gudusky and Marianne Sullivan who said Yes to our original request, and to Ed Quispe, our printer extraordinaire. When people ask me, “Who reads the Compass?” I remember what Ed once told me. “I finally got a chance to sit down and read the Compass. I was on the plane going home to Peru. When I got off, the guy sitting next to me asked if he could read it, too, so I passed it along to him.”

Who knows where the Compass goes?

…. The Patricia Kind Family Foundation

People who believe in you give you courage and confidence to continue your work. The Patricia Kind Family Foundation, one of the great philanthropic organizations in the Delaware Valley, gave us two extraordinarily generous grants. The money was certainly important. No more monetary constraints at Kinko’s. But perhaps more so was the validation by important community leaders that New Directions makes a difference in the world of mental health. Thank you, PKFF.

We can make even more of a difference with our readers’ help. The Kind Foundation will match any contributions you, our readers and members, send us. What an opportunity!

Take a moment to consider what New Directions and The Compass – two famous Philadelphia traditions - have meant to you. Look through these pages and see all our wonderful offerings. People have looked toward New Directions since 1986 as a beacon of hope. And to the Compass as their “arm-chair support group.” Thanks to the Kind Foundation, we’re able to continue the work that’s needed in the Philadelphia area.

If all of this rings true to you, mail us a generous donation. Make a check out payable to “New Directions.” Do it now. Before your forget. We’ve gotten checks ranging from $3 to $1,000. Our address is:

New Directions

PO Box 181

Hatboro, PA 19040

And, as you write your check, remember it’s actually double the amount you’re writing it for. Who could ask for anything more?

Join in the excitement. Be a part of our team. Our support group needs your support.

…. The man in the Double Helix necktie

If we don’t thank our professional advisor - Dr. Wade Berrettini of the University of Pennsylvania - for his generous support and gentle encouragement we should get our head examined. He’s always been there for us, answering our smallest questions (“Wade, should I put this in the Compass?”) - even while he’s solving the mysteries of the universe in his white lab coat: the DNA that made us all. Read his column later in these pages.

You did the right thing, Denis

A wonderful friend of ours, Denis Hazam, called to say he’d 302’d a friend. “Involuntary commitment,” it’s officially called. That means that Denis had witnessed first-hand that “Charlie” was overcome by his mental illness, wasn’t aware of it, and needed hospitalization for life-preserving treatment.

We didn’t have to ask Denis why he was calling for support. It’s one of the most difficult decisions a person can make. Questions arise about our own judgment and competence: Am I qualified to make a decision? Are my perceptions correct? Is the other person truly in need of help? Finally, what are the consequences if Charlie won’t get help?

It’s a soul-searching process. A person must look the truth in the face and then act on it.

Luckily, a neutral arbiter makes the final decision.

As a friend, we reassured Denis that he had done the right thing.

(Denis is head of DBSA HUP – Depression & Bipolar Support Alliance of the Hospital of the University of Pennsylvania. He and his wife Fran run a group known for its compassion and caring, due, of course, to its leadership.)

Dare to reach your potential!

“I have to meet the challenge of keeping myself balanced on a daily basis. I have to use every ounce of my creativity to find coping mechanisms and solutions that keep me stable.”

Those words, from “Living without Depression and Manic Depression,” were written by Mary Ellen Copeland, a master of self-help and recovery, who also has bipolar disorder. Her workbooks should be in the home or the mind of everyone who aspires to reach their fullest potential possible as a person with a mood disorder.

It’s not easy. But because so many people with bipolar disorder or depression are successful - doctors, lawyers, business owners, secretaries - there is no reason why any of us should give in to the illness-fostered sense of hopelessness and defeat. Recovery, as we’re fond of saying, can be made even in the smallest steps. Even Mary Ellen, herself, recounts her early years of desperation and despair. And her tenacious battle to get well.

Let me share another story of recovery I heard while having lunch at the Reading Terminal Market. Seats were at a premium and a woman sat down next to me. Like a stranger on a train, she began pouring out her story to me. Ten years earlier, she’d been a battered wife, physically and emotionally. The words “Just leave him” had no effect. The bonds of attachment, someone once said, are stronger than those of love. Finally, with a plan in place, she left her husband. How did she do it? “Faith in God,” she said. “I never could have done it without God’s help.” They have an unswerving relationship.

DBSA PA

The national DBSA (Depression and Bipolar Support Alliance) – which boasts a thousand chapters across the country - is now establishing state chapters. A month ago, “DBSA PA” became official. As an independent affiliate, New Directions is proud to be a part of their team. Our motto is: The more organizations collaborating together, the quicker things will get done.

DBSA has a terrific informative web site. New on their web () is a valuable book for kids with bipolar: “The Storm in My Brain.” Check it out!

Cognitive Limitations

The first step in getting better is to know what’s wrong with us. It may be scary at first. But the more we know about ourselves, the more we can correct what’s gone wrong…. and devise wellness techniques to keep us in balance.

Part of our condition may include “cognitive” limitations. It’s important to acknowledge this. Cognition refers to our ability to think, to remember, to solve problems, to process information. (We’ve included an important article in these pages by Dr. Greg Perri, a neuropsychologist, who gives us a brief introduction on how our minds are affected by stress.)

If you are interested in pursuing further information about cognitive limitations, you can start by viewing an easy-to-read handbook recommended by Alice Fitzcharles of NAMI Main Line: “Dealing with Cognitive Dysfunction Associated with Psychiatric Disabilities: A Handbook for Families and Friends of Individuals with Psychiatric Disorders” by Alice Medalia and Nadine Revheim.

Visit ,

and click on “Resources.”

They endured

I’ve always called her “Beautiful Edie.” Like many people passing through New Directions, she called and wants to say hello to all her friends up here. Folks will remember Edie as head of two Project Share Drop-in Centers - and one of the first people to carry around a cell phone.

To look at Edie, you can’t detect the fierce mood swings she’s endured her whole life. She’s been able to work – taking leaves of absences when necessary – and developed a lasting and loving relationship with a man, also with mood swings. “Paul” and Edie married. Together they persevered through the nasty side of mood swings: marital instability, moving in with relatives, money problems, job problems. They always pushed through. At 41, Edie gave birth to a daughter, while their life moved forward.

The miracle is that through it all, they endured. They live a normal life. And do normal things. They’re just like everybody else: human beings facing the challenges that life throws in our path.

Every human being has mood swings. Ours are exaggerated to the extreme.

Our favorite mental illnesses

Though I try not to show favoritism, I have to confess my two favorite mental illnesses, from the viewpoint of an insider, are Bipolar Disorder and OCD. I’m also partial to borderline personality disorder and schizophrenia. When New Directions sponsored its recent program on borderline personality disorder, I couldn’t help but notice how many traits people with BPD and BP share in common. Edie Mannion of the TEC Family Center, who co-sponsored the event, believes as I do that Borderline and Bipolar are sisters on the Bipolar Spectrum. It’s all a matter of degree. The men and women who suffer from these conditions, as do artists, are people who possess an “exquisitely sensitive mind.”

As far as OCD, I do hope the media gets around to it. Take geniuses, for example I once wrote a piece on Gregor Mendel: An Austrian monk with a penchant for getting to the root of things. Talk about obsessing! Do you know how many peas this father of genetics experimented on? Something like 15,000!

That’s what it takes to make a genius. The ability to obsess well and be compulsive about it. In Mendel’s case his obsessions were two: God and peas.

Ruth Deming, MGPGP, is founder/director of New Directions Support Group. She was diagnosed with bipolar disorder in 1984 and lives in Willow Grove, PA.

. . . . .

Italicized inserts: “Relatively funny stories.” Thanks to Russ, Greg, Dan, Shelly, and Judy.

*

“Hey, Jude!” I used to work as a telephone survey solicitor. The object was to have the person answer a list of 30 questions. You’d tell the person that the call would take 15 minutes though in reality it took 30. If you could get through the first 10 minutes, there was a good chance of finishing up the interview. One time I had this guy on the phone who agreed to answer the questions if I’d listen to him play some songs on the guitar. They weren’t that bad.

*

. . .LETTERS TO THE EDITOR. . . .

I AM WRITING to thank you for sharing your newsletter with us. It is filled with practical information. The Compass has been a useful resource for patients and their families and also for staff. Some have found inspiration in the personal stories and accounts of recovery. Others have found the strategies for coping and staying well invaluable. The diagnostic and medication information is clear and succinct. We are grateful for the opportunity to continue to receive the Compass.

Chris Ockenlaeder

Coordinator, Allied Therapies

Abington (PA) Memorial Hospital

ABINGTON TOWNSHIP PUBLIC LIBRARY was indeed fortunate to host the New Directions’ Display Case in October on “Teen Depression.” This is a most important topic that affects many families in our community. Our Library is pleased to help bring the situation to light, especially since we have 1,200 patrons visiting daily. Of particular help was the comprehensive resource list you provided for patrons wishing follow-up. We look forward to working with you again.

Nancy Hammeke Marshall, Director

Abington Township Public Library

. . . . .TASTY NUGGETS. . . . .

What we’ve been waiting for! “Support Group for Consumers,” sponsored by NAMI PA, is a monthly daytime meeting at Bryn Mawr Hospital. Format: First half hour: topic discussion. Next, personal sharing of “here and now” issues. Emphasis on the “wisdom of the group.” Interested members must interview first with Carol Carlen, 610-649-6844.

Remember, “I’m not my disease.” William I. Packard, MD, former director of inpatient psychiatry at Bryn Mawr Hospital, is a scheduled speaker at the NAMI Main Line. His talk, “Caring for the Whole Person: A Psychiatrist’s Perspective,” focuses on accepting the illness and establishing an identity separate from the illness. “It is a problem I face, not who I am,” he says. “I try to teach people to be specific about what they feel is lost or damaged so they can embrace and develop what is healthy and capable to be developed and to actively repair what is damaged.”

Shake, rattle and roll. Nancy Wieman, deputy administrator of the Montgomery County Office of Mental Health, will unveil the County’s new plan for restructuring the County mental health system at the NAMI Montgomery County meeting November 16. We’ll keep you posted.

[pic]

Encore! Encore! Fifty people from the community attended a program with the enticing title of “Borderline Personality Disorder Embodied in the Creative Genius of Janis Joplin and Jim Morrison.” The program, held at the Lower Moreland Community Center in October, was sponsored by New Directions Support Group (see director lying on table) and the TEC Family Center (director and former trumpet player Edie Mannion, third gal on left). Program presenters were Dr. Gerald A. Faris, left, and his brother, Dr. Ralph M. Faris, right. They discussed their important new book “Living in the Dead Zone,” available on the web. Also shown are speaker Dr. Pamela London-Barrett on left; Shelly Quigley (center) and hostess Ada Fleisher on right who supplied the coffee and Danish. The program was funded by Eli Lilly & Company.

. . . . B U L L E T I N B O A R D. .

She tells it like it is. “I tell patients there’s nothing wrong with you. You just have a different way of perceiving the world.” – Dr. Patricia J. Jennings, Lansdale

Back to Shul. In my effort to involve myself in social activities I joined a synagogue. I chose a small reform congregation. The members like to describe themselves as “haimisha,” or down to earth. – Rebecca from Abington

Balancing act. As a family member it’s important to keep your own identity. Make sure you maintain your own person and don’t get lost in somebody’s life. Balance is so important. I’m taking a painting class. It’s something I’ve always wanted to do. The group depends on you to come and you support each other – not only do you paint but you become a part of that group. I make things and then I give them away – clay pots, paintings on slates and boxes. Everything I create I give away. I have one of my pots, a little piece of me, going to El Salvador. – Linda from Fairless Hills

“Meeting makers make it” (an AA slogan). I suffer from depression and alcoholism. I’ve been sober 30 years. I attend AA meetings five times a week. There is no possibility I could make it through life if I didn’t attend meetings. And if I didn’t believe in a Higher Power. I noticed that at New Directions meetings spirituality is rarely mentioned and wonder why. – Bruno from Chestnut Hill

The next Richard Feynman? On TV, I saw a course advertised on helping people learn the basics of math. I’m taking classes at Bucks County Community College and have failed math three times. The last time I went to class, I went once and never came back. So I ordered the math tapes in the mail. They’re really expensive. But this time I’ll have a better chance of making it through the class. – Mike from Ambler

The pip. Frankly, we didn’t know what to do with our grown daughter. She was diagnosed with borderline personality and bipolar disorder. She’d take one medication after another. She has a 2-year-old and had to give him up to her husband because she couldn’t take care of him. She was unreasonable and you couldn’t talk to her. Three months ago she went on Abilify (ariPIPrazole). It was like a miracle. She did a 360-degree turn around. God willing, it should only last. – Rona from North Wales

Uncle Sam is watching. I’m on Social Security Disability and get $580 per month. I got a small under-the table job and someone reported me. Wouldn’t you know that the person who reported me doesn’t work and sits around all day making trouble for other people. I got it all straightened out, though. What I did were the following things: (1) Called my SSD lawyer who told me how to handle it, and (2) Called my social security caseworker who helped me out. So the motto is: hold onto all your paperwork and keep it handy in case this ever happens to you. – Chaz from Levittown

No. 2 at bat. I was watching the memorial service for 9/11 on TV. Everybody was standing there silently as people were reading names of people that had died. Life was just taken suddenly away from them. I took that moment to reflect how lucky I am, even though I’ve got bipolar 2 and have been unemployed for 6 months and my wife and I get into fights all the time. I have a job interview tomorrow. I tell myself that each time you get a job interview and I’ve had lots, it’s like stepping up to the plate. You’re not necessarily going to get a hit, but you’ll never get a hit if you’re sitting on the bench. – Bob from North Wales

Emotionally starved. I was never nurtured by my parents. I can’t sleep at night and sometimes I call the Crisis Center because there’s no one to talk to. I had the most amazing guy on the phone. He was giving me philosophy about suicide, negative thoughts, putting a rubber band on your wrist to stop your negative thoughts. He was the most amazing person and helped me get through the night. – Susan from Hamilton, NJ

Lifetime member. One day I was so stressed out I just took my headphones and a copy of the Compass and went to the park to read it. I keep the Compass nearby. I read it from cover to cover. It’s almost like a Bible. – Susan from Hamilton, NJ

Shifting gears. I like to have some time before I start preparing to get ready for work. I have to change gears. I have to get into my “work mode.” I like to have an hour or two in between whatever the last activity I was doing – whether food shopping, going to the mall – whatever – I like to have that time in between. I think about what I’ll be doing at work. I can function at 100 percent when I give myself time to change gears. I’m a group leader at Weight Watchers at three different locations, which are all churches, so I tell people I go to church three times a week.– Fran from Blue Bell

Praise the Lord. What a healing experience! I don’t feel heavy. I feel a burden is taken off my shoulders. I just rejoice. I feel like an angel floating in the air. – Wendy from Levittown after visiting her mother’s revival church in Perkasie

So who are they? If I ever got depressed again, I’d drive down to Maryland and see a neuroendocronologist. Did you know there’s only 2 in the country? – Our Nancy

Delete button. My therapist and I are working on ways to help me get on with my life. She’s always telling me that I’m hanging around with the wrong people, negative people who send out negative messages into the universe. One day I actually listened to her. I got rid of 6 people. I feel like a new person. – Mona from Philadelphia

Debtor’s prison. I got myself into very bad financial straits. I now work with a guy from a firm in Massachusetts who’s helping get me out of debt. I highly recommend him. He’s going to save me $200 per month right off the bat – with lower interest rates. The company’s web site is: or . – Murray from Blue Bell

Hello, is Mr. or Mrs. Deming there? I don’t screen my phone calls. I like the surprise of not knowing who’s on the other end. This morning a solicitor named Dimitrius called. We began chatting after I asked him if he was Demetrius from the movie “Demetrius and the Gladiators” with Victor Mature. He said no, but we chatted anyway. What an amazing guy!!! He’s an ex-con who’d gotten his GED in prison, came out, went back on the streets again, saw the error of his ways - through Christ’s intervention - went straight, earned a BA in business administration and is now working on his master’s. He’s also a missionary. He tours the world playing Christian music and preaching redemption. Check out his web site: . Be sure to read his life story. – Ruth from Willow Grove

BULLETIN BOARD: Special Sleep Section

Are you sleeping, are you sleeping? I’m not a good sleeper. I never travel with anybody because my sleep patterns are so erratic and I need the TV on all night. Sometimes I just pace. Sometimes I sit up and read. I’ve had this problem for centuries. You get used to it. I don’t fight it. There’s no point. If you’re not going to sleep, you’re not going to sleep. – Patricia from Cheltenham

Untangling. Before I go to bed, I’m all wound up. So I sit in my chair and unwind before laying down. That way I don’t have a million thoughts going through my head. I sit and look through photo albums of my grandkids or just let my thoughts drift. It still takes a while before I’m able to sleep. – Carolyn from Chalfont

The mother of all poor sleepers. I have the television on all night and sleep on and off while watching. I don’t know if it’s an addiction or not but I look forward to watching Entertainment Tonight and Martha Stewart. I’ve been watching Martha a long time. She handles food so well. I try to remember her recipes. They’re good but not really wonderful. The “Lime Melt-Aways” were the best so far. – Bernice from Huntingdon Valley

. . . . . L I F E . . . . .

The smell of coffee

MORNINGS AT THE MALL

(New Directions offers 2 morning meetings a month at the Willow Grove Mall. Call 215-659-2366 if you’re interested in joining us in our lively conversations.)

(Some names have been changed.)

Mary Anne, who runs the group, looked especially fetching in her new short hair cut. Once a teacher at an exclusive private school, as well as doing marketing for a Philadelphia museum, her illness – both bipolar and its kissing cousin OCD – knocked her down for years. But she was making a comeback. Though we can’t say why, she had stopped thinking of herself as a professional patient and was now volunteering at Abington Hospital.

She and Kate, a former college English professor – you could actually picture her standing in front of a blackboard discussing Keats – was also knocked down by her illness. She was bringing herself up slowly by working at a library job. “It’s so boring,” she said, “I’ve been getting to work late.”

Ruth, who is very strict, gave Kate a playful tap on the wrist. “Don’t do anything to jeopardize your job.” She mentioned there are certain people – high achievers, perfectionists, not to mention that psychiatrist who’d worked at Yale and made a serious suicide attempt - who go into severe depressions when they stop working. Ruth was one of them. “You think boredom is bad?” she exclaimed. “Wait’ll you wake up in the morning with nothing to do all day but thinking up ways to kill yourself!”

By now, our table was filling up. Mary Anne dragged over another table. You never knew who was going to show up. Or what people would talk about. The topic of using ovens to dry things off came up. Mary Anne shared a tragic but hilarious story about a couple she and Larry go skiing with. Apparently the couple had gone skiing and left their mittens and their hats in the oven to dry. (Dry-by-pilot-light). You can guess what happened. They turned on the oven and actually burned down the house.

Other people’s stories always make us feel better. Ruth said she didn’t feel so bad now after baking her wet shoes in the oven.

Matt needed a second cup of coffee and went downstairs to buy his favorite: Starbucks. It came with a darling cardboard wrapper so you wouldn’t burn your hands. Matt took it off – it had flaps with tiny holes. Everyone wanted to play with it. So he passed it around. He mentioned that his grown son, an artist, could really make something astonishing with it. Unfortunately, said Matt, he and his son were not talking.

“Why don’t you send it to your son,” suggested the ever-ingenious Mary Anne. “Put a note with it that says, “Thinking of you.”

Matt, who is very deep, paused for a moment. You could watch him thinking.

“Yes, I’ll do that, Mary Anne,” he said. “I’ll do that.”

“Let us know what happens,” she said.

ADA’S OUTING: POOLSIDE

Bob brought his bathing suit and his dog, a basset hound named Abby. He and his wife found her at an animal shelter. Bob, who is President of the Smart Club, said the basset is descended from the bloodhound. Abby was the hit of the party unless you count Ada with her toothpicked watermelon, cantaloupe and mouthwatering fresh pineapple.

Out on the patio Ruth sniffed the fresh pineapple and said, “This is the only thing in the world I’m allergic to. If I ever married a rabbi and he wanted to murder me, all he’d need to do is lace my soup with crushed fresh pineapple. I’d be dead within three minutes and no one would be any the wiser.”

Speaking of murder, Ada’s son, Aaron, a Yale graduate who is now a law student at NYU, worked this summer on Death Row in San Quentin. Very nice people, he said of the prisoners.

We were planning a new program, a meeting of the minds. We’d call it “Lunch with Bob” and would invite all these interesting people we all know. Ruth and Shelly both said they were starved for intellectual stimulation. And so was Bob, since his retirement as an attorney.

When we posed the question to Bob, he said he liked the idea, but did volunteer work and took classes every day of the week. The activities were his wife’s idea to avoid “retirement depression,” not to mention keep him out of her kitchen.

We were sorry Bob had to decline. Quipped Shelly, “So we’ll still have the club and call it “Lunch Without Bob.”

ASK THE COMPASS

The Compass receives calls from people with everyday problems and people with extraordinary ones. We’re printing two items, each embodying a number of pressing concerns in the world of mental health. Details of each have been changed.

Part One: Mrs. Olson – Whatever could go wrong, did!

(1) Mrs. Olson has suffered severe mood swings her entire life. To treat this condition, bipolar disorder, she has had the same highly regarded psychiatrist for 12 years. In spite of his nice ways, she has misgivings about his ability to treat her: He has never been able to successfully alleviate her wild mood swings. Certainly, we thought, she could be a treatment-resistant case, but, why, we wondered, would anyone stay with the same doctor if he wasn’t helping her?

To make matters worse, during the course of her treatment, she had been on lithium. It caused irreversible kidney damage, forcing her to eventually go on kidney dialysis. (See editor’s note below on lithium.)

(2) Mrs. Olson has now been on kidney dialysis for five years. She says her whole life revolves around the three days a week she must go in for four-hour treatments. The quality of her life is so poor that she often considers suicide. (We wondered to ourselves if perhaps some aggressive treatment with psychotropics might help, in addition to supportive counseling. We also noted to ourselves that she needed a reason to stay alive.)

(3) As if all this wasn’t enough, Mrs. O suffers from excruciating back problems, necessitating her seeing yet a third physician.

She asked us flat out: “What should I do?”

We told her she had a very complicated case and that we would discuss it briefly with her, while taking her desires and her limitations into account. We would not tell her what to do, but we would lead her to do what she herself believed best for her.

The first thing we talked about was if it was “worth it” to get a consultation from another doctor to improve her mood. Did she have the stamina required to find another doctor? In addition, she was ultra concerned about hurting her doctor’s feelings if she left him. We told Mrs. Olson that her suffering was the most important thing in the world, not her doctor’s feelings. She had an epiphany and saw this was true. She had known this all along, but by verbalizing it to someone else who understood, she was able to make her own decision. By now, the “fight in her” had been reawakened.

Where should she find a new doctor? she asked us. Because of her time schedule – her whole life revolved around doctor appointments – she couldn’t drive very far. But we were certain there must be some excellent psychopharmacologist within a 20-minute drive of where she lived.

We suggested she talk to her family doctor and ask him for top-notch doctors in the area. We told her the key words to use were, “Where would you send a family member?”

Then Mrs. Olson made a good point. She stated that she was afraid doctors would reject her because of her difficult case. That’s true, we said. You have a very difficult case and pose a challenge to doctors. Many doctors will not take you on. But, we said, some doctors absolutely love challenges.

We told her that when she began phoning doctors she should expect to be turned down and expect to be frustrated. This attitude, we said, would lessen the disappointment she would feel if she was rejected by a doctor. She liked that strategy.

We also asked her another question which she hadn’t thought of. We were sorry we brought it up. We asked about “coordination of care.” In other words, are each of your 3 doctors in contact with one another about the medications each prescribe for you. (We often find this to be the exception rather than the rule.) Perhaps her depression had to do with poor drug interactions.

We thought to ourselves that in today’s health care world – where treatment can, at times, be nothing short of abominable - that many patients have taken on the role of “health coordinator” themselves. This applies to all fields of medicine, not just psychiatry.

This issue was clearly secondary to Mrs. Olson. But she was positively revved about finding a new doctor.

We also suggested that if she could squeeze in a little extra time, she might come out to one of our meetings.

Editor’s note: Regarding the use of lithium, we’re aware of a dozen or so people who suffered kidney damage after using the drug for many years. Folks on long-term lithium maintenance should be aware of this risk and discuss it with your doctor. Make sure you get 2 yearly blood tests: the BUN (blood urea nitrogen) and creatinine. Back in 1970 when lithium came out, there were no treatment options. Today we have many.

Part Two:

Our daughter’s in trouble: Worst case scenario

Q: We have a terrible situation. Our 22-year-old daughter attends college in Baltimore and has her own apartment. She had a history of depression as a teenager. We’re a close family and keep in touch several times a week by phone. Suddenly, we notice her behavior is changing. She’s angry with us and hangs up the phone. We get her credit card bills and they are in the thousands of dollars. Her phone has been disconnected and a friend who checked on her said she is no longer living there. We have bipolar disorder in the family and we are afraid she is on a manic high. We’ve been out of touch for 4 days and don’t know what to do. We don’t want to alienate our daughter by bringing in the police. What do you suggest we do? We are also worried about how to handle her if she comes home.

A: Your situation is very distressing indeed. But there are practical things you can do to try to locate your daughter and to ease your mind. First, we recommend that you keep a list of all the steps you take to locate your daughter. Write down the names and phone numbers of everyone you talk to. Include dates of phone calls. This list alone will help put a semblance of order into a chaotic situation. We would also advise you not to worry about alienating your daughter. Her health and whereabouts are paramount.

We spoke with Tony Salvatore at Montgomery County Emergency Service (MCES) in Norristown, which is a psychiatric crisis service. They maintain a 24-hour crisis line, and they are also a hospital for psychiatric patients in crisis. Tony also took our question to Julie Peticca, MCES Crisis Department Director, and Don Kline, MCES Criminal Justice Department Director. Here are their suggestions on how to handle the situation.

• Check with the college that your daughter is attending. The student health center and the campus police may be able to help by determining that your daughter is all right or at least relaying a message on your behalf.

• Get in touch with a mental health crisis center in Baltimore. Privacy and confidentiality policies will limit what they may be able to tell you. However, if your daughter is known to them, they may be able to share your concern with her.

• Despite your concerns, you should contact the Baltimore police department. The police are often involved in mental health crises. They may take someone in crisis to a hospital or mental health center or give a referral when the situation is not as serious.

• You may be able to file a missing person’s report. (Her credit card receipts will have given you an idea of whether or not she is still in the Baltimore area.) It will be up to the police to decide if this is a missing person situation.

• Should your daughter turn up at your home in Montgomery County and you believe she needs psychiatric treatment, do your best to convince her to get help from a mental health provider or at least see her physician.

• If she is severely depressed, psychotic, talking about harming herself, or showing other similar behaviors call MCES at 610-279-6100 (24 hours a day/7 days a week). If, she is suicidal or presents an imminent danger to herself or to others, call 911 immediately.

• In Montgomery County many crises are resolved in the home or at the MCES crisis center. If hospitalization is needed, an individual may be able to request a voluntary admission.

• If an individual is a danger to herself/himself and/or to others, and is unable or unwilling to be hospitalized then an involuntary admission may be necessary. The police, family members, or others who directly witness the individual’s behavior may initiate the process.

• MCES helps with involuntary hospitalizations and can provide information on what is involved. MCES relies upon involuntary hospitalization as a last resort when there is no other way to safely help an individual experiencing a psychiatric emergency.

Good luck and keep us posted!

(Note: MCES was the first agency in the country to provide police training programs for people with mental health problems. Under the direction of Dr. Rocio Nell and Donald Kline, MCES is the model for many other police training and jail diversion programs. MCES is open 24 hours a day. Call 610-279-6100. Visit their web site: .)

. . . J U S T F O L K S . . .

FAVORITE ICONOCLASTS

MAN OF STEEL: “AIN’T I INTERESTING?””

Age: 64

Marital status: Divorced.

Occupation: Retired, living off pension, Social Security, sales off EBay.

Previous job titles: Project manager for computer systems at General Signal Corp.; systems manager for Leeds & Northrup (33 years).

IQ: “170 or something like that.”

Patents: 3.

Biggest obstacles to living well (1) No room to expand. Ex-wife insisted he was a “hoarder” and that he must keep his “junk” confined to approved spaces; (2) numerous series of shock treatments but can’t remember how many; plus 5 involuntary commitments for mania and psychosis.

Thing most proudest of: “The kids.”

Mood states: “Always depressed. For about 40 years. I guess you could say I’m dysthymic. Then in December I get a little relief. I become hypomanic and can enjoy life for about a month. I’m a totally different person.”

Recent greatest pleasures: Charting of most recent hurricane on home-built computerized weather station. Also, watching eclipse of moon from back porch.

Favorite restaurant: Daddypops diner in Hatboro.

Favorite food: Scrapple sandwich on Kaiser roll with ketchup.

Hobbies: Hunting, collecting toy steam engines, flea marketing, asking out waitresses.

Personal statement: “You never met or will meet anybody like me. It’s because I’m so unique. And I often laugh at things nobody else finds funny.”

Philosophy of life: “I have none.”

Defense when accused of being a hoarder: “I’m not a hoarder. There’s a classic definition of a hoarder and I’m not that. I can throw things out. I think hoarders can’t throw anything out. I only save stuff that I’ll be able to use or sell. I don’t save stuff that’s useless like papers or trash.”

Seating areas in house: “There are two places you can sit in my house – in my computer room and in my living room. When I know someone’s coming over I clean off one of the chairs.”

Most recent EBay coup: “I recently sold some electronic stuff. The average person would have no idea what these things are. They were in the trash at a flea market, and I sold them for over $400 apiece. The people that threw them out had no idea what they were.”

Wind behind his wings: “My mother.”

How he perpetuates her legacy: By planting rosebushes and iris.

Where he learned his work ethic: “The week after my father died, my mother started working as a cleaning lady. There were 8 kids to feed.”

Biggest disappointment: Received full scholarship to a Jesuit college. When dean of admissions learned he was diagnosed with mental illness, scholarship was withdrawn, in spite of intervention by mother and the parish priest.

Greatest simple pleasure: A bowl of hot soup.

An aside from the editor: It goes without saying, that this extraordinarily gifted man – like many others – could have gone on to true greatness but for the severity of his disease. All the more reason for us to send NARSAD Research a check to fund research into mental illness. Do it now while it’s on your mind: NARSAD, 60 Cutter Mill Road, Great Neck, NY 11020.

Nothing goes to waste for …

THE QUEEN OF THRIFT

Ultra-modest “Cindy” who’s been in the medical profession for 25 years, lives in a condominium in Philadelphia. Among her many claims to fame is her low electric bill. She told us, for example, that the basic electric rate in Philly is $20. Her and her husband’s is $28.

Here’s how they do it.

You have to understand what appliances in your house use a lot of electricity. Top of the list are the refrigerator, the air conditioner, and the clothes dryer. Also watch for things that get red hot such as the electric stove, the iron, toasters, and hair dryers. Computers don’t use much electricity.

I have a small refrigerator instead of a large one. When I use it, I get everything out at once instead of going in and out.

I always turn the lights off when I’m not in the room. It’s also good to know that fluorescent bulbs use lots less electricity than regular light bulbs.

Home repairs – I do a lot of repairs on things, rather than going out and buying new things. I have a pair of rubber- soled hiking boots that had a hole in the soul. I plugged it up with something like household caulk, a material that would do the job but might not necessarily have been sold for that purpose.

My husband has dress pants. When he carries his briefcase, it rubs on the side of his pants. The fabric turns a lighter shade on that side. In order to extend the life of the pants, I get out my crayons and my pastels to restore the color, so he won’t have to throw the pants away as quickly.

I reuse plastic bags. They can be re-used by washing them with hot soapy water. I also reuse my dental floss, which can also be rinsed in hot soapy water.

If I really have to throw out a piece of clothing, I save the thread from the fabric so I can reuse it. I rip it out in such a way so that I have long pieces of thread, which can be wound around a spool. I never buy thread.

I tend to recycle just about everything. Styrofoam trays from the supermarket have a million and one uses. So do old mouse pads.

There’s a dumpster at the condo where I live. I’ve gotten quite a few things: discarded window shades, curtain rods, fluorescent light bulbs. I’ve also gotten porch furniture, plant potters, house plants. I got a beautiful dying hibiscus out of the trash that just needed a little TLC and a wonderful fan that was broken. It was just a matter of opening it up and putting in a paper clip.

*

Mr. Jack Russell. He sits there all day and basks in the sun. Sometimes he’ll just start barking at people for no reason at all. A lot depends on how fast the people walk. If the people are walking slow, 9 times out of 10 he won’t bark. One time when I was walking him a woman got out of her car and started petting him. He’s almost human sometimes. You know how people yawn and make different expressions when they yawn? He has those same expressions, too.

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This guy means business

LETTER FROM MARK DAVIS

Mark Davis, a famous unstoppable advocate on the Philadelphia mental health scene, wears many hats. Take a deep breath and read his imposing occupation: Behavioral Health Science Special Needs Analyst at Philadelphia Office of Mental Health c/o Pennsylvania Mental Health Consumers Association (which he founded). In addition, he’s founder of the “Pinks & Blues,” a peer-run discussion/support group for bisexual, gay, lesbian and transgendered individuals dealing with mental illness. He is also the newly elected Secretary for the DBSA PA organization. As you will read, Mark is the personification of “survivorship with a sense of humor.”

Dear Fabulous Folks, Friends & Family:

With pride I share my 15th Anniversary of testing HIV-positive. Yes, 15 years since the test result I'll never forget and have grown to live with. That day was as bizarre as any other in the world of advocacy. I was spatting with the President of the American Psychiatric Association for not

including a consumer in a Mental Illness Awareness Week Lecture. They later relented and allowed me to introduce a featured speaker, but instead I afforded the opportunity to first give an awesome consumer speech.

Then off to the PARF (PA Association of Rehab Facilities) conference awards presentation to receive their advocacy award. I remember my Aunt DoDo and Mary Hurtig were there as I hid the tears. Linda Flores and I went to an aerobics class and I later went to an ActionAIDS- sponsored HIV support group at St. Mark's church. A day I'll never forget no matter how many shock treatments I endured later.

A defining moment being HIV-positive was at Rite Aid in the Q-tip section. I couldn't decide between the box of 50 or 300. Being cheap, I didn't think I'd live to use a box of 300 during a time when friends were passing rapidly. It was at that moment that I chose to live long and well and purchase the box of 300 Q-tips. Been buying in bulk ever since, but no longer at Rite Aid!

I would be honored if you would consider personal or agency membership to the organization I am proud to be called Founding President: The PA Mental Health Consumers' Association. PMHCA is a statewide membership organization representative of the individual and collective expression of people who have recovered or are recovering from mental illness. Our purpose is to improve the quality of lives through advocacy, education and the elimination of stigma and discrimination. My roots in the mental health consumer/survivor movement were the turning point in my recovery in 1985, thanks to being the first consumer “hire” at MHASP by Joe Rogers.

To join PMHCA, visit the following web site:

Cheers to each of you, both living and passed, who have played a significant role in helping to recover to live long and well despite the odds.

Love Always,

The Pinks & Blues meets every Wednesday at 6:30 PM at the Church of St. Luke and the Epiphany, 330 S. 13th St., Philly. For info, contact Mark at 215-546-0300, ext. 3301 (office) or 215-627-0424 (home) or email: mark.davis@.

Searching the World

LOVE AND MARRIAGE

Joe Bunting’s mission was to find a bride. Head of the DBSA support group in Delaware County, we know Joe to be a consummate man of action and intelligence. As you’ll read, he lets nothing, not even his illness, stop him from living the kind of life he desires. A couple of years ago, Joe, a man with a deep work ethic, found that his meds were making him drowsy so he could no longer function at top capacity at work. He and his doctor lowered the dose.

He discovered that, “the more my quality of life improved the less medication I needed.

What Joe most desired in life was a wife. So it wasn’t surprising when he told us he’d found a wonderful woman to marry, and that the marriage is nothing short of sublime. Here is his surprising and inspiring story.

I learned about a web site for Chinese women who want to marry foreigners. I went to the site. It did cross my mind that women might be using the marriage as a pretext for escaping from China and coming to America. But my fears were quickly dispelled.

On the web site, every woman lists her profile. When I first saw Liyan’s picture on the web, there was something about her cute little face that attracted me. I was courting about 5 different women by email but Liyan (pronounced “lee-ANN”) stood out. Her biographical profile said she spoke English, which was a critical prerequisite for me. From her profile, you could see that this was a kind woman. She didn’t foresee herself getting married to a Chinese man. She was 32. She was from the Hunan province in the People’s Republic of China, and moved to a technological city north of Hong Kong after receiving her bachelor’s degree. She had the intelligence and experience of dealing with Americans because she worked in an import company. She’d spoken to Americans on the phone. She enjoyed speaking with them but had a lot of misconceptions about Americans. I’d keep correcting her images.

She had talked to two other men and I stood out. Some women fear the abuse stories they hear about American men.

We entered into an email correspondence. You’re sending emails back and forth and finally, you want to make phone contact and hear the voice. The first phone call was really touching… touching to hear her speak English. She profusely apologized for her English. But I could understand the feeling she was putting into the words.

After the initial phone call, we began speaking once or twice a week. (You find a cheap long distance service.)

We talked about her motivation for getting married and moving to America. There is always a chance the woman is “using” you to come to our country. But after we began chatting, there was never a doubt she was interested in me for who I was. She was an adventuresome woman, she liked to travel. The prospect of moving to America was very scary, but she knew she’d met the proper individual and the proper man.

I was going to fly there to see her and get final confirmation. The timing was incredibly perfect now and throughout the whole process. I attribute that to God’s intervention. There was a lot of prayer going on here.

We spent 10 days together. I stayed in a hotel. The culture is entirely different than ours. You don’t hold hands in public, no signs of affection in public. She was always dressed properly. In that initial meeting I said to myself, let me look into her eyes and see if she is being true and honest with me. We had talked about everything under the sun on the phone. Now I just wanted to see if everything was as I perceived it. It was a ten-day visit and I knew by about the third day I was going to marry her. I asked her to marry me.

She was quite shocked because she expected me to go home and think about it. But I was sure.

I remember the moment I asked her. It was in the hotel room. There was a deductive process I had to go through before I’d take such a drastic step. This is such an unusual move. There was also a stigma attached to this, marrying a foreigner through an Internet forum. Here I’m walking into another stigma.

The next major hurdle was to tell her about my illness. Was she going to accept the illness? I wanted to see her reaction. It was very hard for her to understand it. I described it to her as ups and downs… being very down, very sad.

I think it took her overnight to think about. She didn’t understand it. She did not see this in the way I acted and spoke. So, she thought, what was I talking about?

I’ve had nine years of stability which made me take this risk of marrying. But as time went on, the risk threshold began to decrease and I knew what I was doing was right.

She said yes. The cultural adjustment was critical on both our parts. Our culture is just so free and so open. There were a lot of adjustments on my part. There’s a respect you have to have for the Chinese female. If you don’t know these expectations, then you’re going to insult the person. There were little things I never knew about… and there were a lot of apologies on my part.

She’s committed to me, a lifelong commitment. There’s no question about that. For myself, I’ve got someone to talk to and share my feelings with, someone who truly loves me. It’s one thing to be alone and another to be lonely. I was comfortable with aloneness. But I did not like feeling lonely.

What I needed was a partner to complete my life. Liyan is my partner.

Heigh ho, heigh ho

“OUR NANCY”

When we last heard from Our Nancy, she had come through her killer 18-month depression and was now trying to find a job.

I’ve sent out 125 resumes. I even found certain jobs that I had the perfect credentials for. I’d get letters of rejection that said they found people with even better credentials.

I need to work. I don’t want to lose my house because it’s beautiful. The thought of losing my condo is like the thought of losing my whole world. I’m now being open to jobs that I wasn’t open to six or seven months ago because of the need to work. Right now I’m working as a substitute teacher in Philadelphia. I have to get up at 5 in the morning to be at work and you never know until the last minute if they’ll call you or not. It’s horrible, but what can you do?

It’s important for others with mental illness not to give up no matter how much rejection we get. We have to keep reaching for our goals and getting support. If I stopped trying, I’d be on Social Security now and lying in bed with a bottle of wine.

Editor’s note: It’s extremely important for unemployed people with bipolar disorder or depression to realize the importance of returning to the work force ASAP, lest “unemployment depression” set in. The necessity of a “routine” – which we achieve through regular work hours - cannot be overstated, especially when one’s body has gotten used to the rhythms of the nine-to-five world.

*

Wawa, Dunkin’ Donuts. I gave some psychology department colleagues a ride in my car. I had napkins all over the place. One asked me, "Why do you have so many napkins?" I told him a friend once told me that since I eat in fast food places, I should never have to buy paper towels again. Just take out napkins. So, I take out napkins whenever I eat in fast food places. I err on the side of taking too many rather than too few. The name of the friend who told me: Ruth Deming

NOTES FROM A THERAPIST:

“Savor the Day” or “Where is this Canyon anyway?”

by Billie Lee Orenbuch, LCSW

Recently I've been taking a course with Marty Seligman, PhD, of the University of PA in which I've been learning how to understand, become and then teach others about "authentic happiness." This is the kind of happiness you feel all the way down to your bones… for a moment, or an hour, or a month, but you know what it is.

We've had assignments in which we had to argue with ourselves and then talk to each other about it. We've had assignments in which we had to: write formal letters of apology, or, write formal letters of gratitude. We also had assignments in which we had to present letters of gratitude after we apologized. Primarily, these were deeply thought out, gut-wrenching tasks, as opposed to something that could give us pleasure.

Finally, last week, we were given an assignment to "Savor the Day." It’s been years since my husband and I have taken the time to drive around a new area and explore it together. It was an activity that never failed to give us pleasure in the past. I looked at the map and remembered that we had never seen the Grand Canyon of Pennsylvania. I checked the internet and found the distance and a bed and breakfast (4 ½ hour trip).

We made the necessary arrangements: Finding a caretaker for my adult daughter’s new puppydog, her two cats, and my cat. Then we had to drive my daughter and her husband to the airport so they could go to her inlaw’s. We were free to leave after that.

Driving up was much more difficult and less pleasurable than I expected. We drove on the Interstate. We were tired and grumpy. The weather was rainy off and on. We finally arrived at the tourist office, only to discover it had closed fifteen minutes earlier. We drove to the “grand canyon” and saw beautiful tree-covered hills and a long valley with a river running through it. The hills were misted over.

We drove to our bed and breakfast. That turned out to be quite thrilling because the people that are still in the process of building it have poured their hearts and souls into it. It’s brand new and it’s quite charming. Not that this is a plug, but the place is called, “The Woods,” and it's near the border of PA and NY. The buildings are beautiful, the rooms feel like they are part of an upper middle class home. Behind the buildings are formal gardens, and a pond and gazebo. The bed is more comfortable than the one I normally sleep on.

When we got up for breakfast, we had slept well. Breakfast was delicious, overlooking the garden. We were much more cheerful, meandering through the scenic route back to our house near Philadelphia. My husband, who's a history buff, thought we should check out Elmira, because he believed the founder of the Mormon Church, Joseph Smith, came from that city. Unfortunately, we discovered, it was Mark Twain's study and gravesite that are there, but nothing about Joseph Smith. For other history buffs or for offended Mormons, it was Palmyra, NY. After the side trip to Elmira and a visit to Mark Twain's grave site, we followed the Susquehanna River much of the way. Waterways are my favorite way to travel. All the colors of the scenery were richer that day and the curves smoother and softer.

We drove through a dozen nineteenth century towns that we swore we'd seen before. We spoke with several farmers selling produce. Their faces were lined with the sun. Their produce was fresh, crisp, bright in color and appealing. We found many different kinds of fresh, homegrown or homemade fresh produce: fresh goat cheese, honey, maple syrup, pepper jelly, carrots, tomatoes, cucumbers, corn-on-the-cob, and green peppers. We’re still savoring that day.

What I noticed was that it took quite a while to let down from the rush and bustle and worry and just relax and have fun and savor. It required being there for the second day. We seldom allow ourselves that kind of time. This was wonderful. I felt truly refreshed on Monday.

One of the things I learned from the exercise is that life needs to be savored as we go along. It was a problem that it took such a long time to get into the mood to enjoy myself. There isn’t any reason not to be able to decide to have fun or decide to deepen our pleasure when we choose to, not when the stars are right or someone else gives us permission. I have to make it all right for myself and then I have to keep making that choice.

Billie Lee Orenbuch is manager of Psychosocial Skills at Psychological Services & Human Development Center in Fort Washington, PA. She can be reached at 215-884-0093

. . . H E A L I N G A R T S . . .

ASK DR. BERRETTINI

by Wade Berrettini, MD, PhD

University of Pennsylvania

Q: I'm aware of about a dozen people who have been taking lithium for a number of years and are now suffering kidney damage. Is this becoming common for people on long-term lithium maintenance?

A: A small fraction of individuals seem to develop lithium-related decreases in kidney function after several decades of treatment. This sometimes requires that they stop the lithium. This decline in kidney function is poorly understood. There is no way to predict who will experience this. For this reason it is recommended that persons on lithium have annual, inexpensive blood tests of kidney function. Be sure to discuss this with your doctor.

Q: My wife and I have a 35-year-old son who is married and has two children. He recently told the family he was gay and has been meeting with his lover for many years. This, as you can imagine, came as quite a shock to my wife and me. We wonder if there's a homosexual gene. Question: Is there a homosexual gene?

A: No, there is no homosexual gene. As with other complex human characteristics, sexual orientation is a function of interaction among genes and environment. Thus, multiple genes and environmental influences shape sexual orientation.

Q: Several years ago, I played tennis and volleyball. Then I had my first episode of mania, including a psychotic break. In looking back, I remember that a couple of months before the break, I lost my ability to play sports. My hand couldn’t connect up with the ball. A friend of mine, who's a nurse, said it was due to a flaw in my central nervous system. This occurred before my psychotic break. Question: Do you think the two of them – my lack of motor coordination and my ensuing psychosis - are linked?

A: There is no evidence that a deterioration in physical coordination precedes the onset of psychosis.

Q: My mother and I are both artists and think we're quite original. This got me to thinking about originality. I read somewhere that people and chimpanzees share a lot of common DNA. Question: Please clarify the people and chimpanzee DNA percentages. Also, what percentage of DNA do all human beings possess in common and what percentage are unique to the individual?

A: Chimp DNA is approximately 99 percent identical to human DNA. Although there are abundant diversities in human DNA, in general, people share about 90 percent of DNA in common. Only about 10 percent is specific to one ethnic group or another.

Q: My 18-year-old daughter was diagnosed with bipolar disorder a year ago. I’m a teacher and am so emotionally devastated by this I’m seeing a psychiatrist myself and am on Ativan. Is it my fault she has bipolar disorder? I keep asking myself what did I do wrong? Question: Should I continue blaming myself for the problem? What part does heredity play in bipolar disorder and what part does environment play?

A: The fraction of risk for bipolar disorder attributable to genetics (the heritability) has been estimated to be about 80 percent. We do not understand the type of environmental influence which interacts with the genetic susceptibility to produce the disorder. A parent should not blame him/herself for the development of bipolar disorder in a child or any other relative.

*

Dr. Berrettini is a world authority on the genetics of bipolar disorder. He is the Karl E. Rickels Professor of Psychiatry, and Director, Center for Neurobiology and Behavior, at the University of Pennsylvania School of Medicine. For information about his genetics study utilizing 2 siblings with bipolar disorder, call 215-898-0092. For information about research studies at Penn, see uphs.upenn.edu/cnb)

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Just a coincidence? Compass editor, above, was driving down the back streets in her neighborhood when whom should she meet but Cindy Smith (not shown) former staff photographer for the Intelligencer newspaper. Cindy, now a dog breeder, was walking three of her dogs, including “Tish,” (shown above) who is one of the therapy dogs in

Abington Memorial Hospital’s pet therapy program. Story below.

Scientifically proven

PET THERAPY: Cuddle Up

Judi Levicoff has a philosophy that for true healing to take place, man and nature must come together. After all, she says, we are one and the same. And that includes dogs and butterflies and even goldfish swimming in calming aquariums. Levicoff has witnessed the wonder of this healing for the 10 years she's been director of Abington Memorial Hospital's Animal Assisted Therapy Program - "pet therapy" for short.

Just watch the way people react when one of the department's beagles or golden retrievers is brought into the hospital by its owner. "The pets have a unique impact on the whole hospital,” says Levicoff. “They bring everybody together, from the president on down to the staff and the patients."

The dogs are regularly brought to several adult and pediatric units, including the psychiatric.

Only recently, a patient lay still in bed, her face immobile, arms tucked under the covers. Levicoff brought in her own pet, a cockapoo named Lacy. (Levicoff, as well as all volunteers, have been trained and certified to practice pet therapy.)

“Each animal behaves differently in each situation,” says Levicoff. "The dog seems to know what needs to be done."

Levicoff asked the unresponsive patient if she could place Lacy on the woman's bed.

She carefully placed her cockapoo on the ill woman's bed. And through the mysterious process of "nonverbal communication" the dog knew just what to do. She moved around the bed and snuggled close to the woman. "Then she planted a kiss on her shoulder." You could see the patient come out of her malaise and slowly come back to life. She even smiled, the first time in a week.

"They were able to communicate with their bodies," says Levicoff. "Lacy uses her body and her soul to communicate. It's almost as if the patient and the pet were breathing as one."

Pet therapy grew out of an idea in the mid-1980s. There had been anecdotal evidence that pets brought a new sense of health and vitality to a person's life. International organizations were founded, espousing the virtue of pets as part of a person's overall wellness. Studies were completed that indeed proved the anecdotal evidence to be true: people with pets experienced lower blood pressure, better response to medication, and increased socialization.

Abington's pet therapy program was founded by visiting nurse Marilyn Harris. "A visionary" is how Levicoff describes her, a woman energized to make her vision a reality within the accepting walls of the hospital. Harris and Levicoff worked side by side. "It evolved so that I'm now the director," she says.

Twenty-five volunteers donate themselves and their dogs to the program. "The individuals and their dogs work as a team. It takes a special kind of person to volunteer with their dog."

As director, Levicoff has led the center in a surprising new direction. She worked with the University of Kansas, which hosts a program called “Monarch Watch.” People throughout North America track the migration of monarch butterflies that migrate to Mexico. Butterflies are tagged so scientists can follow their route. The program, says Levicoff, has many different levels. "I had an experience that taught me you could work with butterflies and have a relationship with them."

She developed a program at Abington in which butterflies are nurtured from their cocoon stage until their emergence as butterflies. She uses this program with children in Abington's Safe Harbor program, a group for grieving children. "You facilitate a connection between the children and the butterflies. There's a sense of familiarity between them." The children, many of whom have lost a parent, watch the stages of growth until the butterflies are ready to be set free and fly off on their own. "When the time comes to release them, it's as if the butterflies know, and they don't fly away right away." They linger, as if saying goodbye.

Butterfly gardens are now a thing to look for at the hospital - in the pediatric department, and at the front desk in the lobby. Levicoff even knows of dentists who plant butterfly gardens so patients can look outside beyond the dental chair to the flitting butterflies outdoors.

Note: Abington Memorial Hospital recently won an award honoring the hospital’s leadership and innovation in patient care quality, safety and commitment, one of 5,000 hospitals eligible to apply.

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Dr. Jack Gomberg of Project Transition

MEDS ARE NOT ENOUGH: THE MIND BODY CONNECTION

An interview with Jack Gomberg, MD

Project Transition

by Scott Johnston

Dr. Jack Gomberg is a psychiatrist and Fellow of the American Psychiatric Association. In addition to serving as medical director at Project Transition’s Chestnut Hill program site, Dr. Gomberg maintains a private practice in Spring House, PA. He can be reached at 215-628-8585 or email: sjprojtrans@.

Project Transition maintains 2 residential facilities for people with mental illness, one in Chestnut Hill, the other in Warrington.

Q: What are the pros and cons of traditional Western medicine?

JG: Conventional Western medicine focuses on pathology, disease, and treatment. While this approach has been highly effective, the training that most physicians receive doesn’t really emphasize optimal health.

The derivation of “health” connotes wholeness, balance, and resilience. The capacity for the body to heal and repair itself can be seen all the way up the ladder: DNA, cells, organs, and organ systems. Integrative medicine unites a conventional approach with healing concepts – it goes beyond treatment of disease.

One of the problems with conventional medicine is the dichotomy between the doctor and patient. Too often, the patient is just a passive receptacle that gets treated by a doctor whose role is to cure through intervention. A more integrated approach focuses on empowerment. The challenge for both the doctor and patient is to join forces and proactively promote healing.

Q: What is the “mind-body connection”?

JG: The Western convention is to define the body as everything up to the head, and the brain is referred to as the mind. But, in a sense, the mind is everywhere. There are neuroreceptors and neurotransmitters throughout our bodies. So the distinction between mind and body is a difficult call. Physician author Andrew Weil refers to our bodies as physical hardware through which we can run different software. One fascinating example of this comes from research with people who are viewed as having multiple personalities. Each personality, or “alter,” can have unique physiological allergies. This is an example of the same hardware hosting differing software.

Q: What is the role of medicine in psychiatry?

JG: Conventional psychiatry is my mainstay. Many medications utilize the mind/body connection in that they interact with neuroreceptors to help normalize deficient neurotransmitters. The recently developed drugs are more selective in their action... the aim is to get efficacy while minimizing side effects. The newer medications are designed to regulate naturally existing substances in the mind/body. Nothing is perfect, and side effects still occur. While medicine’s role in correcting an imbalance may be necessary, it is often insufficient because it is just one piece of the puzzle. There are many factors that support optimal health: physical, cognitive-emotional, relational, and spiritual.

Q: When faced with complex emotional challenges, we tend to embrace one solution...

JG: Yes… taking medication can delude us into thinking, “Oh, this is the answer.” Too much faith and power are poured into one thing. But any “one thing” is rarely enough. Multiple elements need to be activated in order for sustained healing to occur.

Q: What are the elements of healing? Is the medical field acknowledging them?

JG: The negative side effects of weight gain and diabetes associated with Clozaril and Zyprexa have fostered a greater awareness of health risks like the Metabolic Syndrome. Fortunately, this has resulted in a greater emphasis on health induction through lifestyle modification. At Project Transition, we developed a program called NEST. It augments other therapies and consists of activities that promote nutrition, exercise, and stress reduction training.

Regular exercise helps everything. Research has documented the benefits of cardio-vascular and anaerobic exercise. It can alleviate depression, and it can temper mania by calming racing thoughts and anxiety. But if you’re in a manic storm, you may be tempted to over-exercise, which is not healthy. Nutrition is important, too. For example, in addition to eating right, I also take some nutritional supplements to ensure proper enzyme and immune system functioning. Another element of healing relates to relaxation and meditative techniques – daily meditative breath work is very effective.

The powerful effects of positive relationships cannot be overemphasized. We are social beings - our perceptions, thoughts, and feelings are largely guided by relationships.

Other spokes of the wheel include fun and relaxation… playing with a pet and a walk in the woods are great stress busters. Spirituality is yet another aspect that contributes to optimal mind/body health. Anything that helps raise one’s spirits can be included in this realm.

Q: It can be hard to modify lifestyle, especially when depression is heavy…

JG: Absolutely -- it requires mobilization, which depression can inhibit. Sometimes medicine can help the person get to the place where lifestyle changes are within reach. Family members and friends can provide vital motivational support, too. The bottom line, though, is that optimal health requires effort and practice. To get the dividends, you have to invest.

*

In the raw. The Upper West side menu was incomprehensible to me, but I wasn't going to let on. In a confident voice, I ordered beef tartare. Imagine my surprise when the waiter brought me a large china plate with greens surrounding a scoop of raw beef covered with a raw egg. One bite was all I could stomach.

KAY JAMISON: Iron discipline with blueberries on the side

She’s beautiful, she’s brilliant, she writes books, produces TV shows. She won the MacArthur “Genius Award” and is the most influential person in the world of bipolar disorder. You may own her books. “The Unquiet Mind” is a masterpiece of the bipolar journey, while “Manic Depressive Illness,” which she co-authored with Dr. Frederick Goodwin, is the definitive text on the disorder. Her bravery in “coming out” publicly a few years ago – she’s got manic depressive illness - revealed the risks and complexity in self-disclosure.

Kay Jamison, PhD, is professor of psychiatry at Johns Hopkins University. She was keynote speaker at the national DBSA conference in August. In a reporting coup, John McNamany of McMan’s Depression and Bipolar Weekly (Aug. 23), spoke with her. Here are highlights from both her talk and his personal interview.

What Kay Jamison wants you to know:

- The importance of sleep, which she described as the “underlying pathology of illness.” Her late husband used to remind her to get her sleep, frequently phoning her when she was on the road. She would tell him “he was worth 600 mgs of lithium to me.”

- Personal care: As for diet, writes McMan, two words apply - “Bear Diet” - lots of fish, lots of blueberries. Reading and journaling also important.

- Badger your doctor. “Badger, badger, badger” with questions, and on how to get your meds right.

- A passage from William James, in his “Varieties of Religious Experience,” “changed her life”:

“Whilst in this state of philosophic pessimism and general depression of spirits about my prospects, I went one evening into a dressing-room in the twilight… when suddenly there fell upon me without any warning, just as if it came out of the darkness, a horrible fear of my own existence…”

In a similar vein, McMan quotes another passage from the great poet John Berryman.

“I do strongly feel that among the greatest pieces of luck for high achievement is ordeal… The artist is extremely lucky who is presented with the worst possible ordeal which will not actually kill him. At that point, he’s in business.” Berryman died at age 58 after jumping off a bridge.

- Jamison also expressed that rather than leading a “stunningly boring life” she prefers “tumultuousness coupled to iron discipline.”

McMan noted in his interview that Jamison is at work on yet another book. The theme and title, this time, is the wonderful word, “Exuberance.” (Read a selection from her chapter on John Muir and Theodore Roosevelt on .)

OUR FAVORITE PHARMACISTS

GOING OFF CLOZARIL: A BAD RISK?

A talk with Joel Shuster, PharmD, BCPP

Temple University

This is a story that brings up major issues for patients and families alike. Details have been changed.

“Burt” is a Clozaril success story. As we know, Clozaril (clozapine) was the first of the new generation of antipsychotics (the “atypicals”) - for people with schizophrenia and schizoaffective disorder - and is considered the “gold standard” that other atypicals are measured by: improved side effect profile as well excellent results with both (1) “positive symptoms” (delusions, hallucinations, voices) and (2) negative symptoms (inability to feel emotions, social withdrawal).

The downside of the drug is the necessity of having blood drawn every 2 weeks to see if the patient has developed a rare condition - agranulocytosis - that decreases white blood cell count, thus lessening the body’s ability to defend itself from disease. This condition occurs in 1 percent or less of those on Clozaril. The white blood cell count must be measured weekly for the first six months, then bi-weekly afterwards.

For Burt, Clozaril was the drug he and his family had been searching for. While it certainly didn’t remove all of his symptoms nor return him to the person he once was – a computer programmer who never missed a deadline – it enabled him to live a decent enough quality of life.

His success with Clozaril – he was on it for 8 years - continued despite his increasing unhappiness about getting his blood drawn for lab work. “I felt tethered and confined,” he said. Finding a “good vein” became more and more difficult. Finally, this became such a painful reality that he insisted on switching to another drug. He was fully aware of the risks of switching from something that had kept him hospital-free and the possibility of failing on a new drug. He reassured himself that many new drugs had been on the market since the introduction of Clozaril.

He discussed the situation with his wife and psychiatrist. Both were fiercely opposed to switching meds. After all, why shake things up instead of learning to endure the necessary blood work?

Burt was adamant, insisting that in order to live a quality life, he could no longer endure the needle sticks. His doctor very reluctantly put him on a new drug. It didn’t work. Nor have any subsequent drugs, including the new Abilify which caused severe voice activity.

(Compass update: Miraculously, after four months of experimenting, the proper combination was found: Seroquel, Risperdal and Trileptal.)

The bottom line is that an individual has the right to make choices, even if they do not pay off.

We asked Dr. Shuster - he runs a large Clozaril clinic and his patients call him “Joel” - some questions about Burt’s predicament. First off, he told us that he always uses the generic name of the drug with his patients: “It’s important for all patients to know the trade name and generic names of their medications. As a medication safety expert, I know that this knowledge helps to prevent errors.”

1 - What are the chances of someone successfully switching from clozapine to another drug?

There is not a great deal of good data to answer this question. If clozapine is being used today, a patient has usually failed on many other medications. And if clozapine “is working,” there has to be a fair amount of risk to take someone off the medication that is working.

2 - Are there any drugs in particular that have been found helpful post-clozapine?

None that I know about. Of course, with each new drug that is on the market, there is a chance that the new agent may help.

3 - How long do these drugs take to work?

We always say that the best effect of antipsychotic drug therapy takes about 6-8 weeks. We often see a lessening of symptoms earlier in the treatment.

4 - Do you think Abilify is a good choice?

Abilify is the newest drug on the market. It may have a slightly different mechanism of action compared to the other "atypical" or "newer" agents.

5 – Do you see much resistance to the blood draws in your clinic?

My patients have gotten used to the bi-weekly blood tests. Many have been doing this for more than 10 years. A couple of our people always hate the blood draw, but they keep doing it!

6 - Does such frequent blood drawing pose a danger to one’s veins?

There is no danger to the veins, although occasionally the phlebotomist (lab tech who draws the blood) has to find a new site on the arm.

7 - We’ve heard that in Europe the blood drawing is much less frequent Do you think a person’s blood needs to be drawn as often as every 2 weeks?

In Europe, the blood tests are now done once a month. It is my understanding that a similar proposal is being looked at in this country.

8 – Burt is currently in the hospital trying different medications. Do you think there's hope that in time he will come around?

I believe that there is always hope. But a well-known fact about schizophrenia is that the illness is harder to treat with each psychotic episode.

Dr. Joel Shuster is a professor of clinical pharmacy at Temple University School of Pharmacy. He administers a large outpatient Clozaril clinic at EPPI (Eastern PA Psychiatric Institute), sister hospital to MCP (Medical College of PA). He heads the “Communication Skills” course taught to all fourth-year students and the elective course “Medication Safety” at TU School of Pharmacy. He is a member of the Board of Trustees of the Institute for Safe Medication Practices in Huntingdon Valley, PA. He is a certified psychiatric pharmacy specialist.

*

King of the cheapskates. Bill, a Temple professor, was mad. They had refused to serve him a child's meal at Oak Lane Diner. He wanted it for himself. "What difference does it make who orders it or who eats it?" he asked. He thought of a way around this: to order it “to go.” You could, theoretically, have a child at home, waiting for the food.

MOOD CHARTING

“How to Help Your Doctor Give you

the Best Medicine at the Best Dose”

by LARRY DI BELLO, RPH

Friends (Hospital) Resource Center

Imagine trying to get to a place you’ve never been, from a place that keeps changing all the time. Without a map.

This is the same thing as going to your doctor’s office for medication without either you or the doctor being prepared.

You need to be prepared. First, think about yourself and what you bring to the doctor’s office when you are not prepared: Can you remember exactly how you felt two or three days before? Can you remember, for example: “Was I anxious or depressed?” – “Was my thinking clear?” – “Was I feeling paranoid?” “Did I sleep well?” - “Did I experience physical pain?” – “Was my stomach upset?”

A person can’t really remember exactly how they were feeling, even a couple of days before the doctor’s visit. It’s important to document how you felt between doctor visits.

Let’s take a look at it from the perspective of your doctor.

You walk into his or her office and sit down. The doctor asks you why you are there. You tell the doctor generally how you’ve been feeling and generally what you think is wrong with you. You then relate the symptoms you’ve had for the past couple of days with a vague idea of the symptoms you’ve had in between visits.

From this kind of sketchy information, your doctor has to make a great number of assumptions. The medication can only be as finely tuned as the information you provide him with.

When you consider that every person responds slightly differently to every medication, you are the only person that can provide the doctor the information on what the medication is doing to you. Most doctors have an excellent idea of how the medication works for the majority of patients from the reams of clinical information they have. BUT the information they really need is what the medication is doing specifically to you.

So, make an investment of one or two minutes at night before going to bed. It will go a long way to accomplishing these goals. Two short minutes is all it takes to keep a great Mood Chart. Mood charts are available from any DBSA chapter, from the Family Resource Center at Friends Hospital (215-831-4894), from the internet at or call me at 610-543-2966 and I’ll send you charts - and even teach you how to use them!

Larry DiBello is a retired pharmacist and is “Ask the Pharmacist” at Friends Resource Center. He is a recipient of several awards including the Jonathan Roberts Award, named for the father of Hospital Pharmacy Practice in the U.S. Call Larry with your questions at 610-543-2966. He answers!!!

Our man in neuropsychology

COGNITION AND STRESS

by Gregory D. Perri, PsyD

Cognition refers to thinking skills: the intellectual skills that allow you to perceive, acquire, understand and respond to information. This includes the abilities to pay attention, remember, process information and solve problems, organize and reorganize information, communicate, and act upon information to allow you to function in your environment. (from Medalia and Revheim).

Question: I’ve been looking for a job for nearly six months. My wife and I argue all the time and, as if that’s not bad enough, we’re putting on an addition to our house. Needless to say, I’m stressed to the max. It also seems that my cognitive abilities are compromised, particularly my memory. Is this common for people under a lot of stress.

Dr. Perri: Absolutely! Stress can impact on cognition in a myriad of ways. The first one that comes to my mind is attention. When you’re under a lot of stress, it becomes much more difficult to focus.

It happens to all of us, even those with no psychiatric diagnosis. For example, when you’re extremely fatigued and need to read something technical or difficult to understand, stress will impact your ability to concentrate.

In other words, if you’re trying to focus on a “cognitively complex” activity such as attending to an advanced lecture or reading a journal article, you’re going to need to sustain your attention for an extended period of time. Your stress will detract from your ability to maintain that necessary focus.

Memory is also impacted by stress. This can happen indirectly as well, again, because of the lack of attention. When we need to memorize something, particularly if it’s complicated, we need to be paying full attention to it.

On the other hand, we may have memorized something but when we go to retrieve it, we may have difficulty accessing what we know that “we already know” (word-finding problems). We can see there is a real interplay here with stress. And certainly there is a great amount of frustration that occurs.

We can see the possible ramifications for people with mood disorders – as well as “normal” people - if we look at the extreme case of a schizophrenic brain. We see decreased activity in the prefrontal cortex, which is thought to be a seat of executive function (planning and organizing ability, shifting sets, monitoring behavior, that sort of thing). By looking at this type of brain, we see how intensely connected stress is with the level of cognitive and behavioral functioning. Again, we can probably see some ramifications for the normal brain as well.

Dr. Perri is a post-doctoral fellow in neuropsychology at Widener University. He did his dissertation on “Analysis of Errors Committed by Traumatically Brain Injured Patients” on several psychological tests.

*

Even over pancakes. Two therapists went out for lunch to a pancake house in Bensalem. By the end of their dining experience, they knew all about the waiter’s problems – he was from Morocco, felt lonely and was unsure about local customs. The therapists gave him free advice, saving the waiter hundreds of dollars. (Therapy, said the waiter, is taboo in Morocco..

The Department of Amazing Stories

MY LIFE: YOU WOULDN’T BELIEVE!

By Bob M.

The following true story appeared in the August issue of “Recovery,” a publication of the Consumer Satisfaction Team of Montgomery County. Thanks to Bob for sharing this. It’s a marvel.

Introduction

Forty years ago, my father took my mother, my brother and me to see a family member who had cancer. Before we left, Dad sat down with my brother and me and warned us, “Don’t shake her hand and don’t sit next to her.” So we didn’t. The point of this is that 50 years ago this collection of misunderstanding and fear was what the average person believed about cancer. Today nobody would believe that.

Today many people’s beliefs about mental illness are equally out of date. Many people look upon mental illness with vast amounts of fear. I didn’t know anything about mental illness until life drove me to the very extremes of reality and beyond.

First grade

In first grade, for the first time, I was surrounded by kids my own age. I could see them coming together forming friendships, organizing softball games and having a good time. I couldn’t understand how they did these things, let alone that this was what you were supposed to do. It seemed like everybody was better at living his or her life than I was. My mind seemed to be slower at these things than the other kids. I was mostly quiet, never got into trouble and got good enough grades that the school passed me from grade to grade.

The Teen years

It was as a teenager that I had my first active symptoms of mental illness. I started hearing voices inside my head and seeing things that weren’t there. One day I was standing on the steps of the cafeteria in junior high school along with some of my classmates. Suddenly I saw this one boy had three legs. All of the legs looked real, in full color and 3-dimensional. They moved a little, all very lifelike. It seemed odd to me that he had three legs, but they all seemed real. Then one leg faded away, and he returned to being two-legged. I felt much more comfortable with that. I never told anybody about the incident, not the school and not my parents. I didn’t know how to talk about something so out of the ordinary. I grew up with having these things happen from time to time and I just assumed it was normal.

Young adult years

While there was fantasy in my head, there was also reality. I graduated from Penn State with a Master’s Degree in electronics engineering. I worked in that field for 16 years. I was married for 7 years. The hallucinations would come and go, but most of the time I was able to cope with a mind that was able to grasp enough of what went on to get along.

I remember one incident that happened at a meeting while I was at work. Our group, which consisted of 4 or 5 technical people, was presenting our work to another small number of people interested in the project. As project manager for one phase of the work, my presence at the meeting was appropriate. The meeting started and people were discussing the topic at hand. Suddenly I began to hear these voices inside my head. They were following along with what was going on in the meeting. They would ask me questions, technical questions pertaining to the topic of the meeting. I would think the answer, then they would ask another question. How could someone so out of touch climb the career ladder to such a height? It’s scary. Naturally if my mind was busy processing voices and thoughts, there was not very much of me remaining to focus on what was actually going on in the meeting. I didn’t contribute much, but nothing was said about it.

Suicide

I had many suicidal thoughts. Like the voices, they would come and go. I started the suicidal thoughts when I was in my early twenties and continued them into my mid-forties. Each time I would plan some way to terminate my life. But then my next thought would be that if I did succeed at suicide, somebody would have to clean up the mess. I didn’t want anybody to inconvenience himself or herself by cleaning up my mess, so I went on living. This made me feel really low, that I didn’t have enough control of my life to terminate my life.

Mid-adult years

Mental illness, like many medical illnesses, can get worse if it remains untreated. The voices told me I didn’t have to work. I gave notice and left. That was 20 years ago and I am still not able to work full time. Without the structure that work provided, my condition rapidly deteriorated.

At this point in my life, I didn’t have much human contact and had no real goals. The voices came back almost all the time. I would have regular conversations with them. They told me if they saw me outside, they would kill me. So I stayed inside. Once a week I would brave the wrath of the voices and go grocery shopping. As my condition deteriorated even more, once a week was too much. I stayed home all the time. In a brilliant move, I had pizzas delivered. Every few days I would order three or four pizzas. I spent many hundreds of dollars on pizza. I would never order from the same pizzeria twice so they didn’t get suspicious. This went on for months.

Finally my condition continued to deteriorate and in the winter of 1987 I stopped eating altogether. I would drink only a small cup of water each day. I thought I should be drinking more than this, but the voices replied, “We’ll drink the water for you.” Like the boy with the three legs, this seemed odd, but it also seemed to have some sort of reality bound to it. I still thought about suicide, but then I always thought I didn’t want to have anybody clean up my mess.

The winter of 1987 was a cold winter and I let the heating oil run out. My mind was dealing with too much fantasy to do the rational thing: call the heating company. My life had deteriorated to the point where I would kill myself in any of three ways. I might have frozen to death. I might have starved to death. By not getting enough water, the toxins were building up in my body and I was poisoning myself.

Christmas dinner with John’s family

I lay there in bed, suicidal, delusional, at the extreme edge. There was enough of my mind working to realize I was going to die. I thought I’d like to go to heaven, so I put my mind on heaven. Instantly I was transported out of my bed, and I was standing in front of a desk. Behind the desk was a man shuffling papers. He continued shuffling papers for a moment, stopped and looked up at me. He said, “I don’t have you as coming across at this time, Mr. M.” He knew my name, so I thought this must be a part of heaven. I told him that I heard there was going to be a party in heaven, and I wanted to get in on the party. He looked at me again and said, “ I still don’t have you as coming across at this time. You’ll have to go back down.” Well you just can’t argue with this kind of person. There was a whoosh, and I was back in my freezing bedroom. I was more confused than ever. Was the man behind the desk real, or just imaginary? If he was real, what did it mean?

My mind was in such a deteriorated state that I don’t remember how long it was before the phone rang. It may have been hours. It may have been days. The caller was my friend John, inviting me to share Christmas dinner with him and his family. He could tell by the way I was talking something was wrong. I told him nothing that was happening was making any sense.

John’s wife Judy was a RN with training in mental health. She was familiar with the inpatient mental health facilities in the area. She and John got me into the Lower Bucks Hospital. The hospital was a new experience for me and my mind started to focus more clearly. I could see that something had gone wrong with my life bigtime. For the first time in my life, I felt respect from other human beings. I felt respect from the staff and the other patients. It was all right to talk about hearing voices. It was all right to talk about being suicidal. It was all right to ask for help from others when you needed it.

I was saved by the mental health system. 22 days later, this same system turned against me and nearly killed me. Since I didn’t have insurance, as soon as I started to show signs of more rational behavior, they told me I had to leave. I was so horror struck I was afraid to say what was on my mind. I knew I needed the full time support of a hospital, but they wanted to send me back to where I was living. But that’s where the voices were. I knew I would never make it out of there alive. How could I ever trust the mental health system again?

Eventually I wound up living with friends and family. Being with normal people helped convince me there was something good in me, and that it was worth working on to make me stronger. I found a psychiatrist I could trust. He suggested I attend a day treatment program. I went there but was scared they were going to kill me, like the voices. After a year or two and several changes of medications, I came to trust the staff and the clients at the day treatment program. I started to make rapid progress on my road to recovery.

The present

I am fortunate that the kind of mental illness I have responds to treatment quite well. My mind has become progressively clearer in the 15 years I’ve been in treatment. I am no longer suicidal. I don’t hear voices. I have carefully built a support network of understanding people who I can be friends with or ask for advice if the need arises. Today I work part time, go out on social occasions with friends and am convinced there is something really good inside me. The man behind the desk was right: there really is a party in heaven. Every time I take a step toward living a happier life, the party gets better.

Why?

As my mind has become more rational, I can think back in time and see old ideas in clearer ways. Lately I have been thinking of spirituality. Why did god, if there is a god, let me suffer so? I’m almost 60 years old and have been mentally ill most of my life. Surely whatever good I am going to do during the rest of my lifetime could have been done at a much earlier age and with a lot less grief to others and myself. Why the decades of suicidal tendencies? Why almost freezing to death? Why living alone starving to death? I now believe god was there all the time. God was the thought that prevented me from committing suicide by not wanting to leave a mess for someone to clean up. He was gently pushing me away from making a mistake. God was the phone call from a trusted friend whose wife just happened to know about the mental health programs. That was god moving me into a new phase of my life, a phase where I’ve learned many wonderful things about myself and others from the imperfect mental health system. In real life, nothing is perfect, but it can be useful.

I have recently come to believe that I know why I’m here. It is to investigate spirituality, know the ways it comes into my life and share this with others. This is another way of saying I’m capable of more growth, which will result in a much more normal, happy me. I’ll find new ways to share with friends.

I get the sense that at the present time, I’m about where god wants me to be. I’ve gone from the confused first grader to the outward-bound man. That’s quite a lifetime. Are you with me? Then hold on. This could be interesting.

[pic]

SAVING THE LAST FOR LAFFS

Revelations of a High Maintenance Junkie

By Phyllis Lewy

I am a high maintenance junkie. I love manicures and pedicures. Haircuts, blow-dries and color wow me. The beauty salon is an essential part of my week. It is an obsession and an addiction that I can’t stop and am not sure I want to stop.

Appointments are made weeks in advance and then checked and rechecked. The threat of bad weather forces me to shift appointments, jockeying for the best time.

If addictions are genetic, I come from a long line of junkies: my grandmother, mother and aunt. The beauty salon is and has been a family tradition forged on decades of Saturday morning or Friday afternoon appointments. Looking good has always been a priority. On the day of my aunt’s funeral, my mother and I took my grandmother to the salon. The hairdresser made a house-call when my mother was hospitalized.

What causes such a costly addiction? What causes some women to practically tithe a portion of their income for this weekly ritual? Is it inordinate pride or vanity? Or is it something more?

It is the downright sensual pleasure of having someone fuss and pamper me for half an hour to forty-five minutes. For that period of time, I am truly special and receive star treatment. It is my moment to shine in an otherwise world-weary time of chores, work and obligations. It is a wonderful mood elevator which is cheaper than a trip to the psychiatrist and is healthier than drugs. And that beats a pair of Prada shoes any day.

The Compass agrees there’s nothing like pampering yourself to make you feel good!!! But, please: Facials are not a substitute for consulting your doctor.

PURSUE THE WONDERFUL… INTO NATURE

by Carolyn Constable

At 59, you’ll find Carolyn Constable out on the trails of Peace Valley Nature Center in Chalfont where she works as a naturalist. When the school buses arrive, she takes the kids out on the trails to show them the secrets of nature. Hard to believe, she says, but many inner city school children have never seen a frog or heard its echoing harrup-harrup. As part of her classes, she invites the children to write nature poems, just as she does. “I can’t stop writing,” she says. “It’s just something inside me.” Carolyn was just named “third runner up” out of 70 entries for the 2003 Bucks County Poet Laureate competition.

It’s the time of year that hawks migrate. Over the weekend I stood on a hill at Lake Galena and watched the broad wings fly over. They’re magnificent birds with large wings and large bodies, heading south from New England to Mexico. Their bodies are made to fly. They sail in hot air thermals – or currents - to conserve energy.

Each species of hawk has its own time to migrate. They fly in flocks called “kettels.” One year when I was doing a hawk watch at Cape May Point where you count the number of migrating hawks, our group counted 13,000 birds in a single kettel! It was breathtaking. You can’t imagine how that looked… thousands and thousands flying right overhead.

Later on, we’ll watch for the bald eagles. They used to be endangered, but now they’re considered “threatened.” They fly solo, not in flocks. If you’re lucky, you’ll see one. Watching an eagle soar is a thrill of a lifetime. One time a birding class came out to another hill and an eagle soared right overhead, as if on cue. I learn these stories from other birders.

Birders are really intelligent people. I like to chitchat with the other birders. It’s like sitting in a classroom. I talk to the retired guys. They spend their whole lives birding. The nice thing about them is you can ask them all the questions you can think of and they’re never in a hurry to give you answers.

Once you get into birding, the complexity only deepens. I guess that’s what keeps us coming back.

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ENDQUOTES

A quartet of quotes from artists:

“My work is a continuous development of the same themes and obsessions.”

– Jackson Pollock (1912-1956)

“I look at an object and say, Well, what can I do with this? I I want to bring the object up to its full potential.

– Carl Yeager, Lansdale, PA

When asked if he’s the most talented artist in New York, John Currin, whose retrospective is now at the Whitney museum, replies, “Of course I think that! …I always thought I was the best, even when I wasn't the best. Every artist worth his salt thinks he is the best.''

– from interview in the New York Times 11-16-03

“Art gives me everything I need. It’s my religion. I turn into what I paint. I become waterfalls, I become the sky. I do it only for myself. Only what pleases me.”

- Barbara Postel, Point Pleasant, PA

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The Compass is published 4 times a year on the third Tuesdays of the following months:

January – April – July – October.

Circulation: 2,500 mailed to subscribers, physicians, therapists, private and community mental health centers, drop-in centers, consumer and family support groups, and national organizations.

The Compass is a copyrighted publication of New Directions Support Group, Inc. of Abington, PA. It is published through an extremely generous contribution from Janssen Pharmaceutica Products, LP. We also wish to thank the Patricia Kind Family Foundation and our readers/subscribers.

Editor: Ruth Deming

Assistant Editor: Simon Baniewicz

Production Staff: Mary Begis, Joan Entenman, Ada Moss Fleisher, Bernice Greenwold, Ellen Greenwold, Harvey Pfeffer, Amy Russell, Freda Samuels, Janet Taylor Graphic Layout: E. Hunt Researchers: Ellen Greenwold, Mike DiMarcantonio Gold Pages: Mike DiMarcantonio, research editor Professional advisors: Beth Kelly, LCSW; Edie Mannion, MFT; Billie Lee Orenbuch, LCSW; Sharon Piercy, RN; Linda Jenofsky, MS, M.Ed

Medical advisors: Wade Berrettini, MD, PhD; Laszlo Gyulai, MD; Pamela London-Barrett, DO; Richard Fleisher, DO; Laurence M. Schwartz, MD

Cover: Carl Yeager

Cover Photo: Destiny, Photo taken in Bucks County, PA. 1974. Realized October 19th 2003.

“What is my destiny in life and should I know when it has arrived? Do I have more than one and if so how does one recognize them and cherish them? What is my path destined to be when there are so many questions with so little answers? Perhaps only another can tell me of my fate. Is this the one who waits at the end of this covered path?”

- Carl Yeager

“Tools and Inspiration for People With Mood Disorders”

The Compass is a publication of New Directions, a support and education group for people with mood disorders and their families & friends. Mood disorders – depression and bipolar disorder – are genetically-predisposed, environmentally-triggered central nervous system disorders that respond well to medication and therapy. We meet the first and third Tuesdays of the month at Abington Presbyterian Church, 1082 Old York Road, Abington, PA, from 7:30 PM to 9:45 PM. To register, please call 215-659-2366, ext. 1.

New Directions is affiliated with the national DBSA (Depression and Bipolar Support Alliance) –NAMI PA (National Association for the Mentally Ill, PA state chapter) - member of the Abington Memorial Hospital Referral Network - and works in cooperation with the Montgomery County (PA) Office of Mental Health.

Many thanks to our contributors who widen our understanding of mental illness and of ourselves. We welcome contributions. Send manuscripts to above address. To protect confidentiality, composites may be used instead of actual people. The Compass refers to a variety of medications in order to educate our readers to the variety of medication available. We remind readers of the wide variation of medications on different people. As always, check with your trusted physician to find whether a medication may be suitable for you. None of the articles printed here is a substitute for consulting your physician

The Compass does not endorse or recommend the use of any specific medication, product or treatment.

THE

COMPASS

A Mental Health Quarterly in the Greater Philadelphia Area

Fall 2003, Vol. 16, No. 3

A Publication of

New Directions Support Group, Inc.

Abington, PA

Mailing Address:

P.O. Box 181

Hatboro, PA 19040

Contact us at 215-659-2366

Compass123@



We love hearing from you!

Inside this Issue:

Guest Speakers -1

Editor’s Corner -1

Letters to the Editor -3

Tasty Nuggets -4

Bulletin Board -4

Mornings at the Mall -6

Ada’s Outing -6

Ask The Compass -7

Mrs. Olson -7

Our Daughter’s in Trouble -8

Just Folks -9

Our Favorite Iconoclasts -9

Queen of Thrift -9

Letter From Mark Davis -10

Love and Marriage -11

Our Nancy -12

Notes From A Therapist -13

Billie Lee Orenbuch 13

Healing Arts -14

Ask Dr. Berrettini -14

Pet Therapy -15

Dr. Gomberg -16

Kay Jamison says… -17

Our Favorite Pharmacists -18

Joel Shuster -18

Larry DiBello -19

Our Man in Neuropsychology -21

Gregory D. Perri, PsyD

Department of Amazing Stories -21

Bob M. - 21

Humor -23

Phyllis Lewy - 23

Pursue the Wonderful -23

Carolyn Constable - 23

Kaleidoscope

Gold Pages

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