Paranoid schizophrenics I’ve known

Esteban Santiago in custody

Esteban Santiago, the lone gunman who killed five innocent strangers and wounded six more at the Fort Lauderdale airport on January 6^th, had sought help from the government in November. He walked into an FBI office in Anchorage, Alaska, claiming that the U.S. government was controlling his mind and forcing him to watch Islamic State videos. Agents called police and he was taken for a mental health evaluation, but he didn’t appear intent on harming anyone, so he slipped through the cracks in the system. Two months later, he officially became a murderer.

His delusional claims brought back memories of my years working on locked wards with seriously ill patients at Hudson River Psychiatric Center in Poughkeepsie. With my hard-earned master’s degree in art therapy from New York University, I was embarking on my first full-time job in mental health, and I was especially fascinated by the elaborate delusions of those diagnosed as paranoid schizophrenic. The men on Ward 604 ranged in age from their late teens to early middle age and they were on the maximum-security ward because they were considered a danger to themselves or others. Some were assaultive, others had prison records, and there were a couple of murderers.

Abandoned Rehab Center at HRPC. I led an evening Creative Arts Club here for those allowed to leave the wards.

This was the 1980’s, and like many state mental hospitals across the country, Hudson River was rapidly being downsized as patients were discharged into the community, presumably to be managed through outpatient services and medication. But some were deemed too dangerous for discharge, and others cycled in and out through the system’s revolving doors.

Some of the paranoid schizophrenics believed they took their orders from God or the government, while a few believed they actually were God or at least Jesus. One young man believed he had turned into a woman and had sex with John Lennon. (This was in early 1980, before John was brutally murdered.) I couldn’t resist replying, in my best nonjudgmental therapeutic manner, “Oh, do you want to tell me about that? What was it like?” Unfortunately I can’t recall his reply.

I encouraged the patients to get their visions down on paper, with pencils or paint, and to talk or write about what the images meant to them. As an art therapist, I’d been trained not to impose my own interpretations aloud, but I’d learned to analyze the pathologies revealed by their artwork, to record them in progress notes and to report disturbing content to their shrinks and treatment teams. Often the imagery was violent, replete with swords, guns, blood and dismemberment. Yet not once did a patient assault me or even verbally threaten me. I was their ally, there to foster their creativity and self-expression, not to impose controls on them.

Abandoned day room, Cheney Building, HRPC–much like the one where I held art therapy sessions

Hudson River closed years ago, and I’ve often wondered what became of those patients who were incapable of adjusting to life in the community. Like thousands of others, many probably ended up in prison, homeless or dead. Deinstitutionalization hasn’t been the panacea it was touted as being, and there aren’t enough affordable community mental health services to go around.

Esteban Santiago in Iraq

Esteban Santiago was receiving psychological treatment in Alaska, but his family wasn’t privy to the details. Clearly it wasn’t enough, but maybe nothing could have stopped his deadly rampage. Since he surrendered and survived, maybe he’ll be able to shed some light on his actions.

Two days after the shooting, I began this blog post as a potential op ed piece for the Albany Times Union, but then I realized that my viewpoint wasn’t sufficiently clear, so I put it aside. A day after that, the TU introduced a new, reduced format, with certain features shortened or omitted. The two Perspective pages, with their generous space for columns, both national and local, went on the chopping block. Now they might not have space for my essay in any event, so I decided to post it here. Since I’m no longer limited to 600 words, I can be a bit more freewheeling—if I were aiming for publication in the TU, I wouldn’t have mentioned the patient who believed he’d fucked John Lennon.

I have mixed emotions about hospitalization for the mentally ill, especially those who are truly a danger to themselves or others. Deinstitutionalization was supposed to be a good thing, and those enormous old hospitals were portrayed in the public eye as hideous snake pits. But Hudson River Psychiatric Center was a fairly benign and yes, therapeutic environment. If it weren’t, I could never have worked there for 13 years, enough to get me vested in the New York State retirement system that helps sustain me now.

The patients at Hudson River inspired me to embark on my first novel, then titled The Flip Side. It was good enough to win me some personalized and encouraging rejection letters, and eventually a good agent in Manhattan, but alas, she never sold it. It remains unpublished, but who knows, I may resurrect it one of these days.

Meanwhile, I sometimes wonder what became of those fascinating guys on Ward 604. Did they eventually get discharged and adjust to life in the community? More likely they died young or landed in prison.

Main building at HRPC burning in May, 2007

Robin Williams and the Dangers of Depression

Robin Williams

As one of the millions of people who have suffered from severe clinical depression, I can readily imagine why Robin Williams committed suicide. When you’re in the depths of depression, it sometimes seems as though the darkness will never end, and suicide is the only way out. And when life pelts you with lemons, you can’t muster the strength to turn them into lemonade.

His widow has disclosed that Williams was in the early stages of Parkinson’s disease, although he had not yet gone public with the fact. The diagnosis must have been devastating to a man who built his public persona upon his genius for rapid-fire, manic improvisation. Sooner or later, Parkinson’s would inevitably have eroded those gifts and slowed him down, and perhaps that prospect was more than he could stand.

Michael J. Fox has taken a courageous stand in going public about this devastating illness and appearing on camera with his tics and

Michael J. Fox

tremors on display. But he’s always been a star with a certain sweetness and vulnerability, so his role as a crusader against Parkinson’s is a perfect fit for his personality. Perhaps in time, Robin Williams could have faced the diagnosis with similar grace, but alas, we’ll never know.

His career may have peaked. His CBS sitcom The Crazy Ones was cancelled this year after one season, and he worried about his finances, especially the alimony to two former wives. His California ranch was on the market, and he felt pressured to take roles he wasn’t enthusiastic about purely for the money. In his final days he spent most of his time lying in a room with blackout curtains, too exhausted to get out of bed.

I know that feeling well. I’m diagnosed bipolar, and within the past decade, I suffered two debilitating depressions, both of them after I had completed and published novels that failed to set the world on fire. Both times I was convinced life was no longer worth living, and I contemplated suicide, but like Dorothy Parker in her famous poem, I found something objectionable about all the possible methods and decided I might as well live.

With help from a psychiatrist, a psychologist, and above all my husband, I eventually climbed back out of depression, although I live with the fear that it may recur. For now, medications keep me on an even keel – Zoloft and Seroquel, to be specific, and Lunesta as needed for sleep. All three are now available in generic versions, so I spend under $20.00 a month for meds – a small price to pay for happiness.

But I may be paying a much higher price. I was diagnosed as bipolar twenty years ago, and I’ve been on psychotropic medications ever since. I’ve accomplished a lot in the past couple of decades, including publishing two novels, but I no longer have the overriding drive and energy that powered me through my earlier years as an artist. Laziness and complacency are ever-present dangers. I’m content just being in the present moment – gardening, walking my dog, reading – though I suffer pangs of guilt over my lessened productivity. Is this a normal product of aging, or a side effect of my medications? Maybe it’s both, but I’ll never know for sure.

When I learned of Robin Williams’s suicide, my first thought, after the shock and grief, was that he too was bipolar. If so, he had never publically disclosed it, but certainly his public persona was over-the-top manic. But as I read more about him and listened to old interviews, it became apparent that his personality when out of the camera’s eye was calmer and more reflective. He readily admitted to substance abuse and periods of deep depression and discussed them candidly, so if he’d been diagnosed as bipolar, he probably would have disclosed that too.

Still, I can’t help thinking he may have been in denial about the nature of his illness. The rapid-fire imagination and creativity so striking to those who knew him well may not have been full-blown mania, but it teetered close to the edge. Perhaps he was afraid that the powerful mood stabilizers and antidepressants of modern medicine would dumb him down intolerably, and perhaps he would have been right.

I don’t know what meds Robin was on or what therapy he was receiving. But it’s extremely common for people diagnosed with a mental illness to refuse or discontinue medication because they don’t want to become comfortably numb. And the inexorable progress of Parkinson’s disease, with its many physical and mental symptoms, including depression, would have taken a terrible toll over time.

Robin Williams in Good Morning Vietnam

Doubtless more details will emerge and more people will conduct psychological post-mortems. But in the meantime, although Robin Williams’s death is a tragic loss, I believe I understand at least part of the rationale for his decision.

 

Anger Management Part I

My cat Lunesta, named for my favorite sleeping pill. She really knows how to chill out.

Is it just me, or does anger management get easier with age? It’s taken me decades, but everyday aggravations don’t get me nearly as riled up as they used to. Is it simply that my psychotropic meds are working the way they should? Is it because of hormonal and biochemical changes as I creep toward genuine old age? Or is it the cumulative effect of all the years of life experience I’ve racked up?

Maybe it’s all three, but in any case I’m grateful that I’m usually able to follow Bobby McFerrin’s advice – “Don’t worry, be happy.” (That’s when I’m not in a clinical depression, of course. But deep depression is so enervating, it doesn’t leave enough energy for anger.)

Over the past couple of days, though, something’s been making me intensely angry. No need to go public with the details – suffice it to say that it involves a creative group project I’ve been a part of for several years on an annual basis. Over time, the group’s chairperson has become increasingly dictatorial and resistant to anyone else’s ideas, to the point where I decided I could no longer associate myself with this venture, even though it’s something that’s brought me great pleasure over the years. 

In years gone by, I would have fumed and fretted over whether or not to quit. I probably would have done some yelling and screaming, slugged down a couple of glasses of wine, lain awake nights obsessing over the injustice of it all. Today, there was none of that dramatizing. I simply sent the person an e-mail saying I was dropping out. I’ll admit I copied in a couple of relevant people, and there may be some further fallout, but I’m sticking with my decision to distance myself from a situation that’s clearly bringing me uptight and is thus potentially damaging to my mental health.

I’m proud of how I handled this. I did what I had to do, said what I had to say, but now it’s over and done, and I’ve already moved on. I’m feeling calm, and my pulse rate and blood pressure are back down where they should be. Writing this blog post is cathartic as well – how wonderful to be able to channel all that angry energy into writing that all the world can read! 

Katie Couric show on January 14th, the day I visited

Since my recent visit to Katie Couric’s show, I’ve been watching her more than ever, though I clicked off today because she’s interviewing families with lots of kids, and frankly, I couldn’t care less. But a few programs ago, the show featured a cardiologist who hooked her up to a heart rate monitor, thereby demonstrating that her pulse went up alarmingly when she was caught in midtown Manhattan traffic (even with her own private car and driver!) or before the show when she encountered some fans and wasn’t yet wearing her makeup. Over time, that kind of physiological reaction can do serious damage to a body. Though I’m not a Type A adrenaline junkie, my blood pressure is borderline high, and I believe the ability to chill out at will is a valuable talent worth cultivating.

Buddhist meditation

Author’s note, two days later:

Just as I typed the words “Buddhist meditation,” a friend phoned me. Maybe not coincidentally, she’s extremely involved in Buddhist meditation. Jungian synchronicity, maybe? After that, I had to go to my UU church for choir practice. Then yesterday, we visited my brother in the Bronx, so I haven’t had time to get back to this post until now.

Visiting with my brother Pete Lomoe in his Bronx apartment yesterday. He looks rather like Buddha, doesn’t he?

There’s lots more to say, but I think I’ll save it for my next post. I’ll close with a brief progress note about the situation I described above: writing that e-mail saying Sayonara wrapped up that issue nicely, and though it still comes to mind off and on, I’m still calm and collected about it. Besides, it’s one more responsibility off my plate, giving me that much more time to zero in on my novel.

Does anger play a major role in your life? Any coping strategies you’d care to share? I’d love to hear from you.

Deja vu: Another troubled young man, another massacre

Back in July, I concluded my blog post about the horrific massacre in the Colorado movie theatre as follows: 

Social media and mass communications have become so overwhelmingly powerful, the images of violence and mayhem so inescapable, and powerful deadly weapons so readily available, it’s no surprise that for certain deranged individuals, the lure of deadly international fame will prove irresistible. Sadly, the massacre in Aurora probably won’t be the last.  

I wish with all my heart that I’d been wrong, yet here I am, trying once more to make sense of a senseless act of violence. We don’t yet know what motivated Adam Lanza to kill twenty first-graders and six staff at the Sandy Hook school in Newtown, and the answers may have died with him. We do know that he spent countless hours closeted in his bedroom with his computer, but the authorities are saying he smashed it up so thoroughly that the contents may never be recovered.

Once again, in the wake of this tragedy, the pundits are pontificating about gun control and mental illness, and theorizing about what can be done to prevent future massacres. There are no easy answers, but one is painfully obvious: outlaw or severely restrict the sale and possession of semi-automatic weapons and magazines.

In January of 2011, after Jared Louchner opened fire in a Tucson parking lot, killing six and injuring 14 others, including Congresswoman Gabriella Gifford, I began writing the following blog post: 

As soon as I heard the first reports about the twisted thinking of the shooter in the horrific Arizona massacre, a snap judgment came to mind – I was willing to bet he was paranoid schizophrenic. As an art therapist, I’d worked for over a decade with patients who shared that diagnosis, and I knew the symptoms well. It was Jared Loughner’s creation of a “new currency” to rival the government’s that was the tip-off.

I knew quite a few paranoid schizophrenics who believed in complicated structures of world domination, often involving the government. Sometimes they thought they “controlled” these bizarre delusions, but of course it was the delusions that controlled them – that and the fact that they were confined to locked wards in a state psychiatric hospital.

That was back in the 1980’s – ancient history when it comes to the treatment of mental illness. At Hudson River Psychiatric Center in Poughkeepsie, deinstitutionalization was making rapid inroads, with more and more patients being discharged to the community, but there were still well over a thousand inpatients, many of them there for years on end. All were judged a danger to themselves or others, and many had done prison time. I worked with arsonists and murderers. It was almost inconceivable that some could ever be discharged, yet in the years that followed, most of them were. I don’t know what became of them.

Strangely enough, I wasn’t frightened. None of them ever assaulted or even threatened me. I like to think that was because of my charming personality or therapeutic skills, but more likely it was my role as a creative arts therapist. I didn’t wield the authority to change their medications or make crucial decisions regarding their privileges or discharge planning, so I didn’t constitute a threat. The options I offered – music, art, creative writing and role playing – weren’t required; patients could elect to take them or leave them. Then too, they were on heavy doses of medication.

One night a week, I facilitated a Creative Arts Club at the Rehabilitation Center for those approved by their doctors to leave the wards. In a mostly dark, deserted building, with only a therapy aide and sometimes an art therapy intern for backup, I helped them to create murals and to act out their issues in sociodramatic role playing. We held art shows in the community and staged cabarets for the other patients, with me as the piano accompanist. Years later, these events provided the inspiration for the climactic cabaret scene in my novel Mood Swing: The Bipolar Murders.

I never finished or published that blog post – in part because I couldn’t figure out what conclusions I wanted to make, in part because I was in the throes of profound depression at the time. I was barely able to get out of bed in the morning, and nothing, including blogging, seemed worth the effort. Yes, I too am one of the millions of Americans diagnosed with a mental illness. In my case it’s bipolar disorder, currently well controlled with medication.

It appears Adam Lanza may have had Asperger’s syndrome, technically a developmental disability rather than a mental illness. Perhaps with proper treatment, he might also have been diagnosed with an underlying mental illness and received appropriate help. In any case, people with Asperger’s are certain to be further stigmatized the way people with mental illness already are.

Should our society start locking up more of the mentally ill, the way we did in the good old days of Hudson River? Probably not, but these days millions of them are doing time in prison instead. The old-fashioned psychiatric hospitals were far more humane, and sometimes they actually helped. But of one thing I’m absolutely sure: those deadly semi-automatic weapons have got to go.

 Illustrations for this post are all paintings by the British artist Francis Bacon (1909-1992), one of the biggest influences on my own art. 

Entropy Part II – the lure of laziness

Nia class with Lisa Geddings

It’s high noon, and my Nia* class at the YMCA is just ending. Over a dozen women sit cross-legged on the floor as Richele says a prayer of gratitude. Unfortunately, I’m not there – I’m just getting out of bed.

No, I’m not sick. I’m just lazy. When 10:30 rolled around, time to don my workout clothes and leave for class, I made the conscious decision to stay tucked in bed under a down comforter, sipping coffee and reading the paper. This is by no means the first time I’ve made this choice. My goal is to hit the Y three times a week for Nia class followed by a weight-lifting session on the Fit-Linx circuit. I love the Nia class, and I always feel better afterwards – happier and more energized.

I’m not crazy about the workout on the weight machines, but I like the feedback from the people following me who are amazed at the amount of weight I lift, and I enjoy ogling the men working their muscles with the free weights.

Recently I skipped two full weeks, for the most part with the flimsiest of excuses – for example, the fact that this summer’s purple polish had flaked raggedly off my toenails. I couldn’t find the polish remover, and I was afraid the other women would look at my toes and judge them scruffy (we dance barefoot in class.) Finally back at the Y Monday, I found the class much more strenuously aerobic than it seemed before, and I couldn’t do as many reps on the weight machines as I usually do.

It’s scary how falling out of shape comes so quickly and easily when I cocoon myself in bed instead of making the healthy choice and hauling my tush off that comfy mattress. It reminds me of the description of entropy from my last post: “a measure of the unavailability of energy in a closed system.” Yielding to the lure of lassitude gives entropy a greater hold on our bodies, and there’s strong evidence it shortens our lives.

There’s a saying that Zen monks recite at the close of each day:

Let me respectfully remind you – Life and death are of supreme importance. Time swiftly passes by and opportunity is lost. This moment is an opportunity to awaken. Take heed. Do not squander this moment.*

Biologically, as we age, our bodies yield to entropy. Inevitably, if we live long enough, things begin to break down. Our sight and hearing become less acute, our arteries begin to clog and our cells to break down. By making healthy choices, we can forestall the process to some extent, but in the end, our aging bodies fail us. But do succumbing to inertia and squandering the moment speed the journey toward death? There’s evidence they do. So do genetics, poor choices in diet, and lack of a social support network.

I’m getting a tad gloomy here. That’s one reason I took such a prolonged break from blogging – I didn’t want to play Debbie Downer and depress people with my negative thoughts. But I’ve finally found a way to channel my shadow side: my next novel will feature a character who magnifies the worst features of my depressive side. She’ll wallow in clutter, eat and drink too much and spend most of her waking hours in her Lazy-Boy recliner watching TV – when she’s not playing computer solitaire, that is. On the plus side, she’ll have a wicked sense of humor. I look forward to meeting her when I begin the NaNoWriMo novel-writing challenge next week.

How often do you succumb to lassitude and entropy? Do you have any remedies? I’d love to hear from you.

* Nia’s a movement practice that combines dance, martial arts and healing disciplines. For more information, visit www.nianow.com. In New York’s Albany area, Richele Corbo and Laura Bulatao are the Nia teachers who’ve inspired me over the years. The photo is of a class in Bethesda, led by Lisa Geddings.

**I’m indebted to Reverend Sam Trumbore, minister for the First Unitarian Universalist Society of Albany, for this quote. It’s from a sermon he gave in 2004 titled “Praising Percipiency.” You can find it by going to the FUUSA website and clicking on “sermons,” which are archived by date.

Giving up my Spider addiction cold turkey

It’s been barely an hour, and I’m already in the throes of withdrawal. My body’s tense, my muscles jumpy. My heart is racing, and I’m finding it hard to catch my breath. I’m feeling wired, with an unaccustomed energy that threatens to morph into a panic attack.

What’s the addiction I’m fighting? Is it booze, cigarettes? Maybe drugs, prescription or otherwise? No, it’s Spider solitaire. The spell it’s cast over me is relentless, and I’ve finally come to admit I’m powerless to resist. Just one game, I tell myself, or maybe twenty minutes. But inevitably, those minutes morph into hours – how many, I’m ashamed to admit. I could probably have cranked out a novel during the countless hours I’ve wasted on Spider in recent months. My blog has been one of the casualties; so has my housework, which is dubious at the best of times.

This toxic addiction mushroomed along with my depression, beginning last summer, and by now it’s hard to sort out cause and effect. Do I play too much Spider because I’m depressed, or am I depressed because I play too much Spider? Probably both. But when I’m playing, all sense of time fades away. I lapse into a state of suspended animation, on autopilot. As Pink Floyd would put it, I become comfortably numb – neither happy nor depressed, just vaguely anaesthetized. I’m capable of playing right through meal times, ignoring hunger, thirst, and urgent promptings from my bladder.

What’s going on here? In an effort to find out, I Googled “computer solitaire spider addiction” and came up with 864,000 hits. I was delighted to learn my blog post “Addicted to Spider solitaire?” from September 5, 2009 was fourth on the list. It contains my poem “Skinner’s Last Laugh” and you can find it in my archives.

Countless folks share my addiction. I read accounts by people with problems far worse than mine, some who played up to ten hours straight, who missed work because they’d been playing till five a.m., or who played on the job till they were fired. All agreed that Spider is powerfully addictive, perhaps more so than any other computer game, but for the most part, they couldn’t explain why. One woman had a valid excuse for guilt-free playing – she’s 74 years old, immobilized and housebound, on oxygen 24/7. For her, the game may be a godsend. For the rest of us, not so much – one writer calls it “Satan’s spider game of death.”

Some say the neurotransmitter dopamine, which controls craving and anxiety, is the culprit. Joss Earl writes, “Some theories suggest that dopamine developed as a survival technique for siege-like situations. If a monkey is sitting in a tree with a lion prowling around below, then being patient is essential for survival. Dopamine calms down the monkey and allows him to outwait the lion. . . . almost by definition, addictive drugs are ones that raise dopamine levels.” Research has shown that computer games raise dopamine as well. Certainly Spider alleviates my own anxiety, but it damps down my motivation and enthusiasm as well, and I can no longer tolerate the waste.

So I’m going cold turkey, effective today. Since clicking on the Spider icon has become my automatic response as soon as I log onto the computer, and since I’ve proven time and again that there’s no such thing as “just one game,” I asked my husband to hide Spider deep within the innards of my computer so that I can’t find it. He’s not deleting it entirely – not yet – but he swears he’ll do so when and if I relapse.

He did the dastardly deed while I was watching the soap opera “One Life to Live,” another of my addictions. True, it consumes less than an hour a day, but it falls mid-afternoon during what would otherwise be my prime writing time, and I’m too technologically challenged to tape it. Soon I’ll be deprived of that guilty pleasure as well – ABC has announced plans to cancel the series in January, replacing it with a life-styles reality show. Sorry, but I’ll boycott the new show – my life’s too full of reality already.

So, assuming I don’t freak out, what will I do with all my newfound time and energy? Maybe I’ll finally get around to cleaning up last year’s dead detritus from my garden. And maybe I’ll even get back to writing.

 

 

Summer was a bummer, but I’m back

It’s the first full day of autumn, an auspicious day for new beginnings, and for better or worse, I’m back on my blog, after a leave of absence that lasted virtually all summer. I’ve been mired in a deep depression that stole over me last May, robbing me of my motivation and self-confidence, convincing me that I no longer had anything worth writing about, much less anything people would care about enough to read. But with the coming of fall, I’ve resolved to write myself out of my doldrums.

Writing is an integral part of my identity, and the notion that my writing years might be behind me severely deepened my depression. I spent far too many beautiful summer days ensconced in my old Lazy Boy recliner, endlessly reading other authors’ novels. For the first time in ages, I bypassed the races at Saratoga.

The sorry state of my parched and weed-infested garden all too accurately mirrors my state of mind. Upstate New York’s been unusually dry this summer, with only half its normal rainfall over the past two months, and my imagination has been suffering a similar drought. In May and June, my posts grew less frequent, more downbeat. Afraid of becoming a Debbie Downer like the Saturday Night Live character, I made a deliberate decision to stop blogging, possibly forever.

I made a mistake. I missed the creative excitement that came with crafting a new post, the cameraderie of the online community, and I came to feel increasingly like a nebbishy nonentity. So I’m jumping back in, hoping it’s not too late.

Charles Burchfield

What brought on this dark night of the soul? Probably a combination of biochemical and psychosocial factors. I’ve written before about my bipolar diagnosis, but it’s been well controlled with medication, and over the past few years, my mood has been amazingly upbeat and sunny. Back in May, in the post titled “Depression – cloudy, cool and drizzly,” I said, “I’m a firm believer in the biochemical nature of manic depression, as some still prefer to call bipolar disorder, and I know medications work.” I had faith in my shrink’s ability to tweak my medications enough to banish my increasingly bleak moods, but I’ve undergone lots of tweaking in the months since then, and nothing seems to work.

What triggered my depression, I’ve come to believe, is an old-fashioned identity crisis. For years I’ve identified myself as a mystery writer, but the success I’ve dreamed of has eluded me. I’m proud of my two self-published novels, Mood Swing: The Bipolar Murders and Eldercide, but the sales have been less than stellar. I’d hoped that building an online identity through my blog would boost my readership, but I came to realize that impressive blog stats don’t necessarily mean lots of people will buy my books, and my track record isn’t likely to inspire an agent or editor to beat down my door any time soon.   

Even so, I enjoy online schmoozing far more than marketing my books in person. My depression descended soon after a signing at a local independent book store. It was my first straight solo signing ever, with no talk, panel discussion or party to drum up interest. True, I sold a few books, but each sale took painstaking effort in teasing out the themes that would appeal to each reader. For some it was the regional locale, for others an interest in bipolar disorder or end-of-life issues, for still others an interest in mysteries pure and simple. I’m basically an introvert, and the expenditure of energy left me drained and exhausted, with the realization that I’m just not cut out to be a demon marketer. Never was, never will be.

But am I still a mystery writer? At the very least, I’m a woman who has written four mystery novels and published two of them, and that’s something to be proud of, or so I try to convince myself. Will I write another? The verdict’s still out on that one. But one thing’s for sure – I’m still a writer, and I need to write. My life literally depends on it.

Can I write my way out of this depression? Stay tuned to find out. Never fear, I’ll cover other subjects as well, but I plan to post at least twice a week. And if you’ve read this far, please leave a comment – I know my readership has dwindled during this hiatus, but I need to know you’re out there.

World Elder Abuse Day – a cause near to my heart

Reading Dear Abby this morning, I learned that today, June 15, is World Elder Abuse Day. It’s a subject close to my heart. As President of my own licensed home care services agency, ElderSource, Inc., I witnessed the extreme pressures that can lead to potentially abusive situations, even among loving families who are doing their best to provide quality care for their elders.* Unfortunately, most seniors are not nearly as well off as our clients were.

The National Center on Elder Abuse estimates that as many as one in ten elders experience some form of abuse, but only one in five cases gets reported. They define elder abuse as “neglect, exploitation or ‘painful or harmful’ mistreatment of anyone 65 or older,” and the abuse can be financial, physical or psychological.

We’ve all heard the horror stories that surface regularly in the news – the abusive caregivers, the financial scams that can cost gullible elders their homes. Perhaps less obvious is the neglect that can stem from isolation, especially when dementia, mental illness or substance abuse are involved. Elders living alone, far from involved family, can suffer from self-neglect when they’re unable or unwilling to care for their own needs.

My 81-year-old brother in the Bronx has a wonderful support network of neighbors he’s come to know over 30 years in the same apartment building, but suburban neighborhoods of single-family dwellings don’t offer the same comfortable familiarity. Personally, I plan to age in place – our home is already too small for all our stuff, and I can’t picture downsizing any further. But it’s not a prospect I look forward to with great enthusiasm, and it’s all too easy to envision myself as a neglected recluse in some not so distant future.

What can you do to help prevent elder abuse, including self-neglect? First, learn more about how to recognize the signs and symptoms by visiting informative websites like the following:

Center of Excellence on Elder Abuse and Neglect, University of California at Irvine (www.centeronelderabuse.org)

National Center on Elder Abuse (http://www.ncea.aoa.gov/)

Keep in contact with your older friends, neighbors and relatives so as to help decrease isolation, a risk factor for mistreatment. Be observant for signs of abuse or neglect.

Report possible mistreatment or neglect to your local adult protective services agency or to 911.

Contact your local Area Agency on Aging office to help identify possible sources of support like Meals on Wheels.

Volunteer, either formally or informally. With elderly neighbors living on either side of us, my husband and I drove them to doctors’ appointments and ran errands. I’m grateful for the stories they told me and the closeness we developed near the ends of their life spans, and I hope my own younger neighbors may reciprocate someday. More formally, as administrator for the Memorial Society of the Hudson-Mohawk Region, I help educate people about affordable funerals and how to avoid one of the most common financial rip-offs that plague our seniors.

But why get involved in yet another cause, when there are so many clamoring for our attention? Because we’re all part of a beloved community, both globally and locally, and the person who needs your help may be as close as your next-door neighbor.

 *My experience as President and CEO of ElderSource inspired my novel Eldercide, which addresses the question, “When quality of life declines with age and illness, who decides if you’re better off dead?” The book explores elder abuse taken to the extreme, but fortunately it’s pure fiction – at least from my perspective. Unfortunately, the plot is all too plausible. You can read more about Eldercide on this site.

Depression – forecast cloudy, cool and drizzly?

Weather report from the dreary Northeast: cloudy, cool and gray with intermittent drizzles – a lot like the weather inside my head the past few days. Outside, they’re predicting a positive change, and tomorrow’s forecast promises a perfect spring day, sunny with temps in the seventies. I wish my mental state would brighten too, but I’m not at all sure.

I’ve written here before about my bipolar diagnosis, but from the perspective of someone who has it well under control with medication. Over the past several years, my disposition has been amazingly, predictably sunny.  Now that depression is rolling in like low cloud cover and fogging my brain, my impulse is to hide, to retreat into silence. Who wants to read a blog that’s basically a downer? Maybe you’ll read it and never return. If I can’t say something nice and cheery, better not to say anything at all, right?

Wrong. I’ve always been big on self-disclosure in this blog, and it would feel hypocritical to change now, so I’ve decided to go public with these feelings of depression. My novel  Mood Swing: The Bipolar Murders is all about transcending the stigma of mental illness, and sharing feelings is one way to go about it. The book’s protagonist Erika Norgren reveals her bipolar diagnosis on the 11 o’clock news, and when the book was published, I came out of the closet as well, to my enormous relief. I’m hoping that sharing my feelings here will have an equally therapeutic effect.

I’m a firm believer in the biochemical nature of manic depression, as some still prefer to call bipolar disorder, and I know medications work. A couple of months ago, my shrink tweaked my meds, changing one of them to something less apt to promote weight gain, but in retrospect, maybe that was a mistake. Yesterday, after taking to my bed for the afternoon, I was  alarmed enough to call him, and I’ll be seeing him soon, but he wants me to monitor my moods a little while longer rather than changing the meds too abruptly.

I could launch into a whole laundry list of things to be depressed about, but realistically, I have far more things to be grateful for. This kind of depression isn’t about rationality, though – that’s what’s so frightening about it. Images of the oil spill in the Gulf of Mexico come to mind – the toxic black muck keeps pouring up unstoppably from the depths.

Never fear, I have no intention of dragging you into my slough of despond on a regular basis. There’ll be cheerier postings in the days and weeks ahead, but I may occasionally offer progress reports on my mental status. Meanwhile, I feel like Tinker Bell in Peter Pan – my inspiration is flickering, and I don’t want it to die out. If you believe, it would be good to hear some applause right about now.

Agita – agitation, acid stomach, or both?

Ernst Ludwig Kirchner

In my post about website design anxiety, I really wanted to use what I thought was a Yiddish idiom to convey the sense of gut-wrenching agitation the challenge invokes in me, but the word escaped me. It turns out AGITA is the word I wanted, and my search brings up a few thoughts about the internet, Merriam-Webster, and the changing nature of research.

First, thanks to my friend and Nia instructor Richele Corbo for answering the question when I posed it on Facebook. (I also ended the last post with my query, but no one’s come up with the answer here.) “Aggitah!!” Richele wrote. I’d tried adgena, agina and other similar combinations, and consulted lists of Yiddish idioms to no avail, but no wonder I couldn’t find it – it’s of southern Italian origin.

Playing around with the spelling, I tried my huge old Webster’s Unabridged without success, but I finally found “agita” on Google. One definition came from a medical site:

Agita: heartburn, acid indigestion, an upset stomach or by extension, a general feeling of upset. Italian American slang, from Italian “agitare” meaning “to agitate.”

The online Merriam-Webster’s had the word as well, along with the date 1982, suggesting this was when the word was added. They even had an aural application giving the correct pronunciation aloud. 

Agita: S. Italian dial. pron. of Italian acido, literally heartburn, acid from Latin acidus, therefore a feeling of agitation or anxiety.

Ernst Ludwig Kirchner

So one source claims the word is rooted in agitation, the other in acid. But both agree on the confluence of anxiety and indigestion as well as the Italian origin. It took Richele, who’s of Jewish origin but married into an Italian family, to come up with the link I needed. Here I could wax rhapsodic about our wonderful American melting pot and how it’s enriched our language, but I’d rather focus on the word itself, and how I can now use it with confidence to describe that physical and psychological state that arises from too many hours spent trying to decipher new computer programs. (If you want a fair facsimile, try overdosing on caffeine or trying the wrong antidepressant. Or, come to think of it, those pharmaceuticals I experimented with back in the sixties – but we won’t go there.)

My exploration of agita also reinforces what my husband always says when we try unsuccessfully to prune our book collection: there’s no need to hang onto outdated research materials, because it’s easier to find what you want on line, and the paper versions simply clutter up the house. But does this mean we’ll throw out our entire collection of dictionaries and reference books? I wouldn’t bet on it.

How about you? Do you suffer from agita? And have you been pruning your collection of old-fashioned printed reference materials? Or do you think that’s meshugana?