From Blogcritics.org:

The Democratic Party is the Mental Illness Party

Yes! I knew there was a reason I was a Democrat.

Posted by liz at 06:50 PM | Permalink | Comments (0)

Yesterday I didn't go to get my CT scan because, um, I chickened out. Yes, you heard that right: I am the only person ever to be terrified to get a CT scan. So I'm going today, and thus won't be blogging this afternoon. But I leave you with this clip, which made me laugh out loud, and thus improved my mental health tenfold.

Posted by liz at 02:12 PM | Permalink | Comments (0)

Okay, it's embarrassing to admit, but at least twice a year I spend a half-hour Googling myself. Everyone does it, right? You want to know who's talking about you. It's like hiding in the cubbie hole in grade school while the popular kids whisper nearby.

Now and then I find a reference to myself that really delights me, as I did today. From last year comes this mention from Think-Israel
by Judah Tzoref, who writes:

Why talk about non-Jewish anti-Semites while the world is plagued with Jewish maggots that practice the most virulent type of anti-Semitism, to name a few:

ALEC DUBRO mediaguide@igc.org
GERALD KAUFMAN cootesn@parliament.uk British Parliament Member
CLEMENT LEIBOVITZ cleibovi@gpu.srv.ualberta.ca
MICHAEL LERNER community@tikkun.org
GIDEON LEVY levy@haaretz.co.il
TANYA REINHART reinhart@post.tau.ac.il
ISRAEL SHAMIR ContactUs@MediaMonitors.net
HENRY SIEGMAN hsiegman@cfr.org
NORMAN SOLOMON mediabeat@igc.apc.org
LIZ SPIKOL lspikol@philadelphiaweekly.com

Such colourful assortment of fringe ideologues has been pestering the Jewish nation from the dawn of its existence. They must have some esoteric function, they can be harmful at times, but eventually they drop behind and dissolve into the limbo of the insignificant.

This is the result of one article I wrote many years ago about the situation in the Middle East. I was critical of Israel, and as a result, half the Jewish world completely hates me. But I don't care. Judaism is greatly important to me, as is the fate of Israel. As an American Jew, I'll speak out when I feel it's necessary and I won't mince words. Go on and call me a maggot if you like, Judah. It only makes you look small.

[Image by a student in a class of second graders at Clow Elementary School in Napersville, Ill.]

Posted by liz at 12:35 PM | Permalink | Comments (1)

Below is this week's Trouble With Spikol column that ran in PW. The illustration is by Alex Fine. Someone came to the office yesterday to drop a copy of the column off with the letters "TMI" writ large on it. I suspect that once you get reading, you'll see which sentence that refers to. And yeah, I should've taken it out. It's just that my writing career has been so much about TMI that I don't know when to hide things. Oh, well. You can't please everyone.

Head Flames
Fire shooting from skull. Game over.
BY LIZ SPIKOL

Last weekend I went to Long Beach Island. It wasn't my first time. When I was about 9 my parents rented an apartment in Loveladies. My 15-year-old sister had her boyfriend, a Southerner of some kind, drive up from whatever kudzu swampland he inhabited to join us.

Because I'd never heard an accent like his—thick as molasses, as they say—I was fascinated. He could've come from another planet. (Later, after I spent some time in the South, I realized he did come from another planet.)

He, in turn, was fascinated by my sister—in particular her blond hair and her tight pink-and-white tube top. They wouldn't kiss in front of my parents, but they went for lots of "walks." At one point I cracked the door open and spied them making out on the porch.

The Southern boyfriend, between awkward adolescent thrusts of his tongue, opened his eyes and saw me. Laughing, he said, "Whatchoo lookin' at, snoopy?"

I briefly thought he was referring to the Peanuts character. A split second later I realized he'd called me a snoop, and I slammed the door shut. From that moment on I hated him.

That being my only association with Loveladies, I wanted to give it another try. I imagined LBI sort of like Cape Cod: a peninsula with charming towns, each with a distinct personality but all marked by rich natural beauty.

I don't know about all that. What I do know is that the dark wood paneling in the rooms at the Long Beach Inn can be quite soothing.

Things started benignly. Saturday morning my boyfriend Vince and I took a drive through the different towns. I like to gauge how wealthy places are by the cars I see: When you go from American to German, you know things have changed.

One house had a sign that said "Stein Shrine." "Oy vey," I said to myself, but didn't mention it to Vince. I didn't want to seem like a self-hater.

We decided to walk out on the Barnegat Inlet jetty. I thought I'd skip over a couple rocks, and we'd be at the end. The jetty, it turns out, is roughly the size of Rhode Island. The rain came down in cold spatters, and it seemed like the space between each rock was a Grand Canyon-sized chasm.

Vince was hippity-hopping across the chasms like the tall person he is, while I had to stop and build momentum to get from one to the other. I told him it was because of my height, but then a 5-year-old zoomed past us.

"Screw you," I said to the child under my breath. Then I took it back.

It must've been about halfway to Providence when I felt the familiar signs: a throbbing in the right side of my face, the nausea, the dizziness, the fatigue. Vince saw me wobble (more than I already was), and asked what was wrong.

"The time of the Evil One has approached," I said in my best Lord of the Rings voice. "We must abort the cliffs and return to the Land of Beds and Silence. We will face this challenge later."

Actually, I said, "I think I have a migraine." But next time I'm going to put it more cinematically.

As weak as I felt, I was determined to finish our journey. We did reach the end of the jetty, but there was a horrible beeping noise there that felt like it was piercing my skin. I ran back, this time jumping the chasms like they were lines in a sidewalk.

"I'm going to beat you back there!" I yelled to Vince. Sometimes I think he wishes his girlfriend were less like a fifth-grader.

And this, sadly, is where my LBI experience essentially comes to an end. For the rest of the day I stayed in the wood-paneled solitude of our motel room, and did all that stuff that migraine sufferers do: pray, switch positions, read, not-read, washcloth on neck, pillow, not-pillow, water, iced tea, crackers and so on. I thought about how good it would feel to have someone shoot my head off.

I tried visualization, but I kept getting confused. Should the pain be red or white? And which color should the not-pain be? I tried all different hues, even a grassy field. I tried lying on the cool tiles of the bathroom floor. I got so sick I soiled my shorts and wept as I washed them in the tub.

Gruesome.

You might be wondering why I didn't take any medicine. Ah, but there's the rub. I had one pill left, and it was old and crusty. After frantic phone calls to my doctor's office, I sat in the CVS, slumped on a chair, waiting for my prescription to be filled. John Legend's "Ordinary People" came on the sound system, and Vince said, "This song sounds a lot like early Stevie Wonder."

Through the pain, I mumbled, "John Legend's from Philadelphia."

Even in agony, I can't resist an opportunity to promote my hometown.

In the end the medicine didn't work. So I turned to the only remedy I had left: steak. After two different tries at two excruciatingly loud restaurants (does everyone in LBI have a screaming baby?), we found Fred's Beach Haven Diner, and Fred's T-bone steak. Within an hour of eating it, I felt well enough to watch Animal Planet. It seems like wildebeests really get the short end of the stick.

Vince fell asleep, but I was so happy to be pain-free, I kept poking him. "Don't you want to talk? I feel better now!"

It was too late—both for Long Beach Island and my relationship.

Posted by liz at 10:44 AM | Permalink | Comments (2)

Some people have suggested to me that they might have trouble getting the book under discussion. That's okay. The book is really just a jumping-off point to get us talking. I'll facilitate the talk with questions derived from my reading of the book, and those who have read it can speak to specifics. But the questions raised will be accessible enough for everyone to participate. A few days before the event I'll post some talking points from the subjects we'll likely cover. So if you can't find the book, don't worry. We'll still have plenty of fun.

Posted by liz at 10:40 AM | Permalink | Comments (2)

Thanks to my colleague Dan McQuade for his suggestion for Hero of the Day, Lt. Bruce Herbst. From the Philadelphia Inquirer:

The Tacony-Palmyra Bridge was closed for two-and-a-half hours last night, as a 33-year-old Philadelphia man was talked out of jumping.

To protect the man's privacy, police declined to identify him or the hospital.

Posted by liz at 10:28 AM | Permalink | Comments (0)

As per Will's suggestion, I've just purchased Robert Whitaker's Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill. I'd like to invite other people to read it with me, over the next two weeks, and then meet both online and in person for a discussion group.

This means that on July 13 this site will be devoted exclusively to the discussion of that book. Also on July 13, we'll hold an open discussion at the offices of Philadelphia Weekly. I can provide some cookies, and maybe Vince can stuff some peppers. (Woo hoo!) It'll start at 7pm. I'll send out reminders.

If you're interested in participating for either discussion, please contact me ASAP so I know how many cookies to buy: lspikol@philadelphiaweekly.com.

Please pass this notice along to anyone who you think will be able to share an interesting perspective with us.

Posted by liz at 04:10 PM | Permalink | Comments (1)

Tomorrow morning (today, for you) I'm going to get a CT scan. I'll have to drink some horrible barium stuff, but I'm taking gum with me (secret weapon!) to chew while I drink. Maybe that'll help? Anyhoo, then I have to go to lunch with the owner of the newspaper, with whom i once played lawn chess. (He won.) I'll blog in the afternoon. Stay safe till then!

Posted by liz at 10:59 PM | Permalink | Comments (1)

Ahem.

Today's session was marked by the following revelations:

1. Sometimes it pays to give one's total attention to where one is walking so that one (say, Eliz. S.) doesn't walk to Dr. Fink's old office, now ihabited by someone not nearly so keen.
2. Eliz. S. is pleased to see the return of a working clock across the room from the patient in Dr. Fink's office. The timepiece allows her to hew her comments and pathetic blather to the allotted time of 45 minutes.
3. When Dr. Fink lifts his arm in a strange horizontal way, he is experiencing shoulder pain from some kind of injury or sciatica or whatever, and Eliz. S. feels sorry for him and wishes to give him an Advil.
4. When Eliz. S. tells Dr. Fink a particularly scandalous bit of personal gossip, he is as catty as a schoolgirl on lemon pops, as deliciously shocked and shocking as one would want one's friends to be, particularly when one doesn't really have a lot of friends other than her shrink.
5. When happenstance causes Eliz. S. and Dr. Fink to find themselves going down in the elevator together, it is the only time Eliz. S. does not feel terrified to be riding in a metal box. Because, after all, if the box got stuck, one's shrink would be there to talk one through it. Better than pills, bless their bitter hearts.

Posted by liz at 05:15 PM | Permalink | Comments (1)

Sorry, I don't mean to make that sound like a WWF smackdown. Actually, I'm very interested in what reader WmJm has to say about his experience as a person both with a mental illness and with diabetes. Diabetes is the illness that consumers (like me) often come back to for clarification to the layperson: Having X is like having diabetes. You take the medication, you manage it, it's chronic, but it's livable.

WmJm takes this one step further to talk about his life with both. My favorite line: "So in the psychiatry-pharmacology vs. anti-psychiatry debate this demonstrates a win for both, together, when stitched with humanity in between."

This is long, but it's worth reading. If you want to see the post this comment arose from, it's pro-psychiatry vs. anti-psychiatry. The dialogue there is really interesting.

WmJm's story
I’d like to share briefly the current, ongoing tale of a good support system provided by the often-maligned insurance industry. So: an abbreviated history of my physical illness, which in the whole person framework includes mental illness.

- insulin dependent diabetes mellitus as a teenager, 4 decades ago (no family history known, but hey! everything has to start SOMEwhere, right?)

- about 35 years later I had become depressed but didn’t know it. I blamed it all on my longtime, increasingly ‘brittle’ (insulin-sensitive) diabetic metabolism.

A family friend, a psychologist-family therapist, spotted it in its rather advanced state & got me into some professional help right away. Although I’m certain that it saved me from suicide, that experience with a psychiatrist (introductory dose of SSRI and some talk appointments) was either wrong or just inadequate and things went rapidly downhill as I quit making appointments and ‘confidently’ quit the meds.

Part of our own failing was the inability or unwillingness of my spouse and me to learn about and critically assess this new condition in my health. We, or certainly I, didn’t know: was I acting strangely because I was slipping into another acute depressive episode or was my much more familiar insulin-dependent life? Until it became really disabling I kept chalking it up to diabetes.

[Because sometimes illnesses do fight like cats and dogs, photo by Jacob Dockendorff.]

Another lucky intervention came when a close family member visiting from far away saw my state and got me linked up with CBT (cognitive behavioral therapy) and they put me through a rigorous diagnostic procedure and therapist matchup. This evidence-based logic worked wonders for me - it reeked of clarity and purposefulness! A life raft (with a searchlight and a rudder) in my sea of molasses. I was to be the motor and the captain (NOTE: these are literary allusions of the moment, not referents during therapy!).

And thus the ‘label’ ACUTE CHRONIC DEPRESSION was announced and it helped immensely. I now read about depression, about the SSRI drug families and mechanisms, about the newer combination therapeutic approaches, the ‘case studies’ told by sufferers, and the range & balance from the marvelously varied internet. Without CBT and the Internet’s information, I feel sure I would have assumed that it was I who was failing rather suddenly, despite the evidence of a successful and happy life which included four decades of superbly managing my voracious life-partner - my ‘juvenile’ diabetes.

This was far better care. So different from that first year with the psychiatrist! I was treated like a whole person - I got a referral to a psychiatrist MD who prescribed a different drug, after having me undergo more diagnostic questionnaires & interviews and after communicating with my CBT therapy team. This drug + therapy combo (SSRI + cognitive behavioral therapy) worked well for me.

So now it is time for some comparison between my life of diabetes management and of depression.

IDDM is much more mechanistic - the insulins today combined with the ‘instant’ BG meters make physiological corrections immediately available if one is prepared / equipped and trained in the basic glucose metabolism physiology.

SOCIAL
When in social situations (at work, home, in a movie, wherever) IDDM is ‘easy’ to deal with. “I can’t go the the meeting/drive the car/answer the phone just now because I’m checking my glucose/dosing some insulin/having a low ...”. Treat, recover, move on. The label meant everything: simply mention it and people widely form an idea of how to interact that is usually quite appropriate. And it gives me a teaching opportunity on behalf of diabetes education.

DEPRESSION is far more difficult - weeks transpire between onset and response to a change in meds or other therapy modification, to the degree that the ‘label’ is absolutely useless, in my view, in helping on a day-to-day or week-to-week basis. The label works over the longer view, and mentioning it doesn’t really give others knowledge of how to behave with me.

SOCIAL
When you’re walking around or in your office or home no-one knows you are horribly depressed unless it is one of those under-the-covers episodes. And even if you can respond to self-diagnosis (Oh, I’m slipping into real trouble; need to step back and realize I didn’t make this happen; it is not my ‘fault’) you may be unable to get out of that hole on your own.

With Type 1 diabetes no label is needed internally, because the physiologic response is both readily apparent and immediate.

MEDICAL CARE

IDDM enables you to call the endocrinologist or non-MD diabetes care professional and discuss problems or adjust dosage or combinations of insulins on the phone and know insurance will cover it, or that those few minutes of expert advice may be freely given. A diabetes emergency virtually always is safely treated by administration of glucose (by mouth or by glucagon shot) which anyone can do if so informed - wristbands, medallions, wallet cards and even signs on the bus instruct anyone that this is absolutely the safe route to follow if there is even a suspicion of diabetic hypoglycemia.

MENTAL ILLNESS of course is the forlorn stepchild. Is it typical for a distressed patient to *only* have a suicide prevention number to call in an analogous emergency? Does any average person know the safe way to ‘administer life support’ to the suicidally depressed person? No, they don’t, and even worse - the label ‘mentally ill’ doesn’t yet help them to do any better than the lack of it does. The argument voiced by earlier posters doesn’t address the critical need for a socially-understood ‘label’ in the societal embracing of those with and those directly affected by this disease of mental illness.

WHOLENESS + WELLNESS
Now, the good news (and I want to mention a proprietary program now). Out of the blue one day I got a call from Personal Choice’s Health Connection nurse. This is a ‘health maintenance’ program for subscribers with chronic illnesses. Perhaps my records with them clued them in that I might find use in this service, or perhaps I had checked a box on a billing statement or something.

It worked for me, and has continued to work. My ‘health connection’ knows what I said or did or faced in our prior call so there is seamless continuity. The caller either calls at a specific time or interval, or I call them and ask for my HC. One can imagine that this could become either onerous or so unengaging that it is specious. But if it isn’t working then I can change it in any way: cancel, reschedule, choose a different HC, increase the time per call or shorten the interval between calls.

It is almost like talk therapy, almost like a caring parent, almost like an understood social rule (e.g. no jaywalking in busy city streets, shouting wildly in the mall, no diving into the garbage can at the school cafeteria for that uneaten roll). It is a conversation between equals - one of mutual respect: I respect the remoteness & inability of the HC nurse to act like one of my doctors and my HC respects my need to manage without the HC program at any point I choose.

So in the psychiatry-pharmacology vs. anti-psychiatry debate this demonstrates a win for both, together, when stitched with humanity in between. Science really tries to develop useful tools, alternative therapists try to match society’s demand for scientifically-consistent procedures. Mechanisms like progressive health insurers or governments foster *whole person* well being when they suit any case without incurring too great a cost.

I think the “pro-psych” atmosphere is actually what the public came to demand after centuries of snake-oil salesmen giving home remedies a bad name (for the sake of profit). So now it is the job of holistic therapies to convince society that the new shysters have to be set aside. We can do it, too! In recent years American med schools have come to require holistic medicine classes, to mandate courses in communication and ‘bedside manner’. Big insurers are initiating new programs like Health Connection and are covering more ‘preventive’ care just as they tighten their drug formularies to reduce costs. Maybe these are little indicators of an improved delivery of healthcare.

Posted by liz at 01:56 PM | Permalink | Comments (2)

Poor Kathy DeBell (pictured). She had just started work at a K-Mart, (which seems penance enough) when she was shot and killed by Anthony Law, someone she didn't know. Now DeBell's family is finding the incredible generosity to be sympathetic to Law.

From the Denver Channel:

"No matter what happens to him or what his motives were or what's going on, nothing's going to bring Kathy back, so we don't think about it that much. We know the poor man must have been a very troubled person," said Robert Thompson, DeBell's stepfather.

That man is made of strong stuff.

K-Mart Shooter Has History Of Mental Illness

Posted by liz at 12:31 PM | Permalink | Comments (0)

Posted by liz at 11:44 AM | Permalink | Comments (0)

One thing you gotta say for the New York Times: They haven't yet gotten the memo that "the kids" want shorter, snappier articles, à la Entertainment Weekly. And thank God. I'm consistently impressed by the depth of reporting the daily newspaper does, and the flexibility its writers have to churn out thousands of words on important subjects. Granted, I don't usually read them all, but it's nice to know they're there in case I get especially motivated.

Here's a piece about yet more ickiness perpetrated by big pharma—and the charities that rely on them. I'm starting to think big pharma should be a cartoon character called Big Pharma, complete with Texas hat, spurs (or syringes) on his boots and a big, meaty hands greased for bribes. Anyone out there an illustrator?

Charities Tied to Doctors Get Drug Industry Gifts

[Photo by alba because a cute girl in a cowboy hat is better than a cartoon character any day.]

Posted by liz at 10:54 AM | Permalink | Comments (1)

From WZZM-13:

Jenison - Police are looking for a woman from the Jenison area they say has been missing since Monday. Police say she has a "history of depression."

Carol Becker's family reported to the police she was missing from her Jenison home and is believed to have left between 8:20a.m. and 9:15 a.m.

Becker's daughter Tanya Harris doesn't believe her mother went very far.

Harris say's, “She was undergoing ECT treatments and seemed to be a little better this weekend so the 24-hour watch of her was lifted. She only had about a quarter tank of gas and has no money, no credit cards, no ID on her, therefore, she could not have gone far.”

Carol Becker is a 58-year-old White Female, 5'3” tall, 180lbs, Brown Hair, and Blue Eyes, unknown clothing description.

She was last seen driving a 2000 Chevrolet Astro Van, Dark Blue in color, and MI registration of TEZ-777

Police say, “At this time foul play is not suspected however the incident remains under investigation.”

Anyone with information is asked to call the Ottawa County Sheriff's Office through Ottawa County Central Dispatch at 1-800-249-0911 or Silent Observer at 1-800-825-0221.

Don't know if anyone lives in her area, but it's worth a shot.

Posted by liz at 05:41 PM | Permalink | Comments (0)

When I think about the fact that there are Jewish Republicans, it boggles my mind and makes me sad.

Posted by liz at 05:33 PM | Permalink | Comments (0)

By July 1 Medicaid subscribers will have to prove their U.S. citizenship. There are so many reasons that this is a bad idea, but since it's a reality, here's the crap you have to know:

From the Public Affairs Office of the Dept. of Health and Human Services' Center for Medicaid and Medicare:

Overview of New Guidance on Citizenship Documentation for Medicaid Benefits

HHS today issued guidelines for states to implement a new requirement, effective July 1, that persons applying for Medicaid document their citizenship. The new documentation requirement is outlined in Section 6036 of the Deficit Reduction Act of 2005 (DRA) and is intended to ensure that Medicaid beneficiaries are citizens without imposing undue burdens on them or the states. Recognizing the diversity of beneficiaries served by Medicaid, the guidelines provide for a range of ways that citizenship status and personal identity may be documented. If other forms of documentation cannot be obtained, documentation may be provided by a written affidavit, signed under penalty of perjury, from two citizens, one of whom cannot be related to the applicant or recipient, who have specific knowledge of a beneficiary’s citizenship status. Affidavits can only be used in rare circumstances. Additional types of documentation, such as school records, may be used for children. Current beneficiaries should not lose benefits during the period in which they are undertaking a good-faith effort to provide documentation to the state.

The guidance letter to state Medicaid directors reflects extensive input from experts and groups.
CMS received input from such groups as the National Association of State Medicaid Directors,
the National Association of Community Health Centers, the National Mental Health Association
and the Tribal Technical Advisory Group to CMS.

Today’s letter will be followed by federal regulations that will appear in the Federal Register.
American citizenship or legal immigration status has always been a requirement for Medicaid
eligibility, however, beneficiaries could assert their status by checking a box on a form . The
DRA requires actual documentary evidence before Medicaid eligibility is granted or renewed
beginning July 1. The provision requires that a person provide both evidence of citizenship and
identity. In many cases, a single document will be enough to establish both citizenship and
identity such as a passport. However, if secondary documentation is used, such as a birth
certificate, the individual will also need evidence of their identity. Once citizenship has been
proven, it need not be documented again with each eligibility renewal unless later evidence
raises a question.

Guidance Details
Documentary Evidence
The law specifies certain forms of acceptable evidence of citizenship and identity, and provides
for the use of additional forms of documentation as established by federal regulations, when
appropriate. Today’s guidance outlines acceptable additional forms of documentary evidence.
The guidance adopts a hierarchical approach already in use by other programs in which
documentary evidence of citizenship and identity is sought first from a list of primary
documents. If an applicant or recipient presents evidence from the listing of primary
documentation, no other information would be required. When such evidence cannot be
obtained, the state will look to the next tier of acceptable forms of evidence. A state must first
seek documents from the primary list before looking to the secondary or tertiary lists.
In particular, the following forms of documentation may be accepted:
• Acceptable primary documentation for identification and citizenship:
o A U.S. Passport.
o A Certificate of Naturalization (DHS Forms N-550 or N-570).
o A Certificate of U.S. Citizenship (DHS Forms N-560 or N-561).
• Acceptable secondary documentation to verify proof of citizenship (an identity document
is also required):
o A U.S. birth certificate.
o A Certification of birth issued by the Department of State (Form DS-1350).
o A Report of Birth Abroad of a U.S. Citizen (Form FS-240).
o A Certification of Birth Abroad (FS-545).
o A U.S. Citizen I.D. card (DHS Form I-197).
o An American Indian Card issued by the Department of Homeland Security with
the classification code “KIC”. (Issued by DHS to identify U.S. citizen members
of the Texas Band of Kickapoos living near the U.S./Mexican border).
o Final adoption decree
o Evidence of civil service employment by the U.S. government before June 1976,
o An official military record of service showing a U.S. place of birth
o A Northern Mariana Identification Card. (Issued by the INS to a collectively
naturalized citizen of the United States who was born in the Northern Mariana
Islands before November 4, 1986.).
• Acceptable third level documentation to verify proof of citizenship:
o Extract of U.S. hospital record of birth established at the time of the person’s birth
and was created at least 5 years before the initial application date and indicates a
U.S. place of birth.
o Life or health or other insurance record showing a U.S. place of birth and was
created at least 5 years before the initial application date
• Acceptable fourth level documentation to verify proof of citizenship:
o Federal or State census record showing U.S. citizenship or a U.S. place of birth.
o Institutional admission papers from a nursing home, skilled nursing care facility
or other institution and was created at least 5 years before the initial application
date and indicates a U.S. place of birth.
o Medical (clinic, doctor, or hospital) record and was created at least 5 years before
the initial application date and indicates a U.S. place of birth unless the
application is for a child under 5
o Other document that was created at least five years before the application for
Medicaid. These documents are Seneca Indian tribal census record, Bureau of
Indian Affairs tribal census records of the Navaho Indians, U.S. StateVital
Statistics official notification of birth registration, an amended U.S. public birth
record that is amended more than 5 years after the person’s birth or a statement
signed by the physician or midwife who was in attendance at the time of birth.
o Written affidavit.
• Written affidavits may be used only in rare circumstances when the state is unable to
secure evidence of citizenship from another listing. The affidavits must be supplied by at
least two individuals, one of whom is not related to the applicant or recipient. Each must
attest to having personal knowledge of the event(s) establishing the applicant’s or
recipient’s claim of citizenship. The individuals making the affidavit must be able to
prove their own citizenship and identity for the affidavit to be accepted. Those making
affidavits will be subject to prosecution for perjury. If the persons claiming knowledge
of another’s citizenship has information which explains why documentary evidence
establishing the applicant’s claim of citizenship does not exist or cannot be readily
obtained, the affidavit should contain this information as well. A second affidavit from
the applicant/recipient or other knowledgeable individual explaining why documentary
evidence does not exist or cannot be readily obtained must also be requested.
• Acceptable documentation to verify proof of identity:
o A current state driver’s license bearing the individual’s picture or State identity
document also with the individual’s picture.
o Certificate of Indian Blood, or other U.S. American Indian/Alaska Native tribal
document.
o Any identity document described in section 274A(b)(1)(D) of the Immigration
and Nationality Act.
• Children who are age 16 or younger may have their identity documented using other
means, when the child does not have or cannot get any document on the preceding lists.
o School identification card with a photograph.
o Military dependent’s identification card if it contains a photograph.
o School record that shows date and place of birth and parent(s) name.
o Clinic, doctor or hospital record showing date of birth.
o Daycare or nursery school record showing date and place of birth.
o Affidavit signed under penalty of perjury by a parent or guardian attesting to the
child’s identity.

Driver’s License Documentation to Establish Both Citizenship and Identification
Section 6036(a)(3)(B)(iv) of the DRA permits the use of a valid state-issued driver’s license or
other identity document described in Section 274A(b)(1)(D) of the Immigration and Nationality
Act, but only if the state issuing the license or such document requires proof of United States
citizenship before issuance of such license or document or obtains a Social Security number from
the applicant and verifies before certification that such number is valid and assigned to the
applicant who is a citizen. CMS is not currently aware that any state has these processes in place
at this time. Therefore, until such time that a state has this requirement in place this
documentation may not be accepted.

Reasonable Opportunity
At the time of application or redetermination, the state must give an applicant or recipient a
“reasonable opportunity” to present documents establishing U.S. citizenship or nationality and
identity. The guidance advises:
An individual who is already enrolled in Medicaid will remain eligible if he/she continuously
shows a good faith effort to present satisfactory evidence of citizenship and identity.
Applicants for Medicaid should not be made eligible until they have presented the required
evidence.
If the applicant or recipient tries in good faith to present satisfactory documentation, but is
unable because the documents are not available, the state should assist the individual in
securing these documents.
If the applicant or recipient cannot obtain the necessary documents and needs assistance (i.e.,
is homeless, mentally impaired, or physically incapacitated), and lacks someone who can act
on their behalf, then the state should assist the applicant or recipient to document U.S.
citizenship and identity.

Compliance
As with other Medicaid program requirements, states must implement an effective process for
assuring compliance with documentation of citizenship in order to obtain federal matching funds,
and effective compliance will be part of Medicaid program integrity monitoring. In particular,
audit processes will track the extent to which states rely on lower (third and fourth level)
categories of documentation, and on affidavits, with the expectation that such categories would
be used relatively infrequently and less over time, as state processes and beneficiary
documentation improves.
States will receive the normal 50 percent match for administrative expenses related to
implementation of the new law.

Outreach
The Centers for Medicare & Medicaid Services, the agency that oversees the Medicaid program,
will launch an aggressive outreach program to educate states and interested groups about the new
requirement. These outreach efforts include presentations to interested groups and tools that
states may use to help applicants and recipients understand the requirement. The tools will
include talking points, questions and answers, a sample press release, drop-in article and lists of
acceptable documents. The agency will also work closely with states to help them reach out to
their current Medicaid enrollees and the general public outlining the new rules. CMS will hold
training sessions with state officials including regular telephone consultations during which the
agency will provide whatever technical assistance the states request. CMS will also provide
speakers at national conferences of interested groups such as tribal organizations and advocacy
groups for minority communities.

For more information about the citizenship documentation requirement, go to:
http://www.cms.hhs.gov/MedicaidEligibility/05_ProofofCitizenship.

Posted by liz at 02:09 PM | Permalink | Comments (0)

For the contest, I asked which of the 10 myths are absolutely false. The answers, with McManamy's commentary, are below:

7. Medications are all you need to combat bipolar disorder.
False. While medications are the foundation of treatment for bipolar disorder, recovery is problematic without a good lifestyle regimen (diet, exercise and sleep), effective coping skills and a support network. People with bipolar disorder also benefit from various forms of talking therapy and religious/spiritual practice.

9. Lower quality of life and sluggish cognition are fair trade-offs for reducing mood symptoms.
False, big time. In the initial phase of treatment, meds overkill may be justified to bring your illness under control. But full recovery is based on improving your overall health and ability to function, not just eliminating mood symptoms. Over time, the side effects of medication tend to go away, so patience is advised. You may choose to live with minor side effects such as mild hand tremors. But if major side effects persist, you should work with your psychiatrist in adjusting doses or switching to different meds. The onus is on you to alert your psychiatrist to major side effects and to insist he or she take appropriate action.

10. Once you’ve been diagnosed with bipolar disorder, you can forget about leading a normal life.
False. Living with bipolar disorder is a challenge, and you may have to change your expectations, but you should never give up on living a rewarding and productive life.

The winner is Joni Soule, who guessed 1, 7 and 10. (You know what they say: Two out of three ain't bad.) The prize is my autographed copy of Vincent Van Gogh's letters, filled with madness of a delicious kind. Joni, where can I send the book?

Posted by liz at 11:20 AM | Permalink | Comments (0)

I got an email yesterday from Leigh Hopkins, whose brother Bobby (pictured) took his own life two years ago after a struggle with bipolar disorder. She wanted to share something with me that she wrote right after he died, but, she said, "I'm not a writer." I'd say she is.

The piece she sent is below. I think it's a beautiful tribute to someone who died too soon.

I sit on the shore of Lake Champlain, trembling. Lightening strikes Savage Island no more than a quarter of a mile from where I stand. Thick black clouds creep in from the north, thunder cracks, and a flock of seagulls scatter—their wings a startling white against the darkening skies. Experience tells me that very soon, the Champlain Islands will disappear behind a frothy white squall line, and the storm will be upon me.

During these many summers, one for each year of his life, my brother and I delighted in these storms. Even now I can see his brown eyes ablaze with a mixture of fear and excitement: “It’s coming! Look—it’s almost here!” The two of us would challenge each other, waiting on the shore until the air crackled with the smell of ozone, until the lake became an ocean, until the rain pelted our skin and the wind sent us squealing for cover.

My brother is gone.

Four months ago today, the ever-increasing storms that tormented his beautiful mind overtook him, and he took his own life.

I could lay out in detail how mental illness slowly robbed my brother of the life he was meant to live, but that would discredit him. What I know is that he lived more fully than anyone I’ve ever known. When he ate, he tasted every morsel, and groaned an appreciative “Oo-oof!” when his belly couldn’t hold another bite. When he listened, he listened with the whole of his heart, his eyes mirroring my own. When he engaged in a new project or idea, everyone around him became a part of the process, a part of the play. He created brilliant science, and devoured Rumi, Rilke and Kerouac.

He dreamt of great adventures.

After his death, his colleagues told me of his strange creative genius—of his delightful, yet bizarre queries: “What kind of fuel would you use if you were going to build a time machine?” “On a scale of one to 10, which is worse—a rotten baloney sandwich, or a sharp stick in the eye?” “How much of your life savings would you be willing to bet on a race between a sock puppet and a hamster?”

He made me laugh. He traveled at light speed, yet he couldn’t outrun his DNA.

And so it is.

Four months later, I stand frozen on the shore, hoping that somehow—through this small act of bravery—I might find myself closer to understanding the tempest that wrenched my beautiful brother from this earth. Somehow, by braving this storm, I might hope to understand the fine line between genius and madness, sun and storm, here and gone. If I stand long enough, perhaps I’ll see his brilliant blaze of a soul searing across the sky …

And with a mixture of fear and excitement, I face the world without him.

Posted by liz at 09:51 AM | Permalink | Comments (1)

I found this one last week in West Philly. It's so passionate, but it was in the trash. I'm guessing Bernie and Mandy aren't together anymore.

Posted by liz at 02:42 PM | Permalink | Comments (0)

•Duncan Drops Bid for Governor: Doug Duncan drops out of the Maryland guv race to battle his depression
•Acknowledging Depression: Kay Redfield Jamison says public figures who reveal mental illness can change perceptions
•Merrill Apparently Shot Himself On the Bay: Phillip Merrill's death is ruled a suicide
•Mental health woes rise: College students seek more mental health treatment
•Yates' new trial will test views on mental illness: Andrea Yates goes on trial yet again. What are the implications?
•Device, not drugs, for mental illness: A California woman doing ECT tries the Vagus Nerve Stimulator.
•Program focuses on probationers' mental health: Mental health court can be fun.

Posted by liz at 02:16 PM | Permalink | Comments (1)

A couple days ago George Ebert posted a message on this site:

I am confused. Are you about mental illness or mental wellness? You sure do seem to worship psychiatry. I don't. Psychiatrists diagnosed me, incarcerated me, secluded me, drugged me and shocked me. Psychiatrists dehumanized and disabled me and stigmatized me as mentally ill.

You, however, seem to have found comfort in their industry, labels and treatments. Me, I am targeted as a notorious non-compliant paranoid schizophrenic. Take the cure! Goggle me, or check out recoveryisreal.org.

I'm familiar, of course, with the psychiatric survivor movement, and though some people object to the use of the term "survivor" in such a context, I don't. People have suffered through horrible abuses in the name of psychiatry, most often in an institutional setting. I am adamantly opposed to forced ECT and the use of restraints, two issues I know are important to the survivor movement. I am always saddened to hear the stories of people who were kept in psych hospitals for months against their will. I think the poor and disadvantaged are absolutely more subject to such abuses, and I'm disgusted by the disregard of such people by the callousness of the health and judicial systems.

All that being said, in my career both as a psychiatric patient—including ECT, hospitalizations, inappropriately administered meds, etc.—and as a journalist, I have found that true wellness for severely mentally ill people almost always involves competent psychiatric treatment. This statement is not referring, obviously, to people who were misdiagnosed, and were called "mentally ill" when in fact they had no illness. I'm saying that for those who legitimately have the illnesses, superb psychiatric practice can be the first step on the road to recovery.

Some people characterize themselves as "anti-psychiatry." That seems stubbornly reductionist to me. It'd be like saying you're "anti-opthomology." Psychiatry is a field of medicine, and as such it can be practiced well or practiced badly. I might not like my eye doctor, for instance, but I'm not going to give up on glasses. Instead I'm going to change eye doctors. There's no need to tar the entire field with the same brush.

It would be ridiculous to "worship" any field of medicine. It's not a question of emotion. I take pragmatic advantage of the medical services available to me—in every context. I treat my asthma the same way I treat my psychiatric illness: When I have a problem, I address it with a trained professional. I haven't been schooled in how to treat lung disease, so I rely on my doctor. If my medication is causing unacceptable side effects (my old inhaler gave me oral thrush), I go for a medical consultation and we adjust the treatment. I approach psychiatry in exactly the same way.

In my experience—and I've only been doing the journalism thing for seven years, so I still have a lot to learn—I have literally never met a person with schizophrenia or bipolar disorder who was able to be medication-free for a lifetime and still maintain the kind of life that worked for them and for others. I have seen many people who were medication-free but still plagued by demons, or at least compromised in some way by the illness. This isn't to say there's no other way. It's to say that's been my experience as a journalist, patient, friend and family member.

As for labels, I happily embrace mine because it allowed me to get better. How many times was I told by psychiatrists I was just neurotic or anxious? It wasn't until I was given a diagnosis—a label—that I was able to get the help I needed. The label also opened up a world of consumer support to me. I was able to access listserves and websites written by other people with my symptoms. I still rely on the great supportive network across the country, and am consistently amazed by the generosity in the consumer movement.

That's all for now. These are some of my beliefs, and maybe they'll alienate some of you. I hope not because I think this dialogue is important. Let's keep the lines of communication open, and talk to each other with respect and sympathy. Harsh words do nothing to clarify things.

Posted by liz at 12:19 PM | Permalink | Comments (17)

It's pouring here, but I couldn't find an umbrella this morning. There's an umbrella hook in the closet, but it was sadly naked. I stared at it for a few minutes, waiting for an umbrella to materialize, but nothing happened. So I walked to the trolley with my laptop stuffed underneath my shirt. I've rarely been so intimate with my computer.

I noticed other people with capacious umbrellas at the bus stop and was jealous. One in particular was a cute clear plastic dome with blue piping. It was very quirky-Holly Golightly. When I got to the train station I bought the "jumbo New York" umbrella, which I guess pays tribute to those enormous doorman umbrellas people always marvel at. This one was so jumbo, I could've fit several hobbits under there with me and we'd have plenty of room. I'm never losing this umbrella. (Famous last words.)

Over the weekend many of you sent in links to other mental-health-type blogs. I appreciate that. I'm going through them slowly, only because I want to point you in the right direction. Here are two (courtesy Sachin) that I like. More to come!

Shrinkette: A psychiatrist in the Pacific Northwest nicely straddles the balance between not giving medical advice online and providing information you'd like to know.

Psychiatry, Medicine, Philosophy, Poetry, Music: Wide-ranging notes by a psychiatrist who's unafraid to use medical jargon. Good conversation about ECT on there right now.

Posted by liz at 11:05 AM | Permalink | Comments (1)

Well, I'm off to see my GP now to talk more about my night sweats, my fatigue, and some other less palatable symptoms. The chances are that all my complaints can be explained by the Effexor, but in a weird way I'm hoping there's something physically wrong so I don't have to stop taking the drug. Last night I dreamt I gained 300 pounds from it, so obviously the anxiety is percolating.

After the doctor I'm off to Long Beach Island for a birthday weekend, so I'll be in transit and won't be blogging. I'll miss you all, but I need the break. So I'll see you all on Monday!

Posted by liz at 10:31 AM | Permalink | Comments (4)

I confess I didn't find this link myself; my co-worker at PW, Daniel McQuade did. The reason for that is that I haven't watched American Idol more than once, which I know makes me a freak in this culture, and I don't in fact know who Katherine McPhee is. I gather she's quite popular, though.

McPhee shared her "secret struggle" with People magazine. At her worst, McPhee was purging seven times a day, which is like "taking a sledgehammer to your vocal chords," she says. McPhee's experience should be a lesson for young girls who thinking purging will make them lose weight. At the height of her illness, McPhee weighed 160 pounds. After participating in a three-month eating disorder program, she's now free of the bulimia, and she weighs 135 pounds. You hear that, girls? It's not going to work.

Anyway, McPhee's revelation will certainly help shed light on the issue, if this CNN article is any indicator. On the other hand, since her coming out, as it were, McPhee has canceled a slew of interviews and appearances, presumably because she doesn't want to talk about it. Maybe she regrets being so candid.

McPhee one of millions with bulimia

Posted by liz at 10:10 AM | Permalink | Comments (1)

For a while there I thought I was posting into the ether; I couldn't find many mental health blogs other than Furious Seasons, by fellow alt-weekly journalist Philip Dawdy.

But lately I've become aware of some others that you might want to know about. I mean, if you find my blather interesting, you might find theirs appealing as well. The problem is that I can't tell who's really good at this stuff without spending all my time reading, and I do have a day job. Sometimes I'll be reading a blog that I think is clever and compelling, and then I'll notice some weird flag saying "Zionist Extremism Is My Bag" or a link to a site for Republican Jehovah's Witness bumper stickers, and I have to quickly click away.

Below are a few that I think are worth checking in with, though I'm not endorsing anything specifically because that seems to get journalists in trouble. I'll try to do this every few days. If you know of a blog related to mental health (or write one) that you'd like featured here, let me know.

Dr. Deborah Serani: Blog by a psychologist who specializes in trauma and depression. Breezy and very informational.

Treatment Online's Anxiety, Addiction and Depression Treatments: This is extremely newsy and filled with good links. The "about" section says some of the writers for the blog are pharmaceutical salespeople, which makes me nervous—perhaps unfairly. Either way, the site is a remarkable motherlode of info.

Spanglemonkey: First person diary by a person with mental illness. If your interested in first-person accounts of dealing with the illness with family members, there's some good stuff.

Dr. Helen: Blog by a forensic psychologist in Knoxville, Tenn. Right now there's a handy guide to Borderline Personality Disorder posted, which might be helpful to those dealing with friends or relatives with BPD. That's always tricky.

Posted by liz at 04:33 PM | Permalink | Comments (5)

So that's why Marshall Mathers has been so quiet: He's been depressed. His best friend was shot in the head (which could bring anyone down), and he divorced his wife, Kim, for a second time. (Which, BTW, is just another example of why the institution of marriage is kind of ridiculous.)

The resulting depression sent Em indoors and caused him to gain weight (sound familiar?). But now that he's taking antidepressants (allegedly; his PR person is denying he's taking them. Why?), he's feeling better, and is set to star in a movie-type thing that'll surely be violent and silly.

But it's nice to have him back. Apart from the homophobia (no small thing), I have a little bit of a weakness for Eminem's music. I think he's kind of talented, and come to think of it, not really that much more homophobic than all the other rappers out there. Lovely!

Eminem 'recovering from depression

Posted by liz at 02:31 PM | Permalink | Comments (4)

A couple weeks ago PW's staff photographer Jeff Fusco went to the site called Byberry in Northeast Philadelphia. It's a collection of crumbling buildings that were once a state hospital for the insane. It was, according to the horror stories, a real snake pit—the kind of place that made deinstitutionalization necessary.

Urban spelunkers have long been sneaking into Byberry's haunting buildings, as have ghost watchers, who insist the spirits of the dead remain there. I once wrote an article about it, asking people in the area to write to me with their Byberry stories. I got letters and emails that told of abuse but no one wanted their names used. All these years after it was closed, people are still afraid to talk about it. So I never wrote an article.

Now they're going to turn the site into an office park. It's a huge project, and a bit of a tragedy for those who want to preserve the decaying beauty of the buildings. For a sense of what it's like inside, go here: Some of the images are beautiful.

For a sense of the exterior, I'm trying to upload some of Jeff Fusco's amazing photos, but they're too big. Meanwhile, this is my last call for stories about Byberry. Please do write if you've got something to say about it. And if anyone can get me in there, I'd love to go.

Posted by liz at 11:52 AM | Permalink | Comments (1)

Today there's an article in the Metro, a daily newspaper in Philadelphia, about this blog. The guy who wrote the piece, Josh Cornfield, was very nice and professional. I enjoyed talking to him even though I knew I was being less articulate than I wanted to be because I was distracted. Vince was waiting for me in the car outside, and I felt like I had to speak very quickly. I figured, "Well, maybe Josh isn't a fast typist, in which case maybe he'll only get a few things I'm saying." I assumed the piece would be very tiny. (What I learned today is that Josh is indeed a very fast typist.)

Then he asked if a Metro photographer could come take my photo—while Vince waited in the car some more. (Vince had to be nice about it because it was my birthday, and on my birthday he has to be in a good mood no matter what.) I was wearing an unflattering bra, my hair was frizzed out, I had no makeup on and I was bloated from snack foods consumed during my computer training. I said, "Well, I'm kind of having a bad hair day," but I knew I'd have to get the photo taken. I'm a journalist. I know how the game is played. I hoped it would run as small as a postage stamp.

Instead the photo is 3 1/2 by 7. It's huge. I'm facing away from the camera, making my chin lose all definition. My arms bulge like sausages against the photo's frame. My boobs are a shelf. My hair looks like it was cut by a blind man. It looks better online, but the printed version, which is cropped against those arms, is washed out and ill-defined. If I were photographer Rikard Larma, I'd be frustrated by how my shots looked on newsprint.

I asked a co-worker if that's what I look like. He said I looked fat in the photo but that I don't look like that in real life. Well, at least someone knows the truth. I feel badly to learn how shallow I am. Why should I care what the photo looks like? But I look at it and I think, "Who's going to go to that blog? The blog of Sausage Arms?"

Yesterday I was able to contextualize to make myself feel better. But today I'm kind of worried, from a medication standpoint. If it's the Effexor that's causing this weight gain, what will I do? Is it a side effect I can live with? It seems incredibly depressing to me to be overweight, but not clinically depressing. Effexor brought me back from an abyss that I simply can't afford to slip into again. And I'm willing to deal with its side effects, whether loss of libido or night sweats. But am I going to be fat? I'm not sure I can handle that.

Many people who take psychotropic meds complain about weight gain. And many prescribing doctors deride their concerns. But what could be more essentially important than one's appearance? When the meds are working, we forget how horrible it was to be without them, and problems like weight gain come to the foreground.

I'll never again say, "What's 10 or 20 pounds if you stop hallucinating?" It's not always an acceptable tradeoff.

Blog’s aim: Break down stigma of mental illness

Posted by liz at 10:37 AM | Permalink | Comments (5)

Thanks to everyone who sent me birthday wishes, and sorry I didn't get back to you. I've been out all day at a software training, which is pretty much how everyone wants to spend a birthday, I know. I apologize for the lack of post-age, but I'll be back full-force tomorrow.

Posted by liz at 05:44 PM | Permalink | Comments (0)

Today is my birthday (I'm 18!), and aside from getting to joke around about my real age (I'm 22!), which I won't disclose here (but is closer, say, to 30 ((ahem))), I also get to indulge in some mildly self-pitying reflection, which I generally eschew. (Self-reflection is de riguer, of course; it's the self-pity I try to avoid.)

Last night I dreamt that PW's old art director, Jeff, had long ago had a romantic relationship with my boyfriend, Vince. They'd lived together back in the ’80s or ’90s, but then Vince realized he wasn't gay, so they split up.

But then they saw each other again, and spent time together, and Vince realized he was indeed gay, and would be moving back in with Jeff. Because I like Jeff so much, and because I'm very pro-gay, I felt I wasn't allowed to have any of the emotions I might have had if Vince simply ran off with another woman. No, in this case I had to be generous and loving about it, and feel happy for Vince that he was finally discovering who he truly was. I thought about the great opportunity I'd be afforded for activism. I could write an article called "My Boyfriend Left Me Because He's Gay—and I Support Him Completely!"

But despite my P.C. beliefs, I was devastated. Jeff understood how hard it was for me, and he took me into his house, where a friend fed me juniper berries to make me feel better. They comforted me, but I couldn't stop crying. "I know it's good that he's gay and finally coming to terms with that," I wailed verbosely. "But I'll miss him!" And this would prompt an explosion of tears and the frantic consumption of more berries.

When I woke this morning my face was covered with tears and I was actually crying. Of course, in the light of the morning, the dream seemed ridiculous, and yet I still felt sad. And when I wake up crying, which is at least once a week, I can't shake the sadness. It lingers for the rest of the day.

To make things worse, I did something a woman should never do on her birthday: I tried on a pair of pants to see if they still fit. Clearly, I was possessed by a demon at that moment. They were pants I don't even want to wear till the fall, but I thought, "I feel like I'm gaining weight. Is it possible I'm not? I'll try these tiny H&M pants to see." Naturally, they didn't fit. I pulled and scrunched until my eyeballs were ready to pop, and still no progress. Finally, I threw them on the floor and put on a different pair of H&M pants—linen ones, and we all know how forgiving linen is.

Between the dream and the pants I was ready to slit my throat, and it wasn't even 9 a.m. I binged on peanut butter, straight from the jar, and gloomily read about the gloomy world in Newsweek and Time, thinking, "Dear God, I hope no one ever bans anonymous sources altogether. These magazines would have to fold." This also bummed me out, unaccountably, as did a rotten blueberry I mistakenly ate.

To give myself some perspective on life, I did what I always do when I'm feeling down: contextualize. My pain isn't any greater than anyone else's, I thought. I'm lucky, and here's why:

•I'm not on a German U-boat like the guys in Das Boot, a movie I watched last night.
•I'm not epileptic, as is a character in David B.'s graphic novel Epileptic, which I'm reading right now.
•I don't have tardive dyskenisia, like the guy on the trolley I sometimes see whose head jerks uncontrollably.
•I'm not a soldier in Iraq, like the guy who wrote The Last True Story I'll Ever Tell, which I recently read.
•I'm not Joan Didion, who in the last year lost both her husband and her daughter, and whose exquisitely rendered Year of Magical Thinking would make anyone think twice about self-pity.
•I'm not Britney Spears.
•I'm not in a psych hospital, homeless, drug addicted or grievously ill.
•I'm not in the ward they call "the Hood" in a Philadelphia hospital, which if you read PW's cover story by Steven Wells, is like waking up on the wrong side of the bed in Jacob's Ladder.

All true, yet not quite enough, believe it or not, to mitigate the pants incident. So I looked into the sugar glider cage to catch a glimpse of the babies that have just emerged from their mother's pouch. They're each the size of an index finger, maybe smaller, and they can't open their eyes yet. They were squirming over each other, and grooming themselves, which I found somewhat amazing. They have no sense of the outside world, but their instinct tells them to keep clean, which I'm sure is to keep them healthy. I stared at them for a long time, and then one of them yawned, which was so cute, I had to do some deep breathing.

And that gave me some perspective. These two little lives—they know nothing of pants that don't fit or journalists who rely too heavily on anonymous sources. They only know the essentials: breathing, health, fatigue, hunger, warmth. And I'm breathing. And I'm healthy—or at least well medicated. And I have a soft bed and a roof over my head and more food than I need (hence the pants) and even central air and heat.

For those things, I'm grateful. And aren't those the things that really matter? The rest is gravy. (Preferably gravy on a cheesesteak.)

[My dad took this photo of me many years ago. I'm grateful that—except for the fact that I cut my hair more fashionably now—I look pretty much the same, even at 26! Tee hee.]

Posted by liz at 10:11 AM | Permalink | Comments (3)

Sometimes when I miss my dead cat, I watch videos of cats that look and act and sound like him (like this one) and get sad.

Posted by liz at 04:52 PM | Permalink | Comments (5)

Re: the article in Slate about taking Paxil for social anxiety, fellow blogger Mark writes:

Slate has listed that article as one of its favorites in its 10-year birthday celebration. I read it when it was originally published and it has stayed with me as the worst, dumbest, and most dangerous article Slate has written. The guy stretched the truth to get the pills, and then didn't follow the instructions. This somehow made him qualified to give his opinion on its effectiveness.

Nobody should be treating prescription drugs as if they were taking the Pepsi challenge.

Excellent point, Mark.

Posted by liz at 02:39 PM | Permalink | Comments (0)

Pentagon policy document lists homosexuality as a mental disorder

Posted by liz at 02:35 PM | Permalink | Comments (0)

I remember when "social anxiety" became a bit of a buzzword and every layperson I knew railed about how stupid it was as a diagnostic category. "That's what we used to call shyness," quoth the critics, including me.

Turning once-"normal" states of being into disorders and pathologies has its pros and cons. The words "social anxiety" have allowed a lot of people poleaxed by fear to get medical treatment. Phrases like "conduct disorder" help kids get doped up on Ritalin, which I think is more dangerous. So it's a mixed bag.

Faithful link-sender-inner Sachin Karol emailed this article to me, which chronicles a shy person's experiment with Paxil. It's an interesting take on the subject, but I could never endorse this way of handling medication. My suggestions:

1) Find a qualified psychiatrist who you plan to see on a regular basis before you try medication—someone who'll meet with you for at least a half-hour once every couple of weeks.
2) Don't drink while taking meds.
3) Don't stop taking the meds without consulting said qualified psychiatrist and without tapering off.

Extroverted Like Me: How a month and a half on Paxil taught me to love being shy.

[This image is from Paxil CR's website. I guess the implication is that if you take the drug, you'll be comfortably enough socially to wear a stupid hat.]

Posted by liz at 12:49 PM | Permalink | Comments (2)

No, it's not Trouble With Spikol—though by jove, that column's pretty good! I refer instead to today's Pensacola News Journal editorial by Reginald T. Dogan. (It was Dogan's first name that made me want to say "by jove.")

The article showcases what the best editorial writing can do: advocate for those who lack a voice, and do so in a forcefully articulate fashion. Jolly good, Reg!

Prisons and jails should not be warehouses for the mentally ill

[This is the smallest image of a person ever used on this site. I'm certain Dogan deserves better.]

Posted by liz at 11:32 AM | Permalink | Comments (1)

Well, the big news is that Mama had two babies in her pouch, not one. They can’t open their eyes yet, and they don’t have much hair and they spend a lot of time making little sucking and wheezing noises, but I guess they're okay. Papa has explained that I must be very good to them and protect them, like a good brother should. So I spend more time in the cage now, and less time pressing my face against the bars begging to come out.

Maybe soon Auntie can take a picture of them and I can put them here. Unless Mama and Papa eat them, like they did with my sister, Little Moxie, R.I.P. Though I was very little then, I think it was Mama who ate Moxie, not Papa. She can be mean. And hungry.

This is a real photo of me. I’m sitting on Auntie Liz’s arm, right next to her fake Cartier watch, which she says looks so real no one would know it was a fake. I like to bite the watch and lick it, which makes Auntie nervous because a Cartier watch with teeth marks on it doesn't look as real. But the best thing about Auntie’s arm is how nice it is to pee and poop on. I like to do that as soon as she picks me up.

Bye!

Posted by liz at 10:10 AM | Permalink | Comments (1)

This is a tragic suicide-by-cop story of a young man with bipolar disorder who never had a chance.

The article is from the Philadelphia Daily News, which normally is suitable only for mocking, fish wrapping and hamster bedding. But this is a long piece that chronicles every moment of this young man's life, acting as a sort of explanation for his ultimately tragic demise.

His father also has bipolar disorder, as do nine of his 10 siblings. Pretty intimidating.

'Evil is in my blood,' he said

Posted by liz at 03:44 PM | Permalink | Comments (0)

Oh my God: Pete Doherty has once again screwed up. I have never witnessed a more self-destructive rock ’n’ roll persona, and given rock's pedigree, that's saying a lot. Doherty makes Keith Moon look positively straight-edge.

What's troubling Doherty? He's rumored to be bipolar, but he simply can't be treated because he abuses drugs so desperately. Less than a month after Rough Trade Records cut all ties with him, he's been arrested for having cocaine in his system. He also was under the influence of a benzo—the AP doesn't say which one—but he had a prescription for that. Despite money and fame, this guy can't get successful mental health treatment. If it's this hard for him, it's no wonder the rest of us struggle so.

Pete Doherty Fined for Cocaine Use

Posted by liz at 12:47 PM | Permalink | Comments (0)

I found the write way to beat mental illness

SCHIZOPHRENIA is a serious mental illness that affects one person in every 100. I first began to suffer from symptoms when I was about 12.

Of course no-one knew that's what it was then . . . it was just put down to the start of teenage hormones. But I began to have bouts of low mood and I was anxious around crowds. I started to bunk off school, I really hated it and just could not adjust to the 9-5 routine. It was the mornings that killed me, as I just could never get enough sleep.

The school, Craigroyston High, complained to my mother about my behaviour and after a while I was sent to several children's hearings. They sent me to a child psychologist, who, after one session declared me of sound mind and bad behaviour and I was duly punished.

The more pressure they put on me to attend, the more I skived off. Eventually I was just going in at breaks and lunchtime to see my mates then I'd take off again for the rest of the day.

When I officially left school - without any qualifications - I started to experiment with drugs. It's the normal thing to do where I come from. I got into tripping on hallucinogens. I eventually took a bad trip and fried my head with psychedelic fungi. I thought I'd really done it that time. My brain felt like it was melting in my skull and I thought I was going to die.

From that day on I was never the same. I'd opened a Pandora's box that was to last the next 20 years. I began to suffer from panic attacks and severe anxiety. I was sent for many "talking" therapies by my GP, but none of them fixed me up for very long. I no sooner sorted out one problem when another one would crop up.

I tried my best to hold back the flood but for the next ten years I was ill almost daily. Panic attacks, depression, constant anxiety, sleep disorders . . . it was all happening. Even agoraphobia. Some days I couldn't leave the house. I certainly never left Edinburgh for eight years. And of course I couldn't work.

Then in 1997 my brother and I woke up one morning and found our mother dead. She'd taken her own life after a long battle with the family demon. Knowing what I do now I realise she too was suffering a mental health problem, but then we had no idea.

We were devastated. The council was sending us eviction letters and we had to fend off sheriff officers and debt collectors. We finally sorted most of it out but they know how to kick you when you're down.

Later that year the rest of my family moved out and I was left alone in the house. I started to go downhill fast. I turned to drink, I think I was trying to drink away my problems. I grew worse and I was losing touch with reality. It all ended in my own suicide attempt in 2001.

It was a real attempt. I was 31, living on my own, there was no-one there who could save me. I took a whole month's worth of prescription anti-depressant and anti-psychotic drugs. I had nothing left to give. It didn't work. I woke up after 24 hours to a neighbour banging at the door. Unsurprisingly I was violently sick.

By then I was suffering from delusions and terrible fear and paranoia. I was also hearing voices. I followed the wind that had been sent to guide me all over the streets of Edinburgh on a mission for Scotland. Eventually the wind guided me into Drylaw police station where I told them that in the interests of national security I should be put away until after the general election. They took me to the Royal Edinburgh hospital where I was sectioned [committed] by a court. I was in hospital for three-and-a-half months while they bombarded me with various drugs to see what worked. You see I was hiding my symptoms - the voices were still telling me things would happen to my family if I told the doctors anything.

Eventually I was let out, but was only home for three weeks when I told my sister everything and she called them. I jumped out the window and took off across the estate in my bare feet. It took seven of them to catch me.

They told me I was suffering from schizophrenia. My reaction was total disbelief, but the first tablet took away most of my symptoms. It was amazing.

When I got out of hospital they wanted me to do some daft gardening scheme. I had other ideas.

I told everybody I was going to be a writer. Everybody laughed but I started to type with two fingers and eventually had my first book published less than 18 months after my release from hospital.

It's called The One and it's all about my experiences of schizophrenia while sitting in the Andrew Duncan Clinic.

This is schizophrenia from inside the mind of the sufferer.

In the last few years I've done lots of things I would never have dreamed of as a psychotic, anxious, agoraphobic, angry, depressed, schizophrenic, hypochondriac.

I attended the Edinburgh international book festival and I've done hundreds of public readings. I even did a piece for STV's "Talking Scotland" as well as lots of work for the national health and well being programme, mainly the Scottish recovery network.

I've devised a self-healing programme for myself based on things I learned as a teenager when I practised martial arts and there's a new book on the horizon in the near future.

Of course, I'm still taking the tablets but I'm no longer a danger to myself (I never was one to anyone else).

I'm 36 and quite proud of the fact that despite everything I haven't ended up with a criminal record.

It all goes to show that your life