The Subtleties of an Illness: Depression

This past month and a half has been pretty darn difficult for me. Depression descended and stole all the beauty of the lovely fall season.  It terrorized me and made me feel helpless and without hope. I was close to losing my compass in life.

Depression does this by altering my thoughts, behaviors and feelings. It is powerful, life altering; so  sadly and tragically that it can kill by suicide. During depression my feelings are mistaken and flawed. Instead of knowing that I am capable of meeting life’s daily challenges, I feel overwhelmed by them. Getting dressed, for example, is an achievement. What? Why? With depression all little decisions are magnified and threatening. Choosing what to wear on a ordinary day is fueled by anxiety that whatever I choose, I will choose wrong. The negative thoughts that occur with depression are very real. Frequently, those  negative thoughts whisper that all is wrong with my life and my family’s life.  The thoughts and feelings attack my fundamental beliefs and values.

With beliefs and values shaken, depression is left to achieve a stranglehold on my mind.

Sadness pervades.

And I feel especially saddened for those who lived with depression before effective medications were realized and discovered. It was harder to live with depression back in the decades of the 50’s, 60’s and 70’s.  People with depression, or those who had had a nervous breakdown, were thought of as weak, or lazy or both. Lacking in character. Deficient.

Today we have become more open-minded. We know depression is an illness. Before long scientists will uncover exactly what gets tangled in the suffers brain. And luckily, we’ve found new medications that can be life saving.

My new medication will become active in about 3 weeks. Please understand that 3 weeks to me sounds like an eternity.

Understanding families and friends do ease the experience of depression, but In the meantime, I will endure and live through a bit of hell.

Fall. Tears.

October 4th, a Thursday, was a truly beautiful fall day. Crisp, clear, with a big blue sky. My husband and I went for a long afternoon drive in the rolling hills that characterize the driftless country that we live in and around.

I was taken by surprise when the tears started falling. Around every bend the tears fell. My old nemesis, depression was gaining a hold. It didn’t make any sense to be crying on this glorious day. But  I knew depression well enough by now to realize that depression doesn’t necessarily make sense.  It can literally appear out of the blue.

I got through the day by practicing mindful, close attention to my surroundings and my companion.  These kept me anchored.

But the depression has returned and is trying to take a permanent position in my daily life.  If I don’t work very hard to fight it, the depression will take a serious hold for many months. Shorter fall days of sunlight are a trigger to the seasonal disorder.

Clearly I can’t change the seasons nor would I want to change fall into summer, etc. Autumn is my favorite time of year. So what do I do? The depression is misleading. It tells me all things are bad, negative, and deeply darkly foreboding.

So what do I do?

I have two strategies to help me out of depression’s trap.  One is to revisit my list of things and people for which I am grateful. And the other is to create list of all the things and events I am looking forward to in the next 3 to 4 months. Some of those things and events bring a smile, even now.

I’ll name a few: homemade applesauce, baked squash and chili; college football and basketball games; celebrating Thanksgiving and Christmas with family and friends. Two pastimes, coloring and writing.  And , of course, discourse with my family. As I make this list I brighten up. The world is more inviting and rewarding with each minute.

I truly wish and hope for a fall that is fun and fulfilling and a winter with many sunny days for all of us. And that any depression that occurs can be cut down to size.

Thank you kindly.


It’s happening again … I’ve figured it out now.

Days being near tears; a thunder cloud on my horizon.  A deep down sadness, a grief, and an ever-present fear of losing control.

I figured out what was happening to me.

IT has returned, although this year I thought my sky would remain clear until April and Spring arrived.

I have a full season to go before spring. If my seasonal depressive disorder doesn’t respond to fixes, it will be a long time to be mentally and physically at risk.  A long season trying to swim, to stay above water, to keep afloat.

Seasonal affective disorder, or SAD, troubles me most every fall and winter. You may be surprised to know that, even now, I don’t recognize it until the sun goes down on autumn.  My emotional health was trouble free and my days filled with everyday pleasures when the doom returned, and I finally figured it out.

It’s my old nemesis, Seasonal Affective Disorder, that’s got a grip on me.

SAD. Sad, so what do I do?

Well, it is not that I don’t like winter, quite the contrary—–I do like winter and many of its milestones. But if I do not practice the therapeutic responses I’ve learned, the darkest season gets pretty grim. Thanksgiving, Christmas, first snow and bright clear winter days – pleasurable milestones all – fail me.  I become depressed.

So, what do I do?

The depression may or may not respond to medication changes. I must also employ some practical adjustments.

I remind myself to deliberately pay attention as the season changes. I celebrate the fall turning of leaves. (This year the oak’s leaves were quite handsome.)  I roast hot dogs and marshmallows over an open fire.  And I plan a lovely harvest feast, inviting those near and dear to me.

Gratitude. One activity that helps fight SAD for me, is writing out a list of the things I am grateful for. Yes, construct a deliberate list, written out on paper, and do it as often as needed.

Number one on the list is Jim, my husband with his endless love and support. He is followed closely by our two children who nurture me with more love and support.

The list continues. You might guess what is next. Our grandchildren, a welcoming home, and a good appetite for literature and dining.

The idea is to express this gratitude in acts:  This year I’ve decided to host a Harvest feast.

We are having bison, a wild rice casserole baked in a pumpkin, and skillet blue cornbread with local honey. And I found a refreshing salad in one of my Native American cookbooks. (Yes, I collect cookbooks – and I’m grateful for that passion too! The Strawberry and white corn salad is out of season but I am going to serve it anyway.) Next Saturday we will all gather and rejoice in one another.  Thus, my gratitude is made visible to me.

How will you celebrate the passing of fall into winter?

Notes from Working with a Psychiatrist

I see my psychiatrist once every month, minimum, no matter how busy or how well or how poorly I am feeling!  Over the years, these regular appointments have proven their worth to me.  Recently I’ve been feeling very well – but I met with my psychiatrist anyway and we had a fruitful satisfying appointment. Just as I normally do, I’d made a list of items to discuss with her. Some of them: Updating her on a change in how I was taking my prescribed medications.  A a summary of how I have been feeling coupled with a description of my functioning this past month. And so on.

She welcomed me warmly and waited for me to start the conversation. I was able to tell her that I’d been feeling very well since our last appointment.  As we went on talking, I told her how I had managed my mood and anxiety during the challenges of Christmas and December. I had been calm, collected and in a good mood. Christmas has always been a most difficult time for me, but this year, wonderfully, I had enjoyed the holiday season with family and friends. How I feel during the holidays is a very good indicator of my brain health!

I went on to say, with enthusiasm, that I was optimistic and excited for the year ahead. To be able to say optimistic is another Very Positive Indicator of my mental health status. I also continued to be grateful for and satisfied with our move to a new house in a different community this past summer.  Before we moved there had been several months of exhausting nervousness and anxiety in anticipation (dread?) of the move and its upheavals.

I also told her of my good success dealing with a change in my medication regime. The mood stabilizer I was using had caused me to fall unexpectedly sleepy while driving.  Consequently my husband often drove for me, as he and I had decided the sleepiness was a danger to others and to me. So we wanted to stop taking the med.  I am now able to drive without sleepiness, and as a result driving has again become a pleasant, safe task.  Now my psychiatrist and I are thinking of decreasing the number or the amount of medications I take. Scary, for sure, but another plus!

Why then do I continue to see a psychiatrist: to help me with the inevitable bad days or circumstances; to check that a bad day or two doesn’t become a trend; also for medication reviews, and for affirmation of my own understanding of my mental health.  Lastly, for the great comfort that, should a trend develop into a full blown depressive episode and I become seriously, dreadfully, sick we will both be on top of it.  My psychiatrist, reflecting the caring professional that she is, will be ready to prescribe new therapies, new medications, new approaches and give me hope. I have a real respect for this doctor and a great deal of faith that together we can find workable treatments for me, no matter the challenge.

Thanks, GL

Personal Medicine. A concept formulated by Pat Deegan

As I was preparing my presentation (titled “Living Successfully with Depression and Suicidal Thoughts”) to be given at NAMI Wisconsin’s Family Programs Summit this November, I ran into the term “personal medicine,” meaning an activity that a person does to obtain wellness, rather than something a person takes. The term was introduced by Patricia Deegan, PhD, in early 2003 as a result of qualitative research she did through the University of Kansas – School of Social Welfare [The Importance of Personal Medicine: A Qualitative Study].  Upon interviewing individuals who were taking psychiatric medication, Deegan found that “When describing their use of psychiatric pharmaceuticals or ‘pill medicine’, research participants also described a variety of personal wellness strategies and activities that I have called ‘personal medicine’. Personal medicines were non-pharmaceutical activities and strategies that served to decrease symptoms and increase personal wellness.”

Pat Deegan writes: “Personal medicine is what we do to be well. It’s the things that put a smile on our face and that make life meaningful.” She continues “Many of us have learned that finding the right balance between Personal Medicine and psychiatric medicine is the road to recovery.” [Common Ground Toolkit and Recovery Library]

She cited three examples of personal medicine that work for her: playing with her dog, taking care of her daughter, and reading scripture. I jotted down six examples to begin with: parenting and grand-parenting, cooking and baking, singing, texting and emailing Rebecca and Benjamin, sending notecards to people, and writing. Oh -and reading is a ready seventh activity; it’s the way I start every morning! Listening to music, often at the end of the day, is an easy eighth.

Reading Pat Deegan’s research closely, I see she identified personal medicines as falling into two broad categories: those activities that give life meaning and purpose, and self-care strategies. Both types increase feelings of wellness and help keep psychiatric symptoms and/or undesirable outcomes such as hospitalization at bay.

Necessary personal medicine is sometimes serious work. There was a year in my life when I was moderately depressed. I felt I had to bake five days a week: I had to bake every day I was home alone, at the time between jobs, every day that my husband Jim was away at his work. I baked for three hours every day, minimum. Why? I needed to structure my time, to accomplish something and to knead and stir down pain and numbing thoughts. It was always a batch of chocolate chip cookies one day and bread the next day. This period occurred after the children were grown, so what we didn’t or couldn’t eat ourselves, which was a lot, we gave away.

I learned this lesson [Partners in Recovery – PIR, June 2010] from Ms Deegan:  “It is so easy to get lost in thinking that we are not good enough or that we are irrevocably flawed because we have a diagnosis of mental illness. But healing does not come from outside us; healing comes from within.”

Now I realize that at that time in my life I was using baking as a self-care strategy, without being alert to my decision to do so. Baking simply kept me on my feet, kept me “productive,” and stopped the grinding negative thoughts. The joy and creativity I normally found in cooking and baking was absent. No lofty thoughts occurred while the warm dough was molded under my hands. No images of Grandma or my Mother – my bread-baking teachers – formed in my brain that I can remember. No smell of yeast permeated my mind. I simply did the tasks and came out with good home-baked items.

Good home-baked items. And I did not deteriorate in my mental status. I improved with time, never needing hospitalization or respite care. There is something good and healthy in people with a diagnosis of mental illness. Medicine doesn’t only come from a doctor or a mental health provider team. “Discovering personal medicine is powerful medicine and connects us to the resilient, healing parts of ourselves.” [PIR]

Today, much of the time I spend cooking and baking takes the form of personal medicine that makes my (recovered) life sing with purpose and meaning. I love the seasonal foods and the celebrations that each represent. In our family, every spring, there is homemade cream of asparagus soup with a twist of lemon on the side. Summer brings ruby red strawberry shortcake with berries from the field and real whip cream, plus new leaf lettuce for many simple tasty salads. Then late summer taught me to appreciate warm peach cobbler. Fall is chili and beef stew and the first cinnamon apple pie. The December holidays are hot chocolate from scratch, my delectable Mustard Apricot Glazed Ham, baked sweet potatoes, and pecan pie. All this is done with flow and calm that brings a great deal of satisfaction and attention to detail. My mind and senses are stimulated and utilized in a very positive and reinforcing way. And my family eats well too!

May each of you find the personal medicine that connects you to the resilient healing part of yourself.

The Strengths Model: Meaningful Relationships and Reciprocity

Reciprocity – and the mutuality it implies – is always present in a meaningful relationship……. Each participant sees themselves bringing something of value to the relationship.

Yes, to a relationship between a person with a mental illness and a mentor/other in a helping role. Listen to this wisdom gleaned from The Strengths Model: A Recovery-Oriented Approach to Mental Health Services by by Charles Rapp and Richard Goscha; their chapter entitled “Engagement and Relationship:”

View the relationship as an experience in Mutual Learning. Put the recipient, or the person with the mental illness, in the role as teacher. The mutual learning approach doesn’t only want to know a person’s diagnosis, for example, they want to know about a highly individualized set of experiences. The person being helped, when viewed as a teacher, enters an empowering role. As teacher he/she is engaged in meaning-making and self-understanding. The helper, by listening and learning, seeks to enter the reality of the person by knowing the objective conditions of their lives and their subjective experience of that reality.

Yet the reciprocity inherent in Mutual Learning is easily missed: When the friend/caregiver/mentor/professional is always the giver and the person with the mental illness is always the recipient, the idea is perpetuated that the helper always has what is most valuable. Most helpful relationships have a balance based on mutuality and reciprocity. Refusing offers of reciprocity — whether it is an offer of a cup of coffee, a small gift, or knitting lessons — may be as rejecting as outright stating to the person “You have nothing of value to offer this relationship.” And, as our authors  observe, such condescending behavior “….is downright unfriendly.”

It is interesting to note that actions refusing reciprocity can stay with one for a long time. Here are two examples: Both helpers were excellent psychiatrists and good doctors for me. Both provided me with therapy as well as assessment and medication management.

The first helper happened to retire just as I was beginning to experience recovery. This psychiatrist had been through moderate to severe depressions with me, many drug trials, hospitalizations, and had “seen” my children grow up. He was very helpful to me and I admired and trusted him. Today I think of him fondly and with respect. He got me on the right road to treatment and a progressive, wholesome doctor-patient relationship.

The problem in short is that he didn’t accept a small gift from me of two tickets to a University of Wisconsin Choral Union concert. I was performing in the Choral Union and this doctor had been a backer of my quitting smoking and learning to use my voice, once again, to sing. It was a milestone for me to sing in the University’s acclaimed choir under the well-known and highly regarded Choral Director Robert Fountain. My doctor thanked me for the tickets but mailed them back to me with an apologetic note. Even though our professional relationship had ended, he felt accepting these tickets in any form would violate the professional-patient code of conduct.

I understood, but I cried.

Recently another psychiatrist retired. I had been with this person a long while as well. Through my blossoming periods of experimenting with recovery and hard times as well. Through my periods of NAMI activism and Family to Family service role. Through the empty nest syndrome. There was also a period when Jim became clinically depressed, followed by a period of great doubt and casting about from which, with Mutual Learning, Reciprocity, and Respect, we have since grown and recovered.

This psychiatrist accepted my gifts, which were two. At our last appointment, I bought a picnic lunch, complete with tablecloth and picnic basket filled with delicious finger food. We enjoyed the food and each other’s company. We talked about her future and my own.

I also gave her a book, One Hundred Names for Love, a true story of genuine love in which the author, Diane Ackerman, recounts the challenges and victories she and her husband lived through following his stroke.

The book was appreciated and accepted as a gift. The lunch was relished.

I will always remember that last appointment. It was delightful, reciprocal in nature … and empowering.

The Strengths Model’s Focus on Meaningful Relationships

In my last post, I wrote about the Strengths Model – a progressive attitude about mental health thinking, care and services put forward by Charles Rapp and Richard Goscha in their book The Strengths Model: A Recovery-Oriented Approach to Mental Health Services, Third Edition, 2012.

The first proposition of their Strengths Model is: “The quality of niches people inhabit determines their achievement, quality of life and success in living”.

Here I address an equally important principle underlying the Strengths Model: “People who are successful in living [with mental illness] have a meaningful relationship with at least one other person.”

As a person living with mental illness, I have been fortunate. I’ve had two relationships especially meaningful and empowering to me at most times throughout my adult life. One meaningful relationship was with my husband, Jim. We had the great good fortune of always being able to talk over the hard issues of mental illness. He was, and is, my sounding board and advocate, too. Important also to me was the relationships I’ve had with a succession of strong women mentors. Sometimes that second person was a colleague; sometimes that person was one of my psychiatrists, but a second meaningful relationship was nearly always there.

Why was that second meaningful relationship so important? At times I was unsure just how objective my husband could be. “Of course,” I might (and sometimes did) think, “my husband will encourage and believe in me; he is my husband.” Jim would “have” to be on my side. In the face of negative thinking, a second meaningful relationship was very helpful.

These Meaningful Relationships are characterized by a partnership which is Reciprocal, Empowering, Genuine, Trusting, and Purposeful. Partnerships that intentionally strive to avoid Spirit-Breaking words and actions and focus on Hope-Inducing Behaviors.

It’s also a partnership characterized by continuity in the face of struggle.

For little did I know then how many persons with mental illness lose the support, understanding, respect and love of those with whom they had meaningful relationships, as they progress through life.

I will continue to write about these special partnerships and their characteristics. For these are relationships that can ignite and fuel successful living with mental illness.

The Strengths Perspective

Here’s a statement that intentionally “turns around” our usual way of evaluating mental health outcomes: If we want a successful mentally ill person, we could create a group home and help the ill person thrive within it. But if we want, simply, a successful person with mental illness who thrives in the same community with everyone else, we should help them find persons and resources in the community that will empower their strengths and also help them persist and persevere in working to minimize the disabilities brought on by their mental illness.

You help them persist and persevere by engaging them in their areas of strength, not in focusing on their deficits and defeats.

This suggests we should use a strengths model, rather than the problem-based or deficit model for providing services to those suffering from mental illness or disorder.


I first heard of the Strengths Model back in 2000, when I was in graduate school studying community mental health from Professor Charles Rapp’s perspective. A recent text co-authored by Charles Rapp and Richard Goscha, The Strengths Model: A Recovery-Oriented Approach to Mental Health Services, Third Edition, 2012 simply reaffirms its importance in my thinking. I learned to focus on an individual’s strengths as building blocks to manage a situation or a life. I believe that people with mental illness would be >much< better served if all of mental health services had a strengths-based foundation rather than the traditional deficit- focused orientation.

“The strengths model posits that all people have goals, talents and confidence.” Furthermore, “All environments contain resources, people and opportunities.” (Link) But with the deficit-mindset, our perceptions of these are limited and modest and full of considerations of barriers and pathology. Strengths pale in comparison to the deficits.

“The strengths model then is about providing a new perception. It allows us to see possibilities rather than problems, options rather than constraints, wellness rather than sickness. And after being seen, achievement can occur.

It is Rapp and Goscha’s belief that if those involved in mental health services and policy insist on the “muck and mire of deficits” perception, we cannot be of effective help to all of those affected with mental illness.

I learned that the Strengths Theory has nine key propositions. Several of the nine are block-busters that can explode our current ways of thinking about mental illness services.

Here is their first key proposition: The quality of the niches people inhabit determines their achievement, quality of life and success in living.

A niche is defined as the environmental habitat of a person or category of persons. There are two types of niches at the extreme: entrapping and enabling.

Here are four characteristics of entrapping niches (there are others):

  • Entrapping niches are highly stigmatized; people caught in them are commonly treated as outcasts.
  • People caught in an entrapping niche tend to “turn to their own kind” for association, so that their social world becomes restricted and limited.
  • People caught in an entrapping niche are totally defined by their social category. The possibility that they may have aspirations and attributes apart from their category is not ordinarily considered. To outsiders, the person is “just” a bag lady, a junkie, a schizophrenic….and nothing else.
  • In the entrapping niche, there are no graduations of reward and status. …… Thus, there are few expectations of personal progress within such niches.

Here are four describing enabling niches:

  • People in enabling niches are not stigmatized, not treated as outcasts.
  • People in enabling niches will tend to “turn to their own kind” for association, support, and self-validation. But often the niche gives then access to others who bring a different perspective, so that their social world becomes less restricted.
  • People in enabling niches are not totally defined by their social category; they are accepted as having valid aspirations and attributes apart from their category.
  • In the enabling niche, there are many incentives to set realistic longer term goals for oneself and to work toward such goals.

The strengths model proposes that finding, cobbling together or creating enabling niches should be the major focus of work for mental health services and professionals. The authors continue, “There is good reason to believe that the niches available to people with psychiatric disabilities influence the recovery process and their quality of life.” (pp. 37, The Strengths Model)


I am thunder-struck, when I think of my life and the quality of my life and its influence on my recovery process. A few thoughts:

I have been very fortunate, that the niches in my life have been enabling in my recovery journey with mental illness. I’ll look at a variety of life domains: home or living arrangement, work, education, recreation, and spiritual . Yes, I did a lot of work to gain recovery….but I had a stable set of niches or habitats. Read on:

I lived in a home all the years I have had an illness.   And since the very time of diagnosis and onset I had my own family …… a loving supportive husband and 5 year old daughter and I was pregnant with our second child. We still live in our own home, although it is a different house now, for after 30 years our children are grown. They are fine and healthy and love and care for us as do our two grandchildren. Jim and I continue to enjoy a rich relationship with each other and with our family.

I have had rewarding work. I was employed at St Mary’s Hospital Medical Center and at two nursing homes and one small alcohol and drug rehabilitation hospital as a Registered Dietitian (RD). For 15 years I also taught as a clinical instructor and later lecturer in Nutritional Sciences Department at the University of Wisconsin-Madison. After this career within dietetics, I turned to the mental health field.

I had been able to earn an undergraduate education without much trouble. But much later, when I returned for graduate school, I had a relapse and asked for accommodations. My request was met professionally and I was able to complete the work after some delay but with full effort. I am happy to say that I received my Masters Degree in 2003 from Southern New Hampshire University. In 1993 I had begun a 20 year career of volunteer work with NAMI. After 2007, I joined the staff of NAMI Wisconsin as their Coordinator of Family Programs.

All this work was challenging with a mental illness, but I certainly had roles I valued and that other people valued which were separate from the “role” of being a person with a mental illness. AND NOW, recovered and moved by my life experience I write about mental illness issues and affirm the lives of those who live with them. Today, this website is my vocation in more ways than one.

I’ve lived a whole, stimulating and enjoyable life in large part because the places and people – the niches – I lived in and among were consistently empowering. We must strive to have these empowering environments available in reality for all people with mental illnesses!

Part V – Why does all this recovery happen?

One doesn’t recover from a mental illness in the same way one recovers from a broken arm. Yet recovery and healing is possible, and life can be enriched. We refer to that healing as a personal recovery.

Reading more of Professor Mike Slade’s work on personal recovery I found that my journey rediscovered something essential for the recovery to succeed: a sense of personal agency. This is the belief and assurance that one has the power to positively impact one’s own life; the power to act in one’s best interest. He writes that developing a sense of agency can be a difficult process precisely because mental illness often takes away that assurance and belief. He urges professionals, staff and family to show support which recognizes the importance of renewing the individual’s sense of self agency.

Finding and supporting that sense of agency – the ability to act in your own best interest – in yourself and for those you love is a crucial part of personal recovery.

I developed a great deal of authority over my life when I successfully quit smoking, a task I once thought was impossible for me. You see, when I quit I’d found I could make a difference in my health care, a truly enormous difference; perhaps a life-saving one. And I learned people would support me in this difficult but worthwhile goal!

Now I hopefully approached a new goal, to learn tools and techniques to help counter the persistent negative thoughts common to major depression. The experience of power over my life I’d had when I successfully quit smoking taught me to seek new tools which I could use to achieve new goals: It was time to learn Cognitive Behavior Therapy, and I had no problem learning and practicing its techniques. I continue to be an agent in my own life: Here in my 67th year I set out to find a Personal Trainer so the physical work-outs I desired would be effective and fun. I found one through a good friend; hired her, and have lost weight and body fat while building muscle, etc. I think more clearly and can concentrate more fully since I have been on a regular exercise schedule.

The symptoms of depression and bipolar II persist but weaken; the sense of authority over my own life increases; I’m healing.

Part IV – The Tasks of Personal Recovery

Touching my own experience, I saw in it each of the four recovery tasks listed in the previous post.

Recovery task 1: “The first task of recovery is developing a positive identity outside of being a person with a mental illness.” The person identifies elements that are vitally important to him or her, which will differ in significance from what another person identifies. “…only the individual can decide what constitutes a personally valued identity for them. “

I was lucky. In the midst of serious depression, I was married, a mother, and pregnant with our second child. . I did not lose those identities completely, but they were shaky. The years passed and I started my recovery journey: about 10 years later, the roles of wife and partner, mother to a child and mother to a teenager crystallized and doubt had been replaced often with enjoyment and wonder.

Recovery task 2: “The second recovery task involves developing a personally satisfactory meaning to frame the experience which professionals would understand as mental illness. This involves making sense of the experience, putting it in a box, and framing it as part of the person, but not as the whole person.”

The frame in which I understand my mental illness experience keeps evolving as the mental illness does not cease. But as the illness fades and my recovery grows, the frame gets more refined with the passing years.

I realize that again, I was lucky. I was married to Jim and he knew mental illness to be a no-fault biopsychosocial medical illness. So did I: I had inherited the tendency to depression, but was able to frame this as bad luck, not personal or family fault. Also, I lived near Madison, WI which had good services and I could afford good medical care. Again, I was fortunate.

I also had training in a health care field. I was a registered dietitian, (and still am) and proud that I was on the academic staff at the University of Wisconsin-Madison for 16 years (as a clinical instructor in the Department of Nutritional Sciences). So I was comfortable in various in and out-patient settings. I also knew appropriate levels of anatomy and physiology – and even biochemistry-lite. So I could follow the medical model of mental illness.

So I framed my experience of mental illness as an illness and as time went by, I was more and more able to put the illness in a box and frame it as only part of me but Not ME.

Recovery task 3: “Self-managing the mental illness.” Mental illness becomes ONE of life’s challenges. As people develop personal responsibility, self- management skills develop. This doesn’t mean managing the mental illness completely on one’s own but rather, knowing when to seek help and support.

I was desperate to “get better”. I cooperated in every way I could, even in the long decade of my body failing to respond to any of many anti-depressants. I never skipped a medication or an appointment. I ate well and got enough exercise at that time of my life.

As I began to recover in the 1990’s I took an even more active role in managing my illness. I learned cognitive behavior therapy (CBT) and carried out the exercises on paper, as assigned and in session with a psychology doctoral student. It helped me greatly, the CBT, so that I keep it up today as needed. Nothing has been as effective as CBT for minimizing negative thinking.

Now I’ve taken further steps to guard my health. In January of 2014 I hired a personal trainer(!), adding hour-long work-outs six days every week, three of them with my trainer.

Recovery task 4: “Developing valued social roles.” The key word here is valued. Valued by the individual with mental illness and by the greater social circle/setting/society. The person undergoing recovery, in this last task, must find a niche for himself or herself in their community. It could be a position/role modified from previous times or a new experience altogether . The role may or may not have anything to do with mental illness.

A huge change in my life occurred when I began to volunteer in a big way in the mental health organization NAMI, at the local and state level. You can read about my development in the About Me section of this website.

With this change I gained a tremendous amount of confidence and poise. I also had conviction in the value of what I was doing (teaching and, later, directing the Family to Family Education Program for NAMI WI). I felt education to be a liberating factor in living with mental illness in myself and in the family. I was fortunate in that the work fit me like a glove; teaching small groups of college age adults in the application of didactic material to the clinical setting gave me experience for teaching small groups of adults. My history as an adult child of someone with a mental illness and my own history of depression and after 2002, bipolar II illness, helped me understand families and persons with mental illness and all the dilemmas and controversies that entails.

So I definitely found a position in the community where I was valued and I felt valued.  I carried out my responsibilities with confidence and skill and compassion. I blossomed. I had developed something essential for self-management: a sense of personal agency .… I was the author of my own work.