An Open Letter To The Mothers of Baltimore on Mother’s Day

“A voice is heard in Ramah, weeping and great mourning, Rachel weeping for her children and refusing to be comforted, because they are no more.”  –Matthew 2:18, NIV

Today, on Mother’s Day, no one will be bringing you breakfast in bed or signing your crumpled up card with cereal splashed on it.  The people who would celebrate you: your fathers, uncles, brothers, nephews, sons, are in jail or in boxes.  On Mother’s Day, like every other day, you’re living in a war zone.

This is your story:

“This was my home. This was my family. These were my friends. But they were ghosts now. There were few men looking out for the neighborhood any longer.

What’s left are boys trying to figure out how to be men — and how to avoid getting “big numbers” or ending up in ‘pine boxes.'”

Source:  http://www.cnn.com/2015/05/02/us/lord-of-the-flies-baltimore/index.html

Your men are gone, and everyone else is speaking for you, about what’s gone wrong, what needs to change, and how it can be done.

On Mother’s Day, this is what I want you to know:

  • YOU are the widows and the childless.
  • YOU are the ones who spell Trauma with a capital “T”.  Not just during the riots but every other day of the year.
  • YOU are the ones left counting fingers and toes to make sure the ones that leave the house in the morning come home.
  • YOU are the father, mother, wife, daughter–mourner–all in one.
  • YOU are the bone tired and overlooked.
  • YOU are the ones broken by broken systems.
  • YOU are the ones who would rather slap your boys today than find them in cells or boxes tomorrow.
  • YOU are the gatekeepers.
  • YOU are the fierce momma bear, protecting her cubs.
  • YOU are the shell shocked and battle worn.
  • IF there are stories to be heard, they are yours–not mine, not the talking heads, not the media’s.
  • IF there is healing, redemption even, it will be your victory.

While “we” reflect on what needs to change from a lofty perch, you are the ones too bone tired from work and grief to weigh in.

I’m a White momma raising a Black boy in Baltimore.  I can’t pretend to know your past, but you better believe I’m listening to your present, and I’m both afraid and hopeful for your future, for Baltimore’s future.

Mothers of Baltimore, you are the ones we need to hear from.  If healing will happen, it will happen through you.  YOU are the gatekeepers.  You ARE the gatekeepers.  You are THE gatekeepers.

Please, come forward and share your stories.

A Day in Paris

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I spent one day in Paris over the winter holiday. The build up of anticipation left me pondering: “How does one cram all the charms of a city into the nooks and crannies of a single day?”

I’ve spent years day dreaming about the eccentricities of this particular city.
It was almost nothing like I imagined.

Not once did I hear La Vie en Rose echoing through a corner cafe. There was not one fiercely beautiful French woman pausing at the street corner to adjust her Hermes scarf. And I even saw tourists snapping pictures of La Tour Eiffel sparkling with nighttime lights, in front of police officers, with no repercussions. (Article.)

What I also saw were a thousand selfie sticks in front of Notre Dame alone. The famed lights of Paris at Christmas time. And a well-worn path across the grounds of the Louvre.

The city was even more enchanting because it didn’t meet my expectations. And the ways it differed were intriguing, poetic even: the crooked streets, the expansive architecture, the pathway of the Seine running up and down the curves of the city, the smallest shops next to the biggest cathedrals. I was mesmerized.

But the city was quiet with complacency. My visit was just a week before the Charlie Hebdo attack. A scene that transformed the city from the one I experienced on a lazy, December day to something entirely different. I’m sure Paris will never be exactly the same for its dramatic and devastating experience. And I’m sure I’ll view it through a different lens should I ever have the opportunity to go back.

—————–

I often speak of shifts in my line of work. Shifts are the dramatic changes undergone by individuals and societies alike that can happen in tiny increments or in a single moment.

Paris groaned under the weight of a shift the day of the Charlie Hebdo attacks. A shift that cut into the normal rhythms of the city and left that city dissected for quite some time. This is the type of shift that most of us are afraid of experiencing, and for good reason. Sudden change is scary.

Seeing Paris transformed overnight left me contemplating the quivering anxiety of sudden change. I understand all too well how difficult tragic change is, but I often speak with people who fear positive change as well. Examples include going off to college, moving, getting married, and switching jobs.

It would appear that our humanity produces a type of existential angst around change that is tied to our identities. It goes something like this: If I take the plunge, will I cease to exist as I am? Will this shift rob me of my identity? (If I take the plunge will it prove how unlovable, inadequate, helpless, [insert your own word] I really am?). In essence, will this dramatic change prove my worst fears about myself?

We don’t articulate it that way, of course. It gets voiced as: “I’m afraid I won’t perform well in this new role.” Or, “What if no one likes me in college?” Or, “How can I possibly handle this new responsibility as a husband?” So we avoid change to anesthetize ourselves from the pain that we fear will come with the dramatic shift.

I experienced a dramatic shift this past month. I became a mother. The landscape of my life is forever altered. And yet, I am still me. This change has challenged me in so many ways, but it hasn’t consumed me. I have to learn to be a more efficient yet sleepy version of myself, but I am still me.

It’s foreign yet familiar. It’s foreign in all the swaddled newness a baby brings. Yet familiar in that I can see my typical emotional patterns and pathways being retraced, just in heightened form. My typical stress responses get activated, and I have to work endlessly to use my internal and external resources well. What has also emerged, however, is unbridled joy–a fuller experience of love.

The irony surrounding our change-angst is that our identity development is usually more stunted by avoiding change than embracing it. Think of Howard Hughes, the famed Renaissance man and billionaire who couldn’t enjoy his wealth and success because he had a crippling fear of germs that left him confined to a lonely existence in his home. He had intellect, fame, and fortune, and yet his daily life became more horrific than any phobia he could concoct.

While our experiences are rarely that extreme, there’s a lesson, here, for all of us. Is there a life change you’ve been avoiding? What are you afraid will happen to you if you do embrace it? You’ll be a failure? You’ll miss your life of comfort? You’ll end up alone? Now, reverse that question for a moment. What might happen if you don’t embrace it? You’ll be a failure? You’ll end up alone? Consider how your paralysis might be limiting you right now. Could your avoidance of change end up being the real tragedy?

Avoiding change due to existential angst means not that we’ll escape a crisis of identity; rather, we’ll miss out on a fuller realization of who we are and what we’re capable of.

In the simple yet profound words of one master of change: “Unless you try to do something beyond what you have already mastered, you will never grow.” ― Ralph Waldo Emerson

Oh, how immensely tragic it is when we don’t grow. We are, in essence, allowing ourselves to be handicapped, crippled in our identities. And yet, when we take the risk to grow, there may just be an unbridled joy. Could we possibly discover a fuller experience of love?

PS. This recent change in my world ushers in a formatting change for my blog. Expect shorter sound bites in variable intervals. There will still be stories, just in condensed form. Who knows what discoveries we’ll make in The Raconteer, redefined!

The Bear and the Bull: A Year in Review

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Even Wall Street has its own fable. It’s told through shorthand between financiers. The fable offers a quick sketch of the economic climate at any given point and is represented by the bear and the bull. A bear market is a market in a slump and a bull market is a market rising.

This shorthand was created due to the volatility in the market as a way to concisely describe the status of a rapidly changing, complex system.

This same technique gets easily applied when we take stock of our personal lives: when we do a year in review. When we’re nearing the end of the year, we tend to make reflexive judgments that sum up the entirety of the year either as a bear year or a bull year. We decide whether things are deteriorating or getting better and then we act accordingly.

Whether it was a bear year or a bull year, our summation of things usually ends in avoidance, but for different reasons. In a bear year we can become depressed, overwhelmed and avoidant. And in a good year we can become complacent, over-confident, and sometimes even bullish.

Avoidance in bad years can lead to further decline, and avoidance in good years to reckless mistakes. Either form of avoidance misses out on the opportunity to learn and grow from our experiences.

Investors will tell you that the best approach to either market is an eyes-wide-open one. When applied to our year in review, whether it was a bear year or a bull year, let’s acknowledge it openly and be honest about our role in it. Reflection on the year gives us the opportunity to intentionally review, recap, and then move forward. Avoidance keeps us in limbo, or a place where we’re still impacted by the year without resolution (we’re stuck). Before you hit the fast forward button on the year end, I would invite you to consider taking inventory of your year.

Here are a few questions to prime the pump:

1–What has happened this year that’s important for me to remember? Why?
2–How have I grown?
3–Isolating this past year, who are the people I valued most?
4–What have I learned through pain?
5–Where did I take risks?
6–Where was I genuinely myself? Where wasn’t I?
7–What are my takeaways?

The reset button offered by a dawning 2015 could be an easy excuse to engage in functional nihilism. But if we choose to erase the past year, we risk losing valued memories, growth opportunities, and genuine perspective.

If it was a bear year, embrace it. If it was a bull year, embrace it. This life belongs to you and no one else. If you erase it, there will be no stories to tell, no losses to weep over, no joys to celebrate, and no fables to learn from.

Warmest wishes for a very happy New Year.

More Than a Candy Crush: The Life Lessons I Learned From Candy Land

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While browsing last-minute gift ideas for nieces and nephews the other day, I stumbled upon an old classic–the game of Candy Land.

Instantly I was transported to images of my 5-year-old self crouched in front of a multi-colored board lined with peppermint edges and game pieces that were as life-like as my imagination could reproduce in the ’80’s.

My friends and I spent countless summer days cross-legged and sweating over that flimsy board. There was a thickness in the summer air and an even thicker competition, as we embarked upon a magical journey through “candy cane forests and a sea of swirly twirly gumdrops” in a race to the finish. It makes me wonder if Buddy the Elf took a short cut through Candy Land en route to NYC.

During those magical, sugary hours, I was learning at more than I realized. As I reminisced this week, the thought came to me that Candy Land provides the perfect metaphor for the path to change. So I set out to see if I remembered accurately.

This iconic game comes with an important history. It was first manufactured in 1949, after having been invented a few years earlier by a woman who had polio. She used the game in children’s polio wards to provide a welcomed diversion from their illnesses and from their traumatic and elongated separations from family. There’s a fascinating article that provides an in-depth analysis of the connection between polio and Candy Land’s auspicious beginnings, and how the whimsical fantasy of a world made of candy was a great way to soothe both the frenzied hysteria and the very real anxiety that surrounded the disease.

As an aside, this article entertains the idea that the polio epidemic overwhelmingly shifted the cultural parenting tide from free range parenting to anxiety-driven hovering, and it laments how that cultural change continues to impact modern parenting styles.

The history of the game continues with multiple overhauls (e.g. the 1990’s exclusion of Plumpy); and enduring celebrity remakes from Dora the Explorer to a SpongeBob version. To date there have been 40 million copies sold, making this iconic board game a household name.

So why has this particular game withstood the test of time? Maybe it’s just the brilliant marketing to kids with a kaleidoscope of colors, delicious characters, and an edible plot line. Or, maybe not.

I wonder if the original creator knew how accurately her game predicts the path to successful change. From changing our eating habits, to planning cross country moves, to switching jobs, the path to change looks remarkably similar across the board (pun intended).

Here’s a quick sketch of the game for those who are unfamiliar. I’ll mostly be referencing the version that originated in 1985.

There is a winding path that spans the board and is divided into color blocks and locations. All locations are candy-related: plum swamps, licorice lanes, gum drop stops, etc. The players take turns picking a card that has an image of a particular color block or candy location that maps along the board. The player who picked the card moves to that spot, and then each player continues picking cards until one of the players advances far enough to reach the end: home. However, there is a catch. If you pick a card that coincides with a location that is further back on the board, you are required to retrace your steps. There are also certain places where you can get stuck (in a variety of sticky situations) and lose your turn. But in a whimsical balance, there are candy-coated shortcuts to accelerate your journey as well. So you could jump ahead of and then fall behind other players from one turn to the next.

Without opening a discussion on free will versus “Playing the hand you’ve been dealt,” let’s take a look at some of the toothsome (and gritty) truths that the Candy Land journey shares with the change process:

1–It’s non-linear. It’s not a straight forward journey. It is a forward, backward, and then sideways journey…And then backward again, with a couple steps forward, until you get knocked sideways and end up dizzy, and don’t know which direction you’re headed in.

2–Sometimes there are shortcuts…sometimes there are not. More often than not, there are not.

3–Sometimes there are obstacles…and more obstacles. Perseverance is key.

4–Stuck isn’t really stuck. Even with the obstacles, there’s a way forward. There’s always a way forward.

5–Often times there are setbacks (which are different than obstacles). In the game, there’s a looming awareness that you could end up retracing your steps at any moment. Expecting those setbacks leads to a quicker recovery time.

6–There is an end…and that end is home. The original 1949 version had each player nostalgically arriving at home, and for good reason. At the time, children with polio had to endure traumatic separations from their parents for months at a time while being treated. The reminder of home as the end goal presented comfort and hope. For us, home may be literal or metaphorical, but it’s always the place where transformation has occurred and where comfort and contentment reside.

Now that I’ve hopefully convinced you of Candy Land’s predictive validity as a formula for success, let’s talk about the best part. For those of us who are obsessed with change, and its importance, and who spend our days pondering the minutiae of it all, this game takes us right back to the basics.

Us adults over-complicate the process. Candy Land is that sweet reminder of how simple the message is: stick to the path, persevere, keep the end in mind, and eventually you’ll get there.

Who better to glean wisdom from than children? As the great Madeleine L’Engle once said: “You have to write the book that wants to be written. And if the book will be too difficult for grown-ups, then you write it for children.”

That literary pearl certainly applies here. If adults don’t get the formula for change, if they over-complicate it with a long list of defenses, why not teach it to kids instead?

I remember the rise and fall of my 5-year-old ambitions with the twists and turns of that game. Maybe at that age I was better acquainted, more familiar with, the path to change than I realized. Maybe it’s that my 5-year-old self could stoop more easily to keep her ear fixed to the ground–to pay attention. Whatever the case, I have a sneaking suspicion I was closer to wisdom at 5 than I am now.

I’m thinking of marketing my own version of Candy Land with fill-in-the-blank obstacles to help us plot our individual journeys to change. It will be complete with winding candy paths, sticky barriers, sweet short cuts, and a road that leads to “home”.

Any takers?

Desiring Greatly

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“So it’s gonna be forever
Or it’s gonna go down in flames
You can tell me when it’s over
If the high was worth the pain
Got a long list of ex-lovers
They’ll tell you I’m insane
‘Cause you know I love the players
And you love the game”

–Taylor Swift “Blank Spaces”

Our problem as a culture is not that we desire too much but too little. We are not creative enough about our longings. But we don’t need to be when those longings are hand-picked for us.

It would be easy to mistake cultural decadence for a robust ability to desire greatly. But the two are, by no means, the same. Take Taylor Swift’s song, for example. The chorus above ushers us into a world of romantic decadence complete with a “long list of lovers,” where she plays at discarding relationships like dressing room clothes. She’s “young and…reckless,” and she’ll “take it way too far”. This game she’s playing smacks of indulgence. The allure is instant gratification, but the appeal quickly wears off, so she goes from one lover to the next, but continues to end up alone and unfulfilled.

This game she’s playing at is one that we dabble with, ourselves, in various forms. We feel discontented so we spend countless hours buying clothes, drinking too much, or burning through a long list of hobbies. All of these attempts are formulaic and predictable. If there’s so little imagination, why are these things so popular and appealing to us?

We’re quick to accept cultural definitions for our desires instead of defining them for ourselves; and culture is ready and willing to take up the mantle of defining our wants for us. If the problem at hand is our unfulfilled longings (that show up in a state of discontent or restlessness), then culture’s quick solution is decadence. But those indulgences only mask our desires; they don’t fulfill them.

Do you know what you want? I mean, what you REALLY want? If you’re looking to culture to identify your holiday wishes, you may “really want” a sleek, ribbon-wrapped car stretched across your driveway and poised to respond to your commanding touch. While it’s appealing, it’s also unimaginative. It’s a temporary patch that leaves little energy invested in desiring greatly. The pursuit of desire, with our cultural capacity for opulence, is something you’d think we’d be good at but we’re not.

Freud coined the term “wish fulfillment” to describe the way our unconscious desires manifest themselves in dreams or fantasies (obscured from conscious view) until they culminate in resolution. Culture offers us plenty of fantasies that we willingly accept as the fulfillments of our every wish. But if our true desires are hidden from us, how can we really know what we want or whether we’re being fulfilled by what we’re offered? We can’t.

The next logical question would be, why do we bury our desires? Because we’re afraid of the intensity of those longings, and equally afraid of the people and things we long for. So we ignore/suppress/repress them for fear of what they might stir up within us: an immortal ache. This fear of aching has the uncanny ability to limit our creativity. But the stubbornness of those desires trumps the strength of our suppression, so they come bubbling to the surface anyway. Our fear leaves us frantically looking for something to tame the desires, so we end up relying on culture to soothe the inner beast.

True fulfillment doesn’t come in ribbon-wrapped packages. When we frantically reach for shiny things we merely placate the longings. We appease and pacify, only to end up restless and discontent. Living this way is like dumpster diving for scraps of food when there’s a sumptuous feast waiting for us just across the way. Fulfillment is available to us in the form of intimacy and connection (the feast), but we choose a “long list of lovers” instead. And those trysts end up “go[ing] down in flames,” as Taylor laments.

I love how C.S. Lewis, the famed author of “The Chronicles of Narnia” puts it: “We are half-hearted creatures, fooling about with drink and sex and ambition when infinite joy is offered us, like an ignorant child who wants to go on making mud pies in a slum because he cannot imagine what is meant by the offer of a holiday at the sea. We are far too easily pleased.” Indeed, this kind of logic yanks at our core. Who wouldn’t choose the beach over mud puddles?

To move beyond the allure of cultural decadence we must recognize the immortal ache within us. Those desires are not superficial at all. They are deeply personal and intensely real. True fulfillment evokes our creativity, our imagination, our vulnerability, and our love. True desire is only fulfilled when we partake in a lavish and glorious feast, a feast that nourishes rather than pacifying those desires. Have you ever tasted such a feast?

Oh, The Holiday Breakdown

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I’m pulling from the archives this week. As we approach another round of holidays, I’m reminded of how lists play a role in the festivities. Even the least organized among us desperately resort to lists to manage survival.

  1. The mom who baked five hundred cookies in 5 hours bullet points a list of the reasons she loves her kids enough to do it, and by the end of the 5 hours, she doubts every one of those reasons.
  2. The unhappy in-laws (or out-laws as they like to be called) conspire over 10 ways to get out of Thanksgiving next year.
  3. The money-conscious come up with penny-pinching techniques;
  4. The time-management disabled brainstorm ideas for cutting activities;
  5. And kids keep count of the number of gifts they have compared to their siblings.

My own holiday list from the archives is my favorite sort of list. The kind that celebrates the epic, holiday breakdown. We’ve all been there.

The Official Guide: How to Lose Your Cool Over the Holidays

Nietzsche’s Playbook

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This is a picture of an Andrew Wyeth. I stared at it, at this particular angle, for a long time; examining it with head tilted, then through the camera lens, then squinting, then wide-eyed. This picture renders paint and canvas invisible. They are no longer the mediators of this curtained scene. It is just me, tucking myself behind the curtain to stare at trails and trees. It is me breathing in the fresh air, no paint residue to stale it. It is me observing the pastoral scene sans canvassed limits.

I would argue that Realism (as a genre) succeeds when it removes the obstacle of the medium (paint, canvas, clay, metal) to reveal the transparent image. Well done, Andrew Wyeth.

I would also argue that we’re attracted to Realism because of this very ability to suspend our disbelief; this art feels true to every fiber of our beings, and we want it to be so. It’s serene, crisp, and lovely. It’s better than believing that we’re observing a flat panel fixed to a matte wall. In literature, we call this suspension of disbelief verisimilitude—when an author helps us ignore his fabrications because he has given us a reason to believe, against our better judgment, that his words are true.

In our daily lives, there’s another name for this phenomenon: functional nihilism. “If I don’t think about it, it doesn’t exist.” This is a suspension of our disbelief through willful ignorance. We are choosing to ignore part of the story.

If I don’t think about the canvas barrier that separates me from Wyeth’s pastoral scene, then it doesn’t exist, and I’m whisked away to a world of my own making, one where I don’t have to leave the wooded shelter…ever. You can see the appeal, here.

Freud would call this denial. But that word is overwrought and misses the juxtaposition of violence and pragmatism. We do violence to our memories by sentencing them to oblivion; and we do it practically as a survival mechanism—so we can function.

The heart-wrenching pain of ending a relationship can turn the best of us into functional nihilists. We want to annihilate the beautiful new beginnings that are now sickening and painful. We also want to crush the painful endings that leave us feeling vulnerable and hurt; because to replay them daily, to allow them to be a part of our moment to moment experience leaves our nerve endings perpetually exposed. Who can function when they are perpetually replaying a traumatic scene?

This pragmatism is enacted without discrimination. We willfully forget embarrassing moments, immoral decisions, and guilty feelings as well as major failures, childhood traumas, and relationship endings. This nihilism also applies to procrastination. If we don’t think about what needs to be done, we aren’t obligated to do it.

As with all of our defense mechanisms, we believe the benefit outweighs the cost. But we are blinded to what that cost is, to ourselves and others. Last year I met a woman who shared that she had gone through a bitter divorce. She was happy to declare that she was now “over it”. Intrigued, I asked how she had accomplished this. “I moved across the country.” She said. “Now I don’t have to think about him anymore.” As I listened to her story it became apparent that she had given up a huge support network, a great job, and an established life to get away from her ex-husband. Sadly, in her attempt to avoid one man, she lost almost everything else. And if the payoff was to forget him, it didn’t work. He consumed most of our conversation.

My heart goes out to this woman. Her story, though a dramatic example, is similar to our own. We are oblivious to what we’re sacrificing in our attempts at annihilation. We may not have moved across country, but we have lost out on meaningful living, nonetheless. As for this woman, whenever we engage in functional nihilism it can’t help but impact our relationships, our work, our sense of well-being–our lives.

If we take a page out of Nietzsche’s Playbook, we will find our nihilism expanding beyond the borders. We will find that, over time, what seemed functional now consumes us.

What are those events, relationships, beliefs that you’ve done violence to? If you’re honest, what have you lost in the aftermath of your annihilation?

So as not to leave us in the abyss, this is only part of the story. We can move beyond functional nihilism to embrace growth and healing. We can overcome our propensity to avoid. When we do, we no longer have to suspend our disbelief, because the healing is tangibly, palpably, and delightfully real.

To My Clients About Your Meds

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Dear Esteemed Clients,

This letter, although personalized, is for all students/consumers of Psychiatric medications. It is written with the demoralized patient in mind and heart.

I’m attending a Psychopharmacology conference this week. Not because I love the world of diagnosis, medication, and clinical treatment (although it has an essential place), but because I want to understand you and your medications. I know your medication management can feel more like a high stakes poker game than a streamlined science. You wait for the river to turn up aces and you get twos instead. That is, you hope the benefits will outweigh the side effects, but your current cocktail of tapering, titration, or cross-tapering leads to yet another bad withdrawal effect.

I also know that you suffer the side effects in silence. You tolerate restlessness, sleeplessness, weight gain, mood fluctuations etc., because you think this round of medication is the best it’s going to get, OR because you don’t know how to communicate your symptoms. I want you to know, I hear you. And, you don’t have to settle.

Your doctors are stretched thin in a system where more hours are spent doing administrative work than face to face with patients. And you feel it, acutely. You feel the sterility of baring your soul with their backs turned because they’re typing furiously at the details of your medical confession. You feel their harried pace as you’re pushed in and out of offices. You feel your brain shut down as you’re pressured to share all pertinent diagnostic information in 2.5 minutes. Your doctors have a near impossible task, and so do you.

I hear you. I’m at this conference because I want to better serve you and your pursuit of medication management. I, too, am tired of the many complexities of collaborating with other professionals, and I’m tired of how that affects my ability to advocate for you. I believe there’s a better way, and I’m determined to find it.

So here’s what I want you to know:

1–Self-advocacy is essential. It’s easy to assume your doctor is all-knowing and there’s a great chasm between their expansive knowledge and your limited understanding. But you know your body better than anyone else. You know when something doesn’t feel right. You know when it does. Please advocate for yourself if you know something is wrong. Ask questions; give feedback; keep working at it until there’s a manageable solution.

2–A lot can be done to manage side effects. If your side effects feel debilitating, speak up. You don’t have to settle. It may be a simple tweak, or an added booster medication that can make all the difference.

3–Data is a doctor’s gold mine. Create a medication timeline with dates, symptoms, and previous medications prescribed, and side effects. This will provide a reference point for you, me, and other important providers. The more exact data you can give to your doctor, in simple format, the better he or she can eliminate months of trial and error. And don’t forget to tell your doctor about all vitamins and supplements, because they may interact with your medications.

4–Journal your treatment. After you start a new medication, jot down some brief, daily notes about experienced symptoms and changes. What do you feel physically, and what do you feel emotionally? You can use ratings on a simple scale, and there are even forms you can fill out, if you prefer. This will provide practical information to help you dialogue with your doctor and it will help your practitioner more accurately assess the efficacy of treatment. And if you’re concerned that your medication isn’t working, you’ll have data to support that conclusion. Data that will help them avoid other medications that could result in similar side effects.

5–Avoid the “medication dump”. The Psychiatrist’s worst nightmare is the patient who abandons their medication due to initial side effects without a plan and without communicating with them first. Valuable time is lost when you start a medication, go off of it due to side effects, but don’t see your doctor for another six weeks. That’s six weeks of continued suffering to then end up back at square one. This is demoralizing, among other things. IF your side effects feel unbearable, don’t suffer in silence. Call your doctor. If you can’t reach them, talk to your pharmacist. Many insurance companies also have a hotline for 24-hour consultations with a Nurse Practitioner or doctor. That hotline is another immediate option in case of emergencies.

I hope this list empowers you to make a paradigm shift: narrowing the gap between “omniscient” practitioner and “fragile” patient. Much can be done to increase collaboration, limit side effects, and establish a healthy, working relationship with your doctor. And this, of course, applies not only to psychiatric medication but all facets of your healthcare as well.

As I absorbed the myriad of psychopharmacology data this week, I was reminded that in spite of having a nearly impossible task there are Doctors in this world who care and are fiercely committed to your well-being. So am I. They’re listening; I’m listening. Talk to us.

With Your Health In Mind,

Amy

The UnCola

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I’m attending a Psychopharmacology conference this week; that is, a conference where you learn current best practices in Psychiatric medication management. In short, the intellects are expansive and the humors are dry–like, scorched desert dry. But I digress.

I want to better advocate for my clients by understanding the professionals who prescribe their medications and the barriers to success in prescription and medication management. I have many and varied thoughts on this topic, which is what led me to the conference in the first place. I’m excited to share those thoughts, and more excited to withhold until I invest the time to learn first (and to challenge my own assumptions). In the meantime, musings on a fun fact I learned today:

The drink known as 7 Up formerly contained Lithium–a drug prescribed in the treatment of Bi-Polar Disorder as a mood stabilizer. It was removed in the 1950’s when we became aware of Lithium’s side effects. With the nefarious beginnings of 7 Up AND Coke, it leads me to speculate about the main ingredient in all soft drinks (aka. sugar) eventually being banned as a neurotoxin. There’s irony in soft drinks being taken down not by the usual nefarious culprits, but by an ingredient oft-used as a metaphor for a sweet disposition and whitened innocence. Will soft drinks be enveloped in a sticky, sweet demise? If so, infamous songs referencing sugar will take on a whole new meaning.

Until then, enjoy your refreshing UnCola (as it was once named), and think of me while I navigate the world of dry humors.

The Time Traveler’s Guide

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Twice a year we get to participate in the mystical journey of time travel, springing forward or falling backward in space, also known as Daylight Saving.

For all you grammar geeks, here’s a logophile’s take on those semi-annual time shifts:

“The official spelling is Daylight Saving Time, not Daylight SavingS Time.

Saving is used here as a verbal adjective (a participle). It modifies time and tells us more about its nature; namely, that it is characterized by the activity of saving daylight. It is a saving daylight kind of time. Because of this, it would be more accurate to refer to DST as daylight-saving time. Similar examples would be a mind-expanding book or a man-eating tiger. Saving is used in the same way as saving a ball game, rather than as a savings account.

Nevertheless, many people feel the word savings (with an ‘s’) flows more mellifluously off the tongue. Daylight Savings Time is also in common usage, and can be found in dictionaries.

Adding to the confusion is that the phrase Daylight Saving Time is inaccurate, since no daylight is actually saved. Daylight Shifting Time would be better, and Daylight Time Shifting more accurate, but neither is politically desirable.”  (source)

Apparently Counting Crows got it right; maybe we should take a cue from their playbook and refer to the fall backward phenomenon not errantly as Daylight Saving Time, but as musician-inspired Daylight Fading Time (DFT?).

For many, in spite of the ribbon-wrapped extra hour of sleep, daylight fading brings an unfortunate down side: Seasonal Affective Disorder.  As the darkness creeps in earlier and earlier through the winter months, many are plagued with depressive symptoms including lack of motivation or loss of interest, fatigue, tearful affect, irritability, and sadness.  See NAMI’s description for more.

You may already know seasonal mood changes have been linked to vitamin D deficiencies and are often treated with light exposure therapy and/or vitamins.  What you may not be aware of is some of the changes in “activities of daily living” (as we say in counselor speak) that accompany daylight-fading time.  These scheduling changes come with the natural rhythms of the winter season and couple with plummeting moods.  The combination of winter and the holidays creates the perfect storm for depression.

Let’s look at a typical scenario.  Margaret is a 55 year-old mother of three.  She glances at the calendar this morning, mug in hand, and almost spills coffee all over herself when she sees Nov. 1st.  Her initial association is accompanied by swirling thoughts and frantic internal checklists.  She’ll run to the mall later to find Macys already lit with Christmas lights and red-toned boxes, taunting her about unchecked items.  If we observe her life from November through February, we’ll find a common theme.  The chaos, cold, darkness, and disruption leave her primed for depression.

There are the obligations: parties, school events, and family gatherings.  And there are the accompanying details: what to bring, who to call, and booking travel dates.  There are the physiological changes: less exercise (due to cold weather and time commitments), a diet higher in sugars and fats, and less exposure to sunlight, along with stress carried in the body.  There are increased financial pressures and disrupted routines with extra hours at the office and schedules ubiquitously wrapped around vacation time.

During winter we may have to work doubly hard to avoid plummeting emotions.  Like swimming upstream, the winter months leave us swimming against a current of emotions furiously attempting to sweep us into depression.

Every year I find myself setting goals to counteract this.  Every year there are sneaky stressors that threaten to pull me down anyway.  I would prefer to avoid the work of planning for the winter months.  And yet, the work of planning is easier than the inevitable emotional and physical fallout when I don’t.

As daylight fades, at the very moment I’m posting this, consider the work that will go into preventing a slope into depression.  And consider the work that will go into counteracting it if you don’t.  If it’s inevitable that you’ll face the fading sunlight, how can you prevent the darkness from becoming internal?

 

Your fellow time traveler.