2/11/10

Fall seven times, stand up eight: A review of Therese Borchard's "Beyond Blue"

Therese Borchard defies the simple summary...

Maybe it is her beauty that keeps one unsuspecting of her storm within. Or maybe it's her uncommon gift of elevating the practical and accessible buried within the shrouded and hard-to-talk about. Whatever the reasons, Therese is a gifted writer giving voice to themes of darkness, despair, and empowerment in a style reserved for only the most articulate, curious and self-actualized women writers of our time. 

Today, thousands already read her thoughts about life with depression and bipolar on The Huffington Post, on Beyond Blue, and on many other mental health portals. Now she's written a generous book, Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes that offers her readers 17 broad chapters of authetic and transparent insight into her personal experience of life with depression and bipolar. A few witty chapter heads read: 
  • Booze: The Quiet Car in My Very Loud Brain (Chapter 3)
  • No Really, I'm Not Making It Up: Depression Is a Brain Disease (Chapter 10)
  • Sorry, Wrong Number: Codependency and Boundaries (Chapter 15)
As I read the book, I noticed that Therese's spirit is an honest guide, at once accepting of where she's at and then very demanding of herself to get better and keep at it.  She is all about walking the road beyond "Your Momma's Mental Illness" and giving a view into a wide open frontier rich with Christian tradition, Buddhist teaching, physical endurance training, nutrition guidance, mind-altering pharma, and old-fashioned "muddling on through," American common sense. A "post modern mental health guide" is the phrase that comes to mind.

I highly recommend the book for "advanced" readers; those people ready to explore a modern and more explicitly personal approach to coping with serious mental illness. This is not "chicken soup for the soul", although those ideas are held within. No, it's more of a unique look at how a woman -- even in her lowest moments of despair -- remains engaged and fierce as she attempts to solve the most stubborn of her problems; her mind.

No doubt Therese's tenacity and drive to excel in life fuels much of her self-discovery while breaking the barriers down for others to follow. In Chapter 11, Work it, Girlfriend! My personal 12-Step Program, Therese describes in witty detail how she weaves spirituality, pharma, lifestyle, relationships, and psychology into a set of simple steps. This is not to say that by working these steps one will forever be free of relapse. Quite the contrary. These steps are a component of her healthy living regimen, not its totality, so take them with a grain of salt. (And if you still aren't convinced, see  Chapter 6...) 

Since most of us could benefit from working these steps, I'll summarize them here:
Step 1: Find the right doctor - It was doctor number 7, from Johns Hopkins that was her winner.
Step 2: Find the right cocktail - It took her 23 different tries before she found relief in pharmaceuticals.
Step 3: Exercise - Cardio, cardio, cardio.
Step 4: Eat well - "Because some of us really are what we eat," she notices her mood drop after a day or two of toxic eating. 
Step 5: Sleep! "... It's about putting your head on the same pillow, on the same bed, at the same time every night, and sleeping for the same amount of time."
Step 6: Light Up - Use light to supplement what's naturally available to you. This helps optimize your circadian rhythms.
Step 7: Reach Out! - Connect with a community of folks like yourself. She quotes Martin Buber, "When two people relate to each other authentically and humanly, God is the electricity that surges between them."
Step 8: Get Involved - "... Love must drive every sentence and blog post that I write, every decision and behavior throughout my day."
Step 9: Keep a Mood/Sleep/Gratitude Journal - Discover your own personal patterns. Get insight.
Step 10: Therapy and Lots of It - This mini-chapter alone serves as an incredible cheat sheet for finding the right therapeutic fit. There is no "one size fits all solution" to mental health, especially if you have a chronic disease such as bipolar.
Step 11: Pray and Meditate - Therese writes, "I yell at God a lot, too, and I consider my loud rants prayer because getting mad and communicating my frustration means that I'm in a real, organic relationship with my Higher Power."
Step 12: Fake It 'Til You Make It - "For at least 18 months, forty-five of my fifty minute therapy sessions went to acting lessons; how to feign a stable and functional person until I became one."  
Therese spares little detail telling her story and some may identify strongly with the depression, anxiety, and addiction issues she writes out.  Me, what I found most interesting is Therese's pattern of productive "wrestling" with her own truth. It's hard work! But it is an approach that is becoming more relevant as the complexity and pace of the world (and its changes) accelerate.

The compulsion to understand one's internal workings is not universal but can often pay big dividends of service to the world. While many, many people need to read Beyond Blue because they or people they love suffer from serious mental illness, even more people should read this book to listen into what Therese is calling us to do: Explore, safely, the realm of personal experience in whatever ails you.

This ability to reach within personal chaos and create a cosmos for others is a rare gift. It's like a special evolutionary skill set, one just as rare as these butterflies are rare. 

And come to think of it, isn't life about metamorphosis? It's an especially relevant theme for women who regenerate and respond to so many forces. I am all for brave teachers like Therese to lead us in their areas of expertise.
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2/2/10

10 mistakes every patient makes: Trisha Torrey's new book

Most patients don't understand that their own healthcare is not a right, it's a responsibility.  --Trisha Torrey

Trisha Torrey, Every Patient's Advocate for About.com, frequent Health 2.0 contributor, and active Twitter colleague has just written and released You Bet Your Life: The 10 Mistakes Every Patient Makes.
 
Part consumer guide, part recipe book, part "doctor-patient dating" guide, this book is practical, forward, and detailed in its recommendations to patients like us. The most remarkable aspect of the book is that it takes dozens of complex situations such as patient privacy, patient safety, provider apologies, confirming a diagnosis, to name a few, and breaks them down into usable bites of kitchen table wisdom that can be ported, shared and easily applied. In fact, since reading the book, I have cited dozens of passages in response to questions from friends and family. 

While clever and witty and humorous at times, this is probably not a book that you would hand to a person in crisis who may already be feeling overwhelmed by a complicated situation. No. It is not a book of comfort, per se. But it is an essential book that trains us to make better choices, so it would make an excellent addition to most home libraries. If you have a friend in crisis, why not buy the book for yourself and help your friend navigate the situation with Trisha's insight? There will be plenty to share and your friend may be sparked by some of the advice. 

To showcase just a bit of Trisha's style and convince you to check out the book, below is a paraphrasing of information included in Chapter 6, "An EmPatient's Strategy for Choosing Dr. Right."

Q - How should I establish a doctor's credentials?
Start by looking the doctor up on the state licensing boards. Take a look at the credentials, and make sure that the license is up to date. (One "dirty little secret" of state licensing information is that some states require the practitioner to keep their license up to date themselves, p.70)

If you have a complicated care issue, then check for problems, errors or malpractice by Googling "Dr. Firstname Lastname" plus the word "error" or "complaint" or "malpractice." See what you find.

Also make sure that the doctor is licensed and practicing in the same realm. (She once saw a doctor practicing as a psychiatrist who was not licensed in Psychiatry, but in Internal Medicine!)
 
Once you have found a provider relationship you like, she offers a few things you might want to do to keep it positive:
  • Say thank you. If you feel well-served then go on and say thank you.
  • Refer your friends to the doctor. 
  • Send a "report card" via http://diagKNOWsis.org/reportcard to highlight the positive or where there is room for improvement.
This review would be remiss without emphasizing that creating health and focusing on prevention of illness is the great-empowered patient stance. Trisha's book does cover this idea at the back of the book, in Chapter 24, "Avoiding the Whole Ugly Healthcare Mess: Prevention." She makes a few quiet points about prevention that deserve amplification:
  • Prevention is about taking responsibility for your own health, no matter how good or bad it is, and taking the steps you can take in spite of health challenges; 
  • Prevention is about following doctors orders once the two of you have determined a course of action;
  • Prevention is about stepping out of a comfort zone, or "happy" zone
  • Prevention is about education. Keep on learning and you'll avoid engaging with less effective treatments.