1. The Secret Life of a Manic Depressive
Do’s and Don’ts for the Mentally Interesting was a BBC Radio play based on Seaneen’s blog produced last May and just nominated for a Mind Mental Health Media Award. Always a compelling and honest read, it was no fluke or sympathy vote that caused us to place this blog near the top of our list last year - it deserves many accolades. Well done.

2. The Trouble With Spikol
Another great year for Liz Spikol, a stellar writer and enduring fave. Highlights from 2009: Liveblogging Primetime Outsiders, Maia Campbell’s story, Dr. Fred Goodwin, celeb depression confessions, and the streaming kitten cam. A mashup of adorable with hard-hitting, the puppies make the grim stories a bit easier to take in. Check out her cool video series, too.

3. Coming Out Crazy
Sandy Naiman is fierce and fabulous. With a background in print journalism, her blog was new to the net last year and it’s been fun to see her adapt to the medium - and vice-versa. Some of the perennial trolls have been buzzing around her blog, smelling fresh blood, but she deftly slaps them down with precise words soaked in reality and wisdom. Sandy is a dynamo who is an offline mental health advocate and speaker. In Coming Out Crazy, she’s making gorgeous jewelry from her goldmine of experience as a person living with bipolar.

4. Pax Nortana
Joel Sax has built a small new media empire for himself with a blog, Twitter feeds, vlogs and social networking profiles. Outspoken and productive, he’s a great activist (livetweeting the 2009 DBSA conference) and a chatty blogger who writes about more than the labels he’s been given. Joel also manages @Bipolar_Blogs, which aggregates fresh links to posts from many blogs by people who have been diagnosed with a bipolar disorder (add your blog here).

5. All About Bipolar
Amy (@torturedsoul) is a woman from Tennessee who writes thoughtfully about all aspects of experiencing bipolar disorder, but I especially like that she writes humor. Bonus points for a not-too-cluttered layout with useful links and widgets.

6. In a tie: Furious Seasons and Knowledge is Necessity. Apples and oranges, Phil Dawdy and John McManamy have been among the best on the web for years, but 2009 saw them devolve into public feuding so they’re both bumped down the list together. Hopefully next year will bring a renewed focus on what they each do very well, and a truce.

7. Raw Writing for the Real World of Bipolar
Intimate, absorbing and moving, this is a diary-style blog by Cristina Fender that has mushroomed since she began. She’s now welcoming guest posts and building community, and has self-published a book as well. Energetic.

8. Caught in my Bipolar Burble.
She’s been blogging since 2003 and is consistently brilliant. Intimate and raw, very descriptive and at times hard to read. She’s been through a lot and her treatment-resistant disorder is still not responding to treatments, including a recent failed attempt at ECT (which led to the spin-off blog ECT: Electro-Convulsive Terror). Harrowing.

9. Time for your Meds
“Crazy Tracy” is triumphantly healthy, blogging once again and newly returned to work as a nurse. Her recovery is as dramatic as her dark moments have been. It’s great to see her back, a hopeful example to others who suffer severe bipolar episodes.

10. Crazy Black Woman
“My oddball behavior has been a badge of honor for me to wear,” says Dr. Gina, and I honor her for that behavior too. Her blog has aggressive, hypomanic uproar posts that are fun to read, with extra energy devoted to The Ariafya Universe, a mental health and wellness forum for diverse women. Phew! It’s impressive. Lots to read.

Honorable mentions: Victoria Maxwell’s Crazy for Life, Wellness Writer, Gus Greeper, Bipolar Happens, If You’re Going Through Hell, Keep Going, Bipolar: Crazy Mermaid’s Blog, and Patient Anonymous. Cheers to all!

Enjoy the blogs above, and please leave more links with your comments.

[... C]oroner Ken Holmes said 70 percent of all suicides are witnessed by “tourists, commuters, adults, children and people working on the bridge.” The report also determined that 90 percent of those who committed suicide, were from Northern California with the vast majority from surrounding bay counties.

After many years of debate, a design for a preventative net was approved in 2008. The net is not yet in place. Holmes criticized the Golden Gate Bridge District’s actions, saying they “see little urgency in resolving this ongoing problem.”

MoreMarin.com quoted Mary Currie’s response, which is that the District “are moving quickly as possible towards a suicide barrier.”

Read more

We’re talking about how suicide is tragic, and how to access help. Seven months ago, I started an experiment on Twitter called @unsuicide as a peer support resource for suicide prevention. @unsuicide now has about 900 followers and has been a help for some people having a hard time, and shares info with people who aren’t in crisis too.

Existing suicide prevention organizations mostly didn’t have Twitter accounts when I started, and as they did appear I noticed a trend. All accomplish great work on the telephone, but few understood the new medium, and there are transition issues. Non-profits, with busy staff who lack new media training, tend to use Twitter as a broadcast medium to dump news snippets and links about the organization without following followers in return or having conversations. Orgs were not interested in collaborating or herding new offsite volunteers, either. Most importantly, suicidal followers are unable to have real-time conversations in times of crisis.

Due to time and life restrictions @unsuicide has never promised live crisis services either (though has provided that at times), but promotes sites that do. There is a desperate need for secure, confidential, online services responsive to all age groups worldwide. People guided off Twitter, away from bullies, and into safe secure places to talk in confidence. One-on-one chat with trained volunteer counsellors is the new choice of non-profits, over telephone hotlines.

As the pioneer, RAINN (Rape, Abuse and Incest National Network) offers a great online chat line. Others include YouthinBC.com and Teenline, oriented to youth, and this year Lifeline launched a Veteran’s Chat service. But we need more. A site that’s 24/7 accessible and responsive worldwide, with volunteers who’ll speak in text and Twitter and l33t. People increasingly dislike talking on the phone and want to access services online.

Suicide intervention skills haven’t changed. People talk, share support and hope and connect to professional help. It’s just the way the talking happens that’s changing.

But chatting one on one with a counsellor is not the same as microblogging. The crisis conversation is private while the other… The Werther Effect (named after a 1774 novel which sparked copycat deaths) is suicide contagion blamed mainly on the media. Though well-researched, science hasn’t quite moved into the 21st century yet with published articles on contagion in social media. But the principle is the same. You are the media, so you have the same responsibility. Don’t tweet about methods, celeb suicides, and avoid simple explanations (hard to do on Twitter!). There are ethics guidelines for professional journalists, but academics have not yet published updates for social media. I’ve heard it’s coming, but meanwhile, the AFSP’s media guidelines can be applied to status updates and blog.

Then there’s content. Unlike mass print journalism, people who blog about their mental health issues commonly publish entries about suicidal thoughts and dark emotions. If ambulances (or hearses) were dispatched for every post about wishing to be dead, the budget for replacing worn tires would be huge. The Jed Foundation says, “Try to remember that the person posting suicidal thoughts or intent is reaching out for help.” I disagree. Some people want to connect with peers or just feel heard, validated, without having police appear. I’ve been reading and evaluating blogs about mental health for over a decade. Most writers don’t attempt suicide and keeping a blog is not a reliable indicator of that risk.

Suicide crisis services are there for people to call, a voluntary decision, while a suicidal microblogger’s posts have been interpreted as an invitation to call 911. This is a major shift and disconnect in thinking. Sometimes what’s urgent is finding boundaries in privacy and oversharing. While Demi Moore was lauded for her role in saving a life, some people who write about their mental health issues contacted @unsuicide worried about being hunted down by zealous lifesavers unfamiliar with their writing style and the ways of the web. Whether to contact authorities or respect privacy is still a matter of judgment and not policy. From my experience and a patchwork of professional advice, I can tell you that 1. people should be taken seriously but 2. police aren’t helpful unless you already have precise contact info. Calling another country to say you read a threat on a web site results in puzzled reactions. I have tried it, and also tried to contact Twitter support, to no avail. Since then I’ve decided that confidentiality is more valuable to people than the idea of being rescued by readers. Still, the Jed Foundation recommends calling police if a blogger is unresponsive to comments.

Snarky remarks are, of course, also unhelpful. Cyberbullying includes taunts about suicide, which can lead to real deaths. This is not an issue (as much) for offline suicide prevention, and nobody jumps into a helpline conversation to make rude remarks. Online, trolls do. How to combat that… but that’s another topic. @unsuicide is just one little project, its goal to provide positive info, peer support and refer to practical resources using a new medium. It may help save a few lives, but it’s not going to save the whole world.

Then again, sometimes a single suicide prevention message has an incredible effect.

In the springtime, participants at MentalHealthCamp on social media and mental health shared messages of support on my phone cam. Thank you to everyone who contributed, and Courtney who’d been following the conference hashtag #mhc09 and emailed a video. After technical problems a wonderful editor, Scott Babcock, has salvaged a PSA that is a tribute to the spirit of the event and a message I hope you’ll embed and share with your peers. We care.

• @docjohng (our fearless leader)
• @aliciasparks (glamorous author, Celebrity Psychings editor, World of Psychology contributor)
• @dr_aletta (therapist/life coach, World of Psychology contributor)
• @summerberetsky (mental health writer, World of Psychology contributor)
• @channelNvideo (me, editor of Channel N, features extra neuro/psych videos and new media talk)
• @unsuicide (me again, a suicide prevention peer resource with positive, practical info and support)
• @psychcentral (feeds posts from all the blogs)

Therese Borchard and everyone else who makes this site so valuable, I hope you’ll get accounts too.

Microblogging service Twitter is maximizing in popularity. Though there are naysayers who don’t understand the medium and dismiss it as shallow and narcissistic (just like early blog critics did), Twitter is used in many vital ways. For every snarkster who writes about her lunch, there’s an account like Brainline sharing serious medical info. Musicians set up impromptu concerts while professors analyze journalism, and people organize flash mobs for celebrity tributes or political protests. There are job postings, science fiction flashforward zines… I could go on, but the point is: there are many, many “tweeps” with useful, revealing and cool accounts. Plenty are about psychology and mental health. It was very difficult to narrow this list to just ten, so I used these criteria:

• NO marketing (including “free” e-books, how-to guides, etc.)
• not just “broadcasting” or re-feeding, follows others and reads their feeds
• interacts with friends and followers, replies to people
• shares more than just factoids, quotes, or pop psych aphorisms
• active but not overactive
• not too off-topic, talks mostly about psychology, psychotherapy and/or mental health
• humour, taste, talent, good writing and personality
• poise, swimsuit competition, and how they’ll bring about world peace

Kidding about that last one, but — here are the psych tweep pageant winners:

10. @mtabraham “Professional Counselor - my goal is to help people be more successful through mindful awareness and self acceptance.” Terri Abraham is a very active tweep sharing positive thoughts and info on mindfulness therapy and spirituality. Chatty and responsive even with thousands of followers.

9. @loveisthecure5 “Borderline Personality Disorder Awareness Movement Leader.” I love Love is The Cure because it’s a movement that’s completely peer-driven without being disorganized. Volunteer-based with a sleek professional sheen, there’s no crankery or misinformation. It’s positive, directly supportive, promotes awareness while fighting stigma, and offers cool volunteer opportunities through building a network. LITC rocks!

8. @deborahserani “Psychologist, Professor and Author.” Dr. Deb has maintained a blog for years and has transitioned to Twitter very nicely. She shares cool links on a wide variety of psychology-related subjects.

7. @therapyonline “A wide lens is cast at the Online Therapy Institute ranging from email and chat to videoconferencing and Second Life.” DeeAnna Merz Nagel maintains this popular account with a focus that’s business-to-business for professionals who offer online therapy. She manages to share lots of intriguing info while straddling a thin line between professional organization and marketer - without falling into the dark side.

6. @shiftstigma “Shift believes that people with a history of mental health problems should have the same chances and opportunities as everyone else.” For anyone concerned about stigma - which is anyone involved with mental health - this awesome UK charity keeps an active Twitter account with lots of thought-provoking info and a friendly, accessible tone. Unlike so many organizations on Twitter that are disappointingly aloof broadcasters, they reply to followers and initiate conversations too.

5. @iopsychology “I/O Psychologist who studies motivation, apathy, gossip, and metacognition.” Industrial-Organizational Psychology grad student/TA at Michigan State University. Gordon B. Schmidt writes about research and shares the work of other tweeps and bloggers in the field, but also takes the time to compliment a friend’s puppy.

4. @drdavidballard “Head of Corporate Relations and Business Strategy at the American Psychological Association. Business, psychology, technology, health and productivity.” Dr. Ballard is Tweeting on behalf of a organization so you won’t find personal opinions on things that aren’t professionally relevant, but he is thought provoking, interactive, shares great news links and he writes, well, like a pro.

3. @drkathleenyoung “Licensed Clinical Psychologist Treating Trauma in Chicago.” Her practice (and Twitter & blog focus) is on PTSD, domestic violence, sexual assault, trauma in general which you might think would make for a bleak feed but she’s very upbeat, encouraging, active and interactive. Shares useful info and talks to lots of tweeps whether professional or civilian.

2. @kidtherapist “Children’s Therapist and Author of Kids Awareness Series Books.” Kara T. Tamanini’s feed is an awesome mix of personality, community, well-aggregated professional quality info, and friendly interaction. I adore her account, and I’ll bet the kids that she treats adore her too. Enthusiastic and on point.

1. @drkkolmes “Clinical psychologist in private practice specializing in anxiety, depression, relationships, sexuality and the intersection of technology and mental health.” Very in tune with the net culture zeitgeist, Keely Kolmes has spoken about online mental health at SXSW and MentalHealthCamp. She challenges paradigms and explores boundaries in questions like: Should you “friend” your therapist? Read her blog? Should a therapist Google a client? A 21st century psychologist who’d top any new media mental health list, she unquestionably deserves the crown from us.

Should the winners not be able to fulfil their tweeting duties, here are the runners-up:

@countersuicide Shares crisis resources, suicide prevention info and news. Unlike the professional suicide prevention orgs on Twitter, this heroic volunteer directly interacts with people in crisis online. Crucial and literally lifesaving.
@apahelpcenter From the American Psychological Association, not very interactive but oodles of valuable info.
@marielhemingway My fave mentally healthy celebrity on Twitter, she offers lots of love, positivity and tips for healthy living.

Did I miss someone who you think is a winner? Please share your picks in the comments.

On the other hand, being with a partner during an untreated manic episode can be bad for your mental health and in some cases physical safety as well. Although it is a myth that mentally ill people are more violent, as shown in epidemiological studies, it is also true that there are risk factors that increase the probability of violence. Among them are untreated illness accompanied by substance abuse, and a history of violence. With domestic violence there are patterns involved and habits stick. So if you’re already with a partner who’s assaulted you, well, as one commenter, Melissa, movingly describes:

If I try to approach to console him he sees it as confrontation and lashes out like an angry monster. He compares himself to a wild bear actually. His eyes bulge out showing no mercy and his hands go around my throat and he can barely stop himself from chocking me. And all I have done to bring this on was try to console him, try to nurture him so he may not go into a deep depression because when he does he goes into very self destructive behaviour.

When he is in a BP rage his eyes look like in the movie The Shining, like the eyes of a psychopath, they are filled with pure hate. Yet he says, even in that state, that he knows that I love him, as he shoves me away with all his strengths and demands that he be left alone. I have waited sometimes without moving, wondering will he attack me again, will he kill me this time? And what brought on this response from him? He seemed in a down mood when he came home and I asked him how was his day and I had missed him, he came home late. He turned away instead of answering me, I mentioned that that response hurt me, what was he thinking would he please tell me. And this horrid sound came out of his mouth, an alien growl so loud that made the tenants (2 guys in their late twenties who ride motorcycles) upstairs flee out of the house within seconds after hearing it ….

Ah, that is like to be with a BP partner who will not go for treatment.

How I survived him so far is that I have a safe home to flee to, as long as I can get out.

I replied and mentioned the Hot Peach Pages:

…the illness does not excuse the violence and your safety is more important than your partner’s treatment (although it might also require that he or she gets treatment for both your sakes).

The Hot Peach Pages link to domestic violence shelters, hotlines, counselling services and more, worldwide. It’s an excellent resource and I recommend you find out what’s in your community before you might need it in an emergency. They can also advise on how to approach your partner to talk about getting help for you together, if that’s appropriate.

I am glad you have a safe place to go. Please stay safe. You matter.

And to all the bipolars who’ve ever been violent to an intimate partner now reading - it’s not okay. Get help before regretting a bad episode and losing a relationship, and even going to prison.

To read her reply, visit the original post and scroll down.

Being bipolar doesn’t mean, by default, being violent. But this is one more reason to get help if you’re not getting it now.

During the recent Association for Psychological Science (APS) convention, Ekman and the show’s head writer Samuel Baum were interviewed in a popular session, and other scientists detailed their research based on his FACS system in separate talks. (It can be used clinically to gauge pain, addiction, and more.)

Lie To Me does detail real empirical science, which I think makes the show more fun to watch. You can learn fascinating things about the universal microexpressions, and gestures called “illustrators” (used when animatedly telling the truth) and “manipulators” (nervous movements associated with lying). But I found it even more interesting that some of the show’s techniques are falsehoods. Ekman admitted the show takes a bit of license, using gestures that are not part of FACS and not signals of lying. For example, scratching an itchy nose is supposed to indicate guilt, but he admits that is not so. I wonder how many people might now suspect their partners are having affairs when all they have are allergies? But he does insist that the show’s writers fact check the real science through him and he has a script veto clause in his contract, so no major flaws get past.

Since it is TV and the medium demands it, he says that the character loosely based on him (Cal Lightman, portrayed superbly by Tim Roth) “solves crimes more quickly and with more certainty than I’ve ever done.” But he still feels the show sends a positive message since Cal is the “best kind of interrogator,” a smart and confident character rather than a swaggering gunslinger. Lightman and his glamorous associates are careful when dealing with their cases, stories that have many twists and hidden turns to navigate.

Which leaves me to wonder, as Ekman himself does: What is the consequence of emotional resonance when you can’t control its source? “Emotions never tell us their trigger,” said one of his acolytes in a different APS talk about FACS, but when you’re watching a well-written, well-acted and slickly produced TV show you can be sure some of those feelings will result from what you’re seeing. The dramatic subjects include terrorist attacks, a building collapse, rapes and murders - disturbing subjects. To detect deception Ekman points out that noticing the absence of emotion in a suspect is as important as an emotion displayed. Is that true of a television viewer as well? What might be the effect of the sprinkles of junk science, what he calls the “CSI effect” after the forensic crime drama that’s often pure fiction but audiences believe are professional techniques? Where might the misleading lead?

As for the real research, he points out that once you’ve learned to spot microexpressions you can’t unlearn it, you’ll always see the signs, and learning to manage that in your personal life is essential. Sometimes, as the show’s stories also demonstrate, it’s better not to let on that you notice something to respect privacy. A lie can be kinder than the truth.

The one day program includes a discussion on therapist/client social media boundaries, talks on anonymous blogging, mommy blogging with a mental disorder, blogging as therapy, blogging for students, ADHD, yoga and depression with a blog, and my own presentation on crowdsourcing peer mental health info with social video PSA contests and suicide prevention on Twitter. Featured speakers include Keely Kolmes, Lorraine Murphy, Darren Barefoot, Pete Quily, and many more.

Peer resources and crowdsourcing with peers is hot. From a comment left by Robert Johnson at the MentalHealthCamp blog:

“The reality is that client groups truly are exerting agency and taking matters into their own hands. In the past, traditional therapy allowed for very little contact among client populations. Group therapy may have presented the only opportunity for client interactions, and even those situations were often restricted in theme and content and closely monitored by professionals. It has been my sense that the primary breakthrough the web has provided is an opportunity for peers to come together not only for mutual support, but to compare notes and opinions in ways and settings that were never open to them in the past.

“While the profession may see these developments as potentially undermining their previous hold on the therapeutic milieu, peer-generated mental health support on the web is widespread and unlikely to moderate any time soon. Those looking for support often spend considerably more time in such groups, and often discuss issues more openly than they currently do with their own therapists.

“The dynamics of such groups are complex, and the breadth of value that such groups provide is, despite their years of existence, still wide open to investigation.”

That’s something I’m investigating in my talk and others will touch on as part of theirs. Follow me live, early April 25 @unsuicide.

Psychotherapist Isabella Mori (of the blog moritherapy) is the event’s co-organizer along with social media expert Raul Pacheco-Vega.

“Social media can be therapeutic.” Mori said. “Sometimes an individual’s need for support feels overwhelming. Individuals get a feeling of relief when they can read someone else describe a struggle that they are privately experiencing. This validation is priceless, and is one piece of professional therapy that patients find so helpful.”

We are asking questions such as

• How can blogging help decrease the stigma of mental health?
• How does someone with a mental illness navigate the waters of anonymity in the transparent world of social media?
• How is the journaling that happens in blogging similar to or different from journaling for healing?
• How can social media participants with mental health issues help each other?

Register here to attend IRL. Admission to MentalHealthCamp, which includes a lunch provided by the BC Mental Health Foundation, is by donation with no one turned away for lack of funds. Follow the official Twitter feed @MentalHealthC and for more information, or to volunteer for the event, email mentalhealthcamp@gmail.com.

A troll is a person who comments anonymously (or so they think) with statements that are meant to anger and inflame. Their remarks don’t have to, and often don’t, make any sense. They’re just out to get a strong reaction. An example of a troll comment: “You know your [sic] an idiot when, you write stuff like this.” Childish and pointless, it’s best ignored. Don’t feed the trolls.

A comment like this is another beast: “ADHD is a crock! Psychiatrists who claim that this so-called illness is affecting people are deceitful drug pushers who should be locked up,” said Karl Childers, in response to that Vancouver Sun article on adult ADHD.

The difference is that someone like Mr. Childers really, truly, passionately believes his statement and is not saying it just to randomly anger someone. There’s a decades-old political movement of people opposed to mental health treatment, and they’re prowling the web to leave comments in forums and blogs, etc., beyond their own web sites and books. Consider it outreach.

The Wikipedia entry on antipsychiatry doesn’t discuss commenters, so I wrote a looser definition for the Urban Dictionary. (It was accepted by the editors and will appear soon.)

antipsychiatry (noun)

A political movement against psychiatry, psychology, and mental health treatment. Stemming from a denial that mental illnesses exist, antipsychiatry activists have several core beliefs:

• mental illness isn’t real, all problems are societal and don’t stem from the brain
• people who treat mental illness are shills for “Big Pharma” which is only out to make money and poison people with drugs that don’t do anything but harm people
• psychiatry is a form of societal control out to quash anyone who deviates from what they deem as normal, while psychiatric diagnoses (in the DSM) are made up on a whim and are just stigmatizing labels

Many antipsychiatry activists are consumer-survivors who’ve experienced abuse in the mental health system or believe they might be harmed if they were treated. They are frequently paranoid and are very, very rigid about their beliefs, and obnoxious about sharing them. Scientologists are another type, and antipsychs also exist among academics and even psychiatrists.

Antipsychiatry activists are commonly found online commenting in forums and on the blogs of people who write about mental health, admonishing people to throw out their pills and renounce treatment. Although their primary peeve is with psychiatrists and psych medications (and they’re especially opposed to ECT), some protest against talk therapy and psychological research too.

At the core, the argument is really about mind-body dualism.

Like any type of fundamentalist, they seek to save the world from the evils they perceive. Although some are more polite and less devout than others, they’re basically the Fred Phelps of the mental health world. (Think I’m exaggerating? Read the vicious comments by Lynette in this Furious Seasons blog post.) Some activists are also trollish about their comments, but even when they’re semi-coherent foul-mouthed rants they’re still recognizable by the subject matter.

What can you do if you’re a target? First, make sure you’re in an emotionally safe state before reading comments or visiting unmoderated forums. If you’re feeling fragile it’s not the best time to read insults. Second, know that you’re not going to change the mind of someone whose beliefs are devout no matter what you say. They’re cognitively inflexible and a flame war will only reinforce their views in defence. State your case without directly engaging anyone.

Finally, humor is always a fine strategy.

Twitter is the hottest social medium du jour. 140 character posts about anything (pithy observations, links to text, photos, videos, or podcasts, spreading others’ Tweets in a retweet - RT - etc.) are posted to your Twitter feed, like a public blog feed that can be followed by anyone, while you follow others too. Tweets are that short so they can be sent and received by text messages from mobile devices. That’s what makes Twitter more useful and popular than most other social media; it combines texting with blogging. Livetweeting is writing about something as it happens, usually on scene. A hashtag is the combination of # with a word, which tags a Tweet in a way to let others easily find it, and when lots of people use the same hashtag it brings them into one big webby, texty fast and easy conversation on that subject. A hashtag doesn’t need to be about livetweeting but can be. A good example is #bushfire. Tweeters used it to communicate during recent Australian bush fires, and are still using it to organize relief efforts for that tragedy. If you thought Twitter was just people telling each other what they had for lunch, check out #twestival (and Twestival’s website) and other fantastic charitable movements being hashtagged. Twitter is used for very innovative and positive social actions as well as friends bonding over food (a positive social action also).

But it isn’t always, so I’ll cut to the #bentley #chase.

In Los Angeles, a man sought by police for an alleged armed assault was about to be arrested when he escaped in his white Bentley. He led them on a low speed chase and standoff that lasted several hours. Along the way, he collected a following of television helicopters and Twitter users in the area who livetwittered it. Rumours spread that the man was a celebrity, first Chris Brown then DJ Khaled, leading to even more Tweeters joining conversation in the #bentley and #chase hashtags. Lots of media metacommentary about how Twitter was being taken seriously as a media source by the net and old media TV crews, along with thoughts like “had high hopes this was gonna be DEATH RACE: CHRIS BROWN EDITION” and “you know the music sales are bad when dude has to do a standoff in a #bentley just to get hits on his Myspace!” It ended when, surrounded by police cars, cameras, and people busily livetweeting from their phones, the man shot himself and his identity was later revealed to be Mustafa Mustafa.

The fake Twitter account @WhiteBentley was created to mock the driver as it happened, Wikipedia edits made up a false ending about the wrong guy, and a lot of tasteless remarks about suicide were made. The fakery and gossip show problems with Twitter as a dependable media source (but it can be genuine and unique, so this issue will evolve). Still, we can only have faith that this NBC story was accurate, as those kinds of news reports always lack nuance and background. Who do we trust?

NBC says the man killed himself because he was “distraught over the loss of his business.” Mental health professionals know it’s always more complicated. Domestic violence was apparently involved and likely there was depression, as in the majority of suicides, if not other mental illnesses (but I don’t have info to speculate either). The mass media don’t often report on suicides; due to the well-researched suicide contagion risk there’s an ethical code to keep it out of headlines. When there are reports it’s usually simplified to be about money or lost love. These may be factors but aren’t the full story and the viewer doesn’t learn anything useful - if anything, sort of expected to feel they aren’t at risk if they didn’t just lose a business or lover or Grammy. Rarely are suicide hotline numbers shared.

Meanwhile back on Twitter, the livetweeting of insensitive comments during this crisis wasn’t totally new. We’ve seen it on the Internet over and over in examples that always seem to shock, though the shock never stops it from recurring. Whether suicide is witnessed through a chat room, blog or live cam stream, social media lets people disconnect as easily as they might connect - as with all forms of media. I’m glad to see #bentley #chase criticized for that, but jerks will keep being jerks.

While there are always people who’ll try to help someone in distress, others mock and egg them on even after the threat is proved real and the person dies. Fake suicide blog 90 Day Tania was a media project in response to that, meant to prevent suicides of people with depression who feel they deserve abuse and notoriety on a path to death.

Could fake suicide livetweeting do that too? It’s hard to know how much effect 90 Day Tania had or what similar projects might have, since there’s been no published research on new media interventions that might incorporate suicide prevention programs like psychoeducation, crisis counseling, peer support, or all three. I haven’t found any of those types of services on Twitter beyond possible informal peer support, which isn’t organized.

So, I made the hashtag #unsuicide to share crisis service contacts and related things. Tweet your helpful messages to #unsuicide too, and we’ll watch those metrics trend.

One appeal of blogging about a disorder you suffer from is community; friendships and social supports emerge. But although someone’s insights may help you feel less alone, it can also prompt you to feel worse. I am depressed right now (it will pass, I’m in treatment). I’ve been preparing this list for a while but that made it much harder. Ultimately, though, I think sizing up these blogs while depressed is appropriate since that put me in the target readership. Blogs most likely to be triggering if you’re in a fragile state are marked with a *T*.

We had a number of criteria when we compiled this list, but at the top of the list is a blog that is regularly updated and deals with depression. We also looked for quality of writing, insight, apparent honesty, knowledge, advocacy, humor, information-sharing, poignancy, and personality. These blogs have all that and more.

1. Postpartum Progress

Katherine Stone writes a peer-to-peer blog that covers all aspects of postpartum depression and anxiety, postpartum psychosis, and other mental health concerns connected to childbirth. Newly released research, media coverage of PPD, and her own exploits in advocacy are frequent topics. On our top ten list last year, this year she was also named one of WebMD’s 2008 Health Heroes and a top mental health blog by Blogs.com. She maintains many links to professional resources, blogs and research links, as well as her Surviving and Thriving Moms group.

2. Depression Marathon

Depression Marathon is an intimate and detailed portrayal of an eight-year battle against depression. Etta is a devoted runner who also writes about her training for marathons; a good sideline that adds a second quest to her story. It’s an absorbing blog. She’s been writing for nearly a year but just recently revealed the difficulty she’s having with transparency and being anonymous - something every blogger who writes about personal issues has to confront. *T*

3. The Suicide List

17-year-old Mariah documents her ongoing grieving process after the suicide of her best friend two years earlier, plus her own depression, suicidal urges, and self-injury. A quintessential “emo blog” (I mean that in a good way!) unafraid to tackle mental illness and philosophy. She writes quick posts in a variety of styles depending on her mood; it’s very much the blog of a teenager but it’s a sublime one. A candid effort to make some sense of life, death and pain. Read the handy review page to catch up on key events. *T*

4. The Splintered Mind

Douglas Cootey’s been gaining fame, interviewed by CNN and ADDitude Magazine, who’ve just named him one of the top ADHD bloggers. We’re not surprised: he was an easy choice for our own top ten depression bloggers list last year too. Geared toward cognitive behavioral therapy (CBT) with the mantra “pills don’t teach skills.” Douglas shares a positive attitude, helpful links, and cheerful humor — but still gets real about his dark inner struggles, too.

5. Beyond Blue

A frequently-updated powerhouse of a blog written by the friendly and thoughtful Therese J. Borchard. For those who believe spirituality is important in a holistic mind and body approach to the treatment of depression, it is the ultimate word on the topic. How many Christians promote neuropsychiatry alongside faith while some religious leaders continue to claim that sin and evil spirits cause depression? Therese’s gentle inquiries are revolutionary in a way. She also does occasional vlog posts on YouTube.

6. Storied Mind

John D. explains why he started this project: “I have no cures or therapies to offer. I have only stories, reflections, impressions, records of moments when a bit of life broke through. I invite you to share this space with me, to tell your stories to others who have similar issues to deal with.” The blog design conforms to the awful new trend of undated posts, but you can find the dates in the URLs. I was only recently tipped to check it out, but I’m impressed. He’s a talented writer who can sling a phrase, and every story has a take home message. *T*

7. A Beautiful Revolution

It was a must for our list last year and the quality of Andre Jordan’s blog with its quirky, poignant cartoons is as strong as ever. A new book compiling his unique depression-related doodles will be released in January 2009.

8. Letters from Exile

La explains in her profile that “I write a lot about depression but I don’t consider this a depression blog: I think of it as a record of the way I live now. And the truth is that the way I live now is a daily struggle. But I struggle on and muddle through.” It’s an eloquent blog with controlled glimpses of her life that are good at showing what it’s like to have depression, even though she is careful not to share too many details or identifying data (which is smart!). Posts may be about cooking, or feature a webcomic she created, or log a fragment of conversation, while others are more intimately emotional. Some posts are password-protected but she will share the password if asked. “I only wanted to write something honest and of myself,” said La, and she has succeeded. Warning: Profanity on one of the homepage entries right now. *T*

9. Avoidance Junkie

There’s a bounciness in her blogging style despite heavy subjects, partly from the use of single sentence paragraphs. Though easily pushed into blog cliché-land, they aren’t heavy-handed here. Avoidance Junkie keeps a poetic rhythm, dancing at a pace that gathers you up with it. It makes topics like anhedonia (loss of ability to take pleasure from things the person once enjoyed), sorrow and regret less sticky. There are others who write in a similar disjointed, slightly muffled style but she does it better than most, and for that reason she’s on the list. *T*

10. Chunks of Reality

An engaging and likable blog with very detailed accounts of a life marred by depression. Not just her emotional state, but day-to-day events, relationships, poetry, work, and play. She is very into blogging, and it shows: “Blogging has been quite good for my mental health and it’s an activity I need to do no matter what… kinda like flossing.”

Honorable mentions:

Walking the Black Dog

Still rocking after a year and a half, his is a unique perspective. After hooking up with a study (not affiliated now) he learned the Therapeutic Lifestyle Changes (TLC) treatment approach to depression. It involves light exposure and sleep hygiene, psychological strategies, social support, Omega-3 fatty acids, and aerobic exercise. It does help him, and he explains how. He also shares savvy mental health links.

Fighting the Urge

A young woman with borderline personality disorder (BPD) in a depressive episode writes about her thoughts and psychiatric crises in an emotionally honest and anguished tone. There is much to be gleaned from her experiences.

His and Hers Depression Blog

“My husband retired in 2005, at which time we needed to cut our expenses and I stopped seeing my psychologist on a regular basis and took up blogging. Blogging is definitely cheaper although it isn’t nearly as effective as seeing a professional on a regular basis,” writes Susan King. In a recent interview (Douglas Cootey of The Splintered Mind is quoted in the same article) she explains that blogging is “very helpful” to her for reasons like identifying emotional triggers. Features short entries that are simple and easy to read.

The Reasons to go on Living Project has a deadline of December 15 to finish collecting stories, and is calling for submissions from anyone who has made a suicide attempt and is willing to describe what happened.

“We are doing this … to understand how people’s thinking changes after a suicide attempt. We do not understand the thinking processes that occur for people who choose to go on living after an attempt and there is very little research in this area. We believe that if we had a better understanding of how people found the strength to go living after an attempt, we might be able to better help people who are thinking of ending their lives, before they make an attempt.” - from thereasons.ca

For this project Associate Professor Jennifer Brasch is collaborating with Helen Kirkpatrick, RN. Kirkpatrick is known for her work in narrative studies with schizophrenia, harm reduction, and the homeless. In her paper A Narrative Framework for Understanding Experiences of People With Severe Mental Illnesses* she explains the importance of individual tales.

“People like to tell stories; they are part of the human condition. Stories provide a way to make coherence and meaning of events in people’s lives. … Telling and listening to stories can be powerful change agents in and of themselves.”

They hope to collect at least 200 stories, so help spread the word. Some will be put up on the site just after the deadline, while offline they will read everything and prepare a journal article to be published as soon as feasible.

Along with collecting stories, the archives are meant to be a permanent source of hope (online after Dec. 16). It may become a popular mental health consumer resource like Emerging into Light Gallery, or even The Icarus Project with strong, intimate voices. It will be interesting to read the range they hear from. Here is a chance to make your voice heard.

It’s not meant for a crisis but there are links to resources that are, along with dramatic snippets of facts on the site. They explain more in their FAQ. All participants must agree to a consent form but stay anonymous.

Thoughts of suicide? All the contributors to this project to date have changed their minds, and you may find eloquent reasons to go on too.

* A Narrative Framework for Understanding Experiences of People With Severe Mental Illnesses, Kirkpatrick H, Archives of Psychiatric Nursing, Volume 22, Issue 2, April 2008 doi:10.1016/j.apnu.2007.12.002

1. Furious Seasons

There simply could not be a top bipolar blogs list without Philip Dawdy. He’s an excellent journalist whose blog has become synonymous with unrestrained investigative writing on bipolar disorder, mental health treatments and the pharma industry. He does not hesitate to call out BS when he finds it, and he digs for it harder than any other popular writer. Furious Seasons is an invaluable service to the mental health community.

2. MentallyInteresting.org - Pole to Polar: The Secret Life of a Manic-Depressive

Seaneen, a woman in the UK with characteristic wit and a gift for metaphors, keeps a blog that is much like the disorder: it ranges from hilarious to melancholy to very serious. Even the serious bits are wry, though, e.g. “The crappiest thing about [her recent suicide attempt] is that I lost the eBay auction for the camera that broke on me.” It’s personal without TMI, and conveys pathos without being pitiful. She’s someone you can’t help but feel affection for (unless perhaps you’re her accountant). While compiling this list I was sidetracked into reading her archives for hours, and a blog that compelling to my distractable eyes is unquestionably tops. Please stay alive and keep writing, Seaneen, we all need you.

3. Coming Out Crazy

Sandy Naiman is a skilful storyteller and hers is a highly readable pro blog. She uses an intimate style to share anecdotes and opinions as well as current issues. It’s like chatting with your friendly next-door neighbor — who happens to be an award-winning career journalist and prominent mental health advocate. Her posts are engrossing, sometimes tragic, and quite inspiring.

4. Bipolar Wellness Writer

If you believe that eschewing negativity and training yourself to be reflexively positive is important to recovery, this blog is for you. If you are interested in the constructs of wellness and positive psychology, this blog is for you. If you like to learn practical day-to-day tips for improving your life, this blog is for you. If you enjoy well-crafted, thoughtful and focused writing with regular updates, this blog is for everyone.

5. The Trouble with Spikol

Liz Lemon* Spikol was number one on the list last year and the only reason I’ve bumped her down is that her blog now tends to deviate from mental health into politics and cute photos (although I like puppies as much as anyone). Affable, honest and entertaining even on slow days.

6. Bipolar Beat

I didn’t add this newcomer blog to the list just because Psych Central hosts it. It’s here because it’s a super informative blog written by a doctor with clinical experience and a non-medical expert writing partner. Candida Fink and Joe Kraynak have an “ask a question” feature to prompt some of their posts, but also have no problem generating posts on hot topics like overdiagnosis, supplements, and childhood bipolar. They also maintain the similar Bipolar Blog.

7. How is Bradley?

Bipolar and obese, that’s how Bradley is. But he’s a good egg and this blog is his public quest to lose weight and keep mental stability. Often, medications used to treat bipolar will cause weight gain — lithium, valproate, Zyprexa/olanzapine, Seroquel/quetiapine, the list goes on — so his writing is relevant to many readers who have similar issues. This is an easy to digest personal blog with light humor about a heavy topic.

8. Two video blogs (vlogs) tie for eighth place: John McManamy’s Depression and Bipolar YouTuber, and Bipolar Survivor Back

John has written about the science and history of bipolar disorder and its treatments for years via his site, e-newsletter, blog, and book. While they contain a huge amount of technical (and common sense) information beautifully interpreted for laypeople, his vlog is even more accessible. Explanations of and practical coping skills for specific situations like anger management and body clock problems. Nicely produced and edited, I’d love to see more frequent updates.

Meanwhile, Kimberly’s Bipolar Survivor Back is an articulate video series about the mental health issues she’s suffered since childhood, and getting treatment as an adult. She recently stopped posting videos due to haters. Her experience with trolls is an example of the risks of exposing a personal life complicated by mental illness, and I commend her for trying to combat stigma and educate people.

9. Caught in my Burble

“Your neighborhood misanthropic, buxom, bondage-positive, bipolar, bisexual, flying, loquacious hedonist.” Updated: “Now with VNS capabilities.” Last year I was keen to see if an experimental vagus nerve stimulator implant would help her very severe, treatment-resistant depression. It didn’t really. She still writes extremely well, though.

10. Yoga for Bipolar

I love yoga! I also love substance-free treatment alternatives that genuinely help people! Here they are together in one blog, like a chocolate peanut butter cup. I am grateful that David Morgan “made the decision not to withhold information for profit” since this is a quibble I have with some alternative treatments. Random people who claim their secret blend of herbs, spices and organic bamboo socks will cure bipolar, schizophrenia and cancer all at once if you’ll pay $300 for a DVD — what a deal! (Not!) Yoga is a mainstream, time-honored practice, and it’s nice to see this blog aimed at benefiting bipolar sufferers rather than a bank account. With more frequent updates, fewer product reviews, and more specific instructions for practice, this blog would rank much higher on the list.

Honorable mentions: Bipolar Chica (for being a cool blog), If you’re going through hell keep going (for her sincerity and introspection), and The Bipolar Bisexual (for being topical, funny, and hot — NSFW).

Thank you to everyone in the blogosphere writing such great blogs it was hard for us to narrow our choices to just ten. Like any list of this kind we’ve probably left out a few of your faves, so please share links in the comments.

“It’s a little late for tears, isn’t it Barbara?” she says, the patronizing narrator beginning to chide. “You’re a creature of habit, Barbara, we all are. Unfortunately not all your habits are good ones. Here’s how your day started wrong.”

There’s a list.

“You started your day with no plan at all. Can’t find your hair brush? Can’t remember where you left it?” She continues in the same tone throughout all 14 minutes of this educational film that reminds us social norms change over time.

Barbara is compared to Helen, a neighbour and classmate who behaves perfectly. “[Helen] uses taste in selecting her clothes, and more than that she keeps them clean, and mended. And she’s able to match the right skirt with the right sweater.” At that time, however, this was an important point. Barbara goes off to school in a dirty sweater, which was not okay 50 years ago, as today.

“If you had a habit plan for your mornings you might get off to a decent start one day.” There is useful info about keeping a sleep routine and good hygiene and how some habits smooth life, but poor Barbara isn’t going to learn them this way. If you’d like to build good habits to replace unwanted ones, I suggest starting with a good therapist, or online CBT. (And, break a habit.)

Randy Pausch, RIP, is the perfect example of an exuberant, inspiring speaker in the famous Last Lecture, Really Achieving Your Childhood Dreams. His enthusiasm was viral to millions of viewers, and worth viewing the hour-long lecture format.

I’ve featured another Kay Red Field Jamison video here before, but if you missed it I re-recommend An Unquiet Mind. It’s an eloquent description of her personal experience with bipolar. As well, check out an interview by Charlie Rose: she discusses suicide as a public health issue as well as an emotional problem. I look forward to her next book tour with more talks and interviews, and encourage you to read Exuberance and watch at least one of these videos.