I was astounded that this creature was capable of the empathy that I so craved in my closest friends and relatives. It was like she could read the pathetic and sad thoughts that disabled me and wanted me to know I was lovable in the midst of my suffering.

She continues to be a supportive presence in my life, especially on the days that I grow weary of trying on — and throwing out — every mindful exercise and cognitive behavioral strategy… the hours where staying positive seems impossible. She gets it. I know she does.

Every week I hear tales of four-legged creatures becoming angels in times of terrifying darkness. Indeed, a substantial body of research indicates that pets improve our mental health.

How? Here are a few ways.

1. Pets offer a soothing presence.

Studies indicate that merely watching fish lowers blood pressure and muscle tension in people about to undergo oral surgery. That’s why all the aquariums in dentists’ offices! Think of the behavior Darla in Disney Pixar’s “Finding Nemo” would have exhibited without the fish tank.

Other research shows that pet owners have significantly lower blood pressure and heart rate both before and while performing stressful mental tasks — like, say, performing a family intervention or supervising kids’ homework. Finally, persons recovering from heart attacks recover more quickly and survive longer when there is a pet at home. It seems as though their mere presence is beneficial.

2. Pets offer unconditional love and acceptance.

As far as we know, pets are without opinions, critiques, and verdicts. Even if you smell like their poop, they will snuggle up next to you. In a Johns Hopkins Depression & Anxiety Bulletin, Karen Swartz, M.D. mentions a recent study where nursing home residents in St. Louis felt less lonely with some quiet time with a dog alone than a visit with both a dog and other residents.

The study enrolled 37 nursing home residents who scored high on a loneliness scale and who were interested in receiving weekly half-hour visits from dogs. Half of the residents had quiet time alone with the pooches. The other half shared the dog with other nursing home residents. Both groups said they felt less lonely after the visit, but the decrease in loneliness was much more significant among the residents that had the dogs all to themselves. In other words, at times we prefer our four-legged friends to our mouthy pals because we can divulge our innermost thoughts and not be judged.

3. Pets alter our behavior.

Here’s a typical scenario. I come through the door in the evening and I’m annoyed. At what, I don’t know. A million little snafus that happened throughout the day. I am dangerously close to taking it out on someone. However, before I can do that, my Lab-Chow walks up to me and pats me, wanting some attention. So I kneel down and pet her. She licks my face, and I smile. Voila! She altered my behavior. I am only agitated a little now and chances are much better that someone will not become a casualty of my frustrations. We calm down when we are with our dogs, cats, lizards, and pigs. We slow our breath, our speech, our minds. We don’t hit as many people or use as many four-lettered words.

4. Pets distract.

Pets are like riveting movies and books. They take us out of our heads and into another reality – one that only involves food, water, affection, and maybe an animal butt – for as long as we can allow. I’ve found distraction to be the only effective therapy when you’ve hit a point where there is no getting your head back. It’s tough to ruminate about how awful you feel and will feel forever when your dog is breathing in your face.

5. Pets promote touch.

The healing power of touch is undisputed. Research indicates a 45-minute massage can decrease levels of the stress hormone cortisol and optimize your immune system by building white blood cells. Hugging floods our bodies with oxytocin, a hormone that reduces stress, and lowers blood pressure and heart rates. And, according to a University of Virginia study, holding hands can reduce the stress-related activity in the hypothalamus region of the brain, part of our emotional center. The touch can actually stop certain regions of the brain from responding to threat clues. It’s not surprising, then, that stroking a dog or cat can lower blood pressure and heart rate and boost levels of serotonin and dopamine.

6. Pets make us responsible.

With pets come great responsibility, and responsibility — according to depression research — promotes mental health. Positive psychologists assert that we build our self-esteem by taking ownership of a task, by applying our skills to a job. When we succeed — i.e., the pet is still alive the next day — we reinforce to ourselves that we are capable of caring for another creature as well as ourselves. That’s why chores are so important in teaching adolescents self-mastery and independence.

Taking care of a pet also brings structure to our day. Sleeping until noon is no longer a possibility unless you want to spend an hour cleaning up the next day. Staying out all night needs some preparation and forethought.

This is all to communicate this message: marriages in which one person suffers from depression or bipolar disorder can be extremely fragile.

I know, because I’m in one.

Here are six tips that have helped us and other couples I know defy the statistics.

1. Cut Through the Crap

If you are married to someone who is in denial, you have quite a job ahead of you. “I’m not crazy.” “There is nothing wrong with me.” “I am not taking meds.” These statements do little to move your marriage into the happy zone. In her book, “When Someone You Love Is Bipolar,” psychologist Cynthia Last, Ph.D. dedicates a chapter to the subject of denial and what you can do. She suggests giving your partner a book that he can relate to and providing literature on the topic.

You could also try a scientific approach and provide some evidence in the form of feedback from his friends and family, a list of compelling symptoms (embarrassing photos are great), or a rundown of the disorder in his family. He could balk at that, and tell you that you dress like his mother for even implying such things; however, you’ve done your job to try to educate, and that’s really all you can do.

2. Find the Right Doctor

I consider shopping for the right doctor much like buying your first house. Many components need to go into the decision — it’s not enough to like the bathroom tiles and the bedroom closet — and some bickering is to be expected. If you rush the decision, you might wind up living in a house that you hate for a long time except for the great bathroom tiles. Good doctors save marriages. Bad doctors destroy them. Good doctors help you get better. Bad doctors worsen your condition.

If your partner is bipolar, this is especially important because the average patient with bipolar disorder takes approximately 10 years to get a proper diagnosis. About 56 percent are first diagnosed with unipolar depression. I know this topic well. I went through seven doctors and a ton of diagnoses before I found the right fit. She saved my life and my marriage.

3. Enter into a Triangle Relationship

In any other situation, I hate threesomes. Someone always gets left out and people play dirty — at least they do at my daughter’s play dates. But for marriages that involve illnesses such as depression or bipolar, a triangle relationship with a doctor or mental health professional is essential. It keeps your partner honest, or at least required to unfudge the truth. He reports:“ Feeling perfect. Meds really kicking in. All is going better than it ever has.” Then wifey comes in and spills the beans. “He has been curled up on the couch in tears for the last two weeks, not taking calls from any friends and skipping important meetings at work.”

The triangle relationship also allows you some education about his condition. For example, you might not be aware of what a hypomanic episode looks like until you hear the doctor describe it. In some cases a mutual understanding of symptoms is enough for a couple to avert a full-blown manic or depressive episode because together you can take steps to change the course.

4. Abide by Some Rules

My husband and I have several rules: I call the doctor after three days of incessant crying or no sleep. I tell him when I’m suicidal. He stays with me when I’m a danger to myself. However, the most important rule is this: I have promised him that I will take my meds. It’s like how Jack Nicholson told Helen Hunt in the movie “As Good As It Gets” that she makes him want to take his meds, she “makes him want to be a better man.” The truth is that many marriages get stuck on this one.

Without a doubt, the biggest challenge we face in treating bipolar disorder is medical adherence, according to psychologist Kay Redfield Jamison. “I’d like to make the obvious point that I don’t think is made enough, which is that it doesn’t do any good to have effective medications for an illness if people don’t take them,” she said at the Johns Hopkins 21st Annual Mood Disorders Symposium. Approximately 40 – 45 percent of bipolar patients do not take their medications as prescribed. Come up with some rules, and be sure to include in there “medication adherence.”

5. Learn the Language of the Illness

Sometimes I forget how hurtful my words can be when I’m expressing how anxious or depressed I feel. “I just want to be dead.” “I don’t care about anything.” “If only I was diagnosed with cancer and could make a graceful exodus out of this world …” Oh, no offense. Thankfully my husband knows that it’s my depression speaking, not me. He has been able to separate his wife from the illness. That is the result of lots of research on his part and a few conversations with my psychiatrist.

6. Keep Yourself Sane

Spouses of persons with depression and bipolar unwittingly become caretakers for major chunks of time. And caretakers are at high risk for depression and anxiety. Researchers at Yale University School of Medicine have found that nearly one-third of caregivers who are nursing terminally ill loved ones at home suffer from depression. A study in Great Britain found that one in four family caregivers meets the clinical criteria for anxiety.

Pay attention to these symptoms: feeling tired and burned out much of the time; physical signs of stress such as headaches and nausea; irritability; feeling down, deflated, reduced; changes in sleep or appetite; resentment toward your spouse; decreased intimacy in your relationship. Remember that if you don’t secure your oxygen mask first, no one gets air. If my husband didn’t take time to run and play golf he would be hospitalized alongside me.

“Between a shaky world economy, increasing unemployment, and related issues, many today are being forced to come to the edge of uncertainty. Just like the baby sparrows, they find themselves leaning into the mystery that change brings, because they have no choice: It’s fly or die.”

For persons struggling with depression and anxiety — and for those of us who are highly sensitive — uncertainty is especially difficult. Forget about learning to fly. The uncertainty itself feels like death and can cripple our efforts to do anything during a time of transition.

I have been living in uncertainty, like many people, ever since December of 2008 when the economy plummeted and the creative fields — like architecture and publishing — took a hard blow, making it extremely difficult to feed a family. In that time, I think I have worked a total of 10 jobs — becoming everything from a defense contractor to a depression “expert.” I even thought about teaching high school morality. Now that’s desperate.

I don’t think I’ll ever be comfortable with uncertainty, but having lived in that terrain for almost five years now, I’m qualified to offer a few tips of how not to lose it when things are constantly changing.

1. Pay attention to your intention

I’m not a new-age guru. I don’t believe that you can visualize a check for $20,000 and find one in your mailbox the next day. Nor can you get on Oprah by believing you’ll be her next guest. (I tried both of those.) But I do recognize the wisdom in tuning into your intention because therein exists powerful energy that you can tap.

Awhile back I did Deepak Choprah’s exercise of recording my intentions and seeing how many of them actualized. I was surprised at the synchronicity between intention and events. Psychologist Elisha Goldstein writes in his book, The Now Effect: “Our intention is at the root of why we do anything and plays a fundamental role in helping us cultivate a life of happiness or unhappiness. If we set an intention for well-being and place it at the center of our life, we are more likely to be guided toward it.”

2. Tune into the body.

Psychologist Tamar Chansky, Ph.D. reminds us to listen to the body when we get anxious. If you understand why certain symptoms occur in the body – racing heart, dizziness, sweating, stomachaches – and repeat to yourself, “This is a false alarm,” you are less afraid, less panicked by the situation. Knowing that these symptoms are part of the sympathetic nervous system (SNS) trying to protect you from danger – part of the primitive regions of the brain mobilizing the “flight-or-fight” response –the reaction becomes less about the situation and more about talking to your body about why it’s freaking out so that you can use the parasympathetic nervous system (PNS) to restore the body to normalcy, which, in my case, is still pretty panicky.

3. Imagine the worst.

I’m not sure you will find a psychologist to agree with me on this exercise, but it has always worked for me every time I do it. I simply envision what it would look like if my worst nightmare happened. What if my husband and I could not get any architecture gigs or writing assignments? What if we can’t pay for health care insurance and my heart malfunctions (I have a heart disorder)? What if we both come to a bone fide professional dead end? Then I move to my actions. I think about selling our house, moving into a small apartment, and working as a waitress somewhere or maybe as a barista at Starbucks. (If you work more than 20 hours, you get health care insurance.) I research health care insurance options for persons who make minimum wage. Under ObamaCare, my kids, at least, would be covered. I invariably come to the conclusion that we will be okay. All is okay. A huge adjustment. Yes. But we are getting to be pros at that. This exercise makes me fret less about the things that I think I must have and get back to the essentials—literally a warm meal on the table, even if it’s one a day.

I am comforted by the words of Charles Caleb Colton: “Times of general calamity and confusion have ever been productive of the greatest minds. The purest ore is produced from the hottest fire.”

4. Describe, don’t judge.

In his book Get Out of Your Mind and Into Your Life, Steven Hayes, Ph.D. dedicates a few chapters to learning the language of your thoughts and feelings. Especially helpful to me is learning how to distinguish descriptions from evaluations.

Descriptions are “verbalizations linked to the directly observable aspects or features of objects or events.” Example: “I am feeling anxiety, and my heart is beating fast.” Descriptions are the primary attributes of an object or event. They don’t depend on a unique history. In other words, as Hayes, explain, they remain aspects of the event or object regardless of our interaction with them. Evaluations, on the other hand are secondary attributes that revolve around our interactions with objects, events, thoughts, feelings, and bodily sensations. They are our reactions to events or their aspects. Example: “This anxiety is unbearable.”

If we are feeling anxious about the uncertainty of our job, for example, we can tease apart the language of our thoughts and try to transform an evaluation, “I will be destroyed if I am fired,” to a description, “I am feeling anxious and my job is unstable.” By naming the emotion and the situation, we don’t necessarily have to assign an opinion. Without the opinion, we can process the object, event, etc. without hyperventilation.

5. Learn from fear.

Eleanor Roosevelt wrote, “You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face … You must do the thing you think you cannot do.” My body usually protests against that statement, but theoretically I concur with Eleanor. I sincerely believe the good stuff happens when we are afraid. If we go a lifetime without being scared, as Julia Sorel said, it means we aren’t taking enough chances.

Fear is rather benign in itself. It’s the emotions we attach to it that disable us. If we can confront our fear, or rather approach it as an important messenger, then we can benefit from its presence in our life. What is the fear saying to us? Why is it here? Did it bring roses or chocolate? According to Jones, this is an exercise of getting comfortable with being out of control, of learning to let go of the illusion of control — because we never really had it in the first place — and developing an inner knowing that everything will be okay.

Proper treatment doesn’t suppress emotions or dull a person’s ability to feel things deeply. It builds a protective layer — an emotional resilience — to safeguard a depressive from becoming overwhelmed and disabled by the difficulties of daily life.

However, the tools found in happiness research are those I practice in my recovery from depression and anxiety, even though, theoretically, I can be happy and depressed at the same time. I came up with my own recovery program that coincides with the steps toward happiness published in positive psychology studies.

1. Sleep

Sleep is crucial to sanity because sleep disturbances can contribute to, aggravate, and even cause mood disorders and a host of other illnesses. The link between sleep deprivation and psychosis was documented in a 2007 study at Harvard Medical School and the University of California at Berkeley. Using MRI scans, they found that sleep deprivation causes a person to become irrational because the brain can’t put an emotional event in proper prospective and is incapable of making an appropriate response. Chronic sleep deprivation, especially, is bad news. It often affects memory and concentration. And, according to one recent study, it can cause a decline in cognitive performance similar to the intoxicated brain.

2. Diet

My mouth and brain are in constant negotiation with each other because while one loves white bread, pasta, and chocolate, the other throws a hissy fit whenever they enter my blood stream. My diet has always been an important part of my recovery from depression, but two years ago — after working with the naturopath and reading Kathleen DesMaison’s “Potatoes Not Prozac” — I could more competently trace the path from my stomach to my limbic system. Moreover, I recognized with new clarity how directly everything that I put in my mouth affects my mood.

Here are the bad boys: nicotine, caffeine, alcohol, sugar, white flour, and processed food — you know, what you live on. Here are the good guys: protein; complex starches (whole grains, beans, potatoes); vegetables; vitamins (vitamin B-complex, vitamins C, D, and E, and a multivitamin); minerals (magnesium, calcium, and zinc); and omega-3 fatty acids. I’m religious about stocking up on omega-3 capsules because leading physicians at Harvard Medical School confirmed the positive effects of this natural, anti-inflammatory molecule on emotional health.

3. Exercise

Dr. James A. Blumenthal, a professor of medical psychology at Duke University, led a recent study in which he and his team discovered that, among the 202 depressed people randomly assigned to various treatments, three sessions of vigorous aerobic exercise were approximately as effective at treating depression as daily doses of Zoloft, when the treatment effects were measured after four months. A separate study showed that the depressives who improved with exercise were less likely to relapse after 10 months than those treated successfully with antidepressants, and the participants who continued to exercise beyond four months were half as likely to relapse months later compared to those who did not exercise.

Even as little as 20 minutes a week of physical activity can boost mental health. In a new Scottish study, reported in the British Journal of Sports Medicine, 20,000 people were asked about their state of mind and how much physical activity they do in a week. The results showed that the more physical activity a person engaged in — including housework, gardening, walking, and sports — the lower their risk of distress and anxiety.

Exercise relieves depression in several ways. First, cardiovascular workouts stimulate brain chemicals that foster growth of nerve cells. Second, exercise increases the activity of serotonin and/or norepinephrine. Third, a raised heart rate releases endorphins and a hormone known as ANP, which reduces pain, induces euphoria, and helps control the brain’s response to stress and anxiety. Other added benefits include improved sleep patterns, exposure to natural daylight (if you’re exercising outside), weight loss or maintenance, and psychological aids.

4. Relationships and Community

We are social creatures and are happiest when we are in relationship. One of the clearest findings in happiness research is that we need each other in order to thrive and be happy, that loving relationships are crucial to our well-being. Relationships create a space of safety where we can learn and explore. Belonging to a group or a community gives people a sense of identity. Studies indicate that social involvement can promote health, contribute toward faster recovery from trauma and illness, and lower the risk of stress-related health problems and mental illness.

Plenty of evidence indicates that support groups aid the recovery of persons struggling with depression and decrease rates of relapse. The New England Journal of Medicine published a study in December 2001 in which 158 women with metastatic breast cancer were assigned to a supportive-expressive therapy. These women showed greater improvement in psychological symptoms and reported less pain than the women with breast cancer who were assigned to the control group with no supportive therapy.

Another study in 2002, published in the American Journal of Psychiatry, followed a group of more than 100 persons with severe depression who joined online depression support groups. More than 95 percent of them said that their participation in the online support groups helped their symptoms. The online groups here on Psych Central are a great resource where you can find support from people going through similar struggles.

5. Purpose

The father of positive psychology, Martin Seligman, explains in his book, “Authentic Happiness,” that a critical element to happiness exists in using your signature strengths in the service of something you believe is larger than you. After collecting exhaustive questionnaires he found that the most satisfied people were those that had found a way to use their unique combination of strengths and talents to make a difference. Dan Baker, Ph.D., director of the Life Enhancement Program at Canyon Ranch, believes that a sense of purpose — committing oneself to a noble mission — and acts of altruism are strong antidotes to depression. And then there’s Gandhi, who wrote: “the best way to find yourself is to lose yourself in the service of others.”

6. Gratitude

Gratitude doesn’t come easily to me. When my girlfriend sees a half-full glass of fresh milk, I see a half-empty glass of cholesterol-rising, cardiac-arresting agents. And when the kids’ school is called off because some road somewhere in our county apparently accumulated a half of an inch of snow, she thanks God for an opportunity to build snowmen with she kids. I have a conversation with God, too, but it’s much different.

However, I train myself to say thank you more often than is natural for me because I know that gratitude is like broccoli — good for your health in more than one way. According to psychologists like Sonja Lyubomirsky at the University of California Riverside, keeping a gratitude journal — where you record once a week all the things you have to be grateful for — and other gratitude exercises can increase your energy, and relieve pain and fatigue.

Shameless plug! Join me at one of three private screenings of “Happy,” a film that explores what makes us happy, followed by a discussion on depression and happiness and a book signing. Click the following links for more information:

Here are some insights from their book.

What can understanding failure teach both seasoned and aspiring leaders that they can’t learn only by modeling success?

While studying success provides valuable lessons during good times, often these lessons aren’t applicable in hard times. The road isn’t always smooth and the sky isn’t always blue. When challenges present themselves, lessons gleaned from previous failures can help leaders avoid making the same mistake twice or making the wrong decisions.

Making mistakes — or failing — are part of taking healthy risk. They provide us with new ways of thinking and give us new insights into how we can improve as leaders.

Real failure doesn’t come from making mistakes; it comes from avoiding errors at all possible costs, from fear to take risks, and from the inability to grow. Being mistake-free does not lead to success.

Learning from our mistakes, however, is not always possible. Yes, every great leader makes mistakes they can learn from. But there are only a limited number of mistakes you can make before proving yourself an unworthy leader — you can only fall off the corporate ladder so many times before your climb is finished. And the higher up the ladder you get, the more severe the fall. The failure paradox is that in order to succeed we need to know failure — yet we live in an environment where we can’t afford to make mistakes. The solution? To study and learn from the mistakes of others in order to proactively avoid the predictable pitfalls that await every leader.

What are the specific benefits of learning from failure?

The benefits of learning from failure can be seen at both the individual level and the organizational level. We found strong statistical evidence between the ability to embrace mistakes and improved individual performance. Specifically we found that leaders who learn from mistakes are more proactive in deflecting potential problems, have a higher level of confidence when taking actions and making decisions, more accurately understand their environments, think more strategically, and are more creative.

These traits and capabilities also translated to the organizational level. Specifically we found that companies that are more accepting of mistakes have significantly better financial performance in terms of both top-line revenue growth, as well as bottom-line profit. We live in a culture that values perfections and hides failure. Companies pay their employees to succeed, not to fail.

However, the more we talk about the valuable lessons that come from mistakes and honor discussions about failure, the less likely it will be such a taboo subject.

For The Wisdom of Failure you conducted almost 1,000 interviews with managers and leaders. What about those interviews most surprised you?

We were surprised by how reluctant some leaders were to be associated with the topic of failure. Several times, we had leaders open up to us about key mistakes they had learned from in their own careers, only to call us back the next day to say they didn’t want us to use any material from their interviews in our book. Having their names associated with failure was too risky. Of course, we honored their request.

This reluctance to discuss failure emphasizes not only how difficult it is for leaders to talk about mistakes, but also the costly consequences leaders believe will follow if they do.

But 11 years after the first insomniac was born, I’m still exhausted, as I am convinced he emerged from my womb with no need of sleep, and then his sister two years later with the same curse. I’m not sure how it happened, being that I’ve always needed eight hours of sleep to stay sane.

The last two months there has been a lot of cussing in our house after 8 p.m., when we begin the rituals. In desperation I headed to my shelf of expert advice to see if any nuggets in there would apply, or at least not nauseate me. I came away empty-handed. Great intentions. Perfect principles. Wise stuff. Just not going to work on my rebels, who defy traditional rules and procedures.

So I’m back to threatening. However, threatening, itself, can be complicated, and deserves its own guidelines.

Here are my two cents on how to threaten effectively. These are not principles that will foster healthy sleep habits. They will merely get you a few days of sleep if you are like me, in the state of emergency. Experts aren’t big on Band-aids. I am.

1. Prep the threat.

My fundamental mistake in releasing a threat is not being totally prepared. In an impatient huff, I might blurt out something stupid like, “If you don’t go to sleep, I’m going to … going to … going to …,” brainstorming about which option is best, at which point my two devious offspring start laughing. The result is that they do not take future threats seriously, and I have lost all negotiating power (which effective parents don’t need because they don’t have to negotiate with their kids) because I didn’t think through the bribe before opening my trap in a premature fit.

2. Specify the threat.

Threats should be like legal documents. Hell, you could get out a piece of paper with all the specifications written down and, instead of them pinky-swearing, you could get a signature. The more detailed the better because kids who don’t sleep tend to be smart and manipulative. So when I take away the family iPad from my daughter, she finds a computer in the house and starts surfing YouTube or making videos of herself. When we take that away, she grabs one of our iPhones and downloads an app where she can try out new hairstyles on stick-skinny chicks. If she can’t find those, she’ll steal her brother’s iPod and start uploading photos to his Instagram. I should have stipulated that ALL electronics are banned, that she has to do something really radical like read a book or use pencil and paper and draw.

3. Time the threat.

Just as important as the content of the threat is the delivery: in particular, when you deliver the threat. I’ve found that when my insomniacs are overly tired and irrational they can’t hear a word I say, even if I’m yelling. Therefore, it’s best to wait until breakfast, when I will say very calmly that they have lost electronics for the day or until they learn how to calm themselves down and go to bed without making visits to our room or to a sibling’s room in the middle of the night, sleepwalking, singing Macklemore’s song lyrics, “I’m gonna pop some tags,” or perfecting Anna Kendrick’s cup act in “Pitch Perfect.”

Threatening is not easy. So hopefully these guidelines assist you in reaching for a wide Band-aid and a few nights’ sleep before you have to come up with an entirely different set of new threats. Good luck!

It doesn’t matter that I wake up most mornings to swim 160 laps, am borderline obsessed with eating salads and whole grains, and that I haven’t drank a drop of alcohol in 24 years; that I do yoga twice a week, keep a mood journal, engage in cognitive behavioral therapy, and have a rich spiritual life; that I take omega-3 fish oil capsules, vitamin D, calcium, and other supplements with my extra-pulp juice in the morning; or that I work really hard at communicating anger, frustration, and disappointment so that the repression of feelings doesn’t end up as a tumor somewhere inside my body.

I can’t get an individual or family plan short of signing up for a $10,000 deductible.

Because I have a history of depression.

My illness falls under the ABCs of the non-insurable, the “preventable” illnesses that solicit the red flag of “no way in hell” she’s getting coverage:

A – Asthma (and, hell, let’s throw in Arthritis)
B – High Blood Pressure
C – Cardiovascular Disease (and Cancer, sometimes classified – I know – “preventable,” but which is surely a insurance-killer)
Double D (think bra size) – Diabetes and OF COURSE Depression

Now I’m not so naïve that I dismiss the economic toll these illnesses take on an already fragile economy. Here’s the chronic disease price tag, estimated annual direct medical expenditure, according to the Center for Disease Control, which used different methodologies in calculating costs:

Cardiovascular disease and stroke: $313.8 billion in 2009
Cancer: $89 billion in 2007
Smoking: $96 billion in 2004
Diabetes: $116 billion in 2007
Arthritis: $80.8 billion in 2003
Obesity: $61 billion in 2000

Not mentioned here is clinical depression, which, left untreated, is as costly as heart disease or AIDS to the U.S. economy, according to Mental Health America. It costs over $51 billion in absenteeism from work and lost productivity and $26 billion in direct treatment costs.

Depression tends to affect people in their prime working years and may last a lifetime if untreated. According the MHA:

• Depression ranks among the top three workplace problems for employee assistance professionals, following only family crisis and stress.
• Three percent of total short-term disability days are due to depressive disorders and in 76 percent of those cases, the employee was female.
• In a study of First Chicago Corporations, depressive disorders accounted for more than half of all medical plan dollars paid for mental health problems. The amount for treatment of these claims was close to the amount spent on treatment for heart disease.
• The annual economic cost of depression in 1995 was $600 per depressed worker. Nearly one-third of these costs are for treatment and 72 percent are costs related to absenteeism and lost productivity at work.

That’s not to mention the human toll: seven out of ten deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50 percent of all deaths each year. Almost 15 percent of those suffering from severe depression will die by suicide.

And there is much we can do to prevent it. Four culprits are responsible for much of the illness, the suffering, the costs, and the early death associated with chronic diseases:

• Lack of physical activity
• Poor nutrition
• Tobacco use
• Excessive alcohol consumption

But allow me to climb back onto my soapbox. It’s still not fair. It’s not fair to those of us who go to great lengths to pursue healthy living and do everything in our day in the name of recovery – those of us who get up every morning with a pair of boxing gloves on, ready to fight for our health. It’s just not fair and it’s wrong.

I look forward to my meetings with health insurance brokers less than I do my yearly Pap. As much as I try to mentally prepare myself for the blow – “Repeat to yourself: You’re not going to like what you hear. It’s going to be unfair. You need to stay calm” – I still leave infuriated, which then, of course, has me checking off two of the ABCs: depression AND high blood pressure. That would probably bring my deductible up to $12,000, God forbid.

Originally published on PsychCentral.com

Unfortunately that advice wouldn’t have been able to stop me from praying rosary after rosary when I was in fourth grade to avert going to hell, nor does it quiet the annoying noise and chatter inside my brain today in any given hour. But the fact that a great leader battled the worry war does provide me some consolation.

It doesn’t matter whether you are a chronic worrier without an official diagnosis or battling severe obsessive-compulsive disorder (OCD), a neurobehavioral disorder that involves repetitive unwanted thoughts and rituals. The steps to overcome faulty beliefs and develop healthy patterns of thinking are the same.

Worrying about facing the inferno as a 10-year-old and fretting about whether or not I’ll provide enough income to keep my kids in private school stems from the same brain abnormality that Jeffrey M. Schwartz, M.D. describes in his book, Brain Lock.

When we worry, the use of energy is consistently higher than normal in the orbital cortex, the underside of the front of the brain. It’s working overtime, heating up, which is exactly what is the PET scans show. Too many “what if’s” and your orbital cortex as shown in a PET scan will light up in beautiful neon colors, like the walls of my daughter’s bedroom. However, with repeated cognitive-behavioral exercises, you can cool it down and return your PET scan to the boring black and white.

In their book, The OCD Workbook, Bruce M. Hyman, Ph.D., and Cherry Pedrick, RN, explain the ABCDs of faulty beliefs. It’s a four-step cycle of insanity:

A = Activity Event and Intrusive Thought, Image or Urge. (What if I didn’t lock the door? What if I upset her? I know I upset her.)

B = Faulty Belief About the Intrusive Thought. (If I don’t say the rosary, I’m going to hell. If I made a mistake in my presentation, I will get fired.)

C = Emotional Consequences: Anxiety, Doubt, and Worry. (I am a horrible person for upsetting her. I keep making mistakes … I will never be able to keep a job. I hate myself.)

D = Neutralizing Ritual or Avoidance. (I need to say the rosary to insure I’m not going to hell. I should avoid my friend who I upset and my boss so that he can’t tell me I’m fired.)

Those might seem extreme for the casual worrier, but the small seed of anxiety doesn’t stay small for long in a person with an overactive orbital cortex.

Hyman and Pedrick also catalog some typical cognitive errors of worriers and persons with OCD:

• Overestimating risk, harm, and danger
• Overcontrol and perfectionism
• Catastrophizing
• Black-and-white or all-or-nothing thinking
• Persistent doubting
• Magical thinking
• Superstitious thinking
• Intolerance of uncertainty
• Over-responsibility
• Pessimistic bias
• What-if thinking
• Intolerance of anxiety
• Extraordinary cause and effect

One of the best approaches to manage a case of the worries and/or OCD is the four-step self-treatment method by Schwartz, explained in Brain Lock,

Step 1: Relabel.

In this step you squeeze a bit of distance between the thought and you. By relabeling the bugger as “MOT” (my obsessive thought) or something like that, you take back control and prevent yourself from being tricked by the message. Because I’ve always suffered from OCD, I remind myself that the illogical thought about which I’m fretting is my illness talking, that I’m not actually going insane.

Step 2: Reattribute.

Here is where you remember the PET scan that would look like your brain. By considering that colorful picture, you take the problem from your emotional center to your physiological being. This helps me immensely because I feel less attached to it and less a failure for being able to tame and keep it under control. Just like arthritis that is flaring up, I consider my poor, overworked orbital cortex, and I put some ice on it and remember to be gentle with myself.

Step 3: Refocus.

If it’s at all possible, turn your attention to some other activity that can distract you from the anxiety. Schwartz says: “By refusing to take the obsessions and compulsions at face value—by keeping in mind that they are not what they say they are, that they are false messages—you can learn to ignore or to work around them by refocusing your attention on another behavior and doing something useful and positive.”

Step 4: Revalue.

This involves calling out the unwanted thoughts and giving yourself a pep talk on why you want to do everything you can to free yourself from the prison of obsessive thinking. You are basically devaluing the worrying as soon as it tries to intrude.

That’s one of the questions Randy Pausch, famous deceased Carnegie Mellon professor, asked in his presentation “The Last Lecture.” It went viral, landing him on Oprah and a host of other afternoon and late-night shows.

I loved every other part of his lecture but that.

Because I think the world needs its share of Eeyores: solemn, stoic, realistic, pensive creatures. And I don’t think I’m saying that because I unapologetically claim to be an Eeyore.

I mean, imagine a world of hyperactive, happy Tiggers. How long can you stay with that image before you want to throw something at the striped orange guy?

I, for one, wouldn’t want to share a cube with perky Tigger always asking you what your plans are for lunch, and if you’ve scheduled anything fun for the weekend. I prefer the Eeyore who sips her coffee quietly, taking the morning in before sending any thoughts out into the universe.

The Eeyores of the world are realistic, sensible, and sweet. They tether the dreams of Tiggers to realistic standards so that they can be achieved and sustained. These guys are usually the sensitive folks who, having picked up on nuances in their environments, can usually intuit opportunity or danger. They can offer guidance and insights that come with being the kind of reflective persons they are. Their rich inner life pays off.

Other reasons we need Eeyores:

1. They are less judgmental.

Anyone who has been through the hell of an Eeyore knows to leave all judgment aside. The Eeyore has been told everything from “get your butt off the couch and stop crying” to “if you eat organic grains and go to yoga you wouldn’t feel anxious” and knows how insensitive words can hinder any movement toward recovery. The Eeyore, then, is extremely careful with what he says to folks, healthy and sick, and because of that, he earns the trust of his family, friends, and co-workers.

2. They are more compassionate.

Depression does more than shrink and destroy nerve cells in a brain. It also expands a heart. So the Eeyore catches the woman tearing up in the back corner of a conference room. She can’t help but tune into her intuition, reading a heavy sadness in the room. The Eeyore will go over to her and hug her or take her hand. She is no longer bashful of doing this, because she has been that lady, sitting there crying in a public room on countless occasions.

3. They are emotionally aware.

Eeyores are more aware of their inner emotional states, which can translate into technical or business innovation or can lead to profound creative work as writers, musicians, actors or other artists. Eeyores are usually highly sensitive, which means they process layers and layers of meanings, which can complement the risk takers in an organization.

So, now that we’ve identified an undeniable need for Eeyores in the world, what about the others?

Christopher Robin (the boy): Schizophrenia
Piglet: General Anxiety
Pooh: Eating Disorder/Low Self-Esteem
Rabbit: OCD
Owl: Dyslexia (my favorite)

Do they really represent mental disorders?

Illustration by http://rufiojones.files.wordpress.com

Now, if you’re not someone who has struggled with chronic depression, those stats won’t warrant a happy dance.

But if you’re someone like myself, who assesses her mood before her eyes are open in the morning, hoping to God that the crippling anxiety isn’t there, then those numbers will have you singing Hallelujah.

They are better than the statistics released by a large, six-year, four-step government study called the Sequenced Treatment Alternatives to Relieve Depression trial, or STAR*D. STAR*D looked at the use of popular antidepressants in people with chronic, severe depression who do not respond to a particular drug and may suffer from multiple mental and physical disorders.

The researchers found that trying treatment options such as adding a second drug to a SSRI, switching to a new drug or a different class of drug, and waiting a full 12 weeks to assess results can lead to remission in symptoms in up to half of patients.

That’s not much to celebrate, in my opinion. Good news, but not great.

Folks trudging through the everyday muck of depression and pervasive, annoying, destructive, negative, intrusive thoughts need hope. Lots of it. Daily. Hourly. I know I did. And still do.

In March 2006, I had just finished trying the 23rd combination of mood stabilizers and antidepressants and I still wanted to die. That’s not to mention all the psychotherapy, mindful meditation, light therapy, rigorous exercise, yoga, fish oil, and other techniques I was trying. When my doctor threw out DePaulo’s numbers I did not believe them. However, about two months later, under her care, I was miraculously able to experience a day without any death thoughts. Nada.

The last 18 months have been somewhat of a rerun. I never fully recovered from a crash in August 2011, despite my wholehearted attempts at mindfulness and different kinds of therapy, 10 or so medication combinations, intense exercise, light therapy, diet changes and supplements. Some days were better than others, but I didn’t go much longer than 15 seconds without fighting a death thought. This ongoing silent battle inside my noggin made it very difficult to accomplish anything other than my necessary responsibilities, let alone open space in my life to have fun.

During the last few months, just as in 2006, I have been running dangerously low on hope.

In fact, I began to research transcranial magnetic stimulation, a procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. That and electroconvulsive therapy are the last-ditch efforts for those of us checking off double digits of medication combinations and every kind of alternative therapy out there. I was even mapping out my schedule as to how I would spend my morning for two and half months at Johns Hopkins Hospital and how I would explain this to my manager at work.

“Before we go there, let’s try one more combination,” my doctor recommended.

Sure. Yeah. Whatever. Like that’s going to make a difference.

I was wrong. It took the 11th or 14th, or whatever number combination it is, to give my tired brain a respite from the death dialogue, and the stamina I needed to push me into the real world again … so that I can practice mindful meditation in a way that doesn’t make me feel demoralized, or swim in the morning without having to hold back tears, or pursue a passion such as reaching out to those with depression — all of which are important facets to my recovery.

The 80-in-80 aren’t exactly statistics that you’ll hear promised in an ad for an antidepressant, but those numbers sure are chock-full of hope for this depressive. I hope they are for you too, and encourage you to keep on keeping on until you can keep on without quite as much effort.

However, it wasn’t the great acting or directing that had me so glued to the screen that I was afraid to reach for popcorn.

Lincoln has been my mental health hero ever since Joshua Wolf Shenk, who has since become a friend of mine, published his acclaimed book, “Lincoln’s Melancholy: How Depression Challenged a President and Fueled His Greatness.” Shenk took seven years to research and write the masterpiece, and it gained attention right as I had graduated from one psych ward unit and was going into another one.

The afternoon I sat in the lobby of the Johns Hopkins Mood Disorders Clinic waiting to be evaluated by a team of psychiatrists (after my first hospitalization), I read Shenk’s interview with Karen Swartz, M.D, the Director of Clinical Programs and one of the physicians who evaluated me.

I learned that Lincoln shared my greatest fear: that he would go insane only never to regain his sanity.

In one of his depressive spells, he wrote:

“I am now the most miserable man living. If what I feel were distributed to the entire human family there would not be one happy face on the Earth.”

He had all of the same symptoms of acute depression that are found today in the DSM-IV: social isolation, suicidal ideation, loss of appetite, difficulty concentrating. He told one of his friends that he felt like committing suicide often.

Shenk writes,

“One friend recalled, ‘Mr. Lincoln’s friends … were compelled to keep watch and ward over Mr. Lincoln, he being from the sudden shock somewhat temporarily deranged. We watched during storms, fogs, damp gloomy weather … for fear of an accident.’”

Another neighbor recounts, “Lincoln was locked up by his friends to prevent derangement or suicide.” An older couple in the area took him into their home to keep him safe for a short while. The fact that Lincoln’s behavior provoked a suicidal watch meant that he must have suffered intensely.

Yet, despite his acute pain, our president was able to transcend the crippling nature of his depression and hold on to hope. Explains Shenk in his interview with Johns Hopkins:

“The essential question that Lincoln grappled with during his lifetime was how you have hope in the face of great suffering. That question never ceases to be relevant for him. To me, Lincoln was a main who suffered more than anyone in his circle of contemporaries, and a man who achieved more than anyone in his life. And the reason he was able to succeed all came down to hope. It’s as if Lincoln were saying, ‘In my darkest moments I am still capable of seeing a great life.’ It is a matter of belief: No, it can’t be demonstrated empirically. But the peculiar and grand mystery to it is this: If you believe in hope, then you are on your way to making it true.”

Whenever I remember the story of this great man, I breathe a sigh of relief that I am not alone in my chronic struggle with sadness. His happy ending makes me feel less pitiful and weak about my obsession with death. And I wonder if there may be hope for me even if I, like Lincoln, never stop battling the beast of melancholy.

A month ago I fetched cream for my coffee at a café in South Bend, Indiana. Naturally my family didn’t know a soul in the joint. However, by the time I returned to my table, I knew some incredibly intimate (not to mention interesting) details about the daughter of the man next to me who was reaching for a napkin: his daughter is bipolar; she was anorexic as a teenage ballerina; and she’s on some of the same meds as I am.

I ended up giving him a business card with everything but my email scratched out.

I didn’t want to have the conversation of what I do for living.

It doesn’t have anything to do with who I am.

And that’s why I get so annoyed that we have to start all of our conversations with that question.

As a country, we are obsessed with our jobs: An understatement. Our professions are central to our self-identities and our industries define who we are. We don’t even know how to vacation. It doesn’t matter that United States workers receive far fewer vacation days than other workers in other industrialized countries because American employees fail to take the time off that they have accrued. Our European friends shake their heads at that one.

I remember how refreshing it was to ask a French couple “what they did” (I plead guilty) at a swim meet for our kids.

“We are skiers,” they said emphatically. No equivocation. No insecurity. No approval-seeking.

That was who they are and were proud of being, and told me a hell of a lot more about them than had they rattled off their resumes starting with their last places of employment: “I’m an accountant with Ernst & Young.” “I’m a consultant with Booz Allen Hamilton.” “I’m a program manager with Northrup Grumman.” Snore. Snore like Gramma.

My conundrum is that I wear a few different hats at the present moment, so I, in fact, don’t really know what I am. I know what my ministry or innate purpose in life is — to provide hope to those who struggle intensely with depression and other mood disorders — but it’s not related to what I do for a living as a government contractor. One pays with blessings, the other is generous with benefits. And, unfortunately in this country, most benefits are tied to your job, so while following your dream is all good and noble, you might get screwed if your appendix bursts like mine did a year ago and you need some quick medical attention. Passion, at times, has to take a back seat to medical care and other life necessities.

Upon meeting someone new, part of me hopes I will never hear the dreaded four words (what-do-you-do) because then I wouldn’t have to assess how I am going to respond — with my pragmatic communications-consultant role, or with the idealistic wanting-to-save-the-world profile.

At the least, it would be nice to delay the work conversation toward the second-half of the conversation, after the other top three questions: Where are you from? Why are you here? (conference, cocktail hour, reunion, fundraiser, Chuck E Cheese), How many kids do you have and what are their ages and when were they potty trained?

For this reason, I’ve always loved writer Oriah Mountain Dreamer’s poem, The Invitation, that went viral 15 years ago and was later published in a book. May we all share this vision one day.

It doesn’t interest me what you do for a living. I want to know what you ache for, and if you dare to dream of meeting your heart’s longing. It doesn’t interest me how old you are. I want to know if you will risk looking like a fool for love, for your dream, for the adventure of being alive.

It doesn’t interest me what planets are squaring your moon. I want to know if you have touched the center of your own sorrow, if you have been opened by life’s betrayals or have become shriveled and closed from fear of further pain! I want to know if you can sit with pain, mine or your own, without moving to hide it or fade it, or fix it.

I want to know if you can be with joy, mine or your own, if you can dance with wildness and let the ecstasy fill you to the tips of your fingers and toes without cautioning us to be careful, to be realistic, to remember the limitations of being human.

It doesn’t interest me if the story you are telling me is true. I want to know if you can disappoint another to be true to yourself; if you can bear the accusation of betrayal and not betray your own soul; if you can be faithless and therefore trustworthy.

I want to know if you can see beauty even when it’s not pretty, every day, and if you can source your own life from its presence. I want to know if you can live with failure, yours and mine, and still stand on the edge of the lake and shout to the silver of the full moon, “Yes!”

It doesn’t interest me to know where you live or how much money you have. I want to know if you can get up, after the night of grief and despair, weary and bruised to the bone, and do what needs to be done to feed the children. It doesn’t interest me who you know or how you came to be here. I want to know if you will stand in the center of the fire with me and not shrink back.

It doesn’t interest me where or what or with whom you have studied. I want to know what sustains you, from the inside, when all else falls away. I want to know if you can be alone with yourself and if you truly like the company you keep in the empty moments.

Chistina is an an accomplished writer whose commentary on women’s issues appeared in The London Review of Books, The New York Times, Working Woman, Scholastic, and the Providence Journal. She is also the author of “Great Women Writers,” and has been the recipient of a New York Foundation for the Arts Fellow.

Click through to read the full interview.

1. In your piece for “Exhale,” a literary magazine for “intelligent people who have lost a baby, or can’t figure out how to make one in the first place,” you lay out some creation myths:

• People can go from desperately wanting a child, to “choosing” to be ?child free.

• Anyone can adopt.
• Women wind up childless because they put off marriage to establish ?careers; or were looking for Mr. Right instead of Mr. Good Enough.
• Anyone who wants a baby can get one, because this is America, ?where there is a solution to every problem.
• Pets, gardening, or spending time with other people’s children fills ?in for not having biological children of one’s own.
• People without children are not real adults, and don’t know what ?real love is.
• Infertility is a women’s issue.

I’m so glad you listed all of those, because I admit to having believed some of them. It certainly made me think. Of the seven, which do you think is most harmful to women who can’t have children?

Christina: Each is the most important to whomever the myth is misapplied. Probably the most common is women put off children for their careers. This isn’t the fifties, very few women have the option of graduating high school or college and having a man at the ready to marry, willing and able to take on her and a child. Women who go to college generally come out in debt with huge loans, so do their husbands. They can’t afford day care.

My situation isn’t reflected in any of these myths. I got married young but soon got very sick. I spent my twenties paying off my education, working too many jobs in very tough environments. I got fired from my Wall Street for being sick, yet had to have a good income and health benefits to have a child. Many people who benefit from a supportive extended family at the time they have children don’t understand that many of us don’t have those advantages.

Also, the very assumption that childlessness in a married couple equals infertility in the woman. My friend Elsa wasn’t infertile — her husband was, by vasectomy. By the time they divorced, she was 43. I think there needs to be drawn a distinction between a woman who has gynological problems that stop her from getting pregnant at 25, and situational infertility like childlessness by marriage, and then women who start families at 50. That’s not true infertility, that’s past the natural biological childbearing age.

As I blogged on the New York Times, when celebrities are showcased having babies in their forties, then fifties, society gradually sees this as normal. Mainstream consumer magazines run articles about freezing your eggs in your twenties, so you can have a baby at 45, instead of talking about retuning society and the economic system to make it easier for young women to have children at biologically natural ages.

The solution really, is not to come up with newer and more advanced fertility treatments or yet more third-world adoption options. But to make the world safe and welcoming for people who wind up without children, often for very good reasons.

Many many childless people feel bereaved — it is a situation that deserves respect, not pity or gloating.

2. In that same article you mention your friend Elsa, whose older husband didn’t want more kids. She was often pitied, her husband demonized. People said to her, daily:

• “You’re selfish.”

• “You don’t know what real love is.”
• “Your husband will leave you.”

And then you go one to say that he did leave her “because with so few counterparts in her workplace and community, her sense of private loss and public alienation corroded her marriage beyond repair.” Man, that is such a crucial message there … the absolute requirement of support. If an infertile woman wants to make her marriage work — wants to become immune, if at all possible to the toxic messages around her concerning this issue — what should she do?

Christina: I think the real question is — what can society do to normalize Elsa’s situation? An urban area is more accepting of non-nuclear families, as well as singles. I think it’s her friends, neighbors, pastor, yoga instructors (who might, for example, address the class as if everyone were a Mom — i.e. — “Moms are tired” … as if no one else had challenging life situations!) Her co-workers who preface every meeting with ceaseless chatter about their children. The women at the gym who turn their back in the middle of a conversation when one of their “Mom” friends comes in. It is truly a social status of second-class citizen.

Elsa tried to become very involved in her nieces and nephew, but sometimes the parents, her siblings, resented this.

There is no push button answer. Most books on childlessness are written NOT by people who are childless, but by psychotherapists who are mothers. We need to be able to speak for ourselves, to be heard. The Internet is a great resource lately, but these blogs weren’t around four years ago, when my friend was going through this.

3. You say that 44 percent of women in their childbearing years don’t have children, and some never will. And “while the world is rightly concerned with family issues, the constant focus on motherhood can make it easy for a childless woman to feel that she is less than a woman, that in failing to reproduce, she as failed at life.” Poignant and powerful words. I agree with you. So what can the infertile woman do to feed and nurture herself in a family-oriented world? And especially the infertile woman who suffers from depression? What have you done to sustain your sense of self?

Christina: I’d like to point out — that 44% figure — is women from 15 to 44. As we all know, those numbers can be exceeded in both directions! This figure includes women who may have a step-child, but no biological child of their own — often by their husband’s choice. Step-mothers often parent, but they don’t get the societal credit for it. I have several friends in this situation.

I can speak for what works for me, which might not necessarily work for someone else. First, I write, which is not a replacement for having a child of one’s own, but a distraction, pleasure, obsession, assertion, as well as a way to vent. I am lucky that many of my depressions have been cured by travel, a change of scene, whether a day in New York or a yoga retreat. I get out in nature, I pray and meditate.

The tough thing is, sometimes you pray and you get the answer you don’t want. You can have faith, and the thing you want can still be denied you. Once someone said to me, God has another plan for you. I’ve always had to be very flexible, so I’m O.K. with that. I went to a faith healer once, and she warned, The outcome may not be what you want.

Going to places of religious worship can be very difficult — the Catholic church has respect for the celibate childless (of course!) nuns and priests, and for families, but the message is never good for childless married adults. The message is always, if you believe, God will give you this. But it’s not always possible. I always have to explain to people that I’m not even eligible to adopt, due to health and financial circumstances. Clearly, it is God’s will for some of us to remain childless.

Some years ago, I remember being at the Catholic church at Easter, and while in previous years it had been hard not to feel left out and maligned, both by the sermon and the other congregants, I had a still moment, looking at the decorated ceiling, and I got this message from God, at first this faint tingling glimmer, then a feeling of certainty, that it was O.K. for me to be exactly as I am.

But I constantly have to remind myself of this, because the outer world isn’t telling me that. I remind myself that I have two aunts who didn’t have children, and have had full and happy lives and very enduring marriages, like my own marriage. They were always good role models growing up. I had two uncles who were priests — one, still teaching at 75, took my older sister and me off my mother’s hands to all the Disney films. The other, who sadly passed away a few years back, used to take us on swimming outings to Sherwood Island, a large state park in Connecticut. It was too much of a trip for my mother, who had younger children, work, and her own parents to take care of.

I remind myself how valued these and other childless people were and are in my life. My best teachers, bosses, colleagues, doctors, lawyers, friends — have often been childless. They have a lot more to give, and they give it freely.

I’d like to tell infertile and/or childless people to just tune out the craziness! A few years ago I read a story about then-57 year old, former Good Morning America host Joan Lunden, whose husband had twins by a surrogate, using the eggs from a third woman — and then another set when Lunden was 57. Lunden declared, “I want readers to know this is absolutely O.K. If they’re not her eggs, they’re not her baby.”

Well, I’m not a celebrity, I don’t have a platform like Joan Lunden, but I’d like to float the message that It’s Absolutely O.K. not to do a third world adoption, Foster Care, or a fertility treatment that seems wrong for you on a gut level. But society, and the media especially, needs to start getting the message across that adults without children are O.K. just as they are. I appreciate you giving me this platform.

4. You mention that you have read dozens of blogs as you search online for kinship regarding this issue. Could you share with my readers some of your favorites? Where are the childless hubs online?

Christina: The first I came across last spring was Nymphe: Living Childless and Child Free. The woman who authors the blog is actually childless by marriage, but feels the lack terribly. It’s a very intelligent, deep-thinking forum. Click here for a recent post that addresses some of the complicated spiritual issues of coping with grief.

Another, Coming2Terms.com, is hosted by a woman who confronted fertility issues in her twenties and spent about 15 years going through the IVF mill. She had spent a lot of time on the many fertility blogs during treatments — and found that she needed to create a safe place for people who experienced “the flip side of IVF” that the media seldom talks about.

Finally, Childless By Marriage is pretty self-explanatory! Blogs are probably starting up every day.

In the future I plan to write more for people who live without parenting due to health issues. The media just shows us the woman paralyzed from the neck down who managed to have a baby — with a huge support system, money, etc. Most chronically ill people I know are unmarried and trying to keep a roof over their heads. To become obsessed with having a baby in such a marginal life situation is just madness, but we live in a baby-mad culture right now.

All the discussions of parenthood in the CI (chronic illness) community tend to center on how to get a baby, and get those around you to take care of the baby as well as you. In one discussion blog, a woman wondered if it was wrong to have a child with all her disabilities. Another who’d done so quoted scripture to justify spanking, and spoke of monitoring her children from her bed. I was a voice crying out in the wilderness, when I suggested accepting a childless life as God’s will.

I wrote: “You can develop tunnel vision when you’re in the midst of an infertility struggle.” I want to let other people in my situation know that there’s a light at the end of that tunnel.

I dread winter each year because many of my depression busters require sunny skies and temperatures in the 70s. What does a girl who kayaks and bikes for sanity do in the winter? Lots of things.

Here are a few of them.

1. Give back.

Ghandi once wrote that “the best way to find yourself is to lose yourself in the service of others.” Positive psychologists like University of Pennsylvania’s Martin Seligman and Dan Baker, Ph.D., director of the Life Enhancement Program at Canyon Ranch, believe that a sense of purpose — committing oneself to a noble mission — and acts of altruism are strong antidotes to depression.

The winter months are a good time to do this because the need is greater, the holiday spirit ideally lasts until February, and you don’t have the excuse of attending family picnics, unless you live in California or Florida.

2. Join the gym.

Don’t let the cold weather be an excuse not to sweat. We have centers today called “gyms” where people exercise inside! Granted, it’s not the same — watching the news or listening to the soundtrack from “Rocky” as you run in place as opposed to jogging along wooded paths with a view of the bay. But you accomplish the goal: a heart rate over 140 beats a minute.

The gym is also a kind of support group for me. These women, I’m guessing, are going after the endorphin buzz just like me because alcohol and recreational drugs don’t do the trick anymore. And, like moi, I suspect that they also have great difficulty meditating. Every time they close their eyes, they have visions of screaming kids, Chuck E. Cheese hell, and the crisis of no thank-you gifts for teachers.

3. Use a light lamp.

Bright-light therapy — involving sitting in front of a fluorescent light box that delivers an intensity of 10,000 lux — can be as effect as antidepressant medication for mild and moderate depression and can yield substantial relief for Seasonal Affective Disorder.
I usually turn on my mammoth HappyLite in November, just after my least favorite day of the year: when Daylight Saving Time ends and we “fall back” an hour, which means that I have about an hour of sunlight to enjoy after I pick up the kids from school.

4. Wear bright colors.

I have no research supporting this theory, but I’m quite convinced there is a link between feeling optimistic and sporting bright colors. It’s in line with “faking it ’til you make it,” desperate attempts to trick your brain into thinking that it’s sunny and beautiful outside–time to celebrate Spring!–even though it’s a blizzard with sleet causing some major traffic jams.

Personally, I tend to wear black everyday in the winter. It’s supposed to make you look thinner. But the result is that I appear as if and feel like I’m going to a funeral every afternoon between the months of November and March. This isn’t good. Not for a person hardwired to stress and worry and get depressed when it’s cold. So I make a conscious effort to wear bright green, purple, blue, and pink, and sometimes — if I’m in a rush — all of them together!

5. Force yourself outside.

I realize that the last thing you want to do when it’s 20 degrees outside and the roads are slushy is to head outside for a leisurely stroll around the neighborhood. It’s much more fun to cuddle up with a good novel or make chocolate chip cookies and enjoy them with a hot cup of Jo.

On many winter days — especially in late January and early February when my brain is done with the darkness–I have to literally force myself outside, however brief. Because even on cloudy and overcast days, your mood can benefit from exposure to sunlight. Midday light, especially, provides Vitamin D to help boost your limbic system, the emotional center of the brain. And there is something so healing about connecting with nature, even if it’s covered in snow.

6. Hang out with friends.

This seems like an obvious depression buster. Of course you get together with your buddies when your mood starts to go south. But that’s exactly when many of us tend to isolate. I believe that it takes a village to keep a person sane and happy. That’s why we need so many support groups today. People need to be validated and encouraged and inspired by persons on the same journey.

And with all the technology today, folks don’t even have to throw on their slippers to get to a support group. Online communities provide a village of friendship right at your computer. Every day I read comments like this one from Beyond Blue member Margaret: “Membership in this club to which we all unwillingly belong isn’t something I would wish on anyone; nonetheless, reading how others have survived specific circumstances has given me hope where I’d lost sight of it and inspired me to keep on keepin’ on even when my feet feel as if they’re encased in buckets of cement and will pull me under the stagnant water in the bottom of the pit.”

7. Head south.

Granted, this solution isn’t free, especially if you live in Maine. But you need not travel like the Kennedys to transplant your body and mind to a sunny spot for a few days. I try to schedule our yearly vacation the last week of January or the first week of February so that it breaks up the winter and so that I have something to look forward to in those depressing weeks following the holidays.

8. Challenge yourself: Take up a project.

There’s no time like winter to start a home project, like de-cluttering the house or purging all the old clothes in your kids’ closets. When a friend of mine was going through a tough time, she painted her entire house–every room downstairs with two different colors. And it looked professional! Not only did it help distract her from her problems, but it provided her with a sense of accomplishment that she desperately needed those months, something to feel good about as she saw other things crumble around her. Projects like organizing bookshelves, shredding old tax returns, and cleaning out the garage are perfect activities for the dreary months of the year. And hey, most of them are free!

My mood can often be lifted by meeting a new challenge — an activity that is formidable enough to keep my attention, but easy enough to do when my brain is muddied. Learning how to record and edit video blogs, for this girl who hates technology, turned out to be great fun. Friends of mine get the same boost by joining Jenny Craig and losing the 25 pounds of baby fat, or exploring a new hobby — like scrapbooking. I try to stretch myself in a small way every winter — whether it be taking a writing class, researching the genetics of mood disorders, or something similar. It keeps my brain from freezing, like the rest of my body.

9. Watch the sugar.

I think our body gets the cue just before Thanksgiving that it will be hibernating for a few months, so it needs to ingest everything edible in sight. And I’m convinced the snow somehow communicates to the human brain the need to consume every kind of chocolate available in the house. We are mammals, yes, so do we think we need an extra layer of fat in the winter to keep us warm? I’m starting to think so.

Depressives and addicts need to be especially careful with sweets because the addiction to sugar and white-flour products is very real and physiological, affecting the same biochemical systems in your body as other drugs like heroin. According to Kathleen DesMaisons, author of “Potatoes Not Prozac”: Your relationship to sweet things is operating on a cellular level. It is more powerful than you have realized… What you eat can have a huge effect on how you feel.”

10. Stock up on Omega-3′s.

During the winter I’m religious about stocking in my medicine cabinet a Noah’s Ark supply of Omega-3 capsules because leading physicians at Harvard Medical School confirmed the positive effects of this natural, anti-inflammatory molecule on emotional health. I treat my brain like royalty — hoping that it will be kind to me in return — so I fork over about $30 a month for the Mac Daddy of the Omega-3s, capsules that contain 70 percent EPA (Eicosapentaenoic acid). One 500mg softgel capsule meets the doctor-formulated 7:1 EPA to DHA ratio, needed to elevate and stabilize mood.

1. Bribe yourself.

A so-called parenting expert that I read last week claimed that bribing your kid to get him to do something was an example of irresponsible and ineffective parenting. I suspect that the same man sits in his quiet and tidy little office cranking out advice like that while either his wife or nanny is home changing diapers and doling out time-outs. Let’s face it, bribing feels like one of the most effective tools to get anyone — your kid, your stubborn mother, your golden retriever, or yourself — to do something.

My running coach used this brilliant method to train me to run 18 miles. Before our run, he hid Jolly Ranchers along our route, every two miles, so he’d say to me when I wanted to stop, “In another half-mile, you get a treat! Come, you can do it!” And like a rat spotting a half-eaten hotdog, I’d run to the candy.

You want to make sure you stick to your resolution? Bribe yourself along the road there: at the one-forth mark, one-half mark, and three-quarters mark.

2. Team up.

Think of the buddy system from the scouts — teaming up with someone means that you have to be accountable. You have to report to someone. Which brings down your percentage of cheating by 60 percent, or something like that. Especially if you’re a people-pleaser like me. You want to be good, and get an A, so make sure someone is passing out such reviews.

Also, there is power in numbers, which is why the pairing system is used in many different capacities today: in the workplace, to insure quality control and promote better morale; in twelve-step groups to foster support and mentorship; in exercise programs to get your butt outside on a dark, wintry morning when you’d rather enjoy coffee and sweet rolls with your walking partner.

3. Throw in a gimme.

This is to ensure on December 31 of next year, you will have succeeded at one goal. So make it an easy one: “Throw out my Christmas sweater with a sequenced reindeer,” “Pitch my golf-ball socks with two huge holes in the toes,” “Give away my Yanni CDs,” “Frame the family photo I had taken two summers ago.” You see where I’m going with this one? Heck, if you list a bunch of gimmes, then you’ll feel even better about yourself come next December.

4. Allow some backtracking.

I think most of us say “to hell with it,” around the third week in January because it takes that long for the brain to realize it is going to need a motherload of discipline to keep the resolution, and our goal isn’t so newish and cool anymore. Like last May, when I decided to eat according to the “Skinny Bitch” diet. I consumed hummus and celery for three weeks straight, feeling fantastic every time I fastened my loose jeans. Then I got really stick of hummus and celery… so sick of them that I still can’t eat them to this day.

We need to go in to our resolution knowing that we are very likely going to mess up in a few weeks, or maybe days, and that’s okay, because for every two steps backwards we make another half-step forward. Technically, then, we can categorize it as “progress.” Moreover, if we lose our black and white thinking, and adjust our vision to see more colors– situations and events in which we can’t just eat celery and hummus– then we’ll be able to hang onto to our resolutions until February, and maybe even June!

5. Wear some resolution bling.

Let me explain this one. It has something to do with my obsessive-compulsive self, and being raised by a lot of nuns who held a lot of rosaries and holy water and other faith objects. I need reminders — ideally 234 of them — to refresh me on goals, promises, and prayers I promised myself or recited in the morning with my coffee. And because tattoos are expensive and well, permanent, I go with jewelry, medals, and beads I can hang on to.

So, for example, my resolution this year is to worry less and trust God more, especially financially: to be a little more relaxed, in general, and to try to let the big guy upstairs deal with it before I take it from him, throwing a hissy fit. This is essentially the Serenity Prayer: to accept the things I can’t change, and to know the difference between the things that I can’t change and the things I can.

So I wear a serenity prayer bracelet, each bead symbolizing part of the prayer. My key chain holds a large cross with the serenity prayer engraved on it, and it makes a jingling sound as I drive, to remind me that the pea-brained fellow in front of me who won’t let me around him is one thing I can’t change.