That’s how I think of the relationship between religion and depression: like the chicken and the egg debacle.

I can’t say which came first in my life, because they were both there from the start. And you need only read through a few of the lives of the saints or walk the exhibition aisles at the Religious Booksellers Trade Exhibit to see that holy people aren’t all that happy much of the time.

How is it that we depressives tend to be more spiritual? Or is it that the more religion you get in your life, the more depressed?

Beliefnet approached me to write Beyond Blue more than five years ago because they learned that so many of their readers suffer from depression. Articles about depression and anxiety were among their most popular.

I believe people with depression are more spiritual because we are more aware of that human restlessness or inner void than our happy counterparts, or maybe we are more restless AND more aware of our unease. And we want to fill that void and settle the restlessness ASAP because it feels about as good as cow droppings on our heads.

So we pray. And we inhale frozen Kit Kat bars. Because both are like sucking on a pacifier to satiate the inner longing temporarily (prayer the preferred method, of course). Until our Prozac poops out (and our brain’s wiring and chemistry changes), and we need another kind of cocktail. At which time some of us head to daily Mass or join religious congregations, and others go to the hospital, and some (like me) do everything and anything as long as it’s not Vinyasa yoga (it hurts).

According to St. John of the Cross–the Spanish mystic who experienced something far worse than cow pies when he was harshly imprisoned in Toledo–the purpose of the dark night is all for love: to become better lovers of God and one another. Furthermore, the dark night takes us from isolation to creativity, from withdrawal to contribution.

“Obscurity and attachment, followed by God-given clarity, liberation of love, and deepening of faith, are consistent hallmarks of the dark night of the soul,” writes Gerald May in his fascinating book The Dark Night of the Soul. “Often this liberation results in a remarkable release of creative activity in the world.”

Consider for a moment the three Teresas (not including me) who experienced dark nights of the soul: Teresa of Avila emerged from hers and became the founder of the Discalced Carmelites, a prolific author, and the first woman Doctor of the Church; St. Therese of Lisieux is so popular, dubbed the “greatest saint of modern times” by Pope Pius X, largely due to her articulation of her crisis of faith in the pages of her autobiography, “The Story of a Soul.” And now, with the publication of some of Mother Teresa’s personal writings, we are learning about the modern saint’s personal agony that fueled her mission and incredible contribution to goodness, hope, and love on earth.

I keep pondering Archbishop Perier of Calcutta’s response to Mother Teresa concerning her darkness:

This is willed by God in order to attach us to Him alone, an antidote to our external activities, and also, like any temptation, a way of keeping us humble . . . to feel that we are nothing, that we can do nothing. . . . My only wish and desire, the one thing I humbly crave to have is the grace to love God, to love Him alone. Beyond that I ask for nothing more.

I’m not sure I agree with him. Because if I did, I wouldn’t have sought treatment in the 58,094 ways I did. I believe God wants me to be as healthy, happy, and productive as possible, and that he’s on the side of recovery, not illness. However, I can’t deny that my depression has been a refiner’s fire, impassioning my faith one profanity at a time. I can’t help compare it to the way a writer-mom, Linda Eyre from Salt Lake City, described motherhood:

We start our mothering careers as rather ordinary-looking clay pots with varied shapes and curves—and march directly into the refiner’s fire. The fire, however, is not a onetime process but an ongoing one. Every experience that helps us to be a little more compassionate, a little more patient, a little more understanding, is a burst of fire that refines us and leaves us a little more purified. The more we filter, strain, and purge through the experience of our lives, the more refined we become.

If I weren’t always so restless, I might be tempted to sleep in on Sundays more often, to listen to music during my run instead of pray a novena. I wouldn’t think to thank the big guy for a day without tears, to bless him for 24 consecutive PMS-free (hormonally balanced) hours. I’d be less aware of the rose gardens I walk by to get to the kids’ school (but also less hyper about the bees on the buds). I’m pretty sure that I’d be less spiritual and less inclined to gorge on dessert.

Photo courtesy of The Guardian.

I have said many places that growing up Catholic, for me, was both a blessing and a curse.

A blessing in that my faith became a refuge for me, a retreat (no pun intended) where my disordered thinking could latch unto practices and traditions that made me feel normal. Catholicism, with all of its rituals and faith objects, provided me a safe place to go for comfort and consolation, to hear I wasn’t alone, and that I would be taken care of. It was, and has been throughout my life, a source of hope. And any speck of hope is what keeps me alive when I am suicidal.

But my fervent faith was also a curse in that, with all of its stuff (medals, rosaries, icons, statues), it dressed and disguised my illness as piety. So instead of taking me to the school psychologist or to a mental health professional, the adults in my life considered me a very holy child, a religious prodigy with a curiously intense faith.

For anyone prone to OCD (obsessive-compulsive disorder), religion can serve as a trap within a sanctuary. For me, my scrupulosity in primary school was like a game of Pin the Tail on the Donkey: I was spun around blindfolded without a clue as to which side was the head and which the butt–which rituals made me crazy and which led to the beatific vision.

Almost every anxiety and insecurity I felt as I kid fed into one fear: I was going to hell.

Therefore I did everything in my power to prevent that. My bedtime prayers lasted longer than those recited by Benedictine monks; by the second grade, I had read the Bible start to finish (a few times by the fourth grade); I attended daily Mass, walking there on my own each day; and every Good Friday I would go down to my dad’s den in the basement and stay there for five hours as I prayed the all of the mysteries of the rosary.

I guess I just thought I was really holy until I landed in therapy my freshman year at college. There my counselor strongly encouraged me to read the book The Boy Who Couldn’t Stop Washing His Hands: The Experience and Treatment of Obsessive-Compulsive Disorder by Judith L. Rapoport, M.D. After I read through its pages I breathed out a huge sigh of relief that I might not be headed towards the burning flames of hell. Its wisdom has stuck with me even today when I get trapped in that OCD-scrupulous kind of thinking.

Like the other weekend.

My daughter received her First Reconciliation. As part of the sacrament, the parents are encouraged to go to confession. I hadn’t been in ten years, so I thought I should go to be a good role model. My religion teachers used to tell us in grade school that you go into confession as a caterpillar and emerge as a butterfly. That wasn’t an accurate description of how I felt. My poor caterpillar was limping, as I felt horribly guilty, disgusted with myself, embarrassed, and every emotion they say you get rid of when the priest absolves you and you feel God’s forgiveness.

I think confession and all the rites of the major religions can be a beautiful thing, and lead to a deeper faith and a sense of love and hope. However, for someone prone to OCD, who constantly beats herself up for every less-than-perfect thing she does, or thought she has, these rituals can become weapons used to further hack away at self-esteem.

Two anecdotes from Rapoport’s book accurately articulate the kind of mental anguish attached to scrupulosity:

Sally, a bright, blonde sixth-grader, had looked forward to her Confirmation. Getting a new dress and having her aunt so proud of her outweighed all the hard work. But a few weeks before the big day she started having crying spells, couldn’t sleep, and lost ten pounds. It all began suddenly, when Sally was doing a class punishment assignment. She thought that she wasn’t doing it properly, that she was “sinning.” I’m always doing something wrong, she felt. The feeling stayed with her. Each day her symptoms became more intense. “If I touch the table, I’m really offending God,” she whispered. She folded her arms and withdrew into deep thought. Sally was terror-struck that she might have offended God by touching her hands. Did that mean that she was striking God? She wondered, retreating further into herself.

Daniel described how hundreds of times each day he would “get a feeling” that he had “done something wrong” and that it displeased God. To avoid possible punishment for these “wrongdoings” at God’s hands, he would punish himself in some way, thus reducing his concern about some more awful punishment occurring at some later time. He would also avoid any actions or thoughts that had accompanied these feelings. This led to the development of complex rules which, in Daniel’s mind, placed prohibitions on his behavior and thinking in virtually every situation of his life.

I have to exercise precaution about going to confession — and participating in rites like it — when I’m feeling really lousy about who I am and can’t get away from the self-deprecating thoughts, just as I refused to fast during Lent when I was trying to tackle my eating disorder in college by eating three regular meals a day. Going without food for 12 hours would have caused a major hiccup in my recovery.

Thankfully there are wonderful resources available today on scrupulosity, and because of the awareness, I think that kids today are better educated on what healthy faith looks like as opposed to a form of OCD. That’s my hope, at any rate.

Image courtesy of publicdomainpictures.net.

In his book, Your Emotional Type, Michael A. Jawer and Marc S. Micozzi, Ph.D. examine the interplay of emotions, chronic illness and pain, and treatment success. They discuss how chronic conditions are intrinsically linked to certain emotional types.

I found the boundary concept they explain in the book — first developed by Ernest Hartmann, MD, of Tufts University — especially intriguing.

The authors define boundaries as more than a measure of introversion or extroversion, openness or close-mindedness, agreeableness or hostility, and other personality traits. According to them, boundaries are a way to assess the characteristic way a person views her/himself and the way he or she operates in the world. To what extent are stimuli “let in” or “kept out”?

How are a person’s feelings processed internally? Boundaries are a fresh and unique way of evaluating how we function.

For example, thin boundary people are highly sensitive in a variety of ways and from an early age:

• They react more strongly than do other individuals to sensory stimuli and can become agitated due to bright lights, loud sounds, particular aromas, tastes or textures.

• They respond more strongly to physical and emotional pain in themselves as well as in others.
• They can become stressed or fatigued due to an overload of sensory or emotional input.
• They are more allergic and their immune systems are seemingly more reactive.
• And they were more deeply affected — or recall being more deeply affected – by events during childhood.

In a nutshell, highly thin boundary people are like walking antennae, whose entire bodies and brains seem primed to notice what’s going on in their environment and internalize it. The chronic illnesses (including depression) they develop will reflect this “hyper” style of feeling.

Thick boundary people, on the other hand, are fairly described as stolid, rigid, implacable or thick skinned:

• They tend to brush aside emotional upset in favor of simply “handling” the situation and maintaining a calm demeanor.

• In practice, they suppress or deny strong feelings. They may experience an ongoing sense of ennui, of emptiness and detachment.
• Experiments show, however, that thick boundary people don’t actually feel their feelings any less. Bodily indicators (e.g., heart rate, blood pressure, blood flow, hand temperature, muscle tension) betray their considerable agitation despite surface claims of being unruffled.

You can take the boundary quiz for yourself at the authors’ website: www.youremotionaltype.com.

Jawer and Micozzi then offer some alternative therapies that work best for your type. I would use these in addition to the traditional therapies already working for you. For example, I think it would be very irresponsible of me to go off Lithium and try acupuncture alone. However, some relaxation technique in addition to my medication treatment and other tools I already use (swimming, light therapy, fish oil) might do me some good.

Do we know anyone without it?

I mean, yes, some people don’t admit to having it. But it is assumed these days that if you have a pulse, you have anxiety.

One of my best teachers on this topic is Tamar Chansky, a clinical psychologist and one of the nation’s leading experts on anxiety disorders. She is the acclaimed author of several books, including Freeing Your Child from Anxiety, and the founder and director of the Children’s and Adult Center for OCD and Anxiety.

I am a huge fan of her work. I think I was introduced to it by my therapist, when I was terrified that my son would end up with a brain like mine. And then, through blogging, I came to know Dr. Chansky on a personal level, and she has impressed me even more so, because she communicates in a language I can understand! It’s great!

Her first few books were geared toward children’s anxiety and negative thoughts, but the same wisdom she offers for kids works for adults too. In fact, I have always applied her kids’ advice to me.

Now I don’t feel embarrassed about that! Because this month she has come out with her first book for adults, which I have found incredibly helpful: Freeing Yourself from Anxiety.

So it is my honor to interview her for my readers. Please check out her book if you are struggling with anxiety or know someone who is.

1. Why are we all so anxious? Is it just a product of modern life, or is there something we can do about it?

There’s a quote I came across while writing the book that said, “It’s not that the news has gotten worse; it’s that the reporting has gotten so much better.” Our general anxiety level has risen as a culture, in part due to recent events in history. For example, the recession, the events of 9/11, and the news- and media-saturated lives we lead keep our pulse running a little higher as we practice imagining disaster on a daily basis. That starts to spill over to daily life, and it takes less to get us very stressed. That’s why there has never been a more important time for all of us to learn ways of lowering our baseline level of anxiety.

2. These strategies seem interesting for everyday worries, but what if someone is facing cancer or a layoff—can these strategies really apply?

Absolutely. What’s so interesting about anxiety is that regardless of the actual magnitude of the problem we’re contemplating, the mechanisms of anxiety are the same — we focus all of our attention on the most extreme or unlikely scenarios, leaving us feeling helpless to take any steps to help ourselves. So especially when readers are facing actual challenges, they need these strategies more so that they can stop wasting precious time and emotional energy rehearsing some future disaster that won’t likely occur, and can use those valuable resources on their behalf right now.

3. You talk about distinguishing between the “worry story” and the “story of your life.” That makes it seems like our lives are “made up.” What do you mean by that?

The events in our lives—the triumphs and struggles—are not made up. But the narrative or the story we tell ourselves about them—whether we read them as opportunities or insurmountable conditions or even dead ends—that’s up to us. There are always options. As consumers, we would never accept the “first offer” from a car salesperson or feel compelled to buy the first thing we see at a store. Similarly, people need to learn how not to fall for their first take on a situation, understanding that such gut reactions come from the fast but inaccurate survival-oriented brain. Instead, they can learn to set the “worry story” aside and reach for other more adaptive, accurate, and useful interpretations and angles on what’s actually happening in their lives.

4. Your subtitle mentions four steps. What are they, and how are they used?

Worry gets its power from operating stealth, taking much more authority than it warrants merely by the powerful sounds and statements it makes. Step one, Using Your Caller ID, means relabeling or stamping the thought with the appropriate tag — determining if it’s 1-800-Worry-Me talking to you or your trusted Voice of Reason.

Step two, Getting Specific, means taking the overwhelming first impression of the problem and narrowing it down to the real risk or matter at hand.

Step three, Optimizing, means not giving up but backing up and getting perspective; now that you’ve narrowed down the problem, call in experts or other perspectives to give their take on the situation. Step four, Mobilizing, means getting moving; you’ve defined the problem and see your options—and now you can go from theory to practice and start making changes in your life.

5. You say that we can “save ourselves the trip” when it comes to worry. What do you mean by that?

Worry is a detour off the track of what we need to do, and it generally isn’t a helpful one. Worry is notoriously unreliable, exaggerated, and distorted. Truly it’s exactly the things we don’t need to worry about. Rather than go miles down that road of unlikely scenarios and having to reassure ourselves back from the edge of the cliff, if we immediately recognize the sound of worry — the oh no’s, the what if’s — and respond instead with you again or the like, we can save ourselves from having to go to the edge and back every time a worry comes up.

6. What if people have been worriers all their lives? Can they really change?

The short answer is yes. Neuroplasticity is the idea that the brain is constantly changing and adapting in response to our activities. Look how we’ve all learned to type as a result of email and texting. The brain gets busy with whatever it’s used to so, yes, for some of us we’ve gotten used to worrying—we’re experts.

At the same time, as we learn to devalue the importance of worry, even see it as detrimental, rather than thinking that it’s an important part of being “prepared” or “in control,” we can start to change our reaction. We can switch gears over to rational thinking. It feels much better. In time, as we change our reaction, the brain learns how to do that too. This adaptive response in the face of uncertainty or fear becomes the new default reaction so we don’t have to work as hard to find it. Rational thinking or our voice of reason is now on our speed dial.

So when I received Cameron’s latest book, The Prosperous Heart, I was intrigued and started to read. She attempts to address the practical side of the creative life. To be honest, I’m not sure she succeeds. But that could be my jaded disposition at the moment.

Back when I was making good money writing (before the publishing industry fell into the toilet), creativity produced income and was both fun and practical. Now it is a luxury, and one that stresses me out a lot of the time. It’s difficult to move from a press release about Semantic Web technology into a reflection on my spiritual journey. At any rate, I do think a creative outlet is a helpful tool in keeping a resilient spirit. So may you find wisdom with this book!

Here is a short interview with the author.

Your books, lectures, and workshops have founded a movement that has enabled millions to realize their creative dreams. How does The Prosperous Heart address the practical side of living a creative life?

When I teach, I consistently find that the most “loaded” topic for my students is money. I wanted to write a book that would give my students the tools to address their money issues directly while maintaining spiritual balance and an active creative life.

Creating a life of “enough” is one of the main themes of The Artist’s Way. What does “enough” mean?

So much of our mythology around money centers on the illusion that if we had “more,” we would be more comfortable and more able to access our creativity. But creativity and prosperity are spiritual matters, not fiscal ones. The tools of The Prosperous Heart help people to embrace the life that they actually have, where they often find that they already have “enough.”

In this difficult day and time, what can people do to find prosperity?

There are two very practical tools used by my students. The first one is Morning Pages, where they track their dreams, their disappointments, dreams and desires. The second tool is Counting, where they record money in and money out. We often find we are spending money in ways that do not serve us. As we work with these two consciousness-raising tools, we find ourselves spending along the lines of our true values. As a result, we feel we have “more.” We certainly have enough.

Did you set out to create a prosperity plan for yourself?

Yes. I have a personal prosperity plan. I know where my money goes, and how I can spend it more fruitfully. A prosperity plan is something fluid that may alter month to month.

Do you feel clutter plays a role in blocking creativity and prosperity?

Yes, absolutely. When we clear the physical clutter from our lives, we literally make way for inspiration and “good, orderly direction” to enter.

As a novelist, playwright, songwriter, journalist, teacher, and poet, what are your favorite artistic venues?

I have to say that my favorite venue is whatever venue I’m working on at the time. Right now I’m working on a sequel to my novel, Mozart’s Ghost.

Photo credit Aloma.

Being that my new year’s resolution is to be more content with living with the questions in my life versus rushing towards the answers, I found useful the advice in Allan Lokos’s new book, Patience: The Art of Peaceful Living.

Lokos is the founder and guiding teacher of the Community Meditation Center in New York City, and the author of Pocket Peace: Effective Practices for Enlightened Living.

Here are the three themes that I found most helpful in his book.

1. See things as they are.

Writes Lokos:

In the Buddhist tradition, wisdom is said to arise when we see things as they really are, not as they appear to be. Yet to transform our usual views, opinions, and perceptions so that we can see the true nature of things can be a challenging process. It is a part of our journey that can require great patience both with ourselves and with others. Wisdom is all too often painfully earned. As Confucius said, “By three ways do we attain wisdom. The first is by contemplation, which is the noblest; the second is by imitation, which is the easiest; the third is by experience, which is the bitterest.” Seeing things as they really are, rather than through the distorted lens of conditioned perception, can be challenging to the intellect as well as to our patience.

2. Give up control.

Yeah …. right! But I found his words really do help you breathe a sign of relief … as if your job to control everything in your world has been lifted and assigned to someone else, so that you don’t have as much responsibility and don’t bear as much weight in your daily stuff. Per Lokos:

We have much less control than we might think over causes and conditions that converge to bring about the ever-changing circumstances of our lives. The events of every moment come about from the contingent factors that precede them. Nothing exists by itself; everything is interconnected. We can often see the short-term connections, butt the bigger picture, the universal law of cause and effect … is often obscured to the untrained, unfocused mind. With practice we can learn to put full effort into our actions without our happiness being dependent upon the ensuring results. To do this requires a clear understanding of our intention as well as insight into the connected nature of all phenomena.

3. Forget power, fame, and money.

This one was refreshing for me to read because it ties into a reflection by spiritual author Henri Nouwen that I read every morning to set me straight:

Somewhere deep in our hearts we already know that success, fame, influence, power, and money do not give us the inner joy and peace we crave. Somewhere we can even sense a certain envy of those who have shed all false ambitions and found a deeper fulfillment in their relationship with God. Yes, somewhere we can even get a taste of that mysterious joy in the smile of those who have nothing to lose.

If you’re lucky, you have a few friends like that. I do. And when I read this meditation every morning, I picture their faces, and suddenly the need to get promoted at work or acquire some recognition for my blog disappears, and I feel okay with me even if I stay in a cubicle and take orders as best I can. I don’t need to be a queen to be happy. In fact, that responsibility could make me miserable.

Lokos’s work was just recognized by the New York Times in an article right before Christmas that concentrated on coping with travel stress. I found that he five pointers he lists for anxious travelers also work for mundane tasks throughout the day. Here they are:

Q. What are five things travelers can do to self soothe while en route?

A. 1. Accept the reality that most of what causes stress in travel is out of your control. In fact, you have much less control of things in general than you might like to believe.

2. Feeling rushed is one of the leading causes of stress. Go to airports and bus and train stations extra early. While others may be rushing frantically, you can be strolling leisurely.

3. Check in with yourself. Notice what you are feeling in a particular moment. If it’s annoyance, frustration or fatigue, don’t get all caught up in it. Don’t cling to the sensations.

4. Travel lightly. When I arrive at my destination for the holidays I announce to everyone, “I hope you like this sweater I’m wearing because you’re going to see it a lot.” And mail rather than carry gifts. Even one shopping bag is a nuisance.

5. Those around you are doing their best. Offer a smile that says, “Yes, I know it’s difficult, but we’ll all get there.” Perhaps a little later than scheduled, but you’ll get there. Let someone go ahead of you; it’s part of the holiday spirit.

How are you planning on cultivating patience in your own life?
Do you see yourself putting any of these tips into practice?

Even though I’ve written about this in several previous posts, I fail to remember the pointers when I’m there myself. My present mood dip isn’t a mammoth relapse, thank God. But it is enough of a wake-up call to go back to the building blocks of my recovery program and see if something is missing, or — even if I’m doing everything right — find a few more tools that can help me get to a better place.

I list them here as much for myself as for you. Here are 9 tips that may help you get yourself out of the rut, before you dig in deeper.

1. Go easy.

Even though I’ve read the saying “Easy Does It” in needlepoint for 22 years on the walls of twelve-step support groups, those three words have yet to sink in. The only time I stop to consider their wisdom is when I’m hurting and I have to go slower because I can’t function at regular speed. I’m trying to become as gentle with myself as I am with others, but the progress is slow.

Whenever I do manage to take the pressure off of myself in any way I can — by giving myself a longer deadline on a piece, or scratching out all items on my “to do” list that can wait until next week — I breathe a much-needed sigh of relief.

2. Cry.

I fight tears because I associate them with relapse. At the worst of my depression, I cried enough buckets to take care of “water day” at the kids’ school for at least a decade. So whenever the wetness begins, I try my best to interrupt the process.

However, tears have healing faculties, as I explain in my piece, “7 Good Reasons to Cry Your Eyes Out.” Your body essentially purges toxins when you weep. It’s as if all your emotions are bubbling to the surface, and when you cry, you release them, which is why it is so cathartic. Whenever I allow the tears—a 10 or 15-minute crying fit—I always feel better.

3. Help someone.

This one is tough when you’re not feeling well yourself, but I’ve never walked away from an act of charity feeling worse. I think it has something to do with tricking your mind and body (and the person you are helping) that you actually have your stuff together, so together, in fact, that you are able to offer assistance. I suspect God plops people in front of you that need your help when you want to do nothing but crawl back in bed and ruminate. At least that’s how it happens to me.

In the process of extending my hand, I am reminded that, although I feel alone in my pain, almost every human being is suffering in some form or another, and that if we see our pain as part of the collective pain of human suffering, we have each other and are in it together.

4. Keep doing what you’re doing.

Um. Duh? Yeah, okay, this one is kind of obvious, but really freak’in hard when getting through a simple task feels like competing an Ironman… in crutches. When I’ve got that familiar knot in my stomach — which feels as if I have just robbed a bank and must to confess it to the priest that scares the hell out of me at church — I try to break up my responsibility into miniscule pieces.

If I think, “You have to compose three erudite, substantial blog posts today,” there is a likelihood that I will throw up or at least not be able to eat all day. But if I say, “In the next half hour, you have to construct three simple sentences,” I’m much better off because that I can do. So instead of throwing my arms up and yelling, “To hell with it!” I can take baby steps and do the thing that I am doing.

5. Look for signs of hope.

Here’s where I sound like a scrupulous, devout, whacked-out Catholic, which is somewhat true, although I don’t wear my hair in a tight bun or have anything to do with polyester. It’s just that I need signs of hope. All around me. Because it’s so easy to sink into despair and sadness and hopelessness. But if you have something small in front of you — for me, it’s rose petals — that signifies hope, then you can always make that jump from darkness to light, even while sitting at your desk.

6. Repeat your mantras.

My mantras change everyday. Today I am going with “You are okay,” and “You are loved by God.” Sometimes I utter them in between sentences, while I try to breathe in deeply and exhale. I almost always repeat mantras while I’m in the car, because it keeps me from shouting something nasty at the car in front of me. They do help.

7. Remember victories of past and present.

I will also list — either on a sheet of scrap paper or on the gray matter of my brain — a few victories in my recent history: recovering from a devastating depression that almost took my life, 22 years of sobriety, maintaining a career despite profound mood fluctuations, and celebrating 15 years of marriage, when the divorce rate among bipolars is estimated to be as high as 90 percent. All those things I have done, which is why whatever it is that’s going on now won’t keep me down.

8. Pray.

I don’t know if prayer helps. I mean, I can’t prove it. But it certainly makes me feel like I’m doing something proactive, a small thing that could very well help my odds of feeling better. And, like a placebo, having trust in some benevolent deity is going to be beneficial even if there isn’t a benevolent deity. But I do think there is. It goes back to hope — the golden rope out of the pit of despair. If we can keep a grip on that rope, we can never fall too far back.

When all else fails, pray the Serenity Prayer. Ask God for the strength to accept the things you can’t control: your great aunt’s genes that predispose you to more turbulence in your life than you would like and neural circuits that are firing at each other like the Union army against the Confederates in the American Civil War. Ask God for the courage to change the things you can: surrounding yourself with people when you want to shut out the world for a year; eating almonds, spinach, and salmon for lunch (with lots of Omega 3s) instead of the delicious chocolate cake that is sitting on the kitchen counter; and making an appointment with your shrink to sort out what’s going on. Most importantly, ask God for the wisdom to know the difference.

9. Surround yourself with people.

This one is counterintuitive, as well. The last thing you feel like doing is talking to a person. You might be fine conversing with a computer, a mug of coffee, or a bowl of cereal. People are somewhat unappealing. Unfortunately, isolation never helps you feel better.

I have conducted studies of my own life. I always think isolation is the only thing to do, but my brain is just craving it much like my stomach craved a Big Mac when I was pregnant. Whenever I followed through with that one, the flame-broiled thing (or is that Burger King’s invention?) caused me serious heartburn. When you force yourself into a circle of people there is a slight chance of your forgetting how miserable you feel. Not guaranteed. But possible.

Related:

• 12 Ways to Keep Going

• Getting Through the Rough Spots
• 12 Strategies to Help You Recover From Relapse

You may be grieving the death of a loved one, or the end of a friendship you had hoped would be more, or merely the realization that your father will never be able to give you what you need from that relationship. It seems as though every moment of this life is about letting go, of something or someone that is renting far too much space in our heads. And while there is no way I’d call myself a “let go” expert, I have done a considerable amount of research in this area. So the following are some techniques that … well… will at least get us started.

1. Live in the present.

One of the most beautiful descriptions of grief I’ve ever heard was from Owen Stanley Surman, M.D., a practicing hospital psychiatrist who lost his wife and wrote a memoir about it, “The Wrong Side of an Illness: A Doctor’s Love Story.” In my interview with him awhile back, I asked him how, exactly, does a person concentrate on the moment and know that love is a precious gift not to be taken for granted. He explained:

In Lezlie’s passing, I began to live in the present. Tragedy had cast a spotlight on the beauty of life and the power of love. In Swan’s Way, I learned from Marcel Proust that the past resides in what one has shared in love. Lezlie was with me. Given an opportunity to present at a conference in Jerusalem I explored the Via Dolorosa. At the 12th Station of the Cross, I gazed at the extraordinary crucifix and lit a candle. “Lezlie,” I said amid an outpouring of soul wrenching tears, “This one is for you!”

2. Trust the process.

So much of letting go is finding the right timing. You let go too prematurely, and your process is going to be harder and more time-consuming than it needs to be. You wait too long and things spoil… the relationship or the project. In Dennis Merritt Jones’s book The Art of Uncertainty, he includes this great quote about timing by Gary Zukav:

Fruit drops from the tree when it is ready. Staying too long, or moving too early, misses the mark. The mark is the appropriateness that causes the fruit to fall when it’s ready…. The process has its own timing, and it creates changes in your life when those changes need to happen.

3. Expect regression.

The act of letting go for me is less overwhelming when I go into it knowing that there will be days that I’m clinging for dear life to that person, place, or thing from which I need to detach, or “non-attach.” If I can go into this process recognizing the three-steps-forward, two-steps-back pattern, then I won’t fret when my footsteps start reversing, and I can celebrate any progress I have made.

4. Lose control.

If you think about it, we have trouble letting go because it requires relinquishing control. That’s frightening for a person like me who wants to hold the reins 24/7 so that I know exactly what’s coming next. Non-attachment is about swapping the things we know and can control for those things we don’t know and can’t control. But we must remind ourselves that just because we have never met them before, and are not familiar with them or their relatives, does not mean they are inherently bad or harmful. We essentially have to close our eyes and trust that we will find our way to a new, potentially better place. And that God will provide plenty of guides.

5. Make room.

My mom had a rule growing up that for every article of clothing that came into the house, one had to go out. The result was that my childhood closet didn’t look like my bedroom closet today. It was a tad tidier … a tad. This exercise was a simple ritual of making room for something new. If we can see the letting-go process as a transition to a new beginning, one full of potential and prospects–much like getting a nursery ready for a baby– then we can shift some of our energy and concentration from loss to opportunity. As Joseph Campbell says, “We must be willing to let go of the life we have planned so as to accept the life that is waiting for us.”

6. Break up the pain.

In Elisha Goldstein’s book, Mindful-Based Stress Reduction Workbook, he teaches you how to meditate through pain. Much like a woman does in labor—if you can break up the cycle of pain into pangs of acute pain, followed by interludes less-intense pain, then you can begin to manage it, and breathe through it. I have found the same with swimming. I will be sprinting, trying to make a short interval, and then I get two lap to regain my breath. If you process letting go that way, you can enjoy the brief reprieves between the periods of intense pain.

7. Identify false beliefs.

This one is geared more for those letting go of a toxic relationship. Inevitably we hang on to false beliefs about the person or about the relationship that impede the detachment process. In the past, when I’ve had to let go of an important friendship, I remind myself to focus on the facts, not the feelings. Her actions communicated a very clear message, even if I don’t want to accept that. At one point, I would write down the events so that I wouldn’t forget the hurt I felt when she would come back around and want to be my friend again.

Check out Beliefnet’s beautiful gallery here.

So that would explain why the holidays are so stressful. Those dear relatives who live in San Francisco suddenly are lingering in front of your refrigerator in Cincinnati, Ohio and you have to figure out a socially acceptable way of setting the table together, resisting the urge to re-expose the childhood wounds that you’ve learned to protect.

Here are a few tips I use in interacting with those family members who tend to wake my grumpy inner child, triggering an ugly tantrum right about the time Santa shows up with his loot.

1. Repeat: It’s Not About Me

You think it’s about you when your brother calls you a “selfish, lazy, son of a something,” but actually it’s not. He may point his finger at you and say, “You. I’m talking about you.” But he’s really not. He is seeing something that has nothing to do with who you are.

Don Miguel Ruiz says this in his classic book, “The Four Agreements”: “What they say, what they do, and the opinions they give are according to the agreements they have in their own minds…. Taking things personally makes you easy prey for these predators, the black magicians…. But if you do not take it personally, you are immune in the middle of hell.”

That’s good news for all of us who make a habit of taking everything personally. It frees us to be ourselves, even when charged with a character flaw backed by supposed evidence.

2. Befriend Yourself

Much of the dysfunctional dynamics tolerated during the holidays are rooted in the painful memories of the past. So I go back to the place in history where I first acquired my scars. I return to the original story—for example, as a fourth grader depressed and anxious who has just learned her dad left home—and comfort that scared child as my adult self. I might say to her, “It’s not about you. His leaving has nothing to do with who you are. You are loved. You are enough.”

When I feel the similar pangs of abandonment or rejection coming on over the holidays, I address the kid as would a loving adult. Once you get good at this, you can be a friend to yourself, which comes in handy if you have no direct support in your immediate family. Talk to the pissed off third grader who was just picked last at gym, and tell him that the bullies making fun of him now will all grow up to be losers with disgusting beer guts.

3. Make a plan

You would be wise to start strategizing before the doorbell rings about where you are going to sit, what conversations you will have, how you will respond to sensitive issues, and boring questions you can ask to fill the uncomfortable voids. You might invent five or so canned retorts to be used when unjustly interrogated, or compile a list of necessary exit plans should you reach the about-to-lose-it-in-a-big-way point. Visualizations can also help. For example, picture yourself inside a bubble, with an invisible layer protecting you from the toxic stuff on the outside.

4. Carry a blankie

You don’t have to give up your blankie when you’re two. Just your pacifier. To give me an extra shot of strength to make it through certain family functions, I carry a token in my pocket: a necklace a friend made for me that says, “Seeking Wisdom,” a key chain with the Serenity prayer engraved on it, my St. Therese medal that I squeezed during the two years of my deep depression, my sobriety chip to remind myself of the years I’ve managed without booze, a favorite prayer, or a photo of my Aunt Gigi or another mental health heroes. I will use everything and anything that reminds me that I am okay the way I am, and to trust the process, even though it feels mighty uncomfortable at the present hour.

5. Wait before speaking

If everyone waited two seconds before emitting toxic emotions into the environment, we might have world peace. We’d definitely have fewer automobile accidents, and then maybe all of us could afford automobile insurance! In the pregnant pause between thinking and speaking, your neurons make the essential leap from the amygdala, or fear center of the brain, which processes stimuli like a hormonal teenager, to the more evolved and sophisticated part of the brain.

Before the pause: “I’ve always guessed that you were an idiot, and you’ve just confirmed that.”

After the pause: “I’m sorry … I have to run to the restroom … but hold that thought … or, actually, don’t.”

6. Allow time to recover

Even if you’ve practiced your visualizations, arranged a safe seating chart, devised seven respectable responses to expected questions, and filled your pockets with blankies, you may come away from an evening with difficult family members feeling shattered, bruised, and deflated. That’s normal! As my therapist recently said to me, “Just because you anticipate and prepare for the blows doesn’t mean the blows won’t hurt.” Therefore, allow some needed recovery time after the dinner or weekend or, if you’re really unlucky, week of family feud.

Today I read a meaningful email by someone who had read my book. She said it was the passage on page 120 to 121 that provided the epiphany moment she needed to seek help for her mood disorder.

I was curious to see what was on these pages, so I got a copy out and read this…

Trying too hard was precisely my problem. It was the “mind over spoon” [trying to bend a spoon with my thoughts like the famous psychic Uri Geller does] issue again. In my mind, I was failing because I couldn’t think myself to perfect health. I couldn’t do it all myself.

Dr. Smith salvaged the last crumb of my self-esteem with this compassionate statement: “Mindful meditation, yoga, and cognitive-behavioral therapy are extremely helpful for people with mild to moderate depression. But they don’t work for people such as yourself who are suicidal or severely depressed.”

Her advice was grounded in neuroscience.

One research study at the University of Wisconsin-Madison, in particular, used high-definition brain imaging to reveal a breakdown in the emotional processing that impairs the depressive’s ability to suppress negative emotions. In fact, the more effort that depressives put into reframing thoughts–the harder they tried to think positive–the more activation there was in the amygdala, regarded by neurobiologists as a person’s “fear center.” Says Tom Johnstone, Ph.D. the lead study author at the University of Wisconsin: “Healthy individuals putting more cognitive effort into [reframing the content] get a bigger payoff in terms of decreasing activity in the brain’s emotional response centers. In the depressed individuals, you find the exact opposite.”

And then Dr. Smith asked me this: if I had been in a terrible automobile accident would I be so hard on myself?

“If you were in a wheelchair with casts on each of your limbs,” she said, “would you beat yourself up for not healing yourself with your thoughts? For not thinking yourself into perfect condition?”

Of course not.

When I injured my knee while training for a marathon, I didn’t expect myself to visualize my tendonitis away so that I could run. I dropped out of the race to rest my joints and muscles so I wouldn’t further damage them.

Yet I expected myself to think away my mood disorder, which involved a disease in my brain, an organ just like my heart, lungs, and kidneys.

“What’s most important is to find a medication combination that works so that you can be able to do all that other stuff to feel even better,” she said. “I will give you a list of books you should read if you want to study depression. Until you feel stronger, I suggest you stay away from the type of self-help literature you have brought it because those texts can do further damage if read in a very depressed state.”

I have drifted a long ways from that wisdom.

I am back to trying to bend the damn spoon. Forcing it with all my strength.

Back in August, I nearly died because I believed that I could fix a ruptured appendix with my thoughts. I held off on doing anything about the severe abdominal pain for a day or two because I was sure the agony was all in my head, and that if I convinced myself I wasn’t in pain, then I would start to feel better.

“I’m definitely on the road to recovery,” I explained to my husband keeled over at the kitchen table. Thank God he insisted I call my doctor, because I would be still be trying to bend that spoon in the afterlife had he not been there to knock some sense into me.

A few weeks ago I was encouraged to get a biopsy for the growing lump that my endocrinologist found in my thyroid. I was disappointed that the result was negative.

This should alert the average person that something might not be right. But for me, that only meant I had to try harder and swim more laps, run more miles, sit longer under my HappyLite, and carve out more time for prayer. The death wish translated to my carelessness about letting some component of my recovery plan slide. There was no thought of calling my doctor.

Ironically, the pressure I put on myself to think right and to feel right is aggravating the healing process and making me feel much worse. Just as the University of Wisconsin neurobiologists explain, my amygdala is over activated, on fire, and is in a reckless pursuit of controlling everything and anything it encounters.

So here’s a good reminder to you, and especially to me, that your thoughts can only help you so much. They cannot piece together your appendix, or fix your knee tendons. There are things like biochemistry and faulty brain circuits, cell death and susceptibility genes, and many organic structures of the brain that need to be taken into consideration, so that we all don’t perish as we stare at the spoon.

Here are eight tips intended to keep you from hurling the mistletoe at Uncle Fred because he asked for the butter in the wrong tone of voice.

1. Find your kind of people

The good/bad news of holiday depression is that so many people suffer from it that it’s easy to find a person with whom to relate. It’s unfortunate that one-fourth of the US population would prefer to skip the month on December. However, this means that people who hide from carolers are certainly not alone—and, if they join up with the folks chucking holiday letters in the trash unopened, they will feel a companionship that can definitely lift their moods. The trick is identifying this 25 percent.

Here’s a hint. They are typically the ones who don’t say much after the question, “How are you?” Or, if they do, their response is something like, “Okay… How are you?,” which is code for “How the hell do you think I am?” Stick with them.

2. Embrace your inner slacker

Stress is usually the biggest culprit behind the holiday blues. Stress does bad, bad, bad things to your body, places toxins into your bloodstream, whacks out your heart and other organs. It produces hormones that can change your personality from that of June Cleaver to Sybil.

So your biggest chance at combating holiday anxiety and depression is to eliminate as much stress as you can. And at that statement you just rolled your eyes, like I do every time my mom or my husband says that to me. I look at my to-do list and each item whispers, “You can’t cut me. You need me, remember?”

That’s when I take the red pen and start marking up the page. Christmas cards. Do I REALLY need to send 250 of them? No. Do I even need to send 50? Not really. Let’s put that on the “Would be nice if I have time” list. In other words, you need to embrace your inner slacker, and tell her that you need her help this holiday season.

3. Slow your breath

Slowing down your breath is one of those easy, simple strategies to boost your mood that seems too easy and simple to work. But it does. Because the first thing we do, as a sort of knee-jerk reaction, when we are stressed is speed up our breathing, and start breathing from the chest instead of the diaphragm, which supplies more oxygen to our brain cells. I use the most basic of breathing exercises called the “Four Step” method. You don’t have to do anything but count to four as you breathe in, count to four holding your breath, count to four breathing out, and count to four while resting. Then do it again. If you were unable to follow that, you might want to make an appointment with a professional. If that doesn’t, you know, stress you out.

4. Watch the Inner Critic

You know the little Elf on the Shelf that comes out every holiday season and moves about the house before breakfast each morning? He is supposed to overhear conversations of holiday gift lists, etc. so that he can report back to Santa. Yeah, well, during the holidays, another little guy comes out, too, and he is called the Inner Critic. However, unlike the Little Elf, this twerp is invisible and resides somewhere in the gray mater of your brain. He likes to convince you that you are lazy, weak, stupid, unlovable, ugly, unsuccessful, and basically every other insult you have called yourself over the years. There is no rationale behind his statements. He just likes to make you feel insecure. And he does a great job of it during the holidays. This is his season! But if you watch out for him, and identify his voice before you go one believing his lies, you will save a bit of the self-esteem and confidence you will need to get through your holiday get-togethers.

5. Prepare for idiots

Just as there exists an Inner Critic inside all of us, there also exists idiots outside of us. I’m poking fun a little, but this is a universal truth, and the truth shall ultimately set you free, or at least help you defend yourself this holiday season. If you can identify the idiots, you can brace yourself for their unintentional (or intentional) attacks. In my piece, “The Idiot’s Guide to Dealing With Idiots,” I give a few pointers on how to manage interactions with folks lacking the open-mindedness, intelligence, or empathy needed for a healthy conversation. I like to envision myself in a bubble, protected from any toxin trying to penetrate my being. I also allow time for recovery after seeing an idiot, because chances are good that I will need to do something that reminds me that her assessment of me isn’t accurate.

6. Be sure to laugh

Laughing is as important as eating lots of salmon and spinach (rich in Omega-3 fatty acids that my brain needs) and regular exercise. Humor is a powerful healing element for me (and I surmise for everyone) because it allows me to see a situation from the right perspective. That is why I make sure and post fun stuff on Beyond Blue during December that has the potential to invoke some harsh comments from folks that really need a better sense of humor: The 12 Bipolar Days of Christmas, Christmas Carols and Disorders, and The Dysfunctional Holiday Letter. Let’s face it: If you are not laughing at a holiday letter that discusses at length the successful potty training of triplets or a best-selling memoir composed at the top of Mount Everest, then you are losing out on some great holiday fun.

7. Spot holiday thinking

So we have now identified the Inner Critic and the idiot, losers that can make you grit your teeth every time you hear a Christmas carol. There is a third enemy that is part of the Holiday Axis of Evil: stinking holiday thinking. Related to the other two bad boys, this kind of thinking surfaces during the month of December to sabotage your holiday spirit. However, knowing how to untwist the distorted thinking will release you from its negative energy.

Dr. David Burns names ten forms of distorted thinking in his bestseller “Feeling Good: The New Mood Therapy.” My favorites are black and white thinking, jumping to conclusions, mindreading, overgeneralization, and saying “should” WAY too much. (“I SHOULD bake Christmas cookies for the whole neighborhood like Mrs. Johnson does every year.”)

Burns offers 15 techniques to untwist the distortions. The most helpful for me is to “record the evidence,” an exercise in documenting how things really are, not how they seem to be in one of your insecure moments.

8. Acknowledge the loneliness

For some reason, it seems like most deaths or break-ups happen around the holidays. So the memories of losing a loved one also fall around December. The sense of loss and loneliness can be overwhelming at this time because every few feet you run into a holiday advertisement gracing a couple wrapped in each other’s arms — wide, Colgate smiles — with an angelic baby, adorable puppy, or exquisite diamond necklace in the picture. For anyone estranged in anyway from a significant other or loved ones, this can pour salt in very fresh wounds.

I don’t have any quick tips for this one. But I do take some solace in knowing that everyone — well, except for the idiots — suffer, in some way, from loneliness or loss around the holidays. Just as it is a season of celebrating the many gifts in our lives, it also can be a time that calls to mind what pains us. And just knowing that I’m not alone in that cycle… well, it gives me peace.

“Problems are not stop signs, they are guidelines.”
– Robert Schuller

“The gem cannot be polished without friction, nor man perfected without trials.”
– Chinese proverb

“The greatest glory in living lies not in never failing, but in rising every time we fail.”
– Nelson Mandela

“I have not failed 10,000 times. I found 10,000 ways that won’t work.”
– Thomas Edison.

“I have learned that failure is really God’s way of saying, ‘Excuse me, you’re moving in the wrong direction.’”
– Oprah Winfrey

“Out of difficulties grow miracles.”
– Jean De La Bruyere

“It is not because things are difficult that we do not dare; it is because we do not dare that they are difficult.”
– Seneca

Artwork by the talented Anya Getter.

According to a recent study published in the “International Journal of Epidemiology,” unemployment is a major risk factor for depression, even in people without previous vulnerability. Because my husband is an architect — the housing market is dead, remember — whose work has slowed down substantially, I have an invested interest in this topic and wanted to know what I could do to help him stay physically and emotionally healthy, since, theoretically, one of us should be.

Here, then, are 12 steps to bust your depression when you’re unemployed.

1. Take a breather

Whether you like it or not, you’ve just been given a breather. And chances are that you desperately needed it. One exercise to make you feel better immediately is to think about everything you hated about your job. In fact, make a list! Doesn’t that feel good? You will rejoin the rat race soon enough, so allow yourself some rest right now … a chance to actually eat a meal at home and not watch the minute hand of your watch so much. Try to appreciate the moment in present time, without constantly rushing. This hiatus from the pressure of corporate America will teach you more lessons and make you more resilient than you know.

2. Identify symptoms

According to the National Institute of Mental Health, depression affects 6 million men each year. But most men’s depression goes undiagnosed. They are much less likely to seek help because of the macho thing (they feel like they are supposed to tough it out) and because their symptoms are different than those we typically associate with depression (women’s). So it’s helpful to look out for these clues of male depression: irritability and anger, blaming others, alcohol and drug abuse, feeling ashamed, insomnia or sleeping too little, strong fear of failure, using TV, sports, and sex to self-medicate.

3. Get to work!

Before you get too cozy in your robe and slippers and watch too many episodes of “Oprah,” there’s this piece of advice: Get to work! Just because you don’t have a nice sum of money being deposited into your bank account every other week does not mean you don’t have a job. You have several, actually, and the sooner you start, the easier they will be: 1. Polish the resume. Like, for example, take out the part where you said you were class president of your freshman class in high school. 2. Network. That’s easy today with Facebook, Twitter, and LinkedIn. You’ve got tons of contacts right there at your finger tips. 3. Evaluate your career. Maybe it’s the wrong time to ask the question “Is this really what I want to be doing?” But it could also be the right time, if there ever was a right time. If you really hated your job, entertain the possibility of doing something totally different! And if it doesn’t work out, please don’t blame me.

4. Shift your self-esteem

Most of us get our self-esteem from our jobs, because we subscribe to a Calvinistic work ethic, which dictates that hard work is central to a person’s calling. We Americans are a tad obsessed with work. Men’s self-definition, especially, is wrapped up in their job, so any demotion or pink slip is a major blow to their ego and self-esteem. David Burns describes three levels of self-esteem in his book, “10 Days to Self-Esteem”: conditional, unconditional, and “non-existent self-esteem.” The last is reserved for evolved souls like Mother Teresa and Gandhi. But if we can work toward a place where our self-esteem isn’t as dependent on people, places, and things (and especially our work), we experience a kind of unmatched freedom.

5. Develop some hobbies (and get in shape)

This is a perfect time to find out what you like to do, aside from working and sleeping. Leisure isn’t a luxury for the rich and lazy. Active leisure–where you do more than control the remote–has many health benefits. There was a recent study by Salvatore Madde that showed how active leisure (for four to six hours a week) protected people from experiencing stress and developing depression, anxiety, high blood pressure, and overeating problems. If you do nothing else with your time away from the cubicle, at least begin a health plan and start working out. You will benefit enormously from the antidepressant effects of exercise alone.

6. Work on a budget

You are going to be much less stressed out if you look the monster in the face, than if you run from it. The monster, of course, being your budget. Cut out all expenses that aren’t absolutely necessary: Starbucks coffee, a landline phone number that you don’t use, a cleaning lady or gardening services, cable. Come up with some meals that are healthy but save money on expensive produce. Involve the whole family in these decisions. The more control you have over your financial situation, the less prone to depression you’ll be.

7. Connect with others

It’s easy to isolate when you lose your job. But it’s about the worst thing you can do for your mood. In her PsychCentral blog post, “Keeping My Sanity After Two Layoffs,” Stacey Goldstein describes what she did wrong after the first layoff and what she did right the second time. The first time she made herself leave the house every day, to go to the gym or to see a friend, but she still spent way too much time by herself. The second time she got a part-time job and volunteered on several committees of her community. Both required her to check in with other folks, and brought opportunities to network.

8. Stick to a schedule

Humans thrive when they keep to a routine. Our circadian rhythm, the 24-hour clock system wired into our brain that governs fluctuations in body temperature and the secretion of several hormones, and even our metabolism, require a kind of regular pattern. So stick to one even when you don’t have to. Imagine that you are working from home (because you are). Then structure your day as such. For example, work out in the morning, make some calls after you get back, eat an inexpensive lunch, follow up on some leads during the afternoon, and watch Dr. Phil right before dinner. Or not.

9. Watch your thoughts

It’s easy to catastrophize when something goes wrong in our life. One negative thought builds on another, and before we know it, we’re breathing into a paper bag in the middle of a bona fide panic attack. However, sometimes we can pluck the seeds of negativity right as they are planted, so that our recovery efforts don’t have to involve a paper bag. Just being aware of our thought process eliminates many of the trouble-makers. In the video “5 Forms of Distorted Thinking,” I identify a few of the toxic thought patterns to watch out for. You may also check out David Burns’s “Feeling Good” for more and for some techniques on how to untwist them.

10. Become useful

Everyone needs to feel useful. That’s why so much of our self-esteem hinges on our job performance. But there are a myriad of ways to feel useful even if you’re unemployed. My husband Eric, for example, has taken on more of the responsibilities for the kids–signing off on their homework, managing science projects, setting up playdates, and driving to all the sports practices and games. He also takes the dogs to the vet and gives them their ear drops every morning. Although he has less projects at work, he has more at home, where he is very much needed. Brainstorming for ways you can be useful outside of a job is definitely a mood booster.

11. Prepare for reentry

Not to be an alarmist or anything, but you might want to also prepare yourself for a rocky re-entry. Recent research says that some folks who have been unemployed for long periods of time experience anxiety and depression upon going back to work because the creditors are after them (hence there is more stress), and they are worried that they if they don’t perform perfectly, they will be fired again. However, merely being aware of this, just like the toxic thoughts, can eliminate much of the anxiety. I just wanted you to know, should you experience the same kind of thing, you are certainly not alone in feeling insecure.

12. Maintain some hope

I must end with hope because hope is the ultimate stress reducer. Hope, doctors say, is about the best thing you can do for your body. It’s better than a placebo. So remember, even though you might feel lost and disillusioned, with no path or direction visible to your eyes, it’s definitely true that “when one door shuts, another one opens.” I have seen it happen so often in the lives of family members and friends, and I have experienced it in my own life. So keep on hoping.

* By 2020, behavioral health disorders will surpass all physical diseases as a major cause of disability worldwide.

* Of the more than 6 million people served by state mental health authorities across the nation, only 21 percent are employed.

* More than half of adolescents in the United States who fail to complete high school have a diagnosable psychiatric disorder.

* Between 2009 and 2011 states cumulatively cut more than $1.8 billion from their budgets for services for children and adults living with mental illness.

* In 2009, there were an estimated 45.1 million adults aged 18 or older in the United States with any mental illness in the past year. This represents 19.9 percent of all adults in the U.S.

*Serious mental illnesses cost society $193.2 billion in lost earnings per year.

* The annual total estimated societal cost of substance abuse in the U.S. is $510 billion.

* In 2008, an estimated 9.8 million adults aged 18 and older in the U.S. has a serious mental illness.

With our economy still in the toilet, states and federal government threaten to cut even more dollars in mental health funding, which would result in less or no access to mental health treatment and services for countless Americans. Ultimately the cuts steal the one thing that keeps those of us struggling with chronic mood disorders alive: hope.

Yesterday a group of mental health advocacy organizations hosted a joint symposium titled “Mental Health Hope: Lost People, Lost Dollars, Lost Hope” at the Reserve Officers Association in Washington, D.C. to raise awareness about the imminent threat and impact of such budget cuts. Actress Glenn Close and her sister Jessie, former second lady Tipper Gore, and a handful of prominent doctors and directors of behavioral care centers addressed the symposium moderated by the award-winning journalist Cokie Roberts.

I very much wanted to be there to take notes myself — and to meet my best friends Glenn, Tipper, and Cokie for a cup of coffee — but ironically I couldn’t attend because I need to work so many hours at my day job in order to pay for my mental health care, most of which is not covered by my health insurance plan. Thus, this is an issue I feel very passionate about, and urge you to pay closer attention to yourselves.

“Too often policymakers only see the immediate savings of cutting budgets to mental health services,” said John M. Oldham, M.D., President of the American Psychiatric Association. “We want to emphasize that these programs are already providing significant savings within the health care system and in other sectors of society, by increasing employment and workplace productivity, and by decreasing homelessness, substance use, and overcrowding in emergency rooms.

Mark Covall, President and CEO of the National Association of Psychiatric Health Systems, added:

The work we have done to increase access and quality of care for those in need will be severely threatened without the resources to keep the programs going. We’re already struggling to deal with increased demand due to the down economy. If we see any further cutbacks, the result will be incredibly costly for the wider community.

Actress Glenn Close launched her anti-stigma campaign, Bring Change 2 Mind, to educate the public about mood disorders after watching her sister, Jessie, battle an undiagnosed bipolar disorder for years, and helping her nephew, Calen, who lives with schizoaffective disorder, get the care he needs.

“Access is critical,” Glenn wrote in an op-ed piece published yesterday on the website Politico.com, “because more of us are affected and in need of support than most people realize. Close to 60 million Americans live with a diagnosable mental illness, and one in four families has a relative living with mental illness”

For more information about the symposium, please visit: www.mentalhealthhope.com.

According to Susan Berger, researcher and practitioner in the health and mental health fields for over twenty-five years, those five stages may work well for the dying individuals. But for the folks who are left behind to grieve the loss? Not as successful.

In her groundbreaking book, The Five Ways We Grieve: Finding Your Personal Path to Healing after the Loss of a Loved One,, Berger offers five identity types that represent different ways of creating meaning from the loss of a loved one in an effort to redefine a life purpose, a reason to continue growing spiritually and emotionally, and to find meaning in this life.

Here are the 5 identity types that Berger says represents different ways of grieving a loss:

1. Nomads are characterized by a range of emotions, including denial, anger, and confusion about what to do with their lives. Nomads have not yet resolved their grief. They don’t often understand how their loss has affected their lives.
2. Memorialists are committed to preserving the memory of their loved ones by creating concrete memorials and rituals to honor them. These range from buildings, art, gardens, poems, and songs to foundations in their loved one’s name.
3. Normalizers place primary emphasis on their family, friends, and community. They are committed to creating or re-creating them because of their sense of having lost family, friends, and community, as well as the lifestyle that accompanies them, when their loved one died.
4. Activists create meaning from their loss by contributing to the quality of life of others through activities or careers that give them a purpose in life. Their main focus is on education and on helping other people who are dealing with the issues that caused their loved one’s death, such as violence, a terminal or sudden illness, or social problems.
5. Seekers look outward to the universe and ask existential questions about their relationship to others and the world. They tend to adopt religious, philosophical, or spiritual beliefs to create meaning in their lives and provide a sense of belonging that they either never h ad or lost when their loved one died.

Unlike many authors of grief books, Berger has grappled with grief her entire life. She lost her father when she was just eleven years old. Her mother died nine days short of her (mother’s) fiftieth birthday. She has also interviewed hundreds of people on how they have been able to move on after the death of a loved one.

Throughout her book is the overriding theme that grief can be a doorway to hope. Toward the end of her first chapter, Berger shares a poignant quote found in bestselling author Barbara Kingsolver’s book, Prodigal Summer, by a young scientist, Luca, who was able to manage the family farm and perform her other responsibilities after being suddenly widowed. It’s lovely, I think, this quote, and speaks to how all survivors can be transformed in their grief:

I was mad at him for dying and leaving me here, at first. Pissed off like you wouldn’t believe. But now I’m starting to think he wasn’t supposed to be my whole life, he was just this DOORWAY to me. I am so grateful to him for that.

Berger’s description of her own healing journey is touching as well:

My journey of understanding, like that of the Jews in the desert, has taken forty years. I now understand what a far-ranging impact the deaths of my father and, seventeen years later, my mother have had on me and my family. I have spent much of my life asking questions about why this happened, what effect their deaths had on me and my family, and what contributions I could make to those who have had similar experiences. I have learned lessons about life and death, and these lessons have guided me—for better and worse—throughout my life. They have changed the way I see myself, the world, and my place in it. I am certain that the deaths of my father and mother served as catalysts that guided me toward a particular path in my life, influenced who I have become, the choices I have made, and the ways I have lived my life. As a result, I believe I am wiser, more life-affirming, and more courageous human being than I might otherwise have been.

Her book is an invaluable resource for those struggling with grief or for anyone who just wants to better understand the process of grieving. And I think her writing and insights can be translated to living with chronic illness, as well, because, in some ways, that is also grief: learning to live within the limitations of our health situations.