“Most people recover from the fact that their partner had sex with someone else before they recover from the fact that they were deceived,” says Vaughan. “An affair, in the final analysis, is more about ‘breaking trust’ than about ‘having sex.’”

A few years ago Vaughan took an online poll, asking readers: “If your partner had an affair, what would be more difficult to overcome: the deception, or that he/she had sex with someone else?” Almost three quarters of the men and women polled said deception.

Vaughan believes that secrecy is primarily what distinguishes a close friendship from an emotional affair.

For example, you’ve crossed the line if you are:

• Keeping the details of the relationship secret from your husband or wife

• Saying and doing things with your “friend” that you wouldn’t do if your partner were present
• Sharing things with the other person that you don’t share with your partner
• Making an effort to spend lots of time with your “friend”

“In most instances emotional affairs are just affairs that have not yet become sexual,” says Vaughan. “They either end or they escalate. So (as with any type of affair), it’s critical that all one-on-one contact with the third party be severed — before it escalates.”

Romantic friendships are especially dangerous for women because women typically invest much more of themselves into them than men. A woman may ache and suffer for years as she grapples with her relationship issues while her male counterpart considers the extra attention a mere bonus to his family life, says Vaughan. In other words, a female sees her soul mate; a man sees fun. And, according to Aaran Ben-Ze’ev, author of Love Online, it’s not uncommon for men to be conducting two or even four affairs at once.

Even innocent flirting with co-workers can hurt a marriage. “We only have so much emotional energy in life,” says M. Gary Neuman, a psychotherapist in Florida and author of Emotional Infidelity.

“By chatting and joking with your crush during the workday, that’s emotional energy you should be sharing with your partner, and it drains your marriage of the vitality it needs.”

From June to August last year, this was the routine: load up the double stroller with any floatable object in our house (wings, inner-tubes, noodles, life vests), drag them (and two sinkable kids) to the pool, score some beach towels from the lost and found, and plant ourselves under one of the few coveted umbrellas.

As soon as we hit the snack bar and caught up on the daily gossip from Mr. Snow Cone, I pulled out Burns’ book, Ten Days to Self-Esteem, which is about the size of a floating raft, the word “self-esteem” taller than a fruit freeze pop. But the woman under the next umbrella was reading ADD and ADHD for Dummies, so I didn’t feel so bad.

My mind wandered back to my first session with my therapist, almost two years ago. “Why are you here?” my therapist asked me.

“Because I feel like a Krispy Kreme doughnut,” I replied. “I have no center.”

“The lack of self-esteem is one of the most painful symptoms of depression,” writes Burns in “Ten Days.” “The central belief that causes low self-esteem is ‘I’m not a worthwhile human being. I am inferior to others.’”

My problem (and I doubt I’m alone) is that (I still have to use present tense, but will hopefully change to past tense soon) I have a very conditional definition of self-esteem: I earn self-esteem by my accomplishments, my charitable works, and my popularity. My thinking comes from a Calvinist work ethic, which is widespread in our culture. This perspective is groovy and peachy when life is running smoothly, because it motivates a person to work hard and sprint towards her dreams.

But oy vey when the car (or mind or body or spirit) stalls — or (like last year for me) when your best efforts flop miserably.

When I couldn’t contribute my talents and skills toward some project, or volunteer my time toward a noble cause, or gain the respect and love of people around me, I fell apart, into an abyss of anxiety and depression. “I’m a failure,” I repeated to myself.

However, you have to start somewhere to build self-esteem, says Burns. He describes the process of gaining self-esteem like climbing up a ladder. On the first rung of the ladder is “conditional self-esteem:”

“You decide to like yourself because of your strengths rather than hating yourself because of your weaknesses. You stick up for yourself and defend yourself against your critical inner voice. For many people who feel inadequate, this can be an extremely important first step.”

Then you can climb up the next rung on the ladder, to “unconditional self-esteem:”

“You realize that self-esteem is a gift that you and all human beings receive at birth. Your worthwhileness is already there and you don’t have to earn it. It suddenly dawns on you that you will always be worthwhile simply because you are a human being. It ultimately makes no difference if you are fat or thin, young or old, loved or rejected, successful or unsuccessful. Unconditional self-esteem is freely given.”

Um. Maybe I’ll get there next summer? When I give up stealing beach towels from lost and found, gossiping with Mr. Snow Cone, and making fun of the mom reading about ADHD.

The third run of the ladder is sort of like Dante’s Paradise. (Funny, I chose his Purgatory for my high school English paper, because I found the climb to the beatific vision much more interesting than either heaven or hell.) Here, you give up the very notion of self-esteem and abandon the view that there are worthwhile persons and worthless persons. The third rung adopts a Buddhist perspective that considers self-esteem a useless illusion.

All of us want to feel special and worthwhile, so this radical step might feel as good as taking a humongous book on self-esteem to the pool. But Burns says it can be immensely freeing and practical. I don’t know if I believe him (probably why self-esteem didn’t happen for me in ten days like it was supposed to), but this is what he says about giving up your self-esteem (the right way):

“The death of your pride and your ego can lead to new life and to a more profound vision. When you discover that you are nothing, you have nothing to lose, and you inherit the world. Instead of worrying about whether you are sufficiently worthwhile, each day you can have goals that involve learning, personal growth, helping others, being productive, having fun, spending time with people you care about, improving the quality of your relationships, and so on. You will discover unexpected opportunities for intimacy, for productivity, and for joy in daily living.”

That’s a big promise. One recommendation for Burns: use smaller type, please. I’d like to read you at the park, too.

Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self — to the mediating intellect — as to verge close to being beyond description. It thus remains nearly incomprehensible to those who have not experienced it in its extreme mode.

The closest description Styron finds is that of drowning or suffocation.

Many people feel a gradual slide into this state. Breathing becomes a task to check off the “to do” list along with laundry and the dishes; an insecurity settles in, making simple responsibilities like watching your son play lacrosse alongside a field of fellow moms feel as though you are attempting to sit down with the popular group at lunch in a high school cafeteria divided by distinct social castes; and suddenly you hate yourself more than the cruel cousin you haven’t talked to in 20 years. According to depression checklists, if you feel like this for a month and a half, it’s time to call your physician.

So… That means I should have called my primary care doc like every day of the first two decades of my life. As long as I can remember, I’ve been fighting the thoughts in my head. It’s like the World Cup in there, where Team Negative Intrusive Terrorists have a 10-point lead over Team Positive Perspectives. I have always — or at least from my earliest memory — been sweating 24/7 inside my noggin, asking God to give me a water break with orange slices. Could you imagine my med chart if I had called every time I became uninterested in my hobbies or had difficulty making decisions? I’d be blacklisted from every medical institution. Kind of like I am now with health insurance companies.

There was never a moment when I said to myself, “Self, it’s been two months since you haven’t been your cheery self, and if the Zoloft ad on TV is any indication of what depression feels like, you are certainly a sad egg who can’t — or doesn’t want to — catch that damn butterfly.” However, there WAS a moment when I realized that my modus operandi wasn’t exactly typical, and that life wasn’t meant to feel like a hike up Mt. Everest. In fact, I can pinpoint the exact afternoon that happened.

I was a freshman at Saint Mary’s College in South Bend, Ind., and was working with a college therapist, not because I was depressed (of course!), but because I was having trouble staying sober at a time when every other college kid I knew — especially the ones across the street at Notre Dame — were experimenting with their newfound freedom. (Thankfully, I got to do that in high school.)

I detested the D word because it brought back memories of my aunt, my godmother, who killed herself when I was a sophomore in high school. I associated all language of depression and mental illness with her and was adamant that none of my current troubles had anything to do with the reason she breathed in too much carbon monoxide in my grandmother’s garage.

But I was also sick of struggling.

And my therapist knew this.

During one session she was firmer than usual.

“Coping your way through life is not a way to live,” she said. “If you just admit to being depressed, or having some mood disorder, then I can help get you the treatment you need, and your life can be better.”

Her first sentence — i.e., Coping your way through life is not a way to live — was my epiphany moment. I had incorrectly assumed that coping is what everyone did. No one actually wants to be alive, I had always believed (and still do when I get depressed). They just pretend they like they are having a good time on this excruciating planet because no one likes to hang out with a downer. “La la la la la … Sing a happy song …” We are all joyful Smurfs.

Like most statements of truth, this one took a few years to sink in. I resisted meds. I opposed labels. I avoided anything that might cause someone to suspect that I was born with a brain, involving some creative wiring. But it was my beginning. The moment I cried “uncle.” And even though I’m still no singing Smurf, and cope through life more hours than I want to, I have kept the piece from that afternoon that makes the strain more bearable: hope.

A few months ago, he published The Now Effect, (our book of the month here for April) and I had the pleasure of interviewing him about it.

Therese: What is The Now Effect?

Elisha: The Now Effect is that “aha” moment of clarity and choice that we’ve all experienced. It’s the moment you notice your mind running around the same old bad neighborhoods and come in touch with the choice to refocus on what matters. It’s the moment you’re on your smartphone and your kids are clamoring around you and you realize they are what matter in the moment. It’s the moment a friend of a friend passes away and you reconnect to the ones you love.

Unfortunately, these moments are becoming rarer than ever as our lives are speeding up and life itself is becoming routine.

I wrote The Now Effect to help us train our brains to naturally pop into spaces of clarity and choice. In these spaces we can apply mindfulness, the act of intentionally paying attention to the present moment while putting aside our programmed biases. We can space from our automatic negative thoughts, prime our minds for good and feel more connected which is the greatest anti-depressant.

Therese: Speaking of that, how would this work for people who have struggled with depression?

Elisha: For years now, we’ve been finding the benefits of applying mindfulness in our lives as a means to prevent relapse into depression. Neuroscience has even found that people who practice mindfulness in their lives actually use a completely different part of their brain in reaction to a trigger (like a sad movie) than people who have not practiced.

As we intentionally practice and repeat noticing the spaces of choice all around us, we can get space between our spiraling self-judgments, self-blame, and mind traps that keep us stuck in states of deep unworthiness. In these spaces, not only do we now have some distance from these toxic conditionings of the mind, but we can also choose to apply the exact opposite which is greater self-compassion.

The more you practice self-compassion the more likely it is to become automatic. Self-compassion is interesting, because that could be wrapping yourself in a blanket of caring and love, going outside and letting sunshine splash on the face or it can be distracting yourself as a means to get away from the negative thoughts.

In “The Now Effect,” I dedicate an entire section of the book to the Movie in Your Mind. This is meant to beginning priming the reader’s mind to the idea that thoughts aren’t facts and also gives a number of practices to instill that reality into deeper recesses of the brain to make it more automatic.

I also try and make it more interactive than a regular book with 14 short instructional videos throughout the text, accessible either via a smartphone, embedded in an enhanced eBook or a link is provided in the book where they are hosted.

Therese: If you were to give me a cheat sheet to support me with realizing more of this in my life, what would it be?

Elisha: I anticipated this with readers and actually created a 5 Step Cheat Sheet in the back of the book.

Prime your mind. This is basic learning theory underscoring the fact that “The more you practice, the more your mind is inclined to notice the spaces.” One way to prime your mind is by controlling your environment.

Some can say “Breathe,” “How am I doing right now?” “Drop into mindfulness,” “STOP,” “Keep your heart open,” or “What is most important right now?”

This plays into the subconscious minds ability to pick up on its environment and influence it toward greater presence, kindness, non-judgment, openness and compassion.

Change your mind. Understanding thoughts are not facts can help us be on the lookout for automatic negative thoughts and mind traps. “Understand that thoughts are not facts and you can choose to orient your mind toward the good.”

See, touch, go. Making change isn’t easy and you will stray from your intentions. This is just a fact worth understanding. When this happens “see where you went, touch it, and gently guide yourself back to your life.” This will help you come back to what really matters sooner making you more effective at what you do.

Get connected. At the foundation of depression is disconnection. Make a list of people who are supportive to you, encouraging a more mindful life. Make little efforts to surround yourself with them.

Therese: Is there a practice you suggest starting off with to help us train our brains to be more present?

Elisha: In the Getting Started section in “The Now Effect” I have the first introductory video. Rather than me tell it to you, you can experience it for yourself. Enjoy!

Breaking Free

Here are 4 steps to increase your chances of breaking free from a downward spiral and increase your chances of experiencing the Now Effect:

1. Intentionally be on the lookout for the mind snowballing or when you’re in a low mood. This will prime your mind to pop out of it more often.

2. Bring awareness in that moment to how you are feeling. Name the feelings if possible.
3. Think about how your interpretation of the situation may be influenced by the mood you are in.
4. If you are feeling an uncomfortable emotion or pain, apply some self-compassion and do something pleasurable or kind for you that day. This will send the message internally that you care for yourself and allow for the discomfort to come and go quicker as it naturally would.

As you practice and repeat this with intention, like all things, it will start to become more automatic. In other words, rewiring a healthier and more mindful auto-pilot.

Addiction is a process of buying into false and empty promises: the false promise of relief, the false promise of emotional security, the false sense of fulfillment, and the false sense of intimacy with the world….Like any other major illness, addiction is an experience that changes people in permanent ways. That is why it’s so important that people in recovery attend Twelve Step and other self-help meetings on a regular basis; the addictive logic remains deep inside of them and looks for an opportunity to reassert itself in the same or in a different form.

Nakken brilliantly explains the addictive cycle that I merely call “the exploding head phenomenon”: the process by which I continually seek relief from uncomfortable feelings, a “nurturing through avoidance — an unnatural way of taking care of one’s emotional needs,” as he says. The addict, he clarifies, seeks serenity through a person, place, or thing.

The cycle is made up of four steps:

1. pain
2. feeling the need to act out
3. acting out and feeling better
4. pain from acting out

Just in case you weren’t paying attention, he mentions pain twice. 

It’s so simple it’s laughable, really. When you can draw your little neat diagram to see what’s going on. But when you’re in the midst of it, emotions take over and it’s about as easy as driving your car through a blizzard. On a back road.

With some addictions, there is a physiological component that further skews reality. And while I used to believe that once you were off of booze you were safe from the physiological drama within your limbic system (emotion center of the brain), now I believe that the high of hypomania and mania produces the same illusion of completeness or serenity as when you reached the perfect buzz. Which is why it’s so hard to come clean with your doctor so that you both can work hard at pulling you down from the high before you crash.

“Emotionally, addicts get intensity and intimacy mixed up,” Nakken writes.

During the trance created by acting out, addicts may feel very excited, very shameful, and very scared. Whatever they are feeling, they feel it intensely. Addicts feel very connected to the moment because of the intensity. Intensity, however, is not intimacy, though addicts repeatedly get them mixed up. The addict has an intense experience and believes it is a moment of intimacy.

I wish I had read that distinction about 20 years ago, because I’ve spent too many years confusing the two. Whether it be a work project, or a thrilling new friendship, or a media opportunity, I assumed that the trance state meant that it could complete me (as Jerry Maguire would say) at least take away all the restlessness I feel on a daily basis.

Nakken is right on when he says that it’s important for addicts to understand their propensity or yearning for trance-like states because, in some regards, we have to temper these urges our entire lives. Bottle or no bottle. “On some level,” Nakken explains, “the addict will always be searching for an object or some type of event with which to form an addictive relationship. On some level, this personality will always want to give the person the illusion that there is an object or event that can nurture him or her.”

So, great, then what do we do? According to Nakken, we need to turn to supportive, nurturing relationships in order to grow emotionally and spiritually. Such as…

• Family and safe friendships. Nakken says we learn healthy interdependencies. I have trouble determining which friendships are safe for me, but for now, I’m just going to say those that don’t make me feel like my head is going to blow up.

• A Higher Power. The first three steps in most 12-step programs:
  1. We admitted we were powerless over alcohol — that our lives had become unmanageable.

  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
• Self. Now that’s more helpful for some people versus others. I feel like my “self” right now is a massive liability. But I do trust myself much more today than 20 years ago when I stopped drinking. Nakken writes: “Through a caring relationship with ourselves we learn self-nurturing–the ability to love ourselves and see ourselves as one resource we can turn to during times of difficulty.”
• Community. This one’s absolutely critical to me. Although I don’t frequent many 12-step groups today, I do swim with a fun group of people at 6 am and we laugh our way through our laps. I’m also very active in my parish and find that spiritual support vital to my recovery.

I love Nakken’s explanation of why we need these four kinds of relationships in our lives:

What all four types of relationships have in common is the fact that people must reach within themselves, but they must also reach out. In natural relationships there is a connecting with others–an act of giving and an act of receiving. In addiction there is only an act of taking. Natural relationships are based on emotionally connecting with others; addiction is based on emotional isolation.

“Success is 99 percent perspiration and one percent talent,” my business-savvy father told me back when I was unloading Thin Mints as a Brownie Girl Scout. “The only thing that separates the winners from the losers is perseverance.”

Dr. Seuss was rejected 43 times before his first story was published; a skinny 5’11″ Michael Jordan was cut from his varsity basketball team; Colonel Sanders drove from restaurant to restaurant with his pressure cooker and famous recipe of 11 herbs and spices before he made history with KFC; and didn’t some opinioned jerk tell Katie Couric in her early days that she didn’t have a face for TV?

I sure as heck wasn’t born with the ability to write.

My eighth grade English teacher, Mrs. Kracus, read aloud my essay as an example of how NOT to write. My SAT scores were so low (especially verbal) that I lied about them for 18 years. Any aptitude test I took suggested I pursue a career in math or science. The profile of a writer fit me about as well as Dolly Parton’s bra: an intellectual permanently glued to a book, ready to discuss any classic, from Plato to Hemingway. (God showed mercy on me the day CliffsNotes went to press.)

Oh yes, and my “American Idol” moment, when I asked a professor in grad school to write a letter of recommendation for me. (I was applying for a job as an editor of a Catholic magazine.)

This man of the cloth (a priest), much like a cocky judge, took me outside in the hall to drop the bomb.

“I’m sorry,” he said, squinting his small brown eyes that shot daggers through my heart. “I can’t do that. It just that you…you don’t use words correctly.”

Had I been on a televised set, I may have responded like some weepy contestants.

“No way. Please no, please!”

But that’s not because I’m mentally ill (well not totally). It’s because I had a dream — to become a writer — and I wanted it badly.

Viewers shouldn’t mock the contestants for pursing their dreams on TV. That takes guts. They should fault the judges for their lack of tact and constructive criticism.

“You need to work on your craft, Therese,” a very wise writing mentor told me when he took me under his wing. “And this is how you do it….”

He instructed me to read books on style, take classes, and analyze the technique of writers I respected.

He didn’t sit back in his chair and make fun of me like the arrogant professor I had, like a former boss of mine did, or like a self-absorbed judge does. That’s not helpful at all.

Thinking more like my father, my mentor — a seasoned writer and an established publisher — read my essays, took a good look at my character, and came up with a plan. I’d have to apply the 99.5 percent of tenacity in my personality to compensate for the 0.5 percent of skill (and talent) provided in my DNA.

I don’t know. Maybe all dreamers are mentally ill to some extent… because dreams aren’t grounded in reality or logic. If they were, I’d be a math professor or an engineer for NASA (remember, my math and science scores were higher than English), not blogging in the middle of the night about “American Idol’s” poor suckers who just got the punch (the “forget about it” talk) that almost made me drop the pen (and my dream) back in grad school, when I had a few more neurotransmitters to spare.

I’m rooting for the underdogs. Because talent doesn’t determine who lives out their dreams. Believe me, I know.

By calling myself a manic-depressive would I trap my psyche in “sick” mode? By accepting my diagnosis of bipolar disorder, would I prevent healing? By writing the words “I am mentally ill,” was I holding myself to a place that I was, but not where I am now, or where I could go?

I spent a fair amount of time pondering this (I’m a natural ruminator)…. I thought about attracting bad karma by writing about my illness, about feeding my anxiety by connecting with others who also struggle with depression, about stifling my spirit by posing all of my questions and frustrations online in an effort to figure out and assemble this humongous, Anchisaurus (a kind of dinosaur) 500-plus piece puzzle of mental illness.

And then I arrived at this guess (because there are no answers): No.

I looked to my mental health heroes — Abraham Lincoln, Winston Churchill, Art Buchwald, William Styron, and Kay Redfield Jamison — and realized that they slapped on their labels with pride so to educate and inform an ignorant world about mental illness. Because of these label-wearers, millions of people suffering from depression and other mood disorders have been properly diagnosed and treated.

I thought back to the first days of my sobriety, when abstaining from booze was like running a daily marathon. (I quit drinking right as I left for college… the worst possible time in a person’s life to jump on the wagon.) For three years I attended three or more meetings a week, in which I would say something like, “Hi, I’m Therese and I don’t like what happens to me when I drink alcohol,” because I just couldn’t utter the word “alcoholic” two words after the word “I.”

I stumbled and stalled at step one–accepting that I was powerless over alcohol–unable to progress to step two (came to believe in a power greater than ourselves–which I was cool with.) And I obsessed for three years, as my classmates got drunk at the Linebacker bar, about whether or not I was, in fact, an alcoholic.

Toward the end of my junior year, I attended a meeting devoted to the first step.

“Without the first step, you may as well give up the program,” said one guy.

“It’s the foundation,” said another.

I’m doomed, I thought, so I guess I should get drunk.

I drove my Ford Taurus up to the Indiana-Michigan state line from South Bend. (It was a Sunday night and Indiana was dry on the Lord’s day.) I bought a six-pack of Coors, drove back to Saint Mary’s College, parked the car in the student lot, and downed the cans. Then I waited to see what would happen–if puss would start dripping from my nose, if my fingernails would start to curl–some tangible sign that I was, in fact, allergic to these types of beverages.

The next day I confessed to my therapist what I had done, and how I wanted to end my life I was so disgusted with myself. How could I have done something so stupid? Ruin three years of sobriety? And so close to my three-year chip?

“But I can’t do that bloody first step!” I said. “And if I can’t do the first step, I can’t move forward.”

“Therese,” she said very calmly, “you just told me that you are ready to end your life because you are so obsessed with this question and your struggle with alcohol. I’d say, then, that you are powerless over it. If you can’t say that you are powerless over alcohol itself, then say you are powerless over your obsession with alcohol.”

Oh. Now that made sense. Because there were times when I drank that I could stop after two. I didn’t always pass out in a friend’s coat closet or wake up between two trashcans on a neighbor’s lawn. But the obsession about alcohol — well, yeah, that drove me absolutely crazy.

The week of my Michigan road trip was hellish. Friends, hearing that liquor and I were a pair again, invited me to parties that I wanted to attend in the worse way. After all, I deserved to taste the college experience after living three years as a cloistered monk. With one foot in the Linebacker and the other in the monastery, I was more confused than ever. And the puzzlement was poison to my mind and soul, my body and spirit.

Finally I walked to the gazebo on the campus that overlooks the St. Joseph’s river like I did so many times after my runs.

And somehow I let the obsession go. Because I didn’t care if I wore the label of alcoholic or not. I just wanted peace.

“Like a diagnosis, a label is an attempt to assert control and manage uncertainty,” writes Rachel Naomi Remen, M.D, one of the first pioneers in the mind, body, health field. “It may allow us the security and comfort of a mental closure and encourage us not to think about things again. But life never comes to a closure, life is process, even mystery. Life is known only by those who have found a way to be comfortable with change and the unknown.”

I disagree. My labels have freed me to live in better harmony with the person I wish to be.

It’s an awful lot easier to stay resilient, even if you have a severe mood disorder, when you’re not encased in stress. When you have all that cortisol — the backstabber hormone — mucking around in all of your biological organs, staying sane is about as easy as getting off a chair lift for the first time, or so it feels.

Here are a few steps I’ve been practicing lately to stay resilient in my days and nights loaded with stress.

1. Quit the guilt.

For some reason, the more stressed I get, the more guilty I feel about being stressed, which makes me more stressed. If none of that makes sense, simply move to the next point. If you were raised Catholic or Jewish, my guess is that you can relate. In a recent therapy session, my counselor gave me an assignment for two weeks: every time I’m about to feel guilty, give myself a hall pass until our next session. The two-week exercise made me mindful of the needless baggage I carry with me throughout the day.

Enough with it!

If my guilt is not helping matters — like making me act more like Mother Teresa, which it clearly isn’t, according to my kids — then I shall try to lay it on the doorstep and walk on a little lighter. In my guilt video, you’ll see how I compare it to a bag of rocks.

2. Carve a little space for “Ahhh”

I know I should tell you to meditate or do yoga here, but being that I have not had great success with either, I will tell you what works for me: swimming!

Why? Because I can’t concentrate on anything else when I’m swimming my laps but how many laps I’ve swum. And if you are OCDish like I am, obsessing about numbers of laps is a nice break from fretting about millions of things that could go wrong. I wish I were one of those people who could sit still and meditate or pray for long amounts of time. However, coming to terms with who I am—a person who needs to move while meditating or praying—is part of tackling the stress head on, and ditching the guilt about the way I do it.

3. Laugh at the messes.

Each Christmas season, I like to post “The Dysfunctional Holiday Letter” because it allows me (and maybe you) to chuckle at those holiday letters that make you want to use the airplane bag because they are just so wholesome, positive, and down right impressive! It always seems as if the events in other people’s lives flow seamlessly, and ours is a choppy river. But everyone is paddling against the current. I know this because, as someone who lives her life as an open book—with the front jacket listing 20 of my disorders–people tell me things they wouldn’t publicize to a stranger, much less their relatives and friends. And it’s genuinely funny stuff! All of the mistakes, disappointments, ironies of our lives are Jon Stewart material. If we can try our best to look for the humor in the messes, the cortisol running through our systems will stop being a choppy river, too.

4. Steal the mic from the inner jerk.

Almost everyone — except anyone who has written a self-help book, of course — turns up the volume on the inner jerk when stressed. Why? Because we are all pansies who can’t handle a thing. Or so we think. Our guard is down — we feel weak and pathetic — so the inner jerk takes the mic and sings a melody about the L-O-S-E-R you’re staring at. You need to yank the microphone out of his hands and give it to someone who can remind you of what you do really well. If you can’t think of anyone, you might want to spend some cash to solicit that material.

5. Stop Rushing

American journalist Sydney Harris once wrote, “The time to relax is when you don’t have time for it.” You could interpret that in a number of ways, but I think it means that your feet don’t have to be in the sand in order for you to start relaxing … that much of our rushing here and there has more to do with a distorted view of time than an actual time deficit.

I’ve been trying hard not to rush these days. So, when I’m behind an obnoxious lady at the grocery store who is taking longer to load her items unto the belt than it takes my mom to wash her hair, then I will make a concerted effort to breathe deeply, arrest my foot-tapping, and refrain from checking my messages on my email. Then I will repeat to myself, “This is a beautiful moment. Right here. Right now. Beautiful.” Exhale in. Exhale out.

6. Be Present

One of my favorite psychology bloggers, Elisha Goldstein, Ph.D., often quotes psychiatrist and Holocaust survivor Viktor Frankl, who said:

“In between stimulus and response there is a space, in that space lies our power to choose our response, in our response lies our growth and freedom.”

This is a little related to my point about rushing, but looks at the bigger picture. If we stop rushing our lives, and start paying attention, our brain architecture actually changes for the good, and it easier (and more natural) to be kinder and more compassionate.

Artwork by the talented Anya Getter.

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