My post about mindfulness not resulting in happiness got some interesting responses. One in particular on LinkedIn got me to finally come out about what depression can look like when seen from a different perspective. Since LinkedIn discussions are restricted to group members, below is my reply:

I have been thinking a lot lately about depression since I have spent the last few years in the deepest states of my life. Your comment gets right to the heart of my thoughts when you say, “I don’t know if I can say that mindfulness intensifies depression.” I very much appreciate your bringing it up.

In conversation with others who have pursued a similar path as mine, we have been exploring what depression means and whether we may be cured. We experience the physical, mental, emotional, and spiritual pains, but not the normal reactions to them that get combined in the normal definitions of depression. We actually feel the “pain” more than we ever have, but act normally because the pain no longer controls our choice of how to act.

“I want freedom for the full expression of my personality.” – Mahatma Gandhi

Everybody wants to be free. Freedom is touted as the most basic of human rights. The commonly understood definitions of freedom are “the power or right to act, speak, or think as one wants without hindrance or restraint”1 or “the power of self-determination attributed to the will; the quality of being independent of fate or necessity.”2 Yet, by the very definitions, none of us are truly free. We mistakenly limit freedom to a very narrow range of experience.

A child’s view of freedom is to be free from the direction of parents, teachers, and other people of authority. Even when we become adults, we often cling to the same narrow definition: freedom from coercion of others. But there is a much greater freedom that most of us have never even considered: freedom to choose how to react to every stimulus.

“The old paradigm is for us to avoid emotional pain at all costs while remaining ignorant of the lessons that are available to us.” – The Depression Advantage1 The medical definition of “insight” reads, “understanding or awareness of one’s mental or emotional condition; especially: recognition that one is mentally ill”2 By that definition I have no insight because I don’t recognize my condition as an illness.

Allow me to suggest that insight is the ability to recognize my condition and all of the aspects associated with it. It means not only recognizing the cause of the condition, but the whole experience.

My anti-psychiatry friends ask me why I work with doctors and therapists. Some accuse me of being a sell-out or a stooge for the pharm industry. They think that the way to change the system is to oppose it completely.

I don’t agree. I think the way to change the system is to work with it, not against it. If we can find ways to influence the thinking of those who are working with the greatest number of people, we will have the greatest effect. Communicating with them as a partner is the way to do that.

My daughter Kate and her friend Kelsey are in medical school. They have not decided yet what to specialize in, but if they choose to be General Practitioners they will be the front line in catching mental conditions. They are taking a class now about psychiatry and have been learning about suicide. Their assignment is to interview several people so they can get a first hand feel from those of us who have attempted or seriously thought about it.

One of the first steps toward getting Bipolar In Order is to learn the difference between what we feel or experience and how we react. In our first workshop and in our support group meetings we have an exercise that helps. I want to share it with you here and see how it works without as much guidance or background.

One of the main stumbling blocks to getting Bipolar In Order is the belief that we have no choice in how we react. When presented with the fact that we do, I always hear “what about the times when it is too intense?” or “what about when I go to bed happy and wake up depressed?” “Surely we have no control then?” While it is currently true for most people, with training and practice we can learn to have the choice in an ever increasing range. Eventually we can get to the point where nothing is too intense.

The diagnosis of mental illness is the most dangerous time for many of us. Overwhelmed by fear, confusion and the numbing effect of over-medication, we are vulnerable to any messages that can have long-term consequences. It was during my first months after diagnosis that I fell victim to the myths of mental illness.

As I was trying to make sense of what was happening to me, I was given a list of the most offensive comments anyone could say to the mentally ill. I’m sure you’ve heard of at least some of them. Examples include: “snap out of it,” “you can do anything you want to if you just set your mind to it,” “get a grip,” and the worst one of all, “pull yourself up by your bootstraps.”

While the Advocates are well intentioned, the result is quite the opposite.

It happened several years ago, but I remember it like it was yesterday. My depression was too much for me and I tried to end it by taking my own life. The physical sensations, mental activity, emotions, and spiritual desolation were the deepest I had ever experienced. I thought it was the deepest anyone could go and the only way out was suicide.

I was wrong. I have since been much deeper in every way – physical, mental, emotional, and spiritual. I am currently in the deepest depression of my life. It has been going on for five months now, yet I don’t feel overwhelmed at all. The level of depression that once almost killed me now seems like a walk in the park. So does this one. Since it doesn’t overwhelm me or control my reactions to it, I wonder: Am I even depressed at all?

This video is a segment of a one-hour DVD based on the book Bipolar In Order: Looking At Depression, Mania, Hallucination, And Delusion From The Other Side.

\”I Love My Bipolar Hallucinations\” on YouTube

Although most people who experience delusions and hallucinations react to them in negative ways, it seems that the definition may be creating a false linkage. It could be that hallucinations and delusions are the only symptoms, and everything else is a reaction to these states. Is it true that the only possible reactions to hallucinations and delusional thoughts are adverse ones? My experience says the answer is no. It seems wrong to link the symptoms and reactions together as if there are no other possible reactions. By calling it a disorder, hallucinations and delusions are commonly seen entirely in a negative light.

Every single day I think about the time I tried to kill myself. It is one of my strongest and most detailed memories. I mention it in passing in my talks as if it is just a point of reference, but it has a profound impact on my every thought. I have not heard the bipolar or depression world debating pro-choice vs. pro-life suicide, but it is an internal debate that I often have myself. I wonder if others have had similar thoughts?

My debate is further colored by the suicide of my best friend Santiago. I think about his hanging himself every day, and the effect it had on everyone around him. It is another memory that is so strong it could have just happened. It too has a profound effect on my every thought.

The other day I was showing a visitor around San Francisco and he brought up suicide when we drove by the Golden Gate Bridge. He asked how many people have jumped off (over 1,200 so far) and whether they have put up a barrier yet. I found myself sharing my internal debate and chose to take the pro-choice side.

The following piece was written for Hopeworks Community, where Larry Drain–a prolific writer and activist in the mental health field–invited guest posts for his blog. It captures the essence of my journey and my feelings about recovery, so I’d like to share it here also.

This is my story of recovery from severe depression, and my message is one of hope. On the one hand, I doubt many people have experienced longer lasting or more severe depression than me (though a multitude have it just as bad). On the other, I have found my way to a place of contentment and steadiness that I never dreamt possible.

Although depression has dogged me for most of my adult life, my mood reached new lows after I lost my surgical career to severe arthritis in my neck. My spirits were especially crushed because the loss of occupation brought up lingering self-doubts left over from a highly traumatic childhood.

In recovering, I tried every type of therapy and group program that promised to assist me with my problems. These methods helped me improve my thought patterns, accept the present moment, and find spiritual peace. To my delight and surprise, I am often happy. Although I still get depressed from time to time, my spiritual centering and acceptance work have taught me that grief and sadness are as important and rich as happiness; I would not want to miss the textured sense of connection with tragedy. Whether happy or sad, I am at peace with my mind and my history.