I will go to my therapist’s office this afternoon. I will sit in the waiting room and read an old magazine. Another client will walk from a hallway that leads to my therapist’s office, pass through the waiting room and leave. My therapist will poke her head out, smile and say: “I’ll be with you in a minute.” After a  few minutes she will come back and invite me into her office. I will walk in, notice Kleenex in the waste basket and sit on the couch beside the box of Kleenex.

After a few pleasantries I will start unloading the detritus of my soul. She always pays attention and looks interested. I am her last patient on Friday. I cap off her week of listening to the detritus of other peoples’ souls. I ask myself, who in their right freakin’ mind would do this for a living? Hour after hour, day after day, week after week, year after year, listening other peoples’ misery.

So I asked her. ”It does get to you,” she said and explained how she takes care of herself. Burnout is a big problem among mental health care providers, she said. Then I remembered Tony Soprano’s therapist who had her own therapist on The Sopranos. It never dawned on me that a therapist might have a therapist.

This morning I got to thinking about this after reading about the gunman and his horrible rampage at Fort Hood yesterday. His name is Maj. Nidal Malik Hasan and he is an Army psychiatrist. He also is Muslim. Before he opened fire and killed 12 and wounded 31 people yesterday he had been assigned to counsel soldiers returning from the battlefields with post traumatic stress disorder. Hour after hour, day after day, week after week he listened to the horrors and atrocities of war. The soldiers he counseled were emotionally raw - just off the battlefield.

Then Dr. Nidal Malik Hasan learned that the Army wanted to send him to the very place where those horrors and atrocities occur. There was the “Muslim issue”, too. The doctor is a practicing …

On Thursday former First Lady Rosalynn Carter, 82, will do what she has done for over 30 years - bring together doctors, policy makers and consumers to draft policies that will decrease stigma and discrimination against people with mental illnesses and promote positive policy change on mental health issues.

Mrs. Carter’s annual Symposium on Mental Health Policy is one of the best kept secrets in the ranks of mental health advocacy. Although the symposia are not open to the public, they can be viewed in realtime on the Carter Center’s website. The idea is to bring stakeholders together - not only to listen to each others’ problems but to create solutions that address the needs and goals of all.

I like to think that things happen when they happen for a reason. There are no coincidences in life, just synchronicity. How else can you explain Congress debating health care reform in Washington on the same day that Rosalynn Carter opens this year’s symposium, entitled Fixing the Nation’s Broken Behavioral Health Care System? It’s destiny - good karma.

So when you get to work on Wednesday check your calendar for Thursday and Friday. Make some time to listen in to the symposium - even for a few minutes, for a little inspiration. Sometimes, just listening to others care so deeply about what you care for and hearing how badly they want to help you is enough to get you through the day.

Someone wants to help you. Her name is Rosalynn.

A three-week court hearing about the roles of two doctors in the death of Anna Nicole Smith ended last week with a judge ordering the doctors and Smith’s long-time companion to stand trial on charges of illegally supplying her with prescription drugs, according to the Los Angeles Times.

Amen. Hallelujah. God bless America.

It’s about time.

Smith died 2-1/2 years ago. The medical examiner found a smorgasbord of benzodiazepines in her blood - but no antidepressants. According to reports, she had fallen into a deep depression after her son died in her hospital room, where she had given birth to her daughter just hours earlier. Anna Nicole Smith was 39-years-old. The cause of her death was “combined drug intoxication.” Simply put, she overdosed. But according to prosecutor, Smith did not overdose. Her doctors overdosed her. And now, two of them are looking at prison.

Why is this case so significant? Because finally, someone with some clout has finally realized that doctors who irresponsibly prescribe drugs such as Ativan, Klonopin and Valium - to patients they know are addicts and alcoholics must be held responsible. It was obvious that Smith was an addict/alcoholic. Anyone who watched her reality television show knew that.

Still, her doctors wrote prescriptions - sometimes under an alias - for drugs that are widely prescribed for anxiety and depression and widely abused by addicts/alcoholics. Drugs like Ativan, an anti-anxiety medication. My mother took it in hospice, and, boy, did it work. Klonopin is the drug to which Stevie Nicks was addicted. And Valium, well, let’s just say a lot of us know what Valium feels like. Then there was Soma and Methadone, both habit-forming. And finally Noctec, a very old sedative that is rarely used and must be used — especially by an addict and/or alcoholic — with extreme caution.

If that isn’t criminal malpractice I do not know what it. We saw the same thing with Michael Jackson, whose death was ruled a homicide by drug overdose. Jackson’s doctor has not been charged. However, the doctor prescribed drugs to Jackson - including the benzodiazepine lorazepam - …

I had another “drunk dream” last night. After eleven years of sobriety I do not have them as often but I do still have them and probably always will. “Drunk dreams” are the dreams of recovered alcoholics. In our drunk dreams we relapse. In my drunk dreams I never actually drink or am drunk. My drunk dreams are always after the drink, the awful realization of what I have done and what I must now do.

Last night’s dream was especially disturbing. In it I tried to rationalize my relapse. I had not gotten fall-down, stupid, dance-on-the-bar drunk. I was just a couple glasses of wine. It really wasn’t like the horrible relapses you hear about. It was just a few glasses of wine on a few occasions. Of course, it was never like that in real life. It was always a few bottles of wine on every occasion.

But there I was, at a meeting, realizing that I would have to tell everyone that I had relapsed. I would have to walk to the front of the room and pick up a “white chip” - a poker chip that represents surrender for a newly sober alcoholic.  Oh the embarrassment! Oh the humiliation! Oh the gossip! (Obviously I still have some pride issues to work on…) In my dream my alcoholic brain was fast at work: “You know, no one here knows that you relapsed. No one saw you drinking. You really don’t need to tell everyone you drank. Just keep it to yourself. No one will ever know.”  Then the dream ended.

Now it is 6 am and a mild case of anxiety has settled in my chest. I don’t like this feeling. I don’t like that my dream ended like that. I don’t want to feel like this. But this is the emotional chain-reaction that every dual-diagnosed alcoholic and addict lives with. The illnesses play with each other. And when one cannot come out to play, the others bang on the door of your subconscious until the other comes out to play.

Depression and alcoholism are twins …

I emceed the annual Out of the Darkness walk last Saturday for our local chapter of the American Foundation for Suicide Prevention. This group is very special to me - not just because I have two suicide attempts in my past. It is because of their extraordinary devotion and perseverance to this cause in the face of overwhelming stigma. More and more we hear a celebrity, coworker, neighbor or friend talk about their depression or bipolar or even their struggle with drugs and alcohol. But discussing an actual suicide with the loved one left behind is still the ultimate taboo. You just don’t do it.

We want to hear the gory details, but we dare not ask. Instead, we rely on hearsay and gossip. We tell ourselves that we do this because we don’t want to inflict any more pain on the grieving loved ones. But we really do it because suicide scares the hell out of us and if it could happen to them, it could happen to someone I love.

After the walkers took off I hung out with several couples whose children had killed themselves. It had been many years since their children’s suicides and all of them now volunteer to help others deal with their grief. I asked if I could ask them some questions - not about details of their children’s suicide but about etiquette.

I have friends of friends who have killed themselves but no one close to me has committed suicide. I, too, am very uncomfortable discussing it with a grieving loved one. I don’t know how to start a conversation and I don’t know how to respond if they decide to talk about it.

So, I asked these parents: “What should I say?” “What questions can I ask and what questions should I not ask?” “Is it okay to ask why it happened?

One mother told me she thought I should break the silence by saying: “I hear you had a wonderful son/daughter/husband.”

“Don’t approach it from the perspective of loss,” she said. “This way they will focus on the good rather …

I got sober within hours of my husband and I splitting up. That was 11 years ago. Our daughter was 6. She is about to turn turn 18 and we are in college application hell. For the mentally ill parent - especially those of us who are dual diagnosed - this is our judgment day.

For many of us, we stare at the ACT and SAT scores, the transcripts and the lack of extra-curricular activities and we think, “Man, did I screw up. I failed her and now she will have to pay the consequences for my alcoholism, depression and bipolar.”

Could I have pushed her harder to join a club, try out for a team and study more? Yes. Could I have worked fewer hours and spent more quality time with her? Yes. Could I have been stricter, more disciplined and encouraging? Yes. Should I have gotten help for my alcoholism, depression and bipolar sooner? Yes. I could go on like this for hours, beating up myself for things I could and should have done.

I know a very wealthy woman with no children who blasts recovering addicts and alcoholics for continuing to use our illnesses as excuses for bad behavior. Is that what I am doing now? Am I using my alcoholism, depression and bipolar as excuses for the mistakes I have made as a parent - even as a sober parent? I want to shout - “I was trying to stay sober! My parents were terminally ill! I got divorced (again)! It was hard being a newly sober and single working parent!  I didn’t know I had depression or bipolar back then!”

But another voice shouts back: “Come on, you have been sober, in therapy and on your medications for awhile now. Your parents died years ago. Clearly, you could have been a better parent but you chose to use your illnesses as an excuse.” I simultaneously sit on my pity pot and beat myself up.

I know that all parents make mistakes. But for those of us with mental illnesses - especially alcoholism and addictions - …

I was having a discussion with some friends a while ago and someone asked this question:

If you could be anyone, who would you be?

Angelina Jolie popped into my head because, come on, those lips are really amazing. But the last time I counted those lips came with about 8 kids. No thank you. If I could sing like Aretha Franklin I would never speak again. I admire the hell out of Ruth Bader Ginsberg, not just because she is brilliant and funny but because she can put up with Justice Scalia. Ixnay on Courtney Kardashian. Double ixnay on any of Hefner’s Girls Next Door. Christian Amanpour is pretty cool. Definitely not Ann Coulter.

Can I be a hybrid?

Actually there is a correct answer to this question and it finally came to me after my hybrid request was denied. Me. I just want to be me. Seriously. I finally, unequivocally want to be me. Even with the six pounds I gained in the last year and the gray(ing) hair and gravity impaired body parts, I want to be me.

Do you have any idea how amazing this is? After a lifetime of substance abuse, depression and self-loathing, I finally want to be me - all the time. I still have a slew of character defects - like, I want to shout from the mountain top the real age of someone who shaved a few years off a birth date on Facebook. But I won’t because I am not that kind of woman anymore.

When I was depressed I wanted to be anyone but me. When I was hung-over I wanted to be anything but me. Sometimes, when I was depressed AND hung-over I did not want to be at all. I wanted it to be over, once and for all. I just wanted to check out, permanently. A couple of times - when I was in high school and again in college - I even tried suicide. For years I awoke in the middle of the night to a tape playing over and over in my head, “Oh, didn’t …

There are those, too, who suffer from grave emotional and mental disorders, but many of them do recover if they have the capacity to be honest.

Chapter 5, How it Works, from the Big Book of Alcoholics Anonymous

I had heard this sentence a thousand times at meetings before my diagnosis and never gave it a thought. Now I do. I believe it was written for us alcoholics and addicts who have a companion mental illness, such as depression, bipolar and schizophrenia. I have depression and bipolar along with alcoholism. Now, when that sentence is read, I hear it.

At first I could not figure out what it meant. Capacity to be honest? What does that mean? I am honest. I’m from Wisconsin. We’re terminally honest, don’tcha know? And why does it say “capacity to be honest” instead of just “honest.” Heck, I have the capacity for a LOT of things - you should have seen how much beer I used to drink.

So, what does that sentence mean? For me, honesty means accepting that I - alone - am powerless over all my mental illnesses - alcoholism, depression and bipolar. I cannot get better all by myself. I need to take off my cape and ask for help - and I HATE asking for help.

Honesty means I have to accept that all the meetings and 12th Step work in the world are not enough to make me well - I need medication. Honesty means I have to tell the truth - the whole truth - to my nurse practitioner. I must tell her that I am an alcoholic and I do NOT want any antidepressants, mood stabilizers, anti-anxiety or sleeping pills that could get me high - especially benzodiazepines.

Honesty means I have to treat ALL my mental illnesses - always. I cannot stop going to meetings just because I am taking my medications as prescribed. It does not mean that I can stop taking my …

I have an illness that tells me I do not have an illness. I am an alcoholic. It is one of three mental illnesses that I have - along with depression and bipolar. I have not touched alcohol - not so much as mouthwash or cold medicine - in 11 years. I still go to meetings several times a week and volunteer to work with other recovering alcoholics. But sometimes I forget how bad it was. That is a very, very dangerous place to be if you are an alcoholic, especially an alcoholic with depression and bipolar.

I was a blackout drinker. At some point when I was drinking my memory would stop recording what I was doing. I did not have blackouts every time I drank. I would blackout without warning. Could be after one drink or after two bottles of chardonnay or not at all. I did not know I was in a blackout when I was in a blackout. You probably would not have known either. I could still talk, walk, dance on the bar, drive a car or have sex. You would see a drunk woman making a fool of herself. I would have no memory of any of it.

No matter how hard I tried to remember there was no memory. I would remember walking into a bar or restaurant, or opening a bottle of wine in the kitchen and then nothing until I woke up the next day. I am not capable of describing the fear, embarrassment and shame that follows a blackout, especially when it is paired with an epic hangover. Where is my car? Did I or didn’t I sleep with him? How did I get that bruise? What did I say to her to make her look at me like that? Nothing will stoke your depression like an unknown amount of alcohol coupled with unknown behavior.

It had been a long time since I had thought about my blackouts - until last night. I was blissfully sitting on the couch with my dog - “Dog” - watching an episode …

As someone who has depression, bipolar and alcoholism, I love to read about research. My problem is that I often cannot understand a word of what I am reading. I cannot even pronounce half of the words, which is why I have to thank The New York Times columnist David Brooks and NARSAD for their recent efforts to make neuroscience intelligible and palatable.

Last Sunday Brooks had a simple column on a recent academic conference of the Social and Affective Neuroscience Society.  Normally I would not read a snooze-o-rama like this - especially on a Sunday morning. But the headline sucked me in - The Young and the neuro - and Brooks’ first paragraph held my attention:

“When you go to an academic conference you expect to see some geeks, gravitas and graying professors giving lectures. But the people who showed up at the Social and Affective Neuroscience Society’s conference in Lower Manhattan last weekend were so damned young, hip and attractive.”

Thank you David Brooks and the editor who wrote the headline. You got me. Because of your clever writing I now know that dominant behavior activates the reward center of the brain in Americans,  but in the Japanese that center of the brain was more likely to be activated by subordinate behavior.

A region of the brain in American and Chinese subjects activates when they see members of their own group endure pain, but at lower levels when watching others endure pain. “These effects may form the basis of prejudice.”

Brain scans of Yankee and Red Sox fans showed their “ventral striatum and nucleus accumbens were activated” when they watched highlights of their own team’s games but neither reacted much when watching an Orioles-Blue Jays game. I am not sure what this means. It could be simply be a statement about the quality of play by the Orioles and Blue Jays. Or it could mean “that we are awash in social signals, and any social science that treats individuals as discrete decision-making creatures is nonsense.”

Why is any of this important? There are two reasons:

1. We know …