Psych Central

Depression as fashion…not

By Christine Stapleton

I have a few questions about Urban Outfitters controversial “Depression” shirt – like who the heck would wear that?

You’ve got a cropped t-shirt (who even wears those anymore?) covered the word “depression” in a busy pattern of different size letters. In the t-shirt’s defense, “Depression” is the name of the clothing line. Really? Who names their clothing line after a mental illness? What’s next?

tshirtWell, I don’t know what’s next but I can tell what the last shirt that got Urban Outfitters in trouble. It’s the one that said “Eat Less” on an emaciated teenager. REALLY? I mean, REALLY? You tell me that there was a photo shoot at some studio and the stylists put an “Eat Less” t-shirt on an emaciated teenage model and SOMEONE in the studio didn’t say, “Whoa, whoa, whoa. This is not cool. We can’t do this!”

And there is some buyer at Urban Outfitters (who apparently didn’t get the memo about the Eat Less shirt) who saw the Depression t-shirt and thought, “Ooooo! We just have to carry that shirt!”

Don’t get me wrong. I like a lot of the stuff that Urban Outfitters sells. In fact, I just got a pair of tangerine Chuck Taylors for $10. Obviously, I don’t have much fashion sense but I love a good deal. But what little fashion sense – and common sense – I have were thoroughly insulted by the “Depression” t-shirt.

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‘Tis the season: Depression and seasonal-affective disorder

By Christine Stapleton

For those of you with depression who live in areas that are expecting life-threatening cold weather this week, I am not going to say “I feel your pain.” I don’t and I won’t insult you by saying it.

Although I have felt your pain in my lifetime, I do not feel your pain now because I live in Florida. I also won’t insult you by telling you what the weather is like in West Palm Beach right now.

I was born and raised in northwest Wisconsin and southwest Michigan. Phrases like “wind chill,” “lake effect,” “black ice” and “sub-zero” were part of my daily vocabulary for about five months of the year.shutterstock_24869581

The only thing worse than the temperature was the sky – so uniformally gray that it looked like someone had painted it one solid color. There were no clouds per se – just one massive, flat gray cloud that covered the entire sky for as far as you could see. Nine hours separated sunrise and sunset but it would be months before you would ever see the sun again so it didn’t really matter if it was day or night.

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How’s that New Year’s resolution working for you?

By Christine Stapleton

I don’t do resolutions but apparently a lot of people do because the gym was packed this morning.

If something needs to change, I change it. Relying on a number on a calender has never worked for me. Trust me. I’ve tried it. You can ask any alcoholic and they will tell you they have set deadlines and then either missed them or got sober for a few weeks and then they’re back at it.

It’s the same with dieting. If you can go ON a diet, you can go OFF a diet. You want to lose weight or quit smoking or drinking, you just do it – not because it’s a certain day of the year. resolutionsBecause it needs to be done and every cell in your body is convinced of that truth. In the words of the philosophers at Nike: Just do it.

Of course if you are as hard headed as I am, it may take some time to convince yourself that you really need to make a change. In fact, I brain has concocted truly ridiculous arguments  to prove to myself that I didn’t need to quit drinking, take antidepressants or see a therapist.

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Ringing in the New Year Without Alcohol or Depression

By Christine Stapleton

Two down. One to go.

Yes, we made it through Thanksgiving, rounded second base, aka Christmas, and are headed to third: New Years Eve.

At this point in the holiday season many of us with mental illnesses are merely “coping.”  We are coping with the in-laws. We are coping with children in the throes of sugar detox. We are coping with long lines, stolen parking spots and endless renditions of the same Christmas carols. Seriously, how many different ways can you sing Santa Baby?

We are almost there. For these final days I offer you my 10 commandments for getting through New Years without sliding into a depression or going “Richter” with merriment.shutterstock_81536707

1. Thou shalt not drink.

2. Thou shalt not drink.

3. Thou shalt not drink.

4 .Thou shalt not drink.

5. Thou shalt not drink.

6. Thou shalt not drink.

7. Thou shalt not drink.

8. Thou shalt not drink.

9. Thou shalt not drink.

10. Thou shalt not drink.

Sounds a little harsh, but it’s not bad once you get the hang of it and understand why abstinence is so important for the mentally ill during the holidays. Alcohol is a depressant.

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My 12-step anti-depression program for the holidays

By Christine Stapleton

Every year I’m struck by the same thought during the holidays: why are all the holiday movie classics about people with mental illnesses who are wonderfully restored to good health by a Christmas miracle?

George Bailey jumped off a bridge on Christmas Eve and miraculously snaps out of his depression with the help of a bumbling angel named Clarence. Natalie Wood, the clearly depressed mom in Miracle on 34th Street, is made happy and healthy by a department store Santa who ended up in Bellevue.shutterstock_66174244

Scrooge’s depression is lifted when the grim reaper comes knocking. Linus’ rendition of the nativity seems to alleviate Charlie Brown’s perennial dysthymia.

Folks, I’m here to tell you it ain’t that easy. You’re not going to get an angel like Clarence to show you what life would be like without you and the grim reaper – hopefully – won’t come visit. We’re on our own.

Frankly, for many of us the holidays suck. We’re supposed to be happy, happy, happy! And nothing sucks more than trying to force yourself to be happy, happy, happy and being around people who ARE happy, happy, happy because it’s the holiday season.

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Christmas takes aim at my depression

By Christine Stapleton

And I shall go forth into another holiday season with this mantra: Expectations are premeditated disappointments.

I shall also turn the frickin’ channel when a jewelry commercial comes on the television or that chipper song Feliz Navidad plays on the radio. I will do my damndest to avoid sugar, especially M&Ms. I will avoid the mall and its DMV-ish lines and battles for parking spots.shutterstock_820713

I’m not doing this because I am a bah-humbug kind of girl. I’m doing this because I know that my depression is smack in the middle of the bullseye this time of year. After umpteen years of therapy and medications, I  know that my expectations about Christmas – fueled by the American advertising industry – can push me over the edge.

So, I’m working on having a Charlie Brown kind of Christmas this year. I’m going to focus on putting a single bulb on a pathetic little tree – metaphorically speaking – and remember the nativity. I was raised Catholic, which likely explains a lot of other issues that we’re not going to go into right now, and taught that Christmas is about Christ’s birth.

Santa is supposed to be a side-dish, not the main course. I am going to focus instead on the lessons of the nativity, namely humility and giving.

And in that spirit, I give you this: a simple reminder of the simplicity of Christmas.

Pathetic Christmas tree image available from Shutterstock.



Excelling at the habits of highly miserable people

By Christine Stapleton

Have you ever read one of those Habits-of-Highly-Successful-Entrepreneurs/Athletes/Lawyers/Soccer Moms articles? I read them all. Depending on what kind of mood I’m in and who wrote it, these articles either instruct and inspire me or piss me off.

However, a friend posted one on her Facebook page a couple of days ago that is brilliant: The 14 Habits of Highly Miserable People. This is a must-read for anyone with depression but who is not currently in a depression.

Habits are developed by doing the same thing over and over. For me, it was thinking the same thoughts over and over. Those thoughts fueled my depression and for many a drunken sob fest.shutterstock_127174199

Among the priceless lessons I learned in my recovery from alcoholism and depression is that I can control my thoughts. You would think I would have figured that out at an early age, since I’ve always been a control freak.

But I never viewed my thinking as an activity that needed regulation, like credit default swaps. In fact, I didn’t really view my thought process as a process at all. Thinking was something that just happened all the time, like your toenails growing. You just let it happen.

And boy howdy, does it happen when you are in a depression. All my thoughts were gloomy. Everything was hopeless. The same tapes of failure, victimization and powerlessness played over and over in my head.

Then someone suggested I bone up on Buddhism and try meditation. That’s when the skies parted and my life began to change. I learned that I get to choose what I think. I must be mindful of my thoughts. When I am mired in stinking thinking, I can simply stop thinking those thoughts and think of something else.

Who would have thought?!

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Vacation vs Depression

By Christine Stapleton

It is November 14 and I am on vacation. It is the first vacation I have taken this year and I will never – ever – go so long without a vacation again.

Normally I take a week in the spring, two or three weeks in the summer and a week in the fall or during the holidays. This year, I took a week off in the spring but it was no vacation. I felt myself slipping into a depression and took the time to deal with that. Throughout the year I have taken a day here or a day there when I wasn’t feeling well or needed a long weekend.

But that is not a vacation.shutterstock_140985469

I realized in September that working so much with so little time off was affecting my mental health. Some mornings I woke up and wondered what day it was. Sometimes I tried to figure it out but I got to the point where I was like, f- it – it really didn’t matter what day it was.

I had to work – either at the newspaper or in the yard or on my 85-year-old house, which seems to be falling down around me. I felt that the only thing saving me from falling into my black hole was the floor beneath me – my medications. And I was flat on my ass on that floor.

The last two months have been hellish. As  journalist for 30 years I’ve seen a lot of nasty stuff. However, September and November brought two new cases that raised the depravity and brutality bar. I won’t go into details but both involved mothers who ended up dead – one without a head – and orphaned or dead kids.

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Finally: Medicare rules for community mental health centers

By Christine Stapleton

pillsToday the Centers for Medicare & Medicaid Services of the U.S. Department of Health and Human Services is releasing conditions of participation (CoPs) that community mental health centers (CMHCs) must meet in order to participate in the Medicare program.

This means there are finally rules that  ”focus on the care provided to the client, establish requirements for staff and provider operations, and encourage clients to participate in their care plan and treatment.”

We’re talking about protecting not only the 48 million seniors covered by Medicare but also 8 million other, younger disabled adults who are covered by Medicare. That’s 56 million Americans – more than the populations of California and Florida combined.

In 2012, 100 certified community health centers around the country billed medicare for partial hospitalization services.

There are 184 pages of rules and they are going to make some folks unhappy. There will now be rules for the qualifications of personnel working in CMHCs; client rights; admission, evaluation, comprehensive assessment and discharge or transfer of client; the treatment team and plan and coordination of services; quality assessment and performance improvement; and governance and administration.

Why do we need these rules? Because of complaints of physical abuse, fragmented care and that some CMHCs have stopped providing services once their center has been certified. Many centers have never had an on-site visit from the Centers for Medicare & Medicaid Services after they are certified and if a problem was found, the government is limited in kicking the CMHC out of the Medicare program.

We also need the rules because of the findings of and August 2012 Inspector General’s report entitled Questionable Billing by Community Mental Health Centers. The report found that in 2010 about half of the CMHCs met or exceeded what is considered high billing for at least one questionable billing characteristics.

Additionally, two-thirds of those with questionable billing were located in eight metropolitan areas. Finally, 90 percent of the CMHCs with questionable billing were located in States that do not require CMHCs to be licensed or certified.

Among the 203 comments submitted by the public in response to the proposed rule were complaints that anyone with money, yet no knowledge of psychiatric care can open and operate a CMHC.

These commenters asked for minimum professional standards at centers where the administrator has a financial interest in the CMHC. In response, other existing regulations were changed and now require “two or more persons to serve on the governing body, one of whom must possess the knowledge and experience as mental health clinician.”

The administrator can still sit on the board but “if the administrator has no psychiatric health background, either one of the CMHC’s clinicians or another qualified professional should be appointed to serve as of member of the governing body.

Rules don’t come cheap and this is where we may hear some complaints. It is estimated that it will $30,000 for a CMHC to implement the new rule the first year and $22,000 annually after that.

Now, let’s see if the rules work and are worth the price.

Man with too many meds image available from Shutterstock.



Free mental health care: Moving beyond the freeloader mentality

By Christine Stapleton

Every Saturday morning I refill my pink pill box: S-M-T-W-T-F-S. I have been doing this for years. Three different medications. One of this pill. One of that pill. One-and-a-half of those pills. Every morning and every night, I take my meds. It’s like brushing my teeth – just something I do when I wake up and before I go to bed.

My meds. I go weeks without giving a thought to my meds. I just take them. My life is good. No more hopeless black holes or vibrating with energy like a wide-eyed racehorse pawing at the dirt in the starting gate. Nice and steady. I have grown used to it and I really, really like it.shutterstock_133411307

So, when something comes along that has the potential to seriously disrupt my balance, I tend to freak out. Anxiety is the enemy. Drama is the enemy. I have made enough enemies in my life. I don’t need to make anymore.

There are three things that scare the hell out of me: Sharks. Being trapped in a car after an accident and cut out with the jaws of life; unemployment. As long as I stay out of the ocean and drive safely, I’m in good shape. Right now, unemployment is beyond my control.

And I like to be in control.

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Hoping for a Happy Ending
Check out Christine's book!
Hope for a Happy Ending: A Journalist's
Story of Depression, Bipolar and Alcoholism
Christine Stapleton

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