Sally’s been thinking…about a mental health toolbox

I’m thinking just how helpful it is to have a gifted and compassionate therapist, who has recently been contributing to my toolbox. I thought it would be helpful to share some of the ideas she shared and ideas I’ve gleamed from others.

At the very top of my toolbox is medication. We are still working on the perfect combination, but the process is worth it. Feeling much better allows me to focus on “following doctor’s orders.” I don’t always agree with his decisions, but I follow religiously. There are a couple of very pricey medications that don’t seem to be helpful. I am fortunate in not experiencing too much in the way of side effects, but who wants to take a handful of medications every day? Well, I’m not happy about it, but they act much the same as the lane regulator on my car. Sometimes I find it annoying. Yet it is extremely valuable in keeping me driving in my own lane. The same is true for my medications. They keep me in my lane.

In the little divider box of my toolbox I keep symptoms at the ready. It’s not as if I spend all my time wondering if I’m moving toward depression or mania, but knowing my early symptoms keeps me from falling too far or soaring too high. So, how do I know depression is on its way? The first one is wanting to go to bed or stay in bed even if I’m not tired. I am vigilant about that, making my bed even before dressing each morning. Another sign that depression is on its way is my lack of desire to do basic tasks. Nothing seems worth doing and nothing seems interesting. More than thirty minutes playing computer games is another sure sign. The final sign that alerts me is my lack of conversation. I feel I have nothing to say.

Now, what about the hypomania? Although I have little to say when headed toward depression, one of the key warning signs of abnormal energy rising is that I have a lot to say on a lot of subjects. Talking faster, moving faster, deciding faster are all warning signs. I am naturally a rapid thinker, able to conceptualize anything you throw at me. However when headed to an unnatural high, I have so many ideas racing in my mind that I must stop and write them down. Being the belle of the ball is not my most comfortable style so when I find myself flitting from person to person I remain alert.

So, what do I do when these signs and symptoms appear, I lift the divider box of my toolbox and find just the right tool. From coloring to counting; writing with my non-dominant hand, walking background and doing regular tasks with my right, not left hand. Tapping, crunching, popping those little bubbles in mailers are all good tools for me. I tell my friends what is going on and invite them to visit me, take me out somewhere, or give me a call. Withdrawal is not helpful and even if I have little to say, being surrounded by people who care pull me a ways out of my hole. Not everyone can do this, but a few close friends sure helps.

Now, what about the hypomania? The most helpful tool for me is playing the piano. Sometimes it is learning a new song, technique or notes. Sometimes it is banging out boogies, polkas and familiar tunes. To slow down, I play quietly, slowly and with purpose. I learned about “moment in time” long before mindfulness became a popular stress reducer. Living in the moment; not the past, not the future, develops a sense of gratitude and awareness that can keep me from rushing and not focusing on the next task at hand.

Some of these tools may be helpful to you. Others may not. My hope is that these do help or spark a new idea that is more useful. You matter. Take the time to figure out a toolbox for yourself.

Until next time,



Sally’s Been Thinking…about Mental Illness

I have been thinking about mental illness for a long time. I have enough research and experience with others to write a book. Unfortunately, the topic became quite personal after I completed radiation for DCIS, ductal carcinoma in situ, see last Novembers blog post, I’ve been thinking about Being a Person with a Serious Iillness.

As I drove home from my final radiation appointment, I found myself going beyond the hyper-vigilance that had plagued me for a month. My mind was racing so fast with so many ideas that I knew was not typical Sally thinking. After a visit with my doctor, I was put on a mood stabilizing medication that helped me to sleep and slowed me down. That was great and I moved happily into fall and winter.

Sadly, my best friend had been diagnosed with brain cancer and was fighting for her life. I saw her for the last time shortly after beginning the medication.  I fell into a deep depression that held fast through Beth’s battle and death. It did not dissipate until March, after a week in the sunniest city in the country, Yuma, AZ. I arrived back home in Winterset ready to engage in my life again. I was so relieved to be free of the depression that I failed to notice symptoms of an episode of hypomania. My family tried mightily to help me recognize it, but off I went to Anchorage, Alaska where the sun was shining even through the nighttime hours. I engaged in some unusual behavior for me and the friend I stayed with contacted my family with concern.

I barely returned home when I was off again to attend a conference in Dayton, Ohio. Again, no realization that my behavior was off the charts. It was only after sending a series of strange photos to my family that they began charting a course of intervention that would get me back to normal. Let me tell you that hypomania comes with its own set of denial (much like that of an alcoholic). I did everything I could to assure my family that I was fine and mentally healthy. I saw nothing strange about trading in my one-year old Honda Fit to lease a 2020 BMW Roadster, but they sure did.

I never got to the point of full-blown mania, but my actions were regularly inconsistent with my values. Caring very much for my son, friends and the rest of my family, I agreed to take Alan with me to see my doctor (the one who prescribed the mood stabilizing medication) and to see the therapist I’d found shortly after my last depression ended. Once we heard the diagnosis, we were all relieved. Not happy, but relieved. A psychiatrist confirmed my bipolar disorder shortly after those visits.

Now a new regimen of medication ensued, and I nearly surrendered to the darkest depression I have ever experienced. A shift in medication and seven weeks later, I was on my way out. And up. You may be able to tell that I am definitely recovered from the depression because this is my first blog post since November 2018. This time, however, I am working weekly with my therapist, seeing my psychiatrist who is 50 miles from home, and initiating a plan of many activities to keep me from racing and going back into hypomania.

Why am I writing this? Why am I sharing my experience with a disorder that has so much stigma attached? First, I am writing this to let you know there is life after diagnosis. Secondly, I want to be part of the fight to rid the stigma tied to mental illness.

For what it’s worth, I’m well today, December 5, 2019 and I have a toolbox filled with ideas to deal with both the depression and the hypo mania. That seems the best thing to do at this time.

I have access to treatment. I have family and friends who love me. And I always have hope; the hope that God consistently provides. Here is the bible verse that keeps me from spinning completely out of control in either direction: “We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed,” from 2nd Corinthians, chapter 4. I hope you find comfort and encouragement in these words as well.

Until next time,


I’ve been thinking… about depression and suicide

Since the recent deaths by suicide of a friend, a friend’s son, and a cherished colleague, I have been thinking often about depression, anxiety and the death sentence that comes too often with those conditions. Now, I know many people live with depression (including me and other loved ones) or anxiety and may not be in danger of death, but it remains a very real possibility. Suicide became real for me when a classmate’s brother died by suicide during his first year of high school. The common response fifty years ago was, “Someone would need to be crazy to take their own life.” That kind of talk is less prevalent today, and it casts an ugly shadow, but that statement could lead us to find the truth. The truth is that those who die by suicide are often dying from depression, a disorder of the brain. The morning after the most recent death in my own circle, I wrote in my journal, “Depression is a killer.” Statistically speaking, 800,00 suicides out of 350 million people worldwide with depression seems a very small number. But not to the friends and family of the 800,000. *

In my limited experience, depression doesn’t always kill, but it is a killer. My young friend, a woman of deep faith, was a beautiful, soulful, thoughtful and loving spouse and mother to three sweet young children. From outward appearances, she appeared to “have it all.” And then she died. My colleague had been in ministry for more than thirty years, proclaiming the good news of Jesus Christ among the marginalized, the disenfranchised and the mentally ill. Following his death by suicide, the tributes poured in: “Man, he brought me back from the brink of suicide.” I wonder how many people are alive today because he reached out to them in compassion, with a wealth of understanding about depression. I could continue, telling you stories about my college friend that his girlfriend and I thought we could keep alive by “watching” him; or the relative whose depression was so well hidden, no one knew how he died until two years after his death; or the precious son of a girlfriend, who died by suicide just days before his high school graduation, but you most likely have stories of your own.

Depression is one of those things that we cannot ignore. We must stop stigmatizing. In some cases, we must not give someone their privacy by avoiding raising the issue. As with many illnesses, depression appears in varying degrees. In some cases, it is controlled and treated by medication and talk therapy. In other cases, it is far more challenging and more debilitating than many of us can imagine. I recall being drawn to a couple of small children at our church, who loved hearing the stories I would tell on Sunday mornings. Most of the time, mom and dad were with them, but there were many times when dad was present for worship and other events with just the children. Where was mom? It turns out, she was in the hospital, trying a new treatment for her depression. In the hospital, staying safe. Her depression is severe. Her children are grown and living away from home yet stay in touch regularly. She is open about her illness and finds help and support among family, friends and her faith community.

I guess I’m writing this because it is on my mind and because I consider myself a good listener and a supporter of those with mental health concerns. BUT, I have missed the warning signs far too often and that scares me. It scares me for my loved ones and those I don’t even know. And it scares me to know that if I can be that insensitive when caring for others in my life’s work, then we all need to be more aware. Not just aware of others’ feelings, but aware of the symptoms and signs of depression and suicide. What can we do?

Until next time.


* Most of my information comes firsthand from those living with depression, but I have also found a great deal of valuable help on the National Institute of Mental Health (NIMH) and National Association for Mental Illness (NAMI) websites.

Facts from the NIMH Website: Depression is divided into two categories on the NIMH website. The leading cause of disability for people aged 15-44 is major depressive disorder. More prevalent in women than men, it affects more than 15 million people in the United States. Three (3) million people struggle with what NIMH calls dysthymic disorder (prolonged chronic depression).

NAMI lumps the categories together and says that depression affects more than 350 million people of all ages globally. It is the number one cause of disability, and, get this, predicted to be the number one global burden of disease by 2030.At its worst it leads to suicide, which takes the lives of 800,000 people worldwide each year.