World Bipolar Day

                  March 30^th was World Bipolar Day. I do not know what it is like to live with bipolar disorder, but I think it is important that a depression blog spend a little time sharing about this mental illness.

                  The purpose of World Bipolar Day is to bring awareness to bipolar disorder and eliminate the stigma surrounding it. This day is meant to be an opportunity to educate people about bipolar disorder. It is celebrated on March 30^th because it is the birthday of Vincent Van Gogh, who was posthumously diagnosed with bipolar disorder. 

                  Bipolar disorder was previously known as manic-depressive illness. This disorder causes shifts in a person’s mood, energy, and ability to function. These shifts can be severe. The shifts are not normal ups and downs. The shifts of bipolar disorder can be dramatic mood swings. A person can go from being overly high and/or irritable to sad and hopeless. Then shift back again. The high periods are called manic, while the low periods are called depressive episodes. 

                  Hypomania is mild to moderate level of mania. It often feels good to the person, and they may function well. As a result, they may not recognize that there is something wrong. Severe episodes of mania can include symptoms of psychosis, in which the person is out of touch with reality. They may have hallucinations, which can lead to a misdiagnosis of schizophrenia. 

                  The symptoms of mania include, but are not limited to increased energy, activity, and restlessness, excessively “high”, overly good, euphoric mood, extreme irritability, racing thoughts and talking very fast, jumping from one idea to another, distractibility, and little sleep needed. 

                  The symptoms of depression include, but are not limited to poor appetite or eating too much, trouble sleeping or sleeping too much, nervousness or worry, loss of interest in and withdrawal from usual activities, feelings of sadness that don’t go away, irritability or restlessness, repeated thoughts of death or suicide. 

                  There are four types of bipolar disorder: Bipolar I Disorder, Bipolar II Disorder, Cyclothymic Disorder or Cyclothymia, and Bipolar Disorder, “other specified” and “unspecified”.

                  Treatment includes psychotherapy, medication, self-management strategies, and complementary health approaches (these compliment the first three and do not treat bipolar disorder on their own).

                  Organizations such as NAMI and the International Bipolar Foundation can provide support for individuals living with bipolar disorder. I used resources from both of these organizations to write this post. NAMI also supports loved ones and caregivers of individuals living with bipolar disorder.

                  It is important that we work to reduce the stigma surrounding bipolar disorder. Too often people refer to everyday mood swings as bipolar disorder. As you have read here, there is more to bipolar disorder than mood swings. It is a stigma to casually use bipolar disorder as a description of a person. Bipolar disorder is an illness and as such should be treated as one. 

 

   

                  

Women in Mental Health Who Are Influential in My Life

                  I would like to wrap up this series on influential women in mental health by highlighting women I find influential in my own life. These women include some women who have influenced not only my mental health journey, but also my life. After these women I would like to share some women I have encountered who while not personally impacting my journey, are still influential and who I look up to.

                  There are some women who have provided me with amazing mental health care. I would not be where I am without them. I would not be in a place to write this blog without them. I am not sure I would even be here without them. They are among the amazing women who contribute to the mental health field and belong among the other women I have featured in this series. These women make a difference in my life, and I am truly grateful for their healing presence. 

                  Thank you, Dr. S. You are incredible. You have changed my life and the course of my mental illness. You are there when I need support. You have restored my faith in psychiatrists by being the best. 

                  Thank you, Stephanie. You have guided me and held my hand when I didn’t know if I would make it. You have been there in my moments of crisis. You are incredible.

                  Dr. S and Stephanie, I appreciate both of you more than you will ever know.

                  Thank you, Brittany. You have kept me on the healing track and allowed me to search for my way. I appreciate you.

                  To all the techs who have been a part of both my esketamine and TMS treatments, thank you. Your work is important and healing. 

                  Thank you, Cristina. You understand the importance of mental health and support me in a way many primary care providers have not figured out. You are a reminder that mental health is a part of healthcare. I appreciate you.

                  Thank you to all the women working in mental health. You are seen and appreciated. 

                  And now for a couple women whose work inspires me to keep trying to make a difference.

                  Terry McGuire is the host of the podcast Giving Voice to Depression. As her podcast title says, Terry gives the voices of depression a place to be heard and shared. Her work has made a difference for many including me.

                  Katherine Ponte runs For Like Minds and Psych Ward Greeting Cards. These programs bring understanding to people living with mental illness. Her work inspires me to work to help others living with mental illness. 

                  Both Terry and Katherine use their lived experience to help others. Their work has influenced me, and I hope that one day I will have the reach they have achieved. 

                  I would also like to acknowledge all the women who work for NAMI (National Alliance on Mental Illness). Your work is healing and makes a difference. I have met too many to name all here. Please know that your work and dedication make a difference.

                  My posts this month have highlighted women who have been influential in the mental health field. I shared the work of 10 women this month in addition to the women I have shared in this post. The work of all these women has made a difference. I highlighted them during Women’s History Month, but we should recognize them all year long. This is important. Right now, people in the United States, including our current government, want to minimize or even erase the accomplishments of women. We cannot allow that to happen. I encourage you to recognize the women who make a difference in your life. Share their influence. Reach out and let them know you appreciate them. Give them a card or just say “thank you”. I chose to recognize women in mental health because this is a depression blog. Don’t let Women’s History Month end without acknowledging the amazing things women do every day. Don’t let that acknowledgment end on March 31^st. The achievements of women are not confined to one month.

                  

 

There Are More Influential Women in the Mental Health Field

                  As Women’s History Month nears an end I would like to share the stories of a few more women this week. As I have said, it is important that we recognize their contributions to the mental health field. Men get so much of the recognition, but many advancements would not have happened if it were not for women. There are many women studying psychology and related fields in colleges today. They need to learn about the women who came before them. This knowledge will serve as a motivator and a call to strive for further advancements. Men can also learn from the work of all these women I have written about this month. After you read about these women, share their stories with others, men and women. Let’s give these amazing women the credit they deserve.

 

Leta Stetter Hollingworth (1886-1939)

 

"I do not know. I was intellectually curious. I worked hard, was honest except for those minor chicaneries which are occasionally necessary when authority is stupid, disliked waste, and was never afraid to undertake an experiment or to change my mind."

 

                  Leta Stetter Hollingworth was the first female psychologist in New York City. She worked at Columbia University. Her worked challenged the belief that women had inferior intelligence to men. She studied under educational psychologist E.L. Thorndike. She demonstrated that differences in intelligence was a result of societal roles not being born male or female. 

                  Hollingworth’s dissertation focused on women’s intelligence during menstruation. At the time it was believed that women had a decrease in performance on mental tasks during menstruation. Hollingworth’s work proved that there was no empirical evidence for this.

                  She also worked in educational psychology and coined the term “gifted”. Her work focused on nurturing gifted children. At the time it was believed that gifted children could take of themselves, but Hollingworth showed that these children needed to be nurtured. She developed a curriculum for gifted children.

                  Hollingworth’s early work studied women and led to changes in how women’s intellectual abilities were acknowledged. Most of her work was in the school setting where she worked in educational psychology. She died at the age of 53 from abdominal cancer. At the time of her death, she had more work planned.

                                                                                                                                   

Anna Freud (1885-1982)

 

"The best way to understand children is to observe them when they're on their own, unobserved."

 

                  Anna Freud was the daughter of Sigmund Freud, but she was more than just his daughter. She was an influential psychologist in her own right. She is the founder of child psychoanalysis. Anna Freud’s work contributed to the understanding of child psychology. Interestingly, Erik Erikson, a male psychologist who many in the world of psychology can name easily, was strongly influenced by the work of Anna Freud. 

                  Anna Freud recognized that children had different symptoms than adults, noting that these were often related to developmental stages. Her work included how the ego played a role in managing anxiety. The work of Anna Freud is the basis of modern child therapy and developmental psychology.

She also made contributions in understanding how the mind uses defense mechanisms to protect itself. She demonstrated that everyone uses defense mechanisms, not just people with psychological disorders. 

 

Leta Stetter Hollingworth and Anna Freud both made significant contributions in the field of psychology that have impacted mental health. They are examples of women who dedicated their lives to understanding the mind. 

If you have missed the first four post in this series on influential women in the mental health field, I encourage you to read them. The series started on March 10 and includes posts on 3/13, 3/17, and 3/20. There will be one more post on Thursday. 

 

 

Continuing to Discuss Women Who Have Made Contributions to Mental Health

                  I think it is important that we recognize the many women who have made contributions to the mental health field. Even today there are people who try to diminish the accomplishments of women. This makes it even more important that we learn about and celebrate these women.  If you took a high school or college introductory psychology course, you are no doubt familiar with Freud, Maslow, Piaget, Skinner, and Watson. All men. I did a Google search for pioneers of psychology. The results were all men. As my last few blog posts have shown, there are many women who have made equally as important contributions to psychology and mental health. So, here are two more women that we should know about.

 

Francine Shapiro (1948-2019)

 

“The past affects the present even without our being aware of it.”

 

                  Francine Shapiro created Eye Movement Desensitization and Reprocessing (EMDR) therapy.  This treatment is a safe and effective way to help people address and process traumatic memories. Even though this treatment has been controversial, it has been found to be effective for working with trauma and post-traumatic stress disorder. 

                  Shapiro realized that when people have unprocessed trauma or trauma that is not fully processed, the feelings associated with it linger in the nervous system. Her first realization that eye movements could decrease negative emotion came while she was walking in a park in 1987 and noticed how her eye movements were associated with distressing memories that she had. She experimented with eye movements and found that others experienced a desensitization to distressing memories as a response to eye movements. This led her to develop EMDR. It includes work with the therapist and the eye movements. There is a set procedure that involves recalling a memory before the work with eye movements. EMDR is generally, conducted over 6 to 12 sessions.

                  In 2004 the American Psychiatric Association recommended EMDR as an effective treatment for trauma. Shapiro’s discovery and work are helping people with post-traumatic stress disorder. 

 

 

Nellie Bly (1864-1922)

 

“It is only after one is in trouble that one realizes how little sympathy and kindness there are in the world.”

 

                  Nellie Bly was a journalist, not a psychologist. As a woman, she fought to create opportunities to write newspaper articles. She wanted to write an article on immigrant’s experiences, but was denied by the editor of a newspaper, Joseph Pulitzer. Instead, he challenged her to investigate and write an article about Blackwell’s Island, a notorious New York mental asylum. Bly went undercover by acting as if she had a mental illness. She was admitted to Blackwell’s Island, where she experienced how badly people with mental illness were treated. The result of her time at Blackwell’s Island was a six-part series entitled Ten Days in the Madhouse. People were shocked by what she reported. Her reporting led to increased funding to improve conditions in the asylum. 

                  While Bly is remembered as the founder of investigative journalism, her series, Ten Days in the Madhouse, helped to change conditions in mental health facilities. She exposed the mistreatment of people with mental illness. She gave these people a face and made others aware of their humanity.  Bly’s work demonstrates that a person can influence how people with mental illness are treated even if they are not trained in psychology, leading the way for future mental health advocates.

 

                  Shapiro and Bly made contributions to mental health in different time periods. Bly’s efforts demonstrate that the treatment of mental illness has long been an issue. We are still fighting to improve the care of those with mental illness. Bly’s writing opened doors to allow the world to see that improvements in the care of those with mental illness are necessary. 

                  Shapiro’s work is much more recent. Her work provides a treatment option for people living with a specific mental illness, post-traumatic stress disorder. It demonstrates that new approaches to treatment are always possible. We cannot stop researching and developing treatments for mental illness. 

                  As with the other women I have featured in the last few posts, I am guessing most readers have never heard the names of these women. I encourage you to remember the work of these women. Recognize their work. Celebrate it.

 

 

Even More Influential Women in the Mental Health Field

                   Today I continue sharing the stories of influential women in the mental health field. I believe it is important as woman, an individual with mental illness, and a mental health advocate for me to share the accomplishments of these women. That is why I have dedicated posts to their stories. I have been appalled by the current administration’s diminishing of women. I am also aware of their attempts to reduce mental health diagnoses and treatment. (More on that in a future post. I just need to spend some time researching first.). So, I will continue to post about women’s contributions to mental health. I am dedicating the month of March to talking about these amazing women. It is my hope that people will read and share these posts. I realize I have a small audience, but I can still do my part. If you are reading this, please help me by sharing with at least one person. Together we can make a difference.

                  

Martha E. Bernal (1931-2001)

“However critical I might be of this country, I have felt grateful for the opportunities of which I availed myself.”

 

                  Martha E. Bernal was the daughter of Mexican immigrants. She was the first Latina to receive a doctorate degree in psychology in the United States. She faced discrimination based on being female when she searched for a position after earning her PhD. That did not stop her. She made contributions in the area of learning theory and the methods of treatment and assessment of children with behavior problems.

                  She also helped advance multicultural psychology. Her work helped bring an understanding of the importance of diversity in training, recruitment, and research. In the 1970s she worked to ensure that students of color had the opportunity to receive graduate training. She drew attention to the lack of ethnic minority psychologists. She offered steps to improve this. 

                  Bernal helped establish the National Hispanic Psychological Association. She served as this group’s second president. 

                  The “Martha Bernal Scholarship Fund was established at Arizona State University to honor her commitment to advancing scholars of color. 

 

E. Kitch Childs (1937-1993)

“We must generate a systematic method for conflict resolution so as to lose none of the power of our anger in useless wheel spinning…By doing so we may amplify and augment sisterly cooperation, understanding and in the meantime enhance our self-empowerment.”

 

                  E. Kitch Childs was a clinical psychologist. Through her work she advocated for marginalized women, sex workers, and the LGBTQ+ community. She was the first African American woman to earn a PhD in human development from the University of Chicago. 
                  Childs was very aware of the lack of organized research into the psychology of women. A great deal of her work was focused on feminist therapy. She helped found Chicago’s Gay Liberation Front. Childs provided therapy for the LGBTQ+ community, especially those with AIDS.

                  E. Kitch Childs was recognized for her work to change the American Psychiatric Association’s position on homosexuality, which had listed it as a psychological disorder. 

                  She tailored her approach with clients to meet their specific needs. Often her approach went beyond traditional therapeutic practices. Her clients included the most marginalized and poorest people. She offered sliding scale fees and free services to those who needed it. Childs also offered group therapy that was focused on community-building. Childs used her professional expertise and her own experiences with discrimination to build up communities.

 

                  Bernal and Childs are examples of women who made a difference in not only the field of mental health, but also for people who are the most marginalized. Their work showed that all people matter. The mental health of all regardless of race, gender, and socio-economic status should be valued and cared for. The work of Bernal and Childs are examples of what we should be focusing on as nation.

 

More Influential Women in the Mental Health Field

                 I was going to wait until Monday to write another post on influential women, but there are so many women to discuss, I decided to include more posts. Today I will feature two more women who made important contributions to the mental health field.

 

Mary Whiton Calkins (1863-1930)

“For with each year I live, with each book I read, with each observation I initiate or confirm, I am more deeply convinced that psychology should be conceived as the science of the self, or the person, as related to its environment, physical and social.”

 

                  Mary Whiton Calkins is a graduate of Wellesley College. After graduating she was given permission to attend seminars at Harvard University, which at the time was an all-male institution. She completed all the requirements for a PhD but was denied the degree because she was a woman. 

                  She taught psychology a Wellesley College, where she established one of the first psychological laboratories in the United States. Her research was focused on memory, dreams, and consciousness. She developed a system of self-psychology. According to this system the foundation of the study of psychology should be the conscious self. She opposed behaviorist John Watson’s idea that introspection was not a part of scientific psychology. 

                  Calkins invented a technique, called the paired-associate technique that is still used in memory research today. In this method pairs of items are presented. The items are usually words. Recall is tested by presenting the first item as cue and asking the person to recall the second item.

                  In 1905 Calkins became the first female president of the American Psychological Association. She was the 14^th president in the organization’s history. In addition, she became president of the American Philosophical Association in 1918.

It should be noted that Harvard still refuses to grant Mary Whiton Calkins the PhD posthumously, stating that Harvard did not admit women at the time she completed coursework there.

 

Mamie Phipps Clark (1917-1983)

“A racist system inevitably destroys and damages human beings; it brutalizes and dehumanizes them, blacks and whites alike.”

 

                  Mamie Phipps Clark grew up in the Jim Crow South. She lived with segregation. She witnessed the violence that goes with segregation. 

                  Clark earned a master’s degree from Howard University. She earned a PhD in psychology from Columbia University in 1943. She was the first African American woman to earn a PhD from Columbia University.

                  Her research was focused on child development and racial trauma. Her work was instrumental in desegregating schools in the South. She, along with her husband Kenneth Clark, is known for using doll tests to demonstrate how segregation negatively affected Black children. Her research with the “Doll Test” key evidence in the Supreme Court case Brown v. Board of Education. 

                  Along with her husband, Phipps Clark worked to make the field of psychology more inclusive. Mamie Phipps Clark was a Black woman in psychology when that was a rarity in the United States. She opened the door for diversity in the field of psychology. She used her own personal experiences to devise research that led to the end of segregation in schools. 

 

                  Mary Whiton Calkins and Mamie Phipps Clark made important contributions to the field of psychology and to American society. They paved the way for the women who are doing great work in mental health and psychology today. They broke barriers. Their work should not be forgotten.

 

Influential Women in the Mental Health Field

                  March is Women’s History Month. I think it is a good time to learn about some of the women who have influenced the field of mental health. I will use a few of my remaining March posts to share the contributions of women to mental health.

                  Dorothea Dix

“Your minds may now be likened to a garden, which will, if neglected, yield only weeds and thistles; but if it is cultivated will produce the most beautiful flower and the most delicious fruits.”

                  Dorothea Dix (1802-1887) was instrumental in providing mental health care for people in the 19^thcentury.  During the mid-19^th century people with mental illness were often kept in facilities alongside violent criminals. There was little to no discrimination between how the criminals were treated and how those with mental illnesses were treated. It was a grim world for people with mental illness. They were often abused and mistreated.  Dorothea Dix spoke out and her efforts led to reform first in Massachusetts and the later in Rhode Island and New York. The reforms Dix spearheaded led to reforms throughout the United States and led to a change in the approach to mental health treatment in America. 

                  Dorothea Dix founded or expanded more than 30 hospitals for the mentally ill. She believed that people with mental illness could be cured and worked to spread this belief. She not only led efforts in the United States. Her work had an international influence. 

                  Bebe Moore Cambell

“While everyone – all colors – everyone is affected by stigma, no one wants to say, ‘I’m not in control of my mind.’  No one wants to say, ‘the person I love is not in control of [their] mind.’ But people of color really don’t want to say it because we already feel stigmatized by virtue of skin color or eye shape or accent and we don’t want any more reasons for people to say, ‘You’re not good enough.’”

 

                  Bebe Moore Cambell (1950-2006) was an author, journalist, and teacher who dedicated her life to advocating for the mental health needs of the Black community.  She founded the Inglewood-LA chapter of NAMI (National Alliance on Mental Illness. This chapter is now NAMI Urban Los Angeles. Cambell’s daughter lived with mental illness. Bebe Cambell was an advocate for people of color to have safe spaces to share their experiences, including their experiences with mental illness. She is responsible for improvements in how mental health is approached in underserved communities. She worked to end the stigma that is often one of the reasons for lack of mental health care and treatment in communities of color. 

                  Cambell died from cancer in 2006. As result of the efforts of her friend, Linda Wharton-Boyd and others, July was declared Bebe Moore Cambell Minority Mental Health Awareness Month. This month serves to achieve two goals: 1) improve access to mental health treatment and services and promote public awareness of mental illness and 2) enhance public awareness of mental illness among underserved communities. 

 

                  Dix and Moore Cambell are just two of the many women who have impacted the field of mental health. Next Monday I will feature two more women.

 

 

Pulling Yourself Out of the Darkness

                  Usually, people who do not live with depression do not realize how difficult it is to pull yourself out of a dark place. It is difficult to understand something you have never experienced. The dark place depression drops us into is cavernous. It is painful yet at the same time numbing. When we are in this place, it is difficult to see a way out of it. As someone who has been there, I often find myself fearing the next trip into the darkness. I know it is always lurking, waiting to swallow me into the abyss.

                  Fortunately, I have been able to climb out of the dark depths when depression has taken over. It is never an easy climb. I usually need help to make the ascent. There are often setbacks along the way. Sometimes it takes longer than other times. If you have never struggled with depression, it is hard to comprehend how difficult it is to climb out of a deep depression. Think of it as being like falling into a well. You are surrounded by darkness. The walls are closing in around you. There is no ladder or rope to climb up. You know you need to escape, but it seems impossible. That is depression. 

                  So, how do we get out of the well? How do we climb out of depression? One thing we must do is remind ourselves that there is hope. There is a light waiting for us. We need to ask for help. This might be reaching out to a therapist or psychiatrist. It will often include medication or other treatments. Relying on the coping skills we have learned over time is valuable. We need to recognize that we are not going to climb out without help. Depression does not just shut off. It takes effort. Sometimes we do not have the strength to make that effort. In those times we may find ourselves trapped longer in the darkness. It is a difficult place to be.

                  If you have pulled yourself out of a dark depression, give yourself a pat on the back. You have accomplished something very difficult. If you know someone who has pulled themselves out of a dark depression, give them credit for the work they have done. It is hard work. It takes a strength that many people do not realize they possess. Living with depression requires strength. Some days just getting out of bed takes effort. Going through the motions of life takes strength. I honestly believe that when we live with depression, we possess a strength that we do not realize.  That strength allows us to fight the depression. 

                  Strength also means understanding when we need help. We cannot fight depression alone. Depression is an ugly illness hellbent on tearing us down. It is usually not possible to fight it on our own all the time. Asking for help is okay. It is a sign of strength not weakness. As alone as we feel in the darkness of depression, there is help. We can climb out of it. We do not have to remain trapped in that well of darkness. 

 

 

 

 

 

                   

We Are Not Our Thoughts

“You are not your thoughts; you are the observer of your thoughts.” – Amit Ray

 

                  At times depression fills my mind with thoughts. Many of these thoughts are painful and negative. They hurt. They are difficult to deal with and at times require the help of a mental health professional to overcome them. One thing I have learned as I have battled depression is that I am not my thoughts. The thoughts are depression’s way of seeking control and breaking me down. 

Before reading the above quote, I had not thought of myself as an observer of my thoughts. I have had the sense that they are a separate entity, but after reading this quote I have an image of myself watching the thoughts in my head on a screen, like watching a movie. In many ways it is a powerful image. First, if the thoughts depression puts in my head are like a movie, then I need to tell myself they are a work of fiction. These thoughts are not my reality despite feeling real. When we are watching a movie, we can turn it off or walk out of the theater. How can we do the same when the thoughts start streaming in our heads? Self-talk can become our “stop” button. Perhaps we can work on self-talk in therapy. With the help of therapist, we can learn to tell depression’s thoughts to stop. We can stop “observing” when the thoughts are negative or hurtful. It is not my intention to make stopping the thoughts sound like an easy task. It is not. It takes work to develop this skill. 

There will likely be times when we cannot just stop the thoughts. If we remind ourselves that we are observers of the thoughts maybe we can allow ourselves to separate ourselves from the thoughts. Observers generally don’t engage in whatever they are observing. A true observer should remain separate from what they are observing. How can we apply this idea to depression’s thoughts? I admit this is a hard one and one that I have not mastered yet. Visualization can play a role here. Perhaps we visualize a screen. Depression’s thoughts are on that screen. They are separate from us. They cannot reach through the screen. Our job is to keep them on that screen. By visualizing the thoughts on a screen, we are giving them a place to reside that is outside of us. Again, it is like a movie. We can watch a movie, see the screen, but we are separate from that screen. 

Remaining observers and not allowing depression’s thoughts to consume us is part of the battle with depression. It is not easy. This is a real struggle. The thoughts will seem real. They will consume us at times. In those times we need to practice self-talk and visualization. We need to share these thoughts with our mental health provider. They can help us build a screen. They can help us separate ourselves from the thoughts. By sharing what we observe with our mental health provider, we can gain a better understanding of depression. This will lead us to the path of healing. Thoughts will pop up throughout our lives. Depression is a persistent jerk. It wants our attention. We cannot give it our attention. That is easier said than done. There will be times when we do not succeed at being just an observer. That is okay. Depression is an illness. There are going to be times when we are not well; times when we need help. That is where therapy, antidepressants, and other treatments such as TMS, esketamine, or ECT play a role. There are many facets to living with depression. Stepping back and observing depression’s thoughts is one of those facets.