Thursday, December 31, 2009

Horologe for 2010

I have a beautiful horologe or hourglass filled with black sand. I imagine that the sand comes from Kaimu Beach. Hourglasses were used both to keep track of time and for navigation. Although assumed to have been used in the 3rd century and carried around as timepieces the first evidence of the existence of the hourglasse was in 1338, depicted in a fresco by Ambrogio Lorenzetti. Ferdinand Magellan kept 18 hourglasses per ship as he navigated the globe. How did I learn this? Lost in Wikipedia of course! Fascinating!! My hourglass does not help me with navigation unfortunately but it is a constant reminder for me to slow down. When it was new to me I used it daily to block an hour of uninterrupted writing time. Over the years that ritual has slowly unraveled as have many resolutions made at the end of years past. I do love this time of year because, at least for me, it is a time for renewal and new goals, some which will be met and some not. Gradually over the years it seems that I slowly meet a few more. Time to turn the hour glass over again.

Temperance bearing an hourglass; detail
of Lorenzetti's Allegory of Good Government,

Wednesday, December 30, 2009

December 29, 2009

The morning began with "comes on little cat feet. It sits looking over harbor and city on silent haunches and then moves on" (Fog, Carl Sandburg, 1878-1967).

Soon the sun was out and coming through the cedars and firs.

Stop, stop and listen for the bough top
Is whistling and the sun is brighter
Than God's own shadow in the cup now!
(The Blackbird of Derrycairn, Austin Clarke, 1896-1974)

Tuesday, December 29, 2009

December 26, 2009

I have decided to share photos for the next few days as a way to stay centered in the break between the end of one year and the beginning of another. This was taken on a walk on the beach in West Seattle. Note the paddle surfer is wearing shorts. Quite a contrast from a year ago....

Wednesday, December 23, 2009

Decorations of the Season

Happy holidays, merry Christmas, and a peaceful, blessed and joyous New Year to all! It is a time of mixed feelings for many. There is a busy-ness as people rush from frantic activities to their overwhelming "to-do" list and push onward and forward. There is excitement particularly for children as they participate in their own events at schools and churches, synagogues and with their families. There is also a sense of bah-humbug, anxiety, depression and a general irritation that can strike at any moment or rests within throughout the season. The singers can irritate, the traffic can madden and the lights and trees and tinsel can annoy.

Personally, I love the decorations of the season. We walked through the local botanical gardens last night and not only were the lights beautiful but it was inspiring to think of all the hours and hours of volunteer time spent stringing millions of lights. Children oooohed and aaaahhhed as the skipped and tunneled through the crowds. Grandparents and great-grandparents slowly made their way along the pathways, supported by their families. Through a partnership of the city, parks, a local radio station, local merchants and thousands of volunteers preparing for months the light display is magical. Some find the Christmas crowds overwhelming. I find it comforting, at least in short durations. It confirms my belief in my fellow humans as we gather together to appreciate the work and beauty of this light display. This morning the newspapers scream out the chilling news of another attack on two police officers. Our community has been under fire. Five officers killed and three seriously and critically injured since October. Two of the three attackers killed by return gunfire. More shootings on a daily basis darken the season. A mother and her baby were shot and killed just last night, in their home, by a man with a restraining order. We could be walking in terror each minute of each day based on the onslaught of news n our world. Yet our time together last night simply enjoying a light display gave me a sense of all the good, ordinary, and kind people on this earth.

Nature provides her own decorations as well. We have a 30 foot holly tree in our front yard that is full of red berries nestled within the impossibly glossy green leaves that cannot be replicated by man or woman. When I am tired of the crowds of the holidays I stand under this tree and I am filled with an equal sense of peace on earth. I love this tree when the berries are lit by sunlight, in the mist and rain, and occasionally like last year, covered in snow. A fleeting feeling perhaps, and fragile in this current world but treasured and kept in a special place in my heart. Merry Christmas to all...and a wish for peace on earth.

Wednesday, December 16, 2009

Initial Diagnosis

A special place

Mental health conditions can strike any time of the year and research indicates that depression is particularly sneaky this time of year. A new diagnosis of any mental health condition is particularly difficult and unsettling but perhaps even more so for adolescents and children and the families that make this journey with them. Bipolar disorder can arrive quickly and with terrifying symptoms for some young people. It can come with feelings of extreme anxiety, depression and mania that can include anything from racing thoughts to hallucinations and psychosis. The diagnosis is seldom simple. There is no blood test or CAT scan that can simply and positively identify bipolar disorder. This illness can look like attention deficit hyperactive disorder (ADHD), depression, post-traumatic stress disorder, conduct disorder and even schizophrenia. Typically a diagnosis of bipolar disorder, even in adults, is a "wait and see" process and the initial diagnosis is terrifying for all involved. The diagnosis is critical for the treatment but treatment can't always wait for the diagnosis. Often the effectiveness (or lack thereof) of a medication provides information to confirm or dismiss a diagnosis. It is a very difficult and often lengthy process. I am reliving our own journey as I hear from parents, colleagues and friends who have children that are currently in the midst of an initial diagnosis of this illness. I remember the fear and anguish just hearing the term "bipolar disorder"; trying to make sense of it while not completely believing the diagnosis. My mind was racing, "Not my daughter." This cannot be. I know about bipolar disorder. I teach about it. How could it a) happen to my child, and b) how did we miss it? And...what could we have done to have prevented it? I hear all of this and more from the family members that have shared their own stories with me in the last few weeks. I wrote a previous post, "You need to step back..." sharing my thoughts on how to support someone who has a loved one in the middle of a mental health crisis. Today I would like to offer my thoughts to families who are beginning this "vast journey of ours" as my daughter calls it. It will get better but it is difficult, terrifying, and fills a parent's heart with grief. With care I offer the following thoughts:

If your child or adolescent is hospitalized (once you can take a breath and think straight) meet with the doctors and the care team. Get to know the nurses, hospital assistants, residents, social workers and therapists. Be there as much as you can to learn all you can, be aware and part of any decisions and assure your child that things will get better. If your child is psychotic he or she may say things to you that are completely unnerving and frightening. It is the illness and may have little to do with reality. Don't take it personally. Stay calm (at least in front of your child).

Meet with your own family team. Define "family" as those in the inner circle that can help support your child. Tell the truth. Divide up chores. Take turns being at the hospital or staying with the child. When one member of the family team is ready to crash from exhaustion and worry have a plan for someone else to step in. Assure that the younger children are involved in a way that is age appropriate. Kids know when something is going on and their imaginations are often worse than the reality.

Explain to others in ways that they can understand. Share as much as you feel comfortable sharing but imagine that your child had diabetes and was hospitalized in critical condition from this illness. What would you tell people? You have no reason to be ashamed or embarrassed. I decided to tell the truth from the beginning and, yes, there were awkward silences when someone asked me, "Why is your daughter in the hospital?" and I said she is in a severe depression and is being treated for bipolar disorder.

Ask for help when you need it. Someone needs to contact the school. Someone needs to talk to the insurance company or help sort through the medical paperwork. If there are other children in the home someone needs to assure that they are fed, clothed, loved, comforted, tickled, read to and played with. Sometimes you might need someone to tell others about what is going on because you just can't tell the story one more time or without fear of falling apart forever.

Accept and reject advise as you want and need to do so. Advise comes unsolicited and is sometimes comforting, sometimes helpful and sometimes scares the hell out of you. Often it reminded me of stories mothers tell a newly pregnant woman. Sometimes it becomes "can you top this horrible story" and it does you no good to listen. Practice saying, "I understand that you are trying to help but I really can't listen to any tales of woe or tragedy right now. I need to stay positive."

Be brave, consistent and on top of things with your insurance company. We asked for lots of treatment and care that wasn't readily offered but once we asked for it things fell into place. I cajoled doctors into writing letters of support for things we needed (I was actually the ghost writer on a couple of them at the doctors' request). This included longer time in the hospital, more sessions with a therapist, a different drug (non generic) or a doctor outside of our designated list of providers. Find out if your insurance company has a case manager for critical or chronic illness. Our insurance company did (thank you, Ruth, you are a saint!)! Ruth was a former psychiatric nurse and provided us with so much information and support that ultimately helped our daughter become stable and likely saved the insurance company money. If you do not have insurance meet with the social worker at the hospital and keep asking questions. If something doesn't sound quite right, ask more questions and bring someone with you to help figure it all out.

Let your child's school know what is going on. If this is the first time your child has been hospitalized or newly diagnosed you should ask for a 504 Plan to assure that accommodations will be provided as necessary. If your child misses a lot of school or falls behind in her or his academics you can make a referral for special education assessment. This does NOT mean that your child will have to be pulled out of her class and into a special education room. It does mean that he will have legal protection to assure that services and support are offered to assist him to progress academically and emotionally/socially/behaviorally in school. The school will use the diagnosis from the doctors to document a disability and may do some additional testing as necessary. This does not need to happen right away if your child is not stable but I urge you not to wait too long and do alert the school as soon as possible. That might be a job for someone on the family team!

In a mental health crisis parents aren't thinking about such things as an advanced medical directive but do remember that when a child turns 18 you might still be paying all the bills but you won't have any say in their care or privy to information about their medical treatment. Once your child is stable talk about this and investigate advanced medical care directives in your state. Have this in place by the time your child turns 18.

Find the time to take care of yourself even if it appears to the outside world that you are doing marvelously well. From my own experiences I can honestly say that I waited a little too long before addressing this and it took a toll on my health. I kept up a good front but stress does have a way of eventually reminding you to take care of yourself...when your body gives you a big wake up call. I am so glad to be healthy and centered now but it took some effort.

Finally, every one's experiences are different and we all come from a vastly different place, yet I believe we have something in common. Parents would do anything to heal their child and when you can't it hurts beyond words. I humbly offer hard earned "advice" from our own experiences with bipolar disorder and my training and experience working in the field of special education. It is complicated and frightening and not something that most of us were trained to do. Even for those of us that have knowledge and resources find the world of mental health care for a seriously ill child overwhelming. There are many, many resources available and we have listed some of our "favorites" on our website. I hope that there may a small piece of information that makes things easier for parents whose child is in the midst of a mental health crisis. It will get better. Stay hopeful. I include this picture to remind you to keep a special place and time in your memory ........

Friday, December 4, 2009

The Season: Time for Love

We are entering that time of year when some of us have a little more room in our hearts and perhaps a little more gratitude for the small things. Daughter Linea, she of the bipolar gremlins, is wrestling with a push-back from this challenge in her life. She is fighting hard against all the symptoms insidiously trying to sneak back into her life while finishing winter quarter of her last year in college. She is working on writing a "senior synthesis", a paper that breaks her heart while she looks back over her last years of college. She is studying for finals, completing all the paperwork for graduation, etc. etc. I drove her to the medical center for a blood draw today so that she didn't have to hassle with either the bus or parking as the area around the center is under massive construction. She was exhausted after a night of terrorizing nightmares and certainly not thrilled about the blood tests that go along with the medications she takes. I drove her back to her apartment and headed to campus for my own set of responsibilities while feeling worried about her and wanting to use my magic mother skills and make everything okay. As I drove her home she pointed out the bundled, bag-laden, elderly homeless guy on the street, a regular in her neighborhood. As I dropped her off I again offered to take her out for coffee or breakfast but she planned to have a bowl of cereal and get ready for her day. But she had no milk. She walked down to her local in-and-out to buy some milk and there was her homeless neighborhood man digging through his pack, trying to find a few pennies. She bought her milk...and some protein bars and water for the old man living on the streets, telling him to save his coins. A large percent of our community members who are homeless are mentally ill. We know how lucky we are to have the resources for health care and that we are able to treat Linea's health condition. Linea was hospitalized with many, many people that were released from the hospital to the streets. She was often overwhelmed by the inequity in care and support as she faced this up close and personal. Today she reminded me that even in our own lives, touched with worry and illness, there are those who manage with much, much less. In this season let's give to someone on the street, someone perhaps living with untreated mental illness. Something as simple as a power bar and a bottle of water, perhaps a hot meal,or time spent volunteering for an afternoon in a shelter. My daughter has taught me not to turn away, not to ignore a person living on the streets. I look, I speak, and acknowledge although I have to admit that it has been easier in the past to ignore a fellow human being as I rushed through my life. It is the season to notice, to give, to love.

Wednesday, December 2, 2009

Letting Go Yoga Style

I have been practicing yoga on a somewhat regular basis, even after teaching class until 7:00 p.m. Good for me, finally! I am so tired after working/teaching/writing/advising/talking/ administrating/ all day that I can easily put off getting into my car, driving to the studio, changing clothes and doing the work that is required of me to be in class. But every time I make the effort I leave class feeling SO much better. (I know this is a luxury and one that would be near impossible if I still had small children at home.) I thought I would share something that we did the other night that really struck me as more than just "yoga" but rather a life lesson. Yoga and the meditation involved provides lots of ah-hah moments anyway but this was particularly profound, at least to me. I hope I can properly explain what we did. Starting from a child's pose or balasana (legs tucked under and pointing behind, head forward onto the floor) we then placed a blanket roll between our abdomen and thighs. The leader told us that it would feel "somewhat" uncomfortable, perhaps even slightly painful. This would occur as our abdominal organs were moved into a different space, forcing a release of toxins. Here is the best part! IF we could simply notice the "uncomfortable-ness" but not resist, it would soon subside and we would begin to relax and feel centered. My body was initially very tense and, as our instructor noted, afraid it would be hurt so it was in "protection mode" and staying on high alert. It was so true and quite amazing that as I relaxed, and noticed but didn't fight against the stress, it felt so good. An ANALOGY for life I think. We resist things that we automatically think will hurt us, we tense our bodies and our minds. We can't quite "let go" and trust. The more deliberately we try to release and relax the harder it is to do so but if we just notice our feelings and sit with it, slowly we begin to let go and the pain is released. We feel easier and more centered. This is very hard to do with life but likely, as with yoga, easier with practice.