It’s a Big Bad World Out There.

I have to admit that it’s scary out there sometimes. I wonder how I’ve been able to carve out my niche of tranquility. Cycles being what they are, I’ve sometimes felt more threatened than others and have actually been more threatened at one time than  another.

As a community mental health nurse, I’ve had to get permission from drug dealers to enter housing projects to care for my clients. Giving the apartment number was the only way to get in without a gun to my head. HIPPA violation? No. I didn’t provide a diagnosis or discuss a treatment plan. Besides, if we are going to be real about all this, that gang member knew more about my client’s activities of daily living than me.

I’ve taken different measures to deal with the various types of violence I’ve encountered. I’ve taken histories, rereading them only once. Vicarious traumatization is killing to the  soul. I’ve thrown myself to the ground during crisis calls allowing the cops with guns and clients with knives to duke it out on their own. I’ve sat on my couch watching late night TV news show exactly where the bullets that flew one centimeter lodged into a wall right above my head earlier that day.

Once I think that I’ve experienced it all another thing happens. This  week I was threatened physically and aggressively by a client. I am made of a sampling of human body parts smushed together with a dash of cognition. Sometimes the two are quite divergent. My intuition told me to scram. My thick head told I me that I wasn’t going to be harmed.  I left the area when I was directed to do so. Good thing!

But a funny thing happened on the way to this forum. Instead of being afraid at the moment of truth- I felt angry back. I had this overwhelming notion that I could punch the door just as well and that my kicks could be just as slammin’. My humanness, desire for survival and outright rage at being a target for someone else’s misplaced blame and unwarranted expectations ‘got to me.’

What was my remedy? First I allowed others to help me. A couple of co-workers stood between me and my would be assailant. Someone else wrote out incident reports. Another walked me to the train after work. Yet another spoke in almost ‘baby talk’ to me making me feel like I was wrapped in a fluffy pink blanket. Most importantly, a team decided the person wouldn’t be allowed on the premises- ever again.

After I wrote my objective professional recommendations, I took another couple of deep breaths. Since I didn’t have any sage to smudge myself, I took a white tissue and cleansed my energy field with it. I figured at the time that nothing could be more energy absorbent than a tissue. I shared my many levels of feeling with my loved ones. I, lastly, prayed for myself and for the other who so easily struck that nerve within me that I can usually forgets exists, hides and rarely surfaces.  I get through these scrapes believing love, compassion and empathy will prevail. I’m usually right.

My nurse self was sitting behind the desk again today.  Another day. Another evaluation. Another guy in dire need of detox.

I look forward to your comments or your shared experiences of violence in your work place. Tell us what happened and how you dealt with it.

The Nature of the Beast

Addictions brings up a multitude of opinions, thoughts, and ideas all dependent on whether one is actively substance using or reaching out to help someone who is in the throes of the disease. As a mental health practitioner in this field, I often believe I’ve seen it all. Then the rug is pulled out from under me and yet another thing is revealed.

Working with men who are grappling with varying degrees of addiction in a NYC shelter system has been ‘an eye opener’- no pun intended. I’m often shocked to speak with who I consider a geezer only to find out that the gentleman who totes his walker, has no teeth, and who doesn’t know who our previous mayor was, is younger than me. I’m actually the geezer but you wouldn’t know it on first glance.

Why do I bring this up? We all deal with addictions in some shape or form- unless, of course, you are the person in that Twilight Zone episode where you were actually living in a toy village under the supervision of a giant. Most of us have a sister, a neighbor, a husband or maybe even ourselves who are dealing with the decision not to pick up a drink or a drug. For many people the effects may be a lost evening- so what? We’ve all heard it and said it- “I work hard and deserve to relax.” The creeping thoughts of being late for work in the morning, the novel revision that goes undone “just for tonight” or the last couple of bucks spent on a six pack when your check hasn’t cleared may not be problematic-yet.

The tricky part is that the disease of addictions is progressive. The guy or gal I see in front of me at age 25 will look and feel a lot worse at the age of 55. There is no system that goes untouched by the effects of the disease of addictions. This is a malady that decimates one’s physical, emotional and spiritual life and any other aspects you can think of. Families and other relationships are ruined.

Yesterday, a colleague of mine was personally upset and felt a bit betrayed by one of the young men we’ve been working with. The release that marijuana, cocaine and pills brings is one that is hard to compete with. I reminded her that it is “the disease” that does this. I’ve spoken with several clients who were so upset when Whitney Houston had died. How could this disease take out this very lovely woman who was an icon, who had a daughter she loved desperately, and who seemingly had it all? I can only say the same way it would take out a 75 year old man who is living in a shelter, smoking crack with no one who can be named as next of kin.

I, too, get personally upset sometimes by people who continually relapse on substances. If I were a bank teller, would I be emotionally hurt by the guy who takes ninety percent of his savings out of his account? Would my feelings sting if I was a cashier and someone bought six bags of marshmallows and no sources of protein in their grocery shopping?

Doing my part is all I can do in the world of addictions. There is help out there for people who want it. Until they are ready, all I can do is to be at the ready, too.


Mental Illness Takes a Seat

I’m completing some suggested revisions for my novel Covering the Sun with My Hand that is about a family dealing with mental illness. In my story, Julia Acevedo, Rene’s twin, tells how she and her parents manage the unexpected diagnosis and a subsequent extreme life change when they find out Rene has schizophrenia. Many people who hear the word Schizophrenia think it’s about having multiple personalities. It’s not.

Rene is in his first year as a student in an architect program in a prestigious college. This is a dream come true for Rene, who is a Puerto Rican adolescent in NYC. He is struck with the symptoms of schizophrenia and becomes paranoid and fearful that others are out to get him in his college program. He carries all of his books back and forth each day. If he leaves them in his locker, he’s sure other students will steal them.  It’s so much more than the normal apprehension that comes with the start of a new college experience. Julia notes the changes in how Rene dresses, how he begins to isolate, and is overwhelmed when he admits to believing that his classroom number is an anagram of his birthday, their birthday- all coded by the FBI. She hears him talking to himself behind his closed bedroom door. Rene begins drawing symbols on this same door for protection against evils that he is certain will overtake him. These are just some of the things that the family contends with as they adjust from having high hopes for Rene to excel in school to acceptance that all of their lives will be very different.

As I write this, it sounds strangely enough like a movie or a novel. I wouldn’t be able to raise my hand if someone asked me whether I have a family member diagnosed with mental illness. I’ve been close to people like Rene since my first year as a nursing student-thirty or so years now. When I began nursing school, I trained in large state hospitals like Manhattan State Psychiatric Hospital. I taught briefly as a psychiatric adjunct faculty member on a locked ward at Rockland State Psychiatric Center later on. For many years I worked on a mobile crisis management team. Visiting people in their homes gave me a clear view of the devastation that mental illness can bring. Sitting at people’s dining room tables, I was entrusted with a slant of life that many people may never experience but would be profoundly moved by.

My master’s degree thesis was called Social Support and Coping of Families of Persons with Mental Illness. I completed a pilot study that several families agreed to take part in- they filled out questionnaires and answered brief questions about their intense lives. My professor thought it was a stellar study. She suggested that I take it further and introduce it in another forum. Twenty years later, I am. This forum is fiction writing- different than anything that I would have considered at the time but where it needs to be.  

Novels are real life stories that are told in ways that illuminate some part of the world for others to experience. I look forward to sharing this corner that I’ve kept very sacred to me.

What books have you read or written that you’ve felt was an area that needed to be brought into the light?

The Grief Train

The monstrous carriage rolls into the station. Its metal wheels screech to a halt. The doors open and the conductor yells out, “All aboard!” I stand at the edge of the platform, take a deep breath and just as I’m about to enter, I stall. Not again.

One thing about grief is that it just doesn’t do its thing alone. It dredges up every last death I’ve mourned. It surprises me in its depth. It shakes every bit of intellect I have and throws me into the dark waters of emotion.

Our dear friend crossed over to the spiritual world a few days ago. Because she wasn’t my sister or my mother, this time, I don’t have to tend to the particulars. Because she wasn’t my coworker, who died suddenly at the age of forty four, I don’t have to hold a support group for fifty clients whose mouths were gaping at the wrenching news that had come ten minutes before I was informed I’d be supporting them in their grief.  This time I’m not ten and I don’t have certain responsibilities, like sitting quietly as I make sure that all of my family members are all right- pretending that I don’t mind that no one is asking me how I feel.

This time around, the train is here at the station, but it’s different. I have a spiritual family who is hugging me and I am hugging them. I am at the disposal of her children, who are all warriors in their own rights. I get to remember how she nicknamed our dog and how she was persistent and got the landlord to change that stupid countertop she hated. I get to remember how she calmed me down and told me not to worry because I hadn’t done something perfectly. I get to remember how she tended to me as I was initiated into my bountiful spiritual practice. I will remember how she wasn’t afraid to tell the truth, that she complained when she wasn’t happy about something and that she started exercising in her sixties-telling me we can always change and be open to new things.

This time I don’t think I’m going to get on that grief train. I am going to do my best to keep her love for life within me. I will miss her but she will always be with me. Sometimes the tritest sayings are actually the most healing. Today, I will easy does it. This is the day my HP has made- I will rejoice and be glad in it.

Holiday Sides: Guilt and Blame

Along with the turkey platter why not fill a couple of side dishes with sweet potatoes and stuffing instead of years’ long simmering resentments?
Working in mental health has allowed me a bird’s (turkey or chicken- your choice) eye view of the horrors of the holidays. I rarely take off at this time of year because, unfortunately, many of my clients become suicidal and, occasionally, homicidal.

Invited to listen to multiple stories of fathers throwing turkeys across the room, mothers taking to their beds with migraines and uncles becoming too casual with the touch after a few too many, I’ve learned some things. You are not alone! You’re not the only one who has witnessed your parents go at each other with the electric carving knife. You don’t have to be paralyzed around the thought of Thanksgiving. You may allow yourself to enjoy the holiday- even if you spend your sophomore holiday with friends, leaving your little brother to deal with the madness at home-alone.

If these stories sound personal to you, they are in some ways, but they are universal- contrary to what Wal-Mart, Givenchy and Macy’s would like us all to think. Glittering gold decorations, that new down jacket and vest, or a few glasses of eggnog filled with white rum really may make you feel better about everything that you’ve experienced in the past. Instead, for some, it leads to an uncontrollable craving of buying more, drinking more or eating more-MORE!!! More eventually turns on us and we feel like LESS.

The people I’ve spoken to are usually in some phase of change. Old coping patterns no longer work. New ones seem hard to begin. A simple suggestion of taking a short interval jog/ walk to clear one’s head is often met with “I’m too busy” or “My knees hurt.” Eating a salad for lunch or a Clementine as opposed to an ongoing carbohydrate extravaganza may not seem very appealing. I’m still frequently surprised at the familiar sentence, “I don’t eat vegetables.”

You may wonder how these suggestions may help you endure the holiday season. They can be used as gateway methods of taking care of yourself in a healthy and positive way. There can be comfort in attending support groups, 12 step meetings, or individual psychotherapy. One of my favorite mottos is that “You don’t have to do anything alone”- even if you’ve been taught by example to do it that way. Getting caught up in the wreckage of the past or, as my friend Steve says- the wreckage of the future, gives us one certainty-we deny ourselves the beauty of today.

Instead of passing a side of bitterness, why not pass along one of love and compassion for yourself. If you decide that one more sparkling glass of white wine or another five butter cookies is what you want- go for it. They can be delicious, fun and happy making indeed. If your intuitive side nudges you and tells you that partaking of these will add to more misery why not, instead, grab for the true gold of love and life- it’s yours for the taking too!

Happy Thanksgiving all… now about that gratitude list…

Psychic Psychiatry

When I’m not bopping between blogspots I have a couple of day jobs. As a psychiatric nurse practitioner, I talk with lots of people every day. We talk about how they’re eating, sleeping, what they’re moods have been like and how they feel about their family members and their jobs. You know, the mundane- that wonderful place that exists very close to the paranormal that I’ve mentioned before. On other days, I sit in my spiritual room and do psychic readings for the people who find their way to me. I use tarot, oracles, cigar smoke, water, you name it, I scry it.

Sometimes these people share things with me like their views on their religions, faith, dark nights of the soul and, sadly a little less frequently, their illuminated lives. Sitting with them I help to determine whether I can offer help and in what form. Tapping into my intuitive side, I guide them into delving a bit more deeply into the way they are experiencing their lives. It’s not often that I receive everything they say at face value. There’s a reason why people come to see me. Psychic or psychiatric- they want to know more about themselves.

Every so often I have a therapist ask me whether I can see a particular client of theirs because I’ll find them interesting. These are the people that believe they are seeing clairvoyantly and not experiencing visual hallucinations. They are the ones that hear spirits talk to them and aren’t disturbed by auditory hallucinations. These folks admit that they feel the presence of someone else in the room that’s not visible to most others. They aren’t really paranoid-a term that we use very loosely.

My doctoral thesis was all about the paranormal- another word I take issue with but it’s one that society has decided explains these phenomena quite well. It’s no surprise that a client recently offered me the name of a title of a book I should read that is about two adolescent siblings-one schizophrenic. My book Covering the Sun with My Hand is about twins- one is diagnosed with schizophrenia when they are teenagers. My client didn’t know I’m writing this! Serendipitous you might say. That’s how my professors described it in school.

While writing my book I kept sitting back to ponder whether some of the scenarios were too far-fetched. I wondered how much I was making up and how much was a result of the absorption of information I’d gleaned over the many years that I’ve been working in psychiatry. Well, I never had to sit and obsess too long. There was always someone coming in and telling me about a situation they’ve dealt with that was very close to a scene in my novel. Not only were they sharing their experience with me, I firmly believe that my spiritual guidance was telling me to chill out and relax. It’s all good.

Many of us were brought up learning about roots, sitting at the misa table watching spirits channeled, or sitting at the kitchen table listening to our mothers and aunts talk about those “coincidences.” My mother didn’t mind that I talked to my toothbrush and had imaginary friends. Superstitions, old wives tales, Bewitched’s Samantha Stevens twitching her nose. They all point to the truths of who we are. I searched for “something more” through a doctoral program in research and theory development. I started in a library, online and in journals. I found it in regular people’s living rooms, in train stations and on the street. I found the “something more” within me and can comfortably share about it today. My inner guidance tells me I can.

Have you been listening to your intuitive side, your inner guidance, the voice that whispers in your ear? What does it say?

Depression Doesn’t Rock- Part three of three

If you go to a barbershop long enough you will probably get a haircut. So, if your mental health practitioner suggests medication after the assessment, don’t be surprised. “I don’t want medication,” is something I hear all the time. Sometimes I shudder and sometimes I breathe a sigh of relief. There are different ways to combat depression; there is no one right way. It’s up to you and your practitioner to figure what the best course of action is for you.

Medication- There are many medications out on the market that could help your mood. This is a definite area for you and your prescriber to talk about. Please don’t take the pills that the doctor prescribed for your cousin Ruth. Medications are metabolized in different organs, have different side effects and shouldn’t be used in various health conditions. You will probably need blood lab work done before and during your time on an antidepressant. Ruth means well but, really, she doesn’t have a medical degree. Same goes for when you decide you want to stop taking them. This is just as important as when you start. Don’t catapult your body into a crisis, it just got out of one, don’t go into another if you can help it. And you can.

 Exercise- After a physical check up and receiving the “ok” on starting an exercise routine you can actually begin one. Maybe you were running daily, had an injury and had to stop temporarily, but never quite laced up your running shoes again. Your body is probably screaming at you. “Hey where are those endorphins? I love them. I need them!” If for some reason you can’t go back to a previous sport think about alternative routines. Swimming, biking, weight training, speed walking, the list goes on… Walking around the corner to stop at the bank, then the grocery store, with a stop at the pharmacy, is not exercise. It adds to your overall conditioning but there’s nothing like giving yourself your “special time for me.”

Good nutrition- Seriously, that cheeseburger may taste delightful but your body probably needs something different. Fruits, veggies, whole grain foods, yogurts, lots of water…yummy! The last time you made a fruit smoothie, didn’t you feel great? I also think there’s something to preparing fresh food for yourself. It’s a gift. Taking care of yourself I mean.

Alcohol and marijuana- I know, everyone who has a beer or another substance “to relax” will argue the point. That’s okay. Just know that alcohol and marijuana are depressants, voila, “relaxation.” Each time you put some into your body you are laying on the depression. Depending on how many times a day you find you’re “opening up a cool one,” you’ll probably feel cranky and irritable when you stop this form of relaxation, but eventually you will be less depressed. If you’re using these a lot consider asking your doc the best way for you to taper off, you might need professional help.

Therapy- Talk isn’t cheap. Psychotherapy costs but it’s well worth it. I always say there’s nothing better than talking about yourself for forty five minutes at a clip. There are therapists who will offer a sliding scale fee if you think you can’t afford it. There are different types of therapy, cognitive behavioral, psychoanalytic, psychodynamic, different strokes for different folks. Try it. I feel better just thinking about my days on the couch.

Complementary Healing Techniques- Reiki, Therapeutic Touch, herbs, the use of crystals, Tibetan Bowls. These are just some of the forms of healing that can be used with and without medication and therapy. There are complementary healing practitioners that are available to discuss what forms might work best for you. They work even if you might be skeptical to begin with. We don’t stop at our skins. These measures have been used for centuries because they are effective. If you aren’t well versed in these techniques speak to someone who is, I don’t suggest trying them if you have no idea what you are doing.

Meditation- Go inside, people. We learn a lot about ourselves. What we need. Who we are. What makes us feel the fullness and joy of life. By going within we allow ourselves to listen to the inner voices that nudge us into being who we are meant to be and depressed isn’t it.  

Figure out the cause- not by yourself though. As I wrote in an earlier segment, depression has different causes. Yours might be long term, chronic, low level or profound. Read up on depression and go to a health professional. Get yourself acquainted with the various ways to feel better. Often times when we’re depressed we isolate and feel alone. That is a symptom of depression. Reach out for help and you’ll be whistling ‘Happy Days are here again!”

Any thoughts? Leave a comment! Would love to hear from you.

Depression Doesn’t Rock- Part Two of Three

A change of scenery or a nice hot bubble bath has done nothing to pull you out of your blue mood. While listening to your favorite love songs you actually felt worse, not better. I hope that by now you’ve gone to see your primary doc and are set to see a mental health practitioner. What should you expect? First off, someone who gives you eye contact, so you should do the same. Meet them at eye level, it works. You two should be partners in getting you better and back to being yourself!

 Be on the same page-

First off, the practitioner will ask you why you’re there. Different people go for different reasons. The evaluating person needs to know what’s bothering you. We all have different priorities and limits. I’ve sometimes thought a person should be on medication and they’ve been appalled by the idea. The symptoms of depression may be quite intense but you would have to agree. Don’t you think? Sometimes people are radically against medication but don’t tell me that until way late during the session. You may choose to bring it up early. I’m conservative. So while medication most frequently helps a person to climb out of depression it’s not the only strategy. Sometimes, I’ve been the one who’s appalled. There is help on the horizon and if somehow you’ve managed to make it to a prescribing clinician, there’s something important about that. Get the information you need. You can always rethink your decision after you’ve sifted through it. Or not.

Answer what’s asked-

Sounds simple but sometimes it’s not. A person can feel vulnerable answering personal questions about themselves. Sometimes it’s not in one’s culture or tradition to tell what’s really going on. You won’t get a bad grade, if you’re honest, honest. No one is going to contact your job or husband if you spill the beans on what’s really going on in your head. Sometimes people are afraid that it’s going to be on “a record.” Practitioners do keep documents but these are private. There has to be one-otherwise how can they possibly remember all the details that make you who you are? You want them to remember that you began sleepwalking with a particular pill you took that was supposed to help you get a good night. You wouldn’t want them to prescribe it again if they could help it.

Expect confidentiality-

Your mental health practitioner is not going to tell anyone anything. Unless, of course, you’re hell bent on hurting yourself or someone else. Your practitioner wants you safe and protected. You may not be able to do that if you are very depressed. That’s what we’re here for, remember? That’s why you came for help. If your mental health doctor thinks someone else should know, they will talk that out with you. Yes, it may lead to the hospital but that’s only if you really need it. Really.

Try not to laugh-

Some people think it’s funny when the practitioner asks whether a person hears voices or sees things they don’t believe others are sharing. It’s what we ask. Guess what? A percentage of people who are depressed actually do experience auditory and visual hallucinations. This type of depression is called Major Depression with Psychotic Features. Yes, you can get better-even if you are a little paranoid. There is medication that will help you and you can get back to enjoying the good things in life. Yippee!

Don’t be shocked-

You will probably be asked how much wine you drink or marijuana you smoke to help you sleep or relax. These are known to be depressants. The practitioner might ask you if you are sexually active or having trouble with intimacy. Sometimes a person’s libido goes south of the border when they’re depressed.

Expect questions about your medical health-

The practitioner will ask about your physical condition, may send you for blood work and may ask for permission to chat with your primary care physician. Sometimes our physical and medical selves get cross-fused. We might think it’s one thing but it’s another. A test or a conversation can help clarify for a safer treatment plan for you.

Bring a list of questions-

I’m not talking about testing your clinician on his or her knowledge of the brain and nervous system, unless for some reason you really need to know. They have licenses and board certification attesting to that knowledge and time is short. Ask about your diagnosis, possible treatments, medications if needed and potential side effects. Ask about how long you may need to be on medication before it’s discontinued. Question whether the medication that’s prescribed can be taken if you are planning on attending an extravagant wine testing from Thursday to Sunday. You get my drift. Ask what pertains to you.

Next week I plan to talk about different strategies available for mood disorders.

Are there any other questions you’ve asked or would like addressed? Let me know. Just hit the comment section.

Remember you are never alone!

Depression Doesn’t Rock- Part one of three

Many of us get depressed at some point in our lives. Just like people come in all types of shapes, sizes and colors, depression can be viewed in the same way. What I may describe as feeling depressed may be a bit different from your own brand, but there are similarities across the board.

Four people come to mind when I think of the faces of depression. Their descriptions don’t encompass all types, so if you have something to add, please do, there’s a comment section at the end of this blog entry.

First off, there’s Sleepy Stan. His kids have been trying to get him to test out their scooters at the park on Saturday afternoon. He waves them away because he’s tired. He would prefer to hang out on the sofa with a pillow over his head. Stan promised to get up. Later. His wife hopes when he does that he’ll take a shower this time. Up to now, he’s still managing to get to work but his family misses Saturdays at the park. They haven’t taken an evening walk for ice cream cones all season. The reality is that Stan misses his family too. He can’t seem to get a move on as much as he’d like to and it makes him feel even worse.

Then there’s Famished Frances. She’s been eating a lot more than usual. Her appetite has taken off and she gazes in dismay at the scale she’s finally had the nerve to stand on. Franny’s also a worrier. She’s up at night thinking about her problems, large and small. At first she feels better making those Dagwood sandwiches. They kind of fill that empty space in the middle of her belly and she stops worrying. But then, a few minutes later, she’s worrying again. This time her concerns include how much weight she’s gained and her fear that she’ll never be able to stop eating. Franny seems to remember her mom and her aunt doing the same thing when she was little and wonders if it runs in the family.

How many of you know Irritable Ivan? He’s pissed and he’s just not the same guy you used to know. Everything you say to Ivan seems to rub him the wrong way. He’s annoyed at his brother-in-law who got him tickets for the game, but didn’t tell him he had to pay for his hot dogs. He’s starting to get agitated a lot and has begun to pace. Ivan thinks he’s mad at his wife but then again, it might be all those people on the train who’ve annoyed him today. He really doesn’t like feeling this way. In fact, his boss told him he should consider taking a few days off so he could cool down.

 Melancholy Mona sits in her dark living room. Her partner, Lisa, told her that the least she could do was put the lights on. When she said that, Mona started crying again. Everything seems to push her into a puddle of tears. She wasn’t always like that. It seems like such a long time since she felt good about herself. So long, that she’s been thinking scary thoughts. Mona is almost certain that no one cares about how sad she feels. She’s started to think that maybe it would be better if she weren’t even around. Lisa made an appointment for Mona to talk to their family doctor. She said that she needs help- professional help.

Do you relate? Sometimes we find ourselves experiencing life the way Stan, Ivan, Franny and Mona have been. It could be just a matter of needing a break from the world; it could be a lot of things. It might actually be a thyroid problem or some other medical illness. Depression can be serious and you might want to take a look at it. The following are bonafide signs and symptoms of depression that are found in the DSM-IV TR, the bible of psychiatry.

See if some of what you’re feeling fits in the following list.

–          Feeling depressed most of the day, everyday.

–          Less interested in activities, a loss of feeling of pleasure

–          Significant weight loss or weight gain- maybe 5% in a month

–          Difficulty sleeping at night or sleeping just too doggone much

–          Feeling agitated or slowed down

–          Fatigue or loss of energy

–          Feeling worthless, excessive or inappropriately guilty

–          Have problems concentrating, thinking and indecisiveness

–          Thinking about death, not just dying but suicidal thoughts- with or without plans to do yourself in and having intention to take action.

Sometimes, the depressed person is the last to see their symptoms. They might be blaming themselves for whatever it is they’re feeling and not realize that it’s symptoms of depression. It is probably not something they can just shake off.

If you believe that you may be experiencing some of the items on the list you should consider talking to a professional. It wouldn’t hurt. Your doc can evaluate you or send you to a mental health professional. Don’t depend on your best friend or great aunt Maggie who suffered from depression a decade ago. You deserve talking to a professional.

Next week, I plan to blog about what to expect when you do see a mental health professional. The following week, I’ll blog about different treatments for depression. Stay tuned. In the meantime, lift up those roman shades and let the sun pour into your living room, maybe take a nice walk…

Tell me what you would like to know about depression. I’d also love to hear helpful strategies that you might be aware of!

Here are some other sites that will give you information on depression:

On which side of sanity

All too often we label ourselves as something we feel most comfortable with-a writer, a clinician, a parent and partner. As I create this blog I sift through my thoughts and my feelings, who am I today and who is it that I really want to project out into the larger world. I was given the charge of creating a platform. That was a tall order I realized when I began to think of my roles on this planet-they are many. I looked at the three blogs I’d been writing on-albeit all too infrequently- and noted that my persona has been divided up into different beings that all amount to one-me. My closest relationships know that I write poetry and stories and that I write prescriptions all day long in my work as a psychiatric nurse practitioner. They also know that, just like many of the people I work with, I listen to the voices that speak to me. I call these voices my spiritual guidance, my intuitiveness and my muse.  I am not concerned with others knowing that I listen to my inner voices to point me along in the best directions for me. Like the rest of us, I need all the help I can get. In my work, I encourage my clients to listen to their inner voices, as along as they aren’t disturbing, aren’t destructive and serve the client and others in a positive way. Yesterday evening I posted the second reading that I channeled for one of my spirit guides, Graciella La Gitana, in my weekly column Palabras. This column can be found on This site is a creation for the Latina Writers Workshop that I helped to found with Raquel Penzo and Rebeca Toledo. We write, we read and we help to provide a forum for very talented people to show their creativity. I think that some of my friends would laugh at this title “on which side of sanity.” We are all on one side or the other-at any given time! I happen to enjoy shifting my perspectives and love to show that in my different types of writings and readings. I have a couple of published research articles that are quite different to the poems I’ve written about my subway experience. As I continue to explore myself and share that in my writing, I hope to integrate more of who I am and will continue to share that in the writings that I share with you.