TO WRITE: Making Lists

Keeping a to-do list usually gives me a sense of comfort and efficiency; I know I'm probably not forgetting anything and I can prioritize my tasks and work my way through them. Plus it's a great feeling to check items off as I accomplish them.


But I've found many other uses for lists too, including in my writing and teaching. Lists are a wonderful way to get your mind to open up and search for possibilities that it hadn't noticed before, including writing topics. For example:

• I sometimes ask students to write on a particular color (say, purple). If you don't know where to begin with such an assignment, try making a quick (don't overthink this!) list of things that are that color (lilacs, bruises, a stripe in the rainbow, a few people's eyes). Then choose one item and begin your writing with that. You may find a story about the fragrant vines in your garden or a memory of a childhood injury comes to mind.

• When you want to approach a very large topic such as beauty or democracy or depression, jot down a list of related words first. For depression, I might come up with: medicines, loneliness, lack of joy, supportive friends, ECT, writing, sleep problems, work issues and more. Now begin with one of these listed topics. If the one that interests you right now is still very broad, you may need to repeat the process. The specific words and ideas you come up with in this way allow you to make your writing more meaningful for you and your reader, and they are a great way to start creating a lengthy piece.

Note that I've indicated that you should write your lists quickly. This is a time to really let your mind wander freely and brainstorm. If you're not sure why you thought of "jellybeans" when you looked for associations to "depression," put it down anyway and move on to the next item. After you've written your list for several minutes, you can look back at what this means; perhaps your sister brought you an Easter basket to cheer you one spring when you were low.

Play with this. . .
Here's an exercise from my book, Writing through the Darkness:
Quickly make a list of at least 25 things you're good at. They might range from kissing. . . to reading a map. . . to doing rocket science. Then choose one, large or small, and write for 20 minutes on that skill. Who taught it to you? What's the secret to it? Do you love doing it? How could someone else learn it?

TO WRITE: Conversing with Depression

Let's continue our theme of writing dialog from the last post. I find it very powerful to deliberately have talks with other people or things in my mind, and especially to write down -- quickly and continuously! -- these interchanges as they happen, when unplanned, unexpected words, ideas or memories often appear as mysterious gifts.

I regularly imagine and record conversations with my own depression. More than simply reflecting on how I feel about being depressed, it lets me interact with my concept of the illness, get to know it, and get to know myself better.

Play with this. . .
How do you envision your depression or other troublesome emotion or situation? For example, is it a tornado that swirls around you? A monster that threatens from the closet? A black hole, a thief, a feeling of falling, or some animal like Winston Churchill's "black dog"? If you're not immediately sure, take about three minutes to quickly jot down at least five possible identities for that constellation of feelings, then re-read your list and choose one.

Next, writing quickly and continuously, create a dialog between yourself and your image of your depression. What have you always wanted to ask it about where it came from or what will make it quiet down or leave? What have you wanted to say to it in your times of anger? What does it want to tell you? Write this back-and-forth for 15 minutes. It may give you some clues or help resolve a little bit of your relationship with the illness, and it's a wonderful way to remind yourself that you are not your depression!

TO WRITE: She Said, He Said
Many professional fiction writers claim that writing dialog is one of the toughest tasks they face. While making those back-and-forths sound convincing is important, dialog is also crucial because it is a place where the writer's imagination is laid bare. Good dialog offers new information and uncovers the nuances of a relationship. It doesn't beat around the bush.

Try writing some dialog yourself. Fictional situations and characters sometimes uncover thoughts and feelings you were only dimly aware of, and can help stretch your imagination in new ways.

Play with this. . .
Choose two "characters" who will talk with each other. They may be living people, historical figures, made-up creatures, objects, even places like cities or rivers. Some methods for choosing are:

• Open a book and place your finger on any part of the page. Then choose the noun (person, place or thing) under or closest to your fingertip. Repeat to choose a second character.
• Ask someone to name two nouns or two people at random.
• Choose two body parts. You'd be surprised at what an eye and a liver have to tell each other.
• Choose two feeling states to converse, such as depression, anger, perfectionism, anxiety, joy, confusion, relief.

Then, by writing freely and quickly and simply "taking dictation" in your mind, not planning, take 10 minutes to write a dialog. The conversation may be serious, deep, focused, silly or freewheeling. Reread what you've written and write for 10 more minutes on how it felt and what it might mean to you. Perhaps this clarifies some conflict you've been experiencing or gives you ideas for other "characters" you'd like to hear converse.

TO WRITE: What Are You Doing Here?
In Chapter 5 of my book Writing through the Darkness: Easing Your Depression with Paper and Pen (info in profile) I describe benefits that come from using writing to examine your spiritual beliefs -- your understanding of the mysteries of the world around us and inside of us. (No, I'm not writing only to religious people here; it's different.)

By uncovering, defining and fully embracing our beliefs, we spiritual seekers can sometimes find a sense of meaning in life -- or in our depression. Indeed, I have known writing group members who come to feel that there is a reason, or even a benefit, to their depressed experiences, be it to learn and grow as human beings, to develop compassion and understanding, or to assist others in their healing. (p.61)

Furthermore, spiritual searching also carries health benefits. Many studies have demonstrated that people who consider themselves "religious" or "spiritual" or who attend religious services regularly: 1) have fewer illnesses, 2) live significantly longer, 3) specifically have less depression and, 4) have a greater likelihood of remission from depression. Practical applications of such findings to treatment of depression is under study too. For example, meditation, a component of many spiritual traditions, has been shown to be a useful adjunct to treatments for many health conditions, including depression. (p. 62)

Play with this. . .
Choose an issue that you consider what we call in my classes a "Big Question." For example, Who am I? What am I doing here? Where did we come from? What happens when we die? What is love? What is depression? Write continuously for 15 minutes on your question, being sure to include your personal feelings and experiences. Obviously there are no right or wrong ways to do this -- you don't need to hold to any particular belief system.

TO WRITE: Off to a Great New Year. . . a Bit Late, but Less Stressed
Greetings! Happy 2009 to you. Happy MLK Day. Happy Inauguration Day. Happy Year of the Ox! I have not posted for a few weeks now, which I regret, but I don't think I could avoid it. As we're well aware, life gets hectic for many of us at the end of the year. And we've all heard about the high rate of Christmas-time depressions out there. Well, this year I think I caught that bug.

My depression wasn't terrible; I wasn't immobilized or suicidal or seeing and hearing things that no one else was seeing or hearing, as sometimes happens to me. But it felt like the real thing, not just the blues. I've been tremendously fortunate to have had little depression for the past two years, so this was scary -- the nasty self talk, the ache in the chest, the decreasing interest in things I love, the sadness, that feeling of futility.

But. . . I'm doing much better now. I credit a good psychiatrist and good therapist for this turn-around, as well as my ever present meds regimen, and my serious efforts to reduce the stress in my life. I backed out of some obligations and invitations (and the world did not end), and I'm working hard to change my attitude about the stresses in my life. (I'm Mom to a 1-year-old, and I'm trying to write, to do speaking gigs, to teach and do other volunteer work.) I am taking better advantage of some babysitting help, and I'm working at not waiting until my to-do list is done (it never is) before letting myself read a little for fun. Major paradigm shift.

Play with this. . .
Writing continuously for 10 minutes, take a hard honest look at what is causing stress in your life. You may be trying to overdo it, like I tend to do, or you may be stressed by the lack of structure or busyness in your life right now. Are you feeling a great deal of pressure about trying to regain your health? Are you, like me, putting a lot of energy into being frightened and bracing yourself for the worst when you mood dips even a bit?

Now, part two. . . Write continuously for 10 more minutes about what tiny steps you can take to relieve some stress in your life. Can you relax and have coffee with an acquaintance you want to know better? Can you spend fifteen minutes -- no more -- online looking at job sites if you are seeking work? Can you make your to-do list for today more reasonable? Don't overwhelm yourself with reducing stress -- this is like rushing to get to meditation class (something I've also done). Can you journal it out for a half-hour? Take small actions and congratulate yourself. I believe it's the only way to maintain my own health; perhaps it will help you too.

TO WRITE: Holiday Ups and Downs
So how do you really feel about this holiday season? It can be confusing. Family, friends, partners and mall stores may all expect bliss; magazine articles on SAD and newspaper editorials on the economic downturn may feel like harbingers of depression. Not an easy time for folks with mood disorders. I know I can feel up one minute and down the next for no apparent reason. So perhaps our goal should be to maintain some sense of stability, equanimity, groundedness. But how?

Play with this. . .
Write continuously for 20 minutes on: What helps keep you on an even keel at this time of year? Write as if you are sending this to a friend who needs your advice. For me, writing itself -- including being alone and quiet for 20 minutes -- helps a lot. So do occasional naps (even short ones), eating protein instead of too many Christmas cookies, not watching too much TV or surfing the net too much, and giving charitable gifts in honor of family members instead of just buying gifts for the sake of buying. What helps you?

This holiday period is likely to have both ups and downs for each of us. I wish all of you moments of joy, periods of peacefulness, and the awareness that life will likely settle down some soon, so persevere even if it gets tough.
With warm regards,
Beth

Amazing New Treatment Approved to Treat Depression
It really can be amazing! I know personally. . . .

What is it? The US Food and Drug Administration has now approved the use of a technique that uses strong magnets for "treatment resistant" major depression. This is great news for anyone who has not responded to at least two antidepressant trials and who would prefer not to be treated with the main alternative, ECT (electroconvulsive therapy or "shock treatments"), which can damage memory and carries some additional risks.

The new treatment is TMS or transcranial magnetic stimulation. It involves placing a device that generates a strong but precise magnetic field against a particular site on the left side of the skull, and delivering magnetic pulses for 20 minutes, five days a week for two to four weeks. The patient is conscious during the procedure, which can be done in a psychiatrist's office. What does the patient feel? Not a thing. What side effects are there? None reported at all except occasional mild headaches that respond to over-the-counter meds. No memory loss!

TMS will soon become more widely available, which I feel is fabulous news. You see, TMS completely turned my life around -- after many years of requiring a series of ECT treatments when a suicidal depression struck every few months, I was allowed to try the experimental TMS. Now, I'm technically diagnosed as bipolar, though I mainly experience depression, so my TMS targeted a different area of the brain, this one on the right side. Nonetheless, my treatment was a resounding success, as the newly-approved one has now been for many with depression in clinical trials. By the second week of treatments, the profound depression lifted and I was merely very depressed, but functional. By the end of week four of the five-minute treatments I was well! Really well -- back to baseline.

Now I needed to repeat this four-week series every few months for a couple of years as the depression returned, but the intervals between series gradually grew longer. And I'm delighted to report that I have not needed TMS (or ECT) for over two years! I've had no serious depression symptoms, and I've gotten my life back after 14 years of being unable to work or have kids. I wrote a book last year (see profile), I published it this spring and have been promoting it and, most important, my husband and I adopted a child this summer. Obviously I'm a huge TMS fan.

I know that no treatment works for everyone, but I believe that having more alternatives to try is the key for those of us who've been through every drug trial and don't know where to turn. This is great news.