My name is Tony and I’m living well with Depression.

If more people shared their stories of illness and eventual recovery, it would have a profound effect on those who are suffering in silence. I recently posted a request on the Huffington post asking for stories of recovery.

I heard from a psychologist who refused to recognize his own depression, even as he treated other people in crisis. I heard from a CEO who was so ashamed of his anxiety disorder that he suffered a panic attack in a high level board meeting. I heard from a teacher who was substituting for a health class before she realized she might have post traumatic stress syndrome. I’ve received so many letters and heard so many stories of people’s initial reluctance to recognize their illness and seek treatment. And yet, the reason I am now hearing from these courageous people is because they all eventually found a path to recovery.

It’s not easy. Recovery takes patience, commitment, strong support from family and friends, and the willingness to be brutally honest with oneself. It takes wading through therapies to find the one that clicks with your way of life. Some therapists are extremely gifted. Others are horrible. (I’d love to see an “Angie’s list” of therapists, psychiatrists, psychologists and care centers, complete with reviews and feedback from users.) It’s important to note: In every case of recovery, there is one person who believes in the person so wholeheartedly, they provide enormous support. Most times, it is a therapist or a doctor who provides the unflinching support. Other times, it is a spiritual advisor, a yoga teacher, a friend or a partner.

Tony is one such example.He stopped me in the hallway at work after we worked together on a mental health campaign. “I thought it was hypocritical not to tell you I’m living well with a mental illness.” he said. My heart immediately opened to Tony and his story. He works every day to keep his illness in check. It took many years to figure out the right combination of anti-depressants, therapies, exercise and mindfulness. As Tony notes, these therapies, drugs and coping mechanisms may not always work. He still struggles to keep his negative thoughts in check, but he works his program every single day. “For many years, I wished someone could wave away my illness,” Tony says. “Now, I realize it’s made me the sensitive and compassionate person I’ve become.”

Tony is brave beyond measure. I’m thrilled to bring you his story. And, I’d love to hear yours.

The Silicon Valley Suicides: A survivor’s response

The December issue of The Atlantic just went online a few days ago, and it’s already landed in my inbox a half a dozen times. The senders know me as a mental health advocate, a radio host and the author of a new book called ‘All the Things We Never Knew, Chasing the Chaos of Mental Illness.’

The title of the article, ‘The Silicon Valley Suicides,’ strikes me both professionally and personally.
http://http://www.theatlantic.com/magazine/archive/2015/12/the-silicon-valley-suicides/413140/

My daughter and I are suicide survivors. She is also a freshman at Stanford University.

Yes, I’m concerned. I’m also hopeful.

The Atlantic article talks about an issue widely discussed in Silicon Valley circles, but not so much in the public at large,–why are some of the world’s brightest students committing suicide? Palo Alto has had two high school suicide clusters since 2009, and the rate of anxiety and depression among high-achieving students is alarmingly high.

Palo Alto is not a community that ignores a problem as serious as teen suicide. In fact, community response has been swift; the CDC is helping assess local suicide risk factors, national and local experts advise on the science of suicidality, and the community has refined youth well-being programs. After criticism from students about the pressure to succeed, local high schools have reduced academic and performance pressure and convened “Project Safety Net, coordinating the work of public and private organizations focused on teen wellbeing.

I applaud every effort. And, I’d add this. I don’t believe we’ll “engineer” our way out of this problem without first acknowledging that suicide is a crisis of mind, body, and spirit. If I’ve learned anything in the ten years since my husband died by suicide, it is this: Suicide is the best and the last choice of the sufferer, and any attempt by survivors to answer “why” is frustrating and incomplete.

My husband told his doctors he compensated for his depressions for twenty-five years. Before his first episode of mania, he never spoke of having a mental health problem because his family viewed it as a weakness of self. As I read the profiles of the Palo Alto teens who have died by suicide, I recognize similar traits: high intellect, extreme sensitivity, a feeling of isolation and loneliness. And impulsivity. David never seemed to develop an eye to his divinity, or what some may call self-love. He suffered from a great deal of self-loathing, and the ultimate diagnosis of a mental illness was a radical personal affront to his view of himself. Science, engineering, and technology all focus on the realm of the knowable. I often wonder if David might be alive if he’d been willing to spend more time pondering the unknowable, the mystics, or the divine.

In a decade of research and writing on mental health, I’ve never found someone bold enough to say, “Here’s why people die by suicide.” Each new circumstance challenges the last. But this much seems reasonable: in our development of self, anyone whose identity is undermined by radical personal or cultural change is at risk to suicide. Adolescents and young adults, now living at hyper speed and undergoing radical change, seem to be at higher risk than ever. The very students we thought were destined to be our best and brightest are calling out for help. A big part of their lives, or at least the part that allows us to feel a connection to one another, has gone missing.

We must embrace our humanness and the parts of us that may not be viewed “successful” by an outside world. Fellow writer and Portlander Cheryl Strayed described it as developing the qualities people talk about at your funeral, not the achievements listed on your Linked In profile. We must teach our kids that the qualities of vulnerability, empathy, resilience and compassion are far more important to health and happiness than their SAT score. Mindfulness training is one way to get there. So is prayer. And learning from failure.

If we’re talking about how to solve a serious problem, we may want to develop the app for sitting still, for breathing, and for allowing a spiritual connection to take root. There isn’t an award or accolades given for seeking, but it may hold the biggest reward of all. I’m coming to Palo Alto December 4th to talk about mindfulness and mental health. I welcome your comments and suggestions. www.SheilaHamilton.com

‘What Should We Have Known?’

A conversation with FOX News Health host, Dr. Manny Alvarez.

Mental illness, unlike breast cancer, isn’t celebrated with big marches or pink ribbons. The stigma is stifling and it prevents most people from seeking help. David, my husband, refused to accept the label of bipolar disorder. He could not imagine a life of medications and therapy, which did so little to help. David’s path is not unique. Suicide is now the ninth most common cause of death for men and women in America. Every thirteen minutes, another American dies from suicide.

What could we have done differently?

What should we have known?

It is my belief that many people could benefit from hearing more about how psychiatric conditions unfold. In the years, months and days leading up to David’s death, I didn’t classify him as mentally ill. I missed many signs. I ignored others, believing it could get better. And I scrambled, as the world came crashing down around us, I scrambled to maintain my own sanity and the health of our daughter.

Our daughter celebrates her birthday each June. I can’t help but measure her birthdays with an equal sense of apprehension and elation. She’s a teenager now, and still no sign of the brooding, the polarity, the darkness that descended on David like Portland’s thick gray clouds in January, refusing to budge. Yes, she has his intellect but she also has my relatively sunny nature. She is physically stunning with long, muscular legs and a waist that defies her voracious appetite. She has David’s European cheekbones. The color of her skin is his. Her ears have the same shape. There are times I find myself staring at one of her features for too long. She bats me away, “Mom, enough.”

After David’s death, I’d read every book I could get my hands on about bipolar disorder. I’d measured the likelihood of a genetic inheritance against the things I could influence– her diet, her sleep, exercise, a sense of well-being and unconditional love. She is just fine, so far. Becoming aware of our family’s genetic vulnerabilities was painful, but it provided a unique gateway to also focus on our genetic strengths, and Sophie has inherited a majority of the good stuff. She’s attending college now with the sensitivity, compassion and intellect of a person who will be better than “just fine.”

I want everyone to know about the signs and symptoms that I missed with David. The anxiety, confusion, disorganization, trouble completing tasks and how withdrawn he became. My interest is in preventing another loss of life as exquisite as David’s. I welcome your emails, your stories, and hopefully, your support. Connect with me and sign up for my newsletter. I’d be so grateful if you did.

What is the most important factor in treating mental illness? Competence.

It’s been nine years this week since my late husband David died by suicide. Everything about this time of year releases a cascade of emotion that is unbearable, the softening of the light, the gold and amber in the leaves, the heat during the day dissipating to cold nights. There is a vivid memory of David’s state of mind, a cold, agitated horror at his state of being. Even breathing seemed to be an effort that exhausted him.

At a time when we needed the very best care we could get, we experienced a system that retraumatized David to the point of hopelessness. An initial misdiagnosis, a prescription that pushed David over into a state of akathisia and suicidality, a lockup care center whose contracted doctors made money– not by helping people– but by admitting as many patients as they could squeeze into a bland and hopeless enclosure. We knew it was oppressive when we were in it, but, in insight, it was also a shameful failure of care.

Currently, there is no standard of education for a diagnosis. Many people treat depression, including family practitioners and social workers, and the varying degree of competence is maddening for families who are desperate for quality care. Families seeking help find professional camps divided between psychopharmacology and psychotherapy. And often, medications compound the suffering. Caught in the middle, patients are dying.

This year marks the tenth consecutive year our nation’s suicide rate has increased while outcomes for heart disease, diabetes, and cancer are improving. Half of those who died by suicide were under the care of a general practitioner. One-third of those who died by suicide were under the care of a psychiatrist. As one doctor told me, “It’s time to put the head back on the body.”

We demand excellent outcomes for every other major disease. We track success rates for heart surgeons. We compare and contrast survival rates for cancers. Why has the treatment of mental illness in our country been so lacking that many inpatient psychiatric centers don’t even bother tracking the outcome of their patients? David’s doctors didn’t realize he’d killed himself just one day after his release!

We could be saving lives by coordinating patient care- sharing essential treatment information, scheduling and tracking referrals, and providing proper follow-up care. With today’s technological advances, a fully coordinated system of care is possible, and is even being practices in some parts of the country with very good outcomes.

I’m just one survivor. But for every death by suicide, the National Institute for Mental Health suggests eight people are profoundly affected. Last year, 41,000 Americans died by suicide. The toll of grief, confusion and chaos impacts hundreds and thousands of people every year.

What is the most important factor in treating mental illness? Competence. We should demand it.

Dear Grandma, Here’s Why I Missed My Partner’s Mental Illness.

A reader of my book, ‘All The Things We Never Knew’  suggested it would be impossible to be married to someone for ten years and not realize that they had a mental illness:

Dear Grandma in Arizona,

I’d like to give you some insight into my experience of loving someone with a mental illness. Contrary to what Dr. Phil has said, most people who experience mental illness don’t  “howl at the moon.” The early behaviors of mental illness are elusive, intermittent and commonly misunderstood.

Have you ever felt rage and not understood it? Have you distanced yourself from others? Have you been sensitive to light and sound? Eaten too much or too little?  Have you felt as if you don’t belong? Have your thoughts been slow and depressed or fast and racy? Have you been uninterested or unable to complete a task you know you need to do? Have you ever lost hope?

Maybe you have a few weeks or a few months when you feel better. You try to reconnect, you promise you’ll be a better person. You laugh. And then, your brain goes dark again. You cheat and you lie, denying these recurring depressions are happening, even as the symptoms are occurring with more frequency and more severity.  Your family and friends are frightened, confused and unsure of  how to help. You blame your behaviors on your partner, or your job, or your parents.  As you self-stigmatize and withdraw, you are getting sicker and sicker.

Now, throw in a few traumas. The death of your father. The crumbling of your business. The pending separation of your life’s partner. Boom. All of those methods you used to compensate are gone. Then, a well-meaning doctor gives you an anti-depressant, and suddenly, you are thrown into mania and Akasithisa, an agitated, skin-crawling, can’t sleep state that induces suicidal thoughts.

Then, you find a gun.

Now, you are hospitalized against your will.  A nurse who doesn’t know your name takes your clothes and personal belongings. A doctor who has only fifteen minutes a day for you prescribes more drugs, and when those don’t work, different drugs to counteract the side-effects. You are a threat. And hopeless. You lie about your state of mind to get out of the hospital.  To be free of it all.

This is my experience of my partner’s illness, but in conversations with hundreds of other family members who have cared for someone with a brain illness, there is a shared sense of confusion, guilt, and even denial. It helped me immensely to hear from a primary care physician who shared just how difficult it is to detect and treat bipolar illness.

Recognizing the early signs of mental illness is difficult, but even trickier is getting good care. If our  mental health and medical systems are not changed to stop re-traumatizing people in crisis, our rate of mental illness will continue to climb. If we don’t do a better job of recognizing the sometimes elusive symptoms of mental illness (especially in high-functioning people), our rate of suicide will continue to climb.

That’s why I wrote, All The Things We Never Knew. I laid bare my mistakes in an effort to try to help others recognize mental illness and intervene earlier than I did.  I worked very hard to compile resources for others and investigate the programs and people who are giving people hope. We must believe in the tenants of recovery. It will take a tectonic shift in the way we deliver care.

Grandma, I hope this has given you a bit more understanding and empathy of my story and the stories of others. I wish you and your family only good health and happiness.

With kind regards,

Sheila Hamilton

All The Things We Never Knew is available here:

http://www.amazon.com/All-Things-We-Never-Knew/dp/1580055842/ref=sr_1_1?ie=UTF8&qid=1444499189&sr=8-1&keywords=All+the+Things+We+Never+Knew

 

Win a chance to have your book club meet with Sheila

Sheila Hamilton’s new book “All The Things We Never Knew” is launching at Powell’s on October 20th, and you could win a chance to have your book club meet with Sheila at the Skype Live Studio during the week of November 2nd.

Five winners and their entire book club will be chosen to visit with Sheila over the week of November 2nd. To enter, simply open your KINK app, available on Apple and Android. Coffee and pastries by Beaverton Bakery will be provided. Find out more →

Sponsored by Cascadia Behavioral Healthcare

The mission of Cascadia Behavioral Healthcare is to provide healing, homes and hope for people living with mental health and addiction challenges.

Buy “All the Things We Never Knew” on Amazon.

Demand Hope. Demand Recovery. Nothing less than life will do.

I hosted a public celebration at Pioneer Courthouse Square to mark the end of a hugely successful fundraising campaign for the OHSU Knight Cancer Institute. The Phil and Penny Knight Foundation challenged Oregonians to raise $500 million dollars to fight cancer. Make that goal in two years, Knight said, and his foundation would match the giving. OHSU raised the money in a record sixteen months, with 85% of the giving coming from within Oregon. We made it. It was a moving and emotional experience to learn of the remarkable breakthroughs in saving the lives of people diagnosed with cancer, and to imagine the gains that will accrue after a one billion dollar investment in cancer detection and prevention.

In nearly every area of public health, startling improvements are being made. If research on cancer, heart disease, stroke and diabetes has proven anything, it is that research investments save lives. As Dr. Brian Druker pointed out, research dollars devoted to leukemia allowed him to create a lifesaving drug, Gleevec, which has revolutionized the quest for a cancer cure and saved countless lives.

Sheila Hamilton, Mark Ganz, Ceo of Cambia Health Solutions, Oregon Governor Kate Brown

Sheila Hamilton, Mark Ganz, Ceo of Cambia Health Solutions, Oregon Governor Kate Brown

Now, let’s look at the tenth leading cause of death. Suicide. In 2014, 41,000 people died by suicide, and yet, public and private investments in research are meager, according to the U.S. National Suicide Prevention Research Efforts 2008-2013 Portfolio Analysis. Unlike other causes of death, the suicide rate has shown no decline over the last fifty years. Overall, Americans are now more likely to die by suicide than in an automobile accident. Suicide is the second leading cause of death for teens ages 15-34. And the rate of suicide among middle-aged Americans has increased by 30% since 1999.

What is most perplexing is the accepted rate of failure. Many people who die by suicide are under the care of physicians. In the month before their death by suicide, about half saw a general practitioner. According to the National Alliance for Suicide Prevention, thirty percent of those who die by suicide saw a mental health professional. Health care professionals often fail to ask about suicide risk because they were never trained to or they don’t know how to recognize suicide warning signs.

If we could improve suicide identification and care in primary settings, or in emergency departments, where most people go when they are feeling suicidal, we would have the potential to save lives. If we adopted the expectation of recovery in care settings, we could save lives. If we invested in the prevention of suicide like we invest in the prevention of heart disease and cancer, we could save lives. We know this because we are watching the rate of suicide decline in other countries that have made suicide prevention a priority.

41,000 lives a year are in the balance.

The dedicated folks at OHSU have a great saying. “We fight cancer differently. We win.”
Imagine a similar phrase for the prevention of suicide. “Demand Hope. Demand Recovery. Nothing less than life will do.”

Some Words of Encouragement

All the Things We Never Knew

I chose to write about mental illness in All the Things We Never Knew for one reason–to give people hope. It was excruciating to watch my former husband descend into mental illness and not know where to turn or who to ask for help.

The unexpected gift of writing on this topic is that people now share their most closely held stories with me; they are vulnerable and open, recounting life experiences that aren’t generally water cooler talk.

After hearing about my book, the big burly guy who sat next to me on an airplane told me in detail about his brother, an Iraq war veteran, who suffers from PTSD so severely he sweats through his sheets every night. “He served three tours,” the man said, “and he’s still at war.”

A hairdresser told me about her battle with postpartum depression, and how, after months of seizures she believed were caused by anti-depressants, she attempted to take her life. If her baby hadn’t crawled in the bedroom as she was downing a bottle of pills, she says, she wouldn’t have found her way to recovery.

An older gentleman listened quietly to my brief description of the book and then whispered, “You young people are so brave. I’ve never told anyone about my depression.” I smiled and said, “I’ve never told anyone else I’m not young.” We shared a good laugh.

One in five Americans suffers from a mental health disorder. But, those numbers don’t hint at the tens of thousands of people who suffer in silence. Darkness wins, shame wins, and people feel more alone, and unworthy of love.

Brene Brown defines vulnerability as “Emotional risk, exposure, uncertainty.” It fuels our daily lives. As a therapist in her 12th year doing research, Brown says, “Vulnerability is our most accurate measurement of courage; to be vulnerable, to let ourselves be seen, to be honest.” What stops many from showing vulnerability is shame. Shame, according to Brown, is not guilt. It is a focus on self. Shame is highly correlated with addiction, depression, violence, aggression, bullying, suicide, and eating disorders.

So, here’s my message: If you are one of those people shaming yourself, denying yourself love, hiding from your emotions, know this. You are not alone. There are so many people who want to hear your story and they want to help. People who care are waiting to hear from you at Lines for Life, NAMI, Trillium Family Services, and your local County Mental Health services. These people will fight for you, with kindness and compassion. Be vulnerable, be open, and do not give up. Demand hope. Demand recovery. You are worth it.

Friends! We have a book cover!

Friends! We have a book cover!  And, Seal Press says it’s going to be published first in hardback! Look for it in November 2015.

All the Things We NeverKnew

 

 

Inked!

Nothing to see here. Just signing my first book contract!