Obsessed with Covid-19 news

I flipped open my iPad as I awoke this morning to get the latest update on what was happening in our corona-virus world.  It’s my go-to-upon-awakening task. My pattern has become to check in on my various devices no matter where I am, no matter the time of day and see what is transpiring in our newly pandemic world.  So, no question about it, I have a psychiatric disorder: I am obsessed with Covid-19 news!.  Notwithstanding, when I hear the latest update, I feel afraid.  I’m somehow always hoping to find some relief.  We have a saying in psychiatry that doing the same thing endless times, hoping for a different outcome is the definition of insanity.  So each day I’m acting like an addict who has lost his mind.  Why am I doing something that repeatedly scares me?  Let’s think about this for a bit.

This is an image of a covid-19 virus

Obsessed to witness scary things

Why do we stop to look at things that frighten us like accidents along the highway, scary movies or lions at the zoo?  One reason, oddly, is that witnessing these particularly scary and disturbing things makes us feel more safe.  How’s that?  During our distress, we are in the safety of our non-crashed car, sitting in our comfy movie seat or standing high on the perch above the lion that lurks far below.  We can look fear in the eye knowing that we are safe and sound.  We’re in control while we are witnessing something that could easily be beyond our control.  Nonetheless, though terrified, we watch and we watch. But that’s not the real reason we are compelled to be glued to our devices. Why are we? In case you’re wondering, it’s not because we are a nation of masochists or that we enjoy ghoulish macabre things.  

What’s behind Covid-19 news obsession?

Ask yourself this:  what do you feel when you watch the news about the pandemic?  Likely, terrified that this tiny virus has had the power to upend and snuff out our lives.  Besides fear, though, what other emotions do we experience when we watch Covid-19 news?  We feel empathy for those who are ill or who have died; compassion for those afflicted, blessed for all that we have in our lives; a desire to connect with our loved ones; appreciative of living; spared and lucky. And, we know that we must live our life to it’s fullest. So what do all these feelings add up to?  It’s simple: we feel our own humanness.

Drawn to our own humanity

Though fear is in the mix, we feel comforted and nourished as we connect with our best human self, the person we want to be.  If that isn’t intoxicating, I don’t know what is.  Doing so makes us feel human in many ways.  My iPad and TV screens are mirrors and I see a kind, decent, caring, empathic, grateful, blessed reflection looking back at me.  I like the person that I see.  When I remember that all this lies just beneath my layer of fear, it’s very comforting.  When I can touch those parts of myself, I no longer feel so alone and I no longer feel so afraid.  My humanness makes me feel safe. I’m experiencing my humanness rather than my virus fearfulness. So, for Covid-19 news obsession, don’t live in your superficial scary world…live in your deep human one.

Please tell me what you think…

Butterfly Effect

Edward Lorenz worked on mathematical models to predict weather systems, many years ago. He would use extremely exacting numbers and run his programs repeatedly, analyzing the results. One day, numbers were input that were rounded off in seemingly small inconsequential ways. He was startled to find that a very tiny change in initial conditions created huge differences in the experiments outcome. This is the butterfly effect. It means very minor perturbations such as the flapping of the wings of a butterfly far, far away could influence a hurricane occurring half way around the world. Small acts can have big effects.

Picture of a blue butterfy flapping it's wings


Why did you hug your daughter yesterday? What was the reason you gave your college students a pop quiz earlier this week? Why did you smile at the barista making your coffee this morning? Because you wanted to show your child that you love them. You were trying to impart knowledge to young minds. You were appreciative that the barista was doing something for you. All true, but all missing the larger point.

Butterfly effect: Small acts today, big effects tomorrow

We act in these ways because of the effects these actions might have far in the future. The hope that our daughters will live lives knowing love. Our expectation that our students will do good deeds in life with the wisdom we impart. We know the barista will have a better day having seen our smile that morning. Here’s the thing: we do these acts even though the effects might not be apparent until far down the road. Here’s the bigger thing: we do these acts even though we will likely never see the positive outcomes that might arise from our good deeds. Our small acts today can have big effects on others tomorrow. The butterfly effect.

The world will be in a better place

I define faith as believing that the acts of goodness, kindness and decency done every day will ultimately lead to a greater good. We can’t see that the hug, the quiz or the smile will result in anything wondrous but we have faith that it will. Perhaps without realizing, we hope our actions will play some small part in leaving our world in a better place.

So flap your wings and rest assured that you will usher in the winds of a better tomorrow for us all.

Agree? Disagree? Let me know…

The Silence of the Lambs Lesson

Hannibal Lecter and Clarice Starling

My favorite movie is The Silence of the Lambs. Worse still, my all-time favorite character is Hannibal Lecter. I’m a psychiatrist, but don’t analyze me for this just yet, please. The relationship between Lecter, the insane psychiatrist and the young, inexperienced FBI recruit, Clarice Starling is facinating to me. Lecters maniacal madness drives his desire to know what makes Clarice tick. He is only willing to provide information that will help her capture the serial killer Buffalo Bill if she, in turn, provides intimate information about herself. As he says, it’s a quid pro quo. We come to see that he is genuinely curious about her story as these give-and-take dialogues evolve. Despite this, she holds her secrets tightly and reveals her historical details reluctantly.

This is a theatrical poster of the Silence of the Lambs

Why share our stories

We share our stories for many reasons. Doing so helps others. It empowers us. Our reality is authenticated. It keeps us humble. We take the pathway toward self-affirmation. It gives hope for others. We ease our aloneness. And finally, it allows us to be courageous and unites us all as humans. None of these things are possible when we hide our truth away.

Clarice begins to share the more intimate details of her life with Lecter because she is driven to capture the serial killer still on the loose, we are led to believe. But it is more than this. Though she does so uneasily, she wants to unburden herself and Lecter knows just how to tease out her truth. Despite her protestations, she knows that she needs him to be set free. Clarice, me thinks thou doest protest too much.

Our own self judgements can be frightening

We hold onto our deepest secrets tightly. Whether we have a mental illness, have had an affair or are an alcoholic, we think we are most afraid of how others will react if they see our truth but that isn’t our greatest fear. We are most terrified by the thought of holding a mirror up in front of our face and seeing the reflection of the person staring back at us. Our own self-judgements are much more frightening and crushing than anything Lecter might think about us.

Opening up

Clarice finally reveals the most vulnerable truth about the death of her father and because of this, the lambs in her head that won’t stop screaming. It’s a relief that this isn’t a music-swelling, happy ending movie moment. Nonetheless, we look at her expression and sense some relief now that she has finally and fully unburdened herself.

The lesson learned

The greatest The Silence of the Lambs lesson is that it so courageous to peer into our psyches and dare to share our authentic selves. Our truths don’t kill us, our secrets do. They corrode our souls. It is a good thing that none of us need Hannibal Lecter to free us to speak our truths. Well chosen loved ones and kindred spirits are a much better plan. We can finally silence the scary lambs in our own heads and feel unburdened if we find the courage to speak the words that we had previously believed to be unspeakable.

Please…share your story with me

Covid-19 and love

Most viruses are about .0000008 inches long.  We can’t even see such a thing with most microscopes, but this little bit of matter we call Covid-19 has brought our world to a screeching halt.  It’s gone viral…that’s power.  We read the daily depressing stories of those whose bodies have been ravaged in numbers the likes of which we haven’t seen in our lifetime.

Covid-19 and love: Uncertainty and insecurity

We crave structure and security in our lives.  We may push back against these things but mostly, we like the trash to be picked up on the day it’s supposed to be hauled away, we like our house to get warm when we turn up the thermostat and we like that the veal parmigiana always comes with a side of ziti at our local Italian joint.  Covid-19 has pulled the rug out from us in all these ways, but the biggie is security.  This little virus has caused almost all aspects of our lives to become uncertain.  We’re unsure when we can return to school, when we can hug a friend, when we can go to work, when we can take our kids out to play, when we can eat out and mostly, when we can stop using hand wipes.

With all the security that has been ripped from our lives, it’s kinda remarkable that internal anarchy hasn’t overtaken our psyches.  But for the most part, it hasn’t.  Perhaps we humans are just a resilient bunch.  Likely so, but I don’t think that explains why we are navigating our way through “sheltering-in-place” as well as we are given that so much is now so uncertain.

Connections and kindness in so many powerful ways

The reason is this: we humans are going to get our security one way or another and this virus has forced us to be creative.  It’s true that we have lost seeing Uncle Danny tell bad jokes or tasting Grandma’s awful cooking. But in place of that we have reinforced and enhanced the things in our life that matter the most.  You and I connect with each other in ways that are different than in our pre-Covid-19 lives.  All of us are more concerned and more supportive.  We are more heroic and more generous.  Our lives are more kind and more decent.  We are more compassionate and more caring.  Quite simply, we express more love.  Covid-19 and Love. Because of this, ironically, we are more secure now than we have been in a very long time.  This is why we are going to be ok.

I wonder whether you have experienced more love in your life lately?

Mania and The Shining

Jack’s madness

I know exactly how Jack Nicholson felt in The Shining.  As he descends into madness, his primitive, base impulses become unleashed.  Whether he wishes this to occur or not is irrelevant.  His unraveling happens without his consent.  As we watch, we know that insanity is his destiny, no matter what.  There is no off switch for this.

Picture of Jack Nicholson in the Shining depicting madness

My mania

Bipolar mania and hypomania kidnap the brain.  I never knew it was coming but when I was in the middle of it, no amount of will or wishing or prayer could stop the inevitable from happening.  I was on fire, taken over by a flood of neurotransmitters that transported me to places I hadn’t asked to go.  When my brain was hijacked in this way, I had thoughts I’d never have in my right mind and was propelled into actions that my sane self would never do.  I became a super surfer, careening along the surface of a tidal wave moving at terrible speed. My sleep was disrupted but I didn’t care because I had boundless energy.  I was overly chatty with strangers and mistakenly believed that I could write novels and plays.  I spent money recklessly and I was the smartest guy in the room.  

It was like being taken against my will to a place I no longer knew.  Jack didn’t ask for his downward spiral and I never asked for my upward ones.  His course was a one way ticket downward but bipolar disorder has cyclical escalations with repeated episodes of insanity interspersed with periods of normalcy.

This might sound like it’s a lot of fun but it wasn’t.  During these times, I was irritable, agitated, anxious and argumentative.  Each time one of my elevated periods burned out, my awareness of how I had behaved and the degree to which I had lost my mind were laid bare and lead to crushing guilt.  Eventually, hypomania brought me to my knees.  

My turning point

After years of worsening mood cycles, I was finally standing in front of the bathroom door, like Jack, with an axe, unable to hold back my primal urges. My visceral id was intent on propelling me through that door no matter what. Unfortunately for me, what lay on the other side was a lot worse than a frightened Shelly Duvall. In my elevated state, I was catapulted forward and suddenly my life was at risk. It was this traumatic event that finally forced me into psychiatric care. I realized that I was either going to put down that axe and get treatment or I was going to destroy all that I held dear. There could be no more fractured doors in my future. There could be no more Mania and The Shining.

I am at my best

When Jack does begin to break through the bathroom door, he maniacally peers through the hole he just created. At that moment, he was at his worst and now years later and well treated, I am at my best. We all have primitive beasts inside but mine have been tucked away for years. The only shining I now see ahead of me are the bright lights of all the healthy days yet to come.

Do you have a story of mania? I’d like to hear from you

Bipolar identity: Jekyll or Hyde

Before i was mood stabilized

Before I was stabilized on medications for bipolar disorder, I was very confused about my identity. I was a “moody” guy with good days and bad ones, had periods where I was productive and other times, not so much. I had episodes when I expressed a lot of energy and other times, I felt dragged down. But everyone was like this, I told myself. I was just a moody guy. I didn’t question it. After all, why ask whether it’s dark out at night or light during the day? It just is.

Picture of Dr Jekyll and Mr Hyde in the 1931 Movie

When I finally admitted that I had bipolar disorder and was mood stabilized, I saw my true identity on the inside as even keeled but that I had neurotransmitters that kidnapped my genuine self, pushing me downward into an abyss or hoisting me up to irrational highs. It was a relief to know that I was, at my core, “normal” like Dr. Jekyll but it was awful to know that I could be transformed into the deranged Mr. Hyde whenever my “sickness” expressed itself.

The medications

The experience of having one’s true personhood abducted by their brain is common in those who have bipolar disorder. Our neuro-chemicals cause us to question who we really are. Just as bad, though, the medications we take add to our identity-confusion. Over the years, many of my patients with bipolar disorder have told me that the pharmacopoeia I was prescribing was robbing them of themselves. The pills were causing them to be less fun-loving and their true creative self; their lives weren’t as rich and vital as they were without treatment. Despite my best intentions to help them, I was a perpetrator of their distress. I understood them. I had walked their walk.

Humans must have a clear sense of who we are, defined by our values, ethics, core beliefs and behaviors. Having such clarity anchors us in our world. We can’t have satisfying relationships or meaningful vocations when we don’t know who we are. It’s simply impossible to have a shifting sense of self and live a stable, happy life.

Mood stability

After years of mood stability, I was finally certain about the difference between medication side effects and the genuine, authentic me. I felt good: bipolar was a healthy aspect of my identity. I was fully integrated with a solid sense of self and this provided me with a comfort that I never had experienced before. Perhaps in the future I will have a hypomanic or depressive episode and Mr. Hyde will reappear. When I become stable after that period ends, though, I will know that I am neither Dr. Jekyll nor Hr. Hyde. I am both. I am now a doctor living well who happens to have a mental health condition. It’s as simple as that. Full acceptance of all aspects of my authentic self allows me to have inner peace. I am now whole.

Are you Jekyll, Hyde, neither, both?

A letter to doctors from a peer with bipolar

Physicians are people of good will, dedicating their lives in the pursuit of healing others. The challenge is that many doctors neglect their own health, and consequently they struggle to help their colleagues in need. If I were to write a letter to doctors as a peer with bipolar disorder, it would read something like this:

A picture of Dr. John Budin Writing at his desk

My dear peers,

Your colleagues are in trouble and need you more than you might imagine. Ask yourselves how you might be more helpful to those of us who are currently unwell. We must do more to make their journey one that is safer and easier for them. We all march forward when those who have been suffering in silence speak out. But that is only half the solution. It is too heavy a lift for those of us with mental health conditions to push this heavy rock up the hill by ourselves.

Share your thoughts

Please don’t underestimate how impactful your words or a hug might be. I spoke with a colleague years ago, sharing my story and her response was simply to give me a hug. It was exactly the nourishment I needed. For any given clinician, it can be daunting to know how to shift the current status quo of secrecy and silence in regard to the prevalence of psychiatric disorders within our medical community. I would ask you to merely look in front of you each day. You are skilled practitioners, perceptive in assessing those of us who are unwell. You know who is struggling.

Remember, we change the culture of secrecy one conversation at a time. Dare to ask your friends and your peers how they are. Most of the time they will welcome this because they know it comes from the heart. Have the fortitude to find your voice and in response, they will too. If we don’t put our compassion into words, our silence can be heard by those who suffer as “you do not exist.” We may ask you at times, to lift us up. Please, consider using the decency and concern that you possess. You have chosen a vocation in which you heal others, so train your heartfelt focus toward healing those of us in need.

The topic of physician health is increasingly rising to the surface in our community given the concerns about physician burnout and the evident morbidity and mortality that afflicts us. Given the conversations we are now having (and my good friend and colleague who gave me a hug), I have faith that we can summon our courage and shift the current avoidant stasis You colleagues and friends are waiting for you to do so. Please, reach out your hand.

How might your letter be similar or different?

Bipolar freedom: click your heels three times

Last week, I was late for an appointment and couldn’t find the keys to my car. I realized they were in my pocket all along after searching my house frantically. I can be a bit absent minded sometimes.

Picture of Dorothy in Wizard of Oz wearing her Ruby Red Slippers

Closet doors

We all have closet doors that we believe we can’t open.  Behind these doors, we keep our painful, disturbing and shameful things locked away. Our behavior when our doors are close are to drug, to eat, to spend and to sex. We try hard to outrun our inner storm clouds in a misguided attempt to stay safely warm and dry.  We try to flee from ourselves but only end up addicted, overweight, poor and compulsively sexed.  Running, I have come to see, might be human but it is always a futile effort.

Enter Dorothy

I nailed by closet door shut for many years, ashamed that I had a psychiatric illness, running a marathon to nowhere.  I was trapped by my belief that external circumstances stood in the way of my freedom as if some unseen prison warden held the keys to my psychological freedom.  

Like Dorothy in the Wizard of Oz, I was waiting around to be set free by the Wizard.  If my diagnosis became known, real life consequences would occur.  Professionally, I worried about collegial disapproval and the loss of my medical license.  I believed friends and family would be shattered. Though I was the ringmaster of this circus, I gave others the message that they were to play their part and view me as someone who didn’t need comfort or care.  This farce was all my doing.

Bipolar freedom

After far too many years elapsed, I hit rock bottom and finally had no choice but to realize that like Dorothy, I didn’t need the Wizard to bring me home.  It was my job to accept that I had bipolar disorder: I didn’t need anyone to parole me for a crime I didn’t commit.  It sounds obvious now but it was revelatory back then.  If we can shift our view inward and realize that we all hold the keys to the doors we nail shut, we can use them and liberate ourselves from the cells we construct.  All we need to do is click our heals three times and we’ll be free.  I’ve done it.  It works.

If you are living with a mental health condition, do you feel free?

Unexpected teachings from a bipolar patient

Early in my career as a resident psychiatrist, I learned a rare lesson from a patient with bipolar disorder who urinated on herself. Back then, I had no idea what I was doing. I was incompetent. During my second year, I spent a month on an inpatient unit. One of my tasks was to facilitate a group attended by all the patients and my supervisors.

This is a picture of 3 hands nested together
Photo by Kristin De Soto on Pexels.com

Unexpected teachings from a bipolar patient

One day, a group was going well until a woman with bipolar disorder suddenly stood up, walked to the center of the room, stared intently at me and urinated all over herself.  I watched, speechless and in horror, as the urine trickled down her legs.  I sat in my chair mute, hadn’t the slightest clue what to do and felt publicly humiliated.  Since we shared the same diagnosis, I briefly drifted into my own thoughts. I wondered whether I was witnessing my future, one filled with hospitalizations and public urinations.  

I spoke with her later that day and in her own psychotic haze, she shared with me that the psychiatry resident who had cared for her had rotated off the unit the day before before I arrived and I had taken his place.  She liked him, missed him and felt that he cared about her.  She was scared that I would leave her. I got it.

Earlier that day in the group, she was expressing her unspeakable distress to me using the only language she knew.  She lacked the capacity to put her terrors into words and so, as she she stared at me, she created the puddle around her feet. 

Our similarities: vulnerability and fear

While I have learned to express my fears in ways that don’t involve public urinations, she was making me face the reality that, in addition to our shared diagnosis, we were more similar than we were different.  We both felt vulnerable, we both felt afraid and we both felt inadequate.  Neither of us were in control. Unexpected teachings

Though she couldn’t know this at the time, she taught me that I could find solace in accepting that my life contains mystery and uncertainty.  I’m not always the master of my universe.  I‘ve gotten lost in fear and have been frightened by my vulnerability. I learned something from that brave woman that day that was both undeniable and feeing:  like her, we are all merely human.  I can live just fine with that.  

What lessons have you learned from your patients?

To learn more about the unimaginable gifts from Bipolar Disorder, click here.

The fallacy of either/or thinking in physician health

My favorite scene in the Wizard of Oz is when Dorothy opens the door in her just-landed house in Munchkinland, leaves black and white behind and steps into a new technicolor world. The colorless view she had wasn’t going to bring her home. This is the same fallacy of either or thinking in physician health.

Picture of Dorothy from Wizard of Oz peeking out from house and seeing color, just after landing in Munchkinland

I avoided psychiatric treatment for my bipolar disorder for far too many years and during that time, I continued to practice medicine. Some will view that decision as controversial or problematic. Some will believe that I should have stopped treating patients all together. But given the numbers of clinicians who have psychiatric conditions, I don’t think exorcising us all from the field is the way to go.

The fallacy of either or thinking

We all agree that clinicians shouldn’t practice when symptoms impair their capacity to do their job. But, we view this issue through an all-or-nothing, dichotomized lens: we feel that we must either overemphasize physician health at the expense of patient care or (the current state of affairs) place a premium on delivering care at the expense of physician mental health. We can see no middle ground. But, I believe that we can find ways to shift our black-or-white view. We can deliver excellent clinical care and tend to ourselves simultaneously. Our current mentality perpetuates a stasis where our colleagues suffer in silence or depressingly, end their lives. It is unacceptable to continue to ignore our peers by refusing to find middle ground between the all and the nothing.

Living in a world where we feel we must choose to either sacrifice our patients or ourselves perpetuates the unacceptable status quo currently embedded in the medical community. Here’s the important thing: When Dorothy opens the door, she finds more than a world of color. She finds those of good will who walk with her as she journeys down her yellow brick road. Let’s join hands so we can take care of both our patients and ourselves. Let’s travel to Oz together. If we do that we can eliminate the fallacy of either or thinking in physician health.

I wonder if any readers have struggled to take care of themselves?