Category: Strategies for thriving with mental well being


I sit on the board of directors of the Depression and Bipolar Support Alliance ( an organization dedicated to helping those living with mood disorders.  At our quarterly meeting in December, I sat in a room with like minded people working hard to better the lives of others.  It’s an honor to belong to such a group of good souls whose hearts are in the right place.

Belonging and Attachments

We humans are wired to belong.  Belongingness (yes, it’s a word) is a state of being an essential or important part of something: our primary relationships, our families, our friend groups and our communities, amongst others. Those living with depression and bipolar belong to the mood club.  As members, it’s true that we’ve paid our entry fees with episodes of depression and mania but…we’re in.  Because of this, we find sanctuaries filled with shoulders to cry on, nourishment for our souls and kindred spirits with whom we share our hopes and dreams.  It is only through these connections that we can be the best of whom we are. I don’t believe it’s possible to travel this pathway toward our better selves on our own.  To do so, we must belong.  Through the attachments that come with belonging, we come to know others and allow others to know us in the most genuine of ways.  What more precious gift is there?

Belonging and the Big things

This state of belongingness has allowed me to navigate through adversity.  This, in turn, has compelled me to slow down and get lost in life’s sweet little moments and, at the same time, see the larger things that matter the most:  compassion, kindness, decency, authenticity and true connection to others.

Belonging and Sacred Gifts.

Belongingness has given me precious gifts:  being my better self, knowing others and allowing them to know me, seeing myself honestly as I navigate through adversity, claiming ownership of myself without secrecy, pausing more often to smell those proverbial roses and reaffirming the deeper and most important things in life.  Belongingness has made me richer in all the ways that matter the most to me.  Belongingness has allowed me to know the love of others in ways that I wouldn’t have otherwise.  Belongingness has given me these most sacred of gifts.  I’m very lucky to belong.


In his classic book “Oh, the Places You’ll Go”, Dr. Seuss writes: “You have your brains in your head, you have your feet in your shoes, you can steer yourself in any direction you choose.” It seems that we humans are, by nature, a hopeful group. This is, in fact, true.  Hope is a belief that things will be better no matter the odds.  Even though it might be unlikely that a positive outcome will occur, we retain hope.  We can even feel hopeful during times of stress and adversity.  Indeed, it is remarkable that so many trauma survivors feel positively about their futures.  It’s not surprising that hope is the single most important predictor of well-being for those who have lived through tough times.  So, it’s true: hope does spring eternal. Some say that hope is the same as optimism, but it is not.  We can, after all, feel hopeful even when we are stuck in a pessimistic place.

Hope written on Foggy glass on window

Hard-wired to hope

The science behind hope is quite remarkable.  We have learned that our brains are hard-wired to feel good about our future.  There is an area of the brain called the orbitofrontal cortex that is the neurological area from which the state of hopefulness arises.  When this area is active, our brain releases endorphins which improve our moods and make us feel better.  So it is actually a fact that we are biologically wired to experience hope. Even more remarkable, we can change our brains over time so this neuroanatomical center can become more active.  It is a commonly held misperception that we are destined to lose brain cells as we age.  This is not true.  Our brains are malleable and we can grow new brain cells by doing new things, thinking new thoughts, exercising and eating certain foods.  It turns out that we can learn to choose hopefulness in the same way we can choose the clothes we wear everyday.  

Hope springs eternal

Despite this, there are times when we feel negatively about our future.  It is the human condition that this happens.  During these periods, our hope area is still present in our brain but it is covered up with grief or anger or despair.  All we have to do to feel better is deconstruct the walls we sometimes build around our hope centers. Our resilience and courage in doing so is being human in the most admirable ways.  

Hope is a soft light that comes from within us.  It illuminates a pathway forward out of the darkness that we sometimes feel.  It’s like lighting a match when we are standing in a dark tunnel.  If we believe in a better tomorrow, we can navigate through adversity today.  Hope allows us to move in the direction of our dreams.  So, light up the hope center in your soul.  If you do, with your brains in your head and your feet in your shoes, you can steer yourself in any direction you choose.  After all, hope springs eternal.

Everyone We Meet…

When I shared with family and friends that I have bipolar disorder, I think that they were surprised, if not shocked.  After all, I hid my symptoms from everyone in my life for many years.  I have been very surprised at the outpouring of support and affirmation I’ve received from others, something that I never expected.  A wonderfully supportive husband, sisters, mother and friends have all greeted me with acceptance and love.  I can not imagine being more blessed.  I assumed that I had to keep my authentic self hidden.  I felt alone but this was a self inflicted wound. After all, if I never gave them to opportunity to truly know me, how could I expect them to understand and walk in my shoes?

picture of two sneakers sitting side by side

Our Judgements

Some months back, I was working on a project with a colleague.  One day, we were discussing how to proceed with a particular issue and I made a suggestion that he quickly dismissed.  I experienced him as unnecessarily controlling and unreasonable in his perfectionistic expectations.  He was a difficult person to work with, I concluded.  That is to say, I judged him harshly.  A few weeks later, we spoke on the phone and he apologized for being so dismissive of my ideas.  He began to share his story with me, one that originated in his childhood.

Their Shoes

He grew up in a home where expectations were unreasonably high.  No matter how well he performed or how well he behaved, it was never good enough.  So he arrived into adulthood with perfectionistic voices in his head that were harsh and condemning.  He lived in an inner world of self flagellation.  He then shared that his son was psychiatrically unwell and he felt that he had failed as a parent.  This tortured him. How unkind I was to judge him.  How unfair of me since I had no awareness of his life’s journey.  How unbearable it must have been over the years to live with himself.  I caught a glimpse of what it must be like to walk in his shoes.

Everyone Has a Story

This reminded me of a truism that I learned over the years as a psychiatrist but occasionally still forget when I feel wounded.  A truism that we forget when we judge and condemn without first attempting to understand.  A truism that becomes clear when we get to know each other.  A truism that wise others have noted:  Everyone we meet is fighting a battle we know nothing about.  Everyone we meet is making their way as they know best.  Everyone we meet has a history of pain and joy that makes them love and live a little differently than we do:  So, let’s be open and teachable.  Let’s ask first, then listen.  Let’s be kind.  Everyone has an untold story.

Covid: Give your Gifts Away

Pablo Picasso was a painter, printmaker, ceramicist and theater designer.  He is widely regarded as one of the greatest artists of the 20th century.  As I have read about him, I’ve come to see that he was as wise as he was talented.

Covid Disconnection

We are attempting to cope with the Covid pandemic in many ways. We socially distance, we try to maintain structure and routine in our daily lives and we exercise.  And, of course, we stay connected via phone, email or Zoom.  I have been struck, though, that with all this 24/7 verbiage about Covid, we are often saying very little to each other that is truly helpful.  All this “connection” doesn’t, actually, seem to lead us to feeling more connected.

The Gift of Ourselves

Let us acknowledge that we are feeling powerless, helpless, sad and angry.  When we talk about Covid we might say “this is scary.”  Understandable.  But it’s quite a different thing if we were to say “I feel scared” or to ask another, “are you scared?”  When we utter these latter words, we are opening ourselves up in a human way and expressing compassion and empathy.  “This is scary” does neither. We all crave comfort and security in these Covid-saturated times and being on the receiving end of empathic emotional intimacy and tenderness is salve for our souls.  When we show our true selves and when we ask others to do so, we are, in essence, giving away a precious gift.  The gift of ourselves.  It’s ironic that the more we give, the better we feel.  Genuine giving isn’t depleting, it is repleting.  It is exactly what we need right now.  It’s no wonder that our dedicated and giving healthcare workers are as revered as they are. 

Give your Gifts Away

Pablo Picasso’s life purpose was one rooted in generosity and decency.  He understood that no one becomes poor by giving.  Quite the opposite.  So if you wish to feel less scared, less helpless and less powerless these days, give the most precious gifts of yourself away.  If you have compassion and kindness within you, give it away.  Give it frequently, give it generously, give it freely and give it abundantly.  If you do, like Picasso, you can paint a canvas where you will make those around you feel so much better and you will feel at least as good as they do.

Babe Ruth’s Bat

Babe Ruth is widely considered to be one of the greatest baseball players of all time.  He held numerous career records for athletic feats.  His lifetime batting average was 0.342, an astounding feat.  This number means that when he was at bat, he got a hit about one third of the time.  To say it differently, though, he swung and missed two thirds of the time and was still considered a champion.  We measure him using the correct and fair yardstick given how hard it is to hit a baseball speeding toward you.  We consider him a stunning success even though in reality, he struck out most of the time.  

Picture of Babe Ruth Batting


How do we navigate our way through our own imperfections every day? Our own swings and misses?  If being human implies being imperfect, then we are all very, very human most of the days of our lives.  We fall short of perfection every day.  Given this, why do we idealize perfection as we do? Why do we feel so badly about ourselves when we fail to rise to an unattainable level?  A concert pianist will always hear the one note that was mis-hit and the A student will always focus on the one test where the result was an A-minus.  Wouldn’t it be a lot wiser to expect ourselves to fall short and not castigate ourselves when it occurs?  Why put ourselves through such angst time and time again despite the inevitability of our shortcomings?  This doesn’t make any sense.


Think about this: what yardstick do you use to measure yourself in life? More often than not, one that doesn’t allow you to miss the ball most of the time.  Your expectation is that you’ll swing and hit the ball out of the park almost all the time.  We are not a species that tolerates our human failings. So, we’re not supposed to speak harsh words, to send off angry emails, to mis-hit the piano keys and get that A-minus.  We expect ourselves to be better than one of the greatest legends in the sporting world.  Our batting average is supposed to be 100%.  But what if we were to use a different yardstick to measure ourselves?  What if we used the Babe Ruth yardstick and allowed ourselves lots of swings and misses without self condemnation. A yardstick that allows us to fall short, to reflect upon what we might have done differently but one that doesn’t encourage us to use the bat to beat ourselves up when we are merely human.  Striving to do our best is admirable, perfectionism is corrosive.  

In Life, Choose the Right Bat

So when it’s your turn at the plate in life and you mess up, you have two bats you can pick up to assess who you are.  The perfectionistic bat or the Ruth bat.  Use the Ruth bat. The one that allows you to miss the ball plenty of times without relentless self-condemnation.  If you do this, you’d feel like a champ, babe.

Faith: Touching Shadows

Last week, on a bright sunny day, I was sitting in the shade of a maple tree.  As the sun slowly arced across the sky, the shadows cast by the tree moved across the ground.  Were I to reach out and try to touch those darkened areas, all I would feel would be the earth beneath my finger tips.  Touching the shadows that lay in front of me would always be elusive, though they existed right before my eyes.  

Faith written on rural road

Questioning Faith

A week ago, a woman asked me for advice about her son who had bipolar disorder.  She explained that for the past ten years, he would be adherent to treatment for periods of time and then he’d refuse to take his medications, denying that he needed them.  She witnessed him cycle through periods of wellness and illness, impotent to do anything helpful at all, she felt.  She wanted to know what advice I had for her and my answer was two words: have faith.  How naive I must have sounded, suggesting something that could be construed as nothing more than a trite sound bite.  After all, having faith is easy to suggest, but seems near impossible to feel at times of great distress.

Having Faith

I explained to her that her faith would be well placed because of all those working every day to find cures for the many psychiatric disorders that continue to afflict too many of us.  Her faith would be well placed in the many treatments that already exist that can work wonders to stabilize moods for those with bipolar disorder.  Her faith would be well placed because so many people with mood disorders find their way toward mental health and lead wonderful, rich lives.  Her faith would be well placed because her son had periods of time when he was adherent to recommended care, an excellent prognostic sign.  Her faith would be well placed because her son knew that he had a mother who supported him fully in becoming and staying well.  Her faith would be well placed because she loved him.  Her faith would be well placed because she was part of a worldwide community of those whose hearts are in the right place, supporting their loved ones as they walk down the challenging road of life.  Her faith would be well placed because she was not alone.

Touching Shadows

It’s so hard to retain faith during the difficult times that we face in our lives.  But when we are caught in distress, somehow we journey on believing that tomorrow will be a better day.  Even though we can’t know what our future holds for us, we take a step forward during those dark times.  But darkness can be no more than a space on the ground that is cast by a tree on a sunny day.  It’s not something that we can physically touch but we see it right in front of us.  The shadow exists without any doubt.  And here’s the thing:  that shadow is there only because of the light cast down from sunshine on a bright day.

The Discomfort of Vulnerability

A colleague of mine recently asked me for some help.  He was wondering how best to handle a difficult situation at work.  As he reached out, he half-apologized, wondering whether he might be unfairly imposing on my time.  It didn’t feel like it was an imposition at all, quite the opposite.  He’s such a good guy and so respectful that it’s always a pleasure to share my opinion with him and offer my advice.  As he asked, I noticed something: his reaching out made me feel good even before we conversed about his work.  I wondered why that was the case.  After thinking about it, I figured it out.  He was showing me his vulnerability.

Quote by Brene Brown: Vulnerability is not weakness: It's our greatest measure of courage

Leaning into discomfort

His words didn’t make me think something; his words made me feel something.  This expression of human vulnerability allowed for a connection between us, a moment of closeness.  I know that it likely wasn’t so easy for him to ask but here’s the thing: it’s always uncomfortable to show our truest vulnerable selves.  We have a saying in psychiatry that we grow only when we lean into discomfort.  I believe this is true.  By definition, growth is a journey where we enter an unknown world, whether we are stumbling to learn a new language or falling off our bike as a kid.  Leaning into the discomfort of showing another our tender core is as challenging as it is rewarding.  

Embracing discomfort

Ironically, it is only through embracing this discomfort that we can find comfort.  We can’t have it both ways.  We either live behind thick walls, protecting ourselves, feeling alone, or we open up to the joy and pain in life by feeling uneasily vulnerable.  When we say “I love you” first, when we stand at an AA meeting and say “I am an alcoholic” or when we say “I need your help”, we are extending our hands and opening our hearts.  We humans are hard-wired to connect and being openly vulnerable is the only pathway to true intimacy and well being.

I’m going to do my very best to help my colleague.  I’m quite sure he is unaware that he has moved me.  I respect him for doing so.  And perhaps in return, I will navigate through my own vulnerability, open myself up and let him know how grateful I am for this gift that he has bestowed upon me.  

Swinging and Missing

A few days ago, I sent two well-meaning emails to colleagues.  As I read them after I had pushed the “send” button, I regretted that they were hurtling through cyberspace and landing in the inbox of these two recipients.  It’s not that they had an angry tone but they were too long, divulged too much information and were a bit tone-deaf to the sensitive matters that were at hand.  I know I’m not the only one who has sent emails they wish they hadn’t, but it’s not so common that I do so.  It was a swing and a miss.

mispelling on the word mistakes in a sign that says we all make mistakes

We can take big and little swings

I don’t like swinging and missing, but that is what we humans do. Sometimes, I wish I were a baseball player who has permission to swing and miss two thirds of the time and still be seen as a superstar.  Failed swings of much greater magnitude can leave me feeling quite bad. Sometimes, shame can rear it’s head as I berate myself for doing what I have done.

Guilt I can handle because it educates me. Perhaps next time, I’ll wait a day before pushing the send button. Unlike guilt, though, shame is corrosive, telling me that I am unworthy.  These two emails rose to the level of brief guilt, not shame, I’m relieved to say.

Living with bipolar disorder has caused me to have the biggest swings and misses of my life.  For me, there simply hasn’t been anything worse than hurting those around me. I refused to accept that I had bipolar disorder and for many years didn’t get treatment.  Despite efforts to spare those good souls pain by hiding my secret life away (the swing), I hurt them even more by doing so (the miss).

We can ease the angst of missing the ball

I have found two ways to ease the angst of sending emails I wished I hadn’t and causing pain to those I love.  First, I use the “war crimes” yardstick.  I ask myself: “Did I commit a war crime?”  Since I didn’t, it helps put my deeds in a kinder perspective.  The things I did likely may not have risen to the level that I feel they did.  Almost always the case. A gentler perspective helps.

Second, I try hard to identify the impulses that drove me to take the action in the first place.  The genesis is rarely to be intentionally hurtful.  Most often, it’s an attempt to protect someone else; it’s an attempt to protect myself; it’s an attempt to be closer to someone; it’s a cry for help; it’s an expression of fear; it’s an attempt to receive admiration; it’s an attempt to be noticed.

Recognizing all this allows me to quickly ease my feelings of guilt.  Do I expect myself to go through life without ever erring?  Sure, sometimes I do.  But at those times, I reflect upon what drove me to do things I did.  I travel on the path of humanness just like everyone else.  Sometimes that’s a bit humbling, but sometimes it allows me to feel that I have a world of fellow travelers and innumerable kindred souls.  In this regard, I don’t feel so alone.  And while I can disappoint myself and others, I know that my average of falling short of my high expectations is a lot better than two thirds. It’s OK to keep taking swings and realize my humanity when I miss. Immersed in a life of guilt and shame? No, thanks. Living in a world of humanness? Yes, please.

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

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?