See the Man with the Stage Fright

The life of a writer is much like that of a weather observer at Advance Base in Antarctica in the winter of 1934, but without the snow and all the social distractions. The reference is to Admiral Richard Byrd, who spent five months completely on his own in the deepest of all deep souths. His chronicle of the experience, Alone, is a classic in the psychology of social isolation. I read it when I was about ten and even back then I could totally relate.

Ten-year-olds with books and real heroes - hold that thought.

Anyway, there are just enough of us loners in the world that we can be regarded as borderline normal. What is weird are the abrupt transitions into the rough and tumble of people contact.

Bang! Suddenly, on Wednesday, I needed to be on my game - not in sweat pants and a four-day beard - with a full array of social skills. The occasion was a NAMI San Diego board meeting, which I managed to get through in one piece. The next night was the real challenge. This was our annual business meeting and holiday potluck. It wasn’t that I had to socialize. I was also responsible for entertaining a crowd of 50 people for 30 minutes.

But first let me tell you about my boneless lasagna. I like to cook, and the lasagna I brought to the potluck was a killer. As I was reheating it in the kitchen area at the event venue, I happened to joke that I had picked all the bones out of it. By the time I set it down on the buffet table, everyone knew about my boneless lasagna.

Fortunately, the running joke went over well. The lasagna was also a hit.

Social situations used to terrify me. Now they merely pose an extreme challenge. In a few minutes I would be joining Lisa, our board president, on stage. We were running a quiz night, and I would be taking the lead. I was working off of a script of sorts, but I was also flying off the seat of my pants. We had pulled off a similar event last year, and the people there had witnessed a miracle without even realizing it. If only they knew the real me.

I stepped onto the stage without stumbling. Seven or eight tables had their quiz folders. I introduced myself and explained the rules. This was the difficult part. The audience had yet to settle down and a lot of cross-talking was going on.

“The prize,” someone - maybe Lisa - whispered to me. That’s right, the prize. This was my cue to have Annie, our events and development manager, hold up Walter Isaacson’s new bio of Steve Jobs.

I launched into my first question, which had to do with the rabbit people in NAMI San Diego. Ah! A NAMI San Diego round. People were getting it. On the second question, I found my stride. “The ukulele is catching on worldwide as the ultimate cool instrument,” I opened. “Name our NAMI San Diego ukulele phenomenon.”

Most people knew who that was - Devin - a very likable and committed young man. “Devin embodies what I love about NAMI San Diego,” I went on to say. Suddenly, I had their attention. “We often come to NAMI in need,” I continued. “Then we give back and volunteer. And some of our volunteers wind up working on our staff.” I saw the nodding heads. “It’s a circle of life,” I blurted out. Somehow, the Lion King reference worked.

The crowd was into the game. One of my questions had blue moon as an answer. Instantly, one of the tables in front - Team Darwin, I think - burst out into a spontaneous rendition of the classic Rogers and Hart ditty. A ten-year-old girl on the team - the brains of the operation - burbled merrily along. The crowd cheered. I looked to Lisa. “Score an extra point for this table,” I commanded.

That extra point figures mightily in this story.

Call me butter, ‘cuz I was on a roll. I pointed to Team Einstein, with two MDs and a lawyer at the table. “Don’t worry about these guys,” I advised the others. “They over-think everything.”

All too soon, it was time to wrap it up. Lisa tabulated the scores. We had a tie between the two front tables. Team Darwin (the Blue Moon people with the ten-year-old brains of the operation) - and the other guys. There was the girl. There was the Steve Jobs book on display right next to me.

Could we just declare Team Darwin the winner? I asked. No, the girl’s mom insisted we do it fair and square. Time for the tie-breaker question.  I flipped through my sheets of paper. “Movies and TV,” I announced. I scanned down the questions:

“Which actress starred in Breakfast at Tiffany’s?” No, I decided, not that one.

“What was Marilyn Monroe’s real first name?” Not that one, either.

Then my face lit up. Here we go, I announced. “Name Snow White’s Seven Dwarfs.”

For the rest of my life, I will never forget the girl’s reaction. Her face beamed a thousand watts as she levitated from her chair. Then she grabbed a pen and started scribbling furiously.

Then came the moment of truth. How many dwarfs did you get? I asked Team Darwin. Five, came the response.

Oh-oh. That didn’t sound like enough.

How many? I asked the other table. Five, they answered.

Whew! My team had dodged a bullet.

Did I dare risk another tie-breaker question? I hesitated, then I knew exactly what to do. “Team Darwin has fewer people,” I announced. “Therefore, they have more brain power per population.” Therefore - this time the girl's mom showed no resistance - “I declare Team Darwin the winner!”

I gestured toward the girl. “Come and get your prize,” I said holding up the book.

Really, I should get out among people more often.

****

Your brow is sweatin' and your mouth gets dry,

Fancy people go driftin' by.

The moment of truth is right at hand,

Just one more nightmare you can stand.

See the man with the stage fright

Just standin' up there to give it all his might.

And he got caught in the spotlight,

But when we get to the end

He wants to start all over again ...
- The Band

On the Road - Live From Chicago

Why do I keep thinking it’s Tuesday? It’s the last hour of Wednesday here in Chicago. I’m winding down from the first day of the NAMI national convention. I attended my first five as a journalist. I’m also attending this one as a journalist, but this time I have extra ribbons to stick to my name tag by virtue of my involvement with NAMI San Diego.

I’m here at NAMI to meet people. I was having a $400 cup of coffee and a $600 yogurt (hotel prices) in the lobby when in walked Sue Bergeson, whom I have known for just about forever. Sue is former President of DBSA and is now doing all kinds of great work on our behalf at Optum Health. It’s been more than three years since we’ve seen each other. It was worth flying out to Chicago just to catch up. Very auspicious start.

The convention program is mainly NAMI nuts and bolts stuff - how to run an effective In Our Own Voice program, stuff like that. Not much interest from a journalistic perspective. My last convention, four years ago, I think I attended only one session. I get a lot more out of just hanging out and listening to people’s stories.

Incredibly, before I have even attended my first session, I somehow manage to run into everyone here from NAMI San Diego, spread out over three floors. NAMI San Diego is receiving this year’s Outstanding Local Affiliate Award, and the credit goes to the people I am bumping into here, plus the staff and volunteers and our partners back in San Diego, past and present.

I dutifully attend an affiliate leaders workshop, and, naturally, the thing I get most out of it is meeting my counterparts from all over the country, people like me who serve on local boards. It’s thankless work, so here is my opportunity to thank these people.

Toward the end of the session, NAMI CEO Michael Fitzpatrick walks in and does a Q and A with us. When the session ends, I walk up to Mr Fitzpatrick and tell him I brought my didgeridoo. He doesn’t call security, which I interpret as a good sign.

Didgeridoo diplomacy. Yes, I have “Little Boy” in a bag slung over my shoulder. Several times during the day, I take it out of the bag.

Late in the afternoon, I am drooping. I cut out of a session and head back to my hotel and crash for three hours, most of it rebound sleep. I blow off the evening session - ironically the only one of journalistic interest - featuring Thomas Insel of the NIMH. This is going to be a long convention and I need to pace myself.

I intend to stay till they turn the lights off tomorrow, so I’ll give most of the morning a miss. To bed ...

My NAMI San Diego Walk Video

The video speaks for itself. Great weather, great day, great people. Special thanks to Annie Dunlop for her efforts and the crew supporting her.

You can still donate by going to my NAMI San Diego Walk page.

Scenes From My NAMI San Diego Walk

These are freeze frames from video footage I shot of the NAMI San Diego Walk on Saturday. I serve on the board of NAMI SD and was on the committee that planned the Walk. My main task was to bring my didgeridoo, round up drummers, and shoot video. I showed up at 5:30 AM to film people setting up and organizing. Then the mobs descended.

We had gorgeous weather, it was a great turn-out, and Annie and her crew did a spectacular job making this event truly special.

I arrived back at my place 5 PM, immediately crashed, and didn't wake up for 14 hours.

Stay tuned for the video ...

My NAMI San Diego Walk

This is video I shot last year. I'm walking again on Saturday, with about 3,000 others. I'm bringing my didgeridoo and hope to be able to round up some drummers. I can't emphasize enough the positive experience of walking for NAMI, and the video makes my case.

This summer NAMI San Diego will be honored by NAMI national as the local affiliate of the year. We're out there in the community, we're there in small groups, we're there one-on-one. Our people on every level are an inspiration, employees and volunteers. Many first came to NAMI San Diego in a state of extreme distress, then stayed in all kinds of capacities, helping out any which way they could, with the kind of determination and drive and compassion that words do no justice to.

I'm proud to be serving with them and walking with them.

We're walking to send the world a message and to raise money. Even when we are offering a free service run by volunteers, money is involved. The second someone switches on the lights, money is involved. Lights switch on. More money. More lights, points of lights. Lights, illumination. Money-money-money.

We want to switch on more lights. You can help by going to my Walk Page and making a donation.

Better, yet. Join me on the Walk. One of my readers from Arizona contacted me to say he'll be in San Diego this weekend and wants to walk with me. I can't begin to tell you how this made my day. But you can walk with me in spirit. Some of my readers are involved in their own local NAMI Walks, from places such as Iowa and Connecticut, and I'm there in spirit with them as well. Connections, community, healing.

This is about all of us. Physically apart, perhaps, but together - together - big time.

NAMI San Diego Walk - We Need Your Support

I put this together for NAMI San Diego. Our annual Walk is taking place this Saturday, 8 AM April 16 at Balboa Park (6th and Quince), and I urge you to attend if you're living in the area. You can register on site (beginning at 6:30 AM) or in advance on the NAMI San Diego website).

Also, if you are a fan of this blog, I urge you to support me in supporting NAMI San Diego by making a donation on my Walk Page.

I serve on the board of NAMI San Diego, and I put way too much time into it, which is nothing compared to the heroes who founded NAMI and gave those of us living with mental illness a voice, and more heroes who kept the vision alive and more heroes pushing the vision forward. I am inspired by these people and the great work they do, so please pay attention:

I provide Knowledge is Necessity as a free service, along with mcmanweb. This is the only time I hit readers up for money, and it's not even going to me. Any small gesture of support would be greatly appreciated. Thank you.

Walking for NAMI

I put this together for NAMI San Diego. Our annual Walk is taking place Saturday, April 16 at Balboa Park (6th and Quince), and I urge you to attend if you're living in the area. You can register on site (beginning at 6:30 or in advance on the NAMI San Diego website).

You can help me support NAMI San Diego by making a donation on my Walk Page.

Why I Walk

 Following is a talk I gave this morning at a NAMI San Diego Walk kick-off event. Our Walk takes place April 16 ...

I walk because I am haunted.

I am haunted by my childhood. By the strange looks from family members, from kids in school. They knew. I knew. Even way back then, I wasn’t normal.

I am haunted by my adulthood. A bright promise denied. They knew. I knew. I’m normal! I wanted to shout.

I’m haunted by what I encounter. A question by a father about his kid who refuses to acknowledge his illness - one I can’t answer. Queries I get from my readers - their loved one is acting strange, very strange. What is wrong? More questions - my doctor won’t listen, my insurance is running out. What the hell is wrong with me?

I’m haunted by a world that doesn’t give a damn. People who are supposed to be helping us who tell us that we have a highly treatable illness that at times is barely treatable, and then turn around and say we should be happy where we are - stuck in a miserable half-life, alone, left to fend for ourselves.

I’m haunted by the fact that everything I read or listen to bears no relation at all to my world, your world. Isn’t anyone paying attention? Doesn’t anyone give a damn?

I’m haunted, you’re haunted. Everyone in this room is haunted. That is why we come out in the rain on a Saturday. That is why we get on the phone. We make noise. That is why we show up at meetings. That is why seven weeks from now, rain or shine, we will show up. We will walk. A family, bound together by experiences that haunt us. We will walk. We will send the world a message.

So much to do, so few of us. A good deal of the time it seems hopeless. But we get involved, anyway. Anyway we can.

No one - absolutely no one - should have to endure one day of what we have been through. Not one day. We will walk.

I will conclude with this:

Back in 2004, when I was newly into my second marriage, I was facilitating a DBSA support group in Princeton, NJ. In walked Kevin, exuding a goofy charm, baseball cap on backward. But there was something about his presence that indicated he was no mere goofball. The others in the room felt it, too.

Over the weeks, I couldn't help but be impressed by the way Kevin carried himself. He would walk up to newcomers and introduce himself and start up a conversation. In the group, he was a great listener, dispensing the wisdom of a sage, leavened by a keen sense of humor.

It was amazing to observe him with people much older. At once, he was deferential, compassionate, and exuding great authority. You simply forgot you were talking to someone much younger. You simply wanted to be around him, laugh with him, seek advice from him. 

He had his setbacks, his dark moments. Yet, over time - in group, over coffee, over sandwiches, hanging out - I watched him blossom. With his extraordinary people skills, the sky was the limit.



In late 2006, my marriage broke up. Kevin was the first to offer me support. He also reached out to Susan.

Suddenly, I had my life in seven or eight FedEx cartons and a one-way ticket to San Diego. I popped into the DBSA group one last time. Kevin was facilitating. He gave me a heartfelt tribute. I felt the goodness in the man. Goodness, true goodness. That was the last time I saw him alive.



He had so much to live for, so much to offer. Yet, on a miserable muggy New Jersey morning, his brain tricked him into believing otherwise. He was 28. Years later, Susan and I, plus all those he left behind, are still dealing with it.



I've been suicidal. So have most people with this illness. We fully understand, yet - we totally don't understand.



Kevin, you still shine a light on the world. Nothing - nothing - is ever going to extinguish it.

That is why I walk.

***

If you wish to support me in my walk, please go to my NAMI San Diego Walk page.

Mental Health Quiz: Test Your Knowledge

Every year, NAMI San Diego hosts a holiday pot luck dinner and annual meeting. For last night's gathering, I put together a quiz night and acted as quiz master. I compiled questions in eight categories. These are the questions I read out in the mental health category. Let's see how you do. Answers and commentary further below ...

1 What did John Adams, Abraham Lincoln, Theodore Roosevelt, and LBJ have in common?

2 The Priory of St Mary of Bethlehem, founded in 1247, later to become Bethlehem Royal Hospital for treating lunatics, is more commonly known by this name.

3 Hippocrates and the ancient Greeks referred to “the four humors” or "temperaments". One of them literally means "black bile." Name the temperament.

4 What did Christopher Columbus, Michelangelo, and Isaac Newton have in common?

5 Emil Kraepelin back in the early 20th century described a condition he called “dementia praecox." Today, we know dementia praecox by this name.

6 Between 1907 and 1939, more than 30,000 individuals with mental illness in the US were subjected to this procedure.

7 The 1949 Nobel Prize in Medicine went to António Egas Moniz for developing this treatment for the mentally ill.

8 NAMI was founded by parents who got sick of being blamed for their kids' mental illness. Psychiatry even had a label for these horrible parents. Name the label.

9 Robert Spitzer, the most influential psychiatrist you never heard of, is the man responsible for the modern version of this text, which we quote from all the time.

10 Eric Kandel, Arvid Carlsson, and Paul Greengard shared the 2000 Nobel Prize in medicine for their discoveries concerning "signal transduction in the nervous system." This is a fancy name for brain cells talking to each other. What's the scientific name for brain cell?

Answers

1 US Presidents with mood disorders. (A Duke University study reports that nearly half of the US Presidents had something diagnosable.)

2 Bedlam.

3 Melancholia. (The other three: Choleric, Phlegmatic, and Sanguine.)

4 Bipolar. (That's right, world. We give you the gift of civilization and how do you thank us? You marginalize us. Sorry we couldn't find America sooner for you, by the way.)

5 Schizophrenia. (Dementia praecox suggested a steadily deteriorating brain, but we know recovery is possible.)

6 Sterilization. (Those with mental illness were deemed a menace to the gene pool.)

7. The prefrontal lobotomy. (Some 40,000 lobotomies were performed in the US.)

8. Schizophrenogenic. (The label is as stupid as the reasoning behind it.)

9. DSM - Diagnostic and Statistical Manual. (A piece of fiction put out by the American Psychiatric Association.)

10. Neuron. (I have a theory that neurons only work with coffee. I hope I don't have to share my Nobel Prize money with anybody.)

Dinner for 200

Usually, when I sit down and have dinner all I have to worry about is where I will spill my food. But that changed about 18 months ago, when I took my seat as the new guy on the NAMI San Diego board. I made the rookie mistake of breathing too loud, and next thing I was drafted into service on the committee that plans our annual Inspiration Awards Dinner. Last year’s dinner was such a great success that I found myself, through no fault of my own, reassigned to this year’s committee.

There are 800 million things that can go wrong in putting on a dinner and dinner program for 200. As you can see from the photo, none of them happened. Here I am, just after the Dinner, with John Bell, who received our Young Advocate of the Year Award. John is very recently back from Iraq, where he has served as a medic in the Army. In April, John organized a 5K run concurrent with our local NAMI walk to bring awareness to mental health issues for those who serve our country.

John was a surprise guest at the Dinner, having had his leave request approved only two days before. He is currently stationed at Fort Benning, GA. It was my honor to sit at the table with John and his fiancee, Melissa.

Many thanks to Annie Dunlop, NAMI SD’s development and events manager, who took the lead in organizing the dinner, our board president Lisa Ponfick and Executive Director Shannon Jaccard, Councilman Todd Gloria who MC’d the affair, our awardees, sponsors, and all our volunteers and staff who made Friday evening an occasion to remember.

When Medicine Got It Wrong

On Saturday morning, I attended a NAMI San Diego screening of Katie Cadigan's gut-wrenching documentary, "When Medicine Got It Wrong."

Boy, did they ever. Back in the bad old days (actually, we are still deep in the bad old days), psychiatry blamed schizophrenia on bad parenting, a view that persisted well into the 1980s. The villain of the piece was the "schizophrenogenic" mother, one who committed the crime (in apparent complicity with the disinterested father) of being overprotective toward her child.

Practically on a whim, kids could be legally separated from their parents and locked away for the rest of their lives. By some logic way too crazy to comprehend, it was considered far more therapeutic to consign these kids to the hell holes of state institutions than keep them with their families.

Parents were treated with outright hostility by those who should have known better. One parent in Cadigan's film recalls being told by a hospital staffer that she was the reason her kid was in there. Another parent recalls a psychiatrist telling her kid, in her presence, that it was okay to express his hostility to his mother. If psychiatrists could not find anything wrong with the parents, by God, they were going to find something wrong with them, anyway.

One parent only half-jokingly remarked that "One Flew Over the Cuckoo's Nest" got it all wrong. There was only one Nurse Ratched in Cuckoo's Nest. In real mental hospitals, there were many Nurse Ratcheds.

During the 70s, parents started to get together and compare notes. Then they began organizing. They got in the face of mental health boards and politicians. They were told to behave. They did not. They refused to take no for an answer. This was the beginning of NAMI. Literally, NAMI started out as a kitchen table enterprise. Kitchen tables in California, kitchen tables in Maryland, kitchen tables in Wisconsin ...

Then the people from these kitchen tables banded together and went national. Slowly, the parents began making headway. They found allies among the few enlightened psychiatrists of the day. They helped close down the institutions, they promoted brain science and biological psychiatry, they fought for humane treatment and services for their kids. They moved mountains.

Alas, the law of unintended consequences proved a far more formidable obstacle. Their kids were released into the streets, with no services. The jails and prisons became overcrowded with the mentally ill. And biological psychiatry has yet to deliver on its bright promise.

There has been a generational transition. The film shows a sister as the caregiver for her brother. She has taken over the responsibilities from her deceased mother. The mothers and fathers in the film - unsung heroes, founders of NAMI - are getting on in years. Their kids - well into middle age - are still struggling. We see the early home movies and photos - young kids, laughing, clear eyes, their lives ahead of them. We see present day clips - grizzled adults, thousand-yard stare in their eyes, but with a small flame flickering.

The torch has been passed. A new generation of NAMI advocates are fighting the fight. That generation, in turn, will make way for a newer generation, who in turn will make way for yet a newer generation. No matter how successful we may be in getting people to listen, there will always be a fight. No matter how much progress we may make, we will always be in the bad old days.

Just one person in need is one person too many. We have a long long way to go. Just so long as we have people willing to fight ...

On Friday, Oct 8, at its Inspirational Awards Dinner, NAMI San Diego will be honoring Katie Cadigan as its Inspirational Person of the Year. You are cordially invited to attend. For further info, please check out the dinner page on the NAMI San Diego website.

Fred Gage, NAMI San Diego Researcher of the Year

Tuesday afternoon, I drove down to the Salk Institute for Biological Studies, set above the cliffs of Torrey Pines in San Diego, overlooking the Pacific. My mission was to get a minute of Fred Gage PhD on film.

In 1998, Dr Gage's lab turned neuroscience upside down by discovering that human beings are capable of growing new nerve cells throughout life, a process called neurogenesis. Following from this, Dr Gage found that environmental stimulation and exercise can promote brain cell growth.

Dr Gage's work has literally changed how all of us think about the brain and mental illness and recovery. Soon after, for instance, Ron Duman at Yale found that antidepressants can promote brain cell growth and Husseini Manji, then at the NIMH, found that lithium can act as brain fertilizer.

Together, these and other findings caused researchers and clinicians to rethink mood disorders. Dead or atrophied brain cells, for instance, may compromise entire neural networks. Neurons cannot efficiently communicate with other neurons. Thinking and feeling and perceptions become distorted, resulting in all manner of personal catastrophes.

Looking deeper inside the neuron, we find that various complex bio-chemical processes responsible for the cell's maintenance may be on the fritz. Of special interest are signal transduction pathways, which interact with incoming and outgoing signals from neurotransmitters.

Thus, if a key signal transduction pathway is down inside the neuron, the cell may lack the means to communicate with other cells. The cell may literally shrivel up and drop off the grid. We know that stress can be particularly toxic to nerve cells. Over-excited neurons literally buckle under the load.

But, thanks to Dr Gage, we know the process can be reversed. Physical exercise can regenerate brain cells, as can living in enriched environments. As can certain medications. In other words, we are not stuck with the brains we are born with. Neither are we hard-wired for life.

Neurogenesis takes place in the hippocampus, which is involved in both emotion and memory. Hippocampal neurons are also intimately wired into other areas of the brain. Dr Gage and his team found that not only do new brain cells grow here, but that these new cells can join neural networks.

Dr Gage's work may explain why it takes antidepressants at least several weeks to produce results. In theory, an SSRI should work almost immediately. But if these meds are involved with the complexities of brain cell growth and restoring neural networks, then obviously we are talking about long lead times.

This has led researchers such as Dr Manji to focus on new meds development that can more precisely target pathways inside the neuron (rather than neurotransmitters outside the neuron) and thus significantly reduce lead times. In the meantime, Dr Gage's work has encouraged patients to take a more active part in their own recovery by doing what we know is good for us, namely: be mindful of stress, make sure we are actively interacting with the world around us, and exercise.

I walk across the Salk Institute campus to a large building and find my way to Dr Gage's lab. Dr Gage greets me and leads me to his small office. He has a much larger office upstairs, but here is where he actually works. He apologizes for his casual attire and ducks in a back room to change into an emergency white shirt.

On a white board behind his desk is a very complex diagram of blobs and squiggles, apparently representing something going on inside the neuron. I spot three letters - Wnt - and joke to Dr Gage that I think I actually know what something on his rendering means: Wnt (pronounced wint) signaling pathway.

My knowledge of brain science is largely derived from hearing brain scientists such Dr Gage (I heard him three years ago at a conference) dumb down their presentations for psychiatrists. That way I can almost understand the broad outlines of what is going on. Trying to make sense of brain scientists talk to brain scientists is Mission Impossible.

Dr Gage is curious about where I fit into the picture, and when I tell him how I'm coping with my illness with very little use of meds, with no hesitation he replies, "good." A psychiatrist would have hesitated. I tell him that moving to southern California nearly four years ago did wonders for me.

Enriched environment, exercise - where have I heard that?

Dr Gage will be in London during our Awards Dinner and will be honored in absentia. I'm here to get a minute of him on film, for showing at the dinner. Dr Gage has received no end of high honors from the research community. He was also recognized by Time Magazine as one of the 100 most influential people of 2000. But he is also very clearly flattered that people like us are paying attention, and this comes across loud and clear with the camera rolling.

We finish shooting, then he escorts me outside, where we stroll across the campus engaging in small talk. I ask him if being at the Salk Institute means he doesn't have to worry about where his funding is going to come from, but that is not the case. Like researchers everywhere, he is responsible for raising literally every penny, including his own salary. He says this helps keep him on his toes and keeps his lab lean and mean (he has some 45 researchers under him), but then he adds he's looking at things from the glass half full.

Thus, in my view, the vital importance of bringing our world and Dr Gage's world together. Enlightened research can only flourish with an enlightened public. We shake hands. It's time for him to return to his world, and me to mine. But I cherish those precious moments when our worlds connect, and I'm looking forward to those attending our dinner getting a little taste of it.

John Bell, NAMI San Diego Young Advocate of the Year

I serve on the board of NAMI San Diego. At our annual Inspirational Awards Dinner on Oct 8, we will be honoring John Bell as Young Advocate of the Year.

On April 17, concurrent with the NAMI San Diego Walk here, John organized some 100 fellow soldiers in his platoon in a 5K run in full body armor. "The US Army has taught me not all wounds are visible," says John, who has experienced PTSD. "As tough as a U.S. service member may be, many still suffer the effects of having endured life in a combat zone."

One in six veterans of Iraq and Afghanistan is affected by PTSD, depression, or anxiety. Only half seek help.

You gotta watch this video ...

Hoarding: Very Serious, Very Unrecognized

I've spent the last few weeks moving my stuff out of my old place and into my new one. Correction: A good deal of it wound up in the dumpster and a lot more will be donated to a yard sale event.

Coincidentally, in the middle of coordinating my move (which included acquiring a lot of new stuff), I attended a one-day seminar on Mental Health and Aging put on by NAMI San Diego and The Senior Mental Health Partnership. First talk of the day was on hoarding.

Much to my relief, I learned that I was an unmitigated slob, not a hoarder. As Catherine Ayers of UCSD explained, hoarding does not equate with messiness. Rather, I am merely too lazy to throw away my old things rather than being driven by an obsessive need to hold on to them. Someday there may be a DSM diagnosis for people like me, but not yet.

According to Dr Ayers, individuals who hoard have a distorted belief about the importance of a possession (such as a discarded water bottle) combined with an obsessional fear of losing that possession. The hoarding interferes with the individual's ability to use their home.

Accounts of individuals literally buried alive beneath domestic clutter may come across as comic, but the reality borders on tragedy. As Dr Ayers explained, 45 percent of older people who hoard could not gain access to the fridge and 10 percent could not use the toilet. Getting from one area of the house to the other typically involves negotiating labyrinthine (and often treacherous) "goat trails."

Hoarding is fairly common, accounting for 5.3 percent of the population. Hoarders are typically female, unmarried, and living alone. Never having been married is associated with greatest impairment. Hoarding tends to start in the 30s, with the severity increasing over time. Eighty-four percent of those who hoard have a first degree relative of similar disposition.

Behavior may include indecisiveness, perfectionism, procrastinating, difficulty organizing tasks, and avoidance. Dr Ayers also mentioned an abnormal desire to take control and exercise responsibility. She mentioned one individual who took it upon herself to tape NPR. Her home contained 500,000 tapes.

Three out of four hoarders shop too much, but a real danger, Dr Ayers pointed out, is from stuff that comes into the house, such as mail. Hoarded items tend not to be of high value, such as paper. Since it takes time to go through paper, that paper is not going anywhere.

The illness is attributed to a deficiency in informational processing, though not necessarily in older adults. Older adults may have good neuro-cognitive function, but may be deficient in other areas. Hoarding is listed as a symptom of OCD, but brain scans reveal a different pattern. The draft DSM-5 is proposing the new diagnosis of "hoarding disorder."

Unfortunately, Dr Ayers explained, hoarders don't go to doctors' offices seeking help. Having someone else clean out the place is only a temporary fix, as hoarders go right back to their old ways. SSRIs may help, and cognitive-behavioral therapy aimed at addressing hoarding behavior is in its infancy. Dr Ayers suggested that intensive outpatient therapy seems to be the most effective treatment, with a focus on getting the patient to decide on every item.

For more info:
http://www.ocfoundation.org/hoarding/

My NAMI San Diego Walk Video

Enjoy ...

(This is the high def version that replaces my low def version I had uploaded earlier.)

Scenes From the NAMI San Diego Walk

Balboa Park, Saturday, way too early in the morning.

Walk organizer, Annie.

NAMI doer-of-everything, Rita. She is pictured here, reacting to a rumor that didgeridoos have been banned from NAMI walks.

Little does Rita know ... I'm handing out didgeridoos to kids like candy. More to come ...

Yesterday, I Walked for NAMI San Diego

More to come ...

I Walk So That Others May Cheat in Scrabble

I have no idea what that means.

Tomorrow, I walk for NAMI San Diego. I cordially invite those of you living within jumbo jet distance of San Diego to join me tomorrow. Watch out for the volcanic dust.

I also invite all of you to support me in my walk by making an online donation.

I know a lot of you like to wait till the last minute to donate. This is the last minute.

I serve on the board of NAMI San Diego, and I devote a lot of time to the organization. We are leaders in making vital outreaches to the community, but we need your help.

If you like what I do on this blog, this is your way of showing your appreciation. Many thanks to those of you who have already shown their support.

Three Days to Go for My NAMI Walk

I'm trying really hard to raise money, so please bear with me:

I've been involved in mental health since I was first diagnosed with bipolar 11 years ago, following a lifetime of denial. I used to be a financial journalist, so turning to mental health journalism was my means of coming to terms with my diagnosis. Literally, I wrote myself out of the hole I was in. Here I am, 11 years later, still writing.

Over the years, I have also been in involved in DBSA and NAMI. I was the founding facilitator of a DBSA chapter in Princeton, NJ, and have spoken at national conferences and to local groups. Later this month, I will be flying to Kansas to deliver a keynote address to the Kansas State DBSA Conference. (See side panel for details.)

This Saturday, I will be walking for NAMI.

Over the years, as a journalist, I have had the privilege of hearing the stories of NAMI people from all over the country. I have attended national conferences and I have spoken at state conferences and at local meetings.  Since moving to Southern CA from NJ more than three years ago, I have become increasingly involved with NAMI San Diego.

Last year, I was asked to serve on its board, which I regard as a great honor. Even by NAMI standards, NAMI San Diego does incredible work. This includes a very full menu of NAMI signature programs such as In Our Own Voice, Family to Family, and Peer to Peer, not to mention an info line, numerous support groups, educational programs, conferences, partnerships in the community, advocacy, and outreaches to ethnic and cultural minorities.

I could go on and on and on. Suffice to say, over the years, NAMI has been a tremendous comfort, both to myself and my family.

You don't need to be living in the San Diego area to support me on my walk. NAMI San Diego may have a local focus, but a lot of our work here has a national impact, and is used as a model for local NAMIs everywhere. We have a dynamic new Executive Director (who learned the ropes from our legendary recently retired ED), a highly-dedicated (and hugely underpaid) staff, and volunteers who are an inspiration.

So, here's the pitch: We need money. We're a non-profit organization. Our programs are free of charge. We serve many thousands of people a year in San Diego County, but we badly want to serve more. Everybody in fact.

It can be so frustrating at times, from board level, staff level, and volunteer level. So much need in the community, so much that needs to be done, only so much we can do.

All of us here at NAMI San Diego are motivated by doing things. Serving our community. Our only limitation is our limited resources, and you can really help us out.

Please support me in my NAMI walk. Every little bit helps. If you get something out of what I do here on Knowledge is Necessity, this is your way of showing your appreciation. You can make a donation online on my Walk page.

Also, if you live in the area, I cordially invite you to walk with me on Saturday as a member of my walk team, McMan's Silly Walkers. You can join by going to my Team page.

Many thanks.

Join My NAMI San Diego Walk Team

Last year, I joined the board of NAMI San Diego. Most of us are aware of NAMI and what it does. Whether you live in San Diego or Cincinnati, chances are you or a member of your family has contacted your local or state NAMI seeking information or support.

I know my family did when I went into crisis in Connecticut 11 years ago. I also know it brought my family peace of mind.

Since then, I have been peripherally associated with NAMI. I’ve attended conferences and fundraisers, I’ve spoken to various local groups, I’ve contributed pieces to their publications and websites. Then, last year I rolled up my sleeves and got involved.

Anyway, NAMI San Diego has its annual walk coming up on April 17th in Balboa Park. As well as being our biggest fund-raising event of the year, it also sends a strong message to the community. Here’s the deal:

I’ve formed my own walk team, McMan’s Silly Walkers. Those of you living in southern CA are cordially invited to join me. Be there, be square, be silly. Sign up and get your friends to sponsor you. For info on joining my team, check out my Team Walk Page.

For those of you interested in sponsoring me, you can go to my Personal Walk Page and make an online donation. Trust me, you have my personal word that this is money very well spent.

Also, location is not an issue. Yes, I encourage you to contribute to the NAMI in your locale, as well. But if you support the work I do here, I also encourage you to show your appreciation by sponsoring me on my NAMI San Diego Walk.

Go to the NAMI San Diego website for more info.