Four Hours Sharpening The Axe

The stigma in this country about mental illness is still pretty bad. And there are such serious downsides to diagnosis and treatment. This is one area where it is better to be in the United States. In England, my mental illness has made me uninsurable for life or disability, unable to hold a driver's license and, as far as I read the UK Disabilities Act, my employer's decision to terminate my employment because of my mental health history would arguably be legal. Of course I think if it came to it I could win that case.

I have suffered from depression since the late eighties, I was diagnosed bipolar in 2001 and I had a full-blown psychotic episode after the birth of my son. I have had intense intermittent depression since then, but on the whole. my management of the illness has been pretty good. I am willing to congratulate myself publically on this. My management of my illness is far from perfect, and I still have symptoms, but the experience of the symptoms, I have come to figure out, is nothing less or more than the experience of life. And you owe it to everyone you love to fight as hard as you can to have the best experience of life as you can. Parenthood in my experience really intensifies that obligation. So that means accepting the symptoms you can't change and changing the ones you can. It turns out you can do a lot to change your symptoms. It requires a lot of work, however. A lot of education and analysis.
Abraham Lincoln said that if he had six hours to chop down trees, he would spend the first four hours sharpening the axe. Managing a task requires a lot of preparation. I'm not going to kid you. He's right on that and the four hours sharpening the axe are not necessarily fun. They include:

1. Managing your medication: any psychotropic med, whether a sleeping pill, caffeine, a diet pill. an MAOI, an SSRI, a cigarette, alcohol, pot, an anti-convulsant or anti-psychotic, any one at all has an upside and a downside, and these you must know and consider. My friend Nick always says the large print giveth, but the small print taketh away. Know it. Live it. Track it on a chart so you know what these meds are doing to you. Your job is to salvage your consciousness and in my view all of these drugs are fair game, but must be managed intelligently. Most have too many downsides for anyone to use, or must be used in the strictest moderation. Too much prozac, for instance, or zoloft, and you may not be sad, but you also really don't know what's going on. And that's not really ok for the long term. You owe it to the people you love to love them, and that kinda means finding out what's going on with them. So I will repeat the advice of a Shreveport shrink I loved briefly and platonically on you have to be an angry consumer of everything if you really want to get better. You have to figure out if it is helping or hurting and press the psychopharmacologist or whomever for as much reality as you can handle. And meds are really only one part of a pretty large arsenal you should be using. Because you also need:

2. Some kind of talk therapy: you need to learn to control your illness by making yourself as mentally healthy as you can be. And this requires a fearless and nonjudgmental -- well, theoretically fearless, but I find it terrifying -- assessment of your patterns in relationships and your ability to understand and interact with other people in order to improve it. You have to keep finding your weakest points and addressing them, and you have to keep unlearning ancient habits of your family and, man, it just sucks ass every single time. But each time I do it I become wiser, I become more tolerant. I say less, I appreciate what I have more, in short I am healthier.

3. Exercise (check out for a study on the effects of exercise on depression) The more I can fit into my schedule, the better I am.

4. Fish Oil (they say 3,000 mg a day, I take 2,000 but am considering increasing it, a DHA EPA blend) (this one is especially important if you are screwing with your neurotransmitters with a prescription drug)

5. Optional but man, worked for me: some kind of bodywork - massage, reiki, acupuncture . . . I had really good results with the Alexander Technique, my therapist wrote an article about it at

6. Optional but it works for me: the arts. Plays, novels, finding out how other people think about their world.

Keeping yourself alive and well is a vote of confidence in this world, in the lives of your children and friends and parents and the people who love you. Life is a force, and if you let it, it will help you.


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