“I’m ready to pack it in,” my best friend said.

“Can you have a beer?” I asked.

My friend snorted.

After I hung up the phone I started to castigate myself in a way that should be recognizable to any depressive. We continually look for ways to beat ourselves up and feel “less than” the next person. But this time I felt like I really deserved the self-hatred. My friend, who is not a depressive, was facing several horrible things—her beloved feline had to undergo an exploratory biopsy for cancer, her brother was heading back to a mental hospital, her niece had just been diagnosed with a rare cardiac illness that could cause sudden death and she was working twelve hour days under tense conditions with no let up in site—and all I could say was, “Have a beer!!!?”

I have never been good at giving advice and comfort. I am a comfort seeker, not a comfort-giver; I am a drain on others, and it irks me. It has even cost me some friends. I know that the only reason I can’t comfort the people in my life is because I have no capacity to comfort myself. Most depressives can't.

I called my friend back the following evening and apologized for my deficiencies. Like a good a friend, she understood. I understood, too. It was something I promised myself I’d work on. In the meantime, I asked her: “Do you still feel so bad?”

“Sort of,” she said.

“Well, it’s only natural to feel a little overwhelmed right now,” I responded. “Tell me if there’s anything I can do to help.” It was a small start.

A recent article on Psychcentral.com noted that while most parents remember the anxiety associated with going away to sleep away camp, when it comes to their own children, they see camp as a rite of adolescent passage, rather than a cause of psychological stress that needs to be seriously addressed.

Reading this article brought back a flood of unpleasant memories for me. While I wasn’t diagnosed with anxiety and depression until college, I distinctly remember that many of my symptoms were present when I was going to sleep away camp as a tween. I hated sleep away camp. I begged my parents not to send me, but they did because it was “what everyone else was doing.” When I got to camp I was terrified of all of the “new” children. I made one friend and clung to her like a life preserver. I cried incessantly for my parents to come take me home. As I was a great athlete, they were flabbergasted by my refusal to fall in love with my surroundings. It got so bad, I fantasized about running away from camp and almost did on one or two occasions.

So parents, beware. If your child is having a difficult time at camp, it is not something to be ignored. Clinical depression manifests itself in many ways and intense worry and sadness at the thought of being away from home is one of them. My own parents were clueless and I did not get the treatment I so desperately needed. Don’t make the same mistake with your kids.

According to a recent article in Time magazine: “Antidepressants are the most frequently prescribed class of drugs in the U.S., making up about 5% of all prescription medication recorded in outpatient files, according to 2005 figures from the U.S. Centers for Disease Control and Prevention. But if the demand for antidepressants is so high and the pills are so readily dispensed (with the side effects now reasonably well known), would life be easier if antidepressants were just available at the drug store?”

Time went on to pose the question to an expert on bioethics and the law who assessed both sides of the debate over making anti-depressants OTC. Let me say that I stand on the side that opposes such a move for several reasons. First, many people still do not know the difference between sadness and clinical depression. Therefore, we would have ill-advised pill popping on a massive scale if these medications were to go OTC. Secondly, many people who are clinically depressed would substitute the taking of OTC pills for the more expensive, but essential talk therapy. Lastly, the only ones who would truly benefit from OTC anti-depressants are the drug companies, which would drive us insane with massive advertising for these medications on a scale heretofore unknown. Do they really need to make more of a profit? All in all, OTC anti-depressants are not good for anyone, least of all the clinically depressed.

I read an interesting story on the front page of The New York Times the other day. It said that “Among the combat troops sent to Iraq for the third or fourth time, more than one in four show signs of anxiety, depression or acute stress…” The explanation for this was on the front page in the Style section. Here, I found an article about a marriage counseling group run by the military for couples where a spouse was back from the war in Iraq and was not acting like himself. (There were far fewer women back from the war.) The military wives, the article said, were just itching to express their feelings about the ways in which their husbands had changed and what a toll it was taking on them and their children. But what struck me the most, was that the men who had seen combat did not really want to discuss their feelings. Since no one was in danger of being physically harmed, they felt these troubles were too insignificant to comment upon.

As anyone who suffers from depression knows, emotional harm can do just as much damage as physical harm. For these ex-soldiers, hiding behind machismo can have significant consequences—namely the loss of loved ones to divorce. Not only that, an ex-soldier who “sucks it up” as macho men are taught to do, run the real risk of intensifying their anxiety and depression. And, if men don’t step forward and admit that something is not right, their depression will go untreated, which could, in time, even result in suicide. When it comes to men and depression, our society is falling woefully behind in acknowledging and accepting that men, too, can become depressed. We judge men who are honest about their feelings as “girly men.” Currently, in the United States men account for only about one in 10 diagnosed cases of depression. I bet there are a lot more men out there who suffer from depression, but are too afraid of looking “weak” to come forward. That is the real shame.

Tonight, I read an email that informed me that a man named Joe Jordan, who is an asbestos demolition contractor,  recently bought the Weston Hospital in West Virginia, which is registered as a national historic landmark. He has renamed it the "Trans-Allegheny Lunatic Asylum"" which was its name in another era. Constructed in 1864 as a psychiatric hospital, it housed more than 2,000 patients at its peak. It was closed in 1994.  Further, The Associated Press reported that Jordan is trying to revive the property by offering tours and other "attractions." The planned attractions include a "Hospital of Horrors" at Halloween season, a "Nightmare Before Christmas" tour, and well as "Psycho Path" dirt bike races on the 307 acre complex.

I don't know why mental health advocates are so up in arms about this. All they have to do is convince Jordan to give half the proceeds he gets from the asylum theme park to research on developing new drugs for schizophrenia that do not have terrible side effects. In fact, I even think a petition should be circulated to make an "Asylumland" part of Disney World and send all the money from food and beverage sales there to the National Alliance on Mental Illness (The folks that are all up in arms about Trans-Allegheny.") It is my contention that the more defensive you get when someone threatens you, the more you leave yourself open for further abuse. Further, Mr. Jordan is clearly trying to spark controversy to get publicity for his real estate venture and the more attention we pay to it, the more we are playing into his hand. Laugh it off. He'llgo away when he realizes that no one is going to come to his crumby theme park. 

Let's face it. Mental illness treatment is an art and not a science. As About.com recently confirmed: "There is no current laboratory test that can be used to diagnose depression. Depression is diagnosed based on your reported symptoms, signs that your doctor observes during the interview, your medical history and your family's medical history." Because mental illness is so slippery to get a handle on, many people who are truly ill slip through the cracks. Who can forget John Hinkley, the mentally ill man who tried to assasinate President Reagan? This was right after his psychiatrist told Hinkley's parents that their son would shape up if they practiced "tough love" on him. Instead, this approach created a would-be murderer. Of course, things work the other way too, where a person is not mentally ill and is just playing the system (and his or her doctors) for all they're worth.When I fell into my second depression, I was being treated by a psychiatrist who wanted to try me on a medication that can kill you if you eat the wrong foods while taking it. Instinctively, I knew this was wrong for me, so I stopped seeing him. I moved 3,000 miles away and met another psychiatrist who came highly recommended. I made al ot of progress with the medications he prescribed, and was totally grateful that I had found him.  So the next time a therapist mentions that she studied the science of psychology in training for her professional role, you can politiely tell her that you're not buying that line for a moment.

The House version of the Mental Health Parity Bill passed yesterday, which will eventually mean that employers will have to provide the same employee health care coverage for mental illnesses as they do for physical illnesses. The Senate passed a similar bill last fall and now the two bodies must work together to submit a final bill to President Bush. This is truly a watershed  in the history of mental health care in the United States, but we shouldn't be fooled into complacency. There are several important differnces in the House and Senate version, the most controversial one being the requirement in the House bill that if a group health plan offers coverage for any mental health or substance abuse disorder, then the plan must cover every diagnosis and condition in the DSM.  Many of those who oppose the bill say the House bill opens up a can of worms because employees will insiste on coverage of such "illnesses" as caffine intoxicatoin and sleep disturbances brought on by jet lag--two categories in the DSM.  I hate to say it, but I tend to agree with the alarmists. I just hope that the two bodies can come to a compromise that does not make a mockery of the mental healthcare industry--that's the last thing we need right now. An historic moment, yes. But also a moment to give pause and really think things through.

I am a member of the National Alliance on Mental Illiness and recently received this email alert:

Later this week, the U.S. House of Representatives is expected to take up its version of the mental illness insurance parity bill (HR 1424). The bill would require health plans to cover treatment for mental health and substance abuse disorders on par with all health benefits. In addition, the bill contains a provision requiring health plans to cover all mental health and substance abuse disorders in the APA's Diagnostic Statistical Manual (DSM) if any mental health or substance abuse coverage is offered.

The email alert went on to request members to contact our congresspersons to voice our support for the bill. I sent an email to Carolyn McCarthy, my representative, asking her to vote for the measure. It's no secret to those of us who suffer from them that mental illnesses are the bastard children of the healthcare industry. My current insurance company only allows for 20 therapy sessions--barely enough time to work on any fundamental issues. To the insurance companies, there is still a stigma attached to mental illness, as though it were a disease that we somehow brought upon ourselves and should be capable of handling all on our own. Some insurance companies, I am sure, operate on the principle that mental illness is not a real disease and that therefore we should be embarrassed about asking for treatment. Of course, neither of these things could be further from the truth. I urge you, too, to get in touch with your representative and let him/her know that mental illness needs to be taken seriously. Now.

The recent school shooting in Dekalb, Illinois, was a tragedy on many levels, but I am the saddest about one that will probably go unaddressed. Most newspapers and online news sites reported that the gunman was an exemplary student who had no problem making friends and had a good relationship with his family. They attributed his deadly rampage to the fact that he “had stopped taking his medication.” This may well be true, but in creates a false perception amongst the general public that anyone who is on medication is one pill not taken away from becoming a homicidal maniac. That’s why there is still a stigma attached to taking medications for mental illness and why most people are still ashamed to tell anyone that they take them. The truth is that most people who are on medications are just like everyone else except they lack the chemical in the brain that keeps most people on an even keel. If they stop taking these medications, they do not turn into killers. They simply become depressed. At the worst, they may feel like harming themselves, but not others. “He stopped taking his medication” is just a way to explain the inexplicable. In this attempt to grasp at straws, those who suffer from mental illness are the only ones harmed.

Further, those who are mentally ill stop taking their medications because society still thinks of those who avail themselves of such treatment as weak. Even my own mother, despite seeing how medication has helped me, says she doesn’t see why people need to take pills to feel good. Maybe this latest trouble youngster felt like he had everything going for him and that he “should” have been able to get off his medications. We’ll never know the whole truth because this young man is gone, but what I know is that as long as people still think that everyone who takes medication is somehow flawed, there will be even more incidents like the one in Illinois.

AtI the risk of alienating half of my readership, I must admit that I am a Democrat. It's not an easy thing to be a depressed Democrat these days because we're up against some pretty difficult decisions. Who is the best candidate to defeat John McCain in the general election--Obama or Hillary? For even well-adjusted people this is a tough decision, but for the depressive it's really difficult. Depressives have tremendous difficulty deciding what to eat at restaurants and now we have to determine who is going to lead us into the second decade of the 21st Century? Pleeeease!  I know the difficulty I have making decisions relates back to my parents--they were always fighting and at odds--so I grew into an adult that could always see both sides of an issue, as I do now with Obama and HIllary. So you know what I did when it came time for me to vote in the New York primary? I voted for Obama, but I selected HIllary's delegates. How was that for a fine decision? Anyway, I hope this is all settled fairly soon because I, for one, can't take it!