Thursday, December 17, 2020

The Practicing Mental Illness Newsletter


I have transitioned from this blog to a weekly newsletter and won't be posting new content here. The newsletter contains insightful news on how to predict, prevent and manage episodes of anxiety, depression and mania. It includes compelling and irreverent information on meditation and features from "Getting Older With Bipolar," as well as provocative original thoughts on the politics of mental illness and content on meaningful work.

Thanks for joining me on this journey on this blog, and please continue to travel with me as we approach mental illness from a unique, responsible and compassionate perspective.

Please have a look at and subscribe to the Practicing Mental Illness newsletter here.

Wednesday, December 9, 2020

Jobs and Benefits

What do you do when you can work, and work well, but mental illness increasingly makes it more challenging?

Wednesday, December 2, 2020

Excessive Spending by People with Bipolar Disorder

No one can blow through money quite like a person in a manic episode.  I’ve flown across the country to buy an expensive piece of art.  I’ve pulled into a car dealership and bought an Acura with my American Express card.

Wednesday, November 25, 2020

Bipolar Disorder and Unemployment

The unemployment rate for people with bipolar disorder is over 60%. This rate persists even in people with bipolar disorder who have achieved functional recovery.

Wednesday, November 18, 2020

Handling Anxiety

And now the surge they predicted would come, and now more restrictions as we shut down again to try and stop it. 

People had this hope that, as we came to the end of 2020, we would put up a new calendar on January 1st and all would be back to normal. Now we know that's not going to happen.

Anxiety is to be expected when we face challenges like the ones we face now. It's normal. The point is not to ignore it, and not to run from it. You can manage it and keep it from drastically disrupting your life.

That's what my book, Resilience: Handling Anxiety in a Time of Crisis is about. It's helping people. Check it out here. And thank you.

Wednesday, November 11, 2020

Treating Mania in Older Patients with Bipolar Disorder

Little effort is made toward treating bipolar disorder in seniors.  Geriatric psychiatry is not a sexy specialty for doctors in training, and research on treatment for older patients is scant.

Wednesday, November 4, 2020

Mental Health, Race and the Police

The death of Walter Wallace, Jr in Philadelphia is a tragedy. A tragedy of mental health, not of race.


Last night, knowing what was to come throughout the city, I went to bed sad. Seeing the video on the TV this morning, I am still sad. A man I have much in common with was killed in a police shooting, and the significant story has been lost in a melee of riots and looting.

Wednesday, October 28, 2020

Crazy Politicians

Would you vote for a politician who was open about having a severe mental illness?

Wednesday, October 21, 2020

Learning From Those Who Have Been There

When it became apparent that the COVID-19 crisis was going to have a significant negative effect on people’s mental health, I thought that possibly those of us with a history of severe mental illness might fare better than the average person. After all, we have a lot of experience with limited social contact, lost jobs and stressors that cause anxiety, depression and mania. Perhaps we have better coping skills than most.

Wednesday, October 14, 2020

Celiac Disease and Bipolar Disorder

People with celiac disease are 17 times more likely to have bipolar disorder than those without.

Wednesday, October 7, 2020

Meditation and Mood Swings

Can meditation help you identify oncoming anxiety, depression or mania and give you time to intervene and avoid the worst? I’ve found that it can.

Meditation is simply being still and noticing things. Feelings in the body and thoughts that come up in the mind are observed without harsh judgment or fixation. They don’t need to be dismissed, but are instead observed and reflected on for their effect on one’s wellbeing.

Being conscious of the nature of thoughts and the sensations in the body can be a powerful tool in predicting mood changes.

Wednesday, September 30, 2020

Go for a Walk

Every time I take a retreat at a monastery walking is a key part of practice. At Zen monasteries they call it Kinhin. In Catholic monasteries it is sometime the only opportunity the monks have to speak to one another

Wednesday, September 23, 2020

Parenting and Mental Illness

It's been a challenging year for parents with mental illness. From shutdowns to job loss, many of us have struggled through the Spring and Summer of 2020. Now it's Fall.

Wednesday, September 16, 2020

Subscribe to the Newsletter

I'm transitioning from this blog to a weekly newsletter. It contains insightful news on how to predict, prevent and manage episodes of anxiety, depression and mania. I'll include compelling and irreverent information on meditation and features from "Getting Older With Bipolar."

Thanks for joining me on this journey.

For past copies of the newsletter, and to subscribe, click here.

Wednesday, September 9, 2020

Maybe the News About Longevity isn't Really That Bad

Last week I wrote about longevity and bipolar disorder and the numbers were a little scary. When you dig into them a little bit the situation doesn’t look as grim. It turns out that lifestyle choices are key to living long with mental illness. Unfortunately, people with mental illness often make poor lifestyle choices.

Thursday, September 3, 2020

The Average Lifespan of People with Bipolar Disorder

What’s the average lifespan of someone with bipolar disorder? Now that I’m in my 50s, and now that I’ve lived with the diagnosis for nearly three decades, I wonder if I’ll live as long as others without the disorder. According to research, probably not.

Wednesday, August 26, 2020

Meditation-Free Mindfulness

You don’t have to meditate to develop mindfulness. In fact, any practice that requires that you focus your attention and truly notice what you’re doing and what is going on around you, and within you, can be considered mindfulness practice.

Thursday, August 20, 2020

The Daily Decision Podcast

I spoke with Michael Chabot on The Daily Decision Podcast about my book Resilience: Handling Anxiety in a Time of Crisis. We covered a lot of ground about the effects of the COVID-19 shutdown on people with mental illness and on people feeling symptoms of anxiety for the first time.

Wednesday, August 12, 2020

The Coming Crisis in Mental Health

There have been pandemics, quarantines and shutdowns before this year around the world. The effects of such events on people's mental health has been well-researched.

The results of this research are not encouraging.

Wednesday, August 5, 2020

Missed Opportunity

For a minute it looked like real progress toward racial justice was possible.

The Black Lives Matter movement had many people who previously didn’t even consider racial disparities ponder their role in an unjust system. Ideas surfaced to explore ways we might work together to improve it. Among the disparities discussed were those found in healthcare.

Revealed for many was the gaping chasm between Whites and African Americans in mental healthcare.

Wednesday, July 29, 2020

Measuring Moods with Focus

Behind all of my work is the belief that you can predict, prevent and manage episodes of anxiety, depression and mania with practices in focused attention. These practices are meditation, movement and meaningful work.

Wednesday, July 22, 2020

Anxiety is Normal

Anxiety in and of itself is not a bad thing.  Someone has to worry about paying the bills, and someone has to have just enough fear to make sure the doors are locked and everyone is safe at night.  There are reasons to be cautious and reasons to be careful.  Anxiety, in fair amounts, helps us make good decisions and stay well.

Wednesday, July 15, 2020

Reinforcing Stigma in Unexpected Ways

Do we perpetuate the stigma against those with mental illness by trying to normalize or speak more gently of mental disorders?

Language is powerful. The words we use to define things greatly influence how we feel about them. Can safe words result in damage to the people we’re trying to help?

Wednesday, July 8, 2020

Remarkable People Podcast

I spoke with David Pasqualone on his "Remarkable People Podcast" about mental illness, bipolar disorder and anxiety. The interview focuses on meditation techniques that can help one predict, prevent or manage episodes of anxiety, depression or mania.

Wednesday, July 1, 2020

Older Men and Deaths of Despair

It's striking how many men over 45 kill themselves or die of accidental overdose.

Such deaths, which occur at four times the rate of the general population, can only be prevented if men begin telling their stories and seeking help. But even when they seek help they are often misunderstood and interventions are rarer than they should be.

I wrote about this for the International Bipolar Foundation. Please read The Stories of Men with Mental Illness.

I'll be online in conversation with The Ivy Bookshop on July 9th at 6:30p EDT. Please join me. Register here.

Wednesday, June 24, 2020

Lectio Divina on Psalm 123

Lectio Divina is a practice of meditating on a reading, often a sacred reading, that resonates with you. I'll ponder anything from Shakespeare's sonnets to ancient Chinese poetry. But my favorites for contemplation are the psalms.

Wednesday, June 17, 2020

How Do You Define Mindfulness?

The word mindfulness is tossed around so much these days that it’s become difficult to define. So many people use it in so many different ways, promising so many varying positive results, that I’ve stopped using the word at all. Because I’m not sure what it means.

Wednesday, June 10, 2020

Locating Trauma in the Body

To successfully treat trauma, one must consider and confront the way trauma is held in the body as well as the mind.

Mental illness is a unique physical experience, and too much therapeutic attention paid to the mind independent of the body is doomed to fail, or possibly even make matters worse.

Wednesday, June 3, 2020

Anxiety Begins in Your Body

Anxiety is a physical experience. It’s often first felt in the body, and by paying attention to the body we can learn to predict, prevent or manage difficult episodes.

That’s the main point of my new book, Resilience: Handling Anxiety in a Time of Crisis. Here’s an excerpt:

Wednesday, May 27, 2020

It's Difficult to Correctly Diagnose a Mental Illness

It took years and a few doctors before I was correctly diagnosed and treated. The trouble is, this happens to most people with severe mental illness.

Wednesday, May 20, 2020

Events and Links

The book Resilience: Handling Anxiety in a Time of Crisis is out! I have several virtual readings and workshops to which everyone is invited. I hope to see you there.

Wednesday, May 13, 2020

Resilience: Handling Anxiety in a Time of Crisis

I wrote Resilience: Handling Anxiety in a Time of Crisis for people who face the current coronavirus pandemic and its threats to health, communities and jobs. In the book, you’ll find insights and advice on how to confront uncertainty and maintain positive mental health.

Wednesday, May 6, 2020

Should Psychiatrists and Therapists Disclose Their Own Mental Illness?

I’ve spoken to medical students at the University of Pennsylvania about the experience of being a psychiatric patient. Inevitably, after the class a student or two would quietly take me aside and thank me while relating a hushed story about their own, or a family member’s, struggles with mental illness.

Tuesday, April 28, 2020

The Language We Use Matters

I return often to ideas about how important the language we use to describe ourselves and our experience with mental illness is.

Wednesday, April 22, 2020

Open Monitoring Meditation

On my blog "Getting Older With Bipolar" I published an article on some of the benefits of open monitoring meditation.  Here are some instructions on how to do it:

Wednesday, April 15, 2020

Meditation: The Basics

I write a lot about meditation, and sometimes, in all the research and opinion I loose sight of the fact that it's a very simple, very beneficial practice for most people.

It's not easy to do, as simple as it is, but it's worth it.  I encourage you to try it out.

So how do you do it?

Wednesday, April 8, 2020

My Spouse and I Are Now Together 24-Hours a Day

Relationships with people with mental illness pose special challenges, and offer unique, positive surprises.  Like anything worth the effort, they take a bit of work.

Wednesday, April 1, 2020

Notes from a Reader

A reader of my blogs contacted me with some kind words about my work. The woman, Althea, said that she has been dealing with bipolar disorder for 30 years. That's about how long I've had a diagnosis, so I asked her to write a note on how she manages the disease. She was caring enough to allow me to reprint it. Althea writes:

Friday, March 27, 2020

The Issues Surrounding Telehealth Visits

Now more than ever many of us need to speak with our therapists.  Levels of anxiety are running high, and mood swings seem the new normal for those of us with anxiety, depression and bipolar disorder.

But orders from most state governors have us stuck inside, even in quarantine, and our therapists’ offices are closed to in-person sessions.  While therapists and doctors are scrambling to set-up the technology to conduct appointments over the phone, through FaceTime or Skype, many aren’t equipped to make the change quickly.  And the demand is overwhelming.

Wednesday, March 18, 2020

The Body Knows Best

Mental illness affects the entire body, and in efforts to manage it we must carefully consider what our bodies are telling us.

Wednesday, March 11, 2020

Wednesday, March 4, 2020

Mindfulness As Resistance

Mindfulness practice is often viewed as a relaxing experience that enables a person to view their thoughts, and the world around them, without judgment.  But the practice can also be used to rise up against thoughts that hold us back.

Wednesday, February 19, 2020

Meditation to Predict Mood Changes

Meditation has helped me a lot in managing my bipolar disorder.  There are so many promises made by mindfulness teachers, and so much contradictory information about meditation, that people have lost sight of the fact that the real reason to meditate is to notice things.

Wednesday, February 12, 2020

Embracing the Limits of Faith and Ritual

"Live without limits" may be the worst self-help advice anyone has ever given.  Maybe we need to look back toward the rules that formed us and bound us together as a caring society.

Wednesday, February 5, 2020

Finding Hope and Meaning at Life's End

End of life experiences like redemption, reconciliation and transcendence, are rarely considered by doctors.  To them, death is a failure, and the clinical aspects of treatment leave little room for anything but last-ditch attempts to prolong life and manage pain.

Wednesday, January 29, 2020

Enhanced Short-Term Healthcare Plans

The law that established the Affordable Care Act (ACA, or Obamacare) mandates several criteria that health insurers must meet.  Among them are requirements to cover pre-existing conditions, and a limit on maximum out-of-pocket expenditures.

After several court rulings and Trump administration regulation changes, states can now permit policies that don't include these requirements if the policies cover the insured for less than one year.  Such policies are designed to cover short-term gaps in coverage and to bring more healthy people back into the health insurance market.

Wednesday, January 22, 2020

Try to Just Do Nothing

Now that they've made mindfulness completely overwhelming, how about trying nothing at all?

Wednesday, January 15, 2020

Meditating to Help Manage Mental Illness is not Buddhism

People who are drawn to meditation often are interested in the Buddhist beliefs that underlie much mindfulness practice.  People who won't meditate often object to the Buddhist roots presented in mindfulness training and believe the practice must offend their own faith.

When it comes to using meditation as an adjunct therapy to help manage mental illness, both positions are misguided.

Wednesday, January 8, 2020

Possible Changes to SSDI

If you've read much of what I write, you'll know I am an advocate for getting off of disability insurance, if at all possible, and gaining productive employment.  Only meaningful work and love can truly cure.

Social Security Disability Income and Supplemental Income have been in place a very long time, and have helped many people with severe mental illness have the financial cushion to stabilize and eventually re-enter employment, or live independently if re-entry to the workforce is not possible.