Frankly, I’m shocked-shocked-shocked that Robin Williams wasn’t diagnosed as being bipolar. If he didn’t have a history of manic episodes, he did a damned good job of recreating them on TV.

Actually, I am given to understand that that was not so much “manic episodes” as “loads and loads of cocaine”.

You’re right that the clinical trial data show that the best results with depressive disorder are seen with a combination of medication and “talk” therapy. This is from memory, but I think “cognitive behavioral therapy” and maybe its cousin “brief cognitive behavioral therapy” were most effective with medication.

One of the major stumbling blocks in effectively treating bipolar disorder is that patients most often are diagnosed when they are in a depressive episode and are wrongly given anti-depressants, which tends to make things worse — even leading to rapid cycling, which is a “very bad thing”. So, I’d recommend that people suffering from mood disorders not rely on their primary care doc giving them a prescription for Wellbutrin. See a psychiatrist and get a full work-up. It’s one of the major benefits of Obamacare — so USE it.

Frankly, I’m shocked-shocked-shocked that Robin Williams wasn’t diagnosed as being bipolar. If he didn’t have a history of manic episodes, he did a damned good job of recreating them on TV.

I suppose art could be considered a form of meditation, but there is also something theraputic about creating, building and making, that isn’t always addressed by other ways of focusing and calming whirling thoughts.

When i find myself starting to swing off balance I also tend to look at my eating habits. Chances are I have been either skipping meals or loading up on stuff with little actual nutrition. Keeping an eye on getting decent meals in me from time to time makes a difference.

I gotta keep her fed, and she needs pets and loves and interaction. She gave me a scare last night, though. I couldn’t find her — I was out there shaking the treat bag and calling her at 3:00 am. I did get to visit with the skittish neighbor cat, which was a real treat, because he’s a one-person cat and never rarely leaves his yard.

Sometimes, as an adult, I forget how healing it is to read.

I find it most comforting when I am at a comfortable diner or even a fast food joint, with lots of noise and hustle about me, and I can just sit and enjoy my food or my coffee and read.

I also like to walk, and I often walk without music going, because I like the noise of life around me.

I am in a new state, now, a new city, and it’s so cool at night here during the summer!! I have found solace in sitting on the porch, with my Kindle. Or going out for nightly, cool walks — because in Phoenix, in the middle of summer, it was often too hot to even go for walks at night. There’s something about a lovely, quiet night walk that I enjoy.

I don’t have a car, and I am happier because of it. I am forced to walk, a lot, and I am forced to spend time outside, and I am forced to figure out where I am and how to get places, and I find that a challenge like that, even if sometimes frustrating, is also very rewarding.

I am almost looking forward to winter. It’s hard to be depressed when you’re faced with such a tough challenge. A desert gal now living in New England without a car. It’s going to be fucking hysterical.

Exercise) Something as mild as a walk can be OK if motivation is available. Doing anything that burns serious calories can cause catastrophic mood crashes and lasting depression. I feel like this possibility – even if it’s not very common – should generally be included as a caveat for any suggestion of exercise to help depression.

I’ve definitely found other people with this issue or variations on it. And if you have body image issues, you will have the added bonus of feeling guilty that exercise makes you feel bad, since everyone everywhere has nothing but good things to say about it.

Leaving the house) Yes and no. Lots of body image and social anxiety issues just to get through the door. You have to fight through that sometimes, but might not a good idea when you’re already down, and have those issues. I like this one in principle. I think humans compartmentalize our consciousness in such a way that a change of scenery can change our whole outlook sometimes. And the reverse principle has been true for him – going home making a briefly forgotten depression come back.

Time outdoors, especially in the daytime) unless like me, you can’t stand heat. I spend summer with a hair trigger temper and a frown on my face like the Geto Boys. Right now, I am very uncomfortable, with no relief in sight. I will go to sleep cranky and wake up sweaty, stiff, and cranky.

Sensual Pleasures) Would be nice, but he can’t afford a large enough bathtub. They seem to max out at four feet in apartmentland. Other stuff works a bit sometimes. Food can’t be sensual because of anorexia soundtrack in brainz.

Writing) The single worst thing possible for him is journaling or free writing. It opens a floodgate to the worst self-hate talk. I’m neurotypical and when I was a teenager I remember the same experience: I had two high school classes which involved journaling, and they ended up being tomes of swears and laments. (Bad home life, I got better as soon as it was far enough in the dust.)

He has found escapism is the single best route to feeling better, but it has to be something that engages the mind. He calls this consuming “active” media or entertainment, rather than “passive.” For some reason, TV, books, and movies don’t do it for him. But video games and sometimes pen&paper RPGs can work, as does throwing himself into a big art project while listening to brainy audio on unrelated topics – if motivation is available.

I’m going to stop reading this right this instant, go have a run or a bike ride, I don’t know which, and then come back and finish reading this. it’s exactly the advice I needed to hear at the right moment.

BRB