Mental illness leads to more lost workdays than arthritis and back pain. Think of it as the “silent tsunami”. It is mental health and psychosocial disorder in the workplace drowning productivity in many companies.

I watched it happen from the time of my adolescence to my late ‘30’s. Depression fed my late father’s low self-esteem and he literally worked himself to death trying to feel better about himself at work. His, and our family’s, 26 years of misery could have been avoided had he not feared mental illness stigma and reached out for professional help.  Heart disease disabled Dad when he was in his late ‘50’s. He died when he was only 62.

Like father, like son means that a son's character or behavior can be expected to resemble that of his father. I carried the genetic prdisposition for mental illness well into my adulthood.  After years of struggle and loss, I was eventually diagnosed with bipolar disorder. I learned years later Dad had bipolar, too, diagnosed two years before his  death, but treatment started too late to make much of a difference. Hismanic side exploded in domestic violence, which added Post Traumatic Stree Disorder (PTSD) for my brothers, sisters and me to carry into adulthood. 

Here is how depression made me feel at work. My first career was as a Christian minister. Mental illness stigma was strong in the church in those days so I told no one and did not seek professional help.I hid behind the pulpit with a phoney smile while suicidal ideation danced in my mind nearly every day. I left the ministery after two years. I was mistakenly thinking the depression was caused by my work and made an impulsive decision to go  graduate school, earn a master’s in Radio-TV-Film with a focus on broadcast journalism. My relatively short-lived career as a radio and television reporter and anchorman was eventually destroyed by disabling panic attacks I learned years later were caused by chronic depression and alcohol abuse. I was self-medicating with alcohol.

An odd phenomenon common to most people with chronic depression. I forget I was ever well. I forget I’ll come out the other side (I always do). I forget there even is another side. This is thought of by psychologists as the “amnesia of depression”. Because depression feels permanent. The late Robin Williams once said depression is like having the “worst flu all day that you just can't kick."

People with high self-esteem feel good about themselves and appreciate their own worth. At the same time, they acknowledge their weaknesses but they don’t allow those weaknesses to play an irrationally large role in their lives. The key word is “irrational”. There is nothing “rational” in the mind of someone clinically depressed. In my experience, I was fearful and paranoid at times that colleagues were out to get me in some way. I always had an “enemy” in my mind when I was deeply depressed and so my focus was not on my productivity, but on them whoever they were. My dad, too. I remember his “enemy’s” name very well. His last name was “Snodgrass” (a fine Scottish name meaning “smooth grass”), which made it sound more menacing to us kids for some reason.

People with high self-esteem are happier than those with low self-worth. They’re also more likely to take on difficult tasks and persevere in the face of failure. Therefore, they’re more likely to succeed.

Depression is an illness, employers. Don’t make it harder for your employees to reach out for professional help by not making it perfectly clear mental illness stigma is not tolerated in your workplace. A common misconception about mental illness is that individuals can’t recover from it. According a study by the Partnership for Workplace Mental Health 65%-80% of individuals with a mental illness will improve with appropriate diagnosis, treatment and ongoing monitoring,

In a 2004 study, employees who received high-quality depression care management over two years realized a 28 percent improvement in absenteeism and a 91 percent improvement in presenteeism (when employees are present at work but not productive). That translates to an annual savings of $3,476 per employee (in 2013 dollars), according to Kathryn Rost, a research professor at the University of South Florida.

Employees with mental illnesses just want to do their jobs, says Craig, the employee who was fired after he disclosed his bipolar disorder. He wants “to be treated with dignity and respect with the understanding that bipolar disorder is like any other illness that needs to be treated,” he says. “It can be managed.”

August is my birthday month. I will be 67 on the 7th, but as a typical Leo, I think of myself as 17. The illusion is shattered the moment I look in the mirror after I wake up each morning. I splash cold water on my face, see my messed-up grey hair and, if I get close enough to the mirror, I see a couple of wrinkles I did not notice before.  

Progressive multiple sclerosis has taken its toll on my body leaving me legally blind and needing to use a cane sometimes. MS is a disease of the central nervous system, but there is something else going on inside my brain. It is bipolar disorder, which ruined relationships and my career until I finally learned how to manage it the year I turned 60. It took nearly 20 years after my diagnosis to get to that point.

My psychiatrist did not tell me what to expect in recovery. I thought that if I just took the medication all would be well. I didn’t know about maintaining a healthy sleep schedule, stress management, nutrition, exercise and psychotherapy to start living as normal a life as possible.

This disorder affects all age groups — and the number of seniors with bipolar disorder is expected to increase as the population ages. 

Now that I am an “older adult”, I have challenges each day other than keeping mood swings at bay. According to a study reported in The Journal of Affective Disorders, bipolar disorder often involves disabling and enduring cognitive impairments in older patients. A cognitive impairment is when a person has trouble remembering, learning new skills, concentrating, or making decisions that affect their everyday life. Cognitive impairment ranges from mild to severe. I had to retire and go on disability when I was 60 after giving up trying to hold a job. I could not remember directions necessary for whatever I was supposed to do in my position. I went from being a college professor and Ph.D. candidate in the 1980’s to a technical writer and instructor at the University of California-Berkeley Extension and finally to several unsuccessful telemarketing jobs.

I married an Egyptian woman in 2010 who assured me I would be speaking Arabic in a year. Our dog understands more Arabic than I do. His favorite phrase is “yalla bye bye” which means “let’s go” when it is time for a walk. I can only remember that one and few other words.

In contrast to younger individuals with bipolar disorder, studies have determined that older adults are more likely to be hospitalized for manic symptoms and experience a greater degree of disability related to the depressive symptoms. Older adults are more likely to be “rapid cyclers”, meaning they experience more than four episodes of depression or mania over the course of a single year. That requires psychiatric treatment. Some older adults with BP look forward to the upswings in mood despite the problems they cause. That’s because it is the only time they feel energetic and motivated to pursue something enjoyable. This makes the lows all the worse, however, due to the contrast between the depression and the positive feelings experienced during the manic phase. Mood changes can be complicated because of feelings of agitation, irritability or frustration. The over-expression of these feelings, a common symptom among all ages of people with BP, can complicate intimate relationships with the non-bipolar spouse and children.

Here’s the chilling news: patients with bipolar disorder have a life expectancy that is reduced by about 10 years, relative to the general population, according to Danish researchers. This is due to a higher suicide rate and poor lifestyle choices such as smoking (31% of all cigarettes are smoked by adults with a mental illness because nicotine lifts one’s mood). We are at increased risk for developing dementia, too, a nationwide study in Taiwan confirms.

I now am referred to a “geriatric psychiatrist”. “Geropsychiatry” is a sub-specialty of psychiatry dealing with the study, prevention, and treatment of mental disorders in older people.

All of the news about having bipolar disorder when you are older may be discouraging to all of us Baby Boomers and older. Don’t give in. Our brains are just different from everyone else’s. Bipolar disorder is incurable and this pattern of deterioration occurs in all of us with the disease, whether we are un-medicated, under-medicated, or medicated.

If I give in to the illness, I am finished. Instead, I help someone else. I’ve gone to work on behalf of other people who live with bipolar disorder or other mental illnesses and educate those who do not. My mission is to end stigma, which prevents many people from getting help who need it, and telling people with bipolar disorder how I learned to manage it.

Nineteenth Century American statesman Daniel Webster said “Wisdom begins at the end”. I guess at 66 I am now a “sage”. Well, probably not a “sage” because I have more to learn.

Happy birthday to me. Every day above ground is a good day.

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Much attention is given to counter bullying in schools, workplaces and social media. The abuse is not always obvious, however, and many people feel quietly victimized and strategies for workplace injustice don’t give them a voice. Some people call it the “social death penalty”. Recent studies have concluded that the issue is social ostracism and does more damage to people’s mental and physical well-being than bullying. The bottom line for employers? Higher turnover (high rates of turnover lead to higher costs related to recruiting and training new employees), it reduces performance on difficult intellectual tasks, and can also contribute to aggression and poor impulse control, all of which affects the bottom line.

As a mental health advocate, my attention is drawn to mental illness stigma as one of the reasons why someone may be ostracized. I’m concerned, too, with overall mental health because social rejection increases anger, anxiety, depression, jealousy and sadness. On one of my last jobs before retirement word got among fellow employees out that I had bipolar disorder. Several of my co-workers started treating me with a slight smirk and limited or avoided interaction with me. Ignorance, which is the basis for mental illness stigma, conditioned them to ostracize me and, to them, it was socially acceptable. I needed a friend or two on the job. People I liked and who liked me helped me look forward to going to work each day and doing my best instead of overwhelming feelings of paranoia.

Ostracism is among the most devastating experiences we can endure whether on the playground or in the workplace. Not only can ostracism damage the brain; it is also more commonly directed at those who have cognitive and psychiatric challenges.  I faced both with multiple sclerosis which affected my short-term memory and bipolar disorder where occasional mood swings became obvious.

Professor Sandra Robinson of the University of British Columbia concluded in her study of the issue:

“We’ve been taught that ignoring someone is socially preferable — if you don’t have something nice to say, don’t say anything at all. But ostracism leads people to feel more helpless, like they’re not worthy of any attention at all.”

British film director Derek Jarman best summarizes why every workplace should be reminded social exclusion is unacceptable: “Pain can be alleviated by morphine but the pain of social ostracism cannot be taken away.”

Nineteenth century author and poet Charlotte Bronte wrote in her classic novel Jane Eyre that “remorse is the poison of life”. In other words, you can't fix the past and worrying about it will make your life miserable. I thought I moved beyond my remorse over the major manic episode that destroyed my marriage 29 years ago, I was confronted recently, however, with something I never wrote or spoke about regarding my 50-year journey before and after diagnosis with bipolar disorder. It is the collateral damage I left behind. The damage was burned into the minds of my then 10-year-old son and six-year-old daughter. Their unfortunate mother moved forward eventually with a new husband and I hope she sought appropriate therapy.

My son is now 38 and my 34-year-old daughter is a wife and mother of two, soon-to-be three. Out of respect for their privacy, I will not disclose their individual emotional challenges as they grew up. Now that I am closer to the grave that to the cradle as I approach my 67th birthday, it is time to leave with what I hope are words of healing for my children and for the more than five million American children of severely mentally ill parents.

The scope of the problem is larger than most people assume. These children have a parent with a serious mental illness (SMI) such as schizophrenia, bipolar disorder, or major depression. “Adults with a serious mental illness are likely to be parents. In fact, 68% of women with an SMI are mothers and 57% of men with an SMI are fathers; further, 73% of women with PTSD and 68% of men with PTSD are parents,” Michelle D. Sherman, PhD wrote in her Social Work, Today article  “Reaching Out to Children of Parents with Mental Illness”.

 While sociologists continue working on ways to help these young people, there are specific ways we as parents with a major mental illness in recovery can help. For example, I want all adult children of a mentally ill parent today, including mine, to know:

First, it wasn’t their responsibility to fix or save the parent with the mental illness. They were just a child trying to learn their own way. Their only job today is to accept their parent as-is and develop their own lives.

Second, most people whose parents have a mental health condition don’t develop one themselves. These negative stereotypes only feed mental illness stigma and blocks each child on his or her journey into adulthood.

Third, it’s like putting one's own oxygen mask on first while on an airliner before assisting others — taking care of one's own emotional, physical and spiritual health first is critical.

Finally, your mom’s or dad’s past doesn't dictate your future.

I recognize now that my adult children mourn several losses. They lost a carefree childhood, a stable family structure and in my case my children had to cope with bizarre behavior such as their 38-year-old father running off to Hollywood to be an actor instead of teaching at the university where he was employed and providing for his family. They endured financial stresses because of reduced income or spending sprees. They were aware of strained marital and extended family relationships.

One successful and resilient daughter of a narcissistic, bipolar mother, sums it up nicely: "Ultimately, I have to love myself more than I hate her”.

I often read and re-read essays by American philosopher and psychologist Williams James as I struggled through the ups and downs of recovery from BP. One of his statements is one I share with all adult children of the severely mentally ill: “Acceptance of what has happened is the first step to overcoming the consequences of any misfortune”.

Fulton Oursler, author of The Greatest Story Ever Told, wrote "Many of us crucify ourselves between two thieves - regret for the past and fear of the future." That is what I want to avoid on my journey through recovery from bipolar disorder to more fully enjoy my children and grandchildren.

My friend Stanley Victor Paskavich lives with PTSD from his military service and bipolar disorder. He turned his pain into poetry to help others on similar journeys. Stan wrote a poem for me as it relates to this essay about the collateral damage I left behind in the war with myself.  He called it “Cage the Rage”.

“We all know how the past can become an endless page, and know how it can trigger us to feel anger, hurt and rage. Search deep within to find your one, true self, and trap your demons in your diary so high upon your shelf.”


 My nearly half-century of grief started one sunny December afternoon a week before Christmas. I was 14. 

“She’s gone, Son,” my Dad said as he fought back tears and put his arm over my shoulders. He had come from the hospital to pick me up from my high school.  

My mother was admitted to the hospital the previous afternoon following what we later learned was a ruptured brain aneurysm. She was only 34. I had two little brothers ages six and three. 

Adding to the shock of Mom’s death was guilt that I caused it. I had been caught in a vandalism incident with some other guys. My parents had to pay my portion of the damage. I believed for years that my behavior raised her blood pressure so high that the aneurysm burst. It was only a coincidence, of course, but it took a long time for me to believe I wasn’t to blame.

“Since losing a parent is one of the most devastating losses a child can experience, a man who has gone through this can’t help but to bring  experience into his adult romantic life. His feelings may be especially strong during holidays,” per psychologist Nina Edwards, Ph.D.  Major depression started just after Mom died. I had no one to talk to about my feelings.  My dark mood often filled my head with thoughts of suicide as I walked alone at night in our small Southern town going with no place.

Every kid is one caring adult from being a statistic. Suicide is the second leading cause of death for ages 15 to 24. Fifty percent of deaths in this age group involve alcohol or drug abuse. In most cases, alcohol and drugs are ways of self-medicating mental disorders. I did that with alcohol abuse the next 20 years. 

A teenager does not yet know the appropriate words to describe how he or she is feeling. It is also thought that the school systems should teach children and teenagers how to identify the symptoms of depression and its causes to enable them to get help for themselves as rapidly as possible. That didn’t happen in my little high school in North Central Arkansas and it rarely happens now at most schools.

My long journey through mental illness began that cold December day in 1964. It was brutal. My mother’s sudden death was a traumatic event that triggered a genetic predisposition to bipolar disorder. If there was ever any question about a genetic relationship with bipolar, it was answered in my family, at least. My dad, he discovered two years before his death when he was 62, had bipolar. He could have been diagnosed and treated over 30 years earlier had fear of stigma not convinced him he could just self-medicate depression with alcohol. My brother who was the six-year-old when Mom died was diagnosed with the disease when in the U.S. Army and then discharged without treatment. Fear of stigma kept him from getting professional help once back in civilian life. He self-medicated with alcohol and prescription narcotics until he ended his life at age 35. My step-sister had major depression for many years, too afraid of stigma to reach out for psychiatric help. She died by suicide five years after our brother’s death. My surviving sister was diagnosed with bipolar when in her mid-30’s and now in her late 40’s has stopped hiding her illness from family and friends as she stabilizes with medication and lifestyle changes. My youngest brother is struggling with symptoms of major depression possibly related to PTSD from his service as a U.S. Marine during the Balkan Wars.  

Memories of happy Christmases’ past vanished that Christmas 53 years ago. The four decades following Mom’s death were marked with a major depression each December, ruining the holiday for my wife and — after our divorce — for my partner.

I was eventually treated for major depressions after graduate school, but it was the wrong diagnosis, as often happens with people who have bipolar disorder. I was finally correctly diagnosed when in a major manic episode. I was 42. By then, my untreated bipolar behavior had taken away my family, career and reputation. 

As I approached the 40th anniversary of Mom’s death following another failed relationship, I met a grief counselor by chance. Grief counselors aim to help people cope with grief, mourning the death of loved ones or with major life changes that trigger feelings of grief. He said he often advises his clients to write a letter to their diseased loved one. “Go somewhere to be alone,” he said, “read your letter aloud and then burn it.” I decided to try the ritual on December 17, 2004. I was 54.

Here’s an excerpt from that letter:


I’m so sorry I could not let go of my grief over your death. It was 40 years ago, today, but each December I relive those days and it always leads me into a depression. Depression ruined happy holidays with the mother of your grandchildren and undiagnosed and untreated mental illness eventually destroyed my marriage.

Please forgive me for holding on to my grief. You wouldn’t have wanted that. I finally learned that the power of guilt is not in the failure of others to forgive me, but in my failure to forgive me. 


Your son Tommy

The ashes from the burning letter floated above a cliff overlooking the Pacific Ocean near San Francisco that sunny afternoon. I never had another Christmas depression and my journey to finally stabilizing with bipolar disorder moved forward.

It is the biggest economic burden of any health issue in the world and is projected to cost $6 trillion by 2030. Two-thirds of these costs are attributed to disability and loss of work. And yet shockingly, of the 450 million people worldwide who suffer from mental health conditions 60% do not receive any form of care. “Jobs” is the key word in American politics these days. How to get them back from other countries is important, of course, but what about helping companies retain the employees they have by successfully promoting mental wellness in the workplace?

Employers need to use an informed approach to help boost employee satisfaction, retention and productivity while protecting the company’s legal and financial interests. How? Here are four ways:

* Prevention: Promote mental health as part of an overall corporate wellness campaign. For example, bring in professionals who specialize in mental health and substance abuse issues to present mandatory, yet interesting educational seminars. That will help reduce the stigma attached to mental and substance abuse disorders. Businesses who have done this reported reduction in health expenses and other financial gains for their organizations.

* Awareness: Changes in sleep, mood, appetite, weight, behavior, and personality are caused by many drug addictions and mental health disorders. Other telling symptoms include tardiness, missed deadlines and unexplained or unauthorized absences from work to counter these problems, it is critical that management and HR be given sensitivity training and that professional information and referral resources are readily available. Taking these steps can help employers manage situations before they get out of control.

* Work-Life Balance and Accommodations: The Family Medical Leave Act entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and professionally diagnosed medical reasons, including mental illness or alcohol/substance use disorders. The Americans with Disabilities Act (ADA) requires employers to provide “reasonable accommodations” to assist people with disabilities, including mental health impairments, perform job duties. Employers can help employees with mental health issues by encouraging the use of written checklists, instructions and offering more training time. Sometimes providing a mentor for daily guidance and meeting regularly to discuss progress.

* Employee Assistance Programs (EAPs designed to address substance abuse and addictions, as well as personal and family problems, mental health or emotional issues, marital or parenting problems, and financial or legal concerns. EAPs have evolved and grown in popularity during the last 25 years. The number of organizations with an EAP increased from 31% in 1985 to 75% in 2009. Providing a variety of treatment options for an employee will not only help reduce their suffering - it will curtail the incidence of impaired functioning at work.

 More jobs in America? According to the National Alliance on Mental Illness, some 60% to 80% of people with mental illness are unemployed. In part, this is the crippling nature of the disease. But a large part of the problem that we have in hiring people who have some mental disorder is that we lack the sophisticated vocabulary to talk and act regarding these illnesses.

Managing mental health should hold no fear for managers – whether they realize it or not, they already have many of the skills needed to look after their employees’ wellbeing. Sometimes all it takes is an open mind. Mental health is the mental and emotional state in which we feel able to cope with the normal stresses of everyday life. If we are feeling good about ourselves we often work productively, interact well with colleagues and make a valuable contribution to our team or workplace. The good news is that line managers already have many of the skills needed to promote positive mental health at work. They are usually well-versed in the importance of effective communication and consultation, and the need to draw up practical workplace policies and procedures. Add to these skills an open mind and a willingness to try and understanding mental health problems, and organizations can make real progress in tackling the stigma often associated with mental health.

“The problem with the stigma around mental health is really about the stories that we tell ourselves as a society. What is normal? That’s just a story that we tell ourselves.” -- Matthew Quick (Author of The Silver Linings Playbook)

There is a thin line between the impossible and the possible - that is determination,” Nigerian writer Ogwo David Emenike wrote.

If you have read my blog posts over the past couple of years, there should be no doubt that my mission in life is to end mental illness stigma. It can be a real killer of humans and a disaster for business.

We are in another Presidential election season. One of the issues is the economy, as usual. Instead of thinking about losing businesses to other countries, lets focus for a moment on the businsses that chose to remain in the U.S. What is the work environment? Is it safe? Are employees given equal opportunity to excel in positions of responsibility? Are the health benefits adequate? One characteristic, however, is often left out of the mix of what makes a good work environment. It is mental health.

Someone once said “Success isn't just about what you accomplish in your life; it's about what you inspire others to do." Can employers inspire their employees to do their best by feeling their best? Physical health is good, but what about psychological well-being? Is safe to be mentally ill in your work environment? After all, one out of every five Americans will be mentally ill at some time in their life.

Your company’s success can be crippled by one word that carries with it more harm than a computer virus: stigma.

Mental illness was not an ailment that drew much sympathy from the public 200 years ago instead, those who were mentally ill in the Western world, specifically Britain, France, and their colonies, were detested and often isolated.

The best tool we have today is education, yet many companies do not include it in employee orientation or training of supervisors. The result is presenteeism (working while ill), absenteeism due to depression, and employee turnover, which adds thousands of lost dollars to the bottom line because Depression lowers productivity.

Self-stigma complicates lower productivity among workers with a mental illness. These workers may begin to believe the negative thoughts expressed by others and, in turn, think of themselves as unable to recover, undeserving of care, dangerous, or responsible for their illnesses. This can lead them to feel shame, low self-esteem, and inability to accomplish their goals. To avoid being discriminated against, some people may also try to avoid being labeled as “mentally ill” by denying or hiding their problems and refusing to seek out care. The spiral leads to disaster in many cases: chronic unemployment, divorce, and suicide.

Adequate treatment, on the other hand, can alleviate symptoms for the employee and improve job performance. But accomplishing these aims requires a shift in attitudes about the nature of mental disorders and the recognition that such a worthwhile achievement takes effort and time.

In one study examining the financial impact of 25 chronic physical and mental health problems, researchers polled 34,622 employees at 10 companies. The researchers tabulated the amount of money the companies spent on medical and pharmacy costs for employees, as well as employees' self-reported absenteeism and lost productivity, using the World Health Organization (WHO) questionnaire.

When researchers ranked the costliest health conditions (including direct and indirect costs), depression ranked first, and anxiety ranked fifth — with obesity, arthritis, and back and neck pain in between.

The imbalance between a company’s spending on directs costs, such as health insurance and lost productivity to mental health issues is astonishing. The indirect costs exceed the direct costs.  Researchers suggest that companies should invest in the mental health of workers — not only for the sake of the employees but to improve their own profits.

The literature on mental health problems in the workplace suggests that the personal toll on employees — and the financial cost to companies — could be eased if a greater proportion of workers who need treatment were able to receive it. The authors of such studies advise employees and employers to think of mental health care as an investment — one that's worth the up-front time and cost.

In addition to writing about the impact of mental illness stigma on business, I’ve started a campaign to deter our youth from suicide. It is the second leading cause of death among the 15-24-year-old age group. Impossible? You decide: Teen Suicide: An Unspoken Crisis.

Is ending mental illness stigma possible. Well, as John Lennon wrote:

You may say I'm a dreamer

But I'm not the only one

I hope someday you'll join us

And the world will live as one.”

Nothing Lasts Forever…Except Suicide:
The Day I Decided to be God

If you’ve never thought about killing yourself, yes I use the word “killing” and not the softer words “ending your life” because suicide is self-murder, you will not understand my message. I’ve been through long periods of “suicidal ideation” (not attempting, but only thinking about it) since I was a teenager when the pain of depression was more than my coping skills.

 My last bipolar depression was in 2010. Bipolar depression is not the same as depression. It does not respond easily to medication. I had just re-married in January 2010 after 20 years of living through the trauma of divorce and sudden endings to relationships because of my manic and depressive behavior. I “should” have been happy after my wife and I married, but depression has nothing to do with “happy circumstances”. It is an illness and part of the cycle of someone who has a mood disorder. There was one thought in mind during the first 10 months of my marriage: how can I end the pain? One fantacy was to start walking into the desert here in Southern California with no food or water and let nature slowly kill me. I imagined buzzards flying over my rotting corpse and not being found for years, if ever. The other was suffocation when I actually tried putting a plastic bag over my head to see if it fit one sunny afternoon. I did that while I sitting on the balcony of our home with a backdrop of the beach and wide blue Pacific Ocean. I couldn’t see the beauty of the setting, the love of my new wife, the love of my children and grandchildren. Logic and religion did not matter. I had no right to kill others, so why would I have the right to kill myself?

By the numbers: as many as one in five patients with bipolar disorder completes suicide, according to the National Institute of Mental Health. That is 15-17% of the 5.7 million adult Americans, or about 2.6% of the U.S. population age 18 and older every year making it the number one cause of premature death among people with bipolar disorder. The illness results in 9.2 years’ reduction in expected life span, largely due to lifestyle choices such as smoking and poor nutrition.

Bipolar disorder depression is dis-heartening. There are subtle differences between unipolar and bipolar depression. Symptoms include higher rates of psychomotor retardation (involves a slowing-down of thought and a reduction of physical movements in an individual. Psychomotor retardation can cause a visible slowing of physical and emotional reactions, including speech and facial expressions. One has greater difficulty thinking, more early morning awakening, more morning worsening of mood and more frequent psychotic symptoms such as suicidal ideation and delusions in bipolar depression relative to unipolar depression.

The depression those unbearable 10 months in 2010 was medication-resistant. Finally, my psychiatrist tried a new one on the market and it worked in less than a week. One tiny pill each morning stabilized my mood and gave my wife back the man she married one January night.

 Whenever I’m depressed I cannot remember a time when I was not depressed.  When I’m not depressed, I can’t remember the moments over-shadowed by dread of living one more hour. It seems to be automatic amnesia for those of us with BP. Thank God that at this moment I feel “normal”. How long will it last? A lot depends on self-care such as sufficient sleep, exercise and adequate nutrition.

“Life is like a game of chess.
To win you have to make a move.
Knowing which move to make comes with IN-SIGHT
and knowledge, and by learning the lessons that are
accumulated along the way. We become each and every piece within the game called life!”

--Allan Rufus, The Master's Sacred Knowledge

My brother and sister chose suicide five years apart at the prime of their lives. I don't want to die that way, too. All I want when in the void of depression is for the pain to stop and for me to smile like everyone else. Is that too much to ask?

When I die, I don’t want someone to ask how I died. I want them to ask how I lived.

Tom Roberts is author of Escape from Myself: A Manic-Depressive’s Journey to Nowhere


I Object: Lawyers, Depression and Suicide

I asked in a blog post in July 2015 why are lawyers killing themselves? Simply stated, the legal profession is prone to higher incidences of depression than the general population. One study in 1990 by Johns Hopkins University found that lawyers as a group are nearly four times more likely to suffer from depression than the average person.

A staggering law school debt, inability to establish a private practice forcing many young lawyers to join a large law firm where pressure for billable hours is enormous and social alienation are just a few of the factors contributing to anxiety, depression and substance abuse.  According to a 1991 Johns Hopkins University study of 105 professions, lawyers top the list in the incidence of major depression. Other studies indicate that the rate of substance abuse among lawyers is double that of the national average.

This crisis in the legal profession was driven home to me when I lost a friend to suicide. My friend, let’s call him “Ed”, hung out his shingle in his Arkansas hometown after graduating from the University of Arkansas Law School where Bill Clinton was teaching. "Ed" practiced  family law.  Like many lawyers as we’ve learned in recent years, Ed suffered from major depression. The stress and how to manage it is something I doubt Professor Clinton or any other teacher addressed.  Ed self-medicated with alcohol to the point he became a raging, often violent alcoholic at home. After his wife divorced him, Ed got sober and attended AA meetings every day. Unfortunately, alcoholism was only half of his problem. He did not seek treatment for mental illness because of the stigma attached to mental illness for anyone in his profession much less the public in general. It was even discouraged by his AA sponsor who asserted rather self-righteously that anyone taking an antidepressant could not claim to be “sober”.

As Ed’s depressions deepened and his ability to work weakened, Ed decided one Friday afternoon to check into an upscale local hotel frequented by tourists visiting the Ozarks in his part of Arkansas. He scribbled a note on a hotel notepad in his room, took a 38-calibre pistol from his briefcase, put the barrel in his mouth and pulled the trigger. Ed left behind two young boys who lived with his ex-wife and a lot of friends in AA as well as other lawyers shocked by his suicide.

Statistics indicate that lawyers are 1.33 times more likely to kill themselves than an average citizen. Consider these grim figures:

·        Fifteen attorney suicides since 2010 in Kentucky

·        Six attorney suicides in 18 months in South Carolina

·        One suicide a month for an entire year in Oklahoma

Dan Lukasik founded Lawyers with Depression after he started descending into an incapacitating depression. 

"The stigma is huge with mental illness and depression in this country,” Dan said. “You're supposed to be a problem solver; you're supposed to be a superman or superwoman. You're not supposed to have problems," he said. 

"The general public already has a problem with lawyers and when I started to talk about this problem they didn't want to hear it. They thought, 'a person who makes a lot of money and has this job should not be having this problem,’ " Dan explained.

As I reflect on my friend Ed’s life and death more than 20 years later and as I engage in my campaign against mental illness stigma, I want to reach out to students in law schools to tell them what I wish I had known what I know today when I was a graduate student in journalism school. I faced similar pressures meeting deadlines and trying to beat the competition all the while self-medicating with alcohol for chronic depression too afraid of stigma to reach out for help.  I also look at Ed’s death and whisper to myself “there, but for the Grace of God, go I”.

To all in the legal profession or any other profession, remember the words of British Prime Minister Sir Winston Churchill who had his own mental health challenges:

“If you're going through hell, keep going.”

Health problems associated with job-related anxiety account for more deaths each year than Alzheimer's disease or diabetes, according to a Harvard University study. In fact, the impact stress is having on society as a whole is so profound that? Psychology Today calls cortisol, the stress hormone, "Public Enemy Number One".

It is unrealistic to think we can create a stress-free workplace, but stress can be reduced saving billions of dollars in lost productivity and ultimately in saving lives.

Causes of workplace stress:

* Inadequate health insurance that may result in a financial burden for the employee

or worse yet delayed treatment. In fact, shift work and long work hours were also associated with worse health generally, and bad health decisions? Like smoking.

* Decisions about work hours and shift work have profound consequences affecting sleep and conflicts with family life.

* A 2005 study noted that those who reported high levels of feeling overworked were 20 percent more likely to say that they had made lots of mistakes on the job, which could be especially problematic for those with physically demanding or dangerous positions.

* The stress that comes from the combination of low job control and high demands has also been found to contribute to issues like cardiovascular disease.

* Conflicting priorities between work and home have a negative effect on mental healt and have been linked to some substance-abuse issues.

According to new research by AXA PPP Healthcare in the U. K. following the Germanwings disaster, seven in ten bosses do not regard stress, anxiety or depression to be valid reasons for employees to take time off work.

AXA PPP Healthcare surveyed 1,000 senior business managers, managing directors, chief executives and owners and 1,000 employees and found that 69 per cent of bosses did not believe mental illness warranted time off work. Yet a quarter of managers admitted they had themselves suffered from mental illness at some point.

Although stress is not a disease, it is the first warning sign of an impending problem; if the body experiences unimpeded stress, acute and chronic changes occur,leading to long-term damage to systems and organs within the body.

How can the workplace be less stressful?

* Top-down efforts to foster a more collegial and secure working environment may lead to happier and healthier workers.

* Company-wide events and mentorship programs can help in tackling high-stress levels for employees and the associated health costs for employers.

* Efforts to retain employees for significant periods of time might help too, since workers tend to feel more secure and form more supportive social networks when there is some level of consistency within the employee pool, according to research.

Specific ways owners and managers can help reduce excessive stress in the workplace:

* First, be able to recognize the signs and symptoms of stress in order to effect the appropriate organizational changes;

* Take action aimed at stemming these sources and types of stress.

* And it is essential they understand the various coping mechanisms available and help individuals select the most appropriate ones.

Learning to manage chronic stress is an essential life skill in today’s world. If you find that you are exposed to high levels of stress on a daily basis, it may be best to consult a mental health professional. They can help you learn essential coping strategies that may prevent a physical ailment before it even begins, or alleviate symptoms that you are already experiencing.

As cancer survivor and best-selling author Kris Carr said, "If you don't think your anxiety, depression, sadness and stress impact your physical health, think again. All of these emotions trigger chemical reactions in your body, which can lead to inflammation and a weakened immune system. Learn how to cope, sweet friend. There will always be dark days."

What is your job really worth to you? “I promise you nothing is as chaotic as it seems,” Steve Maraboli wrote in his book, Unapologetically You: Reflections on Life and the Human Experience. “Nothing is worth diminishing your health. Nothing is worth poisoning yourself into stress, anxiety, and fear.”