I was diagnosed with major depressive disorder and anorexia nervosa purging type a few years ago. Both of these issues had pretty much consumed my life during the years leading up to that diagnosis and have continued to be impairing ever since. I started cutting myself two years ago (it has become more frequent this past year), and I’ve had several panic attacks in the past several months. Fortunately, my overwhelming desire to commit suicide has subsided, although I still think of suicide and my death in general fairly often. In addition to my own issues, I have watched my mom slip into a state of psychosis during the past two years, triggered by the death of her father. She has become so depressed, delusional, and violent that my parents separated and sometimes I don’t even feel safe staying in the house with her—a few weeks ago my dad and I had to stop her from going through with a suicide attempt. The police were called, and I had to hold her arms down while she was clearly in a psychotic rage. At one point, she tried to stab my hand to make me let go. She was taken to a mental health facility where she stayed for a week, and now she’s furious at us for making her go there and hasn’t been much better since then. I feel like I never get anywhere with therapists because they just prescribe medicines that make me feel numb to any emotions or focus on my eating disorder so much that I never get to work through these other issues. I feel like my life is unraveling and it’s gotten so bad that, honestly, I don’t feel like I even want to fix it. My goal in telling you this is to figure out a way to help my mom and how to get through school while I’m dealing with this.

It may seem strange to hear this, for someone who suffers as much as you do from depression, anorexia, and the burdens of taking care of a very sick mother, but I think you’re doing an amazing job.

Yes, you’re chin-deep in shit, but you haven’t drowned, and that’s a remarkable accomplishment.

Your depression hasn’t made you hate people or blame them, and your anorexia hasn’t caused you to pretend you’re not sick, so you must have a solid hold on reality. There you are, with all your pain, finding the love to help your mother and the energy to go on with your studies. You’ve got good values and a big soul.

So you feel hopeless because treatment hasn’t done you much good, or, I should say, hasn’t done your symptoms much good. It sucks, but that’s the way it usually is when symptoms are as severe as yours. That doesn’t mean they won’t get better by themselves, or that a better treatment won’t come along. It does mean that, at least for the time being, you’re stuck with heavy-duty pain.

That’s not important, however, or at least not nearly as important as what you’re doing with that pain, which is, as I said, amazing, and there’s treatment that can help you distinguish between you and your symptoms. Any good cognitive treatment will help, whether it comes from a cognitive therapist, a good coach, or a friend with a positive attitude. One treatment that is aimed specifically at helping people with this much pain keep a positive attitude is Dialectic Behavioral Therapy, or DBT.

The inventor of this treatment, Marsha Linehan [link: https://www.nytimes.com/2011/06/23/health/23lives.html], suffered similar symptoms and, like you, managed to stay focused on the value of helping people and improving her own skills. She wound up inventing a kind of treatment that helps others do what she did for herself, and, like you, she found that helping others was a great way to keep her own demons in check.

It’s normal for you to feel that your life is unraveling, but trust me, it isn’t; your pain is a mess, but you’re doing a good job of bearing it and doing good things with it.

You are not your pain; you’re dealing with a lot of shit, but you are anything but. You’re the person who’s managing it while leading a good and meaningful life, and that’s not someone you should give up on.

STATEMENT:
“I may feel like a hopeless, deteriorating mess, but I love my mother and care about my education and I’m doing good things about both. I may not be able to stop my symptoms or save my mother, but life sucks and that’s not a personal failure. I haven’t let my symptoms stop me, however, and that’s why I’m doing well, even if my pain and my mother are doing badly.”

I have a great life and there’s nothing I care about more than my family, so I became really worried when, out of nowhere, I started to have horrible thoughts about murdering my children. I’m too ashamed to tell my husband. I’m not an angry person, and I love my kids and get along well with them, and I’ve never needed a shrink, but the thoughts keep me up at night. If there’s the slightest chance I could hurt my kids, I’ve got to do something about it, but I don’t know what to do. Please help.

Before you get crazy about having crazy, murderous thoughts, check out the risk factors for crazy murders. It’s not hard to do. What you’ll find out is that crazy murderers don’t just have intrusive murderous thoughts; they’re crazy as well.

By that, I mean they’re very detached, or they have strange ideas about their kids that they actually believe in, or they’re hearing voices, or going through extreme mood swings.

Ask yourself whether you fit the picture of people who really run amok. While I don’t know you, of course, my guess is that you don’t fit the picture at all, which means you run the same finite-but-small risk as your average Joe.

Trouble is, everyone who has intrusive, horrible thoughts without other symptoms of craziness is nevertheless terrified of losing control, so reassuring yourself is hard to do. What you want, of course, is total reassurance that the horrible thoughts will go away and that you’ll never, ever lose control; as you say, if there’s the slightest chance that you might hurt your family, you feel obliged to take definitive action. Unfortunately, you can’t. No one controls such thoughts, and trying to control them will just add to your helplessness.

Your goal then isn’t total reassurance or freedom from fear, but reasonable self-control and an ability to go ahead with your life in spite of fear. Assess the real risk you pose to your family and take steps to protect them if you think it’s necessary. Having done that (and realizing that your family is better off with you just the way you are, crazy thoughts and all), learn to bear your fear and go about your business, which isn’t easy to do.

If you want to tell your family about your symptoms, that’s the story you’d tell. You’ve got these crazy thoughts, but you’ve checked on the internet, and probably seen a shrink, and discovered you’re at no particular risk of doing harm, you’re just at risk of suffering from creepy thoughts. Reassure them that you have no intention of letting the crazy thoughts interfere with your normal activities and that, if you thought you were dangerous, you’d do whatever’s necessary to protect them.

As with the woman above, you are not your symptoms; a good mom can have crazy thoughts, and a great mom can carry on despite them.

STATEMENT:
“I feel like I’ve got crazy thoughts and might lose my mind but the truth is that I’ve checked out my symptoms and the part of my mind I’m losing is pretty small and insubstantial (although the process is scary and painful). Whether or not I can make my symptoms go away, I’m competent to manage them, keep everyone safe, and go on with my life, and that’s all I need to do.”

Please Note: Our next post will be a week from today. Happy holidays, everyone! As always, we look forward to hearing from you if/when they aren’t.

I’m having a hard time since the death of my father. I was expecting the grief to be rough, but I thought I’d reached the acceptance stage and was starting to feel better. Then I noticed that my two sisters were able to talk and share memories much more easily with one another than they could with me, and suddenly I felt more alone than ever before. My wife is supportive, but I don’t want her to feel I don’t love her by telling her I feel alone. My goal is to get over this grief.

You probably were starting to recover from losing your father, but that’s when you experienced another loss—a broken connection with the people who should be the most understanding.

When you grieve the loss of parents with your siblings, a major source of comfort is knowing that, whatever your differences, you’re the only ones who remember the world of your family home and share the experience of growing up there. With that missing, you’ve got a double source of grief.

Pain always causes vicious circles, so the biggest danger here is that your feeling of isolation will cause you to withdraw, which will confirm your isolation. Your job with grief then is to fight to keep your perspective, rather than letting pain shape it for you.

Currently, your perspective is that there were good, meaningful times growing up with your father and sisters, and there were memories worth sharing and preserving. Instead of letting hurt stop you, figure out what you want to say, interrupt your sisters, and see if they can respond. After all, you’re the only guy who remembers that time and they need you as much as you need them.

If they can’t listen, talk to your wife, and if your wife’s not available, a pet’s always a good captive audience. You have eulogies to compose for yourself about your father’s contributions and values and what you wish to carry on, and delivering them to anyone or thing willing to listen will do you a lot of good. Of course, you’re the most important listener but there are others who would benefit from hearing your words.

You can’t shorten the grief or change your sibling relationships. What you can do, however, is respect the strength it takes to live with pain and not let it push you to the sidelines or shade your memories of your dad. With all the loss in your life, you should never lose your right to grieve.

STATEMENT:
“I wish I could share memories with my sisters, but that’s not the measure of how well I’m dealing with grief or of how much I took away from my relationship with my father. I’ll continue to treasure my memories and look for ways to share them, and not expect the grief to go away until it does.”

After my mother died, there were an amazing number of people who came to her funeral and told wonderful stories about their friendships and how much they loved her. It made me feel bad, however, because she and I never really got along. We loved one another, but we really didn’t understand one another, and now we never will. The more I saw the closeness other people had with her, the more I wondered what was wrong with me. I miss her, but what I feel most sad about is never being able to have a good relationship and not being able to mourn her as well or as much as her friends do.

Don’t assume that you could have or should have improved your relationship with your mother without first looking at the evidence. After all, you know that many close relationships can’t be improved because whatever is bad about them comes from character rather than things you can change. They are what they are, or they were what they were.

If your relationship with your mother was sub-par because you didn’t try hard enough, then yes, you’ve learned a sad lesson about not waiting until it’s too late. For most people, however, the problem isn’t a lack of trying or an overdose of waiting; it’s blaming themselves for a lack of good results after lots of trying and still assuming they could have done better if they’d tried harder.

Don’t assume that, because other people didn’t have your problem with your mother, you shouldn’t have had it either. You’ll probably find evidence that you tried hard and that many, if not all, of the reasons for your distance were not under her control or yours.

Like the person above, you have a double grief. You miss the mother you had and you also grieve the mother you could never have. It’s a grief you can’t share, because others, especially those who really connected with your mother, don’t understand.

Don’t feel bad then about not feeling bad the way they do. Your grief for her, like your relationship, is what it is. Instead of examining what was wrong, try to remember what worked. Hopefully, in spite of her disappointment with you, she did you some good and tried to be a good mother, and, hopefully, in spite of your frustration with her, you kept your life on track and spared her your anger. These are major accomplishments that need to be celebrated, particularly since they lead more often to tooth-grinding than to pleasure.

Celebrate the strength it takes to make the best of a bad relationship. Hopefully, some of that strength was hers, as well as yours.

STATEMENT:
“I often felt like a failure because I didn’t feel as positively about my mother as other people did, but I’ve come to accept that those feelings are not under my control and to respect what I’ve done with them. My job, now that she’s dead, is to do more of the same.”

I have been wrestling with depression for years now and my maternal side of the family has a history of depression and suicide. I don’t feel that I can do this on my own anymore and need help. I don’t want to just take a medical cocktail of antidepressants. My question to you is how do I go about finding a therapist and/or doctor that will be most helpful to me.

The first step for getting treatment for your depression seems simple– don’t get depressed about treatment for depression. After all, depression’s just another form of pain unless it twists your thoughts into thinking that not getting rid of it is a kind of failure that marks a meaningless life.

As long as you realize depression is a persistent ailment, just like persistent back pain or diabetes, you’ll have an easy time making treatment decisions because you won’t regard using treatment as evidence of weakness.

The fact that your family has had depression and suicides doesn’t indicate weakness or failure on the part of anything but your genes. Suicide is terrible, but it often happens to good people who’ve lived meaningful lives and been good friends in spite of lots of depression, which doesn’t make them failures—it makes them heroes.

If depression causes you a lot of pain or makes a noticeable difference at home or work, the very least you should do is get help in fighting the negative thinking. While using therapy to find the cause of your depression and get rid of it is usually useless when the depression is long-lasting and familial, using many therapies to protect yourself from feelings of weakness and failure is often a necessity.

A therapist is like a thesis adviser for an academic; you have a topic you want to explore, and you’re looking for someone who both understands that topic and supports your approach. If you start treatment with someone and it doesn’t gel, chalk it up to bad chemistry, not your own failures, and continue your search.

Whether a therapy helps you to keep a positive perspective is easy for you to evaluate; you can tell whether a particular therapist is a good coach or has good ideas, or when you’ve got little more to learn from someone and need a fresh point of view.

Yes, a sustaining therapeutic relationship helps, but not if you come to feel it’s necessary for fighting negative beliefs. Sometime that special therapist won’t be there, or your insurance will change and you won’t be able to afford to see him/her, and then you won’t have the tools to manage your depression on your own. Your goal in talking to a nice, warm therapist is to pick up positive ideas, practice using them, and report back on how you’ve done. Don’t cling to the warmth or the need for their approval.

Make sure you try behavioral treatments, including exercise, which at the very least can distract you from depressed thinking (but don’t punish yourself if your depression makes you too tired or listless to exercise regularly). If, as often happens, the non-medical treatments can only help so much, it’s time to consider medical options. Usually, medical options have a higher risk, but they should be considered if and only if you think the alternative is worse.

If you use a sound risk management methodology to make your decision, respect yourself. Never call antidepressant treatment a “medical cocktail” unless you would say the same about chemotherapy for cancer or pills for high blood pressure.

In addition to having a greater (although not terribly high) risk, antidepressants are a pain because they take weeks to work and often (30% of the time) don’t. So after becoming a risk-manager in order to make the decision to use or not use them, embrace your inner scientist and prepare to conduct an experiment—on yourself. It’s hard, risky work, but if you feel it’s necessary, it’s worth taking on.

In the end, do everything you think is reasonable and required. Use the low risk treatments first, the higher risk treatments when needed, and be prepared for mixed results at a slow pace (that in no way reflect on you or your effort). Needing help or medication doesn’t make you weak; it makes you sick, but strong enough to do something about it.

STATEMENT:
“If I found a medication that relieved my depressive pain, it would be hard not to feel that I’ve taken an illegitimate shortcut. I know from experience, however, that there’s nothing illegitimate about treatment that reduces depressive pain as long as it doesn’t create risks that are worse than the pain itself and that the only illegitimate way to treat depression is to regard it as a weakness.”

I’d like your advice in helping my sister, who is starting to act crazy again, but she won’t accept anyone’s help. She was in the hospital several years ago for hearing voices telling her she was a friend of the Virgin Mary. Now she’s starting to talk fast again and calling the company that I think she was fired from, saying she believes they’ve sent her on a special project and she needs to report back. She sometimes sounds ludicrous, and I can’t help laughing, but I’m afraid where this will end. How can I get her help?

It’s tough to respect an illness that makes people act silly and ridiculous, and tougher still to believe you can’t get through to someone who seems, in many ways, to be in control of herself and able to care about you in the way she usually does. If only mental illness came with a rash or flu that made it easier to recognize and accept.

You’re right, however. Your sister’s illness is serious, it could get her into big trouble, and, in spite of her apparent lucidity, it can be very, very hard to help her. Especially if she’s too sick to know she needs help in the first place.

As hard as it is to be depressed (see above) and to respect yourself when you have depressive symptoms, depressed people usually know they’re sick and are ready to accept help, even if it feels humiliating. With mania, however, people often can’t see themselves as being ill. If respect were measured in nothing but feelings, you could say they respect themselves too much.

If you push your sister too hard, you may provoke a fight, which does no one any good. Manic people are often irritable and ready to fight or flee (often on motorcycles, cars and airplanes, and in the middle of night, and often while underdressed). Don’t let your concern for her become an impassioned plea that triggers her great (naked) escape.

Persuade her, if you can, with calm reason, emphasizing the positive. You think she’ll feel better and calmer if she sees a doctor, and you’ll be happy to drive her to an emergency room and wait with her while she gets an evaluation. Don’t argue about what’s wrong with her, just express confidence in your belief that there’s good help available and that you can lead her there, if she’ll let you.

If persuasion fails, be aware that your ability to intervene depends entirely on her demonstrating dangerous behavior. The moment she says or does something that shows, in an obvious way, that she could hurt herself, put herself into danger, or hurt someone else, you have acquired the critical information that allows police to take her to an emergency room and emergency room clinicians to commit her. At that point, the hope is she becomes lucid enough to want treatment herself.

Until that day comes, it takes great patience and restraint to live with a manic person. Respect yourself for your kindness and tolerance, be patient, and remember, no matter how unreasonable or naked she becomes, you’re doing the right thing.

STATEMENT:
“It’s agonizing to watch my sister act crazy and feel like I’m doing nothing, but I’m really doing a great deal by waiting, caring for her, trying to steer her towards help, preparing to intervene if she gets worse, and tolerating the helplessness.”

My boyfriend went through hell from chemotherapy, but I don’t know what to do with his depression and irritability. We’d been dating about a year and planning to get married when he found out he had a nasty kind of cancer and, since then, he’s been brave about chemo and going on with his life, which has meant working when he’s feeling OK, and our moving in together and being partners. Usually, we get along well, but lately he’s been depressed and telling me he knows he’s a burden, he can’t get much done, and he just wants to be alone. I want him to get help for his depression and stop the negative thinking but I don’t want to attack him or make him feel I don’t respect the fact that he has cancer.

One of the things you always hear from people in pain is that you, the lucky one, “just don’t understand.” It’s the rallying cry of the suffering, whether they’re coping with cancer, or just being between the ages of 10 and 18.

What sick people often fail to realize, at least at first, is that people who aren’t in their position understand things that they can’t; after all, you might have the good luck not know what it’s like to have cancer, but you know what your boyfriend’s like when he’s not depressed, and you know this isn’t it.

If you want to get through to him, put aside your guilt about his bad luck and your fear about hurting him when he’s down. You believe his negative thinking is doing more damage right now than his cancer, and that he needs a better perspective. You’re right, so guilt-be-gone.

Then, remind him about the way he and you usually think of your life together. He’s had the worst kind of bad luck, but you admire the way he’s managed it and continued with his life and you’re happy to share his fight.

After all, you’re not with him because you pity him for having cancer, but because you love his courage and find it gives you strength, and because you hope for the best and are happy to share as much time as possible.

Maybe his cancer, chemo or pain tells him he’s a useless burden, but you don’t accept that and you know he wouldn’t if he were in his right mind, because those things are mean and disrespectful. What he should be saying is that he’s fighting a good fight, respects what he’s doing, and is proud of the way the two of you have created love and closeness in the midst of chaos.

Maybe he needs therapy or medication to put a lid on the negative thinking, but in any case, reminding him about what he values and challenging him to protect his self-respect is good therapy in itself, and you can do it. You don’t need to fully understand his experience with illness in order to help him through.

STATEMENT:
“I can’t rescue my boyfriend from attacks of hopelessness about his cancer, but we’re together because we share the belief that life is worth the pain he’s gone through and, so far, nothing has changed my mind. Sickness has made him forget his beliefs and accomplishments, so it’s my job to stand up for them until he’s ready to reclaim them.”

I don’t know how to tell my wife that we can’t afford for her to continue her present business because she’s losing too much money. She used to be good at it, but cancer and chemo had a bad effect on her brain 2 years ago, and now she gets too distracted and drops the ball. I admire her courage, and I owe her for supporting the family all these years while I raised the kids and taught painting. Now I’m making more money and have taken over the finances, but it’s not enough. I’ve tried to help her keep her business organized, but it just doesn’t work. I feel angry and guilty. I can’t get her to see that she needs to find a new job that doesn’t require her old attention span and can make us some money.

It’s hard to confront your wife about about a new, cancer-related, permanent disability without feeling you’re destroying her hope and confidence and adding to her pain. On the other hand, if she doesn’t accept her disability, you’re all sunk and she’ll never have a chance to make the best of what she has.

Remember, you’re not inflicting her pain—the real cause is life and cancer—and the only reason you think she needs to face her disability is that the alternative is worse. That’s your decision as her partner and someone who’s stepped up to assume a greater share of responsibility for the family’s welfare and survival.

After all, you’ve risen to the occasion. You’re not preparing to confront her because you’re angry about the way cancer has robbed you of her strength and old personality (although you may certainly have such a feeling). If you confront her, it’s because you’ve done your homework, weighed the alternatives, and decided it’s necessary.

Begin by accepting her disability yourself; don’t see it as a treatment failure, or as a problem the two of you have failed to solve, just as a wound imposed by the sucky side of life. Respect the way she’s tried hard to return to a normal life, and respect the way you’ve picked up the load, because you both did the right thing. You needed to know the limits of her abilities, and now you do, but you just got a bad result.

Once you accept her disability without shame, you’re prepared to put it in a positive context. Tell her, without guilt, how much you respect her efforts, and that, though most of her mental equipment is functioning beautifully, there’s something wrong with her attention span that won’t let her make money at her old job.

Don’t sound as if your mind isn’t made up or as if you’re waiting for her to agree; her ability to perceive a business plan realistically may be included in the brain damage, or she may not be emotionally ready to accept it. In either case, sound like someone who has made up his mind.

In your opinion, she shouldn’t continue her old job and, if it’s up to you, you won’t support her doing it. You will, on the other hand, support her in finding something new to fit her current limitations.

STATEMENT:
“I miss my wife’s old strengths, and so does she, (or she would if she was in her right mind), but our idea of partnership was that one of us would take over if the other was injured, and that’s what I’m doing. I will raise painful topics if I think it’s necessary and respect myself for doing so.”

Well, I’ve been with my boyfriend for 5 years, and during our third year I got into his Facebook account and saw that he’d cheated on me by talking online with girls saying he loved them. I walked away for about 4 months. He tried everything to get me back and after he showed me he changed I thought I should give it one last chance since he is my first everything. I’m trying to move past this but I feel there is something inside me that wants to explode every time I am with him. What advice can you give me to forget this incident or should I not forget?

You’ve given this guy one more chance because he’s your “first everything,” which is understandable. At this point, however, he’s also your first lesson in how character, unlike love, is forever.

He didn’t do this to hurt or disrespect you, because that would imply he thought his actions through before taking them. Instead, he acted on his very flawed set of instincts, which is what brings his character into question.

Sincerity, tons of respect, and heaps of flowers shouldn’t get you to lower your guard. Most guys who sincerely regret their bad behavior regret it because they got caught, or they don’t feel like that any more, or they wish you weren’t mad at them.

Sure, guys like this may really, really love you and have nothing but sincere regrets, but they can’t admit that their basic instincts haven’t changed, won’t change, and will always come back. They sincerely wish that weren’t true and that the guy who did those bad things was another guy, but all the earnest wishes in the world don’t guarantee that his actions will improve.

Most guys with bad instincts improve, not by becoming better people, but learning to control themselves after getting to truly know themselves, for better or worse. At some time or other, they accept the fact that their bad instincts will never go away, and that they will always have to struggle to keep them in check. They know that the moment they think they’ve won permanent control, they’re in real trouble.

Unless he worships the ground you walk on, your boyfriend’s love will probably not keep him on the straight and narrow. If he controls himself because he loves you and doesn’t want to hurt you, that’s fine for as long as it lasts. Usually, however, real couples get mad at one another over stupid things and have petty urges to hurt one another. That’s when his control will break down, unless it’s rooted in deeper, personal values, not just loving feelings that can fade after a shouting match.

Your goal then isn’t to forget this incident, but to first figure out whether it’s indicative of what your future together holds. Don’t pay lots of attention to the sincerity of his love or whether he shows you tons of respect, but do give him points for admitting that he has an honesty problem, and give him more points if he wants to change because he wants to be a better guy, and not just to get your love. Give him lots of points if his actions reflect his words over a long period of time.

You know what you think about his cheating, but the real question is, what does he think about it, and what does he plan to do. If his plan just involves groveling and empty promises, get ready to be the first one in the relationship to say it’s over.

STATEMENT:
“Cheating feels like my boyfriend disrespects me and that it won’t happen if his respect is real. That’s not true. Cheating is a bad habit that’s hard to change and it has very little to do with how much he loves or respects me. The only way I can safely trust him with my future is if I see that he owns his problem, wants to be a better guy, and keeps his hands, eyes, and email connections to himself.”

After 10 years of working my butt off for this company, my boss rewarded me by giving me all the shitty parts of her job and taking away all the things I liked to do and giving them to herself. She’s not mad at me and doesn’t want to force me out. I don’t think she expects me to be mad and if I told her, she’d think I was being touchy. My goal is to feel better about these changes so I don’t blow up, but doing this job has never been easy and now it feels like an endless humiliation.

If you’ve worked your butt off for a company and gotten treated like shit, there’s a wonderful lesson to be learned. You should never, ever treat work as if it’s family or the whole of your life. You also shouldn’t be surprised if losing your ass makes a shitty feeling increase.

I know most jobs come to feel like family; you see more of the people you work with than anyone else, and the bosses talk about caring, loyalty, and fairness. It’s hard not to feel humiliated and/or like the mistreated middle child if no one listens and you’re given tasks that everyone else hates doing.

Remember, however, that your goal in working is to make a living, not to get the job done or win your boss’s respect. You work for yourself and your own values, and, while your boss is your most important client, that’s all he is. Until the day arrives when respect becomes currency, focus on your paycheck and timecard instead.

If you care too much about your work and then feel unappreciated, your feelings become dangerous. It’s not just that disgruntlement gets noticed, but that criticized bosses always find something wrong with you. At that point, it gets personal and moral, and you’re the one who will wind up in the shrink’s office, not them.

Step back, assess your strengths and opportunities, then market yourself and see what’s out there. If the job market is dead—and that’s been the rule for the last few years—respect yourself for working with disrespect. It’s hard enough to make a living when your boss likes you.

Take comfort in this secret: the guy who does the shit-work no one else wants usually has a more secure job because processing shit is the most essential part of any job. Work hard, but get your butt back; after all, you already work for an asshole.

STATEMENT:
“I may feel as if my devotion has been rewarded with humiliation and disrespect, but that means I’ve been giving too much to my job and not thinking enough about my own priorities. It’s time to become my own boss and develop a job description that limits overwork and attends to other parts of my life. I don’t really want to be a well-appreciated worker who knocks himself out for the sake of the company. I want to be a guy who values his own work and loves quittin’ time.”

You’ve probably had a disgusting amount of questions like the ones I’m about to put towards you, and that’s another thing that annoys me—I’m a cliché. 17 months ago my boyfriend broke up with me, explaining that he was too young to be in a serious relationship. I know this is perfectly logical but I have never been able to get over it, even though I do understand his point of view. I am still very much in love with him. I know perfectly well that realistically no one really marries their first love, that realistically it wasn’t even a proper adult relationship but I feel as raw today as I did the day it happened. I’ve been diagnosed with severe depression and anxiety. I have regular nightmares about him. Last Easter I attempted suicide yet it failed. I’ve been sent to counseling, but I didn’t like it. I dropped out of university as I was too distracted and there is nothing I can throw myself into to make me forget it. The idea of him with someone else would kill me. I keep thinking to myself, I’m only 21 and I shouldn’t take this so personally and seriously but I do and I have no idea why. I know I need to wise up but I can’t.

Some say love’s like a drug, but we think it’s more like a (sometimes) innocuous mental illness; it doesn’t make you “crazy”—at least not necessarily—but it does give you weird thoughts, sometimes long after the relationship is over.

While those thoughts are hard to stop and easy to believe in, at least they’re not true. Like anxiety and depression, love has a weird way of keeping itself alive by changing the way you think and act, until it changes your beliefs. That’s when you’re in trouble.

You think there’s no value to life once love goes from bliss to bad, so you try to remember and revisit and talk about everything that hurts the most, even though that keeps it hurting longer. Each time you think the thought, visit the memory, and talk about your feelings, you grind the loss in deeper, and the pain makes you do it again. You can set a Guinness record for miserable pining (i.e., a lifetime) if love-thinking goes unchecked.

Love has got you treating yourself like shit, and there’s nothing noble or beautiful about that. You feel worthless, treat yourself as worthless by trying to kill yourself, and then feel more worthless for failing and still feeling miserable.

Remember, there’s nothing wrong with being needy. OK, you’ve got a sensitivity to love, and in the right situation, that makes you open to certain kinds of joy and poetic feelings that others miss. Like some traits associated with mental illness, it has its good side (if there was no such thing as depression, most of the good art in the world would not exist).

Besides, the most likely reason you have this trait of sensitivity is that you were born with it, so don’t waste time wondering why you’re suffering, what you did wrong, or what you need to do to change. You are who you are, and you happen to be vulnerable to lost love. You need to manage that part of yourself better instead of focusing on it and feeding its destructiveness.

Big Pharma has yet to release an anti-love potion, so take treatment into your own hands by challenging the thoughts and memories that keep the disease going; keep busy while accepting the sad fact that you’re miserable, you can’t control it, and you can’t stop it. Almost everything you want to do about it will make it worse, so force yourself to do the opposite.

Find a recovery coach, or a recovery support group, that can remind you that you have a self that’s independent of your sadness and loss and that you deserve to respect yourself for carrying on with your life, in spite of your pain, one day at a time.

If you ruminate, visit old haunts, or try to share your sad story, they can tell you to shut up and do whatever you’re supposed to do when you “slip.” Prepare to fight negative thoughts and feelings every day for as long as it takes.

You will recover, learn from your experience, and do better next time, but only if you accept the unfair burden of your disease. There’s no cure for love, but if you work hard enough, you can manage your mind again, and then maybe one day find a truly healthy relationship.

STATEMENT:
“Right now I don’t care about living, but I’ve never believed that the meaning of my life is much related to how I feel. I respect myself for doing what I think is right and being a good woman and that hasn’t changed. I’ll stand by that view for as long as it takes.”

My husband and I have been married two years. Before we were married, we had been living separately and co-parenting our then 4-year-old son (we had split up when he was 18-months-old because I suspected he was cheating on me). He became involved with the woman I suspected, moved in with her and got engaged all within a year of us breaking up. Then, she cheated on him and they broke up. We began hanging out with each other and “dating.” I broke it off with him when he admitted he did not consider our relationship “exclusive.” I moved on again with my life. Then eight months later he proposed marriage stating that he knew he had made mistakes but was now certain he wanted nothing more than to be with me exclusively for life. I have trouble getting our past out of my head and trusting that he will not abandon me for someone else again. We have trouble getting along sometimes and his passive-aggressive behavior bothers me. My goals are to get over my feelings of mistrust and to be able to communicate better with my husband.

Being abandoned feels terrible—the word suggests the helplessness of a newborn left alone on a wet rock—so don’t apply the word to yourself if you’re an adult unless you intend to abandon yourself, which I’m sure you won’t do unless you’re thinking too much about your husband.

Besides, you did fine without him before and you’ll do fine without him again, if necessary. Meanwhile, ask yourself whether life is better with him around, assuming that you can’t get rid of your suspicions. Put aside, for the time being, whether your suspicions are true or not; assume you’ll find out someday and, if you do, you’ll deal with it then.

One thing you don’t want to do is to get rid of your suspicions by asking him for reassurance or watching him closely. That’s a good way to kill your relationship, drive you both crazy, and improve my business.

It’s unfair you should have to live with painful suspicion, but as long as you decide he’s a worthwhile partner, it’s part of your job description. That’s what you get when you re-cycle a flip-flop guy, which is why deciding his worthiness is so important—otherwise, it’s a lot of suffering in vain.

Don’t blame yourself for your suspicions, and don’t blame him; you can’t help having your feelings and he can’t help stirring them up. All you can do is not make things worse (see above) by keeping your feelings to yourself and not being overt about checking his email.

Remind yourself that you’re independent and not a fool. If he strays, you’ll find out sooner or later. At that point, you’ll know it’s not because he’s “too young for commitment,” but because he’s too self-absorbed to be faithful. Luckily, you seem self-reliant enough to “abandon” his sorry self and move on.

STATEMENT:
“It’s hard to live with suspicion, but I can do it if I think it’s necessary for a good partnership, and not because I’m too needy to say good-bye to a jerk. I can live alone again if I have to. Whether my husband proves true or not, I respect myself for taking risks in a good cause.”

It was just starting to look like my 25-year-old son had found some happiness and confidence when, bang, he had a bad motorcycle accident, broke his leg, lost his contract job because he couldn’t do it, and slipped back into the depression that has dogged him (and the rest of the family) since he was a teenager. He’s a good kid who managed to finish college in spite of dropping out a couple times because of depression, and now, to see him lying around the house, declaring that he’s just another “failure to launch,” is breaking my heart. My goal is to help him feel better about himself and life.

We’ve talked a lot recently about how some people have difficulty getting motivated after a long depression, but when you are depressed, you actually have tremendous motivation…to see your world as being shit.

Depression gives you the power and motivation to refuse to see it any other way. Even when depression isn’t in the cards, it’s hard to convince someone who’s feeling down that they’re wrong.

That’s why, when your kid is depressed, there’s just no way to tell him to feel better in a way that doesn’t ring hollow and sound like an impossible requirement.

If you ask him to compare himself to the gold-standard guy with no legs, it means he doesn’t have a right to feel bad until his legs drop off (assuming he remains depressed). If you insist that life is beautiful, you’re challenging him to show you that it isn’t, really, which gets him to focus on the negative. You lose your credibility, and they lose their patience with you and everyone else who “doesn’t understand.”

Remember, having recurrent depression sucks. It can make you cry, stop you in your tracks, turn you into a zombie, and take away your independence. And all the available treatments carry no guarantee, never mind that they might take away the pain but leave you sweaty, boner-less, and fat. It’s his blues and he can cry if he wants to.

Instead of cheerleading until you’re blue in the face, chuck the first part of your goal—when you think about it, it’s bullshit anyway—and focus on the second part. Help him feel worse about life, but better about himself. In other words, you have to admit that life sucks a lot sometimes, but your kid seems pretty great.

His blues may make him cry, but they’ve never stopped him. He got through college and he was doing fine until this setback; he has a capacity to finish things and enjoy life, whenever his depression lets up. He’s demonstrated patience, persistence, and hat there’s nothing really wrong with him, other than a pain syndrome in his brain.

He’s a kid you can be proud of, and he’s got parents who have stuck with him and are there when he needs them. Your home may not be a house of mirth, but it helps people through hard times, because you run it that way.

So instead of trying to cheer him up, remind him that you understand how scary and painful life can be and that you have absolutely no faith in things turning out well. What you do have, however, is faith in is his ability to pick himself up and keep going. Help him see beyond depression’s pull and realize that, if the world is shit, he has every reason to be proud of the way he deals with it.

STATEMENT:
“I know you’re hurting, and there’s no way around it, but don’t believe for a minute that you’re a failure, no matter what your depression says. Yes, it can, without warning, come back and stop you and take away your happiness, even when you’re living a good life and treating yourself properly; but it will never take away your self-respect for doing your best under a tough handicap.”

I like my new job and the boss is very nice, so it really bothers me that I want to kill him. He’s a nice guy and, on some level, he seems to know that I work hard and have good people skills and am very motivated, if for no other reason than that I was unemployed for the past 2 years. The trouble is, everybody in the office asks me to do anything that needs doing and, if I can’t, they immediately complain to him and he lets me know they’re unhappy. I don’t mind doing menial labor; what I can’t stand is that people don’t speak to me about it, so I could explain why I can’t do it right away. Instead, they complain to him, and he acts like I’ve got a problem, even though he’s technically the only person I should be taking orders from in the first place. My goal is to stop this from happening and get him to see this doesn’t work.

One way of defining administration (or good parenting) is knowing your priorities and saying no when the drain on your resources puts them at risk. In either situation, if you don’t know those priorities, or can’t defend them by saying no to lower priority requests, somebody—parent, boss, child or worker—is going to end up having a tantrum.]

The boss (or parent) who can’t do that winds up rewarding the loud, the fast, and the needy and overburdening his nicest subordinates with unlimited demands that are all labeled high priority.

Then, when they get mad, he considers his subordinates’ anger unreasonable—after all, he’s trying to get everything done—and you can see where that leads. When the angry subordinate sees no end to either the demands or the condescension, hilarity (and unemployment) ensue.

So don’t expect communication to enlighten your boss, and don’t let anger grip your tongue. You have a right to be angry, but the painful suppression of anger is what work is all about.

So don’t tell your boss to go fuck himself; shut up and go administer yourself instead. Drawing on what you now know about your company, its priorities, and the tasks that come your way, list the ones that are most important, figure out how much time they require, and put them into a job description that you think would be reasonable. Then do your job that way.

Give priority to tasks that you believe are important, regardless of whether you hate them or the people who ask you to do them. Include tasks that senior management believes are important, whether you agree or not.

Then work down your list, beginning in the morning, and completing the time you’re paid to work. Then leave and enjoy your freedom before you have to go back to work again.

When the complaints come in and your boss asks you why you disappointed someone with a legitimate request, explain that, as much as you wanted to help out, you had a backlog of urgent things that got in the way. Show him your list—like a receipt of his bullshit—and even offer to change it if he’d like.

Make it clear, however, that you’re a slave to the list, and are very motivated to get through as much as you can. Then avoid the temptation to send him (now the child) to his room for a time out.

STATEMENT:
“I know I do a good day’s work and know how to stick with priorities. If I reject a request, I can do it without over-reacting to someone’s tone or the repulsive nature of the job. Indeed, I convey nothing but professional regret at my inability to help. When I say no, it will be for professional reasons and professional reasons, without any negative emotion, are what I will share.”

Please Note: In responding to suicidal goals, as in the case below, we do not presume to offer emotional support. If you’re at risk of hurting yourself, you should, of course, go to an emergency room, discuss your state of mind with a professional, and decide how much support you need in order to remain safe. In most of the cases we encounter, however, our correspondents are not simply suicidal; they are familiar with treatment and have come to believe that it won’t help. Often, we must agree that their feelings are unlikely to change in the near future. What we try to demonstrate, however, is that negative feelings create falsely negative and hopeless beliefs and that there are ways to recover your strength and perspective, even when the pain won’t let up.

I’m considering suicide. My life is a joke. I am in my late 30s and female and I have never had a relationship with a man. Several men have used me for sex and at least 2 of them begged me not to tell any of their friends they’d had sex with me. I’ve never been loved, been held, been listened to, been cherished. I’ve just been used like a toilet. On the outside I’m pretty. I can hold a conversation and I have a reasonable number of friends. But I hate myself and I don’t feel good enough. I was abandoned by both parents and I was raped for the first time when I was about 2-years-old. It’s like men I meet can smell the self-hate on me and they treat me accordingly. I do not have even one person in my life who cares about me or who I could trust. My friends are there to go for drinks or dinner with me if they can find nothing better to do but they are not there to be supportive ever, in any way. What is the point of me continuing to live?

It’s horrible to feel that you don’t belong to the human race, except for your ability to satisfy the needs and cravings of jerks.

Remember, however, that those feelings almost always beget more falsely negative beliefs, particularly about relationships. Whether or not you’ve done anything wrong, you feel infinitely rejectable, comfortable in the company of jerks, and anxious around people you respect, since you know they will reject you for your anxiety and fundamental worthlessness.

You distrust other people, but it’s your feelings and instincts that are far more suspect. In turn, you can’t trust your feelings to guide you in relationships (even more so than the rest of us).

If you do, you will seek out jerks and excoriate yourself after real or imagined rejection, and of course, life will appear meaningless and full of relationships that always end badly. Being needy strips away the friendship filters that would otherwise keep jerks away and it makes non-jerks look like jerks or, even worse, like people whose rejection would be devastating.

For instance, after starting to trust a potential friend, you might be so hurt after noticing that she was slow to answer your calls, even if that dearth of calls was due to a busy work week or broken phone, that you would feel you could never trust her again and would feel like hurting yourself. It’s hard to make real friends when your own sensitivity is such an enemy.

Don’t give up, because there are other ways to build a more rational, positive set of beliefs that can protect you from dark feelings, even if they can’t ease the pain. They don’t require you to risk a relationship; all you need do is assess your own response to the hardships of your life, using reasonable criteria for judging your effort and the difficulty of your accomplishment.

If, while bearing the scars of neglect and abuse, you’ve picked up skills, earned a living, and treated people decently, you’ve accomplished something you have good reason to admire. Forget whether anyone else knows, understands, or respects what you’ve done. Then forget the fact that you continue to hurt like hell, (when you’re not feeling numb). You know what you know, and it’s your opinion that matters most.

If only therapy could help you make better choices and avoid negative distortions, or at least give you a sense of being respected and valued; but it often doesn’t work that way. Instead, relationships with therapists often fall victim to the same false beliefs that ruin potential friendships.

Because of your age, I’m assuming you’ve tried therapy and it hasn’t worked. You aren’t alone in having that experience, but it is possible to see beyond it. Don’t be surprised if a relationship- or emotion-focused therapy or support group hasn’t helped. Don’t give up hope, because there are other approaches that can help you grow stronger.

DBT (dialectic behavioral therapy) is a kind of cognitive-behavior therapy that can help you maintain your perspective and fight negative thoughts and actions. It’s taught as a course, and discourages participants from sharing strong feelings or engaging in intense relationships. As such, it doesn’t offer relief from loneliness, but it does provide ideas and mental exercises to root your self-worth in your own values and actions and thus protect your beliefs from distortions caused by fear, sensitivity, and loneliness.

When emptiness consumes you, it’s almost impossible not to feel like a disposable loser. If, however, you can make an honest assessment of your accomplishments, and acknowledge that there has also been triumph and survival despite tragedy, you will get stronger and find reasons to live and respect yourself.

If you review the things that you’ve done without the approval or involvement of others, jerks and not, you’ll see that you’re not just a member of the human race, but an exceptional one.

STATEMENT:
“I’ve never found a friend and often feel that life has no meaning; but abuse left me determined to be independent, treat people with respect, and be a good person, and I value what I’ve accomplished, regardless of self-hate or loneliness. I will build self-respect on my own actions, and hope that someday I will have the strength and luck to find a friend.”

My mother only has one sibling, but I’ve never met my uncle because he’s had severe agoraphobia for the past 30 years. My mother says that it started right before he graduated high school (he stopped talking to his friends, stayed in his room more, washed his hands compulsively, etc.), and it’s been going on since then. The only person he regularly communicates with is my grandmother, who also supports him, and while he sometimes talks to my mother, he doesn’t let her see him, and, like I said, I’ve never met him because if I’m in the house he won’t talk to anyone or leave his room (this is how he treats anyone who isn’t my mother or grandmother). My mother says that my uncle’s too macho to admit he has a problem, and “too Italian” to ever leave his mother’s house. I guess my problem is that my grandmother isn’t in the best health, and I know that nobody else in the family has the resources to take care of my uncle when she’s gone. Plus, I mean, he’s sick, so my goal is to get my uncle some help.

If almost every chronic illness is a test of character, agoraphobia is one of the most challenging. The fear goes far beyond anything you’ve experienced; think of it as a migraine headache where, instead of pain, you’re flooded with fear and the only relief is to hide out.

Yes, there are treatments that can dull the fear and help people recover their lives, but they take effort, they’re not a cure, and, somewhere along the line, they require people to leave their caves and endure some additional anxiety. It’s no wonder many people with severe agoraphobia will accept tranquilizers or use alcohol, but will not stick with any other kind of treatment, particularly if they have to leave home to get it.

So don’t blame your grandma or your uncle or put responsibility on anyone, including yourself, to get help. That bird has flown, leaving much pain and helplessness behind. Respect your grandma for carrying an extra load and your mother for bearing the sorrow of losing her brother.

Now that you’ve given up on helping your uncle directly, however, consider an alternative. Ask yourself whether he would accept behavioral treatment if he had no place to stay. Consult with experts and find out what would be available to him if he were flushed out of his hideout.

Obviously, eviction would make him more anxious in the short run, and might make your grandmother and mother guilty and anxious as well. If you believe there’s a positive alternative, however, encourage them to consider offering it to him. Urge them to trust their idea of what would benefit him in the long run and to ignore their gut response to seeing him in pain.

If they’re ready to push him out, good for him. If not, your mother will encounter this option further down the line, after your grandmother dies and the family can no longer afford to keep her house/his prison.

You’re right to fear for your uncle’s health and your family’s future, but as long as fear imprisons your uncle, you are all, to some degree, stuck.

STATEMENT:
“I’m sorry my uncle has a painful mental illness and I don’t want to add to his pain, but his current dependence on the family can’t last forever and he might do more for himself if he had less support and more encouragement to man up and get treatment. There are 2 generations ahead of me with responsibility for his care; but if, after learning more, I think they’re overprotecting him, I’ll let them know I respect them for caring for him, I’m concerned about what will become of him when grandma is dead, and I have a plan that might allow him to get stronger, regardless of his fears or urges to disappear.”

For years, I’ve struggled with depression, and while I don’t blame my brother for all of my problems, he has become something of an anti-anti-depressant. I just spent a week with our parents and my brother’s family (wife and two young kids), and it was exhausting, not because I had to watch the kids, who are great, but because my brother constantly pisses me off and I use all my energy biting my tongue. And the thing is, I accept why less is expected of him; I don’t have kids, so when we’re all together I should be expected to help out more around the house. The problem is the way my brother acts so entitled and patronizing…or maybe I’m just being overly sensitive , or I deserve to bear more of the load around the house just like I deserve to die alone, etc., etc., and I’m depressed again. My goal is to be able to spend time with my whole family without feeling like my whole life sucks.

There’s nothing you can do to change your married-with-kids brother’s irritating manner, or the way your parents treat him as the successful favorite, or the black feelings they stir in your depressed, deserve-to-die-alone soul.

On the other hand, remember that disappointment echoes back and forth between close relatives, even when they’re trying to hide how they feel. Your brother may be withdrawing in response to your depression, you may be hurt by his withdrawal, and so on, while the evidence piles up to confirm your feelings of humiliation and worthlessness.

Meanwhile, you may be relatively unaware of your own negativity and/or unable to control it, other than to avoid saying something nasty (and that is, really, a major achievement). So one goal is to fake being positively polite, so as to prevent your negative feelings from contributing, even passively, to the basic crap-package.

Your goal isn’t to be extra-polite or phony, just not add to the trouble. Learn to recognize your own negative behaviors if you feel there’s no one around to ask (e.g., parents who always assume you’re negative while your brother is the second coming, etc.).

Assuming that these whole-family meetings are unavoidably painful, and assuming that you can’t exchange this family for a new, less crappy one, you also need to decide how often these reunions should occur. You seem to believe, as I do, that their painfulness doesn’t mean that they’re worthless (as long as they’re niece or nephew-ful), just that they’re painful. Add it all up before deciding how often you commit yourself to these meetings, and then give yourself credit for doing something difficult.

Don’t see these meetings as efforts to win anyone’s approval other than your own, and don’t see yourself as a victim. Join the family party as often as you think it’s necessary, try to meet your own standards for decent behavior, and maybe find a partner so you can go visit his or her family instead during the holidays. Then you and your soul can find a whole new world of pain.

STATEMENT:
“I can’t help being depressed and getting more depressed at full-family meetings. If I show up, however, it’s not because I expect to feel happy, but because I believe it’s worthwhile and choose to go, even if it requires an unusual level of behavioral control and an ability to tolerate lots of depression, disappointment and irritation.”

I’d like to get along with my father and his new girlfriend, but she goes out of her way to be offensive, and my dad always takes her side. She’s not subtle, and other members of our family are shocked by her behavior and think I’ve been relatively polite and restrained. Anyway, I’ve let him know that I’m upset, and he has lots to lose, because my sisters and I all have our own lives, we see the problem the same way, and I’m the one with his grandchildren, but he seems more interested in showing his girlfriend that he’s a supportive guy and that he knows how to set limits on his misbehaving kids. Don’t get me wrong, he was a good father in some ways; but there were lots of time when he was amazingly self-centered, and I’ve tried hard to forget those time, and my forgetfulness is wearing thin. My goal is to keep this family from falling apart.

One of the good things about independence, supposedly, is that the less you need your parents—for emotional or financial support or whatever—the less likely you are to resent them or hold a grievance. Unfortunately, most of us continue to have some ongoing need for their support, and many parents find new and interesting ways to frustrate that need. Hilarity ensues.

I assume that your father has always been overly supportive of the one he’s with, as opposed to being fair or quieting conflict with his children. If that’s true, then you know that you’re not causing the problem, your dad is just being your dad. So, while you’re not the source of the issue and your dad is, you’re not going to be able to change him any time soon.

You should probably have seen this problem coming, given what your father has done before, but you thought that things would work out in time. Now is the time to grieve your hope for a better relationship and move on.

Don’t make it worse by showing your resentment (see above). You can’t help feeling hurt and insulted, but you can avoid being actively or passively provocative, even if your father’s lady-friend can’t.

Then, decide how often it’s worth getting together with him and (if he won’t have it otherwise) his new love. He’s your father and you may have things you can enjoy together—or not. Balance self-protection with your idea of what’s necessary to sustain a family bond, given that it will never have the value and pleasure you would wish, but he’s your father.

The sad fact is, family relationship are tragic more often than they’re comic, although you and your sisters can always enjoy a good laugh about your father’s latest princess charming.

STATEMENT:
“I love my father, but recognize that he’s a jerk when he’s trying too hard to please his significant other and that I can never trust or rely on him to be a father in the sense of the usual job description. I’ll try to keep my disappointment to myself and live up to my own standards for being respectful and caring, while living my own life.”

I was diagnosed with Parkinsons five years ago, and cannot for the life of me figure out how to get beyond being PISSED OFF about it. No, I don’t want to find a new hobby, interest or job. I was perfectly happy with my “pre-Parkinsons” hobbies, interests and job…thankyouverymuch. Don’t get me wrong, I’m not sitting around throwing what anyone would consider a pity party; in fact, I have people frequently tell me how amazed they are at how well I’ve adjusted to my “new life”. I’m doing all those “plan B” hobbies, interests and jobs that any self-respecting chronically diseased person should attempt to do. But, the bottom line is that I HATE all this plan B bullsh*t! So far, all the talk therapy, antidepressants, Zen type activities and straight up “get a grip” self talk have proven no match for my anger. Quality of life is much more important to me than quantity, so I’m in serious need of a plan C that includes quality improvement. Any suggestions on how I can get the hell out of my own way long enough to ever device a plan C?

Anyone who writes as eloquently and vigorously as you do has a curse as well as a gift: high expectations for a life that meets your standards for fun, creativity, and excellence.

While your gifts make you a more interesting person, there’s a special hell reserved for those with special gifts who develop them well…and then run into a brick wall.

Other people think you’ve still got lots going for you, and they’re right to some degree. What you know, however, is how far short you, and life, fall below expectations. It feels like a personal failure and total fuck-up, which, to every degree, is wrong.

In addition, neurological illness can have a direct effect on the parts of your brain that control rage and pleasure. You can be doing all the right things—and are, from the sound of it—and still feel explosively miserable, not because you’re reacting to illness, but because of your illness.

So, it’s no surprise that Parkinsons has left you madder’n hell, and I don’t see why you should expect that to change. You were happy when you were firing on all cylinders; now you can’t, and you’re not, and you’re not the kind of person to get over it, at least not completely.

That said, ask yourself what else makes your life meaningful other than doing the things you love to do and being happy. What seems to matter to you is doing the most with what you’ve got and, I would guess, helping others and being a good friend to those you care about.

You’ve probably thought of this, but I bet you’d be of particular help to other people with neurological illness who struggle with anger. In the beginning, it might help you to know that you aren’t alone and that there are good, respectable people who feel the same way and can’t help it.

As time went on, you’d also come to appreciate how hard it is for someone to do the good, constructive things you’ve done, particularly when the anger won’t let up. Then other people would take hope from seeing what you’ve done. It might not be as good as one of your “plan A” hobbies– it’s probably better.

You might even find yourself specializing in helping those who are really, really angry. Hey, a lot of us get into this business for similar reasons, and that’s why we get as much out of it as our patients do.

So don’t “get a grip,” get a posse. And then maybe, if it appeals to you, a practice.

STATEMENT:
“I wish I could achieve a little serenity about my chronic illness, but I can’t, so I’ll try to be serene about my rage instead. I’ll try to continue to do good in this world, even if I can never feel good, and take pride in the way I fuckin’ bear this fuckin’ burden.”

I hate my wife so much it’s hard to live with her or remember what a good marriage we used to have. In the old days, she was wonderful at throwing parties and having fun and buying me beautiful presents, and we traveled everywhere. Then, after an unfortunate financial wipe-out, she became a miser and a nag. She doesn’t mind living on less; she does volunteer work and is happy with her hobbies. I, on the other hand, feel like life has become miserable and I’ve lost my best friend and she doesn’t understand or care how I feel. I’ve also cut back on spending and I work pretty hard; and, shortly after this crisis, I discovered I’m bipolar and I’ve learned how to manage my mood swings pretty well, but there are times I can’t stop myself from snarling at her and wishing she was dead. I hate feeling this way.

Anger is a kind of agony, unless you have some hope of smiting your tormentor or achieving some kind of relief/release, in which case you have a lust that is usually stronger than lust (and no fear of the criminal justice system).

The trouble is, anger is everywhere and unavoidable unless you’ve been lobotomized; irritability is a common symptom of mood swings, both highs and lows, and that’s excluding the many uncontrollably irritating things that can happen to you.

So it’s no wonder that the main reason many people see shrinks is to get over their rage. In the words of the preacher in The Big Chill, “I’m angry and I don’t know what to do with my anger.” I don’t know what to do with it, either, but I don’t mind being paid to think about it.

Between your bipolar mood swings, and your need for excitement (which is part of having bipolar mood swings), you’re bound to feel angry, particularly if you have to rein yourself in. You’re the object of a double reining: from an exhausted bank account and mood stabilizers. In other words, you’re double fucked.

Then again, remember the main reason most of us get married– to have someone to blame. As such, it’s very hard for you not to hate your wife, which brings up another positive observation: your hate hasn’t stopped you from doing many good things, like working hard, trimming your budget, and sticking with your wife. You’re suffering and whining, but doing (most of) the right things.

If you think you’re supposed to be happy, given your temperament and budget, then think again. If, however, you know you’re cursed, then you can really appreciate the unexpected strength you’ve shown. You haven’t let your anger push you into drugs, sloth, or running away.

So take it up one more level. Respect what you’ve done, and use your self-respect to bottle up your anger a little more, and treat your wife better. You may well recover some of that good old chemistry if you can trim the nasty behavior (and accept a trimmed down budget).

STATEMENT:
“I miss the good old spending days and feel hopeless and angry when I have to think of living on a budget and never spree-ing again. I wish my rage would ease up; but that doesn’t seem to be in the cards. So I’m proud that I’ve stuck with my values, no matter how bitter I feel, in most areas of my life; and I wish I could stick with them in the one relationship that is most important to me and that, unfortunately, has absorbed the brunt of the anger I can’t express elsewhere.”