Bipolar 2 From Inside and Out

Image from foxyburrow/adobestock.com

Recently, I had a chance to sit down with Harvard professor Dr. Michael Rich (M.D.), founder and leader of The Center of Media and Child Health. In addition to his comments on that topic, Dr. Rich had a lot to say about social media and mental health in general.

What are some of the problems you see for patients with psychological problems in their use of social media?

I take care of a fair number of patients and one of the things that’s hardest for them is to come clean to those who want to help and nurture them. I think first of all that for people who are both struggling with psychological or psychiatric issues – and for all of us – the hardest but most important thing to do, particularly with social media, is to be real, be authentic.

I think that the biggest problem with social media is how we are using it. Essentially most of us use social media to market ourselves to the world. We go to it in hopes that it will build community, we’ll make connections with people. What ends up happening is those who are most vulnerable or folks with varieties of anxiety – most prominently social anxiety – feel anxious in an in-person social situation. They go to social media to take baby steps to try to connect with people. But because we are using it as a marketing tool to the world, what they see appears to be that everyone else is happier, more successful, and “better” than they are. They go to it feeling insecure and they come out of it feeling even worse in many cases.

What really builds relationships and connections is us showing each other our vulnerabilities, showing each other the ways in which we need someone else, not the ways in which we are a prize for someone else.

Image courtesy Dr. Michael Rich

You use the term “problematic interactive media use.” Can you tell us what you mean by that?

Part of why we call it problematic interactive media use is it’s not an addiction. It is more akin to binge eating disorder, in the sense that it’s overuse of a necessary resource in the 21st century. The online space, the interactive media space, is necessary to function at school, at work, etc. Problematic interactive media use is continued overuse despite negative outcomes and it is driven by underlying conditions, including anxiety, especially social anxiety, but also depression.

We don’t see the technology as being the problem, so calling it internet addiction or gaming disorder or smartphone disorder or smartphone addiction points to the technology as having done something to us. It is actually our behavior that is the issue – how do we behave with these technologies, not how have these technologies harmed us in some way.

What do you think about the online therapists that have become so popular since the pandemic?

I think that there are many, many ways to use telehealth that can be very effective, but I think that it is much more effective and much more efficient in terms of progress made when it is with someone you have already met face-to-face in real life, as opposed to someone you are meeting for the first time online. First of all, you get a lot more visual and audio cues.

The other thing, quite honestly – I hate to say it, but there are people who exploit that need, who present themselves as doctors. It’s problematic because obviously someone is not only exploiting it for their own advancement, but they are generating false hope in people. I think it is unethical and profoundly unfair to someone who is seeking any sign that there is a way out of the dark space for them.

I think that what’s really important here is to use the same level of vetting of your caregivers as you would someone you’re seeing in real life. Talk to them and see if you can trust this person enough – whether you feel heard, whether you feel connected, whether you feel that they really care, rather than just going through the motions.

Any final thoughts?

I think we lost a lot when “friend” became a verb. We friend people willy-nilly, but they’re not the kind of friends that you can cry to in the middle of the night or who you could reach out to for a shoulder to lay your head on. I think that we, in our quest for and achievement of near-infinite connectivity, have lost our connectedness in a deep and meaningful way. 

I think that, quite honestly, if we can learn from the authentic behavior of folks who are sharing a vulnerability like bipolar disorder or virtually anything – attention deficit hyperactivity disorder, physical disabilities, cognitive disabilities – if we can actually be honest and true and let people know our limitations, that people will step in and complement us. They will complete us. I think that that is what true friendship or true relationships are. 

 

Interview with Dr. Michael Rich, November 5, 2020

 

Bipolar Conversation

This morning a podcast called Bi-Polar Girl was uploaded, and I was the interviewee. (You can find it on Apple, Amazon, and other podcast sources.) Here’s a look at what was like.

  • Prepping. Before we recorded the podcast, my anxiety kicked in, and I tried to overprepare. I bombarded the hosts with emails asking what I should be prepared to talk about or what questions they were going to ask me. Basically, they told me we were going to “wing it” and have me tell my story.
  • History. The thing we talked about most was when I started showing signs of bipolar and when I was diagnosed. I explained that I was showing signs of it as early as my high school years, how I decided to seek treatment after college, and how I was mistakenly diagnosed with major depression for years before receiving the proper diagnosis and medication.
  • Meds. We discussed medication in some detail – pill-shaming, how every person reacts to meds differently (so it’s useless to “recommend” a particular drug to friends or support group members). We talked about the side effects of various medications, including the fact that the most-feared one seems to be weight gain. One particular point of discussion was how many people are afraid that taking medications to treat their disorder will stunt their creativity or turn them into “zombies.” Snowflake (one of the hosts) and I agreed that our creativity and ability to work were actually improved while on medication, because it enabled us to focus and do more creative work.
  • Family. We also talked about the fact that I have no children and my reasons for that. (We also introduced some of our pets during the Zoom call, or they introduced themselves. Just try to keep an animal out of a Zoom call.) I shared that I felt it would be unfair to a child to have a nonfunctional mother, that I was afraid of going off antidepressants while pregnant, and postpartum depression afterward. Snowflake shared her story of medications, potential side effects, pregnancy, and postpartum depression.
  • My publications. I talked about my blog and my books, Bipolar Me and Bipolar Us. In particular, we discussed gaslighting, which features in my second book, and how people with bipolar are more susceptible to it. Both Snowflake and I shared how we had encountered gaslighters in our own lives.
  • Groups. Chacoman, the other host, questioned me about whether I was involved in any local or regional support groups, and I had to admit that I’m not. Now, during the pandemic, group meetings are problematic at best, but I don’t react well to groups at any time, due to my anxiety (which is how my hypomania manifests). In my case, outreach is limited to my blogs and books, and membership in online support groups.
  • Miscellaneous. We got off topic a number of times. I don’t want to make it sound like the interview was all serious or grim. We also talked about our pets, positive relationships, college memories, and even politics.
  • Plans. I talked about how my next book will be a mystery, with a bipolar main character, and received positive feedback on the idea.

All in all, it was a good experience, worth overcoming my anxiety for. I had only participated in a podcast once before, a not-altogether-successful interview about my first book with an interviewer who had obviously not read it and was more interested in whether any of my family members were also creative. (It was supposed to be a podcast about first-time authors.)

This was not the same sort of thing at all. I told my story, as the hosts had recommended, and we had a genuine, far-ranging conversation about not just my own experiences with bipolar disorder, but with how others cope with it as well. Actually, I learned a lot about myself, from how much my anxiety – and especially social anxiety – still affect me, to how much my teen years illustrated my journey into depression.

So, here’s a big thank you to Snowflake and Chacoman for the opportunity to share with them and their audience. I would absolutely do it again. It helped me step out of my comfort zone and, I hope, will help the listeners as well. It’s a form of outreach that I had never considered, but one that I found valuable – and just plain fun!

 

 

Reminder: Podcast

Tomorrow evening from 7:00 – 8:00 p.m. EST, I will be the guest on the Bi-Polar Girl podcast. You can listen in on Apple, Amazon, or wherever you get your podcasts.

If you want to join in, the podcast will also be a Zoom call. Ask me questions! Give your reactions! Become a part of the event!

Here’s the info:

https://us02web.zoom.us/j/4429894773?pwd=dFlrcGVDNWduN1U1Ly8ydVhMN1lyUT09

Meeting ID: 442 989 4773
Passcode: 894298

Mental Health Privilege

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These days we hear a lot about privilege – class privilege, white privilege, first-world privilege, male privilege, and, I’m sure, many more. The idea is that people who have privilege don’t have problems that other people deal with every day and. In fact, they don’t usually realize that they have this privilege and benefit from it.

I know that I am privileged in many ways. I am white and heterosexual. I have a house, a husband, and work I can do. I have an Ivy League education and grew up in the suburbs, the child of loving parents who never divorced.

But what I don’t have is mental health privilege. I have bipolar disorder.

When a person has mental health privilege, they don’t have to take multiple medications just to keep their brain functioning in something like a normal manner. You won’t get pill-shamed for the meds you take or have random people suggest your problems will all be solved with prayer, yoga, apple cider vinegar, or acupuncture.

(I do recognize that there are many people who take meds for a variety of disorders, including life-threatening ones. I don’t mean to discount their struggles. Physical health privilege and ableist privilege also exist.)

When you have mental health privilege, you don’t have to question whether or when you should inform a boss, a potential employer, or a friend or romantic partner that you have a mental disorder. You don’t have to fear that that one fact will make it more unlikely that you can achieve a stable work situation (or any work situation) or a stable relationship.

When you have mental health privilege, you don’t have to try to find a therapist who specializes in your problem and can actually help you. You don’t have to repeat your whole psychiatric history every time your therapist gets another job, causing you to start all over with a new therapist. You also don’t have to ask your primary care physician, who may or may not know much about psychotropic meds, to prescribe for you until you find a psychiatrist or when one isn’t even available to you.

When you have mental health privilege, you don’t worry that people will avoid you because you act “peculiar,” miss appointments and dates, or can’t handle crowds or even family gatherings. 

When you have mental health privilege, you don’t have to fear that you may have to stay for a while in a mental ward or have treatments like ECT.

When you have mental health privilege, you won’t get shot by a police officer just because you have a meltdown or a really bad day or a psychotic break.

Of course, the privileges I do have protect me some. Realistically, there is less chance that I will be killed by a police officer than would a person of color. In fact, my race and income make it easier for me to access mental health care.

The Journal of Psychosocial Nursing and Mental Health Services, in its July 3, 2017 editorial, makes clear that mental health privilege affects not only people who have mental disorders, but also the people who care for them.  The piece, written by Mona Shattell, PhD, RN, FAAN and Paula J. Brown, MBA, points out, “More than 70% of all health care providers in the United States are White (U.S. Census Bureau, 2017), and many, if not most, have unconscious (or conscious) biases (Institute of Medicine, 2003).” Their level of privilege may interfere with their treatment of their clients. The authors of the editorial encourage those with privilege to use it to help others.

Racial privilege is particularly problematic when considering mental health providers and their clients. NAMI Illinois “reported studies found that ‘black professionals make up only 2.6% of mental health clinicians in the United States, which is low considering that approximately 20% of black Americans seek mental health specialty treatment within a 12-month period.'” “While access to culturally diverse providers is low, the cost of mental health treatment remains high,” they add, “which serves as an additional impediment to bridging the gap between the onset of symptoms and accessing professional care.”

Education about mental health privilege may or may not help. Many people pooh-pooh the idea of any kind of privilege and bridle at the idea that they themselves have privilege by virtue of their health, sex, economic status, or other attributes. Some people’s eyes can be opened. (My husband didn’t recognize male privilege until I pointed out that no one suggested he change his name when we married or that we were “shacked up” because he didn’t.)

It’s understandable in a way.  People have a hard time envisioning that they themselves might ever be mentally ill or poor or homeless or denied work or discriminated against in any number of ways.

But with mental health privilege, it’s even more difficult to get people to understand. Until a close friend or family member faces mental or emotional difficulties – suffers from PTSD, experiences major depression, develops schizophrenia – people will not usually have the opportunity to realize the mental health privilege they have. And they may not even then.

As with any kind of privilege or stigma, if there is to be any improvement, people need to be educated. It’s not easy to open their eyes. But doing so can make a difference in the lives of people who do not share that privilege.

As some of you may know, I have written two nonfiction books, Bipolar Me and Bipolar Us.

Now I’m working on a different kind of writing project – a mystery novel. I had written about two-thirds to three-quarters of it when life happened and I had to put it away for a few years. Now I am back to working on it, and one of the changes I decided to make was to have my main character, a journalist, be bipolar.

It would be too easy and too cheap for me to make the murderer bipolar, and less interesting, I think, than having the person who unmasks the killer struggling with a mental disorder while she does so. The world has had enough of psychologically damaged or deranged killers – especially serial killers. Such a novel would do nothing to lessen the stigma surrounding mental illness – would, in fact, increase it. Too many people already believe that most people with mental problems are dangerous.

One of the people who beta-tested my first four chapters described my main character as “ditzy,” which wasn’t what I had intended. Now, I think maybe she was on to something. Perhaps Maggie seems ditzy because bipolar puts her out of sync with the neurotypical world. Perhaps her reactions are not “standard.”

I don’t want the book to be about her bipolar disorder. It’s still a mystery novel, with a crime to solve, interviews with suspects, dangerous situations, and all that. I just want to have a bipolar person playing an active, positive role.

But how to introduce the concept of bipolar? Should I just have Maggie say early on, “I have bipolar disorder”? (It’s written in first person.) Should she explain what that means to another character?

I think I’d rather have bipolar disorder as subtext, dropping hints that Maggie may have certain traits like imposter syndrome, hypersexuality, and depression; that she takes meds for the condition; that she functions well most of the time, but sometimes an event will send her off the rails. There might even be a chapter where the action stops for a few pages while we see Maggie trying to fight off the depression that is threatening to stall her quest for the answer.

I don’t know of too many bipolar protagonists in fiction, and even fewer in mystery fiction. The only one that comes to mind is Bo Bradley, in one of Abigail Padgett’s series of novels. (I wrote about her and her character once: https://wp.me/p4e9Hv-nE.) In my interview with Padgett, she said, “the experience of people who live with real, clinical mood disorders is still fraught, dangerous and revelatory….But the general public, including me, cannot ever actually ‘get’ what a manic or depressive or psychotic episode feels like.”

That may be true, but people experience many things in fiction – spaceflight, mountain climbing, murder – that they never do in real life. One of the marks of a really good writer is to transport the reader into the story so that it seems real, so that the reader understands what it is to fly that starship and meet that alien, climb that mountain or die trying, or kill that person who threatens you.

Perhaps, if I plan, write, draft, tweak, and edit carefully, I can show the experience of trying to do work – important, difficult work – while fighting the effects of bipolar disorder. It’s a different sort of writing than my nonfiction books.

It’s still a long way off. First, of course, I have to finish writing the damn thing. Then I have to sell the idea to an agent, who will then try to sell it to a publisher. Or I could go the indie route, which would be quicker, but not as satisfying.

Any suggestions?

Podcast Appearance

On Friday, November 13th, at 7:00 p.m. (Eastern Time), I will be a guest on the Bi-Polar Girl podcast! Tune in to it on Apple Podcasts.

It’s a Mad, Mad World

In a mad world, only the mad are sane.

Edgar Allan Poe said that (or Akira Kurosawa) (or maybe Kurosawa quoting Poe). It’s a common enough idea, so many people (including my husband) have said it, or something like it.

And how can one argue with Emily Dickinson, who said,

Much Madness is divinest Sense –
To a discerning Eye –
Much Sense – the starkest Madness –
’Tis the Majority
In this, as all, prevail –
Assent – and you are sane –
Demur – you’re straightway dangerous –
And handled with a Chain –

It’s beautiful poetry, and a reaction to Dickinson’s own situation as a person extremely out of touch with “the Majority.” Today we would diagnose her with Avoidant Personality Disorder or some such.

It’s tempting to agree with Poe and Dickinson, but I can’t. Here’s why.

The world cannot be sane or insane. Those are qualities that apply only to people. The world may seem insane, but that is only a metaphor. The world can be chaotic. The world can be incomprehensible. The world can be unfamiliar. The world can be frustrating. Observing the world can make you laugh, cry, or doubt yourself. I suppose it can even make you doubt your own sanity.

But none of those things are the same as truly being insane.

Of course, the terms “mad” and “insane” are frowned upon now.  We say, instead, that someone “is mentally ill,” or “has a psychiatric disorder,” or even “has lost touch with reality.” But can we say that the world is mentally ill or has a psychiatric disorder or has lost touch with reality?

Can large groups of people – society – be insane? There are many people in the world with serious psychiatric illnesses, but they constitute only a few percent of the world’s population. The rest of society, we have to say, is in touch with reality. It’s just that everyone has different perceptions of what reality is, especially if we’re talking about the actions of other people or other groups. This debate about the sane and the insane is more about the divide between perception and reality, the different perceptions that people have, and the concept that there is no objective reality. Each of us has a mind that interprets reality, but this does not make those realities per se true or false and those minds sane or insane.

But the concept of a world gone insane and a person society defines as a madman (it’s almost never a madwoman) as the only remaining sane person is a device used in fiction. King of Hearts is a 60s-era movie, much beloved by the counterculture, that uses this trope. Catch-22 is another, in which a man trying to prove himself insane is therefore deemed sane. One Flew Over the Cuckoo’s Nest makes us question the “sanity” of psychiatric wards versus the “sane” rebellion of the people locked up in there.

That’s what a lot of these sayings and fictions are really about – rebellion. (And why they were so popular in the 60s and 70s.) They present the hypothesis that the “sane” world requires rebelling against by being “insane.” Or put the other way around, the world is insane and the insane are the only truly sane ones.

Rebelling against what seems to you insane, i.e., the world, is presented as noble and in some sense valuable and wise. You want me to conform? I’ll say that you’re the sick ones and that whatever I do in reaction against that is proof. The further I stray from societal conventions is proof that those conventions are meaningless, stifling, demeaning, and ultimately insane.

Let’s unpack this a little further, shall we? Can the world be schizophrenic? Be bipolar? Have PTSD? Suffer from bulimia? No, those are all human conditions, caused by genetics or brain biochemistry or childhood abuse or some combination of these and other factors. We say the weather is bipolar, but we really mean just that it changes quickly. We say the world is schizophrenic, but that just means it isn’t logical.

So. I have bipolar disorder. Does that make me sane and everyone around me insane? Does it mean that I just don’t “fit in” with society? Does it provide me with wisdom that others who don’t share my condition can’t achieve?

Fortunately or unfortunately, none of that is true. That I don’t fit in is partly because of my personality and partly because of my upbringing. Not everyone around me is sane and I the only one who sees clearly. My disorder provides me with a different perspective on reality than many others have, but it doesn’t make mine right and theirs wrong. Or vice-versa.

There’s room in this world for a lot of perceptions of reality. Let’s not start dividing them up into “sane” and “insane.” Understanding other people’s point of view is not a cure for madness, but it is a way of better coping with the world.

 

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I was diagnosed with bipolar disorder and anxiety a couple  of decades ago, after being misdiagnosed with major depression. During that time, I’ve learned a lot about myself and about bipolar disorder. I’d like to share them now.

  1. Educating people about bipolar is part of my mission in life. Many people with bipolar disorder prefer to keep it to themselves, while others reveal it to only a few selected people – usually close friends or family. And those are valid, personal choices. I have been open about my diagnosis. I’ve maintained my blog (bipolarme.blog) for years. I’ve written two books (Bipolar Me and Bipolar Us). I talk to friends and family about it, even the ones who don’t really understand.This helps me as well as some of them. I have learned that more people than I thought have bipolar, depression, or another disorder.
  2. Other people may be able to “chose happiness,” but I can’t. I’ve seen in my reading and heard from friends and strangers that they are able to keep their bipolar or depression in check through positive thinking or choosing happiness or other non-medical means. None of that has ever worked for me. For me, my condition is a brain illness and must be treated with medication for the underlying causes and with talk therapy for developing coping mechanisms and getting a reality check.
  3. Even meds and therapy don’t keep me from relapsing. I still get depression from time to time. I just don’t fall as far. (I have bipolar 2, so I seldom get mania.) But the medications help me to know that my depression will end, and the therapy helps me know how to hang on until it does. At the back of my mind, I always know that I will find my way back to baseline stability, if not as quickly as I’d like.
  4. I am still able to work, be married, and have many friends. These are blessings that have come despite my bipolar disorder. I may be able to work only part-time, but I am proud of being able to use my education and bring in some money. My husband and I have been married for over 30 years. He is being treated for depression, so he knows a lot about what I go through. And I have good friends who stick with me even when I am difficult (and I certainly can be).
  5. I can still step out of my comfort zone and try new things. I have ridden a zipline, though the act of stepping off the edge was terrifying. I gave a public reading of my first book, though I hadn’t spoken in public since before my major depressive crash. 
  6. I still can’t do everything I’d like to. Being in large groups is still difficult for me, especially if I am the center of attention, such as hosting a party. I can’t even be at a party very long without having to leave. I can’t do holiday shopping in crowded stores. In fact, I do most of my shopping on the Internet.
  7. My creativity is not lessened. My two blogs and two books are evidence of that. And I’ve been working on a novel – a mystery – and am in the process of getting back to it now that I have a new idea for some subtext it desperately needed. I can write poetry, sometimes about bipolar disorder. I can make jokes and conversation. I don’t often feel writer’s block and can push myself through it, even though it sometimes takes a while (as with the mystery).
  8. Bipolar may be a life sentence, but it’s not a death sentence. Yes, I’ve had suicidal ideation (and I’ve written about it – https://wp.me/p4e9Hv-Me). But I got through it and I know that I still can, should the feelings return. And I know that, unless science makes some really spectacular advances, I will be dealing with bipolar for the rest of my life, getting through with the help of medication, therapy, my husband, and my friends.

All in all, I have to say it’s been a good life, despite my bipolar disorder, and I expect it to keep on being so. As I mentioned, educating people about bipolar is one of my passions, and I hope this post helps people understand the realities – not just the depression and the mania, but the possibilities.

…doesn’t mean you should make it into Halloween costumes.

Halloween costumes for adults have gotten ridiculous. You can find “sexy” costumes for almost anything. One year I saw an ad for a “Sexy Crayon” costume. Then there’s this year’s I-kid-you-not Sexy Mail-In Ballot. I find them perplexing and not at all sexy.

Another appalling trend in Halloween costumes, though, is the “mental patient” and “asylum” tropes.

We know that it is scary to have a mental illness. My bipolar disorder makes me question my every feeling and wonder if it’s real or pathology. Schizophrenia is an even scarier mental illness, both for those who have it and the people who interact with them.

Mental illness is also scary to the general public, especially if they hear nothing but the horror stories of mental patients on murderous rampages. The news media feed these fears with endless speculations about what disorder a killer might have had or what psych meds he or she might have been on. They ignore the fact that people with mental problems are more likely to be victims of violence than causes of it. Only in extreme cases, such as a person with both schizophrenia and anosognosia, is violence even remotely likely. The “he must be crazy” reaction to reports of a seemingly inexplicable murder are nevertheless widespread.

Yet there remain harmful and outdated stereotypes regarding mental illness that manifest themselves in holiday costumes. The most common feature of a “mental patient” costume is a straitjacket, despite the fact that such restraints have not been used for decades. But “straitjacket” is visual shorthand for “dangerous mental patient.” It’s as out-of-date and offensive as “sexy nurse” costumes featuring short, tight white dresses and nursing caps, with oversized toy hypos. I haven’t seen a nurse in anything but scrubs in years.

Another disturbing trend among Halloween costumes is the association of mental illness with blood. Many of the costumes feature blood smears or bloody handprints. You can even get “insane asylum” home decor adorned with stark concrete walls and multiple blood smears and handprints. These are suggested for use in throwing “theme parties.”

Combining pop culture with insanity is another source for Halloween costumes. The Hannibal Lecter mask appears in many costume lists, often combined with a straitjacket. (It’s usually advertised as a “cannibal” mask, to avoid copyright difficulties.) Another, more recent, one is the Harley Quinn “Suicide Squad” costume, featuring tight short shorts, black hose, and a huge prop hammer. (At least, as far as I know, no one has tried to do a sexy Hannibal Lecter costume, though I ought to Google it to make sure. There is a “sexy insane asylum patient” costume with a peek-a-boo straitjacket.) Horror movies are also fertile ground for “crazed killer” costumes. In addition to Hannibal Lecter, there are “hockey mask” and “Leatherface” (Texas Chainsaw) masks.

If you find yourself at a costume party with a person wearing a straitjacket costume or  a house decorated with an asylum theme, my advice is to leave immediately. Don’t engage in conversation. This is not the time for educating the populace on the realities of mental illness and the harm that stereotypes do.

Fortunately, this year there may be fewer costume parties because of social distancing requirements, fewer chances to insult and make fun of actual mental patients and those who have spent time in psych wards. Maybe by the time this pandemic is over, we can go back to insulting and misrepresenting Wiccans with sexy witch costumes.

 

In 2013, Allie Brosh was the darling of the mental health community, on the strength of her best-selling book, Hyperbole and a Half and her blog of the same name. Then she disappeared for seven years. This year, she finally resurfaced with a new book, Solutions and Other Problems. 

Hyperbole was such a success because of the humor it contained, as well as the unflinching look at clinical depression. 

It was instantly relatable to those of us who had been through it too:

[I] could no longer rely on genuine emotion to generate facial expressions, and when you have to spend every social interaction consciously manipulating your face into shapes that are only approximately the right ones, alienating people is inevitable.

Sometimes humor and insight were combined, as in this passage:

[T] rying to use willpower to overcome the apathetic sort of sadness that accompanies depression is like a person with no arms trying to punch themselves until their hands grow back. A fundamental component of the plan is missing and it isn’t going to work.

It also offered hope, including the famous passage where a single grain of corn helped the author break free from her depression. The book was illustrated with gonzo drawings of the author as a peculiar stick-figure-ish entity with a pink dress and a strange yellow triangle of a ponytail.

Now, seven years later, along comes Solutions, with that same propensity to tear your heart out with truth about loss, grief, and loneliness; relationship concerns, family tragedy, and physical health scares. Then without warning, you come across a passage like this:

Some years have been pretty hard, but overall, I have a pretty easy life. If I find a dead deer, I don’t have to fight a bear for it. I don’t even have to eat it if I don’t want to.

It should be noted that the stick-figure author avatar has a larger wardrobe now. And that, for those who fear that a book containing so much serious material will be difficult to read, rest assured that there are still plenty of dogs, bananas, a drunken kangaroo-pig, and poop stories.

If you get this book – and you should – it will be worth your while to shell out for the print edition ($30 for the autographed version), as the electronic edition is unsatisfying. The illustrations which flesh out this work even more than they did Hyperbole, do not come off to good effect electronically, with the hand-printed dialogue occasionally unreadable. But you need to see the illustrations, in particular Brosh’s extended series on the lives of her and her sister.

During the seven years that she was off the map, Brosh never lost her legion of admirers. In an interview with BuzzFeedNews, she sounded very like Jenny Lawson (The Bloggess), when she said:

Hey there, weirdos (<—they like when I call them that, I promise). You are more dear to me than you could possibly know. … I don’t know where you all live or what you all look like, but I’ve seen pieces of who you are, and it’s good to know you’re out there.

The comparisons between Brosh and Lawson are inevitable. Both write books that address serious, even devastating, topics with a hefty dose of humor. Both have extensive followings in the mental health community. Both have a tendency to self-isolate, but keep writing through the trauma. 

Brosh says that she has given up her blog because she was more comfortable with the book-writing process. And Instagram. And playing online games anonymously.

I, for one, hope that she continues with the book-writing process, and that her planned third book doesn’t take another seven years to produce. I don’t think I can wait that long.

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