296.89 [F31.81]: Bipolar II Disorder With Dysphoric Hypomania, Rapid Cycling, Most Recent Episode: Severe.

There it was. Finally I had a name for it. As well as a mixed feeling of panic and relief. Knowing that something is wrong with you and not knowing what it is is more dreadful than the illness itself. Illness –  that word. I have an illness. A terminal illness. It has no cure, no fully effective treatment, and it will impair for all time my “social, interpersonal and occupational functioning.” There it was – a selfie in words, grabbing me by the throat.

Dysphoric Hypomania.” That’s when the hypomanic phase is high activity but with negative mood – anger, irritibility, fear;  and self-destructive, self-punitive behaviors – Often involving drugs and alcohol; also hypersexual behavor, compulsive shopping, fighting, firing off angry emails (that you will soon be very ashamed of), blowing up at your spouse for not closing the toothpaste tube, driving nowhere, watching Nickelodeon at three in the morning, and so on.  Why couldn’t I at least have been lucky enough to get the “Euphoric Hypomania?” Great mood, positive activity, heightened creativity, increased (even if over-inflated) self esteem, and that “Everything is really ok” kind of feeling (even when it really isn’t). At least then I would feel happy about half the time.

But I am who I am and I got what I got, and I need to keep learning, day by day, how to live with it. The worst thing I can do is fight it. Resistance is futile. That is not to be confused with resignation, or weakness. This is an illness, and as such it is not subject to the force of will – not any more than diabetes or cancer is. It is about constructively accomodating it into my life and into my very being. Even to befriend it. It’s about adapting to it – using it to your advantage when you can and mitigating the damage when you can’t.   No, the struggle isn’t about killing it off. It’s about managing it.

And I have been given by some very kind people several tools with which to do that: Therapy, medication, meditation, exercise, writing, dancing, and most important of all not to stay alone for very long. My mind is not always my best friend, and at those times I shouldn’t be left alone with it. I don’t have to discuss my disorder with everyone or anyone. In fact I don’t have to discuss anything at all – Just being around people – sitting on a park bench – helps, no matter which phase I am in at the time.  And then there’s the ultimate medicine – helping someone else. No matter how miserable you feel, no matter how bleak things seem, or maybe really are – Your life is always somebody else’s dream. Find that person. It isn’t hard – they are all around you. Give them your hand and feel your insides change. It’s miraculous.

Of course all of these things sound very pretty, don’t they?  And they really do help. But sometimes – too many times – I just can’t bring myself to do any of them. Sometimes the compulsion to self-destruct is just too overwhelming, and sometimes I’m just too depressed to do those things that I know will relieve it. Those are the times that I look at that selfie, pour it a cup of coffee, and invite him to just sit down and make himself at home.

Copyright December, 2017, Dr. Bill

See, I Told You So…

I knew she was cooking supper, delectable, with only my pleasure in mind, but I pushed it away, my appetite quashed by my preoccupation with all the times I failed to appreciate her.

She told me about her day, every detail, all animated and smiling but I couldn’t hear it, feeling too guilty for all those times I didn’t listen.

She was interested in how my day went and peppered me with questions – not understanding that I couldn’t answer or engage because I knew she was no longer interested in me.

She came to sit and put her arms around me but I couldn’t accept her affection, too full of remorse for all the times I pushed her away.

She wanted to make love but I was too busy lamenting our loss of intimacy and that she no longer found me attractive.

She loved me but I couldn’t accept it because I knew I was unlovable.

She forgave me but I couldn’t believe it because I knew I was unforgivable.

She left me, proving that my intuitions were right all along.

R-E-S-P-E-C-T E-T-C.


Image result for old woman with spatula images“My wife.” After four years those words still sound strange to me. They feel strange to me and they’re difficult to say. I suppose that makes sense given that in the twenty years prior to her I had no “wife” (nor reasonable facsimile).Feeling strange can also feel good, though, as is the case here. “My wife” may be hard to say, in that it does not come out automatically, but I do like it. I like the sound of it. I like the un-loneliness of it. And of course I like her too. We are for the most part very happy together. I can tell because when I say “My wife” I smile, and it isn’t intentional, it just happens. So now we have an interesting diagnostic tool: Just look at someone’s facial expression when they say “My wife” or “My husband.” It should tell us a lot about them, their relationship and how they feel about their partner at that moment.

Of course marital happiness, if present at all, is variable and relative, as it should be. Sometimes I love her but don’t like her; other times vice versa, and there are many other combinations and permutations that define how we feel for each other and who we are in relation to one another. But there is one thing, one factor, that must never vary. Without it you will end up either in a miserable marriage because you’re afraid to be alone or you’ll end up alone and lonely and scratching your head wondering what went wrong and where and why.

My grandparents met in Poland before moving to the States in the late 1800‘s (or Russia, depending on the epoch). They were not just married for over 60 years but in love with each other and happy with each other, often through great periods of struggling, like the Great Depression, like having to raise disabled children, to name just a couple of examples. One of the last times I saw them was at their efficiency studio in Miami Beach when she was making latkes as he was sleeping and snoring on the couch. She pointed at him, smiled and said “Look at that – Look at what I married!”  “Grandma,” I asked her, “You and Grandpa have been happily married for 60 years. Most people don’t make it past 5. So what’s the secret?” She turned to me, looked me in the eyes with the spatula in her hand jabbing toward me for emphasis and said “You don’t, you can’t, always love each other – but you must, must always respect each other.” Her look got a bit more piercing for a second as if to be sure that I really got it, and apparently satisfied that I did she returned to flipping latkes.

Grandpa died the following year on that same couch. Grandma became senile and died alone in a wheelchair in the middle of the community room in a nursing home a few feet from the nurses station. She should have died with scores of family members and flowers surrounding her and angels singing.

There really is no justice. Why do we even bother looking for it? Why do we have this completely baseless need to believe in it? Fact be told the evidence points to the contrary. We need look no further than the Holocaust, Rwanda, Sudan, Syria and in our own back yards to see that the whole concept of “justice” is a farce, a fantasy, one that we somehow need in order to make sense of the world, as if it needs to make sense. It doesn’t. So stop wasting your precious time looking for it, or even worse, waiting for it, or worse yet making it up!

You new-age wannabe Buddhists speak of “karma” – The ultimate delusion of justice (the way it is commonly interpreted). You won’t do the prerequisite training and work required to honestly call yourself a true member of any faith or philosophy but you assume the title “Buddhist” because you can afford to sit around in your jacuzzis by the wind chimes contemplating the birds chirping instead of picking pizza crusts out of garbage bins and running from someone chasing you with a knife screaming at you for being a government agent.

I believe that any religious training program should require followers to spend a year in poverty. Real poverty. Being poor as opposed to reading about it or discussing it will teach you true empathy. Not happiness. Not justice – But so much more – The ability and desire to help others, the greatest and rarest gift one could ever hope for – Yet it doesn’t occur to most of us to even hope for it. And you call that justice?

And please don’t misunderstand – I have absolutely nothing but respect and admiration for Buddhists – true Buddhists, those that know and appreciate true suffering – Or those of any faith that do the work, that put in the time. And then do it again. And again. Those that don’t are about as far away as true faith and real happiness than I am from Alpha Centauri.

You don’t believe me? Try it. Go ahead, I dare you – Go work in a soup kitchen. Make that extra trip across town to give away those clothes you never wear. How about just paying the toll for the driver of the car behind you? Mow somebody else’s lawn. Or just smile. Smile at the guy in the tin cup sitting on the sidewalk, because he has his story too, and it is no less important than yours.

So getting back to Grandma, respect and “my wife.” It helps me personally to stay as mindful as I can of the “Prime Directive” – “Do No Harm.” And I say that knowing that at times I will do harm. So then comes “Feel Remorse But Don’t Dwell in Guilt.” Dwelling with guilt is a cosmic trap – It makes us cause more harm, which makes us feel more guilty, round and round and round. Just STOP causing the harm, which will erase, unless you insist on dwelling on it, the guilt, and hence the potential to cause more harm. And by doing that you become a better person, a better partner, and a better friend to yourself and others. That and a little respect will take you warp-speed through a wormhole to the kind of happiness, the only kind of happiness, that is truly fulfilling.


Copyright January 2017, Dr. Bill



I had to go back and take out the exclamation point – It doesn’t apply. “Good Morning” is a greeting, not a proclamation. Nor should it be a command  – an order to follow regardless of whether or not I want to – What if my best friend died yesterday? Are you telling me that I have to have a “Good Morning!” no matter what? And let’s face it – If I disobeyed your command would you really care anyway? It’s a formality, not a heartfelt wish.

I don’t take or use those words lightly, if at all. Not that I wish you a bad morning(!) – I just honestly and respectfully don’t care what kind of morning you have. I can’t possibly know what kind of morning you should have or that you want to have. That in no way means that I don’t care about you (although that is often the case) – It just means that I don’t know what is “good” for you, so how can I wish it to you with any sincerity? And I wouldn’t even be wishing anything directly for you – Just for the time and space that surrounds you for a few hours – your “morning(!).”

It’s like “Have a nice day!” What is a nice day to you? Hunting and fishing, perhaps? Is that what you are wishing me to do or are you really wishing me to do whatever it is that would make my day a good one? I submit that just like “Good Morning!” it is at most a sound made in my direction to acknowledge my presence and wish me some vague and impersonal form of your idea of caring.

Truth be told the expression “Have a good day!” is ass-backward. Here is one of the many places where spirituality and quantum physics meet. They would dictate that the correct salutation would be “May your day have a good you!” “I had a bad day” becomes, more correctly, “My day had a bad me.” Days are days – units of one-dimensional measurement. They aren’t inherently good or bad. Those adjectives don’t even apply to units of time, which are by nature objective – without quality. But we try to force them  – We squeeze them in there. We do so to take the onus, and hence responsibility, off of who we are, how we feel and how we choose to live and place it on an abstract unit of time we call a “day.” Now nothing is your fault anymore, right? It’s just a “bad day,” followed by the unsaid but implied “I couldn’t help it.”

“Have a nice day!” is also a command. While it may seem silly to think that I wouldn’t want my day to go well I still don’t appreciate your instructing me to make it so. May I decide that for myself, please? Can you fathom the idea that I might not even want to have a nice day? In the aforementioned example – my best friend dying – I would think it highly disgraceful, disrespectful and inappropriate for me to so much as attempt to have a nice day. My day would be having a sad me, as it should. My point here is that the very same unit of time  – say a sunny day, for example – is not something that I have. I don’t own it. It owns me. I am subject to its laws and must operate within them. What I get to control are my own feelings, my own experiences, my own actions – but not the time and space within which they happen to occur.

To add to our detriment we also do this when our day has a good us – When we go well but say that the day is going well. We flip time inside out to disavow credit as well as responsibility! Why can’t your day be having a fabulous you rather than just the same old you happening to have a fabulous day? Why attribute it to an arbitrary speck of time rather than you and all the greatness that you are? The day, a unit of time no more meaningful than an inch on a yardstick, had nothing to do with it other than to simply contain it. How would it seem if you heard someone say “I’m having a fantastic inch?” Doesn’t that sound stupid? Yet it is the same thing I’ve been talking about, just using the template of another measurable dimension of our multidimensional world.

Perhaps I’m being too picky about this and I should just look at common greetings for what they are. But what are they? For the answer to that we are forced to consider the source – Does s/he know what a “good morning(!)” or “good day(!)” means to you? Does s/he say it in the few seconds of contact necessitated by a shared elevator ride in order to fill another unit of time?  Or is this person really interested in you?

Try this – The next time somebody asks “How are you?” motion for them to sit down and begin truly answering that question. Start out with “Well, actually….” and then in less than ten seconds watch them start squirming. Watch their eyes glance elsewhere and their vision brush by their watch as if you can’t see it. That is of course even if you get that far. Then hear them excuse themselves and leave, wondering how they can genuinely wish you a great day without being willing to share five minutes of it with you. You might think that there indeed may have been something more pressing for them to do at that time, but then why even ask you in the first place? Because the usual and expected answer – “Fine, thank you,” requires no further discussion and hence no time. “How are you?” only takes four seconds to ask and answer..

Truth be told it it’s actually just a lie – the interest, the question, the appearance of a desire to truly know, giving a damn. Best to just say “Hello” and move on.

And so I shall. May your day have a fabulous you. If you so choose.

(Intentionally Left Blank)

The great pianist Debussy, when asked how he could play those notes so beautifully, responded “It is not in the notes that the beauty of the music lies; it is in the silences between them.”

The value of space is not limited to music: In art, visual design, web and graphics design and paintings – the blank space is what defines the picture. In writing, the most artistic and successful editing is that which does not go back and add or rearrange but rather subtracts.

“Perfection is achieved not when there is nothing left to add but when there is nothing left to take away,” reminded French writer Antoine de Saint-Exupery. Music, writing and speech are processes that improve by subtraction of content, not addition. When I first write a piece I see a lump of clay in front of me, that I have to chisel away at – mercilessly – before it gets too old and dry. And, well, lumpy.

So we have the tune, or words – now what gives it meaning, and life? Tone, inflection, facial expressions, body language and the rhythm of the silence. Any latin music lover knows about “clave” – which in English means “code” – the syncopated rhythm pattern, usually silent, that forms the backbone of the music and gives it clarity, form, substance and meaning.

A good example of where we don’t have clarity is email. All we have are bare naked words. No tone, inflection, expression – no “clave.” We can’t extrapolate true meaning from it, so the best we can do is project ourselves onto it – which tells us nothing about the intent of the sender. The use of email should be restricted solely to the transmission of necessary factual information. How many of us wished we could have unclicked it as soon as we sent it? Or woke up in the middle of the night running to our “send” box, hoping that we just dreamt it? How many times have we misunderstood (or have been misunderstood) and misinterpreted an email and then responded accordingly, leading to an argument, hurt feelings – even a damaged relationship? The format of email is insufficient. Frighteningly so. Our projections are almost always wrong – Because they are sourced in the receiver, not the sender.

We have all heard countless times people saying “But I don’t know what to say to him/her/them.” This encompassess three false beliefs: One, that not knowing how to make noise in advance is bad, two, that silence is bad, and three, that it is your sole responsibility to fill the silence. Rather than ruminating on what you want to say to others, let go of that false sense of responsibility and allow the space – between each other and between your ears – for what they might like to say to you. Listen to their words and their spaces. If they can simultaneously do the same with you then you find yourselves dancing to a beautiful piece of music.

Self-reflecting, or meditation, if you will, is so difficult because it’s just too damn noisy. Simplify it. Stop adding, perseverating, interpreting and embellishing. Start subtracting – All those things that really don’t and never mattered: The breakup you thought would end your life,  the awful first time you had sex, and all the times you didn’t, the “one” you should have married, and the one you did; the job or partner that doesn’t “make you happy” (as if they are supposed to). And then the all-too-familiar narrative: “I’m too old, too poor, ugly, a failure, a loser – and all those “I coulda-woulda-shoulda’s .” It is ALL nothing more than CLUTTER. NOISE. GET RID OF IT –  Toss it in the celestial dumpster – the cosmic repository for “All Things That Do Not Matter.”

If you can clear out the clutter, even a little bit at a time, and embrace the silence,  you will end up with a poem. Or a song. When there is nothing left to subtract you will see in what remains all that is here and all that really matters. You will hear the silence. You will see the spaces.

What I am left with is Love, in its many different forms – the synergistic power of kindred souls, the bond of a friendship not describable in words, or the love between two people who live and die for it but can never explain it.

So I say: “Love, let us just be quiet –

Let’s look at each other’s faces – I’m excited to find out if we smile, or laugh, or cry.”

We touch, we look, we embrace.

We hear the silence between the notes and know the music for the first time.

Copyright December 2017, Dr. Bill

Good Morning, Heartache

You wake up in the morning and take another pill so you can sleep until noon. You think that maybe if you can manage to miss half the day the other half won’t hurt so much. Getting out of bed is like trying to walk right out of surgery. On good days come the dreaded rituals: Brushing teeth, showering, on a great day perhaps a shave.

Coffee just stimulates the pain, not the mood, but you drink it anyway. You sit and stare at the walls, too tired to move, go out, stay in, or even look around. You don’t care, and you don’t care that you don’t care. You’re falling, and you’re just too exhausted to try holding on any longer. Imagine spiraling down a hole, ever so slowly – A hole with no end, no destination, just a general direction downward.

Do you know what I mean? Because if you don’t, I am just not going be able to tell it to you so that you understand. And those people at the edge, up top, they look down and shake their heads and tell you to just get up and just go for a walk and just do this and just do that and it hurts so much more because they all remind you how alone you are because they just don’t know what you’re feeling because if they did they wouldn’t say those things and so it must be me and I’m the only crazy one in this sea of stuff and….and….

After a few moments there’s the daily Council meeting in your head. Each day it forms a consensus, comes back in the room and declares the results, one more time: “Mr. Secretary, please read the minutes of today’s meeting: ‘You are worthless, you are nothing; you are nobody. You never have and never will make a damn bit of difference in this world. In fact your very presence makes it worse. You don’t deserve to be here. You are a pathetic loser – Just look at yourself.’ Meeting adjourned.” And you read the email from the guy who tells you to “Have a nice day.”

If anyone else said those things to you you would promptly show them the door – wouldn’t you? Or you’d hit him or yell or find some way to defend yourself. But here, when it comes from your own head – your own brain – you just sit down, pour another cup of coffee, and listen. You listen and nod and you have nothing to say in your own defense. You believe they are right. And then when they are done reading you today’s minutes, you’re supposed to go out and be in the world. “Don’t worry – be happy;” “People are about as happy as they make up their minds to be;” “Think positive;” “Be grateful for what you have.” And so on. I know exactly what you would like to say to them all.

Welcome to the club. Open to members of all creeds, races, nationalities, cultures and religions. And contrary to popular Western belief, membership is not only involuntary but not at all correlated with wealth, with your stuff. It doesn’t care if you’re rich, poor, sick, well, married, single, homeless or in a palace. You may not believe me, I know – But I have examples. I have the list. I can prove it to you. It’s so hard to believe because we have been trained to think with the template “If only I …;”  Fill in the blank – “Had a love,” “had a better job,” “was single,” “was married,” “had a family,” “had more money,” “didn’t have this disease,” “wasn’t so fat,” “wasn’t so thin,” “looked better in these pants,” “had abs like him,” “hair like her,” “had hair,” and so on ad nauseam.

Then, THEN, THEN you become attached to the depression itself!  It becomes part of you; it defines you. After awhile it feels like an old friend, or the spouse that you can’t divorce just because you can’t fathom life without them. It blinds us to our choices and makes us attach ourselves to it. Resistance only feeds it and makes it worse. It forces us to feed it and the more we feed it the more powerful it gets. And then of all things we invite it to sit down and join us for our morning coffee and to accompany us throughout the day.

Maybe you come from a Ward and June family (If you’re under 50 look it up). There was more than enough love to go around. No alcoholism. No violence. Family vacations, help with homework, kindness, compassion and understanding; yet you still can’t remember how many times you wished you were dead, or at least thought about it; or that you wished you were someone else. A five year-old hides under his bed, thinking about death. He seeks comfort in his parents, and they gave it. But the effects are so short-lived and the monster never leaves. At least not for long. So you’re either in it or you’re waiting for it. And they told you that “Life is just a bowl of cherries.”

As you get older you try therapy, exercise, hobbies, travel, self-help books, medication, you name it. But always the effects were short-lived. The only thing that came close to helping, that actually made the blues go away for just a little while was that bottle of Jack Daniels in front of you. But then that eventually make things worse. A LOT worse. It will feed the depression and it will get you a first class ticket into a mental hospital, prison, a spot under the bridge with a can of Sterno, or just a quicker death. But thinking about that – I mean imagining all that – It doesn’t matter, does it? You don’t really care right now, do you?

What we think of as “love” is the biggest scapegoat of all. We attribute our depression to not having someone, or someone leaving us by going away. Or by finding out that s/he was never really there in the first place. Most people I meet seem to get that “money won’t buy happiness.” What they don’t get is that neither will love. Sorry folks, I hate to break it to you, but finding that Mr./Ms. Right is not going to make you happy if you ain’t happy now.

True happiness – I mean serenity, not ha-ha-happiness – is inversely proportional to expectations. The word for “expectation” and “hope” is the same in some languages. If you know depression, not just sadness but the bleak darkness of true depression, then you know what I mean. If you know depression then you know why you’ll grasp at anything – a person, a drug, sex, a sport, a job, your smartphone, a thrill – just to not feel it for a few moments. But the moments end. Always too soon. And we go on living and reaching for those tiny spaces where the clouds have yet to pass that day but we just can’t quite make it…..

Once Upon a Time

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I arrived a half hour early at the Jamaica, Queens subway station. I thought I’d kill some time at the nearby library before the weekly softball game that I always got chosen last for. I don’t know why I might have thought that it would be any different if I showed up early. I still got chosen last.

Killing time.

Playwright Dion Boucicault once stated that “Men talk of killing time, while time quietly kills them.”

I was just browsing the “Self-Help” section – you know, where they put all those “coming of age” books and so and so’s journey back from whatever hell the author was in. That’s when she approached me and asked if I would help her find a book. Suddenly I had just one purpose in life.

We use many expressions that treat time, an abstract concept, as if it were a solid thing – make time, waste time, use time, pass time, spend time, save time, and so on.To the ancient Greeks time was anthropomorphized: “Father Time.” What would “killing time” have meant to them?

I don’t remember what book it was or even the category or type of book she was looking for. I remember her long sandy hair partly covering her left eye and her off-white sweater unbuttoned at the sleeves. There was a piece of grey lint on her left shoulder that I found hard to resist picking off. She wore a small silver cross around her neck and a Mickey Mouse watch which read 11:24.

There are many expressions commonly used about time: “Good taste is timeless,” “Time heals all wounds,” “There’s no time like the present,” for example.

I frantically drudged from my cognitive recesses what little I remembered about the Dewey Decimal System and managed to find the book for her.

She was wearing sandals and faded jeans torn at the knees before they became fashionable, down to mid-ankle, frayed at the ends. Her smile revealed braces on her top row of teeth. Not the bottom.

I gave her the book and she thanked me profusely. She was smiling with just the slightest tilt that we do when we are searching or curious or just wondering something. Maybe not. I averted my glance way too quickly.

Henry David Thoreau said: “As if you could kill time without injuring eternity.” 

I wanted to ask for her phone number, or if she wanted to have a Coke or something with me, or maybe just take a walk. I could even show her where I play softball every week!

But I didn’t.

The entire interaction took less than twenty minutes. I think of it often. It happened over thirty years ago.


Copyright June 2016 Dr. Bill