Status Update

February 8, 2015 – Dear friends, dear StayOnTop followers:

First of all, let me thank those of you who contacted me with their best wishes (and questions, and all kinds of advice) about my health situation. As you know, I don’t like writing too much about myself. But after months of silence, I feel you’re entitled to some kind of status update.

    Well, in short: I am recovering very slowly, somewhat, but not yet out of the pit. I still do sleep much more than I should and I walk much less than I should; I still frequently feel paralyzed by somberness. The most important thing that seems to be returning right now is a glimmer of hope.

Winter View

Just now, from my desk chair, I took this picture of the view out of my window. Maybe it can serve to illustrate the situation.

My mental landscape is still left barren by the winter cold. Spring is not yet in sight. However… slowly I’m beginning to recognize that in due time spring may return, and that these dry withered shrubs will be green and blooming again. And even more important, slowly I’m beginning to recognize that I actually want to see that happen again.

Lessons Learned?

In the past horrible months I’ve learned at least two things. Or learned… let’s say I was reminded of them.

Psychiatry is still in the Middle Ages

One: we still understand far too little of the complex processes that make up our brain, feelings, and personality. Psychiatry, with all its testing procedures and patented medication, may pose as an advanced branch of modern medical science but in fact it’s still shockingly primitive. When in the past months my psychiatrist had to find some adequate medication to help me, in fact her only option was by trial and error. Just like in the Middle Ages, when doctors had no choice but to fight the Black Death by trial and error.

    Once again I was close to killing myself: so it was obvious that I did need some heavy medication. But what? The first pills she prescribed gave me physical side effects so intolerable that after a month we decided to switch. I will spare you the details. We tried a second option. These pills not only gave me severe headaches: they also made me so dizzy that right when I needed to drive for the first time again (having not driven for the first ten days) I crashed into a parked car. After six more weeks of headache and dizziness I gave up on this medication, too.

    So now, since a week, I’m on my third medication try. A very recent, state-of-the-art antidepressant: the pharmacy people did not even have it in stock yet – they had never seen it before. These pills promise to come with less severe side effects. Miracle pills? I certainly hope so. Will they help me do the trick of curing myself? We’ll see. Maybe time is just as important here as medication.

Patience must be Carefully Dosed

Which brings me to the second thing I learned in the past months: the importance of patience. More specifically the patience of people around you. For when you’re deeply depressed, you are too indifferent, numb and passive to feel much patience or impatience yourself.

    The people who come to visit and help you will sometimes turn out to be far too impatient or far too patient with you. Too much impatience is not a good thing, as it will have an irritating or even demotivating effect. Too much patience is not a good thing either, as it won’t help you in any way to make a few little steps forward.

    So just like with medication, the all-important thing with other people’s patience and impatience is they should find the exact dosage that fits the momentary depth of your depression. This is not easy. Maybe later I’ll post some more thoughts about this.

    For now, please let me ask you for a little more patience. At least by now I do really want to come back blogging again, even though I will not yet be fully back this week or the next.

See You

Thanks for your understanding. Here is a song to listen to: Broken, by Tift Merritt, from her 2008 album Another Country. If you like it and want to explore more of her songs, here is a link to the official Tift Merritt website.

Tift Merritt – Broken

Away For A While

November 20, 2014

Dear followers & readers:

At the moment a bad physical illness, severe depression, and some other problems combined are keeping me from properly maintaining my blogs. I will be away… and silent… for at least several more weeks. I hope that when better times come along, I will meet you here once again.

We never give up, right?

In the meantime, don’t forget that many of my posts from the past few years are still very valid and really worth reading. Go to the Contents (top bar) and give them a try!

My absence also means that probably I won’t be able to daily check your comments before letting them appear. I cannot simply let all comments pass (not even with an automatic filter in place) because this would drown us in a flood of spam.

The consequence is that if in the next weeks you post a comment, it may take a very long time before your comment actually will appear here. Sorry!

(your StayonTop and
HistoryofMentalHealth blogger)

Brave New Flower


Yesterday, my daily anti-depression walk took me through a meadow where I saw a small dandelion. So what’s the deal?

    Well, this field had just been visited by the Grim Reaper Mower and its friends. First the grumbling monster that razed the waving knee-high grass and left it out to dry. Then the sucking, whining monster that dropped a row of neat big bales. And finally the truck that lifted the bales and took them away.

They had left a barren field. Grass had just begun to make a new start:

The Meadow

Traversing this field, I came across one single tiny dot of bright yellow.

One Spot of Yellow

It really was the only one in the entire field. A closeup:

A Brave New Flower

Tiny Splashes of Color

So you are depressed? Then here is the inevitable metaphor, the one you saw coming.

    The barren field is your mind, your life. Your once lushly-waving flowery colorful existence, that now sadly has been razed flat by the Grim Monster of Depression. Ugh.

    But somewhere in that dull monotonous plain of your depression you may find a tiny hesitant spot of color.

    My little flower symbolizes any little moment, however briefly, when you manage to forget how ravaged you are by your depression. Those few seconds when you’re not fretting about yourself: when your feelings of utter hopelessness are pushed to the side, if only for one fleeting instance.

    The little lone flower stands for any of those rare moments when, through the gray self-centered haze of your depression, something from the outside comes through strong enough to be noticed.

    This can be anything. Some really stupid joke on TV that makes you smile for one brief moment, even when you didn’t feel like smiling all day. Or it could be a bite of hot chili pepper from the pizza that you sat munching so thoughtlessly that you didn’t taste anything before.

Pizza Peppers

The dot of color might even come from a sudden little flash of actual feeling – even if it’s deep sadness – that comes piercing through the numb blanket of depression, bringing some unexpected tears to your eyes. Or else it could be simply when for one moment the task of scrubbing a blackened saucepan claims your full attention, leaving no room for other thoughts. Or

    However depressed you are, I’m sure you can fill in something here for yourself.


The secret here is concentration. You don’t need to wait for that single rare moment when you encounter such a tiny lost flower in the barren field of your depressed day. You can go looking for such experiences. And this you do by trying to concentrate, by consciously focusing not on yourself but on where you are and what you are doing.

    If necessary, set an hourly alarm on your phone as a reminder to keep trying this: to fully concentrate for a moment on whatever you see, hear, smell and touch right now. Right where you happen to be.

    And when you do this, chances are you will encounter a few more little “flower moments”. For concentration will bring rewards.

    When I spotted that single small yellow dandelion in the razed meadow, it made me a little more aware of my direct surroundings. Was there more to be seen? While walking on I kept looking around more carefully, more concentrated. And sure enough I came across another cluster of modest flowering right at my feet:

More Brave Little Ones

Concentration is like a pocket knife that can pierce small peepholes through the all-covering blanket of depression. It can bring you back brief moments of color and taste and feeling. The surprise of such moments can be like a reward. And the more you concentrate, the more often you encounter such flowers of mindfulness, the more they will spread.

    And anyway, such moments should also be seen as glimmers of hope. Like this one little dandelion proved stronger than the big grumbling monster that had razed everything.

Sorry (Just In Case)

I think my optimism is well-founded. Concentration efforts can really do a lot for us all.

    But if my optimism here offends you in the depths of your own depression, if it comes across like I’m not taking your plight seriously enough, then I am sorry for that. I do understand that when we are very depressed, any kind of optimistic advice can look just futile and stupid. So if all this only makes you more depressed, I’m truly sorry for that.

    Just remember I’ve been locked in the very same pit where you may be now. It was concentration on little things that gave me back a foothold, that helped me climb out. Even though I keep falling back from time to time, all the way into depression again.

    Sometimes, if you try, the mere effort of trying is enough to be helpful – regardless where it will get you.

 tip: I cannot say this often enough. Please try to concentrate. Concentrate. Concentrate. Concentrate: concentrate on anything that’s not yourself.

New WHO Suicide Report


The World Health Organization (WHO) just published an extensive report about suicide and suicide prevention, worldwide. With many statistics and graphs, this 2014 publication is based on what we know about the year 2012. It also gives recommendations, and tries to correct some common misconceptions about suicide.

Core Data

In 2012 about 804,000 people killed themselves, meaning one suicide death every 40 seconds. This exceeded the number of deaths due to homicide and war combined.

    Globally, in the 15-29 years age group suicide was the 2nd second leading cause of death; in the 30-49 years age group it was the 5th leading cause of death. Among men, the number of effective suicides was almost twice as high as among women.

    It is estimated that in 2012 for every effective suicide, there were over 20 suicide attempts. This would mean that in 2012, there may have been over 15 million suicide attempts.

Probably Even More…

It is important to take into account that the real number of suicides for 2012 may have been even higher than reported, because the numbers above are based on aggregating just official data. To quote the WHO:

    Since suicide is a sensitive issue, and even illegal in some countries, it is very likely that it is under-reported.
    In countries with good vital registration data, suicide may often be misclassified as an accident or another cause of death. Registering a suicide is a complicated procedure involving several different authorities, often including law enforcement.
    And in countries without reliable registration of deaths, suicides simply die uncounted.”


2014 WHO Suicide ReportPeople can kill themselves for many different reasons, and the WHO report also indicates some cultural differences. In Europe and North America we see relatively more “depression” suicides, while Asia has relatively a little more “impulse” suicides.

    But obviously, in general, depression remains one of the main suicide risk factors everywhere.

    I would certainly like to know how many of those 804,000 suicides were directly caused by depression – but understandably there is no place in the world where with every suicide, authorities will also systematically register the motive or background.

    Let’s just leave it at this: these 804,000 suicides stand for 804,000 individual tragedies. Just think about this for a moment. Try to imagine just one or two of them. And we can be sure that with better mental health care (both on individual and on national levels) many of these tragedies might have been prevented.


Since yesterday many news sources have superficially covered the release of this new WHO report. I found it a little strange to see none mentioning that we all can simply download the entire report.

    I would certainly recommend reading it. The full 92-page version is available in Arabic, English, French, Japanese and Russian. For Chinese and Spanish, there is a summarized version could an organization like the WHO really not afford a few more translators? Anyway, here is a link to the WHO downloads page for all editions.

    And here is a direct link that will download the full report in English: Preventing suicide: A global imperative (PDF file).

Suicide Prevention Day

In cooperation with WHO, the International Association for Suicide Prevention (IASP) every year organizes a World Suicide Prevention Day. Next week it’s for the 11th time: September 10, 2014.

    This World Suicide Prevention Day comprises a very wide array of activities, both online events and varied real-life events. It’s meant for everyone who feels involved with the theme of suicide prevention in whatever way. This includes, for example, those of us who lost a family member through suicide.

    Link: IASP – World Suicide Prevention Day – 10 September, 2014. After September 10 the site will still remain worth a visit because of its many resources.

World Suicide Prevention Day 2014

Just one gripe here: this also happens to be one of the ugliest sites I’ve seen lately. Somehow, they managed to make it look exactly like a 1998 Geocities amateur website. Was that really necessary? The world is full of mysteries.


To conclude this post, for my own fuzzy reasons I’d like you to listen to the indie group Bright Eyes (from Omaha): the song We Are Nowhere and It’s Now, from their 2005 album I’m Wide Awake, It’s Morning.

    They sing here about someone who is feeling really lost, but who in the end gets a good luck charm.

    It’s not clear to me which Bright Eyes website is the main one. So here are three links: their page at Saddle Creek; their page at UMusic; and the official site of Conor Oberst, the singer-guitarist (left in the photo) who is the driving force behind Bright Eyes.

Bright Eyes

Bright Eyes – We Are Nowhere and It’s Now

In Memoriam: Robin Williams

Yesterday we heard about the suicide of actor Robin Williams. One more wonderful person who lost a long battle with depression.

Robin Williams

I was a fan of him, ever since I saw him for the first time way back in 1982 in The World According to Garp. And even in his most comical, manic roles you always could feel there was more behind the surface. A human being. One of us. That’s why even his funniest jokes sometimes had a touching undertone, too.

    Maybe it’s weird, but for myself I also feel somewhat unsettled by the fact that Williams and I were the very same age (63). Couple this to the fact that I think I can understand his decision, and perhaps you see why it makes me feel a little shaky.

    For the rest – the past day there has already been written so much about his life, his work, and his death that I have little to add here.

Depression Publicity

    There is something else, though. A celebrity suicide like this one brings depression back into the focus of public attention. Briefly – before the focus shifts to other news again.

    In reaction to the news coverage of Williams’ death, fellow depression patient Molly Pohlig wrote a few sensible words about this kind of publicity. It’s a very short post in Slate that you may want to read:

When the Illness You Live With Becomes Breaking News

A Ballad

As I have little left to say here myself, I’d like to say goodbye to Robin Williams with some speechless music.

    Here is Ballad of a Lonesome Maestro, an almost kaddish-like piece of melancholy played by Joscho Stephan and Helmut Eisel on their 2012 one-off-together album Gypsy Meets The Klezmer:

Joscho Stephan & Helmut Eisel Quartett – Ballad of a Lonesome Maestro

Are You a Genius?


First, a brief update because I’ve been silent here for the last six weeks. I’ve been, and still am, so thoroughly depressed that I’m not capable of writing any of my usual brilliant stuff. Sorry.

    My psychiatrist is going to put me on heavier antidepressants and if all goes well, the new pills should begin to have effect a few weeks from now. I intend to be back here as soon as I’m a little better again. Thanks for your patience, once again.

Reading Tip

Instead of trying to write something myself now, I’d like to give you a link to an interesting article that was published a few days ago in The Atlantic. It’s a long but pleasant read, written by a true professional, University of Iowa neuroscientist and psychiatrist Nancy Coover Andreasen: Secrets of the Creative Brain.

    Her article is based (among other things) on personal analysis of well-known creative personalities from the realm of arts and science. She asks herself where true creativity comes from, whether it is true that there is a relation between creative genius and mental illness (brief answer: yes, statistics do indeed suggest this is the case) and why such a relation exists.

    This really is intriguing reading stuff, not just because it is refreshingly factual but also because every once in a while, you may be tempted to draw some personal parallels. For example, when Andreasen referred to the relatively very high frequency of mood disorders among poets, I suddenly had to think of my own sister who killed herself in her thirties: she also wrote poetry.

    This immediately calls for an obvious warning: sadly, the simple fact that you are suffering from depression does not automatically imply that you’re a creative genius yourself. If only that were true…

    Well, I hope you’ll take the time to enjoy Andreasen’s thoughts on the links between creativity and mental illness.


For reasons I’d rather not explain, I am not going to offer you a depression-related song as background music today.

    Is it possible to be conventional and creative at the same time? And can we stick to ancient almost-rigid formulas, while at the same time kindling a few emotions?

    As an answer, here is the famous Portuguese fado singer Amália Rodrigues (1920-1999) with her classic beach love song Barco Negro (“Black Boat”). With my best wishes to you all: take care.

Amalia Rodrigues 
Amália Rodrigues – Barco Negro

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