Beyond Blue: Surviving Depression and Anxiety and Making the Most of Bad Genes

It is safe to say that few authors of mental health–related books would introduce themselves by presenting these credentials:

Hi. I’m Therese. I’m a manic-depressive, an alcoholic, and an adult child of an alcoholic; a codependent, a boundaries violator, and a stage-four people pleaser . . . a sugar addict, a caffeine junkie, a reformed binge smoker, and an exercise fanatic; a hormonally imbalanced female, a PMS-prone time bomb . . . and, of course, I’m Catholic. Which could possibly explain some of the above.

There is more than enough in this self-description to offend at least a half-dozen constituencies, and the book may miff readers who seek politically correct bromides concerning mental illness. On the other hand, readers who suffer from severe mood disorders-or whose friends, family, or loved ones do-will find consolation, wisdom, and empathy in Therese Borchard’s provocative new book. Borchard, who writes the popular blog “Beyond Blue” (www.beliefnet.com/beyondblue), is well aware of her own departures from the “party line” sometimes taken by various advocacy groups. Thus, she writes: “I . . . hated labels. In calling myself a manic-depressive, would I trap my psyche in sick mode? By accepting my diagnosis of bipolar disorder, would I prevent healing?”

But, with her characteristic independent streak and her acerbic humor, Borchard answers her own questions:

My labels have freed me to live in better harmony with the person I wish to be. And besides, “wounded” people are so much more fun to hang out with than “flawless” folks who deny their illnesses . . . we wounded know how to laugh. And what freedom and humility and community there is in that laughter.

And so, with in-your-face chapter headings such as “Confessions of a Holy Whackjob” and “Booze: The Quiet Car in My Very Loud Brain,” Borchard takes the reader on a guided tour of her own mental illness, from massive breakdown to gradual recovery-and, ultimately, to a kind of shaky but serene wisdom. Many of the chapters expand on, and give context to, Borchard’s blogs (disclosure: I was interviewed once for Borchard’s Web site, and we have corresponded on issues related to bipolar disorder).

The book is divided into 2 sections. The first is essentially a memoir, describing Borchard’s early-onset depression and the multiple diagnoses she received. The second section provides the reader with “a tour inside my brain and . . . some of the demons that live there rent-free,” as well as some techniques she has used to “evict” these demons. For example, in the chapter “When the World Overwhelms You,” Borchard describes 7 techniques that allow her to calm down and regain some emotional control. She does not proffer these as general prescriptions. Nevertheless, many readers will learn from them, as when the author describes how breathing exercises and listening to music have helped her.

Although this book will be of great interest to those with serious mood disturbances, there is much here that will benefit psychiatrists, psychologists, and other professionals. Conscientious psychiatrists will no doubt be appalled to learn that at one point in Borchard’s harrowing journey, a psychiatrist had prescribed the following regimen to treat the author’s bipolar mood disorder: 4 mg of lorazepam, 10 mg of diazepam, 300 mg of oxcarbazepine, 60 mg of duloxetine, 20 mg of citalopram, and 200 mg of lamotrigine!

Borchard accurately remarks, “My insides were toxic,” and resolves, “No more.” Fortunately, after many false starts, she receives competent psychiatric care and eventually achieves a rough-edged emotional stability.

The difficult and sometimes disturbing journey described in Beyond Blue may not be an easy read for some who live with serious mood disorders. And yet, this book is both helpful and ultimately hopeful. With dignity and rueful humor, Borchard shows us that through active engagement in one’s own care and recovery, a productive and creative life is possible-even beneath the shadow of a devastating illness.