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Thursday, December 13, 2012

3 Ways the Fiscal Cliff May Impact Taxes

3 Ways Fiscal Cliff May Impact Taxes

USAA magazine Dec. 2012

As 2012 draws to a close, Americans watch and wait as a major showdown unfolds in the nation's capital. The stakes are high: If the federal government can't hammer out an agreement by year's end, expiring provisions of the tax code threaten to raise taxes on millions of families at every income level.

To help you anticipate the possible outcome of the "fiscal cliff" -- and how the markets may respond -- USAA experts offer their perspectives on how this legislative negotiation could affect the nation's tax code. While failure to reach agreement by Jan. 1 also will trigger automatic spending cuts, our experts here discuss how Washington's actions could impact your taxes.

Three Potential Outcomes

Dan Brouillette, senior vice president of government and industry relations at USAA, sees three ways the debate could play out during the coming weeks.

1. Most likely: A bridge of compromise

While there's a growing appetite for tax reform, Brouillette believes there simply isn't time for legislators to hammer out a major new agreement before Dec. 31. Democrats and Republicans may agree in principle to forge a wider deal later in 2013 and take the first steps toward it by:

  • Maintaining current income tax rates for all taxpayers, regardless of how much they earn.
  • Collecting more taxes from people at the higher end of the income scale by limiting their deductions and increasing the taxes they pay on investment gains and dividends.
  • Extending many other expiring tax provisions, including those that protect millions of taxpayers from the alternative minimum tax.

"Politically, this allows both parties to claim victory. Democrats will have raised revenue from top earners, while Republicans will have avoided increases in income tax rates," Brouillette says.

This is what investors also are expecting. "At this point, the markets are clearly pricing a compromise that leans toward higher taxes on those at the upper end of the income scale," says Matt Freund, senior vice president of investment portfolio management at USAA. Since it's already reflected in current stock and bond prices, Freund says, this potential outcome isn't likely to prompt a big swing in the markets.

2. Less likely: Full expiration -- but only temporarily

If both parties remain deadlocked on New Year's Eve, Americans will wake the next day to find themselves subject to higher income, investment, payroll and estate taxes.

"If this happens, I'd expect stock and corporate bond prices to fall, as investors anticipate the impact of an additional $500 billion of money being diverted from the economy and into Washington," Freund says. "On the other hand, Treasury bond prices might climb, since the additional federal revenue would put a big dent in the country's trillion-dollar deficits and raise confidence that Uncle Sam will keep making interest payments."

If the tax provisions expire, it probably won't be long until many of them return, Brouillette says. He anticipates Congress would take quick action to turn back the clock and restore 2012 tax rates, except for Americans at the highest income levels.

3. Least likely: The punt

Congress may once again choose to forgo making big tax decisions and simply pass an extension of the existing tax structure that lasts six months or even a year or two. Brouillette and Freund agree that while this outcome may be the least likely, it could be the most harmful to the nation's economy.

"An extension of the status quo might spark a rally in stocks and corporate bonds," Freund says, "but a failure to address the nation's growing $16 trillion-dollar debt could be bad for Treasury bonds in the short run and bad for our economy's fundamentals over the longer haul."

Officers and chapter leaders:

I feel this description and explanation is straight forward. If this is helpful to you, please pass it on to your members.

Thank you.


Steve Brannon, D.Div.
State Director
DBSA Tennessee

Wednesday, December 12, 2012

DBSA Jackson - I recently contributed to an article: Holiday depression The Jackson Sun, Steve

Below is the link to the Jackson Sun news article.

Action required: 54 hospitals will close in Tenness without Medicaid expansion

Larry Drain, Legislative Liaision for DBSA Tennessee, provides us the results of his research into the need to expand TennCare.

Thank you, Larry

54 Hospitals will close in Tennessee without Medicaid (TennCare) expansion

by hopeworkscommunity

The following is from the Tennessee Justice Center:

Medicaid Reform is a Lifeline for Tennessee's Hospitals

The Supreme Court ruled in June that the new health reform law permits, rather than requires, states

to reform their Medicaid programs to cover people with incomes up to 138 percent of the federal

poverty line. Now, Tennessee must choose whether to expand Medicaid.

If Tennessee does not

expand Medicaid, it could cause many hospitals to close.

That's because some hospitals now

receive disproportionate share hospital (DSH) payments for providing care to people without

insurance. When the health law was passed, hospitals agreed to accept cuts in DSH, as well as other

Medicare and Medicaid payment reductions. In a world where almost everybody had insurance, as

envisioned by the law, hospitals could afford to take those cuts. Without the expansion, hospitals

will still be stuck providing care to lots of uninsured patients, but they will have to do it on tighter

budgets. Many hospitals, especially in rural areas, will not be able to survive if Tennessee does not

expand its Medicaid program.

There are 121 general medical and surgical hospitals in Tennessee. Of these,

54 are at risk of


because they have, on average, lost money over the past three years or have only had

positive revenues due to DSH payments. These at-risk hospitals directly employ over 21,000

Tennesseans, and indirectly sustain tens of thousands more jobs. If these hospitals close because the

State does not expand its Medicaid program, it would leave

30 Tennessee counties without a


and would have a devastating effect on Tennessee's economy.1 Below is a list of the

hospitals at risk of closing if Tennessee does not expand its Medicaid program.

County Hospital Employees

Anderson* Methodist Medical Center of Oak Ridge 925

Bedford* Heritage Medical Center 234

Bledsoe* Erlanger Bledsoe 71

Bradley* Skyridge Medical Center 766

Bradley* Skyridge Medical Center - West 71

Campbell Jellico Community Hospital 225

Carroll* Baptist Memorial - Huntingdon 157

Carroll* McKenzie Regional Hospital 121

Cheatham Centennial Medical Center at Ashland City 48

Claiborne* Claiborne County Hospital 329

Clay* Cumberland River Hospital 213

Cocke* Baptist Hospital 203

Cumberland* Cumberland Medical Center 892

Davidson Metro Nashville General Hospital 649

Davidson Skyline Medical Center Madison Campus 203

Davidson Southern Hills Medical Center 352

Dickson* Horizon Medical Center 413

Fayette* Methodist Healthcare - Fayette 74

Fentress* Jamestown Regional 145

Gibson Gibson General Hospital 69

Gibson Humboldt General 81

Giles* Hillside Hospital 219

Greene* Laughlin Memorial Hospital 590

*Counties that would be left without a hospital if the identified hospital(s) close.


Annual financial and employment data on Tennessee hospitals is derived from the Tennessee Joint Annual Reports on


available at


Greene* Takoma Regional 427

Hamblen* Lakeway Regional Hospital 239

Hamblen* Morristown Hamblen Healthcare 647

Hamilton Erlanger East 180

Hamilton Erlanger Medical Center 3280

Hamilton Erlanger North 73

Hancock* Wellmont Hancock County 37

Haywood* Haywood Park Community Hospital 92

Henderson* Henderson County Community Hospital 103

Henry* Henry County Medical Center 515

Hickman* Hickman Community Hospital 110

Humphreys* Three Rivers Hospital 75

Johnson* Johnson County Community Hospital 61

Knox Mercy Medical Center West 345

Loudon* Ft. Loudon Medical Center 194

Macon* Macon County General Hospital 119

Marion* Grandview Medical Center 237

Marshall* Marshall Medical Center 127

McMinn Woods Memorial 289

Roane* Roane Medical Center 298

Sevier* LeConte Medical Center 432

Shelby Baptist Memorial - Collierville 323

Shelby Delta Medical Center 448

Shelby Methodist Hospital - North 1065

Shelby Methodist Hospital - South 728

Shelby Methodist University Healthcare 2332

Smith* Riverview Regional –North 144

Smith* Riverview Regional –South 25

Sumner Sumner Regional Medical Center 711

Unicoi* Unicoi County Memorial Hospital 166

Washington Franklin Woods Community Hospital 388

Friday, December 7, 2012

An excellent poem by William Robertson

A Letter between two travellers (a letter from someone who suffers with depression to one with bi-polar illness.)

From this short and shallow valley ,I write
wondering where you are on this starry night.
On the mountian high,as if to fly?
or in the valley low, is what I need to know.

If I walk on that level plain,
and see you about to take flight again,
I would grab your heels, running as fast as I can,
and if I couldn't hold on, I'd fall in the sand.

And from there I would watch you soar to the sun,
but I know for you what's next is no fun,
into the depths of the valley you will fall,
where there seems to be no help at all.

But in this place I also have been,
and been in parts that can't be seen,
and in those I will look around,
in hope that there you will be found.

For when you soar and burn your wing,
and feel the way the rocks of the valley sting,
when the dwellers of the plain look down,
you know I'll be around.

But if I'm trapped in this crevice you can't see,
please come down and rescue me,
I would do the same for you,
and I know you'd do it to.

For one day we'll walk on another plain,
on a clean clear path, free of pain.
I hope to greet you there,
because I know you care.

A Letter between two travellers (a letter from someone who suffers with depression to one with bi-polar illness.)

From this short and shallow valley ,I write
wondering where you are on this starry night.
On the mountian high,as if to fly?
or in the valley low, is what I need to know.

If I walk on that level plain,
and see you about to take flight again,
I would grab your heels, running as fast as I can,
and if I couldn't hold on, I'd fall in the sand.

And from there I would watch you soar to the sun,
but I know for you what's next is no fun,
into the depths of the valley you will fall,
where there seems to be no help at all.

But in this place I also have been,
and been in parts that can't be seen,
and in those I will look around,
in hope that there you will be found.

For when you soar and burn your wing,
and feel the way the rocks of the valley sting,
when the dwellers of the plain look down,
you know I'll be around.

But if I'm trapped in this crevice you can't see,
please come down and rescue me,
I would do the same for you,
and I know you'd do it to.

For one day we'll walk on another plain,
on a clean clear path, free of pain.
I hope to greet you there,
because I know you care.

Thursday, November 15, 2012

A Message from Brad Palmertree and the Tennessee Health Care Campaign

We knowwhat you're thinking. The biggest winner on Tuesday? Health reform.
As you well know, the presidential election was a cloud hanging over the
future of the Affordable Care Act, sometimes better known as "Obamacare."
The election results settle key issues about the direction that healthcare
will take in our nation. With no more hurdles before it, states now have
the responsibility to implement the law swiftly and effectively.

So what happens now?

Insurance Exchanges

Exchanges are online marketplaces in which individuals and small
businesses will purchase private insurance and take advantage of subsidies
to help pay premiums. States should set up their own, but they can opt out
and allow the federal government to do it for them. Tennessee has not made
a decision.However, they must make a decision by November 16th. The
governor favors a state exchange, but he's facing some push-back from
colleagues in the General Assembly.

Medicaid (TennCare) Expansion

As you probably know, the Supreme Court ruled in June that states have the
option to expand their Medicaid program. Again, Tennessee has not made a
decision.This decision point could take a while because it needs to go
through our state legislature's budget process (even though the Feds pay
100% of the expansion for the first 3 years & it slowly goes down to a
permanent 90%). Many legislators have come out strongly against the
expansion, and in fact legislation has already been introduced to prevent

Is that it?

We wish. At the federal level, there's a manufactured "fiscal cliff" that
some economists say will send us into another recession. If Congress
doesn't act by the end of the year, across-the-board spending cuts & tax
hikes will take effect. Here's a really good, detailed explanation of what
it means and what kind of budget cuts & tax hikes are included.

What does that mean for our work?

Medicaid is incredibly vulnerable. Even the President has put Medicaid on
the table when compromising for budget cuts. We must protect this
important safety net for our most vulnerable neighbors.

Additionally, the Affordable Care Act could take some hits around the
Prevention & Public Health Fund as well as the tax credits that will allow
individuals to afford private insurance in 2014. We'll need to watch these
conversations carefully to ensure we're not sacrificing these important

What can I do?

SO GLAD YOU ASKED! Here are a few simple steps for you to take.

Call Gov. Haslam:
615-741-2001 or email him: Let him
know you support a state exchange AND the expansion of TennCare. Here are
some talking points.

Call your state legislators & give them a call or email. Tell them to
support Governor Haslam in his idea of a state-based exchange. Be sure to
mention that you don't like them leaving federal money on the floor to pay
for an expansion of TennCare. Scroll down on this page for some great fact
sheets on the benefits of TennCare expansion.

Share the word! Email, Facebook, & Twitter - use it all! Just use those
little buttons in the upper-right corner of this message.

Support our work! You depend on us and we depend on you. This work can't
happen without you. An investment in THCC means that your voice continues
to be heard throughout the process of meaningful health reform
implementation here in Tennessee.

This is your official election roundup! Keep reading to see what this
week's election results mean for health care in Tennessee.

Get caught up on your ACA education here.

Let's be friends! Stay in touch with THCC on Facebook & Twitter. We'll
keep it interesting...promise.

THCC is a proud member of Community Shares.

Now that we can move forward with confidence, our work has never been more
important. We can't do it without you.
Are you looking for ways to give back to your community? Do you have
experience in web design? Or policy analysis? We're looking for a few good
volunteers. Contact us and let's become best friends!

1103 Chapel Ave. | Nashville, TN 37206 US

Thursday, November 8, 2012

There is more to us and our experiences than we often acknowledge . . .

My dear friend in the UK shares poem that was recently published. I invited her to share as often as she will on our blog! Autumn and her hubby live in England these days,writing and publishing.

Once you've travelled through the forest
for what seems like eternity

becoming shaped by its hollows and bogs
accustomed to shadow and the fold of branches;

when you've met silence in the contours of rivers
and in the waters of countless glowing lakes;

when you've charted the tracks, the traces left
of those who inhabit and pass in the vastness

sensing them in the winds alongside you
and there, just beyond the aureole of the fire's light;

when you've aligned yourself with these –
remembering at last the ten-thousand things –

the ribs of the forest will open.
Autumn Grieve

Saturday, November 3, 2012


      WE are all deserving of fair and equal treatment.  Let me know if you need further information about the the content of my blog entry . . .

GIRLATWINDOW**The Temple University Collaborative on Community Inclusion has been in contact with a reporter who is seeking out current and former college students with mental illnesses who are willing to share their experiences with her. The reporter is specifically interested in students who have been coerced into leaving their academic institutions. She will ask you about: your mental health history; how the university came to know about it; and why they either encouraged or forced you to leave college. She will also ask you to discuss what happened afterward, whether or not you ignored the college's advice to leave, and - if you did leave, how difficult it was to return to school? If you are interested in sharing your experiences please contact Kimberly Leonard her at email address: The story will likely be published in The Atlantic and Kaiser Health News.

Friday, October 19, 2012

Link to JX Sun article on Oct. 8th presentation on ACA

I invited a speaker to Jackson to present on the Patient Protection and Affordable Care Act on October 8th.  It was an informational presentation held for the community.

Don't Let Depression Keep You Down and Out

The following is an excerpt from an article in the Summer 2012 edition of Esperanza magazine. I found it a very positive message for those of us given to depressive episodes. I believe you will enjoy it!

Depression corrodes your self-confidence. Low self-esteem worsens depression. Two good reasons to learn how to build yourself back up.

by Jodi Helmer

Shari M. believed that happiness would come when she reached a certain rung on the corporate ladder. To get there, she logged 70 hours per week as an IT project manager in Minnesota, often forgoing sleep to meet deadlines.

She wasn't just logging overtime at work: She had a newborn son and household responsibilities. She had a lot of support from her husband, she cut back on seeing friends, she gave up her hobbies, but Shari still didn't have time for everything on her overwhelming to-do list.

"I had so many goals and dreams, and I started feeling sorry for myself because I wasn't reaching them," recalls the 44-year-old. "I felt like I wasn't worth as much because I couldn't get it all done."

Exhausted, emotionally fragile, and plagued with headaches and back pain, Shari was diagnosed with depression in 2007. She was prescribed antidepressants and also went to counseling, where she realigned her priorities.

She left her six-figure job in the tech sector to start a new business. She was feeling better and having fun with her start-up. Then her business failed and her self-esteem plunged.

"I was used to things going well and being very successful in life," recalls Shari, whose depressive symptoms resurged. "When the business failed, I felt like a failure."

Self-worth and depression have a symbiotic connection. Kevin Solomons, MD, a clinical associate professor of psychiatry at the University of British Columbia, sees "self-esteem failure" as a key component of the illness.

"If you think of yourself as worthless and hopeless, the emotion that corresponds is unhappiness and misery," explains Solomons, who studies the psychological effects of low self-worth.

Meanwhile, the inability to achieve what you'd like, perform as you used to, or even complete everyday tasks because of depression can lead to or strengthen feelings of hopelessness and worthlessness.

"Depression affects how we make decisions, respond to events and interactions, feel about successes and failures, affecting everything we do from the time we wake up until the time we go to sleep," says clinical psychologist Dennis Greenberger, PhD, co-author of Mind Over Mood: Change How You Feel by Changing the Way You Think.

Greenberger notes that feelings of worthlessness that flow from depression can in turn intensify depressive episodes. By the same token, however, the mutual influence applies to treatment as well.

"There is an interplay among mood, thinking, neurochemistry and behavior, and we know that when you change any one of these areas, the others almost always follow suit," Greenberger explains.

"So, if you change your thoughts through cognitive therapy, you're likely to see an improvement in mood and self-worth, and if you change your neurochemistry through medication, it's likely to improve your mood."

Mission critical

Science has recognized the association between depression and self-worth for quite some time. A study published in Annals of General Hospital Psychiatry in February 2003 noted a "vicious cycle" between low self-esteem and the onset of psychiatric disorders, including depression. The University of Alberta researchers reported that patients with major depressive disorder expressed the lowest levels of self-esteem.

Low self-esteem also increased vulnerability to major depression and adversely affected its prognosis, they found.

For Chuck Bennett (not his real name), no amount of achievement was enough to make him feel good about himself.  He attributed his success as a marketing director for a high-profile publishing company to the talents of his staff, never taking credit for his own hard work.

Convinced of his own inferiority, he felt like a fraud.

"I was seen as ambitious, heading up projects, but I felt like I didn't deserve the position I had. I felt worthless," he says. "I'd push, push, push, thinking if I could just accomplish this one thing, it would get better."

Initially diagnosed with depression in his 20s, Bennett went into denial mode. Embarrassed to have a psychiatric illness, he didn't pursue treatment. Instead, he poured himself into his work, spending as many hours as possible at his downtown Chicago office.

"I became a workaholic and when I started feeling depressed, I would either work harder or party harder, anything to keep me busy and take the focus off of how badly I felt," recalls Bennett, 49. "I became a robot, living on autopilot because I didn't know how to cope with the emotions and anxiety and stress."

Bennett finally reached a point where the self-critical feelings, forgetfulness, lack of energy, and crying jags all became too much. He started therapy in 2004.

"I went from feeling like I was broken and no one could fix me to having the guts to take the steps to get better," he says.

Seeking out help may be the first step in rebuilding self-worth, says Margaret Wehrenberg, PsyD, clinical psychologist and author of The 10 Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It.

"You may have the ability to tackle a problem but you won't take action without encouragement," she says. "When you're depressed, you can't always hear your own negativity. Therapy can help generate new ways of thinking."

Bennett learned in therapy about the link between low self-esteem and depression. He practices recognizing destructive thought patterns and assessing whether there is a realistic foundation for his doom-and-gloom thinking.

He keeps a journal where he can work through upsetting experiences and track his progress. Deep breathing and mindfulness help him cope with anxiety.

Despite counseling and medication, however, Bennett's deep-seated depression persisted. He decided to take a medical leave from his high-stress job in 2011, then went on disability a few months later. Although he is grateful for the time to focus on healing, he admits that not being able to work was a further hit to his vulnerable self-image.

Learning to see depression as an illness, not a character flaw, has given him another tool to defuse his self-criticism.

"I finally realized that if I didn't accept that depression was a disease, I couldn't begin to get through it," he explains. "I have to tell myself every day, 'You have a disease, lighten up on yourself.'"

Positive power

"The idea of being worthless is a thought habit, and unless you recognize old habits, you can't change them," Solomons points out. "Cognitive behavioral therapy helps identify self-defeating thought patterns, offers a more realistic way of thinking, and lets you rehearse different ways of dealing with situations."

Shari says those principles had "a profound impact" on her recovery after her business failed, her depression rebounded, and she began to have panic attacks.

"I was relying on two depression medications to make it through the day and not just curl up in a ball in my bed," she recalls.

This time, Shari recognized that she needed to reframe her thoughts rather than rearrange her life. She turned to a business transformation coach trained in a positive self-improvement technique.

"I now understand that, 'What we think about, we bring about,'" she explains. "The more I felt sorry for myself, the sorrier my life got."

Shari began repeating affirmations and practicing mindfulness. When negative thoughts popped into her head, she told herself, "This thought doesn't serve me well. What could I think instead?"

"I became conscious of my thought patterns, reversing the negative self-talk and practicing more positive ways of responding, and it began to change my state of mind," she explains.

Solomons suggests rehearsing responses to various scenarios like an actor rehearsing a script, asking, "How would someone with high self-esteem deal with the same situation?"

"You're the author of your own views about yourself and you have the power to rewrite them," he says.

That's gospel truth for Shari, who found another job as an IT project manager and stays focused on better work-life balance. In fact, she wrote a book about time management.

"I'm on top of the world," she says. "I see that life is a choice instead of a series of circumstances happening to me."

Goal oriented

Setting and achieving goals is also essential to overcoming depression, boosting positive feelings, and rebuilding self-esteem.

"When you're depressed, you don't tend to see your accomplishments as valuable and feel no sense of power or control over your life," says Wehrenberg.  "When you can't see what your value is, you can't easily see solutions to problems."

Wehrenberg suggests picking small goals—sorting the laundry, walking around the block, writing a grocery list—and choosing a reward for accomplishing them.

"It works because the amount of energy you have when you're depressed is so limited," she explains. "People often discount the importance of taking a small step, but every time you take an action in a positive direction, you feel better."

Kendra F. was pursuing two big goals—a degree in forensic psychology and a position on Canada's national women's hockey team—when she started experiencing heart palpitations, dizziness, stomach pain, insomnia and trouble concentrating.

Instead of racing between the classroom and the rink, Kendra spent increasing amounts of time alone in her Toronto apartment.

"I had the whole world going for me and all I wanted to do was lie on the couch and not deal with anything," recalls Kendra, 32.

Kendra saw a cardiologist, a neurologist and a gastrointestinal specialist. After each exam, the doctors told Kendra she was in perfect health.

It was only after Kendra's symptoms drove her from the Team Canada tryouts in 1999 that someone from the hockey program suggested she see a psychologist. Shortly after that, Kendra was diagnosed with depression, anxiety disorders and agoraphobia.

Kendra stopped seeing friends and dropped out of school. Her sense of self-worth eroded as she began to believe she could never get her degree or succeed in the sport she loved.

"I had this entire life mapped out, I was working toward my dreams and quite successful, and then it all disappeared when I was diagnosed with depression and anxiety," Kendra says.

"I had zero faith I'd be able to get through it and I gave up. I thought if I didn't try, I couldn't fail and I hoped not failing would alleviate the depression."

Kendra says she resisted both her diagnosis and treatment for nearly five years. Finally, she says, "I got to a point where I needed to believe there was more to life. I became more actively engaged in my recovery, reset the expectations, and learned to recognize my achievements and started to build on them."

At the suggestion of her therapist, Kendra started setting small goals and allowed herself to feel successful for meeting them.

"I used to live a very extreme life where everything was win or lose and I wasn't used to feeling like I could accomplish some things but not everything," she explains.

Kendra congratulated herself for preparing healthy meals, tackling household chores and running errands—all activities she took for granted before her diagnosis. Although it seemed silly to be celebrating such small achievements, Kendra says, she did feel a sense of accomplishment for making progress.

Today, Kendra is a director of business development for a staffing company, plays inline hockey for Team Canada and regularly speaks at schools, nonprofit organizations and corporations to help reduce the stigma of mental illness.

"I wake up happy, with energy and focus, and I'm not afraid to dream," she says.

Jodi Helmer is a freelance writer based in Charlotte, North Carolina. Her work has appeared in Shape, Women's Health, Family Circle and other national magazines.

Tuesday, September 18, 2012

Coping with Depression - Set Attainable Gosls

Putting the GO in GOALS

By Sharon Anne Waldrop

An internal battery that's hard to boost is part of living with depression, but our 5-step program gives you strategies for overcoming inertia.

Ninety percent of respondents in the 2009 National Survey on Depression in Canada reported lack of motivation as a symptom of their illness. That overwhelming sense of inertia also feeds depression, making us feel useless and hopeless because we can't seem to get anything done.

Luckily, the cycle works the other way around, too. The more we can accomplish, the better we feel and the easier it is to fend off low mood.

Focusing on small goals and pushing yourself to meet them builds up the charge in that depleted battery. As hard as it is, taking action works as an antidote to depression.

The key is coming up with "meaningful, measurable, and attainable goals," says psychologist William J. Knaus, EdD, author of The Cognitive Behavioral Workbook for Depression (New Harbinger, 2006). "This puts change into focus." Here are five steps to get you started.

1. Keep it simple

The more specific the goal, the better your chances of success, says Dan Bilsker, PhD.

"If you want to go for a walk, write down that you will walk four blocks after lunch on Thursday," suggests Bilsker, adjunct professor in the Health Sciences Department at Simon Fraser University in Vancouver, British Columbia.

Tina, 58, of Winnipeg, Manitoba, who was first diagnosed with depression at age 12, breaks cleaning the bathroom into four smaller jobs: toilet, sink and mirror, tub, floor. Not only does each concrete task seem more manageable, but she ends up with four accomplishments to celebrate.

If you can check something off your to-do list, however small it seems, that success makes other things seem more doable. The particular goal you establish is less important than simply having one to work towards, Bilsker says.

"It's not even necessary that you enjoy it," he adds, "as long as it is something helpful to your recovery."

2. Be realistic

It's tempting to go over-board in your ambitions to make up for a period of sloth, warns Bilsker, but creating unreachable goals only sets you up for failure and feeling worse in the end. If you haven't been exercising, for example, don't imagine you'll start working out seven days a week.

Holland has learned to set just a few goals for herself each day.

"If I write down five but do only two, that's okay," explains Holland, who is director of education at the Mood Disorders Association of Manitoba. "But if I write down 20 and do only two, I'm setting myself up for defeat."

You'll also succeed better if you accommodate the ups and downs of your illness. After living with depression for the past decade, Anne Clarke has learned to accept that some days she moves more slowly. Knowing that keeps the 47-year-old from grinding to a complete halt.

"There is no sense pretending things are normal, and that I can be my usually energetic self, when I'm feeling that way," says Clarke, who lives in the San Francisco area.

"Instead, I … give myself permission to move more slowly, lean a little bit more, and do a little bit less."

3. Strive for five

Another way to make actions easier to contemplate is to set yourself a time limit. Knaus recommends this system: Pick an activity you've been putting off, but that you know is in your best interest to complete. When your five minutes is up, decide whether to stop for now or continue for five more minutes.

Do the same thing every five minutes until you complete the project or decide to take a break. Knowing you have the power to choose gives you a sense of control, Knaus says, which is an important step on the path to positive change.

Holland has found that approach useful when she needs to motivate herself—"I'll do something for five minutes and stop, or decide to do the task for five minutes more," she says—and the strategy keeps her from feeling overwhelmed.

4. Ditch the downers

Depressive thinking—for example, feeling that you're no good, that what happens to you is beyond your control and that nothing you do will make a difference—zaps the motivation you need to set and reach goals.

Holland has learned to run a reality check on negative thoughts to keep them under control. She admits that moving beyond such will-sapping beliefs does take some willpower.

"Own the illness. Understand it and don't use it as an excuse," she says. "Take responsibility for yourself because nobody else is going to do it."

That doesn't mean you can't benefit from a cheering section. Bilsker recommends engaging friends and family members to coach and support you. "Give them a sense of the goals you're working on and ask them to encourage you," he says.

Sometimes that encouragement can simply be helping you feel less low. Holly Rodriguez, 36, of Richmond, Virginia, has a reliable way to boost her mood enough to get moving: "I reach out to a friend whom I know will make me laugh," says Rodriguez, who was diagnosed with major depression in 1999.

5. Praisedon't punish

Berating yourself when you don't reach your goals won't help you move forward. Positive reinforcement will, so be sure to recognize each success, however small.

"Don't shame yourself, ask what's wrong with yourself, or tell yourself that you are overweight or horrible," says Bilsker.

To get out of the downward spiral of self-punishment, he advises, consider whether you would ever say something that harsh or demeaning to a friend in the same situation.

By the same token, give yourself the kind of encouragement and praise you would offer a friend who has
done something worthwhile.

Stan Tolpen of Las Vegas, 56, has a goal to walk at least a mile each day, but he's kind to himself when he doesn't make it.

"Some days I can't do it, but every day I try. I don't let it get me down when I can't do it," says Tolpen, who has lived with severe depression for 30 years.

When Tolpen feels he can't make the whole trip, he'll at least walk up to his front gate and back, then go inside and read a magazine or do something else that he enjoys as a reward for trying. He reminds himself that tomorrow will be a new day and another opportunity to complete the whole walk.

Reminding himself that there is a chance to meet his goal tomorrow is enough to keep him going, he says. His favorite mantra sums it up perfectly: "With hope one can think, one can work, one can dream. If you have hope, you have everything."

Sharon Anne Waldrop lives in rural Georgia. Her work has appeared in Good Housekeeping, Woman's Day, Health and many other national consumer magazines.

SIDEBAR: Turn off the TV

That tempting TV screen is another motivation zapper. Kathryn J. Fraser, MD, an associate professor of psychiatry at University of New Mexico School of Medicine in Albuquerque, says studies suggest that planting yourself in front of the TV can actually worsen depression.

One study of adolescents, published in the Archives of General Psychiatry in February 2009, found that the risk of developing depression as an adult rose significantly with each additional hour of television watching—a correlation that did not hold true for computer games or listening to the radio.

Fraser points to the inertia cycle as one possible factor: You sit around and watch too much television because you're depressed, but you end up feeling more depressed because all you've done is watch television.

"Besides, people aren't meant to just sit," she says.

Given the well-documented physical and mental benefits of exercise, Fraser suggests that if you are going to watch television, do it while working out on a stationary bike, treadmill, or rowing machine.


Author:Sharon Anne Waldrop,      Published in Esperanza, Fall 2012

DBSA Jackson announces a special presentation on The Patient Protection and Affordable Care Act as it impacts Tennessee

DBSA Jackson






 Brad Palmertree, Tennessee Health Care Campaign (THCC)


The Patient Protection and Affordable Care Act:  How Tennessee is Moving Ahead on the Tennessee Health Insurance Exchange and Medicaid Expansion


Monday, October 8th, 2012—6:30 pm-8:00 pm



The Supreme Court recently ruled the Patient Protection and Affordable Care Act constitutional and now the action is at the state level: who is going to be doing what and when in Tennessee?  Join Depression Bipolar Support Alliance Jackson in welcoming Brad Palmertree, Interim Executive Director for the Tennessee Health Care Campaign, as he updates us on the latest activities around the Tennessee Health Care Exchange and Medicaid (TennCare) Expansion.

Brad Palmertree was formerly the Director of Communications for Tennessee Health Care Campaign. He has tracked and researched the Patient Protection and Affordable Care Act from its inception, and uses his knowledge of the law for public education: working with policymakers, legislators, medical providers, social workers, and community leaders to help them better understand provisions of the new health care law.  He holds a Bachelor's of Social Work from Lambuth University and is the current Practicing BSW Representative for the Tennessee Chapter of the National Association of Social Workers. Prior to his work with THCC, Mr. Palmertree worked with at-risk youth in New York City and in Jackson, TN in various capacities. He now lives in Nashville in a house currently occupied by two cats, Rocky & Isabella.


Jackson-Madison County General Hospital


                                                                                        J. Walter Barnes Auditorium

                                                                                       620 Skyline Drive  - Jackson, Tennessee

                                                                            (auditorium entrance inside the main hospital entrance)


                                                                -HELP US BY PASSING THIS ANNOUNCEMENT TO OTHERS -

For additional information, contact Steve Brannon, State Director, DBSA Tennessee

Bus. 731-215-7200

Sunday, September 16, 2012

Self-awareness can help us maintain wellness

The following article was first published in the zine Esperanza, 2010.

 Fighting for self-awareness

By Bruce Clark

It may be a little theatrical to claim that being diagnosed with depression in my early 30s was my road to Damascus, but it was the instigating incident that led me to talk therapy. That therapy gave me a newfound self-awareness that has been an invaluable asset in managing my well-being.

The catalyst for depressive episodes can vary, but it's generally accepted that the stress associated with major life changes can coax the sleeping black dog from his cozy den.

My depression manifested itself after my wife and I moved to Palm Springs, California, from the prairie city of Winnipeg, Manitoba, in 1993. It seems ridiculous to think that moving from a city with the same weather patterns as Siberia to a verdant desert oasis could bring on any negative psychological indications, but the stress of leaving family and friends while venturing into uncharted career territory likely had a great deal to do with it.

I began experiencing typical symptoms; sleeplessness, fatigue, irritability. I was unable to concentrate on my work, and the things that normally gave me pleasure began to seem pointless.

I became frustrated easily and I could feel the anger I had caged up deep inside escaping from the metaphoric bars now weakened by the depression. Growing up in a working-class neighborhood where fighting and aggression were part of the landscape had equipped me with a quick temper and a potential for violence that began to flare up.

I started snapping at my wife. Then, during a recreational hockey game, I went after an opposing player who was using his stick as a weapon. I broke my hand by repeatedly punching the steel cage that protected his face. I know that fist fighting, even during a hockey game, is shameful and ridiculous for a so-called mature adult, but I was out of control. At the time, you couldn't have pulled me off the guy with a team of Clydesdales.

My anger was getting the best of me and I knew I needed help.

With the gentle encouragement of my wife, I found an excellent psychiatrist and began weekly psychotherapy sessions. The formal talk therapy forced me to take more than a passing glance at my life. In answering the doctor's seemingly simple questions about my wife, my parents, and where and how I grew up, I began to realize why I made certain choices and began to understand the mechanics of my behavior.

My doctor prescribed an antidepressant and a stimulant, a combination that gives me a feeling of well-being that had been persona non grata in my life for far too long.

The medication enabled me to get back to work and mitigated my anxieties, but it was psychotherapy that gave me much-needed insight into my own personality, warts and all.

My temper and my anger issues were learned behaviors. My father was a caring, community-oriented man who abhorred injustice and sometimes took the law into his own hands. When I was 11 or 12, a menacing neighborhood dog bit two of my friends. Incensed, my father had me lead him to the house where the dog lived. He confronted the dog's uncaring owner and threatened him physically while I stood beside him.

I was laughing as I recalled the story for my psychiatrist, who didn't crack a smile and said seriously, "You must have been very frightened."

I'd never admitted it to myself but it was, in fact, terrifying to see my father in this potentially violent situation. I defended my father's actions as honorable and said that I thought my dad was doing the right thing by protecting the neighborhood.

When my doctor told me the plot was familiar, it took me a while to understand he was referring to my hockey fight. It became clear that the opposing player hacking away at my teammates was the dog's owner and I was my father.

That realization and many other nuggets of self-discovery have empowered me. Knowing more about what drives me gives me more control over my actions, which in the past were governed by emotions instead of common sense and reason. Being in control is good for my self-esteem and, in turn, good for my psychological well-being.

Depression isn't a prerequisite for introspection, but it did lead me to the psychotherapy that has given me a greater understanding of myself. And I can honestly say, I haven't punched anyone since.

Bruce Clark, a writer and standup comedian, is lucky enough to split his time between Winnipeg, Manitoba and Palm Springs, California.

Thursday, July 12, 2012

Invitation to join Klip


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Thursday, June 28, 2012

All Inclusive?

What about consumers being totally accepted at church? Other "outside" groups of Christians found help from church leaders to become recognized, supported, and embraced inside their church.  I believe it is time that God's love, and a Christian welcome, be extended to the innocent suffers of mood disorders. Scores of them are Christians sitting next to you in the church pews . . . but still in the closet.

BP zine Coming out PB Closet

Saturday, June 23, 2012


The following article comes from the Spring Edition of BP magazine. As many of you know by now, I am working to push back against stigma in my own personal way of being well and living well. The article I share with you shows how misunderstood mental illness is in our "educated" society.  I recruit all of you to follow your wellness program, attend our meetings, and speak up and push back against stigma.   

Stigma—Talk or Walk

By Lizzie Simon

I've always thought that stigma toward people with mental illness comes from ignorance. And when I'm confronted with someone who simply doesn't know much about mental health, I can explain myself, my story, and my viewpoints and stay pretty relaxed through the conversation. After all, there's plenty of stuff I'm ignorant about, and I generally like to give people the benefit of the doubt concerning what they may or may not know about bipolar disorder.

But what happens when the person expressing stigma is extremely intelligent? For me, what to do becomes far more complex and uneasy.

Recently at a party, I was introduced to a small group of people by someone who praised my book DETOUR: My Bipolar Road Trip in 4-D. One of the women in the group asked me what it was about. I told her that it was a cross-country memoir in which I interviewed people who had been successfully treated for bipolar disorder.

"Successfully treated?" she asked, pulling me aside to talk further.

This woman was incredibly articulate and well educated, a university professor. And yet, her thesis was that mental illnesses didn't really exist—that wellness through medical treatment was a fantasy conjured up by the marketers of medicine. In her view, the ways in which people are diagnosed and treated for mental illnesses are nothing more than shoddy methods devised by health-care and pharmaceutical institutions with profit motives. These methods, she said, stripped individuals of their sense of self-reliance, their humanity, and their money.
I agreed with many of her points: you don't have to be a PhD to know that our mental health-care system is woefully flawed. And only the most naïve among us are without suspicion of "Big Pharma." But I was deeply upset by her statements that those of us who believe we have illnesses and therefore pursue wellness are cogs in a vast exploitive machine. For me, it seemed downright cruel to deny the success people with mental illness have in achieving wellness.

My reaction: I was stunned. What can you do in these situations? Do you battle it out or just walk away? Is it worth it to try and "convert" the individual, or is it better to stay focused on what you believe and be surrounded by people who support your beliefs?

I wondered how she could look me in the eye and think that I had been stripped of my own humanity and my self-reliance. I wondered how she figured that any person with mental illness could somehow get by without retaining these qualities. In fact, I told her, people who pursue wellness must continually express this self-reliance and personal advocacy. They have to constantly monitor moods and triggers; they have to navigate their way through the mental health-care system; they have to take responsibility for the ways in which their illness may have impaired their work and their relationships; they have to constantly and consistently pursue wellness. You want self-reliance? I'll show you self-reliance. I had to build my life up from total devastation at the age of 17, after I became horrifyingly ill with bipolar disorder. That's self-reliance.

But I didn't say these words. I couldn't somehow. Instead, I told this woman that I have had contact with thousands of people suffering with mental illness and with their families, that there is no question in my mind that these illnesses are real. I tried to persuade her, but she didn't budge from her rhetoric. It was almost like she had an edge on me, simply because she had only an intellectual relationship to the subject, whereas mine was personal, emotional, political, and intellectual.

I started to worry, is this what everybody at this party thinks? Is this what all of my friends really think? Looking back, I didn't stay as calm as I should have. I didn't make the points I could have. I let her get under my skin, and in doing so, I allowed her to shame me, and shame the work to which I've devoted most of my professional life. Of course, you can't operate socially with shame in the system; it's like spilling coffee into your computer (which I have also done). Everything goes blank.

In the end, I invited the woman to attend one of my lectures and to meet a few families who are struggling with mental illness. I wanted her to test her judgmental and reductive comments against actual human suffering, to expand her vitriolic attack on American health care, business, and politics and thereby acknowledge the painful reality of millions of Americans with due empathy and respect. She said she would email me—we'll see.

While considerably trying, it is meaningful to speak with people who don't agree with me. Not only is the experience a key ingredient to my personal growth, it's also an essential component of a healthy democracy. And I know that we can lessen stigma by being examples, and sources of information, in our communities. I always encourage people to share their stories. I have shared my story with tens of thousands of people through lectures and through Detour, and I have been rewarded in a million ways, a million times over, for my offering. But I'm not immune to stigma.

Once in a while, I guess, I can expect to get stung.

Lizzie Simon is a writer, producer, and frequent guest lecturer for colleges and organizations. She is the author of DETOUR: My Bipolar Road Trip in 4-D, a memoir that chronicles her cross-country adventures, interviewing people with bipolar disorder about wellness.

Monday, June 18, 2012

Steve Brannon becomes State Director, DBSA Tennessee

A news release:  On Saturday, June 2, 2012, Steve L. Brannon was installed as the State Director of DBSA Tennessee (Depression and Bipolar Support Alliance) in Nashville. Presidents and officers of its 12 local chapters from across Tennessee were invited to the special meeting.  The founding State Director of DBSA Tennessee, Gary Miles, recently retired from the directorship.  Brannon served as Assistant State Director for the past 6 years and was unanimously elected as the new State Director.
On the national level, DBSA Tennessee is a unique chapter.  For it is one of only 15 states to develop its organization to create a state level chapter within Depression and Bipolar Support Alliance, national, based in Chicago, IL.  State chapters offer a specialized type of service to the local chapters for growth and development and provide a vital relationship and degree of communication with the national office.  Tennessee’s 12 local DBSA chapters provide one, and some two, support/education group meetings each week.  The DBSA Tennessee state office estimates that their local meetings attract an annual attendance of approximately 8,000 attendees.
Depression and Bipolar Support Alliance (DBSA) is a not-for-profit 501(c)(3) organization with approximately 450 local chapters, nationally, that provide nearly 1000 support groups for people suffering with depression and bipolar disorder, their family and friends.  The meetings have an embracing atmosphere, where each participant can get information about their illness, and learn how to get help. Additionally, with its outreach efforts, DBSA sponsors online and "face to face" support groups. DBSA's scope includes outreach, education and advocacy regarding depression and bipolar disorder. Its national office employs professional and volunteer staff and operates with the guidance of a Scientific Advisory Board.
The national operation answers more than 3,000 calls per month on their toll-free information and referral line and receives over 21 million hits per year on their combined websites. Each month, DBSA distributes nearly 20,000 educational materials free of charge to anyone requesting information about mood disorders. DBSA reaches nearly five million people throughout the country with their educational materials and programs, exhibit materials, and media activities.