Thursday, August 20, 2009

Vincent Van Gogh says...

"Give a bit of yourself -- donate and support the Sutherland Center!"

Read more here about my ride and efforts to support the research and treatment of bipolar disorder at the Sutherland Center.

Tuesday, August 18, 2009

Climbing Beyond Ward

I do not fall into the category of cyclists that have been obsessed with bikes since they were kids, that found their freedom exploring on two wheels or whose identity is tied up with coaster brakes and 1/8" chains. I had a succession of bikes when I was younger -- a big wheel, if that counts, a Schwinn BMX bike with a sweet checkerboard top tube pad, a blue Panasonic 10 speed with safety levers and stem-mounted shifters that I found terminally embarrassing. I toured my street on the first, friends' neighborhoods on the second and Nova Scotia on the last, but when each was done, I moved on to something else; I was never drawn strongly to bicycles.

When I moved to California for grad school, I decided that I needed to figure out a new and more regular exercise plan. Cycling is very popular in Northern California and for good reason -- there's a lot of amazing riding to be done. I bought by first "adult" bike, a 2001 LeMond Buenos Aires built with Reynolds 853 steel, and then my second, a Soma Rush fixed gear, and began to put on miles. Not a ton, but a steady stream, as I rode the same few 20-35 mile routes around Stanford for a chance to talk with a friend or escape from the library. I tried some of the famous climbs in the area -- Page Mill, Old La Honda -- but never got far, mostly because I saw the tops of these steep ascents as all but unattainable, reserved for the skinny, super-fit "real cyclists" on the road. In truth, I sabotaged myself from the start

After four years in and around Palo Alto, I again moved, this time to Boulder, CO. Without the regular schedule of coursework, I had a lot more time to ride and began to explore the area. I quickly learned that climbing was central to Colorado cycling and that the climbs were, if anything, harder than those in California. While generally not as steep, Colorado Front Range climbs are often very long -- 15 to 20 miles is not at all unusual. Perhaps these, too, were only for the fleetest of pedalers. So I continued to ride routes with shorter climbs -- rollers, really -- wondering whether I could get strong enough to make it up Lefthand, St. Vrain or any of the other famous Boulder climbs.

The spring following the move, the snows melted and I decided to find out. Joining an annual April ride departing from Lyons, north of Boulder, I found myself on the lower stretches of the 17 mile ascent up Lefthand Canyon to Ward and the Peak to Peak Highway. In the past, I often tried to charge up big climbs, going as hard as I could from the start; this rather idiotic approach was a holdout from nordic racing in high school, which were all-out 5K sprints ("go out hard, pick it up in the middle, finish fast," was my coach's mantra). That I couldn't apply this strategy to cycling hadn't really connected for me until this April morning. Determined to go as far up the canyon as I could, I settled in to a calm, even pace with several other riders and wondered how long it would take to cross the miles to the top, or if I even could.

Newfound conservative pacing notwithstanding, the climb was not easy. Ultimately, 17 miles at nearly 4% grade proved a long, long way to go -- a reality hardly aided by the last 3 miles averaging 10% that followed the ominously named "Turn of Events." I made it to Ward, however, and beyond -- up onto the Peak to Peak, over its rollers at nearly 9500' elevation, and back down into Lyons. Along the way, I passed riders and got passed by riders, finding that I was neither the skinniest nor the slowest; I learned that I could choose my pace and that if I was patient, I would get to the top; and I discovered the cycling could be my route to seeing a great portion of Colorado that I would otherwise miss out on, beautiful vistas taken in at a human pace.

Most importantly, however, I learned that in a life that often feels very much beyond my grasp, cycling is one thing I can control. I am the sole determiner of success or failure. I decide whether to go on or turn back, whether a climb is too steep or too hard, whether a day is too long or my feet hurt too much. When I returned home that day, for a few hours I truly felt filled with pride. In the three plus years since then, successes on the bike -- Denver to Aspen in one day, my first 600k -- have brought me that same feeling, putting me in touch with a world that, however briefly, seems absolutely filled with possibility and potential.

I don't want to paint a picture of my life as one filled with quiet desperation, though it certainly has its moments. It's just that riding my bike starts with my body and extends to my mind, precisely the reverse of many situations I find so frustrating in my life. I've found that by challenging myself in this way, I can put my finger on something tangible that I am good at, something in which I can reach my goals, making it easier to envision success in other areas.

Tuesday, August 11, 2009

In the News: Mental Illness and Youth

Each week, I'll post links to a couple of articles about mental illness that I think are worth checking out. Of course, among the hundreds of new pieces out there, mine will be a tiny sampling with a different theme week to week. This week, mental illness in youth.

According to a report in the New York Times, "cash-starved states are increasingly relying on the prison system to handle young offenders with mental illnesses, who often need therapy more than punishment." Despite evidence that prisons in America fail to consistently rehabilitate criminal offenders or care for the mentally ill, jails have too often become the destination of first resort in our country. In our judicial system, protections for the poor and indigent, the mentally ill and the mentally retarded (classes that overlap considerably), are often stronger in principal than in practice. Without more robust advocacy and fitting care, those who are less able to understand and look out for their own interests will continue to find themselves on the unequal end of a system that promises equal protection.

Depression “tests” permitting self-screening in adults and kids are now available for the iPhone, with a similar application for generalized anxiety disorder in the works. Strange as this might sound, self-evaluation is a key part of mental health diagnosis and is where most, if not all, psychological treatment begins. If people, particularly kids, can be educated about the symptoms of mental illness and encouraged to reflect upon their own mental state, it seems possible that more will recognize a need for help, rather than continuing to live (or worse, die) in pain.

And a tangentially related note: The National Institute of Mental Health (NIMH) has announced an interdisciplinary study of suicide and mental health among military personnel. Investigators aim to identify risk and protective factors for suicide among soldiers and effective and practical interventions to reduce suicide rates, and to address associated mental health problems. In a situation not dissimilar to the New York Times report above, our government needs, in my opinion, to see its commitments through to the end. If we want to have a military of young men and women wage war, we need to be dedicated to providing the care they need upon their return. Medical care for veterans is woefully poor, while evidence of mental illnesses, including depression and post-traumatic stress disorder, is rampant. Too many soldiers face broken families, dysfunctional lives and suicide upon their return from combat. This NIMH study is a step in the right direction.

Monday, August 10, 2009

How the Wheels Work

In the past few years, amidst the many experiences and changes in my life, two themes seem to have emerged, growing steadily in importance over time. The first is bipolar disorder, the second, bicycles. They may seem a strange pairing, yet each serves as a kind of emotional and cognitive filter, alternately clarifying and distorting aspects of my life. I’d like to talk about each in separate posts this week to give you a sense of where I’m coming from, why this blog seems like the right thing at the right time for me and why it’s called “One Wheel in Front of the Other.”

I was diagnosed with bipolar disorder, as manic depression is now known, during the second year of my PhD program. I had come to a place where I couldn’t concentrate, couldn’t sit still, couldn’t work for longer than 10 or 15 minutes at a time. I was frustrated, angry and scared. How could I pursue a career that depends almost more than anything else on the ability to focus? How could I choose a life that required often solitary work in quiet places when I my mind and body were both racing?

Since my diagnosis, medication – in my case a combination of an seizure medication (many are very effective off-label as mood stabilizers) and an anti-depressant have helped limit, though hardly eliminate, the most serious symptoms. Bipolar is now more often fatiguing or frustrating than debilitating. I do not struggle with major depressions or manias that truly disrupt my functioning, as is the case for so many.

Instead, it appears (psychology being a rather inexact science) that I have a relatively unusual form of bipolar called cyclothymia (also, here),which causes me to move rapidly from low-grade depression to low-grade mania all the time. This is rather like riding an old wooden roller coaster blindfolded, up and down at unpredictable intervals, at times dragging on interminably, occasionally plunging pleasurably, but in any case, rarely flat. As a result, the filtering of my bipolar lens often feels nearly all-pervasive, every moment, every action, every reaction being tinged by its shade. In some sense, this is probably not really the case – I imagine there are times when I am by some measure “normal.” Knowing those times, however, can seem almost impossible.

It can be useful to recognize when certain behaviors or thoughts are related to bipolar. In these cases, coping techniques (for lack of a better term) can help not only control issues in moment, but also over the longer term. Here, the Sutherland Center’s focus on cognitive-behavioral therapy, shown in many cases to be as effective as medication for treating bipolar, has been a godsend. By recognizing the warning signs that difficult moments are heading my way, it is sometimes possible to head them off at the pass, removing myself from a situation either physically or mentally. At the same time, I don’t want to allow bipolar to become an excuse, a way of explaining away other problems that need to be confronted.

Even more importantly, I need there to be some part of me that is genuinely, truly me, a core that I can see, feel, name and describe that transcends the noise. One of the great challenges of mental illness is the elusiveness of one’s true self. How do I tell the difference between the “real me” and the “bipolar me” when they have coexisted for so long and are so frequently muddled together? This need seems to be a constant thread connecting all the people I know with bipolar and other mental illnesses – to a greater or lesser extent, the stories they tell about themselves reveal anxiety over whether or not this genuine self still exists and how hold on to it.

Coming later… it’s at least partly about the bike.

Sunday, August 9, 2009

Give it Up! Please?

So, here it is, the plan, the pitch, the whole kit and kaboodle.

Since January, I have been training and qualifying for a truly epic ride, the Last Chance Randonnée. I’ll leave the details of the ride for you to read via the link, but at 1200K (roughly 750 miles) over 3 ½ days, this will be the most difficult physical challenge I have ever undertaken.

Obviously, completing the ride will be an accomplishment of great personal significance, but I also want to use it as an opportunity to contribute to something larger than myself. The Last Chance is not affiliated with any charity, but I hope to use my ride (and this blog) as a means to raise awareness about mental illness in our society and support the work of the Sutherland Center at the University of Colorado.

Given the length and difficulty of the Last Chance (even the name has a rather grim ring to it, I’ll admit), I thought that per mile pledges might be a fitting way for you to consider supporting my effort, as your generosity will push me towards the finish.

Please know that 100% of your gift will go to the Sutherland Center. I have already paid for the event fee, travel expenses, food, etc.

If you would like to support me in this effort, there are a couple of steps to making a donation:

1. You should choose whether you would like to pledge a certain amount per mile or make a fixed donation either before or after the event. Remember that any amount, whether it’s 1¢ or $1 per mile, makes a difference.

2. If you’re willing, please send me an email telling me of your plans – this will help me keep a running tally of how much we have raised together, which I will post on the blog.

3. When you are ready, go to the Sutherland Foundation’s website and make a donation via the web (you can read more about donating to the Robert D. Sutherland Foundation here). Choose “Honorary Donation” and complete the forms as instructed. Asking that you make an honorary donation is not intended to be vain, it will help the Sutherland Center know how much my friends and family have succeeded in raising. You can also make a donation via mail or fax.

If you have any questions or would like to let me know about your gift, you can send me a message via the blog or email me at redcliffs (at) hotmail (dot) com. And whether you are able to donate or not, thank you for your interest and support!

Thursday, August 6, 2009

Raison d'etre

As many of you already know, a major reason for starting this blog is an effort to raise awareness about the condition and care of the mentally ill in our society and to support the efforts of the Robert D. Sutherland Center for the Evaluation and Treatment of Bipolar Disorder at the University of Colorado, Boulder.

Studies indicate that nearly 21 million, or roughly 9.5%, of adults in the United States suffer from a mood disorder (bipolar or major depression, for example), a number that does not include personality disorders, schizophrenia and many other debilitating psychological disabilities. In particular, bipolar affects roughly 5.7 million American adults, afflicting men and women equally across racial, ethnic and socio-economic groups, and while the average age of onset is 25, there is a growing recognition of its prevalence in children and adolescents. Despite this, public funding for mental health care remains woefully low, leaving the under- and uninsured with few options for help. In such a context, organizations like the Sutherland Center stand in the breach, providing care for many who would otherwise go without.

The Sutherland Center is committed to the support of people with bipolar and their families through diagnosis, treatment and education. Their principal mission is to provide care for the uninsured. Clients are asked to pay fees on a sliding scale that is roughly equivalent to many co-payments. The remainder of the Center’s funding comes from the Robert D. Sutherland Foundation, a non-profit organization dependent on grants and individual donations.

My reasons for seeking your support for the Sutherland Center go beyond the importance of their mission and their contributions in the greater Denver region. When I first came to Boulder, I had a difficult time finding a new therapist from the list provided by my insurer. I contacted the Sutherland Center for recommendations of psychologists who specialized in the treatment of bipolar. They responded not only with a list, but also with a promise – if no one on their list was a good fit for me, they would help. In the end, that’s what it came to: the Sutherland Center has reached beyond their stated mission and have given me the best, most productive care I have received since my diagnosis.

In my next post, I’ll fill you in on my plans and give you information on how to donate if you’d like to do so. More soon…

Wednesday, August 5, 2009

Welcome to One Wheel in Front of the Other

Hi all,

Thank you for visiting my blog. I’ve never done this before, so please forgive me if I begin poorly – hopefully that won’t last. From reading other blogs, I think I’m supposed to start out by saying something about myself or the blog. Truthfully, I’m not quite sure what is to come. I plan on talking some about bikes and riding them. I’ll also try to convey something of my experience living with bipolar disorder. Perhaps I’ll discuss art or politics a little, but that might get boring pretty quickly. In any case, I hope there ends up being something here for each of you, something that makes the reading interesting or at least occasionally worthwhile.

So, with out further ado…