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Diagnosing Obsessive or Intrusive Thoughts


I posted this question on Dr. Andrew Huberman’s Ask Me Anything today. I hope someone else is interested too.

Is it possible obsessive or intrusive thoughts (esp of harm or violence) are easily misdiagnosed as MDD or BPD and not diagnosed/treated as OCD?

Could doctors be perceiving periods marked by higher incidence or severity of the individual’s obsessive or intrusive thoughts as mood swings and therefore evidence of BiPolar Disorder or Major Depressive Disorder (MDD)” and therefore treating the individual primarily for depression instead of OCD (where OCD treatment might be more effective)?

While we’re on the subject, I’m also curious as to whether they are they diagnosed more quickly in boys than girls? Are they diagnosed more quickly these days in the younger kids?

I’m dying to know. Pun intended.

Actually, I’m not dying to know.. My obsessions about dying are on hold now from TMS  – on hold for now, and hopefully for a long time.

Now let’s help other people get rid of theirs!!


xoxoxo, d (and bella)

Grab a Stick!

Mix it Up!

They used to say “Take the Stairs” to help people break the habit of riding the elevator three floors (or one floor, in my case).

Today I’m suggesting you find TEN new ways to MIX IT UP!

Not all in one day,  of course. But how about in preparation for Spring? In preparation for April? In preparation for a new life that’s better than the current life?


I have been doing a few things different so far and they are helping me shift my days from their former dark and dutifully productive to lighter and brighter and more fun.

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For All the Tired Brains.


Lying – not laying – on the sofa, resting the brain, looks suspiciously similar to laying on the sofa doing any number of other things that look like doing nothing.

My brain is overloaded and feels like it needs to shut down  Even though I still have lots of things I want to do.

My brain needs to take a night off. Even though I want to go out with friends and visit family and do some Zoom and draw some stuff and write some more.

But no, the diva brain is just not really having any of that. Diva brain wants to be horizontal and chill.

So me and my brain are relaxing on the sofa. Under the blankies. Under the dog.

Just doing a lot of nothing.

And it feels really good.

It makes sense that my brain is tired since my head is getting hammered on every day.

But it’s worth it. Every tap-tap-tap is gold, changing the neural pathways and breaking down a system of hardwired rules that has been holding me hostage.

And THAT’S just the fun part.

Every once in a while someone will observe that I talk about my brain as if it’s an other something and not me.

Sometimes the conversation gets into the territory of psychosis and whether I think my brain is talking to me . Or whether I think “they” are in charge of my brain.

And then sometimes the conversation is about the frustrating (to me) semantics around brain vs. mind. There are different definitions of the brain and mind in psychology and psychiatry. Unfortunately, I confuse those differences when I write about my living experience. And that frustrates certain professionals in my life who wants me to only use the word mind and not brain.

But I can’t.

Because it’s a whole thing about how I view the hostile occupation of my head by my brain. I feel like I have never been able to freely experience my mind because my hostile brain is governing my head and directing all behavior and activity.

So yeah. My brain is tired.

But I’m sure it will feel more recovered tomorrow since today was no TMS and there were extra naps too!

And I’m hoping maybe I can learn better methods of relaxing the brain now that I don’t have to host constant or recurrent thoughts of violence and harm. Now I want to think of nice things and new projects and new adventures. I don’t want to spend the day debating about whether to do something bad.

So I will try to ease my hammered mind, which is literally what it sounds like.  Or not.  Depending on the definitions of mind and hammered.

Tell me about your brain experience! Maybe we can trade!

Happy Sassy Silly Saturday and basically anything that’s not stressful for you.


xoxoxoxo, d (and bella)


The Death of Suicide

Let’s kill suicide.

Let’s kill all of it. Or at least as much as we can.

I have recently found major relief from chronic and near constant intrusive suicidal thoughts. But I will still have thoughts. And I will still have urges.

So  I still wouldn’t go into certain situations where a certain prompt, a certain look, a certain song, a certain feeling, a certain slight  could trigger an urge.

I have lots of plans in place. But plans have to be discussed. And figured out. And negotiated as circumstances change.

And negotiated in anticipation of circumstances changing.

Let’s kill suicide by talking about how to handle it when the thoughts and mages and urges rise up. Since we know they will.

We can have this conversation. It’s just about life. And how to live it.

It’s just about how to live life.

Let’s just talk about how to live life.

So we can live life.

Happy Friday Eve.

🤎 🤎 🤎

d (and bella)

Smiling. Part I.

If I told you smiling helps you live longer, would you believe me?

Well you should. Because I just pulled up like five interesting sources that I was thinking of talking about and then thought HEY! STICK WITH SMILING STORIES! NOT BORING RESEARCH!

So no research. I’m not writing a thesis.

Just know that if you smile you will live longer. It’s proven somewhere.

But seriously, you have to make yourself smile. You especially have to make it happen if it’s not been happening enough.

You know who you are.

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Save Me



The best thing about having a new brain is that it’s receptive to everything. Everything is possibly the best thing in the whole entire world.

And everything is possibly the answer to the puzzle that could never be solved, but maybe now can be.

The bad thing about walking around with a new brain it that you risk falling into a crumbling pile of tears anywhere anytime without much notice. Sights and sounds trigger old and new memories and wake up feelings you didn’t know existed. It’s not magic like in the movies. It’s shocking, like when the car lurches.

That’s why it’s hard to see Tony Denikos in person. Tony makes my head and my heart hurt so bad. But in the good way.

I just need practice feeling the hurt. Without crumbling in public places.

And I need to start wearing waterproof mascara.

Happy Sunday.

Listen to Tony’s soul soothing music.. He goes there on almost every song so be sure to have something strong around to keep you afloat.

I’ve got coffee and peanut M&Ms. And a fluffy white dog. Luckily, she has no interest in Peanut M&Ms.

xoxoxo, dee (and bella)

You can Follow Tony here.


What’s It Like?


TMS is like having a small hammer bang against your head repeatedly. Technically, each treatment session includes 55 trains of 36 pulses (for a total of 1980 pulses per session) delivered over 20 min at 18 Hz and intensity of 120% relative to the patient’s resting motor threshold (MT).

What does that mean?

Well, the resting motor threshold is the basic unit of dosing in transcranial magnetic stimulation (TMS) research and practice.  There are several different approaches to estimating the resting motor threshold and apparently little consensus on the best method for estimating it. BUT don’t take my word for it. I am not a doctor or a scientist. There is a lot of research easily available on the internet so look it up if you are interested in learning more.

The little I know is that In a healthy brain, neural activity in the motor areas of both hemispheres is functionally related to muscle control. An active movement of a hand is associated with an enhanced neural activity in certain motor areas. My resting motor threshold has been determined multiple times through a process of stimulating my brain with magnetic pulses and measuring the correlating hand movement. It’s kind of cool.

When I have TMS, a cap is put on my head. The cap has measurements indicated on it that show where a magnetic coil should be placed. The coil sits near the front of my head over my right eye close to my eyebrow. The coil is in what feels like a helmet and the helmet is strapped tightly to my head. I wear ear pods to listen to music and I wear mouth guards to protect my teeth and jaw from the twitching caused on the right side of my face. My right eye twitches too but I do not need anything for that. I only need to not be wearing glasses.

The tapping is the minimum amount of power needed to stimulate my brain cells, the amount that meets my individual threshold that causes my thumb muscles to twitch. During the treatment, my right hand twitches so I cannot hold my phone or anything with that hand.

The actual tapping procedure takes twenty minutes and I am awake, sitting up in a comfortable chair. I cannot move since I am attached to a helmet that is attached to a machine. Every twenty seconds, the tapping taps tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap for two seconds.

Every twenty seconds for two seconds.

After a while it’s meditative if you let it be. And after a while my brow goes numb. In a non-annoying way.

But the time goes fast if I listen to music. Sometimes I read texts or emails. by holding the phone up to  my face and far enough away with my glasses held up and squinting since I’m not actually wearing my glasses.

Yes, it is a TMS shit show.

After treatment, I can go back to work. No sedation or anesthesia is necessary so after treatment I am good to go.

Treatment is every day for 30 days, Monday through Friday for six weeks or so.

I have been through two cycles of treatment with remarkable results. I should be on a commercial for TMS. It has changed my life.

Whether the effects of TMS will last or not is a different story, but for the first time ever I have major hope that I can live differently. With TMS, my brain is no longer the boss of me.

With TMS, my brain no longer bullies me into performing repetitive daily rituals that exhaust me and render me incapable of living a normal life.

Now TMS won’t work for everyone, obviously,  since nothing works for everyone. But look at some of the links I’ve provided. The areas they’re researching for the use of TMS are amazing.

But there are so many options out there now that I urge everyone to research everything.

Even with TMS, there are different kinds of coils.

I began TMS for treatment of “Major Depressive Disorder” because that is what the insurance company will authorize, but it turned out that TMS release me from the chains of my Obsessive Compulsive Disorder (OCD).

Now we are trying to get the insurance company to authorize payment for a different coil that targets OCD.

If I could get that treatment, then WOW. I mean, W.O.W.

Like seriously. I could be a totally new person.

Because depression really isn’t my problem. I can manage my depression.

My real problem – the one that really wrecks the quality of my life – is the OCD.

So naturally I wish I had tried TMS years ago, but you don’t know until you know. So I didn’t know about TMS until I knew about TMS.

And I can’t dwell on time I could have been living life instead of waiting for life to be over.

But enough of that nonsense!

I have provided so many resources under the Resources tab. You should take a look even though you shouldn’t use the word ‘should’ and neither should I.

But ‘should’ is a discussion for another day.

For today, find something that gives you hope.

I have hope now that my life can be about living.

That’s not what it was about before.

It’s not that I didn’t want to live, it’s just that the OCD kept telling me to do violent and harmful things through constant intrusive thoughts I could not stop.

Medications helped me to manage those thoughts so I could hold a job and keep cartooning, but managing a life is not the same as living a life.

Now I have hope that I can live my life.

And now I have the ability to help other people figure out how to live their lives too.

A long time ago, I became a professional problem solver. In some parts, they call that a lawyer. In other parts they call that an advocate.

Now that my brain has backed off from sending me violent, harmful intrusive messages I can devote myself to advocacy. Just the way I always dreamed of.

Check out the resources. They are really good.

Today is a great day to do something different to make your life better and you may just find it right here.

I hope it’s at least a start.

I hope your Saturday is really great.

And green. Something about green, apparently.

💚 💚 💚

xoxoxoxo, dee (and bella)

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Could it BE More Easy?


Could this be easier?

It has always been this hard.

I understand that. But can’t we make this easier for you?

But it has always been this hard.

Yes, of course.


What if we simplify it?

Is that even possible?


But it’s been this way forever. 

So it’s a great time to try changing it.

But can I change it?

Well, you’ve got lots of practice so the transition to doing it easier shouldn’t be too tough.

I wish I had known it didn’t have to be this hard.

You were busy learning other things you needed to learn.

Oh yeah. I did need to learn those things.

Yeah. Look at how much you know! You know a lot of useful stuff!

This is kind of exciting! Let’s make everything easier!

Now THAT is a good addiction.

Be addicted to making things easier. And better.

Be addicted to getting there faster. 

But only if you’re getting to somewhere better from somewhere bad.

Otherwise, keep it slow and steady.

And remember to breathe.



Do You Have a Plan?


Anyone who has ever been back-up-against-the-wall in crisis has had to answer the question “do you have a plan?

It’s a question that doctors, nurses and therapists are taught to answer as they triage a desperate situation.

Do you have a plan” enables them to determine how far along a person might be in their desperation.

Because in the world of breakdowns and crises, there are critical differences between ideation, imagery, impulses, urges, and actions.

There are critical differences in how those doctors, nurses and therapists respond and what next steps are taken.

For the person in mental and emotional pain, it can feel like a threshold test of “will you be okay for now?”

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Things Will Change.



When you try giving hope to someone in pain, it only works if the hope is that something will change.

Generally, in offering hope, you must be saying “I have something – an idea, a piece of information, a source, a referral – something that will change the pain you are in.”

Because if you aren’t offering a change from the pain, then what is there to be hopeful about?

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Court’s In Session


Mihaly Csikszentmihalyi said that individuals were the most creative, productive, and happiest when in a state of flow. Prof. Emeritus Mihaly “Mike” Csikszentmihalyi taught at the University of Chicago and was known as the “father of flow.”

He described flow as “a state in which people are so involved in an activity that nothing else seems to matter; the experience is so enjoyable that people will continue to do it even at great cost, for the sheer sake of doing it.”

You know the flow state. It’s like when you’re in “the zone.” When you’re so into whatever you’re doing that everything else disappears.

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Just Another Manic Monday.

Like most normal people who live for the weekend, I’ve never been the biggest fan of Mondays. But tomorrow is different because I get to return to treatment.

It’s Transcranial Magnetic Stimulation (TMS) and unfortunately Covid forced me to lose a few days last week.

But I am recovered from Covid and ready to go again! Dying actually (pun intended) to get back to the best treatment I’ve ever had.

If you’re new here, I’ve written about how TMS has pretty much completely changed my life.

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You “Worked” at Sheppard Pratt?


The next time you take a year off from college, spend it in a psychiatric hospital.

It was the B.E.S.T. experience of my life.

No question about it. Still. To this day.

After my second year of college, I was in need of a break. I had arrived at school so excited to proclaim myself pre-law, but once there I was really drawn more to social sciences and psychology.  Back home, I had volunteered in hospitals (anyone need a Candy Striper or Pinkie uniform?) and I liked the medical environment. So after my fourth semester of college, I left school, came back to Baltimore and got a job at the most beautiful psychiatric hospital around these parts, Sheppard Pratt.

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Nine and a Half Lives

How many lives have you lived in this lifetime so far?

Or chapters. How many chapters does your book have so far?

Do you come in around the suggested 10 chapters for a memoir? Or are you drowning in chapters?

I’m hoping you have a high number of chapters so I can feel better about my high number of chapters.

I think one of my less-than-helpful, sometimes irrational,  core beliefs or automatic thoughts is that other people live a low number of chapters where not too many chapters would mess up a straight-ish line if mapped out.

But I’m smart. I know that’s not true. I do.

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Adventures with Jimmy Carter

I barely survived high school.

I barely passed either. Because of gym.

Somehow I convinced somebody to let me take college classes early. Then I got permission to just move to Washington DC in my senior year.  Along the way there were notes about how I would fail if I didn’t make up gym classes and stupid things like that. But I always figured out how to do whatever was necessary to meet the gym class requirement that stood between me and an exciting, independent life.

Because I was not a big fan of high school. But I had big dreams.

So I left Baltimore and moved to an all-girls dormitory on 2nd Street near Union Station. It was run by nuns and no men were allowed beyond the lobby. It added to the outrageous surrealness of the entire fact that I tricked everybody into letting me just leave home.

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Stop It.

I looked through my journals to see if my notes from the first round of Transcranial Magnetic Stimulation (TMS) are similar to the notes from the second round.

I’m pleased to notice several positive similarities so far.

Just two weeks into each round, I started writing “Stop it” in my journal.

That was me telling myself to stop it.

Specifically that is me telling myself to stop after realizing I was engaging in bad (negative, unhelpful, unwanted, undesirable, maladaptive) behaviors or habits,

And that’s amazing.

Because usually, being quite the OCD-brain, I would obsess about the behavior once realizing I was engaging in the behavior.

In other words, I would meta obsess.

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Who Are You?

What do you do when you’re not sure who you are? Or when you don’t understand what you’re about anymore?

I imagine we all experience it at different points in our lives. Maybe some of us experience it multiple times, until we start finding our true selves.

Or until we start returning to our true selves.

And I guess a lot of us experience it in conjunction with the journeys of others, those we love. Or used to love.

I found myself again after a lot of years being lost. And I can’t believe it.

I wish I could bottle it. Or capture the formula so I could write the best selling book.

But the twisted path that got me here is too sticky and tricky and filled with details that nobody would understand unless they knew the whole story.

And that’s a bad pitch for a best selling book.

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Get There Faster.

Sometimes things take too long.  Fact.

Now sometimes it just feels like things are taking too long, We all know about that.

But then then there are times when things DO take too long.

Or maybe there are times when things too SOOOOOO long and we want to be sure they never take that long again if we can help it.

Well THAT is my new mission in life.

I have a few other missions, of course, but the mission that you might also benefit from is Getting There Faster.

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Why does it matter?

So why do I keep talking about my diagnosis?

Because it could change someone else’s experience.

And here is how it could do that.

For decades, I had horrible intrusive thoughts of death and suicide.

But once I mentioned suicide, I was ONLY treated for depression. And treatment for depression wasn’t enough.

But finally, a doctor connected my intrusive thoughts of death and suicide with OCD. And I was able to get effective treatment,

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You should try Cognitive Behavioral Therapy (CBT).

Many of us have been doing it for years. Or we’ve kind of been doing it.

Maybe we’ve been inspired by CBT, but not really enforcing the changes we dream up for our would-be-better selves.

But now CBT is really OUT THERE. As it should be!  Because CBT is AMAZING.

And it’s free.  And it’s not really that hard.

But it’s also not really that easy since you have to move around that big old roadblock formerly known as yourself.

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