Category Archives: Parenting advice

I’m Back…

I’m an author, working independently in the SF Bay Area. My memoir, A Lethal Inheritance, A Mother Uncovers the Science Behind Three Generations of Mental Illness, published by Prometheus Books in 2012, reflects my continuing interests in memoir writing, parenting, mental health, psychology and neuroscience.

After spending much of the year before and after my memoir came out talking about it online and to groups around the country, for the last six years (until April 2018) I’ve been working a “day job” as Managing Editor of a science blog network for PLOS, the Public Library of Science. It was a good run and I learned an enormous amount about new research in health and medicine, the science of climate change and science communication. Alas, my desire to write full time (again) has become irresistible.

As of today, I’ve returned to independent writing, both as a blogger touching on these same topics, and as a novelist, adding fiction and fantasy to my day to day writing tableau.

I will be reviving the Mental Health Mom Blog as inspiration strikes. I’ll also be accepting guest posts from other writers whose contributions touch on these same themes. One caveat to any new visitors — many of these posts do not reflect the latest scientific research on the topics I cover, particularly the neuroscience. That said, there’s still much of value here, especially in basic psychology, parenting and personal experience.

Contact me personally at

Mental Health Advocacy: Empowering Lived Experience with Evidence — My presentation is yours to use!

Hello readers, and I especially welcome the wonderful parent and professional mental health advocates I met last Friday at the PPAL annual meeting in Marlborough MA — all 400+ of you! I thoroughly enjoyed my time there and came away very impressed with the “Massachusetts model,” a work in progress you point out, for supporting families and communities with mental health disorders.

Click on the link below to see my presentation (30 min) as a downloadable Slideshare file, below

Click on the larger version of this image, below, to see my presentation (30 min) as a downloadable Slideshare file.

Here I am addressing the annual meeting of Parent Professional Advocacy League, in Marlborogh MA on May 29, 2015

Here I am addressing the annual meeting of Parent Professional Advocacy League, in Marlborogh MA on May 29, 2015

As I said in my keynote, you are my tribe. Only those of us who’ve dealt with mental illness and addiction in ourselves and/or a family member can truly know how tough this journey can be — and the importance of social services and one-on-one parent support. I am grateful for everything you do and the lessons you pass on.

You may view, share and re-purpose any part of this presentation in your own work at no charge. If you do, please provide attribution to me as author, with this website as your source. I would also appreciate a heads up on where you’ll be sharing and/or publishing it. THANKS!

—– Victoria Costello

With attendees; among them mental health and social service professionals, parent advocates and youth advocates.

With PPAL Executive Director, Lisa Lambert

Signing copies of A Lethal Inheritance, at PPAL meeting.

Signing copies of A Lethal Inheritance, at PPAL meeting.

Which Websites Can Reduce Anxiety and Depression? Evidence and Recommendations from PubMed Editor Hilda Bastian

Readers: Here is Hilda Bastian’s terrific new post assessing which websites provide scientifically sound psychological help online. In addition to blogging for PLOS on Absolutely MaybeHilda’s day job is editor of PubMed Health and PubMed Commons. Follow her on Twitter@hildabast and at

—Victoria Costello

Painting of a sad womanBefore we go on, you should know there are no sunshine-y quick fixes coming in this post. The kind of websites we’ll be looking at take a lot of effort. And there’s no guarantee the effort will pay off. There isn’t with any therapy for anxiety and depression.

Anxiety and depression can be stinkingly tough conditions to budge. Life is so much tougher when one or both are dragging you down. Any demanding therapy is tougher, too. It’s odd, really, that so many are quick to judge others, and themselves, as weak when they struggle with this.

Extra obstacles, it seems to me, deserve extra recognition. It’s a bit like that classic cartoon by Bob Thaves, commenting on Ginger Rogers, the female half of the legendary Astaire and Rogers dancing duo. Sure, Astaire was great, but don’t forget she “did everything he did backwards…and in high heels.”

Despite the strength that life with depression and anxiety calls on, the stigma of weakness clings, along with the notion that you can just “snap out of it”. There are other ways to think about this. David Dobbs writes of one: “…the sensitivity that opens the person to depression becomes a strength that lets them overcome not just it, but other obstacles”.

Although it’s not easy to change, the way we think about things can affect our moods and behavior. We can get caught in uncontrollable brooding and ruminating about the future or past. All of that can get us caught in vicious cycles that keep us down.

Photo of rough tree barkThat’s not the cause of everyone’s depression and anxiety, nor the reason it continues. But it is common. And changing that kind of deeply ingrained pattern of thinking and behaving can help. Cognitive behavior therapy (CBT) is one way to work through that process.

Between any situation and our reaction or response to it, there is a choice, even if it’s made unconsciously. The work of CBT is to try to change those of our automatic reactions that are futile and misery-inducing.

Take catastrophizing, for example. That’s when we start imagining consequences we feel are likely – how this could lead to this and this and this – and that would be, inevitably, disastrous.

CBT techniques aim to lessen the impact of this kind of cognitive tailspin. And reduce the kind of self-talk that we would condemn as unacceptable bullying in others (“Why don’t you just get a grip, you…”).

I’m not a mental health professional. I became interested in online therapy when colleagues and I were analyzing studies of the internet’s effects. That was many years ago, so our study is way out of date. The internet hadn’t been around all that long then. But evidence suggested that CBT could work just as well in do-it-yourself (DIY) computerized or online form.

Photo of safe place signRigorously studying the impact of psychological therapies is critical. That’s not just so that we don’t waste our time with things that don’t help. Even good ideas with the best of intentions can end up hurting people.

That happened, for example, with “iChill”. That’s internet-based CBT that, it was hoped, would prevent generalized anxiety disorder. But a randomized trial found not only didn’t it prevent the condition, it might have caused worry and depression.

Adverse effects of psychological therapies are the subject of an interesting research program at the University of Sheffield, called AdEPT. They have yet to report the results of this work, but they have started an interesting website, Supporting Safe Therapy.

Time to answer the question we started with: Which websites can reduce anxiety and depression?

There have been dozens of trials now, particularly of CBT-based internet sites or computer programs – and for many conditions. There are also plenty of good systematic reviews, analyzing these trials. (I’ve written explainers aboutsystematic reviews and meta-analyses, if you’re interested in learning more about this kind of research.)

To find websites with evidence of benefit, focusing specifically on anxiety and depression, and not requiring therapist support, I relied on four systematic reviews published in 2013 and 2014. (They’re listed at the end of the post.)

Photo of sunlight and shadeAlthough there are quite a few, I could only find three that were free globally, in English – and they’re all from Australia:

If you’re in the UK, you might be able to get a prescription to websites endorsed after NHS review – like Beating the Blues (and FearFighter for panic and phobia). If you’re in Australia, there’s also the BRAVE-Online program for children and young people. There are solid resources available in the Netherlands and Sweden, but I don’t have the language skills for developing that list.

Some universities and colleges have programs available to their students. And you can see more resources here, but they might not have the scientific assessment behind them that the others do. There are books, too, which I hope to come back to in the future.

What can you expect if you try a website like this? It’s not a way to get instant relief from suffering. It requires work. But on average, many people who try them benefit – how many, and by how much, varies. And there’s not enough research for me to feel confident putting numbers around this.

Online CBT websites won’t suit everybody, though – maybe not even most people. Lots of people abandon them. We don’t really know if working at them harder or longer makes them more effective. And there hasn’t been enough research on how useful (or not) these are for people from different cultures, or for people who have addictions or other mental health problems as well as anxiety or depression.

There is online CBT therapy that’s therapist-guided as well as the DIY kind. Researchers are mixed in their opinions about whether therapists, face-to-face or supporting an online program, make a difference. That’s probably at least partly because they are often therapists themselves.

Photo of grasses against the sky

We collectively spend a great deal of time and money on books, websites, programs, counselors/therapists/gurus – endless theories, lots of people getting rich, on claims they can make us happier. A lot of that is wasted. Most of it isn’t backed up by good science – and much of it, we know, is going to be counter-productive or worse.

Yet, it’s still uncommon in most countries for information on anxiety and depression to even mention internet CBT is an option. Given how many people’s livelihoods are tied up in mental health care one way or another, it’s probably not surprising that free, DIY online therapy faces headwind. That’s a shame. Because even if only a small fraction of the people who try it benefit, it could ease much suffering.


Here’s a good detailed explanation of CBT.

If you know of somewhere there’s a directory of online therapy websites, linked with the sites and the evidence evaluating them, please add it in the comments or contact me.

The four systematic reviews I relied on for finding these websites:

  • Aleisha Clarke and colleagues on preventing mental health problems in young people (2014)
  • E Bethan Davies and colleagues on improving depression and anxiety in university students (2014)
  • Eric Dedert and colleagues on treating depression and anxiety (a review for the VA, 2013)
  • Dawn Querstret and Mark Copley on rumination and/or worry (2013)

I also found these very useful: “Internet-delivered cognitive behavior therapy for anxiety disorders is here to stay” by Gavin Andrews and colleagues (2015) and “Web-based intervention programs for depression: a scoping review and evaluation” by Tian Renton and colleagues (2014).

The “Why don’t you just…” image in this post is my own (CC-NC license)(Cartoons at Statistically Funny.) Photos also by me (CC-BY): The bark of a tree in California, the firehouse in Cleveland Park, DC and in my home.

* The thoughts Hilda Bastian expresses here at Absolutely Maybe are personal, and do not necessarily reflect the views of the National Institutes of Health or the U.S. Department of Health and Human Services.

Pot may be legal for adults but it’s still dangerous for adolescents

Anyone who’s read my book A Lethal Inheritance knows I’ve consistently and strongly warned against teenagers smoking pot, because their brains have not finished growing, and research clearly shows negative effects when they smoke before 21 or 18. Especially if the young person is vulnerable to mental disorders due to heredity. Today’s NY Times has an excellent article by Tara Parker-Pope on the impact (or potential impact) of marijuana legalization on teen pot use. Please note, neither I nor the article are talking about adult use. This is strictly a maturing brain matter….

Highlights…from Parker-Pope’s article…


The brain is still wiring itself during adolescence, and marijuana — or any drug use — during this period essentially trains the reward system to embrace a mind-altering chemical.

Studies in New Zealand and Canada have found that marijuana use in the teenage years can result in lost I.Q. points. Mr. Pasierb says the current generation of young people are high achievers and are interested in the scientific evidence about how substance use can affect intelligence.

“You have to focus on brain maturation,” he said. “This generation of kids wants good brains; they want to get into better schools. Talk to a junior or senior about whether marijuana use shaves a couple points off their SATs, and they will listen to you.”

Because early exposure to marijuana can change the trajectory of brain development, even a few years of delaying use in the teen years is better. Research shows that young adults who smoked pot regularly before the age of 16 performed significantly worse on cognitive function tests than those who started smoking in their later teenage years.

Drug educators say that one benefit of the legalization talk is that it may lead to more research on the health effects of marijuana on young people and more funding for antidrug campaigns.

If you want to read the entire article go here:

Report: Proper SSRI Antidepressant Starting Dose Minimizes Suicide Risk In Young Adults




     A large, well-controlled pharmacoepidemiological study shows that three SSRI antidepressants do not increase suicide risk in 10- to 24-year-olds when given at the proper, recommended doses. Higher doses were associated with a 2.2-fold increase in suicide risk. No similar dose effect was seen in those age 25 to 64.   read »

From, the blog of David Kroll, a pharma expert who used to blog for PLOS Blogs, my current employer. I recommend you to read on!

Becoming a Digital Media Sensation, While Struggling with Depression — a wise and touching post by Jennifer Pastiloff


“I’ve carved out a beautiful life and love what I do, but sometimes, especially lately, I feel the old tug of depression, that magnet of sadness which is buried somewhere next to the grief of losing my father at such a young age, but not relegated to that grief. “

This poignant line comes from an article I’d like to recommend by  She’s a young yoga teacher, inspirational speaker, and a digital media sensation (pictured above), who writes about her battle with depression, and how she’s making tough choices like staying on or getting off antidepressants (for her pregnancy and then after) and how (or even if) she can deal openly with her depression with her friends and many fans.  I’ve pasted another favorite piece of her post below followed by a link to the full post on xo jane…

“About a year after I had gone on anti-depressants, I quit the restaurant. I started leading inspirational workshops, which quickly turned into sold-out workshops and retreats all over the world. I developed this huge online following. It all happened very quickly — I went from career waitress to traveling around the world and being on Good Morning America and featured in New York Magazine. And all this success came while I was on meds.

I felt like a fraud. I felt like I should be able to use the tools I was teaching in my workshops and not have to be on anti-depressants. So I went off last summer, and about five minutes later got pregnant….” read the full post here:

New analysis of international suicide data repeats 10 year old finding; 85% suffer from a mental illness

Almost startling in its consistency, a new peer-reviewed study published in PLOS ONE (April 2, 2014) , a full decade after the often-cited McGill University metastudy on the relationship between mental illness and suicide risk, produced essentially the same major finding —  within 2%. The Australian and American scientists responsible for the new research paper, titled The Burden Attributable to Mental and Substance Use Disorders as Risk Factors for Suicide: Findings from the Global Burden of Disease Study 2010, compiled worldwide data from the World Health Organization (WHO) to show that 85% of people who die by suicide have a debilitating mental disorder. One difference: this study includes addiction as a major mental disorder, which reflects more recent classifications in the mental health field.

The underlying WHO data doesn’t fully represent mid to lower income countries so even this high a percentage linking suicide and mental illness no doubt underestimates the real numbers of people who die by their own hand in places where national and local health systems simply don’t count them. For better or worse, this research certainly covers most of us living in the US.

Sometimes the numbers provide important nuances to help us understand who, how, where, when and even why…

  • Nearly 1 million people complete suicide every year with over 50% aged between 15 and 44 years [14][15].
  • Over 80% of suicides occur in low to middle income countries and close to 50% occur in India and China alone [15][16].
  • the risk of suicide was 7.5 (6.2–9.0) times higher in males and 11.7 (9.7–14.1) times higher in females with a mental or substance use disorder compared to males and females with no mental health or addiction disorder
  • Suicide from firearms, car exhaust and poisoning are more common in high income countries and suicide from pesticide poisoning, hanging and self-immolation are more common in low to middle income countries [17].

There is also a telling graph of which disorders rank as the most and least dangerous in terms of suicide risk, with major depression leading the way: journal.pone.0091936.g004 Lastly, the authors also looked at prevention strategies, and found that equipping general practitioners to diagnose and treat major depression had the highest value as a strategy, with a few caveats, as usual having to do with the quality of care. ” This was one of the few interventions for which there was good evidence of effectiveness as a suicide prevention strategy in a recent review by Mann and colleagues. That said, ensuring that care from general practitioners is evidence-based requires further consideration, given findings that rates of minimally adequate treatment for depression are lower among patients treated solely by general practitioners or in the general medical care sector, compared to those treated by specialist mental health providers.”

The unavoidable point: treatable mental disorders if left untreated put you at a much higher risk for suicide. What else is there to say?

ADHD: a real disorder, denying it hurts children

This is a great article on the website “Real Clear Science” compiling the evidence to respond to those who fall on the overmedication of kids argument to deny the existence of this disorder:



Let Us Not Forget…Suicide, Even By Celebrities, is Most Often Preceded by Deep, Unrelenting Depression

With a spate of celebrity suicides and overdoses in the news, most recently those of L’Wren Scott and Philip Seymour Hoffman, we can find ourselves sidetracked with sordid details of their deaths, and stories of the fame and fortunes they won or lost. Idle speculation is made about possible motivations; e.g. most annoyingly in the case of Scott, did she fear aging, was it her business debts or did Mick dump her?  With such distractions, we can easily forget that a mountain of research now tells us that most people who take their own lives  (87% in a McGill Metastudy) spent many years before this final act battling a serious psychiatric illness. It is this disorder that undermines their ability to handle any new pressures of the sort  L’Wren Scott or anyone else trying to make a living, find love and raise children encounters today, while most people just slog through life’s ups and downs. Most often the particular disorder that precedes a suicide is unipolar or bipolar depression, or schizophrenia. And far too often one of these disorders is camouflaged by a substance addiction, also known as “self medication.”
          Thinking about all this with a high degree of frustration in recent weeks, I came across this book review I wrote about the memoir “Half in Love” by Linda Gray Sexton — someone who, it occurred to me, knows far more than most of us about celebrity and suicide. The daughter of the iconic Ann Sexton, a Pulitzer-Prize winning poet who famously took her own life in 1974, taking many an English major in her thrall (myself included), Linda inherited her mother’s bipolar disorder and her identity as a writer. In her book, Linda Sexton gives us valuable insights into the magnetic pull suicide can have on someone battling depression — particularly when both the disorder and the act of suicide run in a family. I republish it here in hopes we’ll all be reminded of the all too frequent suffering behind these headlines.


Linda Sexton’s Memoir Reveals the Dark Truth Behind Her Mother’s Brilliance

A book review by Victoria Costello (originally published on Psychology, Aug 2011)
          As someone who’s battled life-long major depression, I thought I knew enough about the depths of despair to which this illness can send you. And then I read Linda Sexton’s painfully explicit, at times claustrophobic, yet surefooted and ultimately redemptive memoir Half in Love, Surviving the Legacy of Suicide. When I put down Sexton’s book, I had a profound new understanding of the extent to which unipolar depression, my diagnosis, is the milder second cousin to the bipolar variety. This memoir leaves no doubt of the extreme danger conferred by the massive mood swings of bipolar disorder, particularly the high risk of suicide. It’s one thing to know it, it’s quite another to see it through Linda Sexton’s eyes as the child of a bipolar mother for whom death was both a demanding creative muse and Linda’s main rival for her mother’s attention.
          Interestingly, Anne Sexton managed to include young Linda in her creative writing process, going so far as to arrange poetry writing lessons for her daughter. But the pull of death was something else entirely, first for the mother, and then, in a near repeat of the same tragedy, for the daughter who emulated everything about her. Linda Sexton begins her story on the evening of her first suicide attempt, when she takes narcotic pills and slits her wrists in the bath tub of her family home while her husband is away on business and her teenage sons sleep in their rooms down the hall. As she sinks into unconsciousness, Linda remembers the promise she made to her boys that she would never do to them what her mother had done to her, and then proceeds to nearly do it. The author describes her loss of resolve with heartbreaking honesty. “I was ready, at last, to cheat on love. Ready to renege on assurances that now felt as if they had been too easily given to everyone-children, husband, sister, father, friends. Immersed in communing with my mother, I became a small child that night, a vulnerable daughter. She seemed right then to hover in the room, guiding me. I knew that when I finished, she would be waiting to fold me into her arms, and I would go home with her one more time.”
          The next scene, appropriately, brings us back to the morning in 1974, when, as a 21 year old college senior, Linda learns that her mother, by then a Pulitzer Prize winning cultural darling, has finally, after innumerable attempts, succeeded in killing herself by carbon monoxide poisoning in the family garage. Over the next several chapters, Linda recounts her later childhood and teen years at the hands of this often loving, but wildly inconsistent mother. By the time the author returns to the night of her own suicide attempt, she is forty-five years old, and we are not a bit surprised to learn that she has reached the same age as Anne Sexton when she took her life…so strongly has Linda brought us into her visceral experience of being the adoring, insecure daughter who identifies completely with a beautiful, vivacious, but helplessly narcissistic parent.
download The fact that it is Anne Sexton’s bipolar disorder–never properly diagnosed or treated–producing this deranged parenting is never far from the reader’s consciousness. The daughter well understands her mother’s feelings of hopelessness; within months Linda receives the same diagnosis. Linda Sexton’s journey to recovery is well worth reading for itself. But because of  her mother’s cultural significance, Linda’s story offers us other insights. After reading Half in Love, I re-read some of Anne Sexton’s poetry, and watched some videos of her readings from the 1960s, performances that are now easily accessible on You-Tube.
          I also read with dismay the review given Half in Love in the New York Times in February of this year. While it is mostly positive, the reviewer ends bizarrely by lamenting that Linda Gray Sexton is not a carbon copy of her mother, writing: “There is, however, no getting around the fact that Sexton never becomes as compelling a character as her mother was… Even when she was sickest, Anne Sexton managed to create a vibrant world around herself, never losing her status as a figure to be reckoned with.” About Linda Sexton’s book this critic writes, “There is a surprising blandness to her sensibility, and her cause isn’t helped by overwrought language and hackneyed therapy-speak.” Well, gee, I thought, should we really be surprised that the story of someone in recovery isn’t nearly as “compelling” as that of someone who never leaves the path of self destruction; abandoning her children while self-medicating and, driven by her mania, giving riveting performances of suicidal poetry all over the world?
          The poetry of Anne Sexton is startling and beautiful; just as she was. But what Linda’s story finally makes clear is that her mother could barely get to her desk, let alone write something beautiful when she was in one of her long stretches of depression, which would frequently go on for months. I couldn’t help but wonder…aren’t we beyond the idiocy that says mental illness and great art somehow need each other? There are numerous studies showing that although the mood swings of bipolar and the cliff-edged near psychotic thinking of schizophrenia can bring extra-ordinary creative insights, everything else about these diseases can extinguish the same insights There’s still the odor of romanticization here.
          I highly recommend Half in Love, Surviving the Legacy of Suicide. The good news Linda Gray Sexton offers in her final chapter is the arrival of her own hard won stability. And then, in a touching and beautifully rendered scene, she shares the conversation she has with her two now grown sons, in which she asks their forgiveness and speaks openly about the illness for which they too are at high risk. The fact that this conversation happens at all offers real hope that the legacy of suicide will, at least in this family, finally be halted.

Book Review: By All Means…Where Mindfulness Meets Mental Health

By Edward Brown   Illustrations: Margot Koch

Missing Links Press  Reviewed Jan/2014 (Releasing April 2014)

To Buy on Amazonbook cover

A few pages into this “Zen cautionary tale,”, the dramatic stakes are set high and our attention is arrested when its main character, Edward, barely manages to extricate a piggy hand-puppet from the jaws of a neighborhood feline – just as the interloping cat tries to slink out Edward’s side door.

We soon learn that Edward is a revered, Northern California spiritual master and teacher who, on this day, is preparing to drive a few hours south to give a talk.

In “real life” he is known as Edward Brown, the equally revered Zen Buddhist teacher and author of the beloved Tassajara cook books.

So begins Brown’s intimate, revelatory and often LOL funny novella, which is enhanced by the knowing illustrations of Margot Koch and released this month by San Francisco’s Missing Links Press.

Readers are as grateful as the piggy puppet, named Ponce, when Edward keeps him at his side for the rest of this gently taut adventure tale, complete with a mid-life love story, a near-tragic climax and an emotionally and spiritually rich dénouement. The book’s heart center belongs to the rescued pig puppet. As narrator, Ponce adeptly moves between the voice of Ed’s wounded child-self to that of the grown up Edward – who in turn shows up alternately as Edward the venerable Zen master or “Eddiebear” (Ed’s childhood nickname) — the flawed human being for whom centeredness or masteries of any kind are moving targets.

When Ponce speaks as the young Edward, whose abandonment issues stem from having lost his mother at the tender age of three, Brown makes us feel how that loss formed him and still fuels the 60-something’s foibles and frustrations, as in this scene when Ponce expresses Ed’s satisfaction when Margot compliments his cooking:

This pleased Edward quite a bit because if she liked his cooking enough Edward supposed that she wouldn’t leave, and that would be a good thing not to be abandoned, though, of course, he’d have to keep on cooking.

Brown uses this juicy biographical material to dole out more than pop psych. Ponce’s insights run deep and wide, too, as when he muses on the challenge Zen Ed faces “teaching enlightenment to people not especially interested in waking up”

Even in relationship it seemed that people often aimed to not relate. They’d say, “I like your act, do you like mine, too? You do your act with me, and I’ll do my act with you. Okay? Is it a deal?” Let’s get together and not actually meet, shall we?”

Oh my, I thought, as I brought the book into my lap for a moment of uncomfortable self-reflection.

To provide comic relief from such truth-telling, narrator Ponce is also charged with regularly tossing Ed off his pedestal. Here, in preparation for the appearance in Santa Cruz, Ponce watches impatiently as “the master” carefully selects, folds and packs his proper Zen wardrobe, including the mandatory “white jiban, beige komono, dark brown obi, and a handsome stick,” noting:

Check, check check, if you were going to be a Zen person, it was important to be masterful and nothing says masterful like fine robes. Unfortunately Edwards’ were getting to be threadbare, especially if you looked closely, so everyone knew that he was over the hill just like his robes, a teacher that some conceded, ‘might be good for beginners.’

For me, there was identification and surprise in Ed’s Woody Allen-esque “meltdown” as he multitasks himself into distraction on his way out the door. As I try to insert meditation into my morning routine – before the coffee, Tweets, and Facebook postings that typically launch me into the work day — I have flashed more than once on one of the book’s most reassuring messages:  that we are all beginners.

For Edward, the character, a lack of mindfulness could take a serious toll as he begins the drive to Santa Cruz. A jammed Marin commute brings about a chain of events that force him to confront his own mortality, and highlight his shortcomings as a friend and protector to Ponce (who is, after all, the abandoned Eddiebear).

And yet, all may not be lost. Despite Ponce’s immediate, terrifying predicament, seemingly abandoned by Edward and stuck in a dark, cold place, our piggy puppet discovers that by changing his perspective, by looking “from the center of the sparkle,” there is a glimmer of light and promise of another, perhaps more enduring rescue.

Mindfulness and Mental Health

I recommend Ed Brown’s By All Means to anyone – teens and up — seeking inspiration for a more mindful, less stressful life.

More germane to the mental health community, I believe By All Means can provide valuable comfort and support to anyone struggling with a mental disorder — in themselves and/or a loved one. Writing from the perspective of someone with lifelong depression, and as a parent to an adult child with depression, I can attest that those of us who are dealing with the symptoms of a mental disorder face one daily, constant, and fundamental task: to manage our minds; and, when pulled away by scary, negative thoughts, to step back from the precipice of hopelessness and despair that can engulf us.

Like Eddiebear and Ponce, we each carry emotional wounds into adulthood – wounds that can make dealing with difficult symptoms, and thoughts, all the tougher. But, like the characters in this honest and insight-packed book, we absolutely can acquire and commit to a set of practices – call them spiritual or therapeutic, it doesn’t really matter – that will help us find a way out.

As a beginning student of mindfulness and meditation, I am struck by the similarities between the techniques I’m learning to gently tell my mind “get back to you later” while attempting to focus simply on my breath, and those I’ve been given in cognitive behavioral therapy to manage negative self-messages and obsessive thoughts. In both cases, the primary technique used is to observe without making negative self-judgments; in other words, to practice kindness with ourselves.

So I recommend this book as one way to gain new perspective and help that process. . As always, I also suggest you talk to a friend or a mental health practitioner if you are having a tough time.