Beyond Blue

Beyond Blue

An Interview with Liz Spikol

liz spikol .jpg
This interview is from November, 2007.

Thanks to both Larry Parker, who now has a blog, and Lilit Marcus for directing me toward Liz Spikol’s mental health blog, “The Trouble With Spikol.” I have so enjoyed following her blog because (not totally unlike me) she is brutally honest. A woman who tells it like it is … that’s Liz. And I love that about her.


Liz is senior contributing editor of “Philadelphia Weekly.” She writes the award-winning column “The Trouble With Spikol,” which began as a chronicle of her struggle with mental illness, and has since expanded into humorous musings on everything from graphic novels to how to use a mop. She also writes the paper’s book review column, Lit Gloss. Her blog — named one of the Top 10 Bipolar Blogs of 2007 by PsychCentral — is about mental illness policy, news, personal journeys and more.

You can check out Liz’s video blogs by clicking here.


1) For your Nov. 21, 2005 post, you wrote:

I write a column called “The Trouble With Spikol” for Philadelphia Weekly. It’s often about my struggles with mental illness, specifically bipolar disorder and OCD. I was also diagnosed with dissociative disorder N.O.S.–which means I suffer from intermittent depersonalization and derealization. Blah, blah, blah–check the DSM-IV for more.

Here are the meds I take: Seroquel, Lamictal, Ativan, plus Melatonin for sleep. The meds have saved my life, though I need to add an antidepressant to the mix soon.
I want to write here in a quirky and penetrating way about what’s going on with mental health in this country: medication issues, insurance coverage, stigma, prejudice, stereotypes, substance abuse, co-occuring disorders, diagnosis problems, legislation, psychiatry vs. psychology, electric shock therapy, new treatment options, and more. I’ll also chronicle my own experience.


How did you arrive at that mission? Anger? Frustration? Desperation? What gave you the courage to “come out” publicly. I know from personal experience it’s not easy, especially when you’re surrounded by Tom Cruisish friends and family trying to persuade you that your meds are toxic. Was there one moment that you said to yourself, “the hell with it, I’m going to tell it the way it is.”

It was inadvertent, really. I was working part-time as a proofreader at “Philadelphia Weekly,” trying to do something to get back into the working world after having been on disability. While there, I was given an opportunity to write a teeny little blurb about having an Easy Bake oven as a kid. The editor of the paper, Tim Whitaker, loved the blurb. He thought it showed great promise, even though it was about 150 words. He asked if I wanted to write a column. Every week. About myself. Um, okay. Give it a try, he said. Write about Liz. The life of Liz. Little did he know the life of Liz was seriously pathetic at that time.


So I wrote a bunch of samples that had nothing to do with the real me but that nicely obscured the fact that I’d been struggling with a mental illness for the past seven years or so. I brought the samples with me to coffee with Sara Kelly, Philadelphia Weekly’s executive editor, and she was lukewarm about them.

Finally, I just told her the truth. “The reason I don’t have anything to write about it is because I’ve been struggling with a mental illness for the past few years and haven’t had a life. So I don’t even know where to begin in terms of being a normal person.” Sara said, “That’s your column, right there.”

And thus “The Trouble With Spikol” was born, as a newspaper column. (The blog came several years later.) I was lucky in that my parents were very supportive. They always told me to write my life as I knew it, as honestly as I could. My dad was a writer and editor when I was growing up, so it was the family trade. My parents were thrilled, and they never ask me to censor anything.


2) In my humble opinion, I think what makes your blog top-notch is the combination of valuable resources you give your readers, your commentary on pop culture regarding mental illness and its stigma in this country and around the world, and your own very dramatic and interesting personal experience. Plus, of course, your writing skills. But few people who have been as disabled by a mood disorder as you have–eventually seeking relief in ECT–can function so well on a professional level. I’m amazed. What’s your secret? (Not that this is “Parade” magazine.) If you had to name three things that you remember or do everyday to keep you out of the hospital, what would they be?


1. Take my meds.
2. Take my meds.
3. Take my meds.

Le me elaborate. Every person is different, so it’s unfair to say that taking medication is the answer for everyone. For me, the medication is the foundation of my sanity. Without the medication, everything else falls apart. But let’s say we’re taking the medication for granted. Here are the additional things that keep me out of the hospital:

1. See my psychiatrist every two weeks.
2. Never drink alcohol or use recreational drugs.
3. Get enough sleep.
4. Stick close to a daily routine that involves seeing other people who are expecting to see me, so I feel like I exist.

Oops – that’s four. But what’s number 5? Be nice to myself, and forgiving!


3) I’m also curious as to how you and your psychiatrist decided on ECT (electroconvulsive therapy). I almost went that route after 22 medication combinations failed. Luckily for me, the 23rd was the ticket! How many medication combinations did you try before ending up on the gurney? Or were you so suicidal that you didn’t have time to wait to see if the next combination would work?

Ah, the med-combo roulette. Lovely, isn’t it? I never stopped to count, but it was years and years. I had tried everything.

I was so suicidal for so long, I simply couldn’t bear it any longer. I was ready to die. I had been in and out of the hospital, had attempted suicide, had been officially labeled “treatment-resistant,” which after a few years felt the same as having “hopeless” stamped on my forehead. I was desperate. I told my mother I’d kill myself if I couldn’t try ECT. She had no choice but to agree. ECT was misrepresented as a sort of last-resort treatment, which suggested it might work for more than, say, four weeks. It didn’t. Oh, and no one mentioned my memory would be shot, and I’d lose cognitive functioning.


Later, when I was writing an article about ECT, I called the doctor who’d performed the procedure on me years before. I called him as a journalist, not as a former patient. I asked, “What happens to a patient with dissociative symptoms who gets ECT?” He said, “A patient with dissociative symptoms should never be given ECT.” I said, “But I got it, even though I had those symptoms.” He quickly ended our phone call. Suffice to say, ECT wasn’t a positive experience for me. But I know for others, it’s been life-saving. I just wish people knew more about before they went into it.

4) I’ve watched a few of your video blogs and you look so comfortable in front of a camera. Move over “Lonely Girl.” Personally I’ve struggled a bit with video blogs because they have been one more level of self-disclosure. As you know, it feels a bit like stripping in front of your readers (not that I have experience stripping). How has it been for you? Is it more challenging and time-consuming than writing? Why did you decide to do it?


I’ve always been a bit of a ham. I was one of those kids who loved to be in plays in musicals in school, starting in kindergarten. If I could be onstage, I would. It didn’t matter if I was just playing the triangle, I wanted to be up there. I’ve always felt more comfortable doing public speaking than chatting one on one at a party. Give me a lecture hall with 300 people and I’m completely at ease, even if I’m talking about very personal things. Self-disclosure doesn’t scare me. Hiding scares me. I hid what was wrong and ugly about myself for so long, and it almost killed me to be alone with all that pain. I want to live in the light now. How can people help you and love you if they don’t know you?


5) One of your videos was on weight gain. And you raised some excellent points. At the time you taped that segment (a year ago, I think?), you were feeling really depressed but you didn’t want to go up on your Effexor because of weight gain. I can empathize. I, too, was on Zyprexa for a month and managed to gain 20 pounds in that time. I said to my psychiatrist that, as a person with an eating disorder in her past, I’d take suicidal thoughts over the fifty additional pounds I was about to gain. It’s such a fine line. Any words of wisdom to the depressive who has packed on the pounds to stay sane?

If you ask me, this is the worst thing about dealing with psych illnesses (other than the madness itself): the weight gain. Zyprexa? Oh my god. I gained so much weight on Zyprexa. Right now I’m on Topomax to bring my appetite under control because I did have to increase the Effexor. I mean, ultimately, it’s impossible to live with suicidal depression. It’s easier–though just barely–to live with extra weight. But I have no words of wisdom. I struggle with this every day. It makes me angry and miserable. I play the piano and that’s very important to me. Yet if you told me that, for one pinkie finger, I could stay at a perfect weight for the rest of my life and never have to worry, I would not hesitate. Isn’t that twisted? So yeah, no wisdom here.

6) One more question. What’s gives you the most joy in your life? I realize that I sound like Oprah here. But seriously, what motivates you to get out of bed on the hard days?

Cute If nothing else, I have to see what the daily cuteness is on that website.

  • Wisdum

    I just got this from my brother, thought it might work for you ALL today (or anday !)
    LUV 2 ALL

  • Nancy

    Therese – Thank you for these posts today. This has been a difficult topic for me, to put it mildly. As an overweight, medicated depressed person with me/cfs/fm, I don’t even recognize myself any longer. I have physically become what I worked at preventing most of my life (since my teens), and honestly I hate it. It may sound shallow to some, as people are dealing with many losses and challenges, obstacles and adjustments in life; however, this for me, is big (no pun intended – well maybe, since I thought of using another word and left the word “Big”.
    I have more challenges than weight gain. In fact, physically moving each day is a challenge from my other illnesses. My entire life has changed these last 5 years, but I will stay with the topic on weight gain and its affect on me.
    Several year ago, it became apparent that my meds were no longer effective. The other illnesses had jump-started the depression and anxiety into the worst state ever. Then followed l l/2 years of the merry-go-round of trial and error of meds and comibinations thereof. Finally, it appeared that Effexor, along with others would be the right course. Initially, my Psychiatrist said that this was a newer one where patients could expect to lose weight!! Well, whoopee!, something good out of a nightmare.
    Not. I started to gain weight, which of course, since the good doctor said I would lose weight, made it my fault (in my mind). Since the lower doses of Effexor were not nearly enough to be of any substantial help, I eventually came to be on the full therapeutic dose, which my body went pound for pound with each passing day. I felt as though someone hooked me up to an air pump and was preparing me for the Macy’s Day Thanksgiving Parade. A total blimp – with no strings necessary to keep me from floating away. I was definitely not airborn.
    Add to that the other lovely “invisible” illnesses that have consumed my being and life, and the process just took off at a pace that was unfathomable to me. They include a metabolic syndrome, which was a nice way for saying – “you are going to gain a lot more weight and look like total crap, and there’s nothing you can do about it – sorry -it’s part of the package deal”.
    The “other illnesses” cause a post exertional malaise. I used to run – now I cannot walk 2 flights of stairs without it causing a rebound effect. It’s something that would take paragraphs to explain. There are 22 other components involved, and I never would have imagined this existence for anyone, had I not experienced myself. I still don’t believe it at times.
    Having said that, my one “tool” for weight management in exercising was removed (not of my own doing). I am on the very extreme spectrum of these illnesses.
    I read what Dr. Gupta said about drinking water. I could be a flipping camel. I must drink enough to keep Poland Springs in business all by my own consumption. Yes, I recycle my plastic bottles. I have gone through the gamut of eliminating refined sugars, increased fiber, blah, blah, blah. Having said that, I am now 60 pounds more than I several years ago.
    I did not weigh this much with both pregnancy weights combined. The irony is that back in the 70’s, when it didn’t have a name, I was Anorexic. I was 5’6″ tall at 108 lbs. and wanted to drop more. That was at 16-17 years old. One pound of weight gain was disasterous. My blood sugar was so off that one time when I was standing at the bathroom sink (as a teenager) in my parents’ home, I passed out and crashed through a stall shower door that had “unbreakable glass” and went into convulsions.
    I “recovered” somewhat from that intense phase, but it was always an issue. I loved being pregnant, but after both pregnancies,I returned to exactly where I was in weight prior to being pregnant. I had so many issues with weight and appearance, and I know today, it was not healthy. I would not want to return to being that person who could not see the truth and had a type of body dysmorphic condition.
    I am fortunate that I have a loving husband, who knows the “old me” (funny that I should write that – as though that was the “better” version). I’m at a place that I abhor. I’ve gone through anger, self-hated, grieving, hopelessness, and acceptance, and back and forth again. I have changed clothes sizes more times than I care to count.
    Now for the outside world and their words or lack thereof. I hear what Liz said about people saying when you’re thin – “You look great” – well I know what they’re thinking now. I hate when my mother says – “Well – you can’t tell” – I know she means well, but it doesn’t help. I’d rather have her say, “Wow – it must suck, having to accept the changes and limitations that are a by-product of your illnesses and medications”. I’m not saying that I’d want someone to come up to me and say, “Hey – have you turned into a porker – what the heck did you do to yourself?” And if I didn’t think people thought that before, I know they do now from an experience through another friend.
    A friend of mine had to go on Effexor also. In addition to that, she had surgical menopause and other illnesses. She gained a great deal of weight in the same time frame that I have. We look like different people from her wedding pictures a few years ago. Having said that, she is working on accepting life and herself as is.
    However, friend #2 comes into the picture. I’m now referring to a woman who holds a very esteemed position in the mental health field in our area; along with a private practice in therapy. She had not seen friend #1 (who I just described) in 2 years. When she did, she sent me an e-mail that said this:
    Dear Nancy,
    Hi – I saw “K” on Sunday. She gained a tremendous amount of weight. She looks horrible. What did she do to herself?………. and proceeded from there.
    I was furious on a number of levels with this woman and her e-mail; however, it confirmed what many people “sterotype” weight gain to be. A self-imposed lack of care and attention to one’s self. This woman was literally digusted and horrified.
    I responded to her with “K”‘s circumstances and health issues and called her on her “judgment”. Of course, her reply was that it was not a “judgment” but an “opinion”. Oh gag me on the semantics. I then replied,”Well, now I know what you’ll be thinking when you see me, as I am in the same position physically. So thanks for letting me know.” I suppose I held this person to a higher standard and expectation, particularly because of her line of work. Any illusions I had of her are gone.
    If I were to reduce the meds in order to attempt some semblance of weight reduction, I would personally be playing “Russian Roulette” with the gun pointed to my head. I have a husband and children, and they don’t deserve that. It’s way too much of a risk, and I can just barely function as it is. I know the truth, and it’s about me accepting me, regardless as the whether I think it’s fair or if it pisses me off or as Liz so well put it “I just want to sleep and not be”. Sometimes it’s all too much to constantly process.
    I know the cognitive tools to implement. I utilize them. It is still a difficult journey. I thank God for a husband who loves me regardless. I did know I was getting fat – the other “f” word, when he said to me “Nancy, I love you for the person you are.” Okay – now I’ve really tipped the scales. Yes, I know that is a wonderful,kind, loving and supportive statement. I know he has witnessed me as a different person on many levels, prior to not just the weight gain, but also these other illnesses.
    I feel trapped within this being somewhere, both mentally and physically. I won’t say that I’ve evolved to never being self-conscious. It would be a lie. I’m a work in progress. Just for today, I will think more of living in the solution, deliberately creating a mental gratitude list and venting when and where I can. Not whining, not poor-me, just sharing my own truth; the good and the bad. It’s where I’m at, and I strive to improve. I am trying not to slip into an all to easy state of hopelessness and futility; so I wrote today.
    Thank you, Therese for deciding on this topic for your posts today. It was the catalyst I needed to just write some of this stuff down. It may not change anything on the outside, but as we all know too well, it’s an inside job.
    Blessings to You, Nancy

  • Chantal P.

    I just stumbled upon your blog and was amazed by the great content that you have. It’s great to know that someone with mental illnesses and previous demons was able to be so successful. There is a very large online community that would really benefit from your stories and advice. It’s so much easier to get through something like depression, or being bipolar, or having anxiety when you have people to talk to and share with. I think you could really help alot of people at this one community that I am apart of. It’s at, and if you want to check it out, you can at :
    Thanks so much for posting! have a good one!
    Warmest Regards;

  • lapatosu

    Ah, weight gain. It was the reason I used to go off the meds once. I was approaching 50, had seen too many infomercials, started comparing myself to the wrong people and started believing it was all in my head, and if I didn’t drop the weight then, it would never happen. I lost the weight, but it wasn’t the kind of “diet” I would recommend.
    I’ve been reading Liz’s blog for some time now, courtesy of Larry. I am always grateful for the reminder of meds, meds, meds.

  • lapatosu

    And Nancy – What we are learning is compassion for ourselves and others. Sounds like your former friend in the health field could use a dose.

  • Larry Parker

    Just to state the obvious to start — my mini-blog (that’s all it really is, since it’s just a subset of Bnet) is NOT a competitor of you and Liz. I love you both dearly (as bloggers and fellow travelers, of course — just a fan, not a stalker!) and it would be great to get the opportunity to meet you one day, Therese, as I’ve gotten the chance to meet Liz.
    You’re both different in your religions, family situations and writing styles, yes. But that’s the beauty of what you both do to, as Liz put it, bring this disease into the light. Precisely BECAUSE it can strike anyone of any background, and make us feel so alone even though ironically (and tragically), we are not.
    PS — Nancy — given some of the harrowing experiences you have shared and your storytelling skills, you might want to think about joining the blogging brigade as well :-)

  • Susan~Dove

    I loved watching this video. I had to laugh though because of her blunt honesty and her ability to just be herself. I swear I am going to make a video! When my lazy bum manages to find the old cam that I used to have hooked up and I manage to crawl under the computer desk and hook it up….maybe Christmas huh? lol.
    I love how all these videos of real people make me feel well normal. There really is no such thing that is what a psychologist told me once. Today I had the same thing happen to me. I got out of bed, rooted for some food, seems the human squirrels in my home don’t store much so I decided to go back to bed. I think I went back three times. I even managed to have some dreams about fairies and angels. Now that is something I don’t dream about often so I consider my decision to stay in bed all day a good one.
    Now if I could just quiet that critical parent in me that says…ooo do you know how many hard working men and women out there would die for one day in bed and you get to stay home most of the week and feel sorry for yourself? huh do you? I know I’m lucky in that area only having to work two days a week but the free days can have their own war to wage. Take a creative fast thinker and the brain can go so far into over drive we drive ourselves off a cliff….internally at least.
    Well I got off the track there but I agree with the meds thing. I have spent the past 20 years taking these meds and my first experience I put on 30 pounds in one month and became suicidal. After that I was diagnosed with FMS/CFS and I had no choice but to take more drugs. I started out at 145 pounds post 4th baby and 18 yrs later I am 220 pounds. I take so many drugs I can’t keep them all straight and I’ve even tapered them off without the doctor knowing it. I’ve lost most memories of my children and I can’t remember something you said to me 3 minutes ago. There are far more side effects than I can list. I’ve tried so hard to drop the meds that cause more health problems then they are worth but the mental anguish caused by physical pain and then emotional pain is so great it’s the weight or suicide and I had to choose the weight. Sigh….viscious circle.
    I hate my fat body and it’s ruined what sex life I could have had. So I guess we all need to make our own decisions but ultimately!!! Self preservation is number uno! If you are suicidal without medication take it! if you are suicidal on it then dump em down the toilet or tell the doctors they can eat them if they think they know everything.
    Most of all try to keep some humor and learn to laugh at yourself…it’s my secret weapon…still roflmao

  • geri

    ie: Cute…
    you should also try a daily dose of news to enthuse at
    My motto is, GOOD Happens!
    Terese, Dr. Kevin Keough has been a big supporter of the Good News Network and told me I should contact you. One of the amazing things about 10 years of publishing positive news is when people who have suffered with depression contact me and tell me how they can enjoy life more now that they know about all the good things that are happening out there.
    Sign up for my free email newsletter “The Top Ten Good News of the Week” — and see if it might be something you’d like to pass along to your viewers, or add to your own life.
    (in the right column of my homepage

  • Nancy

    In reference to asking Liz to name three things that she remembers or do everyday to keep you out of the hospital, what would they be?
    1. Take my meds.
    2. Take my meds.
    3. Take my meds.
    I appreciate her emphasis on this issue.
    I read a sidebar on another bloggers philophy on Depression, etc.
    One bullet point was –
    “Be careful! Medication can have lasting side-effects.”
    and I’d like to add to that, Suicide can have permanent ones.
    For me, without meds to this point, I would have committed suicide either overtly or as a by-product of “self-medicating” with excessive amounts of alcohol or other substances.
    I do not enjoy or relish taking meds. It was not a goal of mine as a teenager, looking off to the future as part of my life. Gee, I hope I develop a severe mental illness and require a difficult journey of medication. It just is, and I suppose in all of the imperfectness in the “hunt and peck” process for any of us seeking help with a physical illness involving different types on the spectrum of mental illness, along with unwelcome side effects, it is a better alternative than trying to overcome what was “tougher” than me and fight me to the finish of my death without some “backup”.
    I realize this is not everyone’s experience. Some people’s level of depression or type thereof is simple enough or short term in nature where behavior modification and cognitive thought reframing, exercise and food changes are enough to heal. Wonderful. Those are the blessed creatures.
    I am also blessed, as I have these imperfect medications, which I’ve already taken this morning, which allow me to read and write, be an worker and hopefully a contributor of goodness in life; along with being a wife and mother. I know my children’s life experience would be forever altered should I choose to eliminate meds. I would ultimately wind up driking alcohol to slow or stop my brain, and if not institutionalized, would probably become an old term of “wet brain” or most likely dead.
    I know my own history and patterns, and the saying “Insanity is doing the same thing over and over and expecting different results”. That would be the true insanity for me. I don’t look at myself as insane or nuts or crazy or less than because my being currently requires assistance in the category of psychiatric meds. The same as I look at any meds I currently need for other illnesses.
    I am no pill-popping lover of being a victim or slave to pharmaceuticals. Nor did I embrace a number of other illnesses in my life and the medicines and their side effects. However, in this area, I resisted for longer than I should have. I think back to generations where people didn’t even have the choice of medication. Many were the relatives that were put away; never to be seen or heard from again. Today, although far from perfect, as are we, there are choices. I know what a living hell it is to find a workable solution (not pefect, workable), which can decide to not cooperate with our body chemistry after a period of time, but I guess up to this point, I wan’t to live more than I want to die, as I keep trying.
    I have the following scripture above my computer on my bulletin board in my office – Isa. 40:31
    For those who wait on the Lord
    Shall renew their strength;
    They shall mount up with wings like eagles.
    They shall run and not be weary,
    They shall walk and not faint.
    Well – while I’m waiting, I’m doing my part. Some days I do it better than others, and some days I no longer want to wait. I do get weary and can bearly walk, let alone run. I cannot lift my arms above my head, let alone mount up with wings like eagles.
    That’s where faith, hope, trust in the process comes in. The Lord’s Prayer – “Give us this day our daily bread”. I am provided with the guidance, strength and direction just for this one day. It’s all I’ve got. When I stay in the day and not jump into the fear of the future, I have a chance of having a decent day. Even when it’s not decent, and I feel as though I have not been “given my daily bread”, I pause, I pray, and yes, sometimes I just downright cry from the magnitude of it all.
    So my wish is that we all have a peace-filled day; from the simple things to the larger tasks at hand (Larry – may God hold you in the palm of his hand on your transition today – keep you safe and feel the comfort of his care); that we may all come back to this sacred place of Therese’s “Beyond Blue” to share our experience, strength and hope, and lift each other up and along our way.

  • Larry Parker

    Nancy, I wanted to thank you publicly for your kind wishes.
    I also sent you a private message sharing my gratitude as well.

  • Kay

    Therese…… i tried to sign up to receive your blog in my inbox….I dont want to miss even one of them!! i was directed to Feedburner to fill in a group of letters of the alphabet which i did. but each time i filled in one set another set appeared….and there seemed to be an infinite amout of them and there was no end to them. what do i do next?

  • Cully

    re: So my wish is that we all have a peace-filled day; from the simple things to the larger tasks at hand (Larry – may God hold you in the palm of his hand on your transition today – keep you safe and feel the comfort of his care); that we may all come back to this sacred place of Therese’s “Beyond Blue” to share our experience, strength and hope, and lift each other up and along our way.
    Posted by: Nancy | November 3, 2007 9:46 AM
    Yes! We never know who will hear/read what we say or how it will affect them… like that saying goes – To the world you may be just one person, but to someone you are the world.

  • Daniel Haszard

    Eli Lilly has received the largest criminal fine ever against a drug company over their Zyprexa cash cow,add it all up comes to $4.6 billion, in Zyprexa settlements,fines,litigation.
    We put Lilly products in our babies they really need to clean up their act and quit with the white wash.
    Eli Lilly Zyprexa can cause diabetes
    I took Zyprexa a powerful Lilly schizophrenic drug for 4 years it was prescribed to me off-label for post traumatic stress disorder was ineffective costly and gave me diabetes.
    This is a powerful drug that can damage a young person physiologically for life.
    Please take with caution and learn as much as you can about side effects.
    Daniel Haszard

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When does reciting scripture become a symptom of neurosis? Or praying the rosary an unhealthy compulsion? Not until I had the Book of Psalms practically memorized as a young girl did I learn that words and acts of faith can morph into desperate ...

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