Category Archives: Blog

How to Get Rich From Writing

Here’s my blog post from earlier this month, published this month on the BWL website.

How to Get Rich from Writing

1. Write a book series in a popular genre, with appealing characters and plot.

2. Set the books in a place people love to visit.

3. Sell the series to a TV producer with a budget to film exteriors at your story locations.

When my husband Will and I travelled to Scotland last year, we were amazed by the number of ‘Outlander’ bus tours. These  3, 7 and 10 day bus excursions focused on sights associated with the time travel book series by Diana Gabaldon, set during the Jacobite risings in the 17th and 18 centuries. History, romance, mystery, adventure, science fiction, Outlander has it all. The tours stop at locations mentioned in the books or used for filming. I don’t know if Gabaldon makes money directly from the tours, but they help fuel her fans’ enthusiasm for the novels and the television programs that earn her royalties and gain her new readers. In Scotland we met a man taking an Outlander tour solely for the history. We teased him about being stuck in a bus with obsessive fans, most of them women in love with stories’ elusive hero, Jamie Fraser.

Eilean Donan castle, at the bridge to the Isle of Skye, played a role in the highlanders’ rebellion

Will and I opted for a less expensive tour through the highlands to the island of Skye. Our guide occasionally referred to the Outlander books and commented that they did a good job of portraying the feelings of the Scottish people of the time. This spring Will and I travelled farther south in Europe, to Sicily. While planning the trip, we searched the Calgary library for movies featuring Sicily and stumbled upon the Montalbano mystery series, based on the books by Sicilian author Andrea Camilleri. We started watching the DVDs and enjoyed the stories, their glimpses into Sicilian life, the scenery, and the characters — loyal Fazio, Mimi the womanizer, comical Caterella and chief detective Salvo Montalbano, an intelligent, honest, determined man with commitment issues and a love of good local food.

Will playing Montalbano in Scicli

When we arrived in the Sicilian city of Siracusa in April, we were surprised to find tour companies offering day trips to Montalbano film sites a couple of hours away. Since we were later renting a car and planned to drive through this part of the island we thought, let’s visit them if we have the time. Brochures for Montalbano tours in subsequent cities made us more eager to fit the sites into our schedule.

Our first ‘Montalbano’ stop was Porto Empedocle, birthplace of author Andrea Camilleri and inspiration for Vigata, the fictional town in his detective series. In 2003 the city officially changed its name to Porto Empedocle Vigata to attract tourists, but reversed the decision a few years later, perhaps because the ploy didn’t work or residents objected to the commercialism.

Porto Empedocle
Montalbano’s house in Punta Secca

The next day, we drove to the seaside village of Punta Secca, the location of the fictional detective’s home. This was May 1st, a sunny, warm Labour Day holiday in Italy, and it was hard to find parking. We followed the lighthouse landmark that appears in all the TV shows to Montalbano’s house, in real life a bed and breakfast hotel. Crowds gathered in the adjacent square, everyone taking photos of themselves in front of Salvo’s home. We walked along the beach, where he swims each morning, alone, except when he comes across a dead body or a crime being committed.

Montalbano’s beach, with his home and the landmark lighthouse in the distance

The Vigata police station scenes are filmed in nearby Scicli. Will and I arrived at the town’s main square to find a notice for tours of the ‘Vigata’ police station. Since we were the only English speakers interested at the time, we got a private tour. The guide told us this was Scicli’s actual police station until 2013, when the TV producers bought the locale for a permanent set to avoid having to rearrange items each time they filmed. No doubt everyone involved in the Montalbano series gets a share of the money collected from the tours that pass through the fictional station each day.

Me and Will behind Montalbano’s desk in the ‘Vigata’ police station

We spent the night in Ragusa Ibla. This hilly city and region is the location for all the other Montalbano show exteriors. On the main street, we passed a seafood restaurant announcing that ‘Salvo Montalbano’ eats here. That is, they claimed that Luca Zingaretti, the actor who plays the character, enjoys the food. The street’s bookstore was full of items related to series: DVDs, guidebooks to the Montalbano film sites, all of Andrea Camilleri’s novels plus other books written by him, including children’s books (souvenirs for the grandchildren) and cookbooks of Montalbano’s favourite recipes. A tip for writers: when your novel series goes big-time, make sure you write a non-fiction book about your protagonist’s special interest. Camilleri could almost make a living from sales by this Ragusa Ibla store alone.

Poster in Ragusa: Montalbano actor Luca Zingaretti endorses this local restaurant

Andrea Camilleri is far from the only person getting rich from Montalbano. Luca Zingaretti’s career has taken off. Residents of Punta Secca, Scicli and Ragusa Ibla reap the multiple economic benefits of increased tourism. Sicily has always been a place tourists love to visit, for the beaches, the history, the food and more. Montalbano tourism gives the island a little more boost. Riches aside, this must be enormously satisfying for an author.

Ragusa’s stunning hillside landscape is worth a visit even without Montalbano

Reading enhanced my holiday in Malta

For my July post on the BWL website, I wrote about a book I read during my spring holiday in Malta.

Holiday Reading

When I travel, I like to read books set in the place I’m visiting. Before my trip to Malta this April, I took out an e-book from my local library. The Information Officer by Mark Mills helped me appreciate many of the sights I saw in this island nation in the Mediterranean Sea. The novel takes place in the summer of 1942, when Malta was a British colony. Its strategic location 50 miles south of Italy made Malta a target for Hitler in WWII. During the novel, the Maltese are enduring daily bombings by Axis planes launched from Sicily.

In the capital city of Valletta, Malta, we visited the Lascaris War Rooms, underground headquarters for the Allies’ defense of Malta. This strategy map shows little Malta below the bigger island of Sicily. Italy was under Mussolini’s fascist rule in 1942 and part of the German Axis.

The Information Officer is a detective novel. Our hero, Max, is, essentially, the British officer in charge of propaganda. His job is to boost the spirits of the Maltese civilians under continuous attack. Max investigates the murder of several women, whose deaths are being ignored by his superiors. Is there a cover-up? Are the murders an attempt to undermine Malta’s resolve to sacrifice for the war? In addition to bombing the cities, Axis planes are sinking cargo ships bringing food and supplies and the residents of Malta are close to starvation.

Malta at War museum displays a Maltese citizen’s daily rations for a fifteen day period during the siege.

In the Malta at War Museum, my husband Will and I put on hardhats to explore an air raid shelter built during the siege. A character in The Information Officer commented that the Maltese had become creatures who lived half their lives underground. The tunnels included hospital and birth rooms for those who needed those services after the air raid whistle blew.

Birth room in the air raid shelter

The siege effectively ended in November 1942, after the Allies sent Malta 163 Spitfires for its defense. King George VI awarded the George Cross for bravery to the citizens of Malta. Each April, Malta commemorates the deaths of the 7,000 soldiers and civilians who died during the siege. Other countries, including Canada, still send flowers.

The novel also mentioned other aspects of Malta, which we encountered on our visit. The Dingli cliffs, the island’s highest point, were used for signals during the war.

Hiking on the Dingli Cliffs

Maltese balconies, a characteristic style of  architecture, appear on houses across the island.

Many residents paint their Maltese balconies bright colours

And our hero, Max, took a short recreational break on Malta’s smaller, more rural island of Gozo, as Will and I did with the mass of local tourists on Good Friday.

Sipping a cappuccino in the main square of Victoria (Ir-Rabat), the capital of Gozo

If you’re travelling this year, check out Books We Love’s selection of novels set in lands around the world. BWL authors offer a variety of historical and contemporary stories set in the United States, Europe, Australia, every region of Canada and more.

Using Your Hobbies and Interests in Stories

Summer is officially here. For my June commitment on the BWL Author Insider Blog I wrote about one of my favourite activities, hiking, and how I made use of it my three novels.

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Ten years ago, when my husband Will retired, we joined a hiking club. In a recent radio interview, I talked about the enjoyment we both get from heading out to the Rocky Mountains, a couple of hours drive from our city of Calgary.

“When I’m out there, all my cares vanish,” I said. “We carpool, too, and socialize with an interesting group of people.”

The broadcaster commented that mystery writers might imagine insidious actions that could happen on a hike. He asked if I’d ever included this in a novel. All I could think of was one scene in my first book. Afterwards, I realized that hiking appears in all three of my novels.

Overlooking Arnica Lake, Banff National Park

In Deadly Fall, book one of my murder mystery series featuring insurance adjuster sleuth Paula Savard, Paula hikes the Mount Indefatigable Trail in nearby Kananaskis with three suspects in the case she’s investigating for personal reasons; the death of her childhood friend. As Paula reaches the trail lookout, she starts to think that the two men on the hike are plotting something sinister. During a moment of panic and paranoia, she fears one of them will push her off the cliff.


Will and I hiked this trail before we joined the club and bought proper hiking gear. I found it a treacherous climb to an awesome view of the turquoise Kananaskis Lakes. I’d like to try the trail again with good boots and poles, but it has been closed for fourteen years due to grizzly bear activity.


Mount Indefatigable south peak

Ten Days in Summer, the Paula Savard sequel, doesn’t include a hike. But a suspect is an avid hiker and mountain camper. I felt this interest showed seventy-year-old Florence’s physical fitness and spunk. Florence is camping in the back country when a fire damages the building she lives in and kills the owner, who occupied the ground floor apartment. When the fire is deemed suspicious, she refuses to provide the name of her hiking companion, even though he could give her an alibi. Florence is, by nature, defensive and doesn’t let anyone push her around. She’s also more daring than I am, since I’d worry about bears if I tented in a mountain wilderness.

Not much protection in these little tents

Hiking plays the largest role in my third novel, To Catch a Fox. The book is partly set at a fictional self-help retreat in southern California. While personal growth and empowerment are the New Dawn Retreat’s primary goals, the body is also viewed as important. The retreat’s co-leader, Sebastiano, leads two hikes a day in the hills that enclose the valley location. Hiking struck me as the ideal physical activity for this spiritual place. Climbing trails is non-competitive, accessible to anyone who’s reasonably fit and requires little equipment.


Rummel Lake hike, Kananaskis

It makes sense for writers to use interests and hobbies in their stories. Whether it’s chess, doll-collecting or hiking, this is the author’s passion and a subject he or she knows details about without the need for research. But I also want to create a wide range of characters and there are many Calgarians who give zero thought to hiking. So it might be time for a novel without one single reference to my favoured activity. My next novel in the Paula mystery series will take place in winter, when most Rocky Mountain trails are covered in snow and have avalanche warnings. Hiking will be far from any character’s mind.


Unless someone ventures on a mountain trail and the situation turns treacherous and suspicious.

A Tale of Two Writing Conferences

Here’s the post I wrote for my May blog on my publisher BWL’s website.

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Every August I attend When Words Collide Festival for Readers and Writers here in my home city of Calgary. I don’t need to travel far. The weekend festival takes place at a hotel a fifteen walk from my home. In February, I travelled farther, to Lethbridge, a two-hour drive south of Calgary, to take part in Wordbridge, Lethbridge’s first writers’ conference.

Since the Lethbridge panels were only scheduled for Saturday, I initially planned to make it a day trip. But the conference also included keynote speakers at a snack and chat in the evening. To take full advantage of the event, I decided to stay overnight. My husband Will agreed to go with me and spend the day and evening walking outside if the weather was nice, reading, playing computer games and watching TV. We booked a motel room not far from the downtown venue using our credit card points.

Me in Lethbridge, Sept 2015 – The coulee park in downtown Lethbridge is a cool place to walk

The weekend turned out to be brutally cold. Will spent most of Saturday inside with his computer. At the conference, I sat on an editing panel and shared my experiences of working with editors. One of my tidbits of advice was to suggest that writers early in the process of a writing a book get a manuscript evaluation, which can provide insight into a story’s larger issues that will need to be solved before an expensive edit. The Writers’ Guild of Alberta offers this service to members for a reasonable price. I might take advantage of it for my next novel.


Panel on Working With an Editor

Seventy-eight people attended the Lethbridge conference. We met together in a basement room in the local library for panels that took place on the hour. I enjoyed the intimate atmosphere. The organizers were so pleased with Wordbridge’s success that they have already scheduled a second conference for Feb 7-8, 2020, adding a day of pre-conference activities and another room for two tracks of panels.

Wordbridge attendees at a panel

Wordbridge still has a long away to go to match the activity of Calgary’s When Words Collide, which anticipates 800 attendees this summer and 10 tracks of panels, presentations, blue pencil cafes, pitch sessions and more over a three day period. I expect to participate in a few panels and spend a lot of time in the Merchants’ Room helping with the BWL book sale table.


Nancy Bell and Jude Pittman at 2017 When Words Collide

But it’s not a competition between Lethbridge and Calgary. Wordbridge and When Words Collide complement each other. I’m sure this is why the Lethbridge organizers scheduled their conference for the dead of February, the opposite time of year of August’s When Words Collide. A writer friend suggested that we go to Wordbridge next year with a few other writers and make it a girls’ getaway weekend. That sounds like fun, especially if next February is a tad warmer than it was this year.


Downtown Lethbridge in winter


Launching a Novel

In case you missed it, here is my April 12th blog, which was posted on my publisher BWL’s website.

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On March 26th I hosted a book launch for my new novel, To Catch a Fox. For the venue, I chose Owl’s Nest Books in Calgary because I’d held launches there for my two previous novels and I love this independent bookstore which is so supportive of local writers. You’d think launches would be old hat for me the third time around, but I always find something new to worry about. This time, in addition to reading and answering questions, I tried out a power point presentation using a system borrowed from a friend. At the last minute, I decided to rent a microphone and am glad I did. It was easier to use than I’d expected. Close to 85 people attended the launch and those at the back would have had a hard time hearing my voice, especially after it was strained from 40 minutes of talking.

My friend advised me to make my book cover the first slide, for people to watch during the introductions

For my talk, I wanted an upbeat mood despite the novel’s dark material. So I chose a travel photo theme and showed pictures from my two holidays in Southern California to research potential settings for To Catch a Fox. I found I didn’t need notes, since each slide prompted me about what to say next. My idea was to give a sense of how I worked my own travels into the story and make the settings feel more real for readers when they later encountered them in the book.

This woman conveniently photo-bombed my picture of the Santa Monica boardwalk. Julie, my protagonist, jogs along this same boardwalk.

Initially, I planned to save my readings from the novel to the end of the presentation. Then I realized it would be more interesting for listeners to look at a picture where the scene takes place. So I paused part-way through my talk for my first reading. I was afraid this might break the flow, but it served as a transition between my first and second research holidays.

Julie questions a clerk in this bike shop at the Santa Monica Pier. Like my husband Will and me, Julie and her sidekick Delilah rent bikes and ride on the boardwalk. Their purpose is to question more bike shop owners, who might have known Julie’s mother in the 1980s. Will and I simply rode for fun.

As a non-techy person, I had to make three trips to my friend’s house to get the presentation working properly. My friend’s favourite part of the program was the cheesy apartment that Will and I rented for our first California trip. Julie and Delilah stay in this same place. Another friend who has started reading To Catch a Fox told me she’d have thought I was exaggerating the racy décor if she hadn’t seen the slide show.

The boudoir, where Julie slept. Delilah slept in the sofa bed in the cluttered living room.

I started writing To Catch a Fox when I got home from the first trip. After two drafts, I felt confident of my Los Angeles area details, but wanted to get a better feel for the novel’s primary setting — a fantasy retreat. All I had was a vague sense that it was about a two hour drive east of Los Angeles. When my sister-in-law suggested we join her on a cruise from San Diego, Will and I tacked on a road trip to the California interior. Our explorations wound up locating my New Dawn Retreat farther south than I’d thought, in a sparsely populated orange growing belt. We began the drive with a stop at the California Citrus State Historic Park and bought a bag of oranges. They were delicious.

This landscape below is the closest I could get to my imagined retreat. The New Dawn Retreat in my story features a broad lawn enclosed by hills, with citrus and olive cultivation on the hillsides.

For my second reading, I chose a scene set at the New Dawn Retreat.

The presentation wrapped up with questions and door prizes, which included an Owl’s Nest gift card as my thanks to the bookstore, a recently published chapbook of one of my short stories and, most exciting of all, bottles of Dawn dish detergent.

What I find most fun about book launches is seeing people from different areas of my life gathered together in one place. Friends, family, my fellow hiking and book club members, writer acquaintances, readers who’ve enjoyed my previous novels. I don’t get a chance to talk to them all, but it’s wonderful to see their supportive faces in the audience and to touch base briefly with a few.

And now, what will I do for my next launch? First I’ll have to write the book.

Never Say Never

For those who missed my monthly author blog post on the BWL website, here it is:
Twenty-five years ago, I finished my first novel manuscript. While I often have trouble coming up with titles, this title, To Catch a Fox, appeared on the first page. It came from a mystery novel, The ABC Murders by Agatha Christie. Toward the end of the book, Detective Hercule Poirot compares the killer’s act of framing someone else for the crime to a fox hunt. “The cruelty that condemned an innocent man to a living death. To catch a fox and put him in a box and never let him go.” My protagonist, Julie Fox, was a woman chased and trapped by a former boyfriend and her own demons.

The Fox Hunt by Alexandre-Francois Desportes

I worked on To Catch a Fox for six years, in the midst of moving from Montreal to Calgary and raising a family. When the manuscript didn’t find a publisher, I tucked it away the drawer. It was my practice-novel, I told myself, my learning-to-write process. I was certain the Fox was put to rest for good and was okay with this, I thought.

The red fox is the main quarry in European and American fox hunts – Julie Fox has long, red hair
I turned my attention to short stories, which require less time to complete than a novel, with the goal of getting something published for my efforts. The plan worked, although the publishing part took  longer than I’d expected. About once a year, I’d get a story accepted by a magazine or anthology or, in one case, for a radio broadcast, the news often arriving at a point when I felt discouraged about writing. In addition to the encouragement and growing publishing resume, I found the short stories useful for experimenting with writing styles. My first attempt at suspense was a short story about a woman on the run to Puerto Vallarta, Mexico.

I wrote my suspense story, Zona Romantica, during a holiday in Puerto Vallarta, Mexico
Another short story, Adjusting the Ashes, inspired my mystery series sleuth, Paula Savard. Like Paula, Ashes heroine, Carol, is an insurance adjuster with two grown up daughters, a broken marriage, and a longing for excitement. In her story, Carol investigates an insurance claim in the Calgary neighbourhood of Ramsay, where Paula lives. Adjusting the Ashes segued into my next writing phase, murder mystery novels. I wrote my first Paula novel, Deadly Fall, revised it, and sent queries to publishers and agents. A few bites, but what do I write while waiting for a publishing contract?

Insurance adjusters investigate claims, some of which are suspicious
Out of the blue, a fresh concept for To Catch a Fox leapt from my subconscious mind. Same title, same protagonist Julie Fox, same quest – to search for her mother. But almost everything else changed. The new story would have a suspense structure, with five viewpoint characters. None of the supporting cast appeared in the original version. Rather than Vancouver and Oregon settings, this story would take place in Calgary and California. Julie no longer travelled alone; she’d have a sidekick, her stepsister with whom she has prickly relationship. The plot and what Julie discovers in the end would be totally different.


Who knew the Fox buried in the drawer still had life? If you’d have told me fifteen years ago that To Catch a Fox would be published this year, I’d have said, “Impossible!” Strangely, I feel the title suits the new version better than original, since darker demons and characters now ruthlessly pursue Julie. You’d almost think it was meant to be.

It shows that you can never say never in writing, as in life.

My Top Five Reasons to Host a Book Launch

For those who missed my regular post on my publisher’s website last month, here it is:

Last fall a writer friend asked me, “Is it worthwhile having a book launch?”

I immediately answered, “Yes.” I’d hosted launches for my first two novels and planned to have one for my third release, To Catch a Fox. But my friend’s question prompted me to ask myself: what is the value of a bookstore launch in this age of e-books and online sales?

So here are my Top Five reasons for hosting a book launch.

1. It is a gracious way to tell people about my new novel. Instead of sending an email notice and link to a sales site, I am inviting them to a launch party. Some will feel pleased that I included them in my special event. Most won’t come to the launch, but they’ll have enough details to buy the book online or at their favourite book store, without my asking them to do it.

I’d suggest inviting everyone in your circle of acquaintanceship. For my first launch, I asked people in my gym class I’d barely spoken to before.

“You’re a writer?” some said, intrigued.

It started conversations and closer connections because I’d shared something personal about myself.

For my last book launch I designed an invitation postcard, but economized by printing invitations at my library

2. If you invite people, many will come. My first book launch drew close to 100 people, my second about 85. Both times, they packed the bookstore and a fair number bought copies of the book. Admittedly my two novels were long awaited releases. I’d worked on the first book for years before finishing it and finding a publisher; the second wasn’t published until 6 years later. Now with only a two year gap between my second and third launches, I don’t expect friends and relatives to feel as strong a need to come out and support me. But I’m hoping that newer friends and–dare I say it–fans will make up for some attrition.

Don’t forget the food and drink for your guests

The crowd gathers

3. Local media is more inclined to focus on an event the public can attend than on a book release. The entertainment editor of my Calgary Herald newspaper profiles an author most weeks. When he chooses a local writer, it’s almost always someone with an upcoming book launch or major reading. He schedules the piece for the week leading up to the event. Other local print media, radio and television might be similarly event-focused. It’s hard to get your books into any media, but a launch gives you a better chance. Independent bookstores also focus on events to draw customers and are likely to display your books and the launch announcement in their store windows during the week leading up to the launch.

4.  You might make your newspaper’s local bestsellers’ list. The Calgary Herald, my daily newspaper, publishes a local bestsellers’ list in its Saturday edition. The tiny print at the bottom states the list is complied by information provided by the Calgary’s 2-3 independent book stores. Sales at these stores are so low that any book that sells decently at a launch is almost guaranteed a spot on the list. Many newspaper readers look at the list for ideas of what to read. I know that other city newspapers have this feature. It’s worth checking out.

Calgary Herald Bestserllers’ List 2 weeks after my last launch & profile the weekend before the launch

5. And lastly, a launch is a celebration. You’ve worked hard on this book and deserve a party with family, friends and your devoted readers. Many venues are free or inexpensive. Food and drink might set you back $50-75, but aren’t you, your book and your supporters worth it!

February is Psychology Month Leaves us With Questions

I wrap up February Psychology Month with a look at evolution and Anxiety/Depression: two sides of the same coin?

In the 1950s and 60s, anxiety was the most commonly diagnosed mood disorder in North America. People talked of the Age of Anxiety; The Rolling Stones sang about Mother’s Little Helper, a reference to a tranquilizer commonly prescribed to housewives.

Starting in the 1970s, anxiety became eclipsed by depression.  Today, prescriptions for anxiety are dwarfed by antidepressants, the most prescribed medication of our times.

Why this change? ask Allan V. Horwitz and Jerome Wakefield, authors of All We Have to Fear: Psychiatry’s Transformation of Natural Anxieties into Mental Disorders.

And, furthermore, where is the line between natural anxiety and a disorder?

Their answers to this last question come from an evolutionary perspective. In the primitive world, where dangers were ever-present, anxious vigilance made sense.  Fear of strangers, status fears like making a public fool of oneself, fears of snakes, rodents and heights increased your chances of evading disaster. Better to over-react every time, than to relax once and die. Those anxious genes of survivors were passed on to their modern descendants.

In today’s world, strangers rarely present a threat; if one group of friends hate you, you can find another group; city dwellers are unlikely to encounter snakes and in northern climates snakes usually aren’t poisonous. Yet such fears are bred into us and can seriously impact our lives. Fear of flying is a common anxiety because it combines several archetypal fears – enclosed spaces, heights, loss of control. It wasn’t clear to me at what point the authors felt these fears should be treated by medicine or therapy, but they got across their view that these anxieties are rooted in human nature. It made me feel less odd about freaking at the sight of a mouse.

The authors’ first question reminded me of a movie — I believe it was Starting Over (1979) — where a person had a panic attack at a large gathering of women and a character asked, “Does anyone have a valium?” Every woman reached for her purse. Valium was that decade’s most prescribed anti-anxiety medication, although by 1979 anxiety was already losing ground to depression.

People didn’t change in the 70s and 80s, Horwitz and Wakefield say, becoming less anxious and more depressed. Anxiety and depression have many overlapping symptoms. Sufferers often shift between symptoms of each that could arguably be treated as a single illness. What changed was the diagnosis. This happened for a convergence of reasons.

The anti-psychiatry movement of the 1960s and 70s heightened the psychiatric profession’s inferiority complex (my words) relative to other medical specialties. Psychiatrists wanted to be viewed as scientific and, well, medical. They accomplished this by changing the focus of the 1979 DSM (Diagnostic and Statistical Manual) away from unproven causes to symptoms, which could be clearly specified.

Major depression has always been recognized as a serious illness, one that might require hospitalization like schizophrenia and bipolar disorder. Around this time, insurance companies were increasingly covering drugs that patients used to pay for on their own. The insurers wanted proof that applicants required treatment for medical reasons. The DSM III defined depression as a mental disorder, with simple qualifications – two weeks duration and general symptoms that might be mild, moderate or severe. The manual eliminated general anxiety as a disorder, requiring the anxiety be specific (ie. Social Phobia, Fear of Flying) and that it continue for long periods of time, sometimes years. Diagnoses for general malaise quickly shifted to depression so patients could receive insurance payments.

In addition, by the late 1970s, anti-anxiety medications were getting a bad rap, due to claims of their addictive qualities. In the 80s, when the giant pharmaceutical companies developed Prozac and other new types of drugs, they marketed them as antidepressants, although they might as accurately have marketed them for anxiety. In fact, some of those medications have since been approved by the US Food and Drug Administration for specific anxiety disorders. In 1999 the FDA approved Paxil for Social Anxiety Disorder (SAD) and Zoloft for Post Traumatic Stress Disorder (PTSD). Horwitz and Wakefield predict more approvals will follow, breathing new life — and profits — into the tired antidepressants.

Huffington Post Poll

They also predict a shift in diagnoses from depression back to anxiety. They note that the same sort of attacks that happened to the anti-anxiety medications in the 1970s are now happening to the antidepressants, “with questions about their effectiveness, side effects, potential addictiveness and safety.”  In addition, the patents for the antidepressants will soon start running out, resulting in lower profits for the pharmaceutical companies. This should prompt them to develop newer drugs to treat newly-defined disorders.

The authors add that, “The diagnosis of depression is no longer as useful to psychiatry as it was over the past quarter-century. The profession’s scientific credibility is now far greater than it was in the 1970s, its diagnostic system is generally regarded as reliable, and its biological models are widely accepted.” As  a result, they expect psychiatrists to be more willing to diagnose anxiety. It will be treated by the pharmaceuticals’ new type of medication marketed to treat anxiety, now acceptable to insurers as a genuine disorder.

I would add that anxiety is becoming more socially acceptable. It used to seen as a women’s problem; now men are admitting to having it.

Fighting the Demons

My re-posts about modern pschology and psychiatry continues with The Noonday Demon: an Atlas of Depression by Andrew Solomon. I chose this book because a couple of other books I read mentioned it, with praise.

National Book Award winner; Pulitzer Prize Finalist

Demon differs from those other books for several reasons. The author, Solomon, is a writer, not a medical expert. While the experts dealt with mental illness, in general, Solomon focusses on depression, from which he has suffered on and off for seven years (as of 2001, the year of the book’s publication). Solomon did extensive research to write the book, as evidenced by the 100 pages of footnotes and bibliography at the end. Demon is part memoir, part medical information, and part life stories of depression sufferers, many of whom contacted Solomon after an article he wrote about his depression was published in The New Yorker in 1998.

Solomon states up front that he disagrees with the current fashion of opposing medication treatment for depession because his father had a lifelong career in the pharmaceutical industry. As a result, Solomon can view the pharmaceuticals as both capitalist and compassionate, with a genuine desire to cure.

Given the vast numbers of antidepressant prescriptions issued today, as in 2001, I don’t know if I’d call an anti-medication view fashionable. Solomon’s pro-meds view comes out through the book when he criticises doctors and patients who favour going off medication once the person feels well, with relapse as a frequent result. 

Solomon, himself, suffered his first breakdown when he was 31, following his mother’s death.  Already in psychoanalysis, he sought treatment with medication, recovered, broke down a second time, recovered, and suffered a mini-breakdown before completing the book a year later. As a result, his descriptions of his own experience are detailed and fresh. At the time of writing, he was taking about 12 pills a day, some for side effects of his antidepressant and anxiety meds, and expected to continue on a cocktail of medication for life.  He accepts the genetic view of mental illness and all his life story cases portray it as a lifelong disease. This would be my main quibble with the book: there is no sense that someone might recover from this demon state until the distant day some major physical treatment is found.

When The Noonday Demon was published, Solomon was 38 years old. He wrote in the book that he was fine with popping pills for life even though he knew they wouldn’t completely do the trick. It beat the alternative of more frequent and severe breakdowns. He’s now 52, and doing well, from my brief Google search. He’s married, with kids, still writes articles and books and is a professor of clinical psychology at Columbia University. I’d like to know if he’s still taking multiple medications and still relapsing regularly into depression and, if so, is he still okay with this after sixteen years?

The Noonday Demon is a big book, large in scope and information. The medical details are as sound as any I’ve read written by practicing psychiatrists and psychologists; Solomon’s opinions seem as valid as any expert’s, partly because there is no final word on mental illness. Solomon provides many extras the other experts don’t go near. He travelled far and wide to research alternative treatments and try them personally. An exorcism in Africa involved him hugging a ram, the two of them buried under layers of covers, before the ram was sacrificed, its blood drenched over Solomon’s body.

Solomon was open enough to find merit in most of these treatments, however unusual, although he didn’t suggest that any could compete with medication, ideally supplemented with psychoanalsis. His view of his fellow sufferers in the case histories is sympathetic. I was surprised, though, that after those hours of hugging, he didn’t show more sympathy toward the poor ram that was sacrificed to exorcise Solomon’s demons.

The Age Of Anxiety

For February, Canada’s Psychology Month, I continue re-visiting my blog post reviews of popular psychology books.  Here’s the second re-post:

When Panic Attacks: the new, drug-free anxiety therapy that can change your life by David D. Burns, M.D.

I picked up this book because some 25 years ago I read Dr. Burns’ earlier bestseller, Feeling Good: the new mood therapy, for a psychology course and found its cognitive therapy approach enlightening. Everyone, I thought, could use a dose of cognitive therapy. In fact, the so-called normal might benefit as much the mentally ill.

When Panic Attacks is a self-help book for people with disabling anxiety. Dr. Burns includes charts as well as space for writing answers to his questions posed along  the way. He insists you can’t simply read what he says to get results; you need to be active in your therapy process, with pen in hand. I confess I didn’t write down anything. Mainly, I tried to relate the material to my most anxious, irrational moments, such as my panic when I see a mouse.

Dr. Burns takes a strong stand against the two pillars of modern psychiatry, medication and psychoanlysis. He calls them, generally, useless for anxiety and depression. I get the sense he never prescribes pills. Instead, he makes his patients work on their fears through daily mood logs and applying his 40 ways to defeat your anxiety, until one of those ways works.

His case studies make the process sound easy, but it probably is a lot of work — and scary. His 40 methods include Exposure Therapy, which involves flooding yourself with the object of fear. For me, this would involve bombarding myself with images of mice and rats or real ones. I’d rather take a pill. In addition, my rodent phobia doesn’t affect me enough to truly want to change. During the summer, I still outside on my patio, even though a mouse who lives in the brick wall is likely to scurry by.

Dr. Burns says that a problem with most methods of therapy is that they assume people want to change. In reality, we like the familiar and don’t want to confront our demons and darkest fears.

Anxieties, bad habits and addictions are also rewarding. He often asks his patients, “If you could push a magic button and make all your anxiety, depression or anger disappear right now, would you push that button?” A surprising number of people hesitate.

It seems bizarre, until you realize there are benefits to neurotic fears. He cites an example of a convenience store owner who developed post-traumatic stress disorder after being robbed and beaten at gunpoint. While working on one of Dr. Burns’ charts, the patient came to see that he didn’t want let go of his anger at the perpetrator. The robber deserved it. Anger allowed the patient to feel morally superior. He found satisfaction in being a victim. He believed hanging onto the anger might make him more vigilant against future attacks. All of these thoughts contributed to his continuing PTSD, which he decided, in the end, wasn’t worth these

benefits.