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Not Dead Yet

The good thing about writing this type of blog is that I get to use my personal experience with mental health issues to shed some light on the reality of what’s in the news or in the lab. The bad thing about writing this type of blog is that sometimes my mental health issues get in the way of writing anything at all.

The Lucky Rebel is still alive, but it had some touchy moments in the past year or two. Sixteen times I sat down to write. Two drafts were discarded, and fourteen were saved to the WordPress app on my Android phone. All fourteen were lost when I switched phones this past April. I had a meltdown over the cell phone carrier’s inability to help me coordinate a simple transaction, and in all the confusion, I forgot to upload all those lovely thoughts and musings before the old phone was deactivated.

The problem is, this past year has been an entire series of little bitty meltdowns. Individually, they were a blip on the radar. Together, they snowballed into a complete lack of desire to get off the couch or write anything at all. That new, seriously comfortable office chair might have been a complete waste of money if I wasn’t sure that eventually I’d bounce back. I always do, and I’m getting more familiar with the ups and downs so I can remember that the downs won’t last forever.

Lately, the upward bounce is taking its sweet time, though, which has me a little worried. It’s ironic – the couch is much less comfortable than the chair. But my laptop is nicer than my desktop computer, so I talked myself into staying on the couch. And with that, my inner compass laid down on the couch with the TV remote in hand and decided to stay there.

Don’t get me wrong – I’m still functioning. I’m still working. I can’t say my heart is in it all the time, but I keep up with the work. I’m working more slowly, but I’m working. (Trust me, I’m not billing by the hour anymore.)

Part of the problem is my medication. My psychiatrist prescribed a small dosage of Seroquel several years ago, and I began to sleep so much better. But when my son died suddenly in an accident, I asked him to increase it, and he did. Oh, that felt like the biggest blessing to me. If there was ever a time I needed something to help me sleep instead of freak out all night, it was then. I’m so glad I was already taking it. But then the doctor took off without a word, and I was given a new psychiatrist, who promptly proceeded to double my dosage – not just increase it, double it. Big mistake. The XR part was a great idea – that way, I only had to worry about taking one pill a day – but the increased dosage was completely counterproductive. I now sleep way too much, and I’m starting to feel lethargic when I’m awake. I have to get her to give me a lower dosage when she gets back from vacation.

Come to think of it, I remember that I started to take the new pills the day before I switched phones – I especially remember that I was too much of a zombie to engage in productive problem-solving, and it ended up costing me the rebate that teased me into trading up to a better phone in the first place. Nobody should be asked to make a major decision in that condition, but the rebate had a deadline, so I had myself convinced that I had to go for it. A rough adjustment to any new psych medication is somewhat normal, but that was a seriously ridiculous two months spent undoing the damage of day one, or day two, or whatever day it was.

If I had to guess, I’d say the other part of the problem was the grief itself. Every time I hear about another child’s death, it all comes back to me – the sadness, the pain, the extreme sense of emptiness, that awful choking feeling…everything. I live near a major urban area, so being down is pretty much a weekly thing. (I gotta quit watching the news.) So you can guess what events like a school shooting do to me.

There is no one reason this happens, and no one way to deal with it. It depends on your perspective.

You can crumple up in sadness, thinking that the world is a horrible place – and in one respect, you’d be right. Death does not discriminate by age, and the younger the person, the more horrible and unfair it seems. But in another respect, you’d be wrong because you’re denying the beauty that the rest of the world offers. It’s not healthy to think in terms of a horrible world for very long.

You can be properly outraged and indignant, resolving to do everything you can to make sure it never happens again – but it always does, because the problem has no single solution and we the people can’t seem to agree on the right way to tackle it. Focus on what you can control, and let go of what you can’t. Easier said than done, I know, but it’s the only rational thing to do when nothing else seems to work.

You can blame it on the decline and fall of man’s ability to love and live God’s way of life, but the love of God by a human being is always imperfect by definition. God is powerful, but He created us so that our bodies can physically expire, and that won’t change with all the prayer we can muster together. All we can do is look forward to the time when we will all have spiritual bodies that will never die.

Or you can feel nothing, because this happens all the time, and there’s nothing you can do about it. And I have no answer for that one, because that statement gets closer to the truth in my mind with each passing year.

It seems impossible to face the death of a child when you have emotional problems, but it’s not. Consider yourself lucky if you feel something – anything at all, because it’s only when you shut off your heart that you shut off your ability to cope. The feelings may come out like a dam breaking, or they may be as lifeless as a brick wall. Either situation can make you feel completely helpless. When it finally hit me four years ago, I felt like I had a three-year-old sitting on my chest. I couldn’t breathe without physical pain for months.

That level of pain has gone down, but the hole in my life is still there and no amount of medication will ever fix that. Making sense of it has come down to realizing that sense has nothing to do with it, and that I can’t give up on life. I’m not dead yet, so I might as well make the most of it while I still can.

Grieve, in your own way, for those who are gone, for those who are left with holes in their lives, and for those who lost a bit of their innocence over having to witness it. If you can, support those who will try to make everything a little more bearable in that town. But don’t let the events of the day take away from all the good that is still left in the world, the probability that good will eventually overcome evil, and the truth that love will always be more powerful than hate. You’ll start to see your way more clearly soon. Don’t give up.

Tonight I heard something I’ve never heard before. It was the most unusual sound, and when I figured out what had made that sound, it surprised me even more, mostly because I had just been thinking how strange it was that it was so quiet.

I remember that feeling of surprise the last time I heard something I never heard before. It was such good news, but I hadn’t expected it. In fact, I had just spent the previous week being completely depressed that I would never hear it at all.

When I was actively thinking that my surroundings shouldn’t be that quiet, even at 3 a.m., it was almost as if I was asking for something to break the silence. The rustling leaves were a familiar sound, but the squeak and the spray weren’t. It was the funniest sound. A squirrel had been sleeping in the tree when suddenly he squeaked, which made him sneeze, which blew the leaves around him like the wind. The silence changed – that quickly – and suddenly everything seemed as if it were back to normal.

I’m going to think about that squirrel next time I start thinking that something else needs to change. If I listen hard enough, I might just hear something else I never thought I’d ever hear. I could learn to like surprises if they start turning out to be good ones.

Listen to Your Gut

I found an article that gives new meaning to the concept of listening to your gut. The opening line reads “Early digestive problems may hardwire the brain for depression.”

http://www.newscientist.com/article/mg21028136.500-do-early-gut-problems-set-the-brain-up-for-depression.html

Researchers at Stanford are trying to figure out which comes first, the gut problems or the depression.  The working theory was that hormones released during sadness trigger negative effects on the stomach area, but now they’re not so sure. The gut problems might trigger the depression.

This isn’t exactly a scientific observation, but I can vouch for their theory. I had bad stomach pains when I was young, before anyone noticed signs of depression in me. Diagnosed with nonspecific gastrothisandthat or whatever, I ended up in the doctor’s office or the ER on a regular basis. I was doubled over in pain, and nobody could figure out why. Here’s the kicker: When I went on antidepressants and mood stabilizers in my mid-20s, the gut problems mysteriously disappeared.

A research group from Kings College in London has narrowed down the genetics of severe recurring depression to chromosome 3, and both the Stanford group and a research group from Washington University in St. Louis, Missouri, have come up with basically the same results. In the research world, all three groups finding the same thing is pretty important.

The curious thing about genetic mapping is that there is so much apparently unrelated information on each chromosome. According to the National Institute of Health, there are currently 51 known disorders known to be associated with chromosome 3, one of which is the thoracic aortic aneurysm my dad had. I’m pretty sure that had nothing to do with depression…although come to think of it, he was going through a pretty low time in his life… But I don’t have any of those syndromes or deficiencies…that I know of…yet…hmm.

But then there’s still this “which came first, the chicken or the egg” thing. Do certain disorders make it easier for depression to surface, or does depression pave the way for certain other weaknesses to present themselves – those gut problems, for example?

See, I think the process of discovering all of this is interesting. Someday, all this research put together will help doctors prescribe more effective treatments for depression instead of “hey, I got a new sample – let’s see what this does.”

Social media is a trip and a half. It’s communication on steroids, broken down into semi-connected fragments – a little like my Gemini brain seems to be. It mirrors my life, in a slightly warped way.

I have six sets of people I keep up with, depending on which era of my life happens to be front and center at the moment. In real life, none of these subgroups actually intersect. My family is now scattered all over the country so my high school classmates have never kept up with them, my church friends definitely don’t know my bar friends, and my former coworkers have no idea how awesome my online colleagues are. But I can keep up with every one of them, separately and together, on Facebook. I can introduce them to each other, or I can use the extra features to keep my communication group-appropriate. I even found out that two of my friends, who I would have never guessed had anything in common, are already friends with each other because they take the same classes in college. It’s a miracle. I didn’t even know I knew 175 people, let alone 175 people who wanted to be friends with me. That’s a self-esteem booster right there.

But how many different ways do we really need to keep in touch with each other? It depends on how you like to be touched. Need to know everything right now? Twitter. Need to express yourself? MySpace. Need to get up close and personal with a whole group of people at once? Facebook. Need to stick to business and work a virtual room? LinkedIn. Need to simply give and get information? Scores of other websites are just falling all over themselves wanting you to become part of their community.

I gotta tell you, this is doing a real number on my ADHD. I can’t tell whether all these social media options are feeding the way my brain flips from one thing to the next, or if they’re just aggravating the condition and making it worse.

Then you have the new social politics. If you have a friend on Facebook, and you don’t follow him on Twitter, does that mean you’re being rude? What if you digg something you just stumbled upon, but you can’t tweet it because your BFF just facebooked it all over your wall? And if you don’t learn to use the word “friend” as a verb, are you really ever going to be socially acceptable? 

I have to learn to keep all this straight someday… No, seriously. It’s going to make my head spin until I figure out how to put the puzzle together. The prize is that the spinning stops, the headache goes away, and I end up pointed in the right direction. Wish me luck! I’m going to need it. 

Clueless

I have to say that Squidoo is the coolest website I’ve seen all year. I don’t know why I haven’t seen it before, but I like the idea of each of us being a lens through which everyone can look at some part of the world. The tagline is great: Everyone is an expert on something.

Did you ever talk with an expert one on one, and catch yourself thinking, “I can’t believe that came out of her mouth!” or “Wow … where did that come from?” or “What in the world made him say that?”

You see, everyone – including the expert – is also clueless about something at some point or another. And when you have one of those “huh?” moments, you may have just been a witness to that glorious moment in history, that one moment when this expert will have to say, “Sorry, everyone, I had no clue what to say next, so I just made that one up!”

I’m good for a laugh once in a while, and not because I’m trying to be funny. Let’s just say that the longer I live, the more I learn to shut up when I have no clue what people are talking about. I can play Trivial Pursuit with the best of them, I can explain the theory of relativity, and I can copy almost any tune into sheet music for the piano. Don’t try to talk to me about transposing music for an entire orchestra, though, because I can’t manage the percussion notation. It confuses me, I get dizzy, and I have to tune out before my head explodes. Then there was the time I tried to transpose Wagner’s Bridal Chorus for the bagpipes, never having played the bagpipes myself, let alone seen the sheet music the pipers learn from. (“Oh yeah – no problem!” – how hard could it be, right? I can Google it.) I would be very glad to tell you about that, but the person who actually should be telling that story is the one who asked if I could do it, and I’m not sure he’s speaking to me anymore.

It’s the same with electronics. I’m clueless. We’re remodeling our basement, and my husband decided to change the exhaust fan in the bathroom. Before I went to the home improvement store for painting supplies, I asked if he needed anything. “Whatcha doing, honey?” I said. I was about to regret that question, because he proceeded to actually tell me. That wonderful, patient man saw my eyes glaze over and tried to explain it again in fifth-grade English. As he was pointing at the wires and taking things apart, I caught some of what he was saying, but part of my brain had already shut off by this time. Not wanting to look stupid, I picked up the little orange cone he had put down, noticed it was dirty, and said, “Okay, looks like you need three of these, right?” YES! He thought the lightbulb in my head had finally turned on. I walked into the home improvement store, proud as punch, and asked the guy on the floor, “My husband says to get three of these electrical thingamabobs. Could you please tell me where to find them?”

Now, I can get away with being clueless about electronics. My husband knows about that sort of thing, and what he doesn’t know, we can hire an expert to do. I have no problem admitting I’m clueless in that area. But for some reason, for a while there, I had a problem admitting I was clueless about some types of musical notation. Then there’s the running joke about why men never ask for directions. I know some women who have way too much fun with that one. Unfortunately, they ask for it. The stubbornness is just way too entertaining sometimes.

The truth is, we’re all guilty of that once in a while. Is it a weakness to be clueless about things like when to shut up and when to ask for directions, though? Maybe not. None of us know everything, and even the brightest minds can’t figure everything out. That’s where the strength comes in. Isn’t it harder to admit you’re clueless than announce you know exactly what’s going on?

I might begin to have a hard time admitting I’m clueless about electronics if my husband died and I was left with no money to hire someone if a fixture needed replacing. Would I try to do it myself, or would I call a friend for help? I would probably try to go online, Google it, print out a step-by-step tutorial, and do it myself first so I didn’t bother anyone if I didn’t absolutely have to. (Let’s hope we have a double plot, just in case I screw up.)

Can you see yourself asking someone for help before trying to manage something that confuses you to begin with? Why? I don’t care if we’re talking about exhaust fans, wire hats, or the sheet music for the bagpipes. Why would many of us choose to give up, screw up, procrastinate, or “fake it ’til we make it” before we’ll admit we need directions? Why would we choose to look like a dufus rather than tell someone, “no, I can’t do that – would you help me?” Do people actually choose to be clueless sometimes?

Sometimes it’s easier. Sometimes it just makes your head hurt too much to press forward and learn something new. Other times you want so badly to look good to someone else, you end up doing stupid things to try and impress them…like refusing to turn on the GPS when we’ve been driving in circles through endless farmland, eventually realizing that we passed the same general store three times in the last hour looking for the way back to the highway – the one we can see on the horizon, but can’t seem to find the one road that will take us there. “No, this is the right road. We just didn’t go down far enough.” Three sheep farms, two red barns, and an outhouse later, here’s the general store again. Is it time to put the pride away and ask for help?

For the record, that story was taken from experience, but it wasn’t him. It was me. I’m the one who is most likely to try and “fake it ’til I make it.” Take that appointment for grief counseling I haven’t made yet. It has been two years and nine months, and I’m still driving around in circles, saying, “No, I’m all right, it’s all under control” while I’m playing an emotional game of dodge-the-pothole. Is it time to put the pride away and ask for help?

Everyone has something they’re very good at, and everyone has something they’re clueless about. I don’t care who you are, or where you come from. It’s okay to be clueless once in a while. We all have those moments. If you can finesse your way through those moments, great. If you fall on your face, that’s fine too. (That seems to be how I learn.) Being honest and open to learning has been very good to me when it was time to tell someone I didn’t know how to do something on my own.

And trust me, don’t ever tell anyone you can write for the tympani when you know for a fact you’ll have to do a Google search to find out what a tympani is before you begin.

I’m still amazed that a government agency is asking for our opinions - and better yet, they’re actually listening.

Check out this post for a little background. The verdict is in. The USDA is backing off on a proposal that might have inadvertently encouraged heavy drinking. They had originally proposed to ditch the daily recommendations and set weekly recommended quantities of alcohol, but the public spoke out. Since most people do their drinking only one to three nights a week, those who took the time to comment online were mostly concerned that drinkers would look at weekly guidelines and try to cram one week’s worth of drinking into one night. And that was a real possibility - most of us know how bright alcoholics are when it comes to justifying “let’s have another one!”

The USDA’s new guidelines retained a daily recommendation for alcohol consumption, and they now define heavy drinking and binge drinking as well. They admit there is evidence of health benefits of moderate drinking – apparently they’re trying extra hard not to give anyone the idea that it’s okay to drink like a fish – but they now give the stern “this is bad for your health” statement like you’ll find on a cigarette pack, listing all the health conditions that might get in your way if you drink too much.

According to Join Together, it was the online response from private citizens (both healthcare professionals and concerned consumers) that made a difference in the final policy decision. That is seriously encouraging. All government agencies should have a limited public commenting period like this every time new policies are being considered. 

Get ready to click again – someone else needs our input now. The Centers for Medicare and Medicaid Services (part of the Department for Health and Human Services) is asking what we think about Medicare covering alcohol screening and counseling in primary medical care.

This debate is about whether Medicare and Medicaid should cover alcohol abuse prevention, screening, and counseling. They already cover screening for other medical issues, but this time they’re considering doing that for something that might cross over into services that are normally performed by mental health providers.

Providing the service could mean a significant extension of prevention and early intervention services for individuals struggling with alcohol. It could also be pretty expensive, but then again so is the current drain on state and federal budgets when it comes to incarceration of drunk drivers and other alcohol-fueled criminals, child protective services, healthcare services for abused family members, emergency services for indigent people with alcohol poisoning, and anything else that relates to the public costs of excessive drinking.

A report on reducing underage drinking from the National Academy of Sciences found that government agencies, businesses, and individuals in the United States end up spending – and remember, this is just about underage drinkers – around $53 billion per year (including $29 billion due to violent crime and $19 billion from traffic crashes) because we can’t keep the alcohol away from the kids. Now that’s expensive. And that study was presented back in 2003. What are those numbers like today? And how much greater could the costs be for adults with alcohol problems?

If you want to get in on the debate, their National Coverage Analysis Tracking Sheet is open for comments until March 20, 2011. Let them know – especially if you work in healthcare – what you think about how this might work, who might coordinate the services, how often the services might be offered, or under what conditions Medicare or Medicaid might play a greater role in preventing a lot more unnecessary problems.

This is the best news story I’ve read today! http://www.businessweek.com/lifestyle/content/healthday/649732.html

Can you imagine the guilt on the mind of the staffer who lets the President bum a cigarette, knowing full well that the President is trying to quit? Somehow I just can’t picture anyone saying, “Sorry, sir, you need to tough it out today.”

Tough it out…isn’t that what quitting smoking is like, though? You have this confidence surge every time you resist the temptation, because it’s hard to put the pack down and you know it. If you can resist for a while, you start feeling tough. You start telling yourself, “If I can get through this, I can get through anything.”

But it’s a fight. It’s a constant battle between your lungs and your brain. If you want to quit but it hasn’t happened, your brain says, “I must not be ready to quit.” If you want to quit and it has just happened, you’re fighting the crabbiness and the agitation, and you’re about three steps away from making it all stop by simply having another cigarette. If you don’t want to quit but you’re being hassled about it, your brain says, “It’s my life.” Meanwhile, your lungs are on fire and you’re in denial about it. But on some level, you know that your time is about up if you ever lose your lungs.

I’ve quit smoking three times, and each time I only stopped smoking when the stress in my life eased up on me. I had a hard time being without a cigarette in my mouth when life wasn’t exactly smooth sailing.

Can you imagine trying to go through that as the leader of the free world? I would be lighting up every time I spoke to the Republicans in Congress. I would bring my own carton to a weekend summit of world leaders. I would be frantically signalling staffers to get me an ashtray every time a call came in on that little red emergency phone.

Barack Obama has been going through something similar for at least the past nine months, all while he was functioning in one of the toughest jobs in the world.

If reports of your quitting aren’t greatly exaggerated, Mr. President, congratulations for doing something positive for your health and trying to tough it out. If you can handle this, you can handle anything.

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