TO READ: Groups Offer Comfort and Even Joy in the Mental Health Community
I have a lot of mentally ill friends. Maybe you do too. Twenty-one years ago, when I was diagnosed with major depression (which later became categorized as bipolar disorder) I personally knew only one person who I even suspected of having a mental illness. Now people with depression, bipolar disorder and other conditions are everywhere in my life!
I find that as we go through this life-altering experience, we tend to bond to one another for information and support. You may have noticed it in your life too. When you suddenly get a diagnosis, or a prescription, everything changes, and you need someone to turn to -- someone who's been there. That's why I believe the services provided by the National Alliance on Mental Illness (NAMI) and the Depression and the Bipolar Support Alliance (DBSA) (see links at right) are so vitally important. And I know that sense of connection and shared experiences is one of the reasons people seek out my writing class for people with mood disorders at Stanford.
Being immersed in the mental health culture may involve reading about depression or other conditions, recognizing that you have mentally ill friends or relatives, seeking education and camaraderie in support groups or therapy groups and, in a surprisingly high number of cases, holding paid or volunteer positions in mental health advocacy. (In addition to my writing group, I speak as a volunteer on mental health issues for two organizations.) And there is a great deal of comfort, release and joy in these communities.
This weekend I took part in the NAMIWalks for the Mind of America in San Francisco's Golden Gate Park. The positive vibes and goodwill were everywhere -- from the fact that there were 90-odd teams participating, to the cheers and thanks of volunteers as we finished our 5k walk, to the open-minded chats going on at the booths offering information, books, and items made by people with mental illness. I felt proud to be a part of helping make these illnesses more visible in our still-stigmatizing society.
If you're coping with depression and you're not familiar with NAMI and DBSA, do yourself a big favor and check them out for education on illnesses and treatments, emotional support for consumers and their families, resource lists, legislative and research updates, and especially to learn where there are support groups near you. You don't need to feel alone as you grapple with difficult thoughts and feelings.
Monday, May 14, 2007
Tuesday, May 08, 2007
TO WRITE: Oh, Those 'Parental Units'
Whether you feel your parents are the guiding lights in your life or people who cast dark shadows -- or, most likely, something in between -- there's no denying that parental relationships are crucial to shaping who we are. Think back to your growing-up years: How did you experience them, or the other person or people who raised you? Nearly all of us can point to both happy and painful childhood events. And what of your current relationships: Are your parents living? Do you have regular contact, rare contact, no contact? Do conversations mirror those of childhood, or have they evolved in some way?
These reflections can be eye-opening for anyone, but perhaps especially to people coping with depression. If you feel like it, consider the relationship, if any, between your parents and your difficult moods. Some people believe there is a direct cause-and-effect relationship; others find their parents their greatest support. There's no good or bad -- our parents are only one part of our lives and, as adults, we have already moved on considerably to shape ourselves, and we'll continue to change and grow.
WARNING: This can be an intense topic. Remember the "flip-out" rule -- if it feels too scary to go there, just don't go. Write on something else this week.
Play with this...
Choose one parent or guardian. Take 20 minutes of continuous writing to describe your past and present relationship with that person. Try to incorporate at least a couple of specific stories of events. Also consider how you might like to improve your view of that relationship today -- could you recognize your separateness and release some frustration or pain, for example? Can you feel thankful for any part of your interactions? You may want to share what you've written with a safe friend, partner or therapist. Remember: We are always evolving and becoming stronger as adults.
Whether you feel your parents are the guiding lights in your life or people who cast dark shadows -- or, most likely, something in between -- there's no denying that parental relationships are crucial to shaping who we are. Think back to your growing-up years: How did you experience them, or the other person or people who raised you? Nearly all of us can point to both happy and painful childhood events. And what of your current relationships: Are your parents living? Do you have regular contact, rare contact, no contact? Do conversations mirror those of childhood, or have they evolved in some way?
These reflections can be eye-opening for anyone, but perhaps especially to people coping with depression. If you feel like it, consider the relationship, if any, between your parents and your difficult moods. Some people believe there is a direct cause-and-effect relationship; others find their parents their greatest support. There's no good or bad -- our parents are only one part of our lives and, as adults, we have already moved on considerably to shape ourselves, and we'll continue to change and grow.
WARNING: This can be an intense topic. Remember the "flip-out" rule -- if it feels too scary to go there, just don't go. Write on something else this week.
Play with this...
Choose one parent or guardian. Take 20 minutes of continuous writing to describe your past and present relationship with that person. Try to incorporate at least a couple of specific stories of events. Also consider how you might like to improve your view of that relationship today -- could you recognize your separateness and release some frustration or pain, for example? Can you feel thankful for any part of your interactions? You may want to share what you've written with a safe friend, partner or therapist. Remember: We are always evolving and becoming stronger as adults.
Thursday, May 03, 2007
TO READ: Happy Faces Trigger Less in the Brains of Depressed People
When you're depressed, you know it's hard to put on a smile -- and it can even feel difficult to react to smiling people around you. Now brain research shows that depressed people do have real impairments in the ways they process happy faces.
In a recent study, depressed people were slower and less accurate at "processing" -- in this case, detecting the gender of -- happy faces than were healthy people, as shown by functional MRI. But after eight weeks on Prozac, and improvement in symptoms, this ability returned. On another task, responding to increasingly happy faces, the emotion-processing regions of the depressed brains were less active than they were in healthy people's brains. In this case, the difference was not improved by the antidepressant.
Being able to recognize and respond to other people's emotions is a crucial part of interpersonal relationships. These different responses demonstrate that it's not a personal failing to have trouble reacting to a friendly person when you're depressed, but a measurable neurobiological trait of the illness.
For more information: Am J Psychiatry 164:540-542, April 2007.
When you're depressed, you know it's hard to put on a smile -- and it can even feel difficult to react to smiling people around you. Now brain research shows that depressed people do have real impairments in the ways they process happy faces.
In a recent study, depressed people were slower and less accurate at "processing" -- in this case, detecting the gender of -- happy faces than were healthy people, as shown by functional MRI. But after eight weeks on Prozac, and improvement in symptoms, this ability returned. On another task, responding to increasingly happy faces, the emotion-processing regions of the depressed brains were less active than they were in healthy people's brains. In this case, the difference was not improved by the antidepressant.
Being able to recognize and respond to other people's emotions is a crucial part of interpersonal relationships. These different responses demonstrate that it's not a personal failing to have trouble reacting to a friendly person when you're depressed, but a measurable neurobiological trait of the illness.
For more information: Am J Psychiatry 164:540-542, April 2007.
Tuesday, May 01, 2007
TO WRITE: Simple everyday routines
One way in which writing can help us see ourselves is by bringing the ordinary details of our life into clear view. For example, when you stop long enough to see a daily ritual broken down into its individual steps, you may appreciate it differently -- its intricacies, its roles, even its beauty. Consider this poem by former U.S. Poet Laureate Ted Kooser, who, incidentally, was a life insurance executive in Nebraska most of his life.
The Necktie
His hands fluttered like birds,
each with a fancy silk ribbon
to weave into their nest,
as he stood at the mirror
dressing for work, waving hello
to himself with both hands.
Play with this...
Write a poem about a simple routine task or ritual you do. As Kooser's poem shows, this action can be something quite small and ordinary. Describe the routine, considering its meaning to you, and various ways you could express its qualities to others. Take at least 10-20 minutes to write and revise your poem. (If you really prefer prose to poetry, use that, but try the poetic form first.) What does this everyday habit reflect about your life?
One way in which writing can help us see ourselves is by bringing the ordinary details of our life into clear view. For example, when you stop long enough to see a daily ritual broken down into its individual steps, you may appreciate it differently -- its intricacies, its roles, even its beauty. Consider this poem by former U.S. Poet Laureate Ted Kooser, who, incidentally, was a life insurance executive in Nebraska most of his life.
The Necktie
His hands fluttered like birds,
each with a fancy silk ribbon
to weave into their nest,
as he stood at the mirror
dressing for work, waving hello
to himself with both hands.
Play with this...
Write a poem about a simple routine task or ritual you do. As Kooser's poem shows, this action can be something quite small and ordinary. Describe the routine, considering its meaning to you, and various ways you could express its qualities to others. Take at least 10-20 minutes to write and revise your poem. (If you really prefer prose to poetry, use that, but try the poetic form first.) What does this everyday habit reflect about your life?
Monday, April 30, 2007
TO READ: Depression's Devastating Self-Criticism Explained
When serious depression kicks in, one often-heard complaint is, "I do everything wrong." Now researchers have brain-wave evidence about where this perception may come from. Results from one study show that depressed people make no more mistakes than healthy controls -- but that they truly are better at detecting their errors.
Scientists measured two types of brain waves as subjects did a simple signal-detection task, and found that depressed people were just as quick and accurate as the non-depressed. No slowness or concentration problems were noticed. However, both types of brain waves -- one called error-related negativity, which measures brain resources used in early detection of errors, and the other called error positivity, which indicates error detection -- are exaggerated in depressed people.
Those responses indicate that the depressed group used more of their brain resources to detect errors. Researchers suggest that when they make a mistake, depressed people are more likely to notice it than a healthy person would be. While this extra acuity might be a good thing in certain situations, it also may be responsible for the hyper-criticism often felt during the illness. Something to bear in mind when that I-can't-do-anything-right feeling kicks in!
For more info: American Journal of Psychiatry 2007 164:58.
When serious depression kicks in, one often-heard complaint is, "I do everything wrong." Now researchers have brain-wave evidence about where this perception may come from. Results from one study show that depressed people make no more mistakes than healthy controls -- but that they truly are better at detecting their errors.
Scientists measured two types of brain waves as subjects did a simple signal-detection task, and found that depressed people were just as quick and accurate as the non-depressed. No slowness or concentration problems were noticed. However, both types of brain waves -- one called error-related negativity, which measures brain resources used in early detection of errors, and the other called error positivity, which indicates error detection -- are exaggerated in depressed people.
Those responses indicate that the depressed group used more of their brain resources to detect errors. Researchers suggest that when they make a mistake, depressed people are more likely to notice it than a healthy person would be. While this extra acuity might be a good thing in certain situations, it also may be responsible for the hyper-criticism often felt during the illness. Something to bear in mind when that I-can't-do-anything-right feeling kicks in!
For more info: American Journal of Psychiatry 2007 164:58.
Tuesday, April 24, 2007
TO WRITE: A Sound from Childhood
Memories, especially those from childhood, can often evoke strong emotions, as well as triggering even more memories. Instead of replaying the same old childhood stories in your mind (we all have some that we rely on to piece together the story of our life), try with this exercise about specific sounds to see what other details or experiences you may not have thought about for a while. "New" material can supply all sorts of creative undertakings. In addition, focusing on specific sensory experiences makes for strong writing.
Play with this...
First, brainstorm a list of five to ten specific sounds you recall from childhood. My list includes the zip when my father cast his fishing line from a canoe on a lake, and the blaring honk of the tornado alarm in elementary school. Next, choose one of these sounds -- preferably one you haven't thought about for a long time -- and write for 20 minutes about your experiences relating to it. Then consider how it felt to write this memory -- was it sad, funny, a relief, an "aha" experience? If a particularly difficult memory came up, give yourself a few more minutes to write an imaginary ending to the story that wraps things up in a way you'd prefer.
Memories, especially those from childhood, can often evoke strong emotions, as well as triggering even more memories. Instead of replaying the same old childhood stories in your mind (we all have some that we rely on to piece together the story of our life), try with this exercise about specific sounds to see what other details or experiences you may not have thought about for a while. "New" material can supply all sorts of creative undertakings. In addition, focusing on specific sensory experiences makes for strong writing.
Play with this...
First, brainstorm a list of five to ten specific sounds you recall from childhood. My list includes the zip when my father cast his fishing line from a canoe on a lake, and the blaring honk of the tornado alarm in elementary school. Next, choose one of these sounds -- preferably one you haven't thought about for a long time -- and write for 20 minutes about your experiences relating to it. Then consider how it felt to write this memory -- was it sad, funny, a relief, an "aha" experience? If a particularly difficult memory came up, give yourself a few more minutes to write an imaginary ending to the story that wraps things up in a way you'd prefer.
Monday, April 23, 2007
TO READ: Why Did I Have To Gain 80 Pounds on Antipsychotics?
Researchers may have solved the mystery of why so many people with bipolar, depression, schizophrenia and other illnesses who take certain antipsychotic medications tend to gain weight -- sometimes lots of it.
While these medications may effectively treat symptoms such as hallucinations and delusions, that's a high price to pay. (I know -- I gained 80 pounds in a few months on one of these meds. Fortunately it's almost all come off now that I'm on a newer one instead.) Many people gain to the point that they become at risk for life-threatening conditions such as heart disease and diabetes.
Scientists knew that the link between brain cells and appetite seems to be an enzyme known as AMPK. Now, in a recent study at Johns Hopkins University, when researchers gave the antipsychotic medication clozapine to mice, their AMPK activity quadrupled. When the scientists chemically suppressed the mice's appetites, the AMPK levels lowered. But what mediates such a connection?
It turns out that histamine -- the substance responsible much allergic misery, as well as a protein which aids communication between cells -- plays a key role in the interaction between AMPK and appetite. By blocking histamine's effects, clozapine no longer led to AMPK spikes.
The results are exciting: This discovery may allow scientists to develop both a new generation of antipsychotic drugs that doesn't cause weight gain, and safe weight-loss drugs.
For more info: Proceedings of the National Academy of Sciences, online edition, February, 2007.
Researchers may have solved the mystery of why so many people with bipolar, depression, schizophrenia and other illnesses who take certain antipsychotic medications tend to gain weight -- sometimes lots of it.
While these medications may effectively treat symptoms such as hallucinations and delusions, that's a high price to pay. (I know -- I gained 80 pounds in a few months on one of these meds. Fortunately it's almost all come off now that I'm on a newer one instead.) Many people gain to the point that they become at risk for life-threatening conditions such as heart disease and diabetes.
Scientists knew that the link between brain cells and appetite seems to be an enzyme known as AMPK. Now, in a recent study at Johns Hopkins University, when researchers gave the antipsychotic medication clozapine to mice, their AMPK activity quadrupled. When the scientists chemically suppressed the mice's appetites, the AMPK levels lowered. But what mediates such a connection?
It turns out that histamine -- the substance responsible much allergic misery, as well as a protein which aids communication between cells -- plays a key role in the interaction between AMPK and appetite. By blocking histamine's effects, clozapine no longer led to AMPK spikes.
The results are exciting: This discovery may allow scientists to develop both a new generation of antipsychotic drugs that doesn't cause weight gain, and safe weight-loss drugs.
For more info: Proceedings of the National Academy of Sciences, online edition, February, 2007.
Saturday, April 14, 2007
TO WRITE: A Cold Got You Down? Write About It!
I see low, deep gray clouds and the spattering of raindrops outside my window here in Northern California today. And the weather report says a big part of the country is getting snow on this day before tax day. Have the recent shifts in weather contributed to a spring cold for you, as it has many people I know? (So far, so good for me ... for this month.)
After you wake from your weekend nap and pop some more Benadryl, don't turn on the TV to numb your mind. Instead, consider curling up with a cup of hot tea and a blanket in your favorite chair and writing out just how miserable you are. You might just feel better. Your mind will engage and you may forget your sore throat for a while. And remember that writing has been demonstrated to improve immune functioning. I'm not claiming that writing will cure your cold -- but research does show that writing even 20 minutes a day for four days in a row about a difficult or traumatic experience leads to fewer doctor visits for months later. Now that's something to think about!
Play with this...
Describe how your body feels right now as if you're writing for someone who's never had a cold -- the aches, the fever, the lethargy, the stuffiness. OR describe a time you were sick as a child -- what were your symptoms? Who took care of you? How did the illness resolve? Write continuously for 20 minutes. When you look back at the pages you've filled, you'll see you have accomplished something today after all.
I see low, deep gray clouds and the spattering of raindrops outside my window here in Northern California today. And the weather report says a big part of the country is getting snow on this day before tax day. Have the recent shifts in weather contributed to a spring cold for you, as it has many people I know? (So far, so good for me ... for this month.)
After you wake from your weekend nap and pop some more Benadryl, don't turn on the TV to numb your mind. Instead, consider curling up with a cup of hot tea and a blanket in your favorite chair and writing out just how miserable you are. You might just feel better. Your mind will engage and you may forget your sore throat for a while. And remember that writing has been demonstrated to improve immune functioning. I'm not claiming that writing will cure your cold -- but research does show that writing even 20 minutes a day for four days in a row about a difficult or traumatic experience leads to fewer doctor visits for months later. Now that's something to think about!
Play with this...
Describe how your body feels right now as if you're writing for someone who's never had a cold -- the aches, the fever, the lethargy, the stuffiness. OR describe a time you were sick as a child -- what were your symptoms? Who took care of you? How did the illness resolve? Write continuously for 20 minutes. When you look back at the pages you've filled, you'll see you have accomplished something today after all.
Monday, April 09, 2007
TO READ: Religion Shown to Help Depression for Many of Us
The data is overwhelming: Study after study shows that people who consider themselves religious or spiritual, especially those who attend weekly religious services, tend to be generally healthier and longer-lived than those who don't. And -- this rule of thumb holds true for depression in particular too. Interestingly, it's reported that 95% of Americans believe in God or a Universal Spirit. Along the same lines, a study of psychiatric inpatients found that 80% consider themselves religious or spiritual.
In terms of overall health, for example, one study which tracked more than 5,000 people from right here in Alameda County, CA, found that those who attended religious services at least weekly were 25 % less likely to die during the study than others. A huge 1999 study of 21,000 American adults found that by attending religious services more than once a week, people tended to extend their lifespan by up to seven years in general, and up to 14 years in African-Americans.
In terms of depression, the results are remarkable too. For example, in one study of 177 people (age 55-89) over one year, self-reported religiousity was correlated with less depression, and with recovery from depression in those who were initially depressed. Another study looked at depressed and medically ill men over age 60 for one year and found that, even after accounting for 27 other variables, religiousity was associated with both a greater likelihood of remission and a quicker remission from depression. In one review of 29 studies examining the relationship between depression and religious involvement, 24 found that religiously involved people had less depression and fewer depressive symptoms; five found no association.
Treatment of depressed religious people has been shown to be more effective in terms of post-treatment depression when religious content is added to standard cognitive-behavioral therapy and, in another study, when religious content is added to standard psychotherapy.
And what if you don't consider yourself a "religious" person? Good news: benefits of a spiritual but non-religious practice can still provide benefits that complement your medical treatment. Consider a regular yoga or meditation practice, for example. Also, giving to others through works and services can often provide a strong inner response. In addition, pay attention to your personal support network, and health habits such as drinking and smoking -- all of these have been shown to be improved by religious involvement, but don't rely on believing.
Remember -- spiritual beliefs should not be used to replace your medical care! Instead, appreciate how they can complement and augment one another in your efforts to feel better.
For more info see: www.mayoclinicproceedings.com/inside.asp?AID=1338&UID and www.mcmanweb.com/article-102.htm
The data is overwhelming: Study after study shows that people who consider themselves religious or spiritual, especially those who attend weekly religious services, tend to be generally healthier and longer-lived than those who don't. And -- this rule of thumb holds true for depression in particular too. Interestingly, it's reported that 95% of Americans believe in God or a Universal Spirit. Along the same lines, a study of psychiatric inpatients found that 80% consider themselves religious or spiritual.
In terms of overall health, for example, one study which tracked more than 5,000 people from right here in Alameda County, CA, found that those who attended religious services at least weekly were 25 % less likely to die during the study than others. A huge 1999 study of 21,000 American adults found that by attending religious services more than once a week, people tended to extend their lifespan by up to seven years in general, and up to 14 years in African-Americans.
In terms of depression, the results are remarkable too. For example, in one study of 177 people (age 55-89) over one year, self-reported religiousity was correlated with less depression, and with recovery from depression in those who were initially depressed. Another study looked at depressed and medically ill men over age 60 for one year and found that, even after accounting for 27 other variables, religiousity was associated with both a greater likelihood of remission and a quicker remission from depression. In one review of 29 studies examining the relationship between depression and religious involvement, 24 found that religiously involved people had less depression and fewer depressive symptoms; five found no association.
Treatment of depressed religious people has been shown to be more effective in terms of post-treatment depression when religious content is added to standard cognitive-behavioral therapy and, in another study, when religious content is added to standard psychotherapy.
And what if you don't consider yourself a "religious" person? Good news: benefits of a spiritual but non-religious practice can still provide benefits that complement your medical treatment. Consider a regular yoga or meditation practice, for example. Also, giving to others through works and services can often provide a strong inner response. In addition, pay attention to your personal support network, and health habits such as drinking and smoking -- all of these have been shown to be improved by religious involvement, but don't rely on believing.
Remember -- spiritual beliefs should not be used to replace your medical care! Instead, appreciate how they can complement and augment one another in your efforts to feel better.
For more info see: www.mayoclinicproceedings.com/inside.asp?AID=1338&UID and www.mcmanweb.com/article-102.htm
Friday, March 30, 2007
TO WRITE: Could a "Laughter Club" Beat Out Prozac?
Is it hard to laugh when you're depressed? Well, consider doing it in a group. That old saw about laughter being the best medicine is being enthusiastically applied in Shanghai. China Daily reported that this month faculty members at Fudan University began inviting students to "laugh away their cares and concerns" by joining the Heartfelt Laughing Club.
Members, inspired by observations that laughter is powerful - and contagious - typically meet in parks early in the morning. They raise their arms high and begin laughing loudly, then silently with mouth closed, then open, in an effort to ease everyday stresses. Sometimes the laughter is combined with yoga and meditation. Chinese psychologists leading the Fudan group discovered that others follow the humor-filled practice too: There are more than 80 laughter clubs in India, and several thousand around the world!
Do you think they could be on to something?
Play with this ...
Even if it's been a while since you've giggled much, recall some times you have. Did you laugh yourself silly at Bugs Bunny as a kid? Or was it that time you and friends played a prank on a teacher? For me, watching Monty Python or Saturday Night Live with my gang of pals in high school comes to mind.
Write the story of a funny - no, hilarious - thing you once laughed at. How did it start, how did you react, did you feel different afterward? Are similar events still amusing to you now, or have your tastes changed? And what might make you laugh today - could you rent a video, play with the dog, rehash a family mishap with your sister? As usual, give yourself 20 minutes to write continuously about the laughter in your life. And leave a comment to let us know what works for you!
Is it hard to laugh when you're depressed? Well, consider doing it in a group. That old saw about laughter being the best medicine is being enthusiastically applied in Shanghai. China Daily reported that this month faculty members at Fudan University began inviting students to "laugh away their cares and concerns" by joining the Heartfelt Laughing Club.
Members, inspired by observations that laughter is powerful - and contagious - typically meet in parks early in the morning. They raise their arms high and begin laughing loudly, then silently with mouth closed, then open, in an effort to ease everyday stresses. Sometimes the laughter is combined with yoga and meditation. Chinese psychologists leading the Fudan group discovered that others follow the humor-filled practice too: There are more than 80 laughter clubs in India, and several thousand around the world!
Do you think they could be on to something?
Play with this ...
Even if it's been a while since you've giggled much, recall some times you have. Did you laugh yourself silly at Bugs Bunny as a kid? Or was it that time you and friends played a prank on a teacher? For me, watching Monty Python or Saturday Night Live with my gang of pals in high school comes to mind.
Write the story of a funny - no, hilarious - thing you once laughed at. How did it start, how did you react, did you feel different afterward? Are similar events still amusing to you now, or have your tastes changed? And what might make you laugh today - could you rent a video, play with the dog, rehash a family mishap with your sister? As usual, give yourself 20 minutes to write continuously about the laughter in your life. And leave a comment to let us know what works for you!
Thursday, March 29, 2007
TO READ: Approaching a Genetic Understanding of Depression
Scientists continue to chip away - and sometimes blast away - at the mystery of depression. And they're making progress. In a major step forward, a consortium of psychiatric researchers announced last month the identification of a region on chromosome 15 that has "a very good chance" of ultimately explaining why some people develop depression.
You probably know that both genetic and environmental factors are believed to be responsible for depression. A better understanding of specifically which genes (there are thought to be several) in our DNA place us at risk for depression would constitute a major research breakthrough: If scientists can locate the key genes, they can determine how they affect the brain and, as a result, can develop more effective therapies for the illness.
Two studies reported in the February American Journal of Psychiatry were conducted by groups at six universities, led by Stanford professor Douglas Levinson, M.D. First these researchers studied 650 families in which two or more members had experienced multiple bouts of severe depression that began in childhood or early adult life. They scanned the entire genome and found areas of "linkage" between depression and DNA markers in several areas. Then they homed in on the most suspicious region, which lies on chromosome 15.
What they found, after studying more than 88 DNA markers in that area, was what Levinson called "one of the strongest genetic linkage findings for depression so far."
The consortium is now studying more than 2,000 people to identify specific genes in the regions, including on chromosome 15, that look most likely to carry variations that increase depression risk.
Scientists continue to chip away - and sometimes blast away - at the mystery of depression. And they're making progress. In a major step forward, a consortium of psychiatric researchers announced last month the identification of a region on chromosome 15 that has "a very good chance" of ultimately explaining why some people develop depression.
You probably know that both genetic and environmental factors are believed to be responsible for depression. A better understanding of specifically which genes (there are thought to be several) in our DNA place us at risk for depression would constitute a major research breakthrough: If scientists can locate the key genes, they can determine how they affect the brain and, as a result, can develop more effective therapies for the illness.
Two studies reported in the February American Journal of Psychiatry were conducted by groups at six universities, led by Stanford professor Douglas Levinson, M.D. First these researchers studied 650 families in which two or more members had experienced multiple bouts of severe depression that began in childhood or early adult life. They scanned the entire genome and found areas of "linkage" between depression and DNA markers in several areas. Then they homed in on the most suspicious region, which lies on chromosome 15.
What they found, after studying more than 88 DNA markers in that area, was what Levinson called "one of the strongest genetic linkage findings for depression so far."
The consortium is now studying more than 2,000 people to identify specific genes in the regions, including on chromosome 15, that look most likely to carry variations that increase depression risk.
Tuesday, March 20, 2007
TO WRITE: What We See and What We Don't
Many writers claim that observation is what their work is really all about. Author and writing teacher Natalie Goldberg says, "Writing is 90% listening."
But it's not just the writer surreptitiously monitoring the lovers at the next restaurant table for plot ideas and dialog. In fact, every human needs to observe his life and the world around him and try to fit the two together. Observing and reflecting are key, whether it's deciding when it's safe to step off a curb, or determining when to change careers. For people living with depression, observing the situations that make us feel worse or better, and the reactions we have to those stimuli, can be a powerful tool. We can use this technique both in the present and in retrospect.
Play with this...
Write continuously for 20 minutes, starting with the following prompt, and see what you discover.
Looking back, it was obvious...
Many writers claim that observation is what their work is really all about. Author and writing teacher Natalie Goldberg says, "Writing is 90% listening."
But it's not just the writer surreptitiously monitoring the lovers at the next restaurant table for plot ideas and dialog. In fact, every human needs to observe his life and the world around him and try to fit the two together. Observing and reflecting are key, whether it's deciding when it's safe to step off a curb, or determining when to change careers. For people living with depression, observing the situations that make us feel worse or better, and the reactions we have to those stimuli, can be a powerful tool. We can use this technique both in the present and in retrospect.
Play with this...
Write continuously for 20 minutes, starting with the following prompt, and see what you discover.
Looking back, it was obvious...
Monday, March 19, 2007
TO READ: Changing the Structure of Your Brain
Wow, am I reading a great book right now! Train Your Mind, Change Your Brain by the wonderful science writer Sharon Begley, is billed on the cover as, "How a new science reveals our extraordinary potential to transform ourselves," and, "A groundbreaking collaboration between neuroscience and Buddhism."
Sound confusing? Well, I suppose anytime you get the Dalai Lama to write a foreword for a book on nerve cells in the brain, it's unusual, that's true. And neuroscience is typically thought of as a daunting field. Despite those things -- or maybe because of them -- I'm telling everyone I know to read this book! It's absolutely fascinating and it's very accessible.
Here are some of the things I've learned so far, boiled down and boiled down again. When I was a college student, and even when I was a graduate student in biology, it was taken as a given that whatever brain cells you were born with were what you got for good -- no exceptions. This was simply a basic rule of neuroscience. But... Begley describes a whole host of recent experiments that show how that belief is hooey. Instead, the incredible changes our brains can make -- the "neuroplasticity" of the brain -- will amaze you. For instance, in people blind from birth, you might imagine that the enormous visual cortex part of the brain would sit silent, since no visual input can get in through the eyes. No! In fact, instead of lying dormant, the visual cortex actually switches jobs to help the person hear certain tones and rhythms more acutely than sighted people can. In other words, it helps them compensate. Similarly, the brain region believed to only be able to process auditory stimuli can, in deaf people, be recruited to help the visual cortex to gain even more information from peripheral vision than usual, thus helping a deaf person to notice and react to changes in the environment more quickly.
What these kinds of experiments mean is that we can change our brains. By attending to particular things in our environment, we can cause regions of nerve cells in the brain to grow, to shrink, to adjust their function, even to change jobs completely. So, if you take up the violin, even as an older adult, your brain's motor cortex in the region controlling your left (fingering) hand, will grow. It takes attention and practice, but our minds really can change the structure and the electrical and chemical activity in our brains! That's consciousness changing matter.
I'm only half-way through the book, but I'm hooked. So stay tuned for an upcoming discussion of what happens when neuroscientists study the brains of Buddhist monks who have meditated for years, and learn what these discoveries mean for the treatment of OCD and depression.
Wow, am I reading a great book right now! Train Your Mind, Change Your Brain by the wonderful science writer Sharon Begley, is billed on the cover as, "How a new science reveals our extraordinary potential to transform ourselves," and, "A groundbreaking collaboration between neuroscience and Buddhism."
Sound confusing? Well, I suppose anytime you get the Dalai Lama to write a foreword for a book on nerve cells in the brain, it's unusual, that's true. And neuroscience is typically thought of as a daunting field. Despite those things -- or maybe because of them -- I'm telling everyone I know to read this book! It's absolutely fascinating and it's very accessible.
Here are some of the things I've learned so far, boiled down and boiled down again. When I was a college student, and even when I was a graduate student in biology, it was taken as a given that whatever brain cells you were born with were what you got for good -- no exceptions. This was simply a basic rule of neuroscience. But... Begley describes a whole host of recent experiments that show how that belief is hooey. Instead, the incredible changes our brains can make -- the "neuroplasticity" of the brain -- will amaze you. For instance, in people blind from birth, you might imagine that the enormous visual cortex part of the brain would sit silent, since no visual input can get in through the eyes. No! In fact, instead of lying dormant, the visual cortex actually switches jobs to help the person hear certain tones and rhythms more acutely than sighted people can. In other words, it helps them compensate. Similarly, the brain region believed to only be able to process auditory stimuli can, in deaf people, be recruited to help the visual cortex to gain even more information from peripheral vision than usual, thus helping a deaf person to notice and react to changes in the environment more quickly.
What these kinds of experiments mean is that we can change our brains. By attending to particular things in our environment, we can cause regions of nerve cells in the brain to grow, to shrink, to adjust their function, even to change jobs completely. So, if you take up the violin, even as an older adult, your brain's motor cortex in the region controlling your left (fingering) hand, will grow. It takes attention and practice, but our minds really can change the structure and the electrical and chemical activity in our brains! That's consciousness changing matter.
I'm only half-way through the book, but I'm hooked. So stay tuned for an upcoming discussion of what happens when neuroscientists study the brains of Buddhist monks who have meditated for years, and learn what these discoveries mean for the treatment of OCD and depression.
Monday, March 12, 2007
TO WRITE: How Do You Care for Yourself?
Last time I circulated a notepad asking for writing topic suggestions in our class meeting at Stanford, I got an amazing mix of responses. We've already written using several of them as our jumping-off point -- from "joy" to "patriarchy" to "I'm afraid of" to imagining being "rich beyond dreams."
But one topic that comes up very regularly on such lists is how to manage your moods. And on this page, the topic of "self-care" came up specifically. Everyone who has coped with a mood disorder, even for a short time, has probably gravitated toward some activities that feel self-soothing or calming or activating or encouraging, depending on what you need at that time. When I'm depressed, reading a novel or writing about the situation over a big cup of coffee at Starbucks helps considerably. It doesn't remove the depression, but it reminds me that there are still things I can enjoy - even if only a little bit - and that I have the ability to seek out those things. And, in my case, the jolt of caffeine doesn't hurt either.
Play with this...
What self-care techniques can you recommend to others? Does walking the dog help you bond with her and get some exercise? Does herbal tea help you get a much-needed good night's sleep? And what about writing -- you may not feel up to crafting a poem, but does a good freewrite in your journal ease your burden a bit? Write continuously for 20 minutes on self-care and see what you discover -- then share your findings with a friend who could use them, and perhaps pick up a few tips from her too.
Last time I circulated a notepad asking for writing topic suggestions in our class meeting at Stanford, I got an amazing mix of responses. We've already written using several of them as our jumping-off point -- from "joy" to "patriarchy" to "I'm afraid of" to imagining being "rich beyond dreams."
But one topic that comes up very regularly on such lists is how to manage your moods. And on this page, the topic of "self-care" came up specifically. Everyone who has coped with a mood disorder, even for a short time, has probably gravitated toward some activities that feel self-soothing or calming or activating or encouraging, depending on what you need at that time. When I'm depressed, reading a novel or writing about the situation over a big cup of coffee at Starbucks helps considerably. It doesn't remove the depression, but it reminds me that there are still things I can enjoy - even if only a little bit - and that I have the ability to seek out those things. And, in my case, the jolt of caffeine doesn't hurt either.
Play with this...
What self-care techniques can you recommend to others? Does walking the dog help you bond with her and get some exercise? Does herbal tea help you get a much-needed good night's sleep? And what about writing -- you may not feel up to crafting a poem, but does a good freewrite in your journal ease your burden a bit? Write continuously for 20 minutes on self-care and see what you discover -- then share your findings with a friend who could use them, and perhaps pick up a few tips from her too.
TO READ: Gamma knife surgery - could it help depression someday?
A former writing student recently made me aware of a "knife-less" brain surgery technique which is becoming widely used around the world. Called gamma knife surgery, it destroys tiny bits of brain tissue by focusing beams of cobalt radiation on, for example, a brain tumor. The gamma knife can be used even for deep brain sites and, unlike conventional radiation treatments or surgery, can be focused with one-tenth of a millimeter precision, so healthy tissue is largely unaffected.
Sounds very impressive to me. Now vascular malformations, both cancerous and benign brain tumors, epilepsy and other conditions are being treated with the gamma knife on over 60,000 patients each year, according to one web site.
But what about depression? I surfed and web-surfed some more, but haven't come across any studies on using gamma knife surgery in this realm. Yet. One site discusses using it for obsessive-compulsive disorder and even vaguely suggests using it for depression in the future....
But where in the brain would it be used? As this blog has described several times, more and more evidence is stacking up that says brain structures - not just the flow of neurotransmitters - are changed in depression. Perhaps one of these sites could be treated. Often the confusing point in these cases is that we don't know whether those structural changes cause, or are caused by, depression. The other approach would be to simply focus on brain regions now understood to regulate emotions and mood. But identifying the precise areas to target is still too difficult. Still, it sounds as though researchers are starting to consider the possibilities of gamma knife surgery for psychiatric illnesses. One more potential future treatment to keep an eye on.
For more info: www.sciencedaily.com, www.sd-neurosurgeon.com
A former writing student recently made me aware of a "knife-less" brain surgery technique which is becoming widely used around the world. Called gamma knife surgery, it destroys tiny bits of brain tissue by focusing beams of cobalt radiation on, for example, a brain tumor. The gamma knife can be used even for deep brain sites and, unlike conventional radiation treatments or surgery, can be focused with one-tenth of a millimeter precision, so healthy tissue is largely unaffected.
Sounds very impressive to me. Now vascular malformations, both cancerous and benign brain tumors, epilepsy and other conditions are being treated with the gamma knife on over 60,000 patients each year, according to one web site.
But what about depression? I surfed and web-surfed some more, but haven't come across any studies on using gamma knife surgery in this realm. Yet. One site discusses using it for obsessive-compulsive disorder and even vaguely suggests using it for depression in the future....
But where in the brain would it be used? As this blog has described several times, more and more evidence is stacking up that says brain structures - not just the flow of neurotransmitters - are changed in depression. Perhaps one of these sites could be treated. Often the confusing point in these cases is that we don't know whether those structural changes cause, or are caused by, depression. The other approach would be to simply focus on brain regions now understood to regulate emotions and mood. But identifying the precise areas to target is still too difficult. Still, it sounds as though researchers are starting to consider the possibilities of gamma knife surgery for psychiatric illnesses. One more potential future treatment to keep an eye on.
For more info: www.sciencedaily.com, www.sd-neurosurgeon.com
Monday, March 05, 2007
TO WRITE: Are You Friendly with Your Little Pink Tablets?
If you take antidepressants - or mood stabilizers, antipsychotics, anti-anxiety drugs, sedatives, stimulants or any other of the panoply of psych meds - how do you feel about them? For many people with depression, that handful of tablets and capsules that it sometimes seems we gobble like candies can be hard to get down. That is, while we know intellectually that these drugs are helping us, or at least could help us, many of us still have mixed emotions about taking them.
Have you ever wondered what exactly those pink or white or turquoise or yellow pills are doing once you swallow them? Scientists still can't fully explain how they operate to change our thoughts and our entire mood. How does that mystery leave you feeling? At different times I've felt dumbfounded, nervous, grateful, embarrassed, angry, resentful and relieved to reach for my regular doses from those amber bottles.
Play with this...
Write continuously for 20 minutes describing your feelings about taking medicines for psychiatric reasons. What emotions did you feel initially? Have they changed at all? How do you feel when you take your prescribed dose today? And would you feel any differently if these were drugs you were taking for some non-psychiatric ailment? Untangling such thoughts and feelings may provide some insight into our attitudes toward our depression and our life situations as well as our treatments.
If you take antidepressants - or mood stabilizers, antipsychotics, anti-anxiety drugs, sedatives, stimulants or any other of the panoply of psych meds - how do you feel about them? For many people with depression, that handful of tablets and capsules that it sometimes seems we gobble like candies can be hard to get down. That is, while we know intellectually that these drugs are helping us, or at least could help us, many of us still have mixed emotions about taking them.
Have you ever wondered what exactly those pink or white or turquoise or yellow pills are doing once you swallow them? Scientists still can't fully explain how they operate to change our thoughts and our entire mood. How does that mystery leave you feeling? At different times I've felt dumbfounded, nervous, grateful, embarrassed, angry, resentful and relieved to reach for my regular doses from those amber bottles.
Play with this...
Write continuously for 20 minutes describing your feelings about taking medicines for psychiatric reasons. What emotions did you feel initially? Have they changed at all? How do you feel when you take your prescribed dose today? And would you feel any differently if these were drugs you were taking for some non-psychiatric ailment? Untangling such thoughts and feelings may provide some insight into our attitudes toward our depression and our life situations as well as our treatments.
TO READ: Drug Combo for Resistant Depression
Has your depression - or you - been dubbed "hard to treat"? Been through drug after drug without success? A new study looking at treatment with the combination of antidepressants Effexor (venlafaxine) and Remeron (mirtazapine) looks encouraging.
Irish psychiatrists just reported a study of 32 patients (44% men) who had been through an average of 2.5 drug trials without depression relief. Impressively, after 4 weeks on this combination of meds, 44% had responded; after 8 weeks, 50% responded; and at a 6-month follow-up, 75% of those still taking the meds had significantly responded.
The down-side? No "serious" side-effects were reported, but 19% of patients felt sedated and 19% experienced weight gain. Five of the 32 quit the trial because of these effects. Remember to keep trying if your depressive symptoms haven't been helped by meds yet - just because one drug or combination doesn't work for you doesn't mean others won't!
For more info: Journal of Psychopharmacology, Vol. 21, No. 2, 161-164 (2007).
Has your depression - or you - been dubbed "hard to treat"? Been through drug after drug without success? A new study looking at treatment with the combination of antidepressants Effexor (venlafaxine) and Remeron (mirtazapine) looks encouraging.
Irish psychiatrists just reported a study of 32 patients (44% men) who had been through an average of 2.5 drug trials without depression relief. Impressively, after 4 weeks on this combination of meds, 44% had responded; after 8 weeks, 50% responded; and at a 6-month follow-up, 75% of those still taking the meds had significantly responded.
The down-side? No "serious" side-effects were reported, but 19% of patients felt sedated and 19% experienced weight gain. Five of the 32 quit the trial because of these effects. Remember to keep trying if your depressive symptoms haven't been helped by meds yet - just because one drug or combination doesn't work for you doesn't mean others won't!
For more info: Journal of Psychopharmacology, Vol. 21, No. 2, 161-164 (2007).
Friday, March 02, 2007
TO WRITE: Are You "Religious"?
Many, many people, I've found, bristle at this question. OK, those who practice the rituals of a particular religion, who attend temple or church or mosque regularly -- or even just once a year on a holiday -- have little problem with it. But what about the others? I've often heard the response, "Well, I was raised (insert religion here), but I never really practice it...."
Either of these responses can be fruitful to explore. Our relationship -- or lack thereof -- with a religious life sheds light on many aspects of our world view, our moral and ethical beliefs, our sense of spirituality outside a formal religion, and what we draw on in times of crisis, such as depression.
Play with this...
What religious beliefs did you grow up with -- Were Mom and Dad strict atheists? Did Grandma take you to mass every week? Did you learn to bow and pray several times a day? Meditate? Did you develop your own ideas about the mysteries of life?
How do those childhood beliefs and experiences affect you as an adult -- Do you practice any formal religion now? Where did you get married? What are you teaching your children? And how do your past and current beliefs affect you as you cope with depression?
Write for 10 minutes on each of these two main questions and see what you discover.
Many, many people, I've found, bristle at this question. OK, those who practice the rituals of a particular religion, who attend temple or church or mosque regularly -- or even just once a year on a holiday -- have little problem with it. But what about the others? I've often heard the response, "Well, I was raised (insert religion here), but I never really practice it...."
Either of these responses can be fruitful to explore. Our relationship -- or lack thereof -- with a religious life sheds light on many aspects of our world view, our moral and ethical beliefs, our sense of spirituality outside a formal religion, and what we draw on in times of crisis, such as depression.
Play with this...
What religious beliefs did you grow up with -- Were Mom and Dad strict atheists? Did Grandma take you to mass every week? Did you learn to bow and pray several times a day? Meditate? Did you develop your own ideas about the mysteries of life?
How do those childhood beliefs and experiences affect you as an adult -- Do you practice any formal religion now? Where did you get married? What are you teaching your children? And how do your past and current beliefs affect you as you cope with depression?
Write for 10 minutes on each of these two main questions and see what you discover.
Thursday, March 01, 2007
TO READ: Men and Depression
Conventional psychiatric wisdom has it that depression is twice as common in women as in men. But that rule of thumb may not be correct.
Newsweek's cover story last week (Feb. 26, 2007 issue) was on men and depression, and it reports that more and more medical providers are discovering that men just don't admit or even face up to their depressive symptoms at the rate women do. Six million men will be diagnosed with depression this year, and more and more men are seeking treatment as stigma gradually lessens. Still, many men feel they must maintain a certain image -- for themselves as well as for others -- of being "in control." As a result, the article claims, men's moods may manifest as irritability, anger, alcoholism and other substance abuse, even violence.
In addition to the untold suffering of these men and their families due to such effects, depression leads men to commit suicide at rates at least four times greater than women. At a societal level, depression's effects are enormous as well: studies estimate that adult depression leads to $83 billion (with a "b") worth of lost productivity.
I certainly know many men who have had the "manliness" to step up, realize they have a problem, and seek treatment for their depression. They, like women in our society, still face tremendous stigma. But they do it. "Coming out" with depression is often the wisest, and healthiest, thing they can do -- for themselves, their families and their careers.
Conventional psychiatric wisdom has it that depression is twice as common in women as in men. But that rule of thumb may not be correct.
Newsweek's cover story last week (Feb. 26, 2007 issue) was on men and depression, and it reports that more and more medical providers are discovering that men just don't admit or even face up to their depressive symptoms at the rate women do. Six million men will be diagnosed with depression this year, and more and more men are seeking treatment as stigma gradually lessens. Still, many men feel they must maintain a certain image -- for themselves as well as for others -- of being "in control." As a result, the article claims, men's moods may manifest as irritability, anger, alcoholism and other substance abuse, even violence.
In addition to the untold suffering of these men and their families due to such effects, depression leads men to commit suicide at rates at least four times greater than women. At a societal level, depression's effects are enormous as well: studies estimate that adult depression leads to $83 billion (with a "b") worth of lost productivity.
I certainly know many men who have had the "manliness" to step up, realize they have a problem, and seek treatment for their depression. They, like women in our society, still face tremendous stigma. But they do it. "Coming out" with depression is often the wisest, and healthiest, thing they can do -- for themselves, their families and their careers.
Tuesday, February 20, 2007
TO WRITE: Is There a Book In You?
This weekend I attended the San Francisco Writers Conference for three long intensive days. I came away with new information, contacts, publishing leads and ideas. But one comment I recall, made by a presenter, really made me smile: Everyone has a book in them.
I think it's true. How often have you heard someone discuss an experience or a passion and say, "I could write a book." Maybe you've thought it too -- "My life could be a book!" Those of us who've struggled with depression or other mental illnesses may be especially prone to this, wishing we could accurately communicate to others what bizarre and painful journeys we've been through. Whether it's a manual on collecting toy trains, a steamy romance novel, a family history, or a memoir of your illness, most people I've asked about this do feel they have a book "in them."
Play with this ...
Imagine you were to sit down at the kitchen table and start writing or typing your first book. What would it be about? What would you really like to say to the world and leave behind in perpetuity? It doesn't need to be brilliant or perfect, it just needs to be from your unique perspective, as it will be. Now write continuously for 20 minutes on what you'd like to say to people about something you know well or can imagine well. You may feel lighter after pinpointing what you'd like to get out. And, who knows, maybe this will trigger you to pick up your pen again and begin Chapter 1!
This weekend I attended the San Francisco Writers Conference for three long intensive days. I came away with new information, contacts, publishing leads and ideas. But one comment I recall, made by a presenter, really made me smile: Everyone has a book in them.
I think it's true. How often have you heard someone discuss an experience or a passion and say, "I could write a book." Maybe you've thought it too -- "My life could be a book!" Those of us who've struggled with depression or other mental illnesses may be especially prone to this, wishing we could accurately communicate to others what bizarre and painful journeys we've been through. Whether it's a manual on collecting toy trains, a steamy romance novel, a family history, or a memoir of your illness, most people I've asked about this do feel they have a book "in them."
Play with this ...
Imagine you were to sit down at the kitchen table and start writing or typing your first book. What would it be about? What would you really like to say to the world and leave behind in perpetuity? It doesn't need to be brilliant or perfect, it just needs to be from your unique perspective, as it will be. Now write continuously for 20 minutes on what you'd like to say to people about something you know well or can imagine well. You may feel lighter after pinpointing what you'd like to get out. And, who knows, maybe this will trigger you to pick up your pen again and begin Chapter 1!
Monday, February 19, 2007
TO READ: Human Brain Cells That Continuously Regenerate Discovered
A site in the human brain in which new nerve cells are constantly being regenerated has just been identified for the first time. Researchers are excited that the results open wide the possibility of repairing the brains of people with neurodegenerative diseases such as Alzheimer's, and even treating brains damaged from injury or other diseases.
These newly discovered stem cells travel from just below fluid-filled chambers or "ventricles" of the brain, through a microscopic tube, to the area of the brain that deals with smell, morphing into new nerve cells along the way. The results, reported by scientists in New Zealand and Sweden, was published in the journal Science, according to BBC News. This cellular system had previously been identified in mice, rats and other species, but not in humans, and its detection encourages researchers that these animal models are applicable to humans.
For decades, scientists believed that the brain did not develop any new nerve cells after birth, but that theory has been disproven in recent years. Thus, as in this situation involving the brain's "olfactory bulb," the brain can grow new nerve cells to respond to different stimuli encountered throughout a person's life. Brain cells and the connections between them deteriorate or die in certain diseases. In mental illnesses such as depression, subtle changes in the brain's cellular structure have been identified in recent years too, but little is known yet about those alterations.
For more information: BBC News 2/16/2007.
A site in the human brain in which new nerve cells are constantly being regenerated has just been identified for the first time. Researchers are excited that the results open wide the possibility of repairing the brains of people with neurodegenerative diseases such as Alzheimer's, and even treating brains damaged from injury or other diseases.
These newly discovered stem cells travel from just below fluid-filled chambers or "ventricles" of the brain, through a microscopic tube, to the area of the brain that deals with smell, morphing into new nerve cells along the way. The results, reported by scientists in New Zealand and Sweden, was published in the journal Science, according to BBC News. This cellular system had previously been identified in mice, rats and other species, but not in humans, and its detection encourages researchers that these animal models are applicable to humans.
For decades, scientists believed that the brain did not develop any new nerve cells after birth, but that theory has been disproven in recent years. Thus, as in this situation involving the brain's "olfactory bulb," the brain can grow new nerve cells to respond to different stimuli encountered throughout a person's life. Brain cells and the connections between them deteriorate or die in certain diseases. In mental illnesses such as depression, subtle changes in the brain's cellular structure have been identified in recent years too, but little is known yet about those alterations.
For more information: BBC News 2/16/2007.
Tuesday, February 13, 2007
TO WRITE: Life's "Grand Essentials" Amid Depression
A writing student recently sent me the following quote, and then I saw it elsewhere a couple of days later. I felt it was calling to me.
"Three grand essentials to happiness in this life are something to do, something to love, and something to hope for."
-- Joseph Addison (1672- 1719)
When depression is lurking or even feels smothering, consider this recipe for happiness. It won't replace your other healing techniques, but for me, it provides perspective, a sense that life isn't as complicated as it sometimes feels, and gratitude. Every time I use it to take stock of my situation I come up with different responses. They don't need to be big things either - coffee with a friend, a soft cat, and looking forward to a positive new volunteer job have been fulfilling for me.
Play with this...
Take 20 minutes to respond to the Addison quote. List several things in each of the three categories if you like, then reflect (in writing) on what they mean to you in terms of your emotions and mood. Does imagining these things in your life leave you a little more satisfied, or does it feel discouraging? If it's the latter, are there tiny things you could work on in these areas of your life that might bring more contentment?
Beth
A writing student recently sent me the following quote, and then I saw it elsewhere a couple of days later. I felt it was calling to me.
"Three grand essentials to happiness in this life are something to do, something to love, and something to hope for."
-- Joseph Addison (1672- 1719)
When depression is lurking or even feels smothering, consider this recipe for happiness. It won't replace your other healing techniques, but for me, it provides perspective, a sense that life isn't as complicated as it sometimes feels, and gratitude. Every time I use it to take stock of my situation I come up with different responses. They don't need to be big things either - coffee with a friend, a soft cat, and looking forward to a positive new volunteer job have been fulfilling for me.
Play with this...
Take 20 minutes to respond to the Addison quote. List several things in each of the three categories if you like, then reflect (in writing) on what they mean to you in terms of your emotions and mood. Does imagining these things in your life leave you a little more satisfied, or does it feel discouraging? If it's the latter, are there tiny things you could work on in these areas of your life that might bring more contentment?
Beth
TO READ: Peer Support Study Results Extremely Positive
I just read the results of several research studies that asked: What benefits do peer support programs offer to mental health consumers? The answers, on the website of the Depression and Bipolar Support Alliance (www.dbsalliance.org), were astounding.
In these programs, consumers act as trained service providers to others with mental health issues to: help them develop self-management skills, aid in restoring social roles such as work, and encourage them to find - and commit to - more effective care for their illness. Organizations including the National Alliance on Mental Illness (www.nami.org) offer such peer-to-peer training programs.
In Canada, research on a program known as the Consumer/Survivor Initiatives found very positive results in terms of mental health symptoms, recovery support, and reduced use of hospital and emergency services. The CSI report found:
-- The average number of hospital days for participants dropped from 48 to 4.
-- More than $12 million was saved in reduced hospital stays for three hospitals over one year.
-- Self-described "lonely" consumers who were partnered with a peer mentor used on average $20,300 less per person in hospital and emergency services in the one year post discharge.
I've known many people who've benefited from peer services, as well as informal friendships and support groups, but I still found the degree of these improvements amazing. It seems obvious that training peers to provide such support - which I believe benefits them as well - should be a priority in all mental health care systems.
I just read the results of several research studies that asked: What benefits do peer support programs offer to mental health consumers? The answers, on the website of the Depression and Bipolar Support Alliance (www.dbsalliance.org), were astounding.
In these programs, consumers act as trained service providers to others with mental health issues to: help them develop self-management skills, aid in restoring social roles such as work, and encourage them to find - and commit to - more effective care for their illness. Organizations including the National Alliance on Mental Illness (www.nami.org) offer such peer-to-peer training programs.
In Canada, research on a program known as the Consumer/Survivor Initiatives found very positive results in terms of mental health symptoms, recovery support, and reduced use of hospital and emergency services. The CSI report found:
-- The average number of hospital days for participants dropped from 48 to 4.
-- More than $12 million was saved in reduced hospital stays for three hospitals over one year.
-- Self-described "lonely" consumers who were partnered with a peer mentor used on average $20,300 less per person in hospital and emergency services in the one year post discharge.
I've known many people who've benefited from peer services, as well as informal friendships and support groups, but I still found the degree of these improvements amazing. It seems obvious that training peers to provide such support - which I believe benefits them as well - should be a priority in all mental health care systems.
Monday, February 05, 2007
TO WRITE: Finding Your Own Deep Wisdom
I taught a creative writing workshop at a spiritual retreat among the redwoods in Aptos, California this weekend. In one exercise, we used the following Native American quote, followed by a short guided meditation, to access our inner wisdom as presented by an animal. As you try this freewrite, remember not to think too much -- you're simply there to take dictation.
Play With This...
This quote is from J. Reuben Silverbird (Navajo/Apache):
I taught a creative writing workshop at a spiritual retreat among the redwoods in Aptos, California this weekend. In one exercise, we used the following Native American quote, followed by a short guided meditation, to access our inner wisdom as presented by an animal. As you try this freewrite, remember not to think too much -- you're simply there to take dictation.
Play With This...
This quote is from J. Reuben Silverbird (Navajo/Apache):
We must listen
to the wisdom of
the Animals of the
Four Nations:
Forest, Land, Water & Sky.
With this in mind, close your eyes and visualize yourself walking alone. You might be in the forest, the desert, on a beach or a mountaintop. Ahead you see movement. As you approach, you see it's an animal. As you near it, the animal begins to speak to you. When you're ready, open your eyes and take at least five minutes to write down what the animal says to you.
Later, reread what you wrote and reflect on what meaning those words might have for you. You, like some others, may find that this sort of exercise, like a dream, provides insights into your life and current issues, particularly if you consider the possible symbolism in what is revealed. If it is useful for you, you may want to try it again in another setting or with another animal.
Friday, January 26, 2007
TO READ: Writing Saves Lives
Many writers love to claim it: The act of writing not only helped my life, it saved my life. Author and teacher Louise DeSalvo begins her book Writing as a Way of Healing with this claim; poet, author, painter Natalie Goldberg describes "How Poetry Saved My Life," in Top of My Lungs; my students have made this bold statement; I use it in Chapter 1 of my book-in-progress, Illuminating Words: The Power of Writing to Ease Depression to illustrate one of the key aspects of my recovery from severe bipolar disorder.
In this week's edition of Newsweek (Jan. 22, 2007), writer Anna Quindlen's column is titled Write for Your Life. In it, she describes how the disadvantaged teens documented in the new movie Freedom Writers find connection and even pride when a young teacher gives them blank notebooks and says to write anything at all. Now I know that some writers, including Virginia Wolff, have said that a piece of writing is not truly complete until someone else has read it, but I disagree. I've seen it in my students when they report on their journaling; I've felt it myself. Even writing for oneself can be meaningful and healing.
"Writing is a form of personal freedom. It frees us from the mass identity we see in the making all around us. In the end, writers will write not to be outlaw heroes of some underculture, but mainly to save themselves, to survive as individuals," according to novelist Don DeLillo as quoted in Quindlen's article. I think he puts it very well. While writing intended for family, friends or publication is no doubt fulfilling and empowering, there is a place, a crucial place, for personal, private writing as well. And it even saves lives.
Many writers love to claim it: The act of writing not only helped my life, it saved my life. Author and teacher Louise DeSalvo begins her book Writing as a Way of Healing with this claim; poet, author, painter Natalie Goldberg describes "How Poetry Saved My Life," in Top of My Lungs; my students have made this bold statement; I use it in Chapter 1 of my book-in-progress, Illuminating Words: The Power of Writing to Ease Depression to illustrate one of the key aspects of my recovery from severe bipolar disorder.
In this week's edition of Newsweek (Jan. 22, 2007), writer Anna Quindlen's column is titled Write for Your Life. In it, she describes how the disadvantaged teens documented in the new movie Freedom Writers find connection and even pride when a young teacher gives them blank notebooks and says to write anything at all. Now I know that some writers, including Virginia Wolff, have said that a piece of writing is not truly complete until someone else has read it, but I disagree. I've seen it in my students when they report on their journaling; I've felt it myself. Even writing for oneself can be meaningful and healing.
"Writing is a form of personal freedom. It frees us from the mass identity we see in the making all around us. In the end, writers will write not to be outlaw heroes of some underculture, but mainly to save themselves, to survive as individuals," according to novelist Don DeLillo as quoted in Quindlen's article. I think he puts it very well. While writing intended for family, friends or publication is no doubt fulfilling and empowering, there is a place, a crucial place, for personal, private writing as well. And it even saves lives.
Monday, January 15, 2007
TO WRITE: Be Proud of What You See
I attended a retreat this weekend for writing and silent meditation. It was glorious. About 40 other women and I spoke only when we were meeting in groups to discuss spirituality, writing, and the role of "mystery" in our lives. Meals, writing periods and free time were all in silence - no small talk all weekend. In this freeing and reflective state, the sharing we did do in groups was especially meaningful. One comment that struck me was an older woman recalling how her father firmly told her and her siblings when they were children: "Every morning look in the mirror and be proud of what you see."
Play with this...
Try out this father's advice. Look in the mirror and consider what you are proud of in yourself. Then write continuously for 20 minutes on what you discovered. Personal traits, good habits, accomplishments, kindnesses? Even if you're feeling depressed today, try honestly to find areas of pride - at the very least, you are trudging through a lousy period and you're demonstrating bravery and persistence and modeling those traits to others... all things to take pride in. Now can you look in the mirror again tomorrow and be proud of even more?
I attended a retreat this weekend for writing and silent meditation. It was glorious. About 40 other women and I spoke only when we were meeting in groups to discuss spirituality, writing, and the role of "mystery" in our lives. Meals, writing periods and free time were all in silence - no small talk all weekend. In this freeing and reflective state, the sharing we did do in groups was especially meaningful. One comment that struck me was an older woman recalling how her father firmly told her and her siblings when they were children: "Every morning look in the mirror and be proud of what you see."
Play with this...
Try out this father's advice. Look in the mirror and consider what you are proud of in yourself. Then write continuously for 20 minutes on what you discovered. Personal traits, good habits, accomplishments, kindnesses? Even if you're feeling depressed today, try honestly to find areas of pride - at the very least, you are trudging through a lousy period and you're demonstrating bravery and persistence and modeling those traits to others... all things to take pride in. Now can you look in the mirror again tomorrow and be proud of even more?
TO READ: Should I Start Omega-3's?
A bipolar friend of mine was recently stunned to discover that along with my other meds I don't take an omega-3 fatty acid supplement. She claims great results from taking omega-3-containing fish oil pills - several grams of them - every day for her depression. So am I missing the boat here? I know omega-3's were hot news a few years ago, but what's the evidence say now? My psychiatrist and I set out to discover the latest conclusions on their usefulness.
Although omega-3's were previously widely touted (notably, in The Omega-3 Connection, a 2001 book by expert Andrew Stoll), the latest reviews of all the published studies in this field seem to reach the same conclusion: Maybe they're useful; the verdict is still out.
To summarize extremely briefly, people got very excited when population studies found that people in parts of the world where lots of fish is eaten have lower rates of depression than in regions where fish is a smaller part of the diet. The unsaturated omega-3 fatty acids found in high levels in fish oil could logically play a biochemical role in the brain, and some studies have indicated that depressed people have particularly low levels of omega-3's. Sounds promising in theory, but when psychiatrists around the world eagerly began to study the effects of fish oil supplements for their patients, things got complicated.... In 2006, at least three groups of scientists did careful statistical reviews, each of at least 12 published studies (see Am J Psychiatry 2006; 163:6, June 2006; World J Biol Psychiatry 2006; 7(4): 223-230; and American Journal of Clinical Nutrition, December 2006). Every one concluded the same thing: We don't know yet if omega-3's are really effective.
Yes, there are some quite positive studies, but there are others that contradict them, showing no significant correlation at all between omega-3's and depression improvement. And, the studies are not all easily comparable either - some look at major (unipolar) depression, some at bipolar depression, some at other psychiatric conditions; the doses used haven't been standardized; they use different lengths of treatment; and some used omega-3's alone while others used them to augment antidepressant therapy. All of these things require a good deal of further study before we can say with certainty whether and how to use these supplements.
So, what am I going to do? Well, no negative side effects have come up in my reading or talking with friends; my internist says I could start taking some anyway for general heart health; and I really, really don't want to have another serious depression coming my way.... So, yes, I think I'll give a moderate dose (a few grams a day) a try for a month or two. If I don't feel any problem with it, great; if I actually think I feel better or can prolong my remission, fabulous! Meanwhile, I'll keep an eye on the literature in this field and be open to altering my plan. Stay tuned.
A bipolar friend of mine was recently stunned to discover that along with my other meds I don't take an omega-3 fatty acid supplement. She claims great results from taking omega-3-containing fish oil pills - several grams of them - every day for her depression. So am I missing the boat here? I know omega-3's were hot news a few years ago, but what's the evidence say now? My psychiatrist and I set out to discover the latest conclusions on their usefulness.
Although omega-3's were previously widely touted (notably, in The Omega-3 Connection, a 2001 book by expert Andrew Stoll), the latest reviews of all the published studies in this field seem to reach the same conclusion: Maybe they're useful; the verdict is still out.
To summarize extremely briefly, people got very excited when population studies found that people in parts of the world where lots of fish is eaten have lower rates of depression than in regions where fish is a smaller part of the diet. The unsaturated omega-3 fatty acids found in high levels in fish oil could logically play a biochemical role in the brain, and some studies have indicated that depressed people have particularly low levels of omega-3's. Sounds promising in theory, but when psychiatrists around the world eagerly began to study the effects of fish oil supplements for their patients, things got complicated.... In 2006, at least three groups of scientists did careful statistical reviews, each of at least 12 published studies (see Am J Psychiatry 2006; 163:6, June 2006; World J Biol Psychiatry 2006; 7(4): 223-230; and American Journal of Clinical Nutrition, December 2006). Every one concluded the same thing: We don't know yet if omega-3's are really effective.
Yes, there are some quite positive studies, but there are others that contradict them, showing no significant correlation at all between omega-3's and depression improvement. And, the studies are not all easily comparable either - some look at major (unipolar) depression, some at bipolar depression, some at other psychiatric conditions; the doses used haven't been standardized; they use different lengths of treatment; and some used omega-3's alone while others used them to augment antidepressant therapy. All of these things require a good deal of further study before we can say with certainty whether and how to use these supplements.
So, what am I going to do? Well, no negative side effects have come up in my reading or talking with friends; my internist says I could start taking some anyway for general heart health; and I really, really don't want to have another serious depression coming my way.... So, yes, I think I'll give a moderate dose (a few grams a day) a try for a month or two. If I don't feel any problem with it, great; if I actually think I feel better or can prolong my remission, fabulous! Meanwhile, I'll keep an eye on the literature in this field and be open to altering my plan. Stay tuned.
Monday, January 08, 2007
TO WRITE: Picturing yourself
We carry visions of everyone we know; we can't help but recall the sparkling eyes of a lover, the tall frame and warm embrace of a friend, the boss's scowl even when you are on time for that big meeting. We hold pictures of their non-physical characteristics as well. Jill is such a talented mathematician, Matthew is arrogant, Lauren has a heart of gold.
So how do you envision yourself? This is a much trickier question. How do you really perceive your own size, shape, color? Your talents, skills and weaknesses? Your faith, maturity and sense of justice? The list goes on and on, of course, and for those of us living with depression or another mental illness, our self-image can be even more complex, and sometimes harder to access too. The illness's effects change who we are, and the illness can alter the way we view everything, including ourselves.
Play with this...
Imagine you are creating a character for a novel you're writing, and that character is based on you. How will you describe her/him for brand new readers? Write continuously for 20 minutes and describe this person - yourself - as objectively as possible. Consider as many aspects of yourself as possible, including the role depression plays in your self-image.
When you reread your piece later, look at whether there are things you'd like to adjust, whether by modifying something about yourself, or by simply deciding to look at something in a new light. The opinion of a trusted friend or therapist might be valuable if you're interested in making changes in your self-image.
Beth
We carry visions of everyone we know; we can't help but recall the sparkling eyes of a lover, the tall frame and warm embrace of a friend, the boss's scowl even when you are on time for that big meeting. We hold pictures of their non-physical characteristics as well. Jill is such a talented mathematician, Matthew is arrogant, Lauren has a heart of gold.
So how do you envision yourself? This is a much trickier question. How do you really perceive your own size, shape, color? Your talents, skills and weaknesses? Your faith, maturity and sense of justice? The list goes on and on, of course, and for those of us living with depression or another mental illness, our self-image can be even more complex, and sometimes harder to access too. The illness's effects change who we are, and the illness can alter the way we view everything, including ourselves.
Play with this...
Imagine you are creating a character for a novel you're writing, and that character is based on you. How will you describe her/him for brand new readers? Write continuously for 20 minutes and describe this person - yourself - as objectively as possible. Consider as many aspects of yourself as possible, including the role depression plays in your self-image.
When you reread your piece later, look at whether there are things you'd like to adjust, whether by modifying something about yourself, or by simply deciding to look at something in a new light. The opinion of a trusted friend or therapist might be valuable if you're interested in making changes in your self-image.
Beth
TO READ: Genes May Predict Antidepressants' Effects
If you're reading this blog, chances are you've been there: Your doctor is prescribing an antidepressant for your unipolar or bipolar depression, then mentions the caveat - a big caveat - that this may take up to eight weeks to be effective, if it even is effective for you. When you're miserable, eight weeks is a very long time.
Once again, however, genetics may soon come to our rescue. I've written previously on the burgeoning use of genetics in other aspects of depression diagnosis and treatment (see 10/9/06 and 11/13/06), but now researchers are approaching the very practical issue of predicting "Which med will work for me?"
National Institute of Mental Health scientists screened the genes of nearly 2,000 people being treated with Celexa. They found variations in two genes associated with the treatment. One turned out to be linked to serotonin, one to glutamate, both of which are brain chemicals (neurotransmitters) involved in depression. It's only a start, but ultimately researchers hope to have a panel of genetic markers that can be used to predict which patients are at high risk of failure or side effects if the proposed medicine is used. Hopefully before long we'll see the end of the sometimes endless trial-and-error method of finding the right antidepressants for each suffering person.
For more info: WebMD.com for WebMD Medical News, 12/6/2006.
If you're reading this blog, chances are you've been there: Your doctor is prescribing an antidepressant for your unipolar or bipolar depression, then mentions the caveat - a big caveat - that this may take up to eight weeks to be effective, if it even is effective for you. When you're miserable, eight weeks is a very long time.
Once again, however, genetics may soon come to our rescue. I've written previously on the burgeoning use of genetics in other aspects of depression diagnosis and treatment (see 10/9/06 and 11/13/06), but now researchers are approaching the very practical issue of predicting "Which med will work for me?"
National Institute of Mental Health scientists screened the genes of nearly 2,000 people being treated with Celexa. They found variations in two genes associated with the treatment. One turned out to be linked to serotonin, one to glutamate, both of which are brain chemicals (neurotransmitters) involved in depression. It's only a start, but ultimately researchers hope to have a panel of genetic markers that can be used to predict which patients are at high risk of failure or side effects if the proposed medicine is used. Hopefully before long we'll see the end of the sometimes endless trial-and-error method of finding the right antidepressants for each suffering person.
For more info: WebMD.com for WebMD Medical News, 12/6/2006.
Tuesday, January 02, 2007
TO WRITE: Behind me and before me...
Welcome to 2007! After a short winter recess, WriteOutOfDepression is back, and I am looking ahead to the new year with a lot of excitement and a little trepidation too. Now that that busiest of seasons for many of us is over, where are you turning your attentions? In order to take stock and prioritize my ideas for the coming year (or at least the coming week or so), I have been making lists. For me, lists are a good way to trigger my sometimes sleepy winter brain, and they provide me with lots of options and ideas for further writing, something that always helps ground me in a new place or time.
Play with this...
Take a few minutes to quickly list 10 things that you remember about 2006. They might be personal, local or global. Choose one to write on continuously for 15 minutes, focusing on what that remembrance means to you yourself.
Then take about five minutes to list 10 things you imagine for 2007 - things you expect to occur or things you hope for. Look over your list and try to identify at least one small action you'd like to take to affect a desired item - or to hinder something you hope won't come to pass. (I, for example, would like to keep writing consistently on my book manuscript so that it's in good shape when I get a publishing offer; I also want to be more active in contacting my representatives about ending the war in Iraq.) Write continuously for 15 minutes on what doable action(s) would make you feel empowered in 2007.
May you find peace, good health and creative fulfillment in 2007,
Beth
Welcome to 2007! After a short winter recess, WriteOutOfDepression is back, and I am looking ahead to the new year with a lot of excitement and a little trepidation too. Now that that busiest of seasons for many of us is over, where are you turning your attentions? In order to take stock and prioritize my ideas for the coming year (or at least the coming week or so), I have been making lists. For me, lists are a good way to trigger my sometimes sleepy winter brain, and they provide me with lots of options and ideas for further writing, something that always helps ground me in a new place or time.
Play with this...
Take a few minutes to quickly list 10 things that you remember about 2006. They might be personal, local or global. Choose one to write on continuously for 15 minutes, focusing on what that remembrance means to you yourself.
Then take about five minutes to list 10 things you imagine for 2007 - things you expect to occur or things you hope for. Look over your list and try to identify at least one small action you'd like to take to affect a desired item - or to hinder something you hope won't come to pass. (I, for example, would like to keep writing consistently on my book manuscript so that it's in good shape when I get a publishing offer; I also want to be more active in contacting my representatives about ending the war in Iraq.) Write continuously for 15 minutes on what doable action(s) would make you feel empowered in 2007.
May you find peace, good health and creative fulfillment in 2007,
Beth
Monday, December 18, 2006
TO READ: Great Books on Depression and Other Mental Illnesses
I've just finished reading a couple of terrific books on mental illness issues and want to pass my thoughts on, while hoping you'll let me know of other new ones or old favorites.
The Unholy Ghost: Writers on Depression (edited by Nell Casey with an introduction by Kay Redfield Jamison; 2001, Perennial) is titled for a phrase poet Jane Kenyon used to describe her deep depression in Having It Out with Melancholy. Though it's not brand new, it was new to me when I picked it up recently, and I've found it fascinating. The book is a collection of essays by noted writers who have dealt with the illness, either personally, or as a spouse or family member.
While these writers seek to describe what many of us find indescribable about our experiences, they also tell their own very engaging stories of despair. Some of them relate these periods to their ideas about their own creative work, wishing that depression should be abolished if that were possible, or arguing that the illness is actually useful.
The Creating Brain: The Neuroscience of Genius (by Nancy C. Andreasen; 2005, Dana Press) was an exciting read for me as a biologist and as one deeply intrigued with the relationship of mental illness to creativity. In addition to considering what constitutes creativity and how the brain creates, among other issues, it includes a full chapter on Genius and Insanity: Creativity and Brain Disease. Many of you will also be quickly drawn in, I suspect.
Building on long-reported connections, Andreasen's careful study of writers reveals a dramatically higher rate of all mood disorders (80%) than in a carefully matched set of non-writers (30%). No writers in this study had schizophrenia. She is now studying whether scientists, or their family members, have higher rates of schizophrenia. She reports that during periods of instability, poets and painters are generally unable to create, but that during remissions they can draw upon these difficult experiences in their work. Also discussed is the fear of some writers and artists that psychiatric treatment of any kind might stifle their creativity.
Both of these books offer unique, valuable and very interesting takes on illnesses that are being written about more and more, but not always with new insights. What are you reading?
I've just finished reading a couple of terrific books on mental illness issues and want to pass my thoughts on, while hoping you'll let me know of other new ones or old favorites.
The Unholy Ghost: Writers on Depression (edited by Nell Casey with an introduction by Kay Redfield Jamison; 2001, Perennial) is titled for a phrase poet Jane Kenyon used to describe her deep depression in Having It Out with Melancholy. Though it's not brand new, it was new to me when I picked it up recently, and I've found it fascinating. The book is a collection of essays by noted writers who have dealt with the illness, either personally, or as a spouse or family member.
While these writers seek to describe what many of us find indescribable about our experiences, they also tell their own very engaging stories of despair. Some of them relate these periods to their ideas about their own creative work, wishing that depression should be abolished if that were possible, or arguing that the illness is actually useful.
The Creating Brain: The Neuroscience of Genius (by Nancy C. Andreasen; 2005, Dana Press) was an exciting read for me as a biologist and as one deeply intrigued with the relationship of mental illness to creativity. In addition to considering what constitutes creativity and how the brain creates, among other issues, it includes a full chapter on Genius and Insanity: Creativity and Brain Disease. Many of you will also be quickly drawn in, I suspect.
Building on long-reported connections, Andreasen's careful study of writers reveals a dramatically higher rate of all mood disorders (80%) than in a carefully matched set of non-writers (30%). No writers in this study had schizophrenia. She is now studying whether scientists, or their family members, have higher rates of schizophrenia. She reports that during periods of instability, poets and painters are generally unable to create, but that during remissions they can draw upon these difficult experiences in their work. Also discussed is the fear of some writers and artists that psychiatric treatment of any kind might stifle their creativity.
Both of these books offer unique, valuable and very interesting takes on illnesses that are being written about more and more, but not always with new insights. What are you reading?
TO WRITE: Spirituality's Role in Mental Health
In my way of looking at the Universe, we are all "spiritual" people -- not necessarily "religious" or even consciously spiritual in day to day life -- but spiritual just the same. We all have relationships with our self, with the world around us, with the mysteries life offers, and I believe that the way we face these things defines our spirituality. This is a very liberal use of the word "spiritual," I realize, but stay with me here.
Whether you are a Muslim, Jew, Buddhist, Christian, Hindu, agnostic, atheist or other, you have certain views about how the world operates and about what you most deeply treasure in that world. And, whether you hold truth, kindness or other principles as your highest values, whether your worldview is shaped by a traditional religious background or not, I argue that your mental health is affected by your spirituality.
The majority of psychiatric inpatients note that religion gives meaning and purpose to their life, according to several studies. In a general patient survey, 75% would like their doctors to address spiritual issues as part of their care. Clearly these are vitally important issues for many of us.
Play with this...
Write for 20 minutes on your spiritual views and how they relate to your depression or other mental illness. For example, does being an atheist ground you when you're ill? Does your belief in God help you to keep going despite your symptoms? And have your mental health experiences changed your worldview? Exploring spirituality with respect to your mental illness may make you more consciously aware of your beliefs and may even provide you with a lifeline when difficult thoughts and painful feelings strike.
Beth
In my way of looking at the Universe, we are all "spiritual" people -- not necessarily "religious" or even consciously spiritual in day to day life -- but spiritual just the same. We all have relationships with our self, with the world around us, with the mysteries life offers, and I believe that the way we face these things defines our spirituality. This is a very liberal use of the word "spiritual," I realize, but stay with me here.
Whether you are a Muslim, Jew, Buddhist, Christian, Hindu, agnostic, atheist or other, you have certain views about how the world operates and about what you most deeply treasure in that world. And, whether you hold truth, kindness or other principles as your highest values, whether your worldview is shaped by a traditional religious background or not, I argue that your mental health is affected by your spirituality.
The majority of psychiatric inpatients note that religion gives meaning and purpose to their life, according to several studies. In a general patient survey, 75% would like their doctors to address spiritual issues as part of their care. Clearly these are vitally important issues for many of us.
Play with this...
Write for 20 minutes on your spiritual views and how they relate to your depression or other mental illness. For example, does being an atheist ground you when you're ill? Does your belief in God help you to keep going despite your symptoms? And have your mental health experiences changed your worldview? Exploring spirituality with respect to your mental illness may make you more consciously aware of your beliefs and may even provide you with a lifeline when difficult thoughts and painful feelings strike.
Beth
Monday, December 11, 2006
TO READ: This is Your Brain on Therapy
Scientists are learning more on a daily basis about how the brains of people with depression differ from those without it. But can those differences be used to predict how best to treat depressed people? According to recent research, they can.
Using functional magnetic resonance imaging (fMRI), researchers at the University of Pittsburgh School of Medicine measured activity in two key areas of the brains of depressed persons while they responded to different words. The words were chosen to have negative, positive or neutral associations, and the patients were asked to choose words that reflected their feelings when they felt depressed. Then each person participated in a 12-week program of cognitive behavioral therapy (CBT) for their depression, and their depression levels were measured again.
The results seem strong: Among the nine patients with a particular brain activity pattern (a decrease in activity in the subgenual cingulate cortex) when responding to negative words, seven recovered during CBT. Among the five people who did not show that pattern, only one responded to CBT. The positive and neutral words produced no changes related to mood improvement in CBT.
So, even given this small initial trial, fMRI seems to provide a predictor of which depressed people will respond to CBT, a structured therapy that teaches how to control emotional reactions and rumination. Learning how to identify depressed patients who are likely to benefit from CBT versus some other therapy could provide quicker, more effective treatment for all.
For more info: Am J Psychiatry. 2006; 163:735-738.
Scientists are learning more on a daily basis about how the brains of people with depression differ from those without it. But can those differences be used to predict how best to treat depressed people? According to recent research, they can.
Using functional magnetic resonance imaging (fMRI), researchers at the University of Pittsburgh School of Medicine measured activity in two key areas of the brains of depressed persons while they responded to different words. The words were chosen to have negative, positive or neutral associations, and the patients were asked to choose words that reflected their feelings when they felt depressed. Then each person participated in a 12-week program of cognitive behavioral therapy (CBT) for their depression, and their depression levels were measured again.
The results seem strong: Among the nine patients with a particular brain activity pattern (a decrease in activity in the subgenual cingulate cortex) when responding to negative words, seven recovered during CBT. Among the five people who did not show that pattern, only one responded to CBT. The positive and neutral words produced no changes related to mood improvement in CBT.
So, even given this small initial trial, fMRI seems to provide a predictor of which depressed people will respond to CBT, a structured therapy that teaches how to control emotional reactions and rumination. Learning how to identify depressed patients who are likely to benefit from CBT versus some other therapy could provide quicker, more effective treatment for all.
For more info: Am J Psychiatry. 2006; 163:735-738.
TO WRITE: Changing Perspectives in Your Writing
In his book Writing to Heal, James W. Pennebaker reports that recent research demonstrates the importance of the writer's perspective or voice when writing about traumatic issues. People who derive the most benefit from writing on a difficult topic for several days in a row are those who can switch from writing exclusively about their own thoughts and emotions to writing about how others who were involved might have experienced and thought about the trauma.
This change in perspective can be accomplished by writing in the "first-person" voice versus the "third person" voice. (If these terms make you cringe about a failed fifth-grade grammar test, fear not. The first person uses "I, me, we," as in: I ordered a pizza for us to have for dinner. The third person uses "she, he, her, him, they," as in: She ordered a pizza for them to have for dinner.)
Play with this...
Think of an annoying event in your life -- not a massive trauma -- that you've been worrying over. Now write continuously about the event and your reaction to it for 10 minutes from your usual first-person perspective. ("I threw up my hands when...")
Now read over what you've just written. Then write on the same topic, covering the same basic information, for 10 minutes from the third-person. You'll sound like an outside observer. ("She threw up her hands when...")
Now read over your second writing and compare how these two pieces felt to write. (Writing in the third person may feel awkward at first, but does get more comfortable with practice.) Did it give you a sense of distance from the problem? Was that useful to you? This technique can be particularly helpful when you are later approaching a serious trauma through writing.
Beth
In his book Writing to Heal, James W. Pennebaker reports that recent research demonstrates the importance of the writer's perspective or voice when writing about traumatic issues. People who derive the most benefit from writing on a difficult topic for several days in a row are those who can switch from writing exclusively about their own thoughts and emotions to writing about how others who were involved might have experienced and thought about the trauma.
This change in perspective can be accomplished by writing in the "first-person" voice versus the "third person" voice. (If these terms make you cringe about a failed fifth-grade grammar test, fear not. The first person uses "I, me, we," as in: I ordered a pizza for us to have for dinner. The third person uses "she, he, her, him, they," as in: She ordered a pizza for them to have for dinner.)
Play with this...
Think of an annoying event in your life -- not a massive trauma -- that you've been worrying over. Now write continuously about the event and your reaction to it for 10 minutes from your usual first-person perspective. ("I threw up my hands when...")
Now read over what you've just written. Then write on the same topic, covering the same basic information, for 10 minutes from the third-person. You'll sound like an outside observer. ("She threw up her hands when...")
Now read over your second writing and compare how these two pieces felt to write. (Writing in the third person may feel awkward at first, but does get more comfortable with practice.) Did it give you a sense of distance from the problem? Was that useful to you? This technique can be particularly helpful when you are later approaching a serious trauma through writing.
Beth
Thursday, December 07, 2006
TO READ: Reading Books as a Depression Treatment
Bibliotherapy, also known as "guided self-help," has been studied for several years as a treatment for mild to moderate depression. In bibliotherapy, people with depression are assigned to read a self-help book such as David Burns' Feeling Good, instead of, or in addition to, treatment with psychotherapy and/or antidepressant medicines. The results are impressive.
Numerous controlled studies have been conducted and, in at least some, researchers have concluded that a four-week self-study period with an appropriate book was as effective as individual psychotherapy, participation in a cognitive behavioral therapy group, or taking an antidepressant -- and bibliotherapy worked faster. In a three-year follow up study, the beneficial effects of bibliotherapy were sustained.
Can reading really alleviate depression? There are some specifics to keep in mind. The book must contain real information on how to recover from depression. Typically the books used CBT-based approaches. (Peter Lewinsohn's book Control Your Depression was also found useful; Victor Frankl's Man's Search for Meaning led to no improvement.) In some studies the reading was conducted between psychotherapy sessions that reinforced the importance of the books and their exercises. Also, bibliotherapy has not been applied to severely depressed patients.
As you may suspect, bibliotherapy provides a vastly more economic way to treat mild to moderate depression. Some researchers have suggested that conducting bibliotherapy on the Internet may be effective, and cost effective, as well.
For more info, see: Smith, et al, (1997), J. consult. clin. psychol., 65, 2.
The Wall Street Journal, August 9, 2005, p. B1.
holisticonline.com/remedies/depression
Bibliotherapy, also known as "guided self-help," has been studied for several years as a treatment for mild to moderate depression. In bibliotherapy, people with depression are assigned to read a self-help book such as David Burns' Feeling Good, instead of, or in addition to, treatment with psychotherapy and/or antidepressant medicines. The results are impressive.
Numerous controlled studies have been conducted and, in at least some, researchers have concluded that a four-week self-study period with an appropriate book was as effective as individual psychotherapy, participation in a cognitive behavioral therapy group, or taking an antidepressant -- and bibliotherapy worked faster. In a three-year follow up study, the beneficial effects of bibliotherapy were sustained.
Can reading really alleviate depression? There are some specifics to keep in mind. The book must contain real information on how to recover from depression. Typically the books used CBT-based approaches. (Peter Lewinsohn's book Control Your Depression was also found useful; Victor Frankl's Man's Search for Meaning led to no improvement.) In some studies the reading was conducted between psychotherapy sessions that reinforced the importance of the books and their exercises. Also, bibliotherapy has not been applied to severely depressed patients.
As you may suspect, bibliotherapy provides a vastly more economic way to treat mild to moderate depression. Some researchers have suggested that conducting bibliotherapy on the Internet may be effective, and cost effective, as well.
For more info, see: Smith, et al, (1997), J. consult. clin. psychol., 65, 2.
The Wall Street Journal, August 9, 2005, p. B1.
holisticonline.com/remedies/depression
Monday, December 04, 2006
TO WRITE: Focus the Power of Your Writing
For the past eight years, I've led a creative writing class for people with mood disorders, meeting weekly at Stanford University's Psychiatry Department. While we often explore our mental health issues through writing and sharing, we write on other topics as well.
Why bother writing about sand or your favorite meal or a photograph of a cheetah? Many reasons, I believe. For example, these exercises help us "warm up" as we begin a two-hour writing session; students report they are calming, clarifying, thought-provoking; and reading their pieces aloud helps validate writers' thoughts and feelings in a safe community. But these unusual topics also make us better, stronger writers by developing our use of techniques including: memory, the senses, and vivid detail. These three things are among those many authors (of fiction and non-fiction) emphasize when teaching others to hone their writing craft.
Writing about your family car when you were a child requires you to: Dig into your memory banks, which may lead you to long-forgotten stories as well. Describe the way the car looked and perhaps sounded as it backfired, felt as it hit a bump, or smelled of popcorn after a drive-in movie. And it encourages you to stretch yourself to come up with vivid details that will really bring the reader into your experience -- how Mom's beehive hairdo almost touched the ceiling, how big brother whined as he begged to be allowed to drive.
All these techniques help writers to better develop a narrative and to develop changes in perspective. Both these things have been found in studies to be more likely to effect health changes when writing about trauma -- something we're likely to address in the second in-class exercise of the day.
Play with this...
Write a description of your high school gym teacher. Try to use all of your senses as you look back to recall him or her. Use vivid details as much as possible to elucidate his/her character. What stories do you recall? Help an imagined reader really know this person.
Beth
For the past eight years, I've led a creative writing class for people with mood disorders, meeting weekly at Stanford University's Psychiatry Department. While we often explore our mental health issues through writing and sharing, we write on other topics as well.
Why bother writing about sand or your favorite meal or a photograph of a cheetah? Many reasons, I believe. For example, these exercises help us "warm up" as we begin a two-hour writing session; students report they are calming, clarifying, thought-provoking; and reading their pieces aloud helps validate writers' thoughts and feelings in a safe community. But these unusual topics also make us better, stronger writers by developing our use of techniques including: memory, the senses, and vivid detail. These three things are among those many authors (of fiction and non-fiction) emphasize when teaching others to hone their writing craft.
Writing about your family car when you were a child requires you to: Dig into your memory banks, which may lead you to long-forgotten stories as well. Describe the way the car looked and perhaps sounded as it backfired, felt as it hit a bump, or smelled of popcorn after a drive-in movie. And it encourages you to stretch yourself to come up with vivid details that will really bring the reader into your experience -- how Mom's beehive hairdo almost touched the ceiling, how big brother whined as he begged to be allowed to drive.
All these techniques help writers to better develop a narrative and to develop changes in perspective. Both these things have been found in studies to be more likely to effect health changes when writing about trauma -- something we're likely to address in the second in-class exercise of the day.
Play with this...
Write a description of your high school gym teacher. Try to use all of your senses as you look back to recall him or her. Use vivid details as much as possible to elucidate his/her character. What stories do you recall? Help an imagined reader really know this person.
Beth
Thursday, November 30, 2006
TO READ: Could Depression Relief be "All in Your Mind"?
We've all heard it, or even thought it ourselves: You're not "really sick," your depression is just "all in your mind." Before you grind your teeth too hard, read about how neurofeedback, aka EEG biofeedback, has helped a few people ease their depression by training their brains.
It seems that in depressed people a particular type of brain wave, the alpha wave, is not equally strong in the left and right brain hemispheres, but is more active on the right. This distribution of alpha waves can be related to mood. Though the technique is highly experimental, and no controlled studies have been conducted yet, researchers at Northwestern University and the NeuroQuest Neurofeedback Center in Evanston, Illinois have seen some positive results when depressed subjects learned to balance the alpha waves in their brains.
After electrodes were stuck to spots on their face and scalp, depressed research subjects were trained in 15-30 minutes sessions to play a sort of game. In this rudimentary computer game, played simply by thinking, not using the hands, success was measured in changes in brain waves. When their alpha waves in the left frontal cortex grew stronger than in the right, they heard a note played on a clarinet. Their goal was to keep this tone playing as long as possible. The training worked -- at least for some people. One woman had outstanding results: After 12 years of recurrent depressions that were not responsive to treatments, she learned in just 35 hours of training to control the waves so that her symptoms decreased dramatically. Amazingly, she remained depression-free during the next six years as the scientists followed her case.
Brain training, as it's called, is being studied for many other uses as well: predictions of seizures in patients with epilepsy, treatment of ADHD, communication for those who cannot speak or move and, yes, even improving healthy people's cognitive skills such as memory, concentration and musical abilities.
For more info, see: Scientific American Mind, February 2006.
We've all heard it, or even thought it ourselves: You're not "really sick," your depression is just "all in your mind." Before you grind your teeth too hard, read about how neurofeedback, aka EEG biofeedback, has helped a few people ease their depression by training their brains.
It seems that in depressed people a particular type of brain wave, the alpha wave, is not equally strong in the left and right brain hemispheres, but is more active on the right. This distribution of alpha waves can be related to mood. Though the technique is highly experimental, and no controlled studies have been conducted yet, researchers at Northwestern University and the NeuroQuest Neurofeedback Center in Evanston, Illinois have seen some positive results when depressed subjects learned to balance the alpha waves in their brains.
After electrodes were stuck to spots on their face and scalp, depressed research subjects were trained in 15-30 minutes sessions to play a sort of game. In this rudimentary computer game, played simply by thinking, not using the hands, success was measured in changes in brain waves. When their alpha waves in the left frontal cortex grew stronger than in the right, they heard a note played on a clarinet. Their goal was to keep this tone playing as long as possible. The training worked -- at least for some people. One woman had outstanding results: After 12 years of recurrent depressions that were not responsive to treatments, she learned in just 35 hours of training to control the waves so that her symptoms decreased dramatically. Amazingly, she remained depression-free during the next six years as the scientists followed her case.
Brain training, as it's called, is being studied for many other uses as well: predictions of seizures in patients with epilepsy, treatment of ADHD, communication for those who cannot speak or move and, yes, even improving healthy people's cognitive skills such as memory, concentration and musical abilities.
For more info, see: Scientific American Mind, February 2006.
Monday, November 27, 2006
TO WRITE: What Are You Grateful For?
As the long weekend of family, food and crazed shopping ends, I'm reflecting on what it all means. What am I really thankful for, and do I ever truly stop and think about those things? Some recent psychological research suggests that the trait of being grateful is a particularly powerful one. The psychologists involved suggest the following practice for greater contentment: Keep a special notebook, and at the end of each day, write down three specific things for which you are grateful. These can be large or small things -- I was able to sleep six solid hours last night; I called my sister for support today when I felt really low; I felt engaged when reading the front page of the newspaper. Ocassionally look back at your notebook and see what things jump out at you or form a trend. Are these things you could strive to increase in your life?
Play with this...
Try the exercise described above for a week. Then reread your notebook entries and write consistently for 20 minutes on your findings. If you feel a sense of satisfaction, lightness or joy, continue the practice and see how your feelings evolve over time and how you might apply your discoveries day-to-day.
Beth
As the long weekend of family, food and crazed shopping ends, I'm reflecting on what it all means. What am I really thankful for, and do I ever truly stop and think about those things? Some recent psychological research suggests that the trait of being grateful is a particularly powerful one. The psychologists involved suggest the following practice for greater contentment: Keep a special notebook, and at the end of each day, write down three specific things for which you are grateful. These can be large or small things -- I was able to sleep six solid hours last night; I called my sister for support today when I felt really low; I felt engaged when reading the front page of the newspaper. Ocassionally look back at your notebook and see what things jump out at you or form a trend. Are these things you could strive to increase in your life?
Play with this...
Try the exercise described above for a week. Then reread your notebook entries and write consistently for 20 minutes on your findings. If you feel a sense of satisfaction, lightness or joy, continue the practice and see how your feelings evolve over time and how you might apply your discoveries day-to-day.
Beth
Wednesday, November 22, 2006
TO READ: The Creativity-Depression Link: Rumination
Science, as well as centuries of popular observation, has shown that there is a strong relationship between mood disorders and creativity. Artists, writers, musicians and scientists all have higher than usual rates of depression, for example. But why? Does depression lead somehow to creativity? Or are creative pursuits somehow depressing? Research now shows that there may be no direct link between the two. Rather, their connection may be the tendency to ruminate.
In the 1990s, one overview of research studies on creativity and depression concluded that major depression in writers and artists is 8-10 times higher than in the general population. Another study found that people working in the creative arts had a lifetime prevalence of depression of 50%, while scientists came in at 24%, and the general public had a rate of 9%. In particular, poets had a depression rate of 77%; fiction writers, 59%; and visual artists, 50%.
More recently, researchers at Syracuse University and Stanford University found evidence that the strong relationship between mood disorder and creative behavior is rumination -- having conscious thoughts about a particular topic that recur whenever the person is not facing immediate outside demands. This tendency to self-reflection increases the risk for depression, and it also triggers interest in and ability for creative activities.
The results suggest that depressed people, who tend to be ruminators, may turn to creative pursuits when they are feeling better in order to express their feelings and the content of that self-reflective thought. Also, rumination may allow the depressed individual to later generate more ideas, some of which are original and can be pursued -- though of course, the possibility of having repetitive negative thoughts about oneself is higher too.
From: Verhaeghen, et al. (2005). Why we sing the blues: The relation between self-reflective rumination, mood, and creativity. Emotion, 5, 226-232.
Science, as well as centuries of popular observation, has shown that there is a strong relationship between mood disorders and creativity. Artists, writers, musicians and scientists all have higher than usual rates of depression, for example. But why? Does depression lead somehow to creativity? Or are creative pursuits somehow depressing? Research now shows that there may be no direct link between the two. Rather, their connection may be the tendency to ruminate.
In the 1990s, one overview of research studies on creativity and depression concluded that major depression in writers and artists is 8-10 times higher than in the general population. Another study found that people working in the creative arts had a lifetime prevalence of depression of 50%, while scientists came in at 24%, and the general public had a rate of 9%. In particular, poets had a depression rate of 77%; fiction writers, 59%; and visual artists, 50%.
More recently, researchers at Syracuse University and Stanford University found evidence that the strong relationship between mood disorder and creative behavior is rumination -- having conscious thoughts about a particular topic that recur whenever the person is not facing immediate outside demands. This tendency to self-reflection increases the risk for depression, and it also triggers interest in and ability for creative activities.
The results suggest that depressed people, who tend to be ruminators, may turn to creative pursuits when they are feeling better in order to express their feelings and the content of that self-reflective thought. Also, rumination may allow the depressed individual to later generate more ideas, some of which are original and can be pursued -- though of course, the possibility of having repetitive negative thoughts about oneself is higher too.
From: Verhaeghen, et al. (2005). Why we sing the blues: The relation between self-reflective rumination, mood, and creativity. Emotion, 5, 226-232.
Monday, November 20, 2006
TO WRITE: Tell me what helps!
A recent comment left on this blog -- a request for help, really -- got me thinking about how easy it can become to focus on what makes our depression and other symptoms worse, not what makes us feel better. One of the many uses of support groups for those living with mental illness is that through sharing with others, we can often identify healing techniques, be they large or small. Writing can also trigger us to pinpoint what works for us, both as we put our finger on these approaches ourselves, and as we share them with others.
Play with this...
Imagine a person who has just been diagnosed with your illness coming to you for advice on how to ease the pain. What would you suggest? I'd include both broad approaches -- educating oneself through the links listed in this blog, seeing a highly-recommended physician -- and small, specific tricks -- holding my cat, coffee with a trusted friend, writing down my feelings of confusion. Writing continuously for 20 minutes, describe what you'd say to this new acquaintance who needs your help. And let me know what you come up with!
Beth
A recent comment left on this blog -- a request for help, really -- got me thinking about how easy it can become to focus on what makes our depression and other symptoms worse, not what makes us feel better. One of the many uses of support groups for those living with mental illness is that through sharing with others, we can often identify healing techniques, be they large or small. Writing can also trigger us to pinpoint what works for us, both as we put our finger on these approaches ourselves, and as we share them with others.
Play with this...
Imagine a person who has just been diagnosed with your illness coming to you for advice on how to ease the pain. What would you suggest? I'd include both broad approaches -- educating oneself through the links listed in this blog, seeing a highly-recommended physician -- and small, specific tricks -- holding my cat, coffee with a trusted friend, writing down my feelings of confusion. Writing continuously for 20 minutes, describe what you'd say to this new acquaintance who needs your help. And let me know what you come up with!
Beth
Monday, November 13, 2006
TO READ: Depression gene enlarges "negative" brain region
If you're clinically depressed, your brain's structure is probably different than that of your healthy friends. That's right -- while the use of biochemicals such as serotonin is undoubtedly different in depression, as we've heard for years, there are gross physical differences in the brain tissue as well. Several research studies have demonstrated that numerous regions of the brains of people with depression differ from that of non-depressed people -- usually certain areas are smaller in depressed people. Now, there's evidence that the "negative emotions" part of the brain is bigger in those with depression.
Last week in the journal Biological Psychiatry, scientists reported their studies of a particular gene, the serotonin transporter gene (SERT), which has two forms, known as short and long. If you have two short SERT genes (one from each parent), you're likely to have a bigger "pulvinar" in your brain. The pulvinar region handles negative emotions. People in the study who had depression had pulvinars 20% larger and with 20% more nerve cells than people with one or two long genes. Researchers believe about 17% of the population has two SERT genes.
The SERT gene also affects the nerve cells' use of the neurotransmitter serotonin. Prozac, Zoloft and several other antidepressants act by keeping serotonin more available for cells to communicate.
How does this new information help us? "The brain is wired differently in people who have depression, and probably from the point of view of treatment, we should try to identify these people as early as possible and intervene before the 'hard-wiring' gets altered," the lead researcher told Reuters.
If you're clinically depressed, your brain's structure is probably different than that of your healthy friends. That's right -- while the use of biochemicals such as serotonin is undoubtedly different in depression, as we've heard for years, there are gross physical differences in the brain tissue as well. Several research studies have demonstrated that numerous regions of the brains of people with depression differ from that of non-depressed people -- usually certain areas are smaller in depressed people. Now, there's evidence that the "negative emotions" part of the brain is bigger in those with depression.
Last week in the journal Biological Psychiatry, scientists reported their studies of a particular gene, the serotonin transporter gene (SERT), which has two forms, known as short and long. If you have two short SERT genes (one from each parent), you're likely to have a bigger "pulvinar" in your brain. The pulvinar region handles negative emotions. People in the study who had depression had pulvinars 20% larger and with 20% more nerve cells than people with one or two long genes. Researchers believe about 17% of the population has two SERT genes.
The SERT gene also affects the nerve cells' use of the neurotransmitter serotonin. Prozac, Zoloft and several other antidepressants act by keeping serotonin more available for cells to communicate.
How does this new information help us? "The brain is wired differently in people who have depression, and probably from the point of view of treatment, we should try to identify these people as early as possible and intervene before the 'hard-wiring' gets altered," the lead researcher told Reuters.
Friday, November 10, 2006
TO WRITE: What makes you you?
When living with depression or any other mental illness, it's all too easy to lose sight of who we really are. We're busy taking meds or going through other treatments to help change the ways we think and feel, and underneath it all our sense of self can be seriously compromised. The following quote by William James has helped me on several occasions to connect to what I consider my core -- my unique abilities, character, desires, needs, goals.
"Seek out that particular mental attribute which makes you feel most deeply and vitally alive, along with which comes the inner voice which says, 'This is the real me,' and when you have found that attitude, follow it."
Play with this...
Write continuously for 20 minutes on "What makes you the real you?" Afterward, reread your piece and see if you can come up with ideas on how to "follow it."
Beth
When living with depression or any other mental illness, it's all too easy to lose sight of who we really are. We're busy taking meds or going through other treatments to help change the ways we think and feel, and underneath it all our sense of self can be seriously compromised. The following quote by William James has helped me on several occasions to connect to what I consider my core -- my unique abilities, character, desires, needs, goals.
"Seek out that particular mental attribute which makes you feel most deeply and vitally alive, along with which comes the inner voice which says, 'This is the real me,' and when you have found that attitude, follow it."
Play with this...
Write continuously for 20 minutes on "What makes you the real you?" Afterward, reread your piece and see if you can come up with ideas on how to "follow it."
Beth
Wednesday, November 08, 2006
TO READ: Migraines and depression -- What's the connection?
I want to report today on migraines, usually considered a neurological, not a psychiatric issue. However, I contend that for some of us there's a real connection. I say this because of personal experiences, and because of similar stories numerous others have told me about their illnesses. (See, for example, the comment from "Patricia" below the November 1 posting in this blog.) My ill health actually began, 20 years ago, as severe daily migraines that appeared suddenly for the first time, and made it very hard to work. After a year of trying various medicines, during which my depressive symptoms first appeared, an old tricyclic antidepressant took care of both ailments. At least it largely took care of the migraines; the depression has returned umpteen times. Of course, not everyone has even that much success, though medicines used have advanced a great deal.
Interestingly, however, there may soon be non-pharmacological treatments for migraine sufferers. The New York Times reports this week on two experimental treatments being studied in large trials for migraine -- ONS, or occipital nerve stimulation, and TMS, transcranial magnetic stimulation.
ONS uses electrodes implanted just under the skin on the back of the head to deliver electric current to a specific nerve. The electrodes are wired (under the skin) to a pacemaker-like device implanted in the upper buttock. The treatment sounds analogous to the VNS, or vagus nerve stimulation, therapy now used for treatment-resistant depression, where a device implanted in the upper chest is wired to electrodes in the side of the neck and delivers pulses of electricity. Very different nerves -- similar idea.
And TMS is already being studied for the treatment of both major depression and bipolar depression. I've previously described in this blog how fabulous TMS treatment has been for me. The idea in using TMS for migraine is similar. Instead of the side-of-the head stimulation I've gotten, here the back of the head is targeted. Again, a device pressed against the head provides brief magnetic pulses, which alter the electrical activity in a localized region of the brain. In neither case is it known exactly how the stimulation helps, and it doesn't help everyone. Also, the migraine studies so far are limited to those who experience an "aura," or a premonition period, before the migraine. Still, the idea of having more electrical -- as well as chemical -- treatment options for both depression and migraine is exciting. Stay tuned for more results.
Beth
I want to report today on migraines, usually considered a neurological, not a psychiatric issue. However, I contend that for some of us there's a real connection. I say this because of personal experiences, and because of similar stories numerous others have told me about their illnesses. (See, for example, the comment from "Patricia" below the November 1 posting in this blog.) My ill health actually began, 20 years ago, as severe daily migraines that appeared suddenly for the first time, and made it very hard to work. After a year of trying various medicines, during which my depressive symptoms first appeared, an old tricyclic antidepressant took care of both ailments. At least it largely took care of the migraines; the depression has returned umpteen times. Of course, not everyone has even that much success, though medicines used have advanced a great deal.
Interestingly, however, there may soon be non-pharmacological treatments for migraine sufferers. The New York Times reports this week on two experimental treatments being studied in large trials for migraine -- ONS, or occipital nerve stimulation, and TMS, transcranial magnetic stimulation.
ONS uses electrodes implanted just under the skin on the back of the head to deliver electric current to a specific nerve. The electrodes are wired (under the skin) to a pacemaker-like device implanted in the upper buttock. The treatment sounds analogous to the VNS, or vagus nerve stimulation, therapy now used for treatment-resistant depression, where a device implanted in the upper chest is wired to electrodes in the side of the neck and delivers pulses of electricity. Very different nerves -- similar idea.
And TMS is already being studied for the treatment of both major depression and bipolar depression. I've previously described in this blog how fabulous TMS treatment has been for me. The idea in using TMS for migraine is similar. Instead of the side-of-the head stimulation I've gotten, here the back of the head is targeted. Again, a device pressed against the head provides brief magnetic pulses, which alter the electrical activity in a localized region of the brain. In neither case is it known exactly how the stimulation helps, and it doesn't help everyone. Also, the migraine studies so far are limited to those who experience an "aura," or a premonition period, before the migraine. Still, the idea of having more electrical -- as well as chemical -- treatment options for both depression and migraine is exciting. Stay tuned for more results.
Beth
Friday, November 03, 2006
TO WRITE: How do relationships affect your mental health?
All of our personal relationships are bound to affect us in myriad ways, and our mental health is definitely one of them. Think about the people in your romantic life, for example -- your spouse, partner, or a current or former relationship. Does that person know about your depression, bipolar disorder, or other mental health problem? Can you discuss it with him/her? Is that person supportive? Have you learned over time how to best handle conversations with her/him on this topic? What would you like to change in this area?
Writing about our relationships can be extremely fruitful -- and fascinating. For a great example of writing on changing romantic relationships, check out the essays on the blog of a writer friend of mine at: MovingInMovingOn.typepad.com.
Play with this...
Choose your current partner or a person with whom you had a former romantic relationship. Writing consistently for 20 minutes, describe how you relate(d) to that person on the topic of your mental health. Does reading what you wrote provide any insight into changes you might like to make in this realm, if any?
Beth
All of our personal relationships are bound to affect us in myriad ways, and our mental health is definitely one of them. Think about the people in your romantic life, for example -- your spouse, partner, or a current or former relationship. Does that person know about your depression, bipolar disorder, or other mental health problem? Can you discuss it with him/her? Is that person supportive? Have you learned over time how to best handle conversations with her/him on this topic? What would you like to change in this area?
Writing about our relationships can be extremely fruitful -- and fascinating. For a great example of writing on changing romantic relationships, check out the essays on the blog of a writer friend of mine at: MovingInMovingOn.typepad.com.
Play with this...
Choose your current partner or a person with whom you had a former romantic relationship. Writing consistently for 20 minutes, describe how you relate(d) to that person on the topic of your mental health. Does reading what you wrote provide any insight into changes you might like to make in this realm, if any?
Beth
Wednesday, November 01, 2006
TO READ: Depressed? Keep trying new meds
The final portion of a large, six-year federal study of depression was published today in the American Journal of Psychiatry. The findings: While one-third of people were helped by starting on the antidepressant Celexa, one-third more got better if they were patient and added or switched to a second, third, or even fourth antidepressant, as needed. Thus, 67% of the 3,671 of the depressed patients studied reached remission by taking one or more medicines.
The downside of trying additional antidepressants, however, is that relapse becomes more likely the more drugs you try. Among those who achieved remission with the original Celexa prescription, 40% relapsed in the first year. For those who had to use a second, third or fourth drug, the relapse rates rose to 55, 65, and 70%, respectively.
The final portion of a large, six-year federal study of depression was published today in the American Journal of Psychiatry. The findings: While one-third of people were helped by starting on the antidepressant Celexa, one-third more got better if they were patient and added or switched to a second, third, or even fourth antidepressant, as needed. Thus, 67% of the 3,671 of the depressed patients studied reached remission by taking one or more medicines.
The downside of trying additional antidepressants, however, is that relapse becomes more likely the more drugs you try. Among those who achieved remission with the original Celexa prescription, 40% relapsed in the first year. For those who had to use a second, third or fourth drug, the relapse rates rose to 55, 65, and 70%, respectively.
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