Tuesday, April 29, 2008

upsides of being down...

Upsides of being down

Focusing on depression in a purely clinical way is preventing us understanding our susceptibility to it and ignores the good it can bring, argues psychiatrist Paul Keedwell

This article appeared in the Guardian on Wednesday February 27 2008 on p1 of the Society news & features section. It was last updated at 13:02 on March 03 2008.
Stephen Fry

Stephen Fry was accused of 'normalising' mental illness when he discussed his bipolar disorder. Photograph: Kirsty Wigglesworth/PA/Pool

The following correction was printed in the Guardian's Corrections and clarifications column, Monday March 3 2008

We exaggerated the precociousness of John Stuart Mill in saying he wrote his famous work Utilitarianism in 1861 at the age of 19 in the article below. He was 55 at the time.


Discuss the positive aspects of mental disorder, and the British public seems to feel threatened. When actor Stephen Fry gave an account of his bipolar disorder, he was accused of "normalising" what was a "severe mental illness", that he had the luxury of shunning treatment due to his privilege and wealth. These sorts of criticisms missed the point: his wealth was earned largely because of his so-called disorder. The years when he was contributing to hit TV shows such as A Bit of Fry and Laurie and Black Adder were largely fuelled by protracted periods of elevated mood - in the form of mild mania, or "hypomania".

On the other hand, straightforward depression (unipolar depression) has no elated, productive, hypomanic side and, as a consequence, very few people have written about the positive aspects of the condition. The focus has been on the acute symptoms of what can be an incapacitating illness, while forgetting that depression has meaning, and that there is a life after recovery.

The assumption that depression is a disease has been reinforced and perpetuated by biologists, psychiatrists and pharmaceutical companies, all of whom have a vested interest - consciously or unconsciously - in the clinical perspective. This might be an appropriate model for the more severe "melancholic" forms of depression that psychiatrists tend to see, but not for the majority of cases of depression. Most depression is dealt with in the GP surgery or resolves itself without a single medical consultation. Most of the time, depression is hidden from view because of the stigma attached to it.

Although technological advances in antidepressant treatments have undoubtedly been responsible for the alleviation of much suffering, strict adherence to the medical (disease) model is preventing a more complete understanding of why we as a species are so susceptible to depression, with at least 20% of men and 25% of women experiencing the condition in their lifetimes. The disease model may also be engendering a sense of powerlessness in those with depression or ex-sufferers. What so commonly goes along with this perspective is the implication that the condition is due to some unusual constitutional weakness. The only solution, therefore, is chemical.

It is a complete nonsense to talk of depression being unusual when it is plainly common. The search for a "depression gene" has foundered because the genetic underpinnings are spread across the population, like the genes determining height. Most of us probably have a moderate susceptibility to the condition under certain stressful circumstances. Nevertheless, we see GPs overprescribing antidepressants, and the World Health Organisation talks of increasing access to "treatment" to deal with the global epidemic in depression-related disability - predicted to be second only to heart disease as the most important cause of disability by 2010. All of this ignores the "ultimate" cause of depression.

My recent review of theories and personal observations suggests that depression might serve some useful functions. It also highlights how ideas that have been around since the 1960s have been largely ignored by the mainstream media. The "war of depression" - between the view that depression is enlightening and the view that it is hindering - has raged for a long time.

The truth is that short-term pain can lead to longer-term gain. A recently published follow-up study of depression in Holland - the Netherlands Mental Health Survey and Incidence Study (Nemesis) - used a sample of 165 people with a major depressive episode, and provides some preliminary scientific evidence to suggest that depression is indeed helpful in the longer term. Researchers who were looking for evidence to suggest that depression leaves people chronically disabled were surprised to discover the opposite.

Life's trials

The population they followed from before illness to the period after recovery showed that people seemed to cope better with life's trials after depression than they were doing before its onset. In the group as a whole, averaged ratings of vitality, psychological health, social and leisure activities, occupational performance and general health all significantly improved upon recovery from depression, compared to functioning prior to the depression. A minority of individuals got worse after a depressive episode, mostly in the realms of general health, vitality, and physical functioning. However, much to the researchers' surprise, severity of depression and availability of treatment were not significant predictors of this decline. It was more to do with additional problems such as social isolation, having a physical illness, or drug or alcohol addiction.

Depression can lead to great insights and achievements. The precocious philosopher John Stuart Mill wrote his famous work, Utilitarianism, in 1861 at the age of 19 and became depressed at the age of 21. Upon recovery, he confessed that the experience had taught him an important lesson - that he should not sacrifice his social and emotional development to intellectual ambition. More than 2,000 years ago, Socrates warned of the same danger: melancholia was thought to be a consequence of rigorous philosophising. However, Aristotle believed it to be a state of immense moral and spiritual value because of the insights it could bring.

Evolutionary theories of depression explore why the condition has apparently persisted so commonly and universally since ancient times. Culturally sensitive surveys of traditional communities of the world suggest that the "core elements" of depression are indeed universal. Certain communities in Africa regard depression as a natural consequence of an inter-dependent way of life, and those with depression are given time out from normal responsibilities until they recover.

Furthermore, we see the behavioural manifestation of depression occurring in other mammals that have the same capacity for maternal bonding, intimate relationships, and play, and that have similar brain biology.

To explain why depression has not been "bred out" through Darwinian natural selection, theories have suggested that rather than being a defect, depression could be a defence against the chronic stress that misguided people can put themselves under. It is possible that depression defends us against the tendency to deny our true needs by chasing unobtainable goals and helps to bring these needs into sharper focus. More specifically, the proposed benefits are as follows: removal from a stressful situation, introspection, problem solving, the development of a new perspective, and reintegrating this with the community upon recovery.

This sequence is repeated in the legends, myths, tribal beliefs, and religions of the world that tell the story of solitary exploration in adversity leading to personal growth.

Depression may bring about a "rebirth" because it removes self-delusion. There is some evidence from scientific studies to show that depressed people are rather more realistic in their thinking than "healthy" individuals - the phenomenon of "depressive realism". It prompted the scientific journalist Kyla Dunn to write: "One cognitive symptom of depression might be the loss of optimistic, self-enhancing biases that normally protect healthy people against assaults to their self-esteem. In many instances, depressives may simply be judging themselves and the world much more accurately than non-depressed people, and finding it not a pretty place."

With recovery, and with the lifting of mood, a new kind of truth could emerge that lies somewhere between the overly optimistic and the overly negative. The new truth would be devoid of blind optimism: a more humble assessment of the depressed person's own capability, containing a more balanced picture of his or her perceived strengths and limitations.

Other functions have been proposed by evolutionary psychologists. Ed Hagan has suggested that getting depressed is like going on strike for better pay and conditions - it is a way of making the wider social network more aware of your needs. Paul Watson has suggested that the sobering quality of depression makes us more aware of any changes that might need to occur in that social network.

Coping strategies

Depression may have forced our ancestors to look again at their strengths and their limitations, their coping strategies, their direction, their priorities, their supports. Regardless of the reason for falling into depression, the journey has the potential to make us better equipped, in a general sense, for life. If we are too busy to think and feel, to be mindful, depression might represent the first opportunity to take an honest inventory of ourselves. If the modern world prevents us from learning from depression, perhaps it is the fault of the modern world and not this ubiquitous


beautiful things grow out of shit...

The new Daniel Lanois cd has inspired me -
and her is the letter to a friend...

i just wanted to apologize for the horrible and gloomy email I sent to you the other week. Sometimes I forget that not everybody wants to hear me gripe and complain about how hard life is - I can be such a downer, and I'm so sorry for having dumped that on you. I know you have so much of your own shit going on and I didn't mean to add to it all...

I'm leveling off somewhat. My mom is getting back into the swing of things, but I have to keep on reminding her that she had two huge operations done at the same time - had a part of her lung and all of her lymph nodes in her armpit removed, had a huge stomach flu - was not on any pain meds for the first day after the operation (which still makes me angry and horrified) and spent two weeks in a shithole that was equal to a third world country hospital. She has her good days when she zips around the city, visiting my grandmother and shopping, but then she gets tired. NO KIDDING LADY! I tell her - the body needs time to heal, and I'm realizing, so does the mind. Never thought of the mind as a muscle - we take for granted that we are always using it - keeping it running 24/7 - even in our sleep, but it too needs rest - and after any traumatic experience, it too needs a period of recuperation and regeneration - and we both are needing to find that space where we can take part in these things...

I picked up the new Daniel Lanois cd - (he worked with U2 and Brian Eno). His music is kinda folky and ambient. He did all the production work on U2's Unforgettable Fire CD so if you know it - that's his style... Well, I'm a huge fan and when i got the cd, and listened to it, I thought of u - it's so complex, on so many levels, and as an artist, he strives to find soul and meaning in his work and life. There was one conversation he has with Brian Eno on the cd...

LANOIS: I’m trying to make a film…about beauty itself… about the source of the art rather than everything that surrounds the art…

ENO: …What would really be interesting for people to see [in your film] is how beautiful things grow out of shit, because nobody ever believes that… Everybody thinks that Beethoven had his string quartets completely in his head, that it somehow appeared formed in his head… and all he had to do was write them down… But what would really be a lesson that everyone could learn is that things come out of nothing… the tiniest seed in the right situation turns into the most beautiful forest. And then the most promising seed in the wrong situation turns into nothing… and I think this would be important for people to understand because it gives people confidence in their own lives to know this is how things work… If you walk around with the idea that there are some people so gifted and have these wonderful things in their head, but you’re not one of them – you’re just a normal person who could never do anything like that - then you live a different kind of life. You could have another kind of life where you say, “Well I know that things come from nothing very much, start from unpromising beginnings, and I’m an unpromising beginning, and I could start something…”

I’m an unpromising beginning, and I could start something…

That almost left me in tears - something in it rung true - to me, for us - what we are looking for in life, what we are looking for in our art, even within ourselves. The idea that we are all coming from nothing, every day - a new day - a clean slate, our bodies - constantly regenerating new cells, that as artists, our souls can start something new as well...

Thursday, April 24, 2008

waiting for the bus alone


waiting for the bus alone
Originally uploaded by ruudpakua
ruudpaka - I like to sunshine too.

Thank you for this brilliant image...

Thursday, April 10, 2008

The best way to find yourself

"The best way to find yourself is to lose yourself in the service of others."

~ Gandhi

Mom is coming home today. And after the arduous journey we've had, it will be a real warm homecoming.

I have learned many things on this journey - the most important being that when we serve others selflessly, we can really begin to find peace within ourselves.

It has been a long and at times really rough and brutal road, but knowing that I was there to hold her hand when she was at her weakest, being able to stand up for her when she could, not made me realize just how much she has done for me, and what a blessing it was for me to give it back to her.

so we are on the mend, upward and onward, hoping for the best, and thankful for every day we have together and the memories we now share.

Tuesday, April 08, 2008

pooh pooh

I got a call from mom this morning - there are 10 cases and growing of a nasty nasty gastro/stomach flu on the floor! On the 7th floor, they've imposed a complete quarantine - every patient has it along with 2 nurses.

When it rains, it pours!

But she sounds a little better - was able to eat a toast and a few sips of coffee and keep it down since 9am this morning.

What a wild ride it's been - from nasty nurses, food from from a david lynch movie to this outbreak of gastroenteritis.

whatever doesn't kill you, only makes you stronger - right?

yea - right...

but all we can do is laugh - and hope for the best, and look forward to a better tomorrow.

Monday, April 07, 2008

irony

how ironic is it that today, the day my mother was supposed to be discharged from the hospital, she comes down with (what we hope is nothing serious and is only) a stomach flu?!

And she was in such good spirits over the past few days - looking better and on the mend...

and double irony - the doctor told her the other day:
"the longer you stay here, the greater your chances of catching something."

that was a belated april fools joke - as all of this seems to have been and is quickly becoming...

oh yea - she was admitted on the 1st of April...

Saturday, April 05, 2008

happy happy day!

Ah - my birthday was brilliant!
It really was a day to remember.

Quick update:

went to see my mom - at 3:30pm exactly (the time I was born 40 years ago) with a cafe au lait and a bouquet of flowers to celebrate my birthday and her successful birthing. She really got a kick out of that. We even decided to re-create the birthing scene - I sat and winced at the foot of the bed while she made a schrunched up face - the same one she made as she pushed me out after 36 hours of labor. Even her best friend Betty was there - as she was 40 years ago, timing my mom's contractions. We all had a really good laugh - and what is better medicine than laughter?

E took me out for an amazing filet mignon dinner. Oh, how I was longing for a good steak after a week of processed box dinners and bland kosher lunch sandwiches! I had a nice big glass of wine and apple crumble for desert. Hmm. Mouth just watering thinking about it!

I bet E that I would be the first to fall asleep when we got home, and was looking forward to doing so, until I got the pants scared off of me by a rousing "surprise!" from my friends!
The dude tried to round up as many of my friends as he could to throw me a surprise party. This was the first one ever - and it was so very very special.

We had a wonderful time - sharing memories (some of them, more than 20 years old. Now that's a way to make a group of people feel over the hill!) and got some words of wisdom from my 40 something gang of pals: "Life really does being at 40. You've gone through so many milestones in your life, have amassed wisdom and experience. Would you really want to do it all over again? You're mature and finally comfortable in your skin. These are the good days.


And indeed they are... :-)

Thursday, April 03, 2008

hell in a hosptial doctors handbag and U2

Oh
my
God


Those three words express so much when I think of all the horrors my mother has experienced since the postponement of her operation - not to mention day one from when she was operated on Wednesday morning.

But the good thing is that she is on the mend and fingers crossed, will continue to do so despite the horrible circumstances that seem to surround her with ever breath she takes. And also that we are taking it all in stride - with a smile.

I mean, when things couldn't get any worse (like when the epidural she was supposed to have for her pain was actually running down her back and not into her spine because it was inserted improperly !!!??!!) the recovery room nurse breaks the machine that was taking the fluid out my mom's lungs, tosses it on her bed, and ships her off to her new room without any indication that it needed repairs (it was only my mother who noticed that it was not working...), to cleaning machines whirling down the hall at 4am, and doctors yelling to eachother at 5am across her bed - all we could do was laugh to keep from crying.

This experience has taught me that there are two types of people in the world - those who are completely ambivalent about people's suffering, and those who genuinely care. We have seen both sides of the coin, but if it weren't for the handful doctors and nurses who went the extra mile, this really would have been a nightmare come true. Instead we are left with Larson-esque tales from the FarSidesque hospital from hell which will rekindle amusing memories to tell our friends and family for years to come.

***

Mom apologized today for not being able to get me a birthday present. She had given me an early one a few weeks ago - a spice rack (a really fancy one - like a lazy susan) and said:
"I really feel bad for not getting you anything, but just spin your spice rack and think of me."


And how ironic is it that I will be spending time with her in the hospital this afternoon when 40 years ago to the day (and at 3:30pm - to the hour) , she was in a hospital bringing me into the world.

I told her we would celebrate by wearing bed pans as party hats and blow up latex gloves for balloons. At this point, we don't care if they all think we're nuts - they drove us there in a limousine!


***

despite me being terrified about turning the big number, I tried to calm myself and silence those nagging pessimistic mantras with memories of happier times - back in cegep with good friends, and being a dj at the campus radio station. What a blast from the past it was when a special song came on my ipod: "in the name of love" by U2.

A few days after the single came out in 1984, I had my show at the station and decided to play it for the first time. People went wild and came in by the dozens to ask what they were hearing.

I was born April 4th - the exact same day martin luther king got shot.

Early morning, April 4
Shot rings out in the Memphis sky
Free at last, they took your life
They could not take your pride

It seems like yesterday, but that afternoon remains etched in my memory - and what a sweet memory it is.

That spring afternoon, the sun was shining, life was full of possibilities, I was young but embraced turning one year older. Some recollections of really happy times in my life.

This afternoon, after the visit with my mom, it was also a sunny day. The snow was melting, and on the horizon - new beginnings.

Now I'm a year older looking forward to making this the happiest time of my life.

happy birthday to me :-)

passion rekindled...

how fitting that I was talking with a friend of mine tonight about rekindling my passion about photography and cinematography...



Aries Horoscope for week of April 3, 2008

In the film Fight Club, the character played by Brad Pitt storms into a convenience store with a gun, then herds the clerk out back and threatens to execute him. While the poor man quivers in terror, Pitt asks him questions about himself, extracting the confession that he had once wanted to be a veterinarian but had dropped out of school. After a few minutes, Pitt frees the clerk without harming him, but says that unless he takes steps to return to veterinary school in the next six weeks, he will hunt him down and kill him. In my opinion, that's an overly extreme way to motivate someone to do what's good for him. I wish I could come up with a less shocking approach to coax you into resuming the quest for your deferred dreams, Aries. Can you think of anything?