DC Drunks

Interesting.

According to a new study by the Substance Abuse and Mental Health Services Administration (SAMHSA), 8.1 percent of adults age 26 or older in D.C. are alcohol dependent.

Of course, DC is a stressful town. It's where people who are high strung and type A move to. I wonder what the AA rates are in this town? How many people are in AA? Judging by the amount of clubs and meetings, a lot.

TEAM up for health

"A new form of CBT, known as TEAMS (Think Effectively About Mood Swings), is being developed .... It aims to improve on previous therapies by focusing on current problems, like depression, anxiety and irritability, and helping patients to set goals for their life as a whole.

The aim of this new approach is to encourage patients to accept and manage a range of normal emotions -- like joy, anger and fear -- and a controlled trial is about to start following a successful case series of the TEAMS approach."

Sounds dumb (Teams. Whatever.) but good at the same time. A new approach: think about your moods as something that happens, not something that controls you. Think about what joy or sadness is, and let it pass. Sounds pretty much what I try to do. I try to identify them and not let them control me.

CBT (Cognitive behavioral therapy) really worked for me when I did it. It just teaches you to think differently; almost to not take everything so seriously. It's a nice prescription for how to go about life. You know, one day at a time, not taking everything so seriously. Sounds like AA, doesn't it?

They taunt me

I have to admit: I smoked some cigarettes lately. It's been since November 21 that I quit, but on Saturday I had about 3, and Tuesday I had 4. Unfortunately, someone left their half empty pack with me, and I've been staring at them for an hour now. See, earlier today when I went to a meeting I stood outside and smoked with some folks. And now, I want another one.

Nicotine is a lot like cocaine. "A single 15-minute exposure to nicotine caused a long-term increase in the excitability of neurons involved in reward." You get it in your system and that's it. You want more. So I've been watching for my dad to go to sleep, or at least go in his room, and here it is almost 2am and the man is still reading his book. I can't escape, or even go out on the porch. He's blocking the way. Damn it.

I promised Jennifer I would not buy another pack once this one is gone. And I won't. No matter how much I miss smoking, I don't want to go back to it while I'm living at home. Ahh, you catch that? That was me giving myself permission to smoke again one day. Bad. I've got to watch that. "Smoking is bad," says Jennifer, who can't seem to quit either.

Do your drugs really work?

"Americans are less than 5% of the world's population, yet they consume 66% of the world's psychological medications."

That's a lot of us drugged up on Prozac and Xanax and the like. But do these meds even work? According to this article, they work 25% of the time. As much as a placebo does. Yet we're paying millions of dollars a year for them, and risking complications like permanent involuntary movements and heart disease. Psychiatry has changed from one of care and do no harm to drug and don't care about it. Who knows what we're really taking in with these medications!

I'm not saying stop taking them. I'm going to keep taking mine. They're the only thing between me and a horrible depression, and I'm much happier risking losing a few years to heart disease than dying now because of depression.

A suicide index

Researchers have come up with a suicide index for rating how likely someone is to commit suicide. Apparently, being young, female, unemployed, and living alone are great indicators. Ahem. Anyway:

"In places such as the United States, for every death from suicide there are between three and four hospitalisations resulting from failed suicide attempts, and between 15 and 20 emergency room visits for the same reason."

That's a lot of suicide attempts. And a pretty high failure rate. Which is a good thing, but why do humans try to kill themselves? What makes us so self-destructive? Do other animals do it? Is it because we think philosophical thoughts? Other animals get depressed, why don't they try to kill themselves? I bet they do and we just don't know it.

Keep an eye on those girls

Watch your daughters friend choices.

"The findings show that girls tend to initiate the transition to a mixed-gender friendship network earlier than boys, and continue this transition at a faster pace during adolescence. As a result girls who experienced this transition early and fast were more likely to develop substance abuse problems during late adolescence."

I always tried to make guy friends, and I had a lot of guy friends in my neighborhood. I definitely pursued boys in order to be friends with them, and, of course, a lot of those friendships turned sexual. And I got a lot of my drugs from these older guys. But I always knew I was going to be a trouble maker. Since I was little I knew I'd be tattooed and drug-using. I always thought I'd either be dead or married with kids by now. Turns out I'm neither, and not using anymore, either. Who woulda thunk.

Flying in the sky

An interesting take on what it means to make a decision while manic. "Manic individuals have a sense of urgency -- that they need to make a decision right now so that they don't miss the opportunity that sits in front of them."

His description of mania thinking is pretty right on. You've gotta do it, and of course it's a good idea! Other people don't understand all the ways you've rationalized it to yourself. Of course it's going to work out. You're on top of the world.

Self flagellation serves it's purpose

Do cutters suffer from more guilt over little things? I wonder if they could test that theory. What they did test was does pain relieve guilty feelings. And apparently the answer is yes.


"According to the scientists, although we think of pain as purely physical in nature, in fact we imbue the unpleasant sensation with meaning. Humans have been socialized over ages to think of pain in terms of justice. We equate it with punishment, and as the experimental results suggest, the experience has the psychological effect of rebalancing the scales of justice -- and therefore resolving guilt."

Kind of like self-flagellation that was so popular in the middle ages and beyond, where people whipped themselves or things like that to atone for their sins. Perhaps we cutters are just trying to deal with guilty feelings? I wonder if there are more cutters in Judeo-Christian religions? I mean, hell, they're based on a strong sense of guilt. It would be interesting to know.

EDNOS

I just found a really great blog called Two Whole Cakes. She's funny and irreverant, and I like her style. Anyway, she also had some good things to say about the recent study that came out about eating disorders:

So what we have here is a comprehensive study instructing us that anorexia is as common in boys as girls, that children are developing eating disorders at 12, and that eating disorders are extremely dangerous to kids’ health both medically and emotionally. Also, that while anorexia rates have remained stable, the instances of binge eating disorder and bulimia have doubled since the 1990s. In a complete coincidence, the fearful cultural rhetoric regarding an alleged obesity epidemic has also doubled—at least—since the 1990s. But this is totally unconnected.

It doesn't surprise me at all that the incidences of eating disorders are rising in the U.S. Just look at some of our role models. Kids are looking to celebrities, who are all about 80 pounds at 5 foot 1, which is just ridiculous and never an achievable look if you are built bigger than a pixie.

One of the other things the study says is that people with eating disorders otherwise not specified (EDNOS) are rising. That means people like me who obsess about what they put into their body and then binge. I definitely have a bad relationship with food, but I'm fat and so don't qualify for anorexia and I don't puke, so I'm not bulimic.

So how do we turn this around? Well, better, healthier role models would be good. People who love their bodies just the way they are. Less reliance on medical science to create "perfect" Barbie-like women. I don't know. There's got to be a way out of it.

SAMHSA says....

"Recent data from SAMHSA indicate that 45.1 million adults (19.9 percent) in the United States had mental illness in the past year. Of those, nearly 20 percent of adults (8.9 million) also had a substance use disorder."

That's a lot of us who are sick. And amazing that there's still such a stigma when it's so ingrained. Imagine, almost 20%. That's (I have no idea, but let's call it) one in 5 people you know has a mental health problem, whether it's post-partum depression or schizophrenia. Look around you. That's a lot of people you know who are either hiding it or disabled by it. And of those people, another one in five has a substance abuse disorder.

Amazing that we still discriminate and have so much stigma against those two illnesses when so many people are affected by them. Imagine, it's not just you who is affected by your depression. It affects your family, friends, co-workers. You can't help but make a difference in other people's lives whether you're trying to or not. So all those people are affected by mental illness and yet we're still ashamed and afraid. Amazing.

Campaign for mental health

"She compared to the level of understanding regarding mental health issues as about the same as it was for cancer patients in the 1970s.

'Back then, you didn't talk about cancer, you didn't even say the word,' she said. 'People were afraid to talk about it with cancer patients because they were afraid they might upset them.'

Later, however, it was well understood that cancer patients needed an emotional support system that would be there for them throughout the course of the illness.

'And we need the same,' she said."

That's the second article in as many days I've seen compare mental health to cancer in the 70s. It seems that before they had breast cancer awareness ribbons and month and walks, people didn't want to talk about cancer. It was a big secret. So maybe, just maybe, mental illness can build on that model. We already have Out of the Darkness walks about suicide prevention. Do we have a ribbon color like all the cancers and other illnesses? Can we do a wear ___ color for mental illness? Or remember when you could wear jeans to work on Friday and they would donate money to, I think, heart disease? Is this what mental health needs? A campaign?

Moderately abled

Here's something I found interesting: "Bipolar disorder is responsible for the loss of more disability-adjusted life-years than all forms of cancer or major neurologic conditions such as epilepsy and Alzheimer's disease, primarily because of its early onset and chronicity across the life span."

I know my mom hasn't worked in 14 years, and probably never will again, even though she's otherwise perfectly capable of working. Unfortunately, she gets really manic or paranoid and runs herself out of a job within 6 months. There seems to be a theme online, too, that the Twitterers and bloggers are all writers for a living. Is it because we bipolars don't play well with others? Are we hard to work with? Who knows, but we do have higher disability rates than others, apparently.

Facebook won't save you

Now in Britain you can report your Facebook friends who you think might need a little help. "The initiative was unveiled just weeks after it emerged that a British charity worker left a suicide note on Facebook but none of her 1,082 friends on the site responded. Some even mocked her note."

Now, the mocking part stings. It wasn't necessary in the article, but it does deliver a little slap. None of her over 1,000 friends took it seriously, and some even thought she was making a joke. It just goes to show that you have to take these things seriously.

I remember in high school a friend of mine told me how he was going to kill himself the next week. He had it all planned out, and man was it elaborate. I couldn't help myself - I went straight to the principal. I remember sitting in the office when they brought my friend in, and he glared at me. I was so scared that he would hate me, but I knew it had been the right thing to do. A few days later when he was back at school he thanked me for saving his life. I had helped someone listen to him. We're still friends (we even have matching tattoos) and I'd do it again in a heartbeat.

I hope that one of my 364 friends would speak up for me if they saw something wrong on Facebook or Twitter. You hate to think technology makes you more alone, but it kind of does. People seem to distance themselves from real life and become friends in name only. I try to see those people as much as possible. Most of those people are family or family of close friends. It's good to keep everyone connected.

We're all crazy here

"The U.S. attracts people who believe they can achieve a better life," Schlager says. "They come to believe they can pick up and start again. It's a self-selected sample of people who are grandiose and impulsive. It takes a certain suspension of belief to actually believe you can come here and make it happen. Those are a significant percentage of people on the bipolar spectrum."

The U.S. has the highest bipolar rate out of 11 countries studied. Of course, countries with more stigma had lower rates, probably because of a reluctance to talk about it, but the researchers used the same criteria all across the board in one-on-one discussions with people.

So why is the U.S. so crazy? I like the theory above. The theory that it takes someone a little hypomanic to think they're going to succeed halfway across the world with no money and not knowing the language. Hell, I think I can make it in Austria all the time. Luckily, I won't move without a job. Homeless I will not be, no thanks. My mom does it sometimes, and I'm not interested.

Anyway, it's pretty neat to think of a country of individuals and adventurers as a bunch of bipolars, too. Apparently, we're all crazy here.

What your doctor doesn't know

"Then, his goal was to help his patients become happy and fulfilled; now, it is just to keep them functional."

A great article by the New York Times on how psychiatry has become a pill farm instead of the talk therapy it once was. I totally identify, as I'm sure you do. I see my doc maybe once every 6 months, more if I'm in crisis, and I see him for 10 - 15 minutes. I tell him I feel _____ and he flips out the prescription pad.

If I could see him an hour a week, or even once a month for 30 minutes, the man might know what's going on with me and be better able to craft my med cocktail. But instead, he has to rely on what blanks I can fill in. And I'm an informed consumer who doesn't lie to my docs. What about other people who don't know what are symptoms? Who don't know what to look for? How does the doctor know what to prescribe?

It all scares me, honestly. No wonder so many people are on meds. Psychiatry is quick on it's way to becoming sham medicine.

A man walks into a docs office....

"'Our data suggest that a person who walks into a physician's office feeling sad will tend to recall experiencing more symptoms than they probably really did,' Suls said. 'If a person comes into the physician's office feeling fearful, they're more likely to scan their body and read any sensations they're experiencing at that moment as something wrong.'"

Apparently, you're neurotic, too. People with depression and anxiety often experience their symptoms in a physical sense. People with depression recall having had more symptoms than they probably did, and people with anxiety think they have it all right now. Interesting, huh? So when you go to the doctor with that constant "migraine" it might just be your depressive memory saying, "damn, I've had this headache for millions of years and it was so bad I couldn't think." I know I tell myself I have all sorts of diseases and syndromes (I'm totally a hypochondriac), but I tend not to report the bodily symptoms to the doc. I like to tough them out. I'm not saying it's smart, it's just what I do.

Anyway, it's always good to keep track of those things. Write it all down. How were you feeling today? Is it depression? Anxiety? Side effects? You never can tell, but it's good to have a record.

A gene discovered

Why does the news media not care? This is huge! They found a gene that may have something to do with bipolar disorder:

"Our results provide strong evidence that genetic variation in the gene NCAN is a common risk factor for bipolar disorder," concludes Dr. Cichon. "Further work is needed now to learn more about the biological processes that NCAN is involved in and how NCAN variants disturb neuronal processes in patients with bipolar disorder."

There's your genetic testing and all sorts of moral questions right there. Should we test for it? What does it mean? Does it effect treatments? Can they do specifically tailored treatments for the gene? If you present with symptoms and yet don't have the gene can you be diagnosed bipolar? If not, what are you?

So many questions, and they'll never be satisfactory answers, methinks.

Go ahead, take that nap

"...participants who slept for at least 45 minutes during the day had lower average blood pressure after psychological stress than those who did not sleep."

Finally, proof to what I've known all along: naps are good for you! We should institute nap time at work. Siestas. Just a little 30 minutes around 2pm where we could all take some time to snooze. I think it would increase worker productivity by yards. I know I would be more productive after a nap. And now we have proof that we'd all be healthier, too!

Do it anyway

Scientists have developed a new mouse model to test how SSRIs work. "Many antidepressants have been shown to target other proteins besides the serotonin transporter and … their efficacy in treating depression takes many weeks to develop." So basically, they still know nothing.

Doctors don't really know how or why the drugs work, they just seem to do something. They're still not really sure about lithium, and it's been used for hysteria for centuries.

The brain is a funny thing? So why do we mess with it? Why pour in fabricated chemical models that we don't know what they do? Why take meds? Because they do work (most of the time), and anything is better than the horrible depression. If you know what I mean, you know why you take meds. Nothing is worse than that black hole, that impermeable fortress of death. Yuck. Yay science!

Are you a Coke addict?

"His Diet Pepsi cravings stem from a prior addiction to nicotine, not caffeine. 'It's all tied to smoking,' says Bagi, who smoked a pack a day for 20 years and started drinking diet soda to mask the aftertaste of cigarettes. He eventually kicked the smoking habit -- but the Diet Pepsi one stuck."

Ok, honestly, read the whole article. It's interesting all the ways diet soda may be addicting. Caffeine, conditioning, the sugar rush that's just out of reach. All these things could lead to addiction.

I'm going to admit something here: I don't have an addiction. I haven't had a diet Coke today, and I wasn't planning on having one. If I run out I often don't notice for days. But I do like them. I enjoy drinking them, and will order one over water any day. I think the problem with me is I don't like water. It's boring. So I'll drink coffee or diet Coke, or even orange juice, over water.

I only started really drinking soda when I quit drinking booze. It was just a substitute. Something to hold in my hands. And I kept it up because it's convenient and has no calories. I would honestly rather have fruit juice but it has too many calories.