Wednesday, February 25, 2009

Storied Mind: Why Depressed Men Leave - 2

Written by john on February 21st, 2009

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Some Rights Reserved by nyki_m at Flickr

Some of the comments on the last post in this series hit hard on two issues. First is the question of personal choice: is a man supposed to escape responsibility for destructive behavior by attributing everything to depression? The answer is no! Depression is never an excuse for inflicting pain and loss, breaking up families, violent rages or destructive behavior of any kind. The other compelling question that is asked over and over again, often in desperation, is: What can I do?

I’ll try here to deal with both of these issues here rather than put them off to the end of the series, as I had originally planned.

1. Responsibility

Whatever might roil me internally in the midst of this condition doesn’t change or lessen my responsibility for the harm my behavior is causing. My wife hasn’t kept silent but has confronted me whenever she needed to about what I was doing to our relationship and everything I was putting at risk. Hearing that from her was not enough by itself to shatter the power of denial, but it was essential to be confronted with the facts of her feelings. That truth needs to get through the layers of depressive self-absorption and isolation in order for recovery to begin, but it is knowledge that has to be put to use by me. I had to decide to take responsibility for my own recovery.

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Storied Mind: Why Depressed Men Leave - 1


Written by john on February 9th, 2009

Why Depressed Men Leave - 1

Written by john on February 9th, 2009

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Some Rights Reserved by lepiaf.geo at Flickr

About a year ago, I wrote a series of posts about my experience with the fantasies of a better life that often prompt depressed men to leave their families. You can find the first of those stories here, here and here. Those brief pieces tell only a small part of a long and troubling story. To stay in recovery I have to know more, and so I’m starting a new series of posts specifically about why men want to leave, how we change, where we want to go.

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Hara Estroff Marano: Buddhism and the Blues


Buddhist psychology's core techniques of meditation and awareness may have much to offer ordinary Westerners.


By: Hara Estroff Marano


To most people Buddhism is an ancient Eastern religion, although a very special one. It has no god, it has no central creed or dogma and its primary goal is the expansion of consciousness, or awareness.

But to the Dalai Lama, it's a highly refined tradition, perfected over the course of 2,500 years, of analyzing and investigating the inner world of the mind in order to transform mental states and promote happiness. "Whether you are a believer or not in the faith," the Dalai Lama told a conference of Buddhists and scientists at the Massachusetts Institute of Technology, you can use its time-honored techniques to voluntarily control your emotional state.

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Anger in the Age of Entitlement: Uncertainty Is Your Friend, Part III: Emotions Are All of the Above

By Steven Stosny in Anger in the Age of Entitlement

All available evidence suggests that the brain has enormous flexibility to do a lot of different things at one time. Mental focus is hard because it forces the brain to concentrate its resources, something it is naturally inclined to do only with the prospect of reward or in the face of threat.

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Anger in the Age of Entitlement: Uncertainty is Your Friend, Part II: Testing the Illusion of Certainty about Emotions

By Steven Stosny in Anger in the Age of Entitlement


emotions uncertainty.jpg
There's a famous story about the philosopher Ludwig Wittgenstein watching a sunset with a student and marveling about how anyone could have believed that the sun revolved around the earth.

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Anger in the Age of Entitlement: Uncertainty is Your Friend, Part I

By Steven Stosny in Anger in the Age of Entitlement

Anger uncertainty.jpgA number of years ago the dean of a leading medical school opened the commencement ceremonies with a message to the newly graduated physicians, "Fifty percent of what we taught you is wrong.

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In Practice: Fuhgeddaboudit


By Peter D. Kramer in In Practice


spiderIf we had a drug that could erase bad memories, should we use it? That was the question the press extracted from an arguably limited set of observations reported in an on-line article in Nature Neuroscience.

You've probably heard about the experiment. A trio of Dutch researchers showed normal subjects photos of spiders, accompanying one image with an electric shock. The next day, the scientiest re-presented the images, with or without pre-administering the subjects an anti-adrenalin drug, propranolol. Down the road, those who had taken propranolol were less likely to startle when exposed to a loud noise in the presence of an offending picture. The conclusion was that the drug interfered with the consolidation of the emotional memory, stripping it of its fear element.

This finding is a slim reed on which to rest a philosophical inquiry, but in truth the medical ethics field has been debating the broader question for the better part of a decade, based on earlier, similar suggestive research involving propranolol. In 2003, the President's Council on Bioethics weighed in, arguing that the modification of emotional memory was a worrisome alteration of personhood, one that risked trivializing signal forms of pain that compose a complex self. In 2007, the American Journal of Bioethics devoted most of an issue to discussions of an essay that argued in favor of choice in the matter of muting disabling fear.

Yesterday, for better or for worse, I represented the bioethics community when AirTalk with Larry Mantle, a public radio show, took up this issue, under the heading "The Spotless Mind." The broadcast does a fair job of presenting the issues — those who are interested should give a listen.

I want here only to clarify a single point - one that was at the heart of Listening to Prozac. When we wrestle with an ethics question in neuroscience, often it is important to ask what worries us: Is it that we disapprove of the goal of an intervention, or that we dislike the intervention itself.

Do we really, for the most part, worry about the attenuation of fearful memories? Let's say that a patient comes to a doctor and says, "I had a terrible experience yesterday, and I'm worried that it will haunt me. Can you help prevent the fear from lingering?" That's the set up.

Now imagine that the doctor prescribes "tincture of time," that is, she reassures the patient: "Don't worry. I know you. That memory will fade." No one, I would guess, has moral worries about that scenario. Yes, there will be a change in the self, but so what? The content in our library of memories shifts all the time. If the self is continuous, that's not because our emotions are always identical.

What if the doctor says, "You're adept at meditation. Tomorrow, when you recall the event, enter into a relaxed state. Later, the memory will upset you less." Do we object to that prescription? If not, then in truth we do not fret about the result, a muted emotional response to a real stimulus.

How about a more mechanical behavioral prescription? Let's say we believe in the efficacy of "Eye Movement Desensitization and Reprocessing," or EMDR, in its simplest form. The doctor trains the patient to recall the trauma while moving his eyes this back and forth. The memory loses its force. Are we alarmed? Well, perhaps this approach does seem a bit eerie.

Now think of an ingested substance, chocolate or green tea. The doctor has the patient call up the memory while enjoying a soothing snack. Do we object to that sort of interference with reconsolidation?

My point is a simple one. We only initiate an ethics debate when the intervention is a medication - here, one with a complex name, propanolol. (In truth, the consolidation of anxiety may be a fairly easy target; it looks as if steroids, opiates, benzodiazepines, and anesthetics might do the job, along with beta-blockers.) That category, medication, seems to bring into play technology, doctors, patient status, and drug companies, and therefore hierarchy, social coercion, and communal norms. Now we worry, if we do, about altering the self in ways that the culture favors.

There's much more to say on this topic, but for the moment, I think I'll stop with this question: Why is it that we debate the ethics of muting anxious memories now, in the years since it's seemed propranolol can do the trick, when we never argued over that capacity before? Like everyone else, I understand the dystopian science fiction scenario of "eternal sunshine," but to undertake a serious philosophical discussion we need to do better of specifying what's at issue. Why precisely do we worry over a drug's doing a job we are happy to see accomplished by any number of other means?


Urban Mindfulness: Mindfulness and the Financial Crisis


By Jonathan Kaplan, Ph.D. in Urban Mindfulness

Here in the city (and all over the country), anxiety about the financial crisis is palpable and omnipresent. Thousands of people, especially within the financial services industry, have been losing their jobs. Real estate construction and development have slowed or ceased, while home sales plummet. Retail businesses and restaurants have been doing poorly too as many of us cope with a decrease in income by reducing our spending.

How can mindfulness help?

Mindfulness can help by reducing our suffering in a very painful situation. The financial crisis has a negative effect on our home finances, savings, and fulfillment of some life dreams (at least temporarily). This is our current reality--and it hurts. Unfortunately, we often make this bad situation worse as we become mired in regret, fantasy, and worry. "If only I sold my stocks 1 year ago..." or "I'm never gonna get another job" are common reactions to the crisis. However, emotionally such thoughts make us feel worse. So here are a few mindfulness pointers:



*  Notice where your mind goes. Are you stuck in regret or blaming others? Are you catastrophizing about the future? Bring your attention back to rest on your breathing.



*  Find ways to reconnect with positive aspects in your life, like your health, family, or faith. Often, we dismiss expressing such appreciations by adding "Yes, but..." The "but" takes away any joy or satisfaction from things that are going well. Real life is good and bad, not good but bad.



*  Re-evaluate and do constructive planning and problem-solving. Mindfulness can help us see what is really happening and deal with it appropriately. Not being able to pay the bills might be a reality for you. So, minus the worry, anxiety, and recrimination, what are your options? How can you increase the money coming in and reduce the money going out? Perhaps you need to find another job, borrow money from friends or family, or sell some of your stuff. None of these actions are easy, but they might be necessary. Getting caught-up in worry, guilt, shame, and other destructive emotions can only delay taking productive action and make you feel even more miserable.



*  Finally, notice your mindset now vs. 1 year ago. Chances are, you saw your life as being deficient at that time, too. You wanted more money, an iPhone, or whatever. You told yourself, "If only I had [X], I would be happy." Now, we are confronted with reality of having less than we did previously; our mindset matches actually matches our circumstances. In fact, we might even find ourselves longing for how good we had it before, at least financially. At the time though, we weren't satisfied with it. This irony suggests that we need to recognize the problem in dwelling on thoughts that we're deficient or need something that we do not have. Not until we recognize and accept our current circumstances can we be free to change it.


The Human Experience: Emotional Hunger Vs. Love


By Robert Firestone, Ph.D.  in The Human Experience


Emotional hunger is not love. It is a strong emotional need caused by deprivation in childhood. It is a primitive condition of pain and longing which people often act out in a desperate attempt to fill a void or emptiness. This emptiness is related to the pain of aloneness and separateness and can never realistically be fully satisfied in an adult relationship. Yet people refuse to bear their pain and to face the futility of gratifying these primitive needs and dependency. They deny the fact of their own ultimate death and do everything in their power to create an illusion that they are connected to other persons. This fantasy of belonging to another person allays the anxiety about death and gives people a sense of immortality. Hunger is a powerful emotion, which is both exploitive and destructive to others when it is acted out. People identify this feeling with love and mistakenly associate these longings with genuine affection. Nothing could be further from the truth.


Feelings of emotional hunger are deep and are like a dull but powerful aching in your insides. You may often find yourself reaching out and touching others or expressing affection and loving movements in order to attempt to kill off this aching sensation. People often give physical affection and attention when they feel the most need for it themselves. This type of physical affection is draining of the emotional resources of loved ones, particularly one's children, rather than enhancing their development psychologically. It is wise to be suspicious of your own use of the word "love" or "I love you." If you search yourself truthfully you may discover that you say these words most often, not when you feel the most for others, but rather when you experience strong dependency needs and feel the need for reassurance.


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Friday, February 13, 2009

Telegraph.co.uk: Florence Nightingale 'might never have succeeded with modern stigma against mental illness'


She became world-famous as the saviour of countless lives and the inventor of modern nursing, but a new report suggests that Florence Nightingale might never have been able to transform hospitals if she had to combat today's stigma against mental illness.



By Kate Devlin, Medical Correspondent
Last Updated: 3:48PM GMT 10 Feb 2009


Florence Nightingale 'might never have succeeded with modern stigma against mental illness' The document, co-written by Alastair Campbell, the former Government spin doctor, also questions whether a modern politician could reach the top of their profession suffering from Winston Churchill's "black dog" of depression.

And it queries whether the ideas of other leading figures, including Charles Darwin, Marie Curie and Abraham Lincoln, would be ignored in today's society, which the report found was heavily prejudiced against people with mental health problems.

More than one in four people, 29 per cent, do not think that someone with a mental illness can hold down a responsible job, the study found, while 60 per cent of employers said that they would feel unable to employ someone suffering from mental health problems.

The report warns that achievements including the theory of evolution, the creation of modern nursing, developments in cancer treatment and the abolition of slavery may never have happened under modern ideas about mental health.

As well as Churchill, Curie and Lincoln both suffered from depression, while Darwin had extreme bouts of anxiety and agoraphobia and experts believe that Florence Nightingale suffered from bipolar disorder, also known as manic depression.

The report speculates that without Churchill, Britain could have made a compromise peace agreement in 1940, allowing a Nazi-dominated Europe and the loss of freedom and democracy.

It also warns that the "next Churchill" could be missed because of the modern demands on politicians.

Mr Campbell said: "I am not convinced that a modern politician who admitted to mental health problems would be able to get to the top.

"Churchill was by common consent Britain's greatest ever leader, and voted the greatest ever Briton, but I wonder whether his depression would have stopped him becoming Prime Minister in modern Britain.

"As I watch politicians and other public figures deal with the pressures of modern leadership, not least dealing with harsh 24 hour scrutiny, I sometimes wonder how these great historic figures would have fared had they been alive today.

"Churchill with his depressions, drinking and long lie-ins; Darwin with his severe anxiety that showed up in stomach disorders, crippling headaches, agoraphobia, trembling, palpitations of the heart, and mental torment which often left him in floods of tears.

"Would the media and public have been understanding about their conditions? – these statistics suggest otherwise."

The report, released today and co-written by historian Nigel Jones, is part of a campaign called Time to Change, organised by the mental health charities Mental Health Media, Mind and Rethink.

According to the report almost nine out of ten people with mental health problems have experienced stigma and discrimination, often by employers.

One in four Britons suffer from it at some point in their life, and Mr Campbell said that his own experience had shown how important the role of work could be to aid a patient's recovery.

He said: "When Tony Blair asked me to work for him in 1994, I told him about my breakdown and my drink problem. He said he wasn't worried. If a Prime Minister can have that attitude, then I think it is about time the six out of ten who say they wouldn't consider taking on someone with a history of mental illness join the four out of ten who say they would."




Sustainablog: Is Climate Change Making Us Mental?

Written by Robin Shreeves
If you were to click on my bio here for Sustainablog, you’d see that I started down this green path because my son who was six at the time had read about global warming and gave us the “what for” over the SUV we owned. We joke now with him that he was the one that got this whole thing started for our family, yet at times he seems, at almost ten years old, the least interested in the environment. In a way, that may be a good thing.

The Boston Globe reported that climate change takes a mental toll, and that children and adults alike are starting to have “psychosis or anxiety disorders focused on climate change.” Children especially “are having nightmares about global-warming-related natural disasters.”

Read the rest of the article here:



San Jose Mercury News: Lawmakers debate mental health cuts


By CATHY BUSSEWITZ Associated Press Writer
Posted: 02/12/2009 04:27:26 PM PST


CARSON CITY, Nev.—Lawmakers challenged major cuts in the state's mental health services on Thursday, saying they won't agree to reductions that would jeopardize the health and safety of Nevada communities.

Gov. Jim Gibbons has proposed closing 11 of the state's 21 rural mental health clinics, and increasing the number of patients per staff member at mental health facilities in Reno and Las Vegas.

While overall human services spending, about a third of the state's general funds, for the coming two fiscal years is up, funding for mental health services would decrease 5 percent, to $473 million.

"Several of us took vows that we would never support reductions again," said Sen. Bob Coffin, D-Las Vegas, referring to budget cuts to mental health in 1991. "Now we face the greatest reduction I've ever seen."

"The mentally ill cannot complain. Their families are shy about complaining," Coffin said during a joint Senate-Assembly budget subcommittee hearing. "Who is going to fight for the mentally ill? I am not going to support these cuts. I am going to follow through with my vow of 1991."

Of the 21 rural mental health clinics, two already are closed, another nine would be closed by June 30, and services would be moved to regional hubs.

Read the full article here:


The Buffalo News: Hard times are pushing many into mental illness


By Deidre Williams
NEWS STAFF REPORTER



It’s all weighing pretty heavily on Barbara Smith, a widowed grandmother who lives in the Black Rock section of Buffalo.

She fears layoffs are coming soon at her job a local nonprofit agency. That’s on top of the hours that were cut recently at her part-time job at a local florist.

And don’t forget the weather: the very cold, very snowy past weeks, followed by a couple of days of warming, then 60 -mph winds and wet snow that knocked out power to more than 50,000 homes and businesses.

“I guess the news is bad for everybody,” Smith said, “and it just seems to get worse.”

All this contributes to what experts call the new face of mental illness.

Doom and gloom seem to have dominated the news lately.

Consider the headlines:

• A global economic crisis.

• A recession here at home.

• The near-daily tally of job cuts at large companies worldwide.

• Record snow and frigid temperatures locally, then flooding and a wind storm.

• Gasoline prices creeping up again after receding from record highs.

“There’s a lot of bad news,” said Brian D. Barnas, a University at Buffalo student. “That’s the times we’re in right now. That’s what’s going on in the world.”

As a result, many Americans are facing fear, anxiety, uncertainty and stress.

The despair and desperation that come with such feelings is the “modern face of mental illness,” said Thomas P. McNulty, president and chief executive officer of the Mental Health Association of Erie County.

Many people have heard of schizophrenia, bipolarity, and eating and personality disorders, McNulty said.

“But today the modern face of mental illness includes mortgage crises, job loss, people stressed to the limit financially. It’s an entirely different emotional situation,” McNulty said. “The modern-day things we can face can turn into a severe emotional disturbance.”

Read the full article here:


Monkey See: Valentine's Day Un-Romances

by Linda Holmes

I have a long history with romantic movies of all kinds. Goopy musicals, kicky-girl rom-coms, masterpieces of banter -- you name it, and I've probably fallen for it at one time or another. Unfortunately, the older one gets, the more some of these fall apart, and the more others don't work at all. I give you five (of many) Un-Romances. Be warned: all descriptions contain spoilers.

1. Jerry Maguire


This really pains me, because I thought this was a terribly touching story the first time I saw it. As much as "you complete me" and "you had me at hello" are now as dessicated as "Show me the money!" there was a time when they seemed like sort of nifty things for people to say to each other. Of course...I was 25.

Why it's an Un-Romance: What's frustrating is that for the first three-quarters or so, this movie demonstrates all kinds of incredibly valid points. Don't perform dramatic stunts (like quitting your job) to impress guys with good teeth. Don't have drunks over to your house. Don't introduce your kid to guys he'll fall in love with unless you're pretty sure about them. Don't date your boss. Don't try to save disasters. Don't ignore your sister when she warns you about guys who are "hanging onto the bottom rung." Don't get married as an alternative to the nightmare of driving a U-Haul.

And then in the closing moments: BOOM! It turns out that the guy who clearly was not in love with you can suddenly discover he's in love with you, and that all your bad decisions are now irrelevant. If only real life worked...anything like that.

More, after the jump...

2. Sex And The City



This may not even need saying at this point, but given that we're being threatened with a sequel, perhaps that's not the case.

Why it's an Un-Romance: Oh, where to begin. With the ditching of the faithful Smith, one of the only nice men in the history of the entire show? With the refusal to dump the endlessly dumpworthy Big? With the shoes/clothes/closets obsessions that seemingly eclipse every other interest? You can't have a romance between characters unless you have characters, and "loves shoes" is not a character.

2. The Mirror Has Two Faces



This mostly obscure 1996 Barbra Streisand film is simply the first one that came to mind to represent all movies of its kind: the It Was Only After Your Makeover That I Realized You Never Needed A Makeover love story.

Why it's an Un-Romance: Certainly, it's dangerous for anyone to fall into the post hoc ergo propter hoc fallacy, and it could be that it's a coincidence that the "falling in love" part comes after the "application of artificial nails" part. But it doesn't seem that way. It kind of seems like, in the above clip, Glam Barbra wins the happiness that Dumpy Barbra was not entitled to.

3. Sweet Home Alabama



One of the romantic comedies that made Reese Witherspoon the It-Girl of the genre for a time, it seems like a sort of funny, harmless, torn-between-two-lovers piece of business. As if its effect on Witherspoon were not enough, it also did good things for a fellow named Patrick Dempsey.

Why It's An Un-Romance: Agreeing to marry someone when you are in love with someone else and then dumping the person you've agreed to marry at the altar is not romantic, full stop. You are not a romantic hero; you are...kind of a jerk. Having never been left at the altar (whew!), I can't say I speak from experience, but in the many (many) movies in which this happens, the perpetrator always loses my sympathy instantly. See also: Affairs are not romantic, and I am talking to you, The Bridges Of Madison County.

5. Reality Bites



The ultimate early-'90s slacker romance, here is another one that does
a lot of things right in the first three-quarters. No, wait -- the
first nine-tenths.

Why it's an Un-Romance: Ethan Hawke's work in
the front part of this movie is grossly underrated: he may be
detestable, but the guy is pitch-perfectly infuriating, disguising
meanness as a complex personality and push-pulling on Winona Ryder
until she finally does actually sleep with him, at which point he
flakes out and she -- in the movie's truest scene -- stomps her foot
and screams, "I knew this was going to happen!" And she did, and it
did, and that's what makes it a sad (and plausible) story. What isn't
plausible is that he then, out of nowhere, appears at the end to
announce that he's sorry and he's in love with her and now they will go
off happily into the future with only his acoustic guitar and her
father's gas card to sustain them.


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