Sunday, December 18, 2011

Bad Feelings Come From Your Brain, Not Your Life

Well, it's been a while since I've last posted--three months, to be exact.  But today I have something to talk about.

Recently I read an article that was published in the December 1975 Saturday Evening Post that addressed depression and brain chemistry.  Scientists were still learning things about brain chemistry back then (as they are today) and had not yet developed the drug Prozac, but what the author says is interesting, in that she says that severe depression can be relieved quickly with the use of drugs. She also says that long term therapy might need to include psychotherapy.  The central point she makes is that depression is a common malady and has been for centuries, and that we should think of it as a medical condition rather than a shameful mental illness.

I would concur with everything Marion L. Steinman says with respect to depression; all of it is still true today, as well.  But I would also say that with the advent of all these popular drug therapies it's become almost trendy (among a certain set) to be taking anti-depressants.  In fact, many non-psychiatric physicians have taken to prescribing psychotropic drugs as if depression were strictly a medical condition that is effectively cured with medication.

Many people believe that to be the case, including those who suffer from depression or anxiety.  But I've always believed that there's more to it than that.  The drugs don't work for everybody, and they don't work perfectly either, even for those who've taken them for years.  Plus, there are still the residual effects of the condition that cause emotional and behavioral problems not fixed with drugs.

Recently, drug marketers have been trying to get people who already take an anti-depressant to take an additional drug to deal with the depression that is not completely cured by the first medicine.  This additional drug is more powerful and is actually a different kind of drug--an anti-psychotic rather than an anti-depressant--with many more serious side effects. 

I feel this strategy is at best misguided; people might be better helped (with less risk) by learning to do other things to mitigate the ill effects of their brain chemistry instead of immediately medicating it.  At worst, the pharmaceutical companies' strategy is purely financial: drug companies are trying to find more people to buy the drugs they manufacture--drugs that are currently being prescribed to only a small group of people--whether they really need them or not.

Implicit in the ads is the message that only perfect relief from depression is acceptable.  Unless you're happy all the time, your current drug is not doing its job.  This message is not helpful.  Depression and other brain-chemistry caused psychological maladies are not the same as pneumonia or some other disease that can be cured with medication.  Even if a person's antidepressant is effective, the condition is chronic and must always be accounted for and monitored in his or her daily life.

One of the comparisons Marion makes in her article is that depression is like the common cold.  While that's a comforting analogy for people who tend to think of mental illness as wierd, it's not quite accurate since the common cold comes from an outside source, while depression comes from within. A better analogy would be one that compares depression to a chronic genetic disease like Parkinson's or muscular dystrophy.  Medication can alleviate symptoms but does not make the condition disappear.  (For a while doctors thought Prozac could change one's brain chemistry permanently.  I think they have probably since found that they were wrong.)

If a person has a debilitating chronic condition, he or she must work around it as much as possible. Medications can only do so much.  The person who lives with the condition must find ways to accomodate its presence in his or her life.  Depression is like that; medications can help, but people must still do things to deal with it as best they can.  I've come up with ways to deal with mine without medication, but even people taking medication need to find ways to cope.

My method is simple: awareness and pre-emptive strategies.  If those don't work, then strategies to cut the duration of the attack are the next option.  Being aware involves 1) acknowledging that the feelings are generated by the brain and not by the outside world; and 2) realizing I can do something to make them go away or at least diminish them.

What I do depends on where I am and what I'm doing at the time I feel the onset of brain chemistry imbalance.  If I'm at work, there are certain things I can't do that I can do at home, and vice versa.  Most of my coping strategies involve some form of scanning--either visual or auditory or even olfactory or tactile--that focuses the mind on paying close attention, noticing details.  But exercise, reading and writing also help because they involve focusing the mind on a particular goal.  It's important to remember that the action doesn't have to have anything to do with what is happening at the time the brain chemisty takes a turn.  That's because it's usually true that the brain chemistry's fluctuations themselves don't have anything to do with what's going on at the time.  They may be random or on a cycle, but the changes occur because of something in the brain, not something in the world around us. 

It is vital to remember this one point because it makes the bad feelings into a physical problem, not a mental or emotional or relationship problem.  And so when you feel the bad feelings coming on, you don't have to fight with your spouse or quit your job or make a drastic change in your life.  And you don't necessarily need to hide in your house or disrupt your daily life either.  You can even do the exercises in your head while going about your normal routine--driving to work, sitting on the toilet, taking a lunch break, cooking dinner--by making that activity part of your therapeutic strategy.

For instance, while cooking dinner you can pay close attention to the smells or the colors or the textures of the food you are preparing.  While driving to work, instead of talking on the phone, you can pay attention to the cars around you, to the sounds of the smells or sights within your view.  You'll probably be safer that way, too, as well as less stressed out.  Often people who are depressed or angry think about what has gone wrong or will go wrong in their lives.  If you pay close attention to something neutral, it stops you from those thoughts. But the act of noticing (scanning/focusing) itself works to alleviate the symptoms.  I have my theories about why that's true, but the fact is it works!

I guess that's enough for now.  More next time.  See you then.

Saturday, September 17, 2011

Fight or Flight? How About Neither?

I don't write in this blog every day because a daily report of my feelings would, I think, be repetitive and boring.  Every day is pretty much the same: I wake up feeling afraid or depressed and then I have to do something to make that feeling go away.

What I do varies with how bad the feeling is.  Usually, just getting up and moving around, doing my morning routine, helps dispel the gloom.  Exercise, when I have time for it, also helps, sometimes a lot.  If the feeling is really bad, then I know that the reading I do on the bus to work--especially if it's a very interesting book--will probably help. And when I get to work, my job will help even more because it's a job that involves a great deal of scanning (a very useful activity for gloom-dispelling).

But there's more to it than just pushing back the gloom.  Throughout the day, I also have to remain vigilant to its influence on my interactions with other people.  I can make bad brain chemistry go away, but only temporarily.  It's always lurking behind the scenes, waiting to jump in at the most inopportune times.

For example, I can be having a particularly bad morning brain-wise, but if I have time to work on neutralizing the bad feeling, especially when I first get to work, I can succeed in being pleasant.  If I don't have time to do my therapy, then I might not fare as well.  Something a coworker says might trigger the fight-or-flight response and I'll snap at that person, saying something regrettable that hurts her feelings.  That's not very good for coworker relations.

What could be worse, though, is that now I've shown a side of me that I wanted to keep hidden, the side that is irrational and somehow shameful because it's out of my control.  And once that BBC beast is out of the closet, there's no putting it back.  The damage is permanent: no matter how my future actions might modify people's view of me, I will henceforth be seen as someone with a "temper."

Okay, it's true, it's a minor character flaw compared to some. I could be something worse--a chronic liar or a thief or a drug addict.  But the fact that my fits of temper happen suddenly and without my consent bothers me.  I don't like these irrational feelings to take control of my mind.  So I try to stay alert to the pre-cursor feelings and stay away from potential clashes with people during those times.  It doesn't always work, and sometimes it's exhausting, but it's all I've got for the moment.

I'd call it "anger management," a commonly used term these days, but I don't think it describes the actual phenomenon.  What I am managing (and I think many other people are too) could not be anger because most of the time there's no good reason to be angry--at least not as angry as the situation would seem to warrant.

Conflict is inevitable between people who live or work together, and we don't get what we want all the time.  That frustrated desire produces anger, it's true.  But the response to being thwarted should match the type of obstacle, it seems to me.  Being temporarily blocked on a small matter should not produce a full-out rage.  If it does, it's a sign, I believe, that the emotion being expressed is not anger at all, but fear.  And not just ordinary fear, but the kind of fear that evokes a fight-or-flight response--that is, fear for one's life.

Why would someone be in fear for her life just because someone got ahead of her in line at the copy machine?  There's no good reason, obviously. Something else is going on.  I think it's brain chemistry.

Here's how I believe it works: the brain is humming along with its normal balance of chemicals and then suddenly the level of tranquility chemicals takes a nose-dive for reasons known only to DNA. As a consequence, the person with this bad brain chemistry suddenly feels very frightened. Being a rational creature, he looks around for a cause and, coincidentally, at that moment he is told the meeting he scheduled for 1:30 is going to have to be postponed to 4:30 because the big boss went overtime on his meeting and screwed up the schedule. But now because of the boss, the employee's schedule is screwed up; he was going to go home early today to watch his son play soccer. So he "goes off" on the messenger, loudly telling him and anyone within earshot that the boss is an incompetent jerk who can't even control a meeting let alone a department.

Is this fellow inconvenienced by the schedule change? Definitely. Frustrated? Probably. Is his life in danger? Of course not. But he feels like his life is in danger because that is what his brain is telling him. And in that circumstance, his response is completely rational and not disproportionate at all: between fight or flight, he chooses fight. Unfortunately, when he makes that choice, he puts himself in real danger if the inappropriate rage he expresses over this minor incident causes him to lose his job.

Someone might say that such a person has anger management issues, and if he were to go for treatment, he'd be taught techniques for dealing with his anger. That's all well and good, but it seems to me that the treatment is telling him that his anger is not the problem, only the expression of that anger. It's okay to feel anger; it's not okay to express that anger by punching someone in the nose.

But I say that what he is unsuccessfully managing is not anger at all, but bad brain chemistry.  And if he doesn't know that, all the anger managment techniques in the world won't work, because he doesn't realize that the cause of his behavior is not his unruly anger, but brain-chemistry-induced fear.  And not realizing the true cause means that he will continue to feel irrational fear, mistake the cause as outside himself and life-threatening, and respond in what to him is a rational way to meet that threat.

This is not to say that knowing the truth will set you free.  Just because I know the cause of irrational "fight" (as opposed to flight) does not mean that it's easy to manage.  But at least I can look for the warning signs and try to head off an imminent attack before it happens.  I don't always succeed, but I've gotten the number of incidents down to two or three times a year, when it used to be two or three times a month.

It's a work in progress.  I've got "flight" (depression, anxiety) pretty well handled; "fight" is going to take a while longer to contain.

See you next time.

Wednesday, August 3, 2011

Pollyanna's Secret

There have been many times in my life when someone with bad brain chemistry (BBC) argued that to pretend to feel happy when you're not happy is phoney.  "Don't be a Pollyanna," that person would say, then follow up with a declaration of contempt for those people who are always cheerful or perky.

I must admit that from time to time I was one of those Pollyanna-hating people.  And the only reason I felt that way is because I couldn't believe that anyone could be that happy--even Pollyanna had to be putting it on. And to fake feelings you don't have is contemptible.

But as I eventually learned, there are people who are that happy.  They have good brain chemistry and a happy disposition.  And maybe in addition to being blessed with those good traits, they've learned to look on the bright side of life, so that even when they have an occasional sad moment, they talk themselves out of it.  And what's wrong with that, anyway?  ("Always look on the bright side of life" is, as you may know, a line from a sarcastic song by Monty Python, people with bad brain chemistry, no doubt.)

I think that bad brain chemistry people don't really hate the Pollyannas of the world--they envy them.  They want to be happy too, so they try to figure out how they can get there.  What they come up with, however, is based on false data, the data they invent in their efforts to determine why they are currently unhappy.

For example, a BBC person feels bad, but doesn't realize he's feeling bad because of bad brain chemistry, so he goes off in search of a reason in his environment.  He scrutinizes his life, his work, his family, his friends, his health, the government, the air--you get the picture.  With all that scrutiny, he's bound to find something that bothers him.  Let's say he picks his work.  There he finds a rigid, obnoxious boss with whom he's had numerous clashes.  But there's more to dislike at work.  There are also his coworkers, who are uncreative apple-polishers; and there's the work itself--boring and beneath his talents.  He might go on, finding other faults with his job to add to the already tall stack of grievances.  No wonder he's so unhappy!  Who could be happy in such a place?  So he starts looking for a better job, one where he's appreciated for his intelligence and where he's surrounded by interesting, creative people. And if he's really in the throes of BBC-inspired zeal, he may quit right away, all the better to spend time looking for that perfect job.

But of course there is no perfect job.  Even if he finds a job that is closer to ideal than the one he has now, he'll soon find something wrong with that one too, and the cycle will begin again. And again.  Such is the nature of the quest for happiness that doesn't take into account the main cause of unhappiness: bad brain chemistry.

Tuesday, July 26, 2011

For Lack of a Brain Transplant

Sometimes I wish I didn't have this problem so I could actually fully enjoy life.  Do the drugs designed for this malady really help?  Do they really take it away?  The one time I tried SSRIs they made me feel good for a while, but was an artificial good, a drug-induced high, a feeling I knew wouldn't last.  And before long, they did nothing for me. When I tried to up the dosage, they made my heart flutter, an unfortunate side effect. Some people are helped, apparently, and are satisfied with SSRIs.  But helped is not the same as cured.  No drugs offer what the brain-chemistry-challenged really want: a brain transplant.

But is it a good idea to whine about a malfunctioning brain?  No.  People may feel sympathy, but since there's nothing they can do about your trouble, eventually they'll turn away. If you're always carrying your gloom cloud, few people will be able to stand being around you for long because that gloom is infectious.  And some people are aggressive with their gloom--sort of a not-so-nice combo platter of fear and anger.  They're miserable, but also angry that people around them are not miserable too, so they do their best to dispel any sunshine.  Sort of like the dementors.

As much as I hate the relentless marketing of antidepressants, I have to say that at least the ads are making the issue one people can talk about. And lately I've noticed the actual depiction of a gloom cloud in one of the ads. (But I must say the people carrying the clouds don't look miserable enough.)  It's too bad what they're advocating is that people who suffer from bad brain chemistry should take more and more drugs: If one isn't doing the trick, try two or three!

Anyway, I guess the answer is to just keep doing what I'm doing, since at least it allows me a measure of happiness.

Sunday, July 10, 2011

My Annoying Little Doom Cloud

Over the last few days, my brain chemistry's been especially bad.  There's a terrible feeling of despair hovering over me, like a curtain of doom, waiting to fall.  Of course, as usual, there's no reason for me to feel this way.  Oh, yes, there are the common reasons people my age feel bad--I'm getting older, people I care about are dying, my body is starting to fail--but those reasons exist every day. 

Yet I don't feel bad every day. Only sometimes do I focus on the sorrowful facts of life and ignore the joyful ones.  And at those times the real reason I feel bad is that my brain is depriving me of tranquility chemicals.  The lack of those chemicals causes my mind to go looking for the source of my bad feelings.  When I find it--the fact that I'm no longer young, for instance--I feel better because I now have a reason to feel bad.  I might try to fix it by eliminating what I deem to be the source of my despair, if it's possible.  If not, then I'll suffer not-too-silently, complaining to friends or family. Or I might try to block it out.

But no matter what I do in response--whether I fix it or complain about it or ignore it--chances are the bad feelings will be gone in a few days anyway when my brain chemistry changes for the better.

Being aware of that reality makes all the difference to me.  I feel terrible, but instead of looking to the world around me for a reason, I look within and realize it's just my brain chemistry doing a number on me--and that it will pass. 

Sometimes it helps to picture that dark cloud as something separate from me, like an annoying little brother following me around, pushing my buttons, cramping my style.  He wins if I let him get to me, so I try not to.  I sometimes have the urge to explain "him" to people: "Don't mind my little gloom cloud; he's always like this--a pain in the butt."

It also helps to do some scanning activities to make the feeling go away for short periods of time.  This technique is especially useful at work, where showing unwarranted emotions can be hazardous. (Can you think of a time when a coworker suddenly burst into tears for no discernible reason? Pretty strange, no?)  Fortunately, my work involves a lot of scanning, so throwing myself into such tasks automatically makes the day better.

Writing this blog is helpful in a number of ways.  I can put off the bad feelings, sort out my feelings about my dilemma, and share my insights with those who care to listen in, who might be helped with their own bad brain chemistry.

See you next time.

Saturday, June 25, 2011

Wishing It Was & Making It Happen

This morning I was dancing in my living room (something I do for exercise and brain chemistry therapy), listening to Santana's Supernatural. One of the songs, "Wishing it Was," perfectly describes the dilemma of bad brain chemistry.  Here are some of the lyrics:  "Beauty and grace is what touches me most / Good times can put me in fear / I always feel safe when things are bad / So I cannot let you come near / It seems that I thrive on the dark side of things / I always feel alive when death bell rings / Now you come and bring out the tears in me."

As I explained in my theory of bad brain chemistry, the hyper-alert or super-observant person feels anxious because she is aware of the dangers or potential dangers around her.  Once she figures out where that danger is coming from and deals with it--by fighting or running away from it--she feels better. But for those of us who live in a relatively safe environment, real dangers are few and far between.  Yet despite the absence of danger, the hyperalert (HA) person still feels anxious.  He wants to fix the anxiety, but in order to do so, he must find the source of that anxiety and deal with it.  That's pretty hard to do, of course, when it doesn't exist.  So he comes up with a source of danger, something not too difficult to do if he has any kind of imagination.  Once he identifies the "danger," then he can respond to it and feel better.

I think the seemingly paradoxical statement from the speaker in the song--"I always feel safe when things are bad"--illustrates my point quite well.  If things are going well for him, he gets anxious, because he knows danger is lurking somewhere: "Good times put me in fear."  But once he responds to the danger, he feels better: "I always feel alive when the death bell rings." 

But the line that is the most poignant, and perhaps most indicative of the bad brain chemistry dilemma is this one: "So I cannot let you come near."  He can't allow himself to be happy with someone he loves because that makes him unhappy.

Here's the chorus of the song: "Pain never makes me cry, but happiness does / It's so strange to watch your life walk by / Wishing it was / Wishing it was more like a fantasy / Where every day surprises me / Wishing it was."

He'd like to have a "fantasy" life where he enjoys the "surprises" of life, but he can't.  To me, surprise has a good connotation: something you don't expect happens to you, and you're pleased.  If something unexpected happens to an anxious person, he's afraid.  That's not going to work in a love relationship because part of getting to know someone is exploring the differences, delighting in the strangeness of the other.  For the hyperalert person, the stranger is a threat that must be escaped from or destroyed.

The last part of the song shows his regret over the way he is: "This feeling won't last cause I cannot survive / I tell you I've been here before / When it's moving this fast / It's a matter of time / One of us walks out the door." He chooses to escape the danger of a relationship before it goes too far.

In the wild, animals only explore the strange other when they feel safe.  Bad brain chemistry interferes with the natural inclination to explore, to socialize, to pair-bond because it won't allow the person to feel safe when she is safe.

And that's what I struggle to do every day--make the bad brain chemistry go away so I can enjoy the good things in life.

Tuesday, June 14, 2011

The Hidden Face of Bad Brain Chemistry

At 4:30 this morning I woke up, as I usually do, but was unable to fall back to sleep.  I remembered that my mother is once again threatening to leave the nursing home and move back in with my sister, despite the fact that she is well cared for in a very nice home. Even she admits it's a nice home, which is a big admission for her.  Then I remembered all the other times over the years that she and my father and my sister have made terrible decisions.  Of course, when that would happen I'd be angry and frustrated because I care about them and the pain they go through when things go wrong. I always hope they will listen to me or learn from their mistakes, but it seems as if they seldom do.  They refuse to plan ahead or anticipate the consequences of their decisions until it's too late and the die has been cast.

Ah well, it's not as if I've never made a bad decision.  I do know, though, that many bad decisions are the result of bad brain chemistry.  For instance, when I'm in the throes of depression or fear or rage, I just want out of it, and will do anything to make a change to my mood.  In the past, I would change my mood by changing my life--quit my job, move to a new state, etc.  I've since learned that all I needed to do was make the bad brain chemistry go away.  And making it go away is simple--I just do some scanning activity, such as playing Solitaire.  Exercise helps too.  Or writing, as I'm doing now.

I can't control other people, and I guess I don't really want to.  I just want them to know what I know--that brain chemistry is controlling them, but they can do something about it.  They can help themselves before they do something they'll regret.  They can get a handle on bad brain chemistry.

Of course, knowing what to do and doing it are two different things.  Rage is a manifestation of bad brain chemistry that's particularly difficult to control, I've found.  When I'm in a rage, I lash out before I can remember that it's just bad brain chemistry, that it's a response to fear, and that how I'm about to respond--yell at my boss or pass on a curve, for instance--is probably way over the top and may be quite risky.

How to keep from letting bad brain chemistry rule?  Recognize it for what it is.  Don't be fooled by the disguise.  What looks like righteous indignation may really be craven fear.  What seems like a rational decision based on facts is underneath an irrational decision based on bad brain chemistry and trumped up evidence.  Be suspicious of speed.  Most decisions don't have to be made immediately, so what's the hurry?

Again, not so easy when the mood is upon me.  But I keep working on it.  And I'll keep posting my progress here.

Monday, May 30, 2011

My Daily Dread

Early this morning, as usual, I awoke with a feeling of dread. I've read that the body is at its lowest ebb around 3 a.m., and I know that must be true because that is the time that I seem to feel the worst.  If I can go back to sleep, I'm okay, but if I don't go to sleep right away, I start thinking.  Usually I'm thinking of all the things that either have gone wrong or could go wrong, things I did or didn't do that I regret, things I fear or resent.  Once I start thinking that way, it's hard to stop.  Often I end up staying awake, getting up in three or four hours to go to work, sleep deprived.

It's been many years since I slept through the night without waking, without going through the hour of dread.  It's been only about 10 years that I've recognized the dread for what it is--bad brain chemistry--and tried to deal with it rationally, using a number of mental tricks I've developed to stop the obsessive thinking so I can go back to sleep.

Sometimes I think about a story I want to write, or one I've read.  Or I think about a mundane task I need to perform and visualize myself going through it.  And if I'm really having a hard time putting thoughts aside, I play word games in my head.  One that works well is to imagine a word that's fairly long and has a variety of vowels and consonants in it, such as perpendicular, and try to come up with as many words as possible that can be made from those letters, such as per, perp, pen, pic, pend, ped, pile, etc.  That exercise focuses my mind on something neutral, forcing it to set aside the obsessive thoughts and allow me to go back to sleep.

This morning, I thought about starting this blog, how I would begin to tell the story of a problem that has plagued me nearly all my life.  That technique worked pretty well; I was able to drift off and get a couple more hours of sleep.  It wasn't the first time I've used that particular focusing trick; I've planned this blog many times before, but never followed through.  This time, for whatever reason, I've been able to move past planning and actually begin.

So here I am, chronicling what for me is a daily struggle to keep what I used to call the gloomy-doomies at bay.  Writing is one of the things I do that helps.  But I have to be careful not to make writing an occasion for anxiety. If it's to work as a therapeutic endeavor, it has to be virtually risk-free. Perhaps that's why blogging works--I have very little to lose with this form of writing, especially since almost no one knows I'm here.  It is what it is: my thoughts on the topic at hand at the particular moment I write them.  I do try to be coherent and express myself as well as I can, but the important point is to get it down on "paper," to create a message that communicates what I know and feel about . . . whatever.

Here is something I know about dealing with bad brain chemistry: it's not at all easy, but it is, I think, simple.  And it is possible.  The main truth, the one I start with, is that chemical imbalance is a physical problem but one that can be solved by using the mind.  And that is what I'm chronicling here: my defective brain chemistry, its effects, and my efforts to control as much as possible its impact on my life.