What causes schizophrenia? We really don’t know.
A new hypothesis suggests that schizophrenia is a developmental disorder, which involves epigenetics—that switching business. Our brain with its 100 billion neurons begins developing in utero but is not fully formed until age 25 or so. Brain development involves neurons migrating from their place of origin to their destination (neuron pruning is also involved). The trip is set in motion by a gene switching on. If there were a glitch in this switching mechanism, it would not become apparent until adolescence, when brain development goes into high gear, and also when schizophrenia commonly flares up. This new insight is promising, but it doesn’t quite capture Susanne’s case, since she was in her early 30s when the disaster arrived.
Thanks for the link, John.
Depression is not … a lot of things. But:
Depression is not all the work you haven’t done yet — it’s the fatigue that makes everything you start so difficult, everything you finish feel so inferior, and every effort in between feel so pointless.
Let me tell you this: nothing will scare the masses of undiagnosed and/or untreated mentally ill Americans away from the psychiatric care that they so dearly need quite like a database that will be intended to deny them access to firearms but that will undoubtedly be used for other purposes.
[Note: I did download their image and post it here, but I only did so in case the image URL changes or goes offline. The image is linked to the original entry and is their copyright; I will remove the image on my end upon request.]
So I had this realization Sunday morning at church, in a discussion of spiritual gifts: just because mine is leading1 doesn’t mean that I have to use it in all phases of my life. I was specifically thinking about work. As I contemplate a new job2, I’ve been seeking both project management and non-management jobs. I would prefer a non-management job at this point in my career3. That is a big shift for me, as I’ve really been defining my self-worth through my job performance, which is unhealthy in a number of ways:
- If there were a way to quantify my job performance independent of my coworkers and situation, that would be one thing, but this isn’t baseball, where sabermetricians have worked to provide context-independent measurements of player performance. There is always the Yearly Review, which always left me with the same thought: “I would’ve graded myself more harshly than my boss did.”
- In any regard, deriving self-worth from performance is a fruitless endeavor. Self-worth is best derived from one’s value system and the degree to which one holds to those values4.
- The things I do at my job do have value5, but how I show and receive love for my fellow man is far more important to me. I can do a lot of things in life, but it’s far better that I care for other folks in life.
In parsing through all of that, I had the thought: what if I re-oriented my thinking here? I did the management thing because I am a leader, and because I wanted to lead. However, wouldn’t a better expression of that leadership gift be done in a church body where it could be better used, rather than in a work situation where it’s mostly for profit? I think so. Let’s be clear: I’m not going to turn down a management position that comes my way; after all, I do need a job. But given a choice, I might choose a different route to leave breathing space in my life for leading in a more meaningful6 position.
So two weeks ago, I found myself in a very dark place, at that point where my psychic pain exceeded my ability to cope with it. I could write lots and lots and lots about how I got there, what’s going on in my head, what’s happened since then, and all that. I’ve written a lot of it already, and I don’t know whether or not I’ll ever publish it. All I know is that I’m very thankful that the small part of me that still wanted to live won out over the large part of me that didn’t want to live. I sought treatment, got it, and was overwhelmed by the love of family and friends.
Since 2009, I’ve been a member of the Huntsville Master Chorale. In the rational part of my brain that kept working on Monday the 20th, I thought to send our director, Dr. Erin Colwitz, an email to let me know that I’d be missing practice. [This same rational part of the brain is what also made me go home, get my medication, check my mail, and deposit my paycheck before I went to the hospital.] The next night, Dr. Colwitz apparently gathered some recording equipment, and they put this together with no notice.
I am overwhelmed.
With apologies to Mark Pilgrim’s original list:
- Thinking about the food from the moment you wake up—not because you are hungry, but because you need food to cope with the day.
- Eating at home before you go out to eat with friends. You can still get that full feeling but not stuff your face in front of others.
- You, at home on a Friday night, with a large pizza, breadsticks, and 2-liter of soda that are gone before you can watch a re-run of Law & Order.
- Stopping on your way home from a friend’s house for Chicken McNuggets at 11pm. You’re not hungry, really. You just want to binge.
- Spending $17 on a single meal when you’ve got $56 in the bank and it’s two days until payday.
- Not one but two Chinese restaurants knowing you by your order: one because you always get the steamed dumplings, the other because you always order the fried wontons.
- Eating said fried wontons in the time it takes you to drive home from the latter restaurant.
- Even when traffic is light, you still get it done.
- Going to the kitchen for a 10pm snack, just because it seems like the thing to do.
- Then going again at 11pm before you head to bed, because the first snack “wasn’t enough”.
- Floorboards full of empty fast food bags.
- Several folks at Hardee’s knowing you by your breakfast order.
- Going to a different Hardee’s on the weekend just because you don’t want to go to the same one seven days a week.
- Wondering why you just ate that, because you weren’t even hungry.
- Shrugging your shoulders and going back to the kitchen after wondering.
- Thanksgiving not being that big of a meal for you, because you eat more when you binge than you do in front of your family.
- Taking advantage of the family napping during the post-Thanksgiving food coma to go back for thirds.
- And fourths.
- Talking about your food addiction with friends, then bingeing after you get home.
- Thinking about getting a roommate just because there’d be someone around for you to be ashamed of all the eating you’re doing.
- Thinking that a roommate would mean more eating-out money.
- Going to a therapist for over a year, dealing with all your mental and emotional issues, and still being confronted with the fact that you’re an addict—even though she told you that on your second visit.
- Denying that you have a problem.
- Having friends tell you that they don’t see why you’re so fat, because “He doesn’t eat that much around me.”
- Polishing off a can of cashews in an afternoon, when you’d intended to have them around as a snack for a couple of weeks for energy in mid-afternoon when you’re fading a bit.
- Being afraid to go grocery shopping at all, because you don’t want to have food in the house. You’d just eat it if it were there.
- Not wanting to practice and refine your culinary skills, because you’d just get fatter.
- Whatever you can tell yourself to justify the next binge or forgive the previous one.
- Writing this list and wanting to binge just reading it.
There’s a gulf between liking to eat—overeating from time to time—and a true food addiction. It’s the difference between having a hangover on Saturday morning after a little too much fun on Friday night to having that hangover every day of the week—but nobody notices, because you’re a functioning alcoholic. What I’m slowly learning in recovery is that it’s not really a matter of willpower. I’ve got a lot of willpower: and my self-will is to eat until the cows come home. I have to redirect that self-will with a better will that keeps me from bingeing. I’ve chosen to do that through a dozen steps and reliance on a higher power. You may find other methods that work for you, and more power to you if they work. But man, everything I’ve tried to-date just leaves me worse off.
I dropped about 25 pounds over the course of a couple months late last year. Nowhere near enough, of course, but a good start. I have gained all that back and then some since, even at a time when the worst of my depression issues were behind me. In fact, I’d argue that my eating habits got worse because I was feeling better about myself—things were good, so why did I need to diligently check my weight and see where things were every day? Screw it, I’d dropped the 25lbs and it wasn’t even that hard. I was done eating to soothe the bi-polar, right? Just keep up with the diet and the exercise …
As long as I look at it as a process of recovery, of small steps along a larger path, of forgiving myself and others and making amends to myself and others, of recognizing that I could fall back in that hole at any time if I stop working at it, I’ll be okay. I didn’t get fat overnight, and I won’t get to a healthy weight overnight, either.
One day at a time.
I started this as a response to something Paul wrote; decided to trail off the comment I’d left with something here:
Sure, we’re governed by our history [I’m with Joe; love that line]. But I’d also argue that these feelings of stuck are there for us to re-evaluate things. They’re the cognitive reminder that either the course needs correcting, or the old plan wasn’t followed, or that the old plan was shit and now what do you do?
I view life as a rope, fixed on one end: our birth, into the situation we were born into, with the talents and flaws we were doled out. On the other end, we’re weaving in all these strands of things, making the rope we have. You can’t really cut the rope that fixes you to your past—it’ll always be there in your mind, even if you “re-invent yourself” and become a whole new person. You’ll still know that it’s there.
But just because that fixed endpoint is there, and the momentum of the rope that’s laid out has an arc to it … that doesn’t constrain you to putting new strands in, taking old strands out, and trying to change the arc of the rope.
I’ve been coming to grips with a lot of things in the last year or so. I have hit four realizations …
- This mental illness that I have is something I’ll have for the rest of my life. I’ll need mood stabilizers as long as I live. It’s admittedly painful to realize that you can’t lead a normal life without pharmacological intervention, but … I can’t go on living like I was. I just can’t. I was an undamped oscillating function—okay, a diving board springing ever faster and higher. The hypomania and the depression came in longer spells than they used to; the depressive spells were deepening. I literally couldn’t have handled it for much longer. I’m convinced that I’d have been dead by 35 without seeking help, so I did. Damn straight I take that green tablet every night.
- My value as a person comes from my beliefs, my ethos, my core. My value does not come from the work I do, the degree I hold, my SAT score, how much I do for other people, or anything like that. I believed that lie for more than a decade, and it ended up with me ever more desperately seeking ever greater success to keep proving to the world that I Am Somebody. A project manager at 27? A NASA award-winner at 29? All I heard in my head is that I was peaking too soon.
- I can handle my emotions. I’m an emotionally intense person. I shouldn’t fight that. I should let these things come and go in the waves that they do. Fighting that is just a terrible way to live.
- I’m an addict.
More on that last one soon. I just came to that realization on Tuesday, and I’m still coming to grips with it.