Science and Anti-Science on Depression
Posted on February 16, 2011 in Depression Thinking
The question gets asked at just about every convention I’ve ever attended. To be sure that I am not hallucinating, I have checked with my wife to see if she has heard the same explanation given and she has. Yet to read the blogs of some who oppose medical models for depression, you would think that there is no research to credit the position that low serotonin levels may cause depression. The picture I get of such people is of putting their fingers in their ears and shouting Neener-neener so that they do not hear the explanation. A simple search of the web using the phrase “serotonin depression” yields this description at WebMD:
One theory about how depression develops centers on the regeneration of brain cells — a process that some believe is mediated by serotonin, and ongoing throughout our lives. According to Princeton neuroscientist Barry Jacobs, PhD, depression may occur when there is a suppression of new brain cells and that stress is the most important precipitator of depression. He believes that common antidepressant medications, such as Celexa, Lexapro, Prozac, and Paxil — designed to boost serotonin levels — help kick off the production of new brain cells, which in turn allows the depression to lift.
Although it is widely believed that a serotonin deficiency plays a role in depression, there is no way to measure its levels in the living brain. Therefore, there have not been any studies proving that brain levels of this or any neurotransmitter are in short supply when depression or any mental illness develops. And while blood levels of serotonin are measurable — and have been shown to be lower in people who suffer from depression — what doctors still don’t know for certain is whether or not the dip in serotonin causes the depression, or the depression causes serotonin levels to drop.
Antidepressant medications that work on serotonin levels — medications known as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors) are believed to reduce symptoms of depression, but exactly how they work is not yet fully understood.
Yep, pretty much what I hear at conferences all the time. But you only hear the insistence that “scientists have not demonstrated a link between serontonin levels and depression” from the anti-psychiatry crowd. Up to the podium they boldly walk and claim the Nobel Prize for themselves based on the same sort of reasoning that leads Creationists to dispute the Theory of Evolution. It amounts to “Science is not certain, so we have won the argument because we ~are~ certain.”
Certain, I should note, without having conducted a single experiment to the contrary.
Certain because they follow spiritual and other nonscientific teachers who, unlike scientists, don’t test their hypotheses.
Certain because they know that no one will line up to have his brain probed. And they certainly aren’t volunteering.
Certain because they cannot say “I don’t know” and “I was wrong.”
There was a time when the leading thinkers of the age were certain on these matters. They held that demons possessed us and they prescribed such cures as exorcism, confession, imprisonment, and death ((Yes, I know it sounds a lot like what contemporary Fundamentalists promote, but I am now talking about scientists not opinionated outsiders and medical professionals who take and leave what they want of science.)) . Others were certain that the mentally ill were possessed by spirits and were due the reverence of shamans or other holy men. These times were called the Dark Ages.
It was the uncertainty of Science that rescued us from these superstitions.
I personally believe that good has come of mental illness, but I have also seen the mentally ill wreck their own lives and the lives of those around them because they were Certain. Science has given us several imperfect terms to describe these states including grandiosity, racing thoughts, hypomania, and paranoia. While I think we have a lot to learn about mental illness — as much as we can from those who suffer with it — we’ve come a long ways from the days I have just described.
We don’t know the full story about depression. Only recently have medical professionals come to separate depression from bipolar disorder, recognizing them as likely being rooted in different dysfunctions of the brain. All you need to do is give a bipolar anti-depressants and you will see a different reaction than in a depression sufferer: the bipolar patient gets manic. Many people aren’t helped by anti-depressants at all. So does this show that depressions aren’t serotonin-spawned? My personal take is that there may be several different types of depression. This, I dare say, doesn’t agree with the ones attacking psychiatry because it holds out the hope that other treatments may work for other people ((Ketamine is often mentioned as a possible future replacement or augment to contemporary depression treatments, for example.)) The Scientist says “We don’t know a lot about the brain just yet and there are reasonable barriers to our understanding.” The anti-Scientist says this means we can’t trust Science to give us the answers. The reasonable human being whether a sufferer of mental illness or not realizes that this latter assessment is just wrong.
Ravens
Posted on February 16, 2011 in Creatures
The best events catch me by surprise. There’s a section of the Harding Trail that tightens itself into a fold before springing back. When you come down the hill, the trail slides down into this bend, then climbs again on the switchback before rounding a corner and again starting for the base of the unnamed mountain. It was here that the birds cried out to each other and here that I heard them. A pair of fine, large ravens grasped each other by the feet and plummeted head down into the nameless gorge. Two others swooped overhead as the first pair separated before a catastrophic stop and joined them in a flight that took them to the north north-east. I hoped to see more of their mating, but they disappeared over the crest of a ridge. A lonely white-tailed kite hunted for songbirds along this promontory, but it evacuated the vicinity as the ravens whirled past it.
Then the other day — Monday — Drake and I found a solitary raven squatting at a backroads cul-de-sac we frequent. The stout bird squawked and stared across Harding Canyon. Drake was drawn to it. The raven permitted him to come within a few feet and then wheeled into the sky. The rest of our descent was accompanied by caws which registered that the bird sought a mate without success.
The Sad Place Beyond Chemical Imbalances & Stigma
Posted on February 8, 2011 in Depression Reflections
Either I have reached a spot where my bipolar disorder is about to garret me or what is happening to me is not due to chemical imbalances. In either case, I have felt miserable for the last several days. And I can’t tell you why. One reason is that I am compelled to observe confidentiality to extremes that even the national headquarters of DBSA say are extreme. Long time readers of this blog can remember when I made a carefully restricted reference to something that was going on in a group and one person and her ex-husband went ballistic on me, both on this blog and in real life. So I pretend that there is nothing to say about my bipolar disorder and I know some of you have seen the effect as my impenetrable silence.
The other comes when I want to talk about family. I will say it only briefly: my mother had a stroke and the damage to her brain has apparently caused dementia. No talk here of the family politics involved in that because I grew up in a family where you didn’t talk about the family members’ weaknesses. You mocked strengths instead. This was supposed to be terribly backbone building and what it led to is a fine example in me of someone who, when people meet him after many years they say “But you were the one with all the promise!” At nearly 53 years old, I feel like a husk.
So I am in a corner, unable to compare, unable to reveal, and unable to speak about the darkness. It would be easier if it were all due to my illness. But I don’t like the drama as some do. I so urgently need to talk about it, too.
UPDATE: I am catching myself engaging in the “it’s-been-forever-without-change” thinking which is the hallmark of depression. Witness the remark above about being “miserable for the last several days”. This isn’t true except in the shadow-show of my present episode. Don’t let that lead you to underestimating its potency or the importance of confronting it.
Rape and Why I Became Pro-Choice
Posted on February 3, 2011 in Abortion Strange Violence
Not even events in Egypt could hide the GOP attempt to redefine rape. Only broken bones and bruises would have qualified under New Jersey Representative Chris Smith’s codicil to the No Taxpayer Funding for Abortion Act, meaning that if your 13 year old had a fling with her 30 year old school teacher, she was stuck with the child. It also meant that if you doped your date first, it wasn’t rape. The bill attempt to limit abortions to “forcible rape” victims outraged women and those who loved them and caused the GOP to engage in the fastest Congressional backpedal in recent years.
At the heart of this controversy was an attempt to dismantle Choice by narrowly constricting who could have an abortion. Mind you the gap is still too narrow. Let me tell you why: Women seek abortions pretty much for one reason: the child is unwanted. Some of these women have been raped. Some of those who have been raped actually report the rape to authorities. Some of these women don’t. Some women have been intimidated into sex. They gave their consent under the law, but they weren’t happy about it. I will grant that some are habitual abortion-seekers who use it as a means of birth control. But let’s say I am running an abortion clinic. How do I distinguish between the ones who just didn’t report the rape and the ones who were intimidated into sex from those who are abortion junkies?
The answer is that I can’t. I will have to take the woman’s word for it or else hire a detective service to investigate the sex lives of each client. Why force women to lie? The fact is that before six months, miscarriages are highly unlikely to produce viable and healthy offspring. The idea that the opposite is the case is nothing but ecclesiastic fantasy.
The Republicans were trying to clear the mess that comes with saying “We will allow abortions only in the case of rape”. And this past week, they showed what a mud hole that leads us into. In a time when we should be cutting back bureaucracy, they are openly inviting the creation of more, draconian bureaucracy. Bureaucracy that doesn’t serve to protect those walking around, but to bind them, to effectively turn women into livestock.
I used to be anti-abortion and, in many respects, I still am. I would rather that those women who used abortion as a means of birth control were discouraged, but I can’t see how to do it without harming women who I feel should have access to abortion. It is wrong, it is evil to expect that people be forced to give up as much as nine months of their lives. I am for better sex education and better distribution of birth control ((which many opponents of abortion also seem to be against.)). There needs to be something for when birth control fails. I oppose a police state where each case need be investigated by officials with a humongous case load. My throat constricts when I say this, but I have become Pro-Choice.
My Lack of Health Insurance Nightmare
Posted on February 2, 2011 in Bipolar Disorder Insurance
Lipstick Chronicles is mourning the passing of Melissa Mia Hall who died because she could not afford to see a doctor. “She knew she needed medical care,” writes Sarah Strohmeyer, “but feared a visit would result in a lengthy hospital stay that would “ruin her credit rating.”
Twenty years ago I worked at a company with the most minimal of health plans and employers who believed that they had a right to scrutinize every claim the insurance paid out. I knew I was sick — anxiety clutched my chest, depression kept me from sleeping, and, for brief intervals, I felt the boundless impulsiveness of mania. But my employer did not believe in “wasting his money” on a plan that included mental health benefits. So in these pre-parity days, I held on as best I could in a company that kept me in layoff after layoff. Pressure mounted and in the end, after the company folded, I responded by going into mania and volunteering to work in former Yugoslavia.
Several things would have been possible if I had had single-payer health insurance. First, I could have quit that awful job and educated myself towards a new, more appropriate career. Second, I could have received the psychiatric care that I needed. In 1994, while on my wife’s plan, I did receive some, though I was misdiagnosed for 11 years. I’m afraid that it was too late for me, though. Though therapists have tried to push me back into working again — always imagining a world where an intelligent, fifty three year old man with 16 years of unemployment can go back to school and start again as a professional — I’ve been locked out by my illness and by economic realities.
Like Melanie I was afraid of what would happen to my credit rating, so I did not do what I needed to do for my health. I couldn’t afford decent therapy or psychiatry. And it cost me my credit rating for a time, my salary, and my dignity.
Two Sad Dog Stories
Posted on February 1, 2011 in Dogs
The man walking his Boston Terrier along San Diego’s Prado didn’t see the problem. The choke chain made his little dog more controllable. You couldn’t have the yearling running about, being excited about the world. “Now he’s a good dog,” he said. I didn’t mention studies that showed that choke chains kill dogs by breaking their tracheas ((If you are going for strictness, you can either get a [[prong collar]] which applies hurt to the skin only or a harness which allows you to prevent your dog from moving where you don’t want him to be. We use a harness for Drake, but also make sure he gets some off-leash time when I take him for hikes.)) . One can only save one dog at a time.
There was nothing I could do about the tan and white chihuahua/terrier mix we saw run down the next day on the road coming back from [[Cabrillo National Monument]] ((Photos accumulating here)) . The little dog was out with his owner who called him into the street. A black compact sped down the avenue, quite unable to stop. The little body rolled under the wheels and got flipped up before falling hard onto the asphalt. No blood burst from the corpse. The teenage girl ran into the street to cradle him in her arms. We stopped and tried to give comfort. The dog’s tongue hung out of his mouth and flopped around as little spasms jerked his body. “He’s alive! He’s still alive!” cried his owner. “I don’t think so,” I said but she would have nothing of this certainty.
I recruited a woman who had come out of her house to see what the commotion was to drive her and the dog to a vet. The driver of the black car came back. He, too, was in tears. The crowd of motorists and pedestrians which had gathered for the passing of the mongrel dispersed. I told Lynn sadly that I thought the dog was already dead but had cowardly left the vet to convince his young owner of the bad news.
Toxic Society: It’s What We All Put in the Pot
Posted on January 23, 2011 in Abuse Civic Responsibility Compassion Terminology
With Utah Senator Bob Lee’s declaration that if we stop the violent rhetoric “the shooter wins” — for starters — I realize that National No-Name-Calling Week is going to be tough for me. But I do see value in holding my temper and refraining from short-cutting reasonable arguments against — there, I almost did it. I stopped myself. Let’s just say that Bob Lee is wrong in the extreme and doing little more than trying to find an excuse for continuing to be a — damn. I told you this wasn’t going to be easy.
These are terrible times. We confound the right of being able to say what we want — even that which is rude — and draw from that the confused notion that being offensive and divisive is an obligation. So we jump to the worst before we rise to the best — if we ever bother to rise at all. This week, I am going to try to mark a better course. If Lee persists in defending violent rhetoric, I will point out the act without adding an epithet. We have enough bullying going around (and Lee’s statement is as bad a defense of bullying as I have ever seen), so for one week, let’s try to find the better place of considered discussion. This week, let us refute and rebut the logic without resorting to the shorthand of abusing the messenger. Democracy is not for the lazy: we must work to gain agreement and consensus.
People not to think about this week: Antonin Scalia, Clarence Thomas, John Boehner, Sarah Palin, Michelle Bachmann, Bob Lee.
It is what we all put in the pot that makes for a toxic social atmosphere.
I promise you this: I shall do my best to argue the issues not diss the person. If I fail, I shall pick myself up pronto and set myself to the spirit once more. Wish me luck.
Ignore Sarah Palin Week Is Coming!
Posted on January 20, 2011 in Scoundrels
You’ve grown sick to your stomach watching her whine. She’s the Voice of the Tea Party, the lady who put gun-sights on Gabrielle Giffords and other Democrats she didn’t like. She’s a glamor girl set to become the President. She’s nauseating and she’s hungry for attention.
Don’t give it to her.
From February 28 to March 4, 2011, this blog will not mention Sarah Palin. No matter what she does, no matter what incidents her hatred engender, her name will not appear in any blogs posted during this time.
You can:
- Change the channel if she comes on TV
- Surf to another page if she pops up on the web
- Turn to another article if she appears in a newspaper, magazine, comic book, etc….
- If a friend mentions “Sarah Palin,” reply as if he or she said, “Para Sailing.” And keep doing it. Para sailing is way cooler.
- For your dose of gossip, consider switching to someone far less annoying. Like Snooki.
- Visit “Telling Sarah Palin She’s Full of Crap” on Facebook, and join 100,000 other people who will be talking about everything else BUT Palin.
- Refer to her as “she who shall remain nameless” for the duration of the week
- Have other conversation topics ready to go
Give this boy my dog
Posted on January 17, 2011 in Dogs Encounters Hikes and Trails
On the San Juan Loop, originally uploaded by EmperorNorton47.
After months and months of hiking the Harding Trail at the upper end of Modjeska Canyon, we bought a Federal Lands Pass and set out for a region of the [[Cleveland National Forest]] about forty five minutes away from our condo in Portola Hills. The main attractions were an unburnt expanse of chaparral and two waterfalls.
The San Juan Loop runs a rugged circle around an unnamed hill. Most people choose to see the waterfalls first, but we took a clockwise course which sent us down the steepest hill of the course, against the flow of traffic. This meant that the last part of our walk took place in the shade of greasewood, scrub oak, and other elements of the local biome.
We met many families doing the walk for [[Martin Luther King Jr.]] Day. The most memorable of these was one of the first we encountered. Four members stood around a fifth, a dwarf with a scraggly beard. I quickly made out that in addition to being small, he was developmentally challenged, so I treated him with extra courtesy.
“Would you like to give my doggy a treat?” I asked?
He took the piece and held it out as I showed him, with hand open so Drake could lick it up. Then he reached forward and embraced my doggy. Drake stretched his neck and gently licked the dwarf’s nose.
Damn, it was one of those moments when if someone had told me I was going to die, I would have said “Give this boy my dog.” I know they would have got on famously.
The Beauty of Wikipedia
Posted on January 17, 2011 in Folly Watch InterNet Debates
All sectors of the political spectrum get caught in making rapid accusations. I did this just now on a conservative web site when I misstated that the mayor of Houston is a Republican. I did this because another member of the left said she was and a quick check showed that she is not. I posted an immediate retraction and posted a correction to the web site where I found the information. The question is whether the conservative web site will have the decency to delete my still-as-of-this-posting-moderated comment or will allow it to appear without my retraction. I have my reasons to doubt that he allow a progressive to stand as reasonable, but people can surprise you.
The more important lesson to be drawn from this is simply Check your facts. We have Wikipedia for a reason.
Do I Engage in Violent Rhetoric?
Posted on January 16, 2011 in Accountability Terrorism Violence
This idea came to me while I was out hiking in the Santa Ana Mountains this afternoon. I have often been critical of the language used not only by Tea Baggers but also by my fellow liberals and progressives. If you’ve visited this blog enough, you know that I have often taken people to task for employing what I call “folk diagnosis” — calling another person “crazy” because they disagree with that opponent’s politics. But the times are calling for another concern: the use of violent, threatening rhetoric against our opponents to intimidate and silence them. It has undoubtably, on the one side, fueled the eliminationalist movement of the Tea Party. On the other, I am concerned that I have done the same at some point on this blog.
So here is your challenge: catch me doing it.
Leave your findings in the comments. Be sure to reference exactly where you found it so I may review the claim.
The Extreme Right’s Plan After Tucson
Posted on January 14, 2011 in Accountability Civic Responsibility Insurance Stigma Terrorism Violence
Proposals from Right-wing extremists about Tucson amount to this: Blame the mentally ill for what happened. Stigmatize the mentally ill. Do nothing to help the mentally ill obtain needed health care and medications to contain their illnesses. Cut back on programs for the mentally ill. Do nothing to make it harder for anyone to obtain assault weapons like the 30-round Glock that Loughner used to mow down the crowd. Accept no blame for the violent rhetoric that obviously influenced the gunman to zero in on Gabrielle Giffords. Keep up the same old Tea Party show. Undercut the partisan pause.
In other words, the plan is no plan. Just run on automatic knee-jerk.
