Thursday, July 31, 2014

The Blog Has Moved!

Hello all,

If for some reason you've come across this blog in your adventures, you should know that I've moved the blog to a new Wordpress address, which can be found here:

Monday, May 26, 2014

The Evil Demon - Depression and Perception

I shall suppose that some malicious, powerful, cunning demon has done all he can to deceive me...I shall stubbornly persist in this train of thought; and even if I can’t learn any truth, I shall at least do what I can do, which is to be on my guard against accepting any falsehoods, so that the deceiver – however powerful and cunning he may be – will be unable to affect me in the slightest...

-Rene Descartes, Meditations on First Philosophy

The Evil Demon is a concept in Cartesian philosophy. In his philosophy, Descartes argues that he cannot know if there is actually an external world, or if an evil demon more powerful than him is deceiving him to believe there is an external world when in reality there is not, or that the external world is vastly different than what he perceives it to be.

Initially it sounds absurd, but think of how our eyes work. We don't actually see things in the world, but rather the nerves in our eyes receive the light bouncing off those things, convert them into electrical signals, and then deliver those signals to our brain which produces an image in our mind. It's possible that our eyes are malfunctioning, and that we're not seeing what we think we're seeing. The same is true for other senses. We might not actually be hearing the things we think we're hearing, or feeling what we think we're feeling. For all we know, we're all actually just brains in vats having all these sensations delivered to our brains, which lead us to believe we're perceiving an external world that isn’t actually there.

I don't find it particularly useful to believe that the external world is a vast illusion created by an evil demon or that we're brains in vats. Not the least of which because we don't have any other reality to think we're actually living in, and also because believing that the reality I perceive doesn't actually exist kind of makes this whole blog-writing enterprise just feel silly. However, the idea of how our perceptions dictate how we understand the world is very useful when thinking about mental illness.

Perception is everything. That's not just a pithy saying. Perception is literally everything. Or at least everything we perceive (which depending on your philosophy might be everything anyway). We don't see the world without light entering through our eyes and getting interpreted by our brains. We don't feel things without our nerves transmitting electrical signals based on what we touch, which are then interpreted by our brains. And we don't draw conclusions about the world without drawing them with our brains.

Mental illness is, among other things, a disease of perception. A disease wherein the way we see the world is different from how it actually is (or at least a close approximation to how it actually is). With mental illness, we observe the world, and draw conclusions from those observations, in ways which can differ radically from the observations and conclusions of more "healthy-minded" people.

Since early adolescence, I have struggled with anxiety, particularly as it concerns valued relationships. I have a tendency to overthink and overanalyze every small detail of interactions, down to the exact order of words in sentences. Often with that analysis I come to believe that I have done something to bother or annoy other people. For example, if, say, Dave the hypothetical person doesn't respond to a text message I send in as timely a manner as I would like or expect, I become convinced that there was something in the last message I sent, or in my recent behavior, that led to Dave not wanting to speak to me. It did not matter if I could not think of any particular example of this supposed bad behavior, or if I didn't see anything particularly offensive in my previous text. Nor did I consider that maybe the reason Dave wasn't responding to me was because he was distracted by something else, wasn't at his phone, or simply didn't think the text was one he needed to respond to. I was convinced I had done something wrong, and that he was reacting to that.

Thought leads to action. I believe that I have done something wrong, and this leads to me profusely apologizing, or continuously engaging in "checking" behaviors, to make sure I hadn't done anything wrong. Time and again, Dave responds to these apologies and checkings with confusion--he did not think I had done anything wrong, and was surprised that I was apologizing. If anything, it was the constant apologizing and checking that was more problematic than any perceived mistakes I had made. I don’t need to go further into detail on that, I’ve described it well enough before.

The reality of what was going on was radically different than how I perceived it to be. In reality, I hadn't done anything wrong to Dave. But I perceived that I had. With the evil demon, Descartes thought it possible that he might not be living in the world he thought he was, and his perceptions were lying to him. It is the same with mental illness. We don't live in the world. We live in a torture chamber contained entirely within our own heads, where we see the world through filthy lenses and distorted mirrors. The worst possibilities, unlikely though they may be, become distressingly real. And because of how real they become to us, we feel we have to act on those possibilities, often with unpleasant results.

The question which should be asked of any person with depression or other mental illness is "why do I think that the way I view the world is right?" As I discussed last week, mental illness is in part related to habit, and how we perceive the world is one of those habits. Instead of perceiving the world in the dismal terms that come so easily in our mental illness, we can instead attempt to perceive them in a more positive, or at least neutral, light.

So with that in mind, I send a message to my hypothetical buddy Dave, and he doesn't respond in as timely a manner as I would like. My first response to this is to think "he's not responding to me because he hates me, or because I've offended him." However, I could also think "maybe he's not responding because he hasn't seen my message or he forgot about it."

Both my first response and my second response are valid ways of looking at things, because both are theoretically possible. The kicker is that we don't know which one is true. The truth of the matter is ambiguous, at least until we can talk to Dave and find out, and even then there's no guarantee that we'll get the right answer. The difference between the options is that one of the ways makes me feel like crap, and the other makes me feel more understanding of Dave and of myself. So why not go for the more positive possibility?

Alternatively, some may argue that the positive outlook is risky. If we try to view things in a more positive light, we run the risk of deluding ourselves. Which is true, but it works both ways. Viewing things in any light, we run the risk of getting things wrong, simply because reality so rarely conforms to our expectations. And I would argue that viewing things in a negative light is the greater risk, because not only are we more miserable, but we are more likely to act on that misery, which tends to lead to similarly miserable outcomes. I've talked before about the importance of hope, and it applies again here. If I believe Dave hasn’t responded because I’ve offended him, I become distressed and want to apologize, which may bother Dave. If on the other hand, I choose to believe that Dave must have forgotten about the message, I allow myself to feel content, and do not apologize for anything, because I’ve done nothing to apologize for!

The point isn't to believe one option or the other. The point is to remember that you don't know the answer, but are assuming the one that makes you miserable. Either could be possible, only one possibility actually is. I don't know which, or if it's even one of the two possibilities I'm consideringc (for example, it could very well be that Dave is actually a hypothetical person and therefore is not capable of responding to my text message at all). I view the negative possibility as reality, and thereby act on it, to potentially damaging results. Of course, no matter how we react, the outcome might not always change. What changes is how we feel, and how we behave in response to those feelings.

Perception is key. In fact, it's not just key, but also lock, door, floor, wall, and the rubber stopper on the floor that keeps the door from banging into the wall and ruining the paint job. Our interior world is the thing which we can most control, even if it doesn't always feel like that. We can't always change the world. But there is a world that we can change. Our world.

If there is any advice to take from this post, it's this: if you have mental illness, be it depression, anxiety, or any other condition that you suspect might impact your view of the world, doubt. Doubt what you believe about the world, about yourself, and about others. Doubt what you think you know. Doubt your intuitions, your first reactions, and your common sense. Doubt your reasoning and your justifications. Doubt what you think about the future, and doubt what you think about the past. Doubt that life is as bad as you think it is. Doubt every way of looking that has harmed you or made you unhappy. Because there is a pretty good possibility that the way you're looking at the world is wrong.

Monday, May 19, 2014


“We are spinning our own fates, good or evil, and never to be undone. Every smallest stroke of virtue or of vice leaves its never so little scar.” - William James,

In 1965, Martin Seligman and his colleagues were conducting an experiment that involved giving dogs electric shocks, because this is what scientists did before the idea of humane treatment of animals came into vogue. They split the dogs into two groups. One group would be able to press a panel to stop the electric shock, and one group would be kept in a harness and unable to do anything to prevent the electric shock.

They then placed the dogs within an area separated from another area by a low fence. On the side of the fence which the dogs were placed on, the floor contained an electric charge, while the other side of the fence did not. The fence was low enough that the dogs could easily jump over it to the shockless floor. 

The dogs which had been able to stop the electric shock quickly jumped over the fence to the other side, while the dogs which had been unable to stop the electric shock simply lied down and did not attempt to escape the shock. Because they could not escape the pain before, the dogs did not think they could escape it then, and so they didn't even try. 

Martin Seligman coined this phenomenon "Learned Helplessness". Learned helplessness is the idea that when we are unable to improve our well-being in some areas, we grow to believe that we cannot improve our well-being in others. To some degree it's a logical response; we can't escape this pain, therefore we can't escape other forms of pain.

Depression is, in part, a habit.

Which is not to say it's not other things as well. Depression is an incredibly complex condition with poorly defined boundaries. The exact combination of factors which lead into depression--be they habitual, neurochemical, psychological, philosophical, spiritual, or otherwise--vary from person to person. Today, however, I will focus primarily on the habitual side of depression.

Our lives are made up of habits. Every thought, every feeling, every action done reinforces itself, so that it is easier to do the next time. This can be used to good extent, obviously. When we begin driving, we spend a lot of time looking at the road, and feeling every turn and sensation, which ironically makes us less likely to notice obstacles on the road, because we're overloaded with information. Yet after enough practice, the basic components of driving become so easy to do we hardly think of them, and our mind is free to focus on the road in front of us (whether we actually do that is another story).

At the same time, however, it can similarly be used to bad effect. When we think certain negative thoughts, for example, it becomes easier to think those thoughts in the future, and harder to argue against them. Over time, the thoughts can come so easily that it's as if we don't think them at all, the thoughts are just there. And when we don't have the resources to try and argue against them, the thoughts seem perfectly reasonable, for we don't have any alternative or them.

What Martin Seligman showed with the experiment, among other things, was how habitual ways of thinking in the past inform our present habits. Many of us have had occurrences in the past where we were hurting and couldn't stop from hurting. For some people this may have had to do with upbringing. For others it's related to trauma. For others it was simply the depression. Regardless of the cause, we hurt, and we could not stop it. We felt powerless.

Over time, we grow used to that feeling of powerlessness. It sinks into our minds and changes the way we think of things. The sense of powerlessness moves from its point of origin to other areas as well, into the parts of our lives that have nothing to do with the hurt. We feel not only powerless in that one place, but in other places, like with keeping friendships, holding down jobs, or working for our lives to improve. Even when removed from the hurtful environment, those habits stay with us as a remnant

It's this concept of habit that is related to the idea of the "hedonic treadmill", or happiness set-point. The idea is that though certain life events may temporarily change our feelings, we generally return to a certain state of happiness over time.  However, this set point can change. Richard Davidson, for example, has argued that, because of the neuroplastic nature of the brain, happiness can be cultivated just as any other habit can, such as through counseling, physical exercise, and meditation. Research has shown that engaging in small but consistent activities such as religious practice and exercise can improve one's overall levels of happiness. Martin Seligman, who you may remember as the dog-electrifier from earlier in this post, is one of the leaders of the positive psychology movement, which asserts the capacity for individuals to change their ways of thinking,  and has written numerous books on the subject.

What this all means is that our happiness, and by extension our depression, need not be set in stone. We may not be able to control all factors which contribute to our depression, but we can control how we think and what we do, and their effects on our overall well being cannot be understated.

Which then leads to how to approach it.

The above image is called the Cognitive-Behavioral Triangle, which is the foundation used in Cognitive-Behavioral Therapy (CBT). What the triangle shows is that our thoughts, feelings, and behaviors are all interrelated, with each informing the others. If we feel a certain way, for example, we may think a certain way. If we think a certain way, we may behave a certain way. And if we behave a certain way, we may feel a certain way. And so on.

CBT is closely related with the idea of forming habits and breaking them. By feeling a certain way long enough, we reinforce the thoughts that initially led us to those feelings, and in turn reinforce the behaviors that also stem from those feelings, and so on. This applies to both helpful and unhelpful points. What's important is that we can interrupt the unhelpful cycles of thought by replacing some unhelpful thing within the triangle with a more helpful thing.

Suppose I wake up feeling depressed. I don't have any particular reason for why I feel depressed, I just do. But while I'm depressed, certain thoughts are easier to think, namely negative or pessimistic thoughts. "This day is going to suck" or "I won't be able to get anything done today". By thinking those thoughts, I in turn reinforce the sense of unhappiness. Which reinforces the negative thoughts.

On the other hand, suppose I wake up feeling depressed, but rather than allowing those negative thoughts to come unresisted, I challenge them. I may not be able to stop the "this day is going to suck" thought, but I can respond to it with "I don't know how the day will turn out but I can still do my best in my current situation, which can improve my chances of getting a possible outcome." Wordy, perhaps, but it's challenged my first thought with a more hopeful, reasoned thought.

Similarly, suppose I'm applying for a job. My first thought may be "There's no point in doing this, I'm not going to get the job anyway", and I may be inclined to not write my resume.  But a thought to respond to that might be "I may not get the job, but I definitely won't get the job if I don't try." And then push myself to write the resume and submit it. I may still not get the job, but I've provided an alternative to think instead of the pessimistic thought I originally had.

That's just two examples, and I am far from an exhaustive reference on this subject. There are books upon books on CBT, and many therapists are specially trained in it. Worksheets and other resources are available online. And of course, this is not the only method of therapy or habit-breaking available.

But what's perhaps most important to note is that this method and any other method cannot be done inconsistently. It must be performed constantly and doggedly. Habits are tough to break, and it'll be all the harder to break a habit if it's not tackled with enough energy and commitment. It'll require a lot of hard work, and at times it will be a real pain. But the outcome can be very, very positive. We can, if not rid ourselves of depression, then improve how we respond to it. We can make our lives better, not by changing the world around us, but by changing ourselves. We can learn to approach the world in a different way, a way that is affirming and empowering to us.


The Depression Habit Spiral

Monday, May 12, 2014

Explaining Depression: The Apple and the Tortoise

If that title sounds like a bad rip-off of an Aesop's Fable, rest assured, it'll all be explained a few paragraphs down. Sort of.

Depression, in many cases, is about perception.

Ask yourself what it's like to be depressed. If you're anything like me, you'll use a lot of sense-related verbs. When you have depression, things feel bleak. They seem hopeless. When I actually am depressed, I don't just think that things feel bleak, or seem hopeless. When I'm depressed, things are bleak, and are hopeless.

With depression, the tools we use to perceive and interpret the world are not functioning correctly. We perceive the world in dismal terms, that we have no future and are unlikely to get good outcomes, and that nothing we do can make a difference, among other things. And because we perceive the world that way, we come to believe that is how the world actually is.

That's one of the reasons why people who are depressed, in a lot of cases, struggle to believe they have depression. Other people may tell them they have depression, and that what they're feeling isn't true, but it is very hard for a depressed person to believe that, because their feelings exist in direct contradiction of what the other person is telling them. The other person may say things aren't as bleak as the depressed person thinks, but the depressed person feels like they are that bleak.

Imagine trying to convince someone that the apple they are holding in their hands isn't actually an apple, but is actually a tortoise wearing a straw hat. No matter how hard you reason, argue, beg, and assert, the other person is very unlikely to believe that they're holding a hat-wearing tortoise. When they look at what's in their hands, they see an apple. When they touch it, they feel the shape and texture of an apple. When they smell it, they smell an apple. And when they bite it, they taste an apple (as to how the supposed tortoise feels about being bitten, well, best not to think about that).

Now imagine telling the person holding the apple/tortoise that the reason they think it's an apple is because someone has put a mind-control chip in their head causing them to perceive tortoises as apples. Most likely, the person would be somewhere between amused and insulted. How ridiculous is it that someone put a tortoise-to-apple mind-control chip in their head, when it's so clear to them that they're holding an apple in their hand and not a tortoise! People tend to trust their own senses. For the most part that's a good thing, as it was probably the main reason we're not still living in caves. It becomes a problem when the things they're sensing are unnecessarily infringing on their lives.

The best way someone could be convinced that they have that mind-control chip in their head is if a lot of people, whom they trusted, told them that is exactly what is happening. Loved ones and medical professionals would have to line up and explain to them that a mind-control chip is in their head. If the person's still doubting, they might ask questions like when the chip was put into their head, how it works, and if they can't get good enough answers to that, it's all the easier for them to doubt.

And even after telling them all that, and giving convincing reasons, the person might still resist believing, because of how disturbing the thought is that they're wrong.  If they have such a chip in their heads, that means that the apple they perceive in their hand was never an apple at all. That they were wrong the entire time. That there is actually a tortoise in their hand (and given how long the tortoise has been there through all this, it's probably gotten hungry and started chewing off a few fingers). It's easy to believe what you already believe, especially if your feelings back it up. Changing what we believe is tremendously uncomfortable, especially if our faculties lend themselves to what we already believe, and more so if the new way of looking at things makes us feel weaker, less intelligent, or simply duped.  So for the most part, we try not to do it.

It's important to remember that depression (because we're talking about depression again) says nothing about how strong we are, how smart we are, or how good a person we are. All depression says is that we have depression. And what depression has done to us is make us see things in a way that's different than how they actually are.

Monday, April 28, 2014

Worry, Anxiety, and Uncertainty

I've been told I overthink things.

To some degree this is little more than a loveable quirk (at least I hope it's loveable). I often take things I've observed, and try to dissect them as much as I can, often to the point of absurdity.

Recently, for example, I noticed that I had been reading more works of nonfiction than fiction. I was fascinated with this, and brought it up to my friends. I asked "When did this happen? Why did it occur? Do fiction books just not interest me as much anymore? Was I ever really that into fiction books?" For my friends, the reaction was mostly a combination of bemusement and exhaustion. It wasn't the first time I'd overanalyzed something as simple as me changing my preference of literature.

Unfortunately, my tendency to overthink isn't limited just to little things like that. I overthink everything. I dissect them, analyze them, ruminate over them. Often I overthink the things I fear might happen, or the things I don't know. And then I overthink them more. And more. And more.

Other words for it are anxiety, and in extreme cases obsession. It can be found in OCD, ADHD, and GAD, among doubtless many other conditions. The point is the same: there are thoughts, and I cannot let them go.

Let me give an example. For as long as I can remember, I've been afraid of brain damage. I fear it happening to me, and I fear the effects it could have on my personality, my beliefs, and my relationships with other people. I fear the philosophical possibility that if I suffer brain damage, that I cease to be myself.

I'm sure many other people have these fears from time to time. The difference for me is the immediacy and intensity with which I feel them, so that I feel not that brain damage might happen, but that it will. Several weeks ago, I spent an entire afternoon caught up in these fears of brain damage. I researched philosophical theories of the relationship between the mind and brain, theories of personality and the self. In my fear I bought a book how to live with brain trauma. I began feeling psychosomatic sensations in my head, minor throbbings and lightheadedness, and became paranoid that these were the precursor of an aneurysm, or an unnoticed concussion. All of this culminated in a point where I had checked myself into the school mental health counseling services, and broke down in despair over what brain damage might do to me.

I have not had brain damage. There was no reason for me to assume I had that likelihood in the near future. My family had shown no previous risk for strokes or the like, and I was not engaged in any high-risk activities that would put me at risk for brain damage. Even if I did suffer brain damage, there was no reason to believe it would affect me in the horrid, personality-effacing ways that I feared it would. All of that didn't make a difference to me. It could happen, there was nothing to prevent it from happening, and therefore my mind interpreted that it would, in the worst possible way.

That's an extreme example, but the same phenomenon occurs again and again in my life. These questions include, but are not limited to:
  • Is there a God? (And other philosophical questions)
  • Does someone I care about really love me?
  • Do I really love the people I think I care about?
  • Do I have some early stage of cancer right now but don't know it yet? 
  • Is this future event going to turn out the way I want it to, or  fear it will?
A common thread throughout is that all of these questions are things there are no easily knowable answers to. Take love for example. I want to think I love other people, but how do I know truly? Is there some test I can take to verify that the emotion I feel is love? What if I'm only convincing myself I'm feeling love? What if there's no such thing as love? I don't know, so I try to dissect every feeling, every thought, analyze it and reduce it, and ask myself "is this love? Am I feeling love?"

Unfortunately for me, there is no answer to this, or at least none that our society currently knows. Philosophers have been debating love for thousands of years, and if I were to take a guess, I'd say they'll be debating it for thousands of years more. We can put our stock in one view of love or another, but in the end there's no way we can guarantee that we have the right idea.

And that's where the anxiety comes in. Anxiety is about trying to get certainty in things we can't be certain about. We want to know about our future, about our relationships, about God, as clearly and certainly as we know the time of day. We want certainty, but we can't get it, so we become miserable thinking about the things we can't be certain about.

Often, when faced with this anxiety and uncertainty, our first response is to double down on our desire for certainty, often through checking behaviors. We try to do what we can to be as certain as we can be, even if what we can do doesn't actually leave us any more certain. A person afraid of catching disease may frequently wash his hands. A person who is insecure about their relationships may constantly apologize to other people for some wrongs they think they have done. Someone who is worried about whether there is or is not a God may spend a great deal of time reading philosophical works on the divine in search of an answer.

Unfortunately, all of these techniques are temporary solutions, and often can be more problematic in the long-term than they help in the short term. If someone feels they have to constantly wash their hands to prevent from catching disease, they build up the fear of the disease in their mind, and become increasingly anxious the longer they go without washing their hands. Someone who constantly apologizes for perceived wrongdoings in relationships may tire his loved ones through constant apologizing, ironically making the success of relationships less certain than if he did nothing at all. And with philosophy, well, men have been debating these things for thousands of years. We haven't gotten a certain answer yet, and continued readings of philosophy will only make that uncertainty all the more pronounced.

Yet for the anxious mind, what else can they do? When I have felt acute anxiety over something, I feel like the only thing I can do is, if I cannot be certain, to get as close to certainty as I can. Yet there's only so close one can get to certainty. No matter what I do, there will always be a gap between what I know and what I want to know, and there is no way to bridge that.

The only option, then, is to accept it.

When I first heard that suggestion, I bucked it as hard as I could. I couldn't imagine accepting the things I feared would happen, because in my mind that was as good as allowing them to happen, to admit defeat and give into the real possibly of my worst fears being realized.

But the possibility was always there. Most of the time, worrying about those fears doesn't prevent them from occurring, it just make the interim until/if they occur all the harder to bear. No matter what I do, no matter what I think, the things I worry about can still happen. I may get cancer. I may lose my loved ones. I may get brain damage and may through brain damage have my personality inexorably erased from existence.

But so far, none of those things have happened. So far, all that I have done is worry about them. And worry. And worry. My quality of life has been lowered over things that have not even happened yet, if they happen at all.

One may still be resistant about giving up their anxiety. One may argue that their anxiety has been useful, where by worrying about things they then do things to prevent the things they worry about from happening. And that may be the case for mild anxiety.

But for more severe cases. Cases like my own, I've found the exact opposite.

Often when I worry, I don't prevent the things I fear from happening; I make them all the more likely. By fearing bad outcomes to such a severe extent, I impair myself, and reduce my ability to function properly. When I've worried about a test or an assignment, I become paralyzed with fear, and avoid starting the project, or working on it as much as I should, because of how deeply I associate the project with the uncomfortable fear of failure. With friendships and other relationships, I become so worried about losing them that I no longer able to function normally in them, in the ways that started those relationships in the first place. I become visibly anxious and uncomfortable around them, and the other person does not want to be around someone like that, and so they begin to drift away. Which causes me to become more anxious. Which causes them to drift away.

Maybe for some of those cases, my anxiety didn't make things worse. Maybe in some of those cases, my anxiety had no effect on what was going to happen, or even delayed it. Maybe in some cases, my anxiety has actually prevented some of the things I worry about from coming to fruition. I can't think of any, and I seriously doubt there were more than a few, if any at all, but it's possible.

It's still not worth it.

I'm afraid of many things because I fear they will ruin my life. But anxiety has already done that for them. Anxiety has taken away my ability to enjoy the world from day to day, and has left me in constant fear of the future. Anxiety has made me paranoid and insecure, constantly worrying that I'm doing something wrong, or putting myself at risk. Anxiety has curled up inside of me like a parasite, and eaten me up from the inside.

And I want it to stop.

We can't always change the things we want to. We can't always know the things we want to. In those cases, all we can do is accept.

Accept all the things we do not know, and cannot be certain about. Accept that we will not get the answers to many of our questions for a very long time, if we ever will. Acknowledge that we are suffering greatly in our anxiety over the things which we do not know, and that worrying about them is unlikely to change the outcome of the things we worry about (they may even make the bad outcomes we worry about more likely!). The things we are afraid of may happen, and if/when they happen, they may be very hard to deal with. But we cause ourselves a great deal of misery now about something that hasn't happened yet, and may never happen.

Do we want to live in a world where we're constantly worrying over the things we don't know? How much better could our lives be if we could acknowledge the things we don't know, accept that the worst may happen, and still strive to live the best lives we can at this moment in time?

Jonathan Grayson, author of the book "Freedom from Obsessive Compulsive Disorder", from which I've drawn a great deal of material for this post, said in his book that "Living with uncertainty means choosing to cope with whatever may happen. There is no alternative." He is right. We have no other option, save to continue to suffer and agonize over the countless things we do not know, and that is no option at all. To get better, and to free ourselves from our anxiety and obsessions by no longer letting ourselves be in fear over them, is the only option we have. And we can begin the process now.

Monday, April 21, 2014


There are few things crueler in the world than feeling alone. All the pain and suffering in the world can be endured if we have others to share the load with. Alone, those burdens are frightening and all the more terrible.

I've felt alone. I've felt alone with other people around me. I've tried to talk, to communicate, but my ignorance and anxieties make me feel limited and distanced. I've felt alone in my depression, where the illness itself works to isolate and separate me from the rest of the world, and convince me that others do not love me. I've felt alone late at night, when there's no other voices to be heard but my own, and the things that it's saying are more than I can handle. Today I felt very alone for a very long time.

In my experience, loneliness is is accompanied by hopelessness.  Odd, considering we deal with problems by ourselves all the time, and most of the time we do them with no trouble. But when I think of myself as being by myself, the situation becomes much more difficult. The difference seems to be between being alone and feeling alone. It's the difference between not having others around us but still feeling their love and support, versus feeling like we're the only ones taking on the weight of the world.

We need to know we're not alone. We need to know that others are there to help us. We need to know that what we have struggled with others have struggled with. We need to know that out there, somewhere, is someone who cares about and values us as we would like to be valued.

But sometimes it's very hard to find that.

For those of us who have had traumatic experiences, who have had problematic childhoods, or who have dealt with the isolating experiences of mental illness, it can be very hard to feel like there's someone out there who can understand us. There are many solutions to this, and I would encourage everyone who feels this to look for what works for them.

But here is something that works for me:


Yesterday morning , as I was preparing for the day, I felt very depressed. I wouldn't call it despairing, but things felt empty. I wasn't sure why I was doing anything, what it was all going towards. The future felt narrower, and I felt smaller.

In the end, what got me out of this slump was not any philosophical tract on "revolt against the face of despair" or whatever. The feeling did not suddenly go away. No medicine removed it. Instead, I was inspired by an anecdote from Victor Frankl's Man's Search for Meaning, whereby Frankl, while suffering in a concentration camp, is able to inspire himself to continue on by thinking of his wife. The quote is wonderful, as is the whole book, and is included below:
We stumbled on in the darkness, over big stones and through large puddles, along the one road leading from the camp. The accompanying guards kept shouting at us and driving us with the butts of their rifles. Anyone with very sore feet supported himself on his neighbor's arm. Hardly a word was spoken; the icy wind did not encourage talk. Hiding his mouth behind his upturned collar, the man marching next to me whispered suddenly: "If our wives could see us now! I do hope they are better off in their camps and don't know what is happening to us." 
That brought thoughts of my own wife to mind. And as we stumbled on for miles, slipping on icy spots, supporting each other time and again, dragging one another up and onward, nothing was said, but we both knew: each of us was thinking of his wife. Occasionally I looked at the sky, where the stars were fading and the pink light of the morning was beginning to spread behind a dark bank of clouds. But my mind clung to my wife's image, imagining it with an uncanny acuteness. I heard her answering me, saw her smile, her frank and encouraging look. Real or not, her look was then more luminous than the sun which was beginning to rise.
Like Frankl, I thought of those I loved. I thought of my closest friends and loved ones, past and present. People who still cared for me and those who I knew no longer did but whom I still cared for nonetheless. I thought of their faces, of precious moments spent with them. I thought of wanting to make them happy, and I realized that the way to best make them happy was if I was happy, or at least as close to happy as I could be in the present moment. I could show my love for them by extending that love to myself, and willing myself to endure the suffering I was feeling now.

And that helped. The pain lessened somewhat, and what pain remained became easier to bear. It did not go away, but things became just a little bit easier, in part because I was able to take the pain and bear it in the context of something beyond myself I realized I was not alone. I was part of a larger world, filled with others who were affected, changed, by my presence and my actions. My pain became not simply something I was bearing for my own sake. It became something I bore for the sake of others as well. There's something very empowering in that.


That was just one technique. Sometimes it works, sometimes it doesn't. It's good to have multiple techniques at our disposal, as sometimes one does not help us but other does so.

But no matter what, we need to remember that we are not alone. Orson Welles once said that through friendships and relationships we give ourselves the illusion that we are not alone. But I think it is loneliness that is the illusion. True, each of us lives only in our own bodies. We can only ever see what it's like in our own heads, not the heads of others. And yet we do believe that others are around us (at least most of us do). We feel them and speak with them in our lives. And we care about people, and we believe they care about us, through the things they have done for us, the ways they've helped us get to where we are now. We can all think of people who have helped us. Fred Rogers made use of this to great extent in his acceptance speech for the Daytime Emmy Lifetime Achievement Award, and I encourage you to watch it:

"No man is an island", as John Donne said. We are part of something much greater than ourselves. Everywhere on this world there are people like us, who see through eyes as we do, hear the world as we do, and think as we do, though their thoughts may take them to different conclusions. Whatever we feel, we can know that there are others who have felt the same. When we hurt, there are others who have hurt the same ways as well. Each of us feels and thinks and experiences in our own unique ways, but though the details may be different for each of us, the core of them is the same.

Maybe we are alone. Maybe each of us is an island. Hell, maybe Hilary Putnam is right, and we're all just brains in a vat that believe we are making these connections. I choose to believe that we're not. I choose to believe that though we may feel very alone at times, and though we may not be as close to others as we'd like to be, we're never truly alone. There are always ways for us to connect, and feel that connection, though sometimes they might be very hard to find.

I'd like to end this post with the paragraph immediately following the quote from Victor Frank's Man's Search for Meaning above:
A thought transfixed me: for the first time in my life I saw that truth as it is set into song by so many poets, proclaimed as the final wisdom by so many thinkers. The truth - that love is the ultimate and highest goal to which man can aspire. Then I grasped the meaning of the greatest secret that human poetry and human thought and belief have to impart: The salvation of man is through love and in love. I understood how a man who has nothing left in this world still may know bliss, be it only for a brief moment, in the contemplation of his beloved. In a position of utter desolation, when man cannot express himself in positive action, which his only achievement may consist in enduring his sufferings in the right way - an honorable way - in such a position man can, though loving contemplation of the image he carries of his beloved, achieve fulfillment. For the first time in my life I was able to understand the meaning of the words, "The angels are lost in perpetual contemplation of an infinite glory."

Monday, April 14, 2014

The Courage To Be Vulnerable

Consider this article, which discusses how men, because of societal gender expectations of being stoic, strong alpha-males, often hide their mental health difficulties from others in an attempt to appear in control, and in doing so fail to reach out for the support that they need, and see their mental health deteriorate as a result:
One of the things I've found is that men have a difficult time talking about and getting help for their mental health or if they're feeling suicidal. There seems to be some societal pressure that says "You're not a true man if you don't have it all together, all the time."
I would argue this is true, but that it goes beyond men. I would argue that everyone feels that pressure to hide their mental illness from others, along with other perceived deficiencies in appearance, our health, or our character.

There are reasons for this. Mental illness stigma is very present in our society, and we fear we will be rejected or misunderstood by others we care about because of that stigma. More than that, it seems simply human nature to want present ourselves as the best possible version of ourselves. We are inclined to hide our own flaws and issues, partly because in doing so we believe we make others more affable towards us, and perhaps also because in hiding them from the public eye we are able to, in some degree, deny to ourselves that we have them.

Hiding one's personal struggles is not always a bad thing. In some situations, we do need to keep our problems, mental health or otherwise, hidden from other people. We feel little to no compunction to hide family stresses or financial difficulties at work, in a business meeting, or when we are giving a speech, if for no other reason than that we would expect the same of anyone else in such a situation. Too often, however, this is stretched to our friends and loved ones, and we feel we have to hide our struggles from them as well.

Time and again I have seen people, even those who have experienced mental illness in the past and gotten help for it, afraid to disclose their current struggles. I myself have been guilty of that sometimes--if I think that I have been generally improving, and then I have a bad depressive episode, there is a powerful fear that my recovery has stopped, or that I will go back to feeling worse. Never mind that I've had such feelings numerous times before--and that very often every depressive episode can feel like the worst one--I feel like I can't let anyone know, for fear of frightening them, or for fear of admitting to others and to myself that I wasn't doing as well as I thought I was, or that by simply talking about it, I will make myself worse by acknowledging it.

The result is that I keep my struggles balled up inside of me, trying to fix them myself so that no one else can see what I am struggling with. Sometimes I end up managing whatever problem I'm having and get better. Other times the problem continues to gnaw away at me until I have no choice but to make the problem becomes visible on its own--often in the form of a breakdown.

But when I do open myself up to others, very often I find the reaction is not a pushing away from me (though sometimes that is the case), but an understanding, an acceptance, and a willingness to help. I think something we forget about a lot of times when we are considering hiding our problems from others is that our loved ones do want to help us. They want us to feel good and be happy, and they want to contribute to that. While we might be worried about burdening them with our own problems, often times it can make them feel good because we've exposed our problems to them, and let them into our inner world so that they can help us.

Obviously, this does not apply to everyone. For people who have unhealthy relationships, relationships where the other person routinely demeans them and makes them feel bad about themselves, or otherwise constricts their ability to live a healthy life, telling such people risks causing more harm than good. The very foundations of those relationships aren't built upon a desire to help us in the first place. And of course, there is the recurring fear that even if we do reveal our problems to people who love us, that they will dismiss our problems and, though they do not intend to do so, nonetheless hurt us.

And unfortunately, they might. There are no guarantees. Some people may believe that we are overreacting, or being self-centered, or whatever the myriad of other reasons people give for why mental illness isn't mental illness, or why our problems don't matter. To some degree it's fear of thinking of someone they love as being one of those oft-maligned stereotypes they see in the media, as well as numerous other reasons I don't feel I have the understanding to talk about. They may turn away from us, or dismiss us, or even think less of us. We can't control that.

Nonetheless, very often letting others in to our own issues provides a way for us to get better. It allows others to understand how we are struggling, and understand how their own behavior affects us, and try to better accommodate us.  It allows others to give us advice, and opens us up to new perspectives which we may not have thought about, either because it was simply something we hadn't considered or because we were so distressed we didn't have the breathing room to consider other options. Sometimes just knowing that others know, and understand to some degree, is comforting and therapeutic on it's own, making us not feel so alone.

In the end though, we can't be certain how another person will react. And since most of us are used to hiding our problems inside ourselves for quite some time, it can be very difficult to open ourselves up, to show ourselves at our most vulnerable and able to be hurt, and ask that others help us.

Some may consider keeping one's internal problems wholly inside themselves a show of strength, but I would argue the opposite--hiding one's troubles is a sign of fear. Fear of appearing weak. Fear of having loved ones think poorly of you. Fear of thinking poorly of yourself.

A greater show of strength is one which emphasizes that we are not nearly as strong as we'd like to be--that we are flawed human beings, and we need other human beings to support us.

I am talking about the courage to be vulnerable.

I am talking about the courage to open oneself to other people, flaws and all, and risk being hurt by them. Not because you will be hurt, but because by doing so you allow them the opportunity to help you, and to connect with you in a deeper way. You show to yourself that you are willing to take a risk, in the hopes that you will get better.

It is not easy to say to another person, "I have a problem", but it is so crucial for us to do that. There are some battles we cannot always fight on our own, where we need the love and support of someone else to get us through it, and the only way they can give us that love and support is if they know what we are going through.rld

Monday, April 7, 2014

Healthy Body, Healthy Mind

Today I am depressed.

The cause is relatively easy to fix, fortunately, but in the time I have it, it's a real pain to manage. I did not get enough sleep last night. I elected to watch videos on youtube when I should have been going to bed, and as a result I went to bed later and woke up intermittently throughout the night. When I woke up, I struggled to go back to sleep. I became anxious about whether or not I would fall asleep, what would I do during the day if I couldn't fall asleep now, is thinking about this keeping me awake for longer, and so on. Once I had woken up, I should have gotten out of bed, had something to eat, and taken a Xanax to quell the anxiety, and I might have salvaged a bit more sleep than I did. Alas, I did not, and this is what I have to show for it.

The result was I became depressed. Obviously, I was tired. I felt reduced motivation to work, and what work I did do was filled with a low but present sense of dread. When I was left with idle thoughts, I felt empty and the future seemed bleak. At one point I had thoughts of suicide. They were ill-defined and fleeting, quickly rejected after a few seconds, but for a period of time, however short, they were there.

I eventually remembered to use the techniques I had learned for myself to allay the depression. I began by turning off the melancholy music I was listening to (not surprisingly, Copeland is a bad choice to listen to when you're already feeling down), reminded myself that the feelings I was experiencing were transient, and even started to count the windows on nearby buildings to distract myself, which oddly enough ended up being the most helpful technique.  I pushed through that part of the day, and for a period of time my depression lessened and enabled me to better get work done.

As I write this, I am still tired, and as a result, still feeling somewhat depressed. Hopefully I will get a good night's sleep tonight, and will have learned an important lesson for the future, but for right now, I just have to grit my teeth and slog through the rest of the day.

In the meantime, my experiences today seem like a good jumping-off point for discussing a part of recovery discussed less often than it should be, and that is general physical health and how it relates to our mental health.

As I said, I have little energy today, so in lieu of much more introduction to the subject, I will simply throw some articles at you.

"Nutrition can play a key role in the onset as well as severity and duration of depression

"People who exercise regularly have positive boosts in mood and lower rates of depression"

"Sleep Therapy Seen as an Aid for Depression"

On reflection, these results seem obvious. Of course being well-fed, healthy, and well-rested makes us feel better. What's surprising is how deeply such healthy habits can affect us. When I don't eat enough, I become anxious. When I exercise regularly, I'm left with a glow that stays with me throughout the day. When I don't get enough sleep, as has been seen today, I suffer for it.

A few weeks ago, for whatever reason, I hadn't eaten enough in my meals. I was participating in a class project that afternoon and was becoming increasingly distressed and depressed. I doubted my ability to perform the tasks required of me, and wanted to leave class early and retreat to my room. Acting on that feeling, I went to my teacher and told him how I was feeling, at the time hoping he would see how I was struggling and give me his permission to go home.

Instead, he suggested I eat a protein bar. I did, and almost instantly I felt better, and went at my tasks that afternoon with a vigor and excitement that just a few minutes earlier seemed so foreign to me. Was some of that placebo? Probably. But all of it?

It's important to realize that depression is not only an illness that affects the brain. It is an illness which affects the whole of our bodies. Yet at the same time, by bettering our bodies, we contribute to the bettering of our mental health as well. Medication, therapy, and social support can all be very helpful, and in some cases crucial, to our recovery. It's important we don't disregard how our overall health can affect us as well.

Monday, March 31, 2014

An Argument For Hope

Late last year, I said you can get better. I argued this from a logical and evidential perspective. But I realize that such arguments alone can often be insufficient. Each of us views our situation as unique, because it is. When we are in the throes of depression or other mental health issues, we come up with our own, personal reasons for why statements like "you can get better" don't apply to us, that even the hardest of evidence cannot overcome.

I am not going to try to convince you out of that, because it is not a belief based in logic and evidence, so a logical and evidential response does nothing. Instead, I am going to argue why it is so necessary to believe that you can get better. At the end of this, I do not expect to convince you that you can get better. Believing that is your own choice.


At its core, recovery has a foundation of hope.

Hope is often viewed as a sketchy thing. It is, by definition, not based in a rational view of the world. Which is not to say that it is irrational, but that it has its domain in the realm of the future, whose outcome we do not know. We can guess what might happen, and sometimes those guesses can be very well-informed, but in the end, we're still at the mercy of uncertainty.

Uncertainty is the killer for many struggling with their mental health. Faced with a great unknown, our first instinct is to assume failure. We assume based on past experiences, past sufferings. We think to ourselves "things have been bad in the past, and things are bad now, so things will be bad in the future".

Recovery is about taking that line of thinking and rejecting it. It is about saying "things have been bad in the past, and things are bad now, but that does not mean they have to continue to be bad".

At any point in our life, misfortunes can occur. We can make mistakes. We can suffer tragedies through no fault of our own. We can face setbacks. At the same time, there is potential for our lives to improve. We may face an unexpected windfall. We may make the right decisions that pay off. We can better ourselves. Both outcomes are possible. They are not equally likely, but they are possible.

"You can get better" is a statement of faith. I say that not in a religious sense. I am not advocating for or against any belief system, save the one that says we can have a better life than the one we have at this moment. "You can get better" is making a statement about the future which we do not know, and cannot verify. It does not change the world. But it can change ourselves.

We can, if we so choose, believe that the worst outcomes will happen. We can believe that our lives will continue to stay bad, or get worse. If we do that, we run the risk of resigning ourselves to that outcome. If we believe that things will get worse, we deprive ourselves of motivation for trying to improve, because what is the point of trying to improve if things are only going to get worse? In that sense, believing things will get worse becomes a form of self-sabotage.

If, on the other hand, we believe that things can get better, we open ourselves to the possibility that they will. We direct our actions towards that possibility. Medication, therapy, improving our financial and social situation, these all become routes towards that possible bettering. They can help, because we believe that they can help.

Believing that things can get better does not mean that we are opening ourselves to false expectations. It does not mean that we are deluding ourselves that our outcome will be perfect, that we will achieve a utopian existence or some form of enlightenment. It doesn't mean that solutions will be easy. Such beliefs are as based in poor mental health and an irrational view of the world as the belief that we will only get worse, and is often the root of pseudosciences and scams that threaten to derail recovery attempts.

Recovery is long and it is onerous. It is not a straight road but a winding one full of potholes and detours and the risk of sudden mudslides. It involves trying out different medications and different therapists. It is about taking risks and taking the sometimes unpleasant results that come from those risks. It is about getting hurt, and moving on from that hurt.

If we go on that path, there is no guarantee that we will get better, because no guarantee exists. If we do not go on that path, however, we will most certainly not get better, because we did not even try.


So here is what I say:

I cannot make you believe that you can get better. There is no argument I can give that is so logically perfect that everyone will be convinced by it.

But I can say it, and you can choose to believe it.

There are no guarantees. There never are. Countless things can happen. But if you don't believe that things can get better, there is only one outcome.

But if you believe that things can get better, things can change. You open yourself up for the possibility of getting better.

I am talking about making a leap of faith. I am talking about putting your trust in a future you do not know. I am talking about believing in something even if you do not know that it is true. Not because it is true, but because you can gain so much by believing it.

I cannot say that you won't be hurt, because you will be. I cannot say you won't make mistakes, because you will. Life is hard. Life is full of struggles. This is as true for you as it is for everyone else.

What I say is that you can get better. You can still make it through.And you can choose to believe that.


Teaching Hope - A short overview of a Positive Psychology-based definition of hope and the benefits of health

The Wills And Ways Of Hope - A longer article describing hope and it's numerous benefits.

Monday, March 24, 2014

The Importance Of Other People

Isolation does not mix well with mental health. Often mental illness can leads to ourselves spending a lot of time alone. Sometimes this is because the very effects of our mental illness make us not want to spend time with others, or enjoy spending time with others less. Sometimes this is because the content of our thoughts can be so strange and frightening that we feel like a pariah, and isolate ourselves from other, "normal" people, who we may be afraid of hurting, or afraid they may notice how we're feeling and avoid us.

Everyone is alone sometimes. Sometimes we need to be by ourselves for a while. For people with good mental health, being alone is not that much of a problem. For someone who struggles with mental issues, excessive isolation can be very problematic.

We are social creatures. Most of us thrive and depend upon the companionship of other people. We enjoy spending time with them, and they help us feel loved, and valuable. Often, they help keep our demons at bay by their presence alone, their own voices counteracting our own self-critical or otherwise problematic voices.

In the absence of people we can enjoy ourselves with, the only things we have to keep ourselves company are ourselves. And sometimes, we don't give ourselves the best company. Critical and negative voices in our head routinely attempt to beat us down. Obsessions make themselves known in our idle thoughts. The sheer knowledge of our own loneliness folds in on itself and makes us hate ourselves for being alone. There is a reason that lack of social support triggers suicidal thoughts, and that is because when we don't have other people who by their very presence counter the assertions of our own negative thoughts as being alone and unloveable, it becomes more and more attractive to believe those negative thoughts are true.

There are some people who may be reading this and feeling upset. They are currently alone, or believe themselves to be alone, and hearing about how loneliness can worsen one's mental health may send them into negative thought spirals that in turn leave them feeling worse. It is important to note that I discuss this not to condemn those feeling alone to more unhappiness, but as a reminder that their mental health can be very much improved with the presence of others.

And there are multiple opportunities to connect with other people. We may be away from our friends, but we can meet and talk with new people. There are events going on around where we live, and even if there aren't, or none of them appeal to us, there are a wide range of communities online, filled with like-minded people whom we can spend time with. I say this knowing that some of my closest friends are people I met, and know primarily, through website forums and Facebook. Sometimes, the sheer attempt at connecting with other people can be helpful, because it acknowledges to us that we can work to change our situation.

That said, while relationships with other people are very helpful, some are more helpful than others, and some are not helpful at all, or even harmful. acquaintances who continually drain our energy (and other resources), who denigrate us or otherwise make us feel bad about ourselves, who fail to accept us for who we are, and who routinely violate our trust are all relationships that can take a toll on our already taxed mental faculties. Some acquaintances may not believe, as many people in our society do, that we do not have mental health issues, but that we are being "weak" or "selfish". With these people, it is best for us to keep ourselves at a distance. We need not necessarily end a relationship entirely, but we must learn to set boundaries that prevent them from hurting us.

Of course, even when we know our mental health can be improved by spending time with other people, it can be difficult to do so. We may have negative thoughts that lead us to believe we won't be able to enjoy ourselves with them, or that they won't want to spend time with us. Very often, this is not true. Very often, this is the result of our mental illness, and we need to fight against that. We often need to push ourselves into those social situations, even when we don't want to, or feel like we can. Often we surprise ourselves.

Though it may sometimes be hard to see, a great deal of our mental health is in our control. We can choose what we do and how we spend our time. We can choose to spend our time in ways that helps us get better. Spending time with other people, people who make us feel good and loved, is one of those ways, and may be one of the most crucial.


Further Reading

Social Support Is Critical For Depression Recovery

Monday, March 17, 2014

The Magic Cure

Not too long ago, I was convinced that by switching degrees, maybe even switching colleges, I would no longer be depressed.

The reasons at the time all came across as very logical to me: I was struggling with relationships among people of my own degree, and at my own college. I felt increasingly cynical about my degree, wondered if it would provide the career opportunities I wanted from it, if it would satisfy me. I became increasingly fearful that if I pursued this degree at this college, I would be unhappy and a failure.

In the light of that, the idea of transferring to another college to pursue another degree seemed attractively simple. From my perspective, the career prospects were better. I would be better fulfilled on this career path. I could get along better with the people pursuing that degree. I would succeed and be happy.

Then I told my therapist.

He pointed out to me that, in my enthusiasm for transferring, I did not think about the finer details. What sort of courses would I take? Would some of the courses I take be ones I would struggle with? I would be going to a new community surrounded by people I did not know. Even though I struggled at my current college, there were people there who knew and liked me. How would I deal with the isolation of being a second year transfer? Was I even fully aware of the demands that this career would have on me?

I hadn't thought of any of those things. As my therapist laid out these options everything became darker. Everything was frightening again. Everything was uncertain. And as I became more frightened and anxious, I realized just how fragile the illusion I built for myself had been. And it was an illusion. It was not a possible choice motivated by reason and contemplation, but by emotion and desperation. It may very well have been a good move, but the way I was thinking about it was not.

It has been almost a month since that episode. I am significantly calmer, and more at peace with my current choice of career and college, though there is still that uncertainty, which may indeed never go away. The problems I struggled with that motivated me to consider switching colleges and degrees are still here, and with time dulling the frenzied emotions, I recognize that even had I transferred, many of those problems would not go away, because those problems are in many ways internal, and very deep-rooted. I was searching for a solution that could come from outside, instantaneously, and easily.

I had been searching for a magic cure.

We've all searched for magic cures at some point in our lives.  They can be hard to identify at times, but a good identifying mark is the phrase "if I just".

"If I just read the right book about dealing with my depression, I'll get better."

"If I just have a relationship with this person, I'll be happy."

"If I just leave home and go to college, all of my problems will be solved."

I have had all of these thoughts. Ultimately, I could either not achieve the "just's" I set for myself, or I achieved them and discovered they did not "just" solve my problems like I had hoped. I scoured countless advice books looking for that one bit of golden cure-all, and came up short. The relationships I wanted did not come about. I went to college, and discovered I had the same problems I did in high school.

That is not to say that such things were or would have been useless. Much of the advice I've found in my searching has been useful in learning how to cope with depressive episodes. Relationships can be fulfilling and its players mutually supportive of one another. College took me out of the stagnant environment of my then-current state as an unemployed high-school graduate and gave me direction in life and motivation to pursue that direction. They did not "just" solve anything, but they did or could help to push me towards better mental health.

Magic cures need not necessarily be about trying to change. Magic cures can also be about staying put and waiting for whatever problems to pass. This can be seen in abusive relationships, where battered victims tell themselves that what's happening to them will past, that their loved one will become nicer, or that the things making them angry will end. Magic cures are about achieving massive results without making ourselves too uncomfortable.

The problem with magic cures is not that what we're thinking as magic cures can't be helpful. They absolutely can. But when we view them as easy cure-alls, they encourage us to think they are all we need to do, and often that they can be done easily and quickly.

We underestimate the amount of effort that goes into them, and threaten to go into them ill-prepared for what we would face. If I actually went through with changing colleges without taking into consideration the things that my therapist pointed out, I would have been blindsided by them, and that could have made my depression worse.

We may feel like we can abandon other, more difficult tasks of self-improvement out of the belief that our one magic cure is all that we need to get better, and as a result we can obstruct our own recovery. They provide us a false hope that will only lead to disappointment when we discover our problems are more complex than a single act can solve.

More than that, magic cures can be dangerous. Magic cures often appear as some major shift in lifestyle or behavior, such as quitting a job or moving to a new town. They are attractive because they allow us to think our problems are caused primarily by external, passing things, rather than something more internal. And sometimes that is the case. An abusive and restricting household, for example, can cause a great deal of misery, and leaving that household for a more stable one can be helpful. Yet other times, we change places only to find that our problems have not disappeared but moved with us, and we are without the old support systems and coping techniques we had before.

The fact is, we can get better. But for most of us, it is not through a single act, but through a series of acts, performed consistently, sometimes begrudgingly, that bring us closer and closer to where we want to be. It can be difficult, but it is not impossible. To get there, we have to expend a lot of time, a lot of energy, and have a lot of hope. When we see something, anything, that promises to solve all of our problems, with seemingly minimal effort on our parts, we threaten to deceive ourselves, and obstruct our own recovery.

We must continually look for ways to get better, but sometimes we need to take a moment and ask ourselves what exactly we're looking to get from our decisions. We must make sure that we are not putting all of our hope in a single option, but continually looking to improve in as many ways as we can. Similarly, we have to be sure that when we make our decisions, we do them from a point of reasoned consideration, not one motivated by emotion alone.

Monday, March 10, 2014

Dance Alone Will Not Save You: What Silver Linings Playbook Gets Wrong About Mental Illness

Let me begin by getting this out of the way: The Silver Linings Playbook is a nuanced and sympathetic portrayal of the mentally ill. At parts.

For those who are not familiar with the film, The Silver Linings Playbook is about a man named Pat who struggles with bipolar disorder. Estranged from his wife after he had a violent episode upon discovering her with another man, he has spent eight months in treatment, and is now looking to reconcile with his wife despite his wife having moved on. On the way, he meets a woman named Tiffany, who also struggles with mental illness. They gradually grow closer together through their shared neuroses, and engage in a kind of social therapy through practicing together for an upcoming dance competition, yet Pat still struggles with his interest in Tiffany and his refusal to move on from his wife.

Had the film stayed like this, it would have been fine. The film contains stories which many of us can relate to. Stories of people who struggle with mental illness, stories of their family who struggle with their struggles. It makes headway by having a mentally ill protagonist who has been violent who is not defined by his violence and mental illness, but rather that it is one of many issues he struggles with, along a sense of abandonment, refusal to let go of the past, and a fear of further failure.

The problem is that, while it is many ways respectful of mental illness, in many ways it is also misleading, dishonest, and in some cases outright disrespectful of people with mental illness and the struggles they go through."

Here are the three big problems with Silver Linings Playbook:

Mental Illness Becomes "Cute"

Since at least the time of "One Flew Over The Cuckoo's" nest, mental illness has been shown through a distorted, saccharine perspective, portraying those who have it as quirky or creative "free spirits" rather than sufferers of the debilitating and destructive force that mental illness is.

Pat often behaves in a very childlike manner, getting easily distracted and having over-the-top reactions to circumstances. He speaks in a fast-paced and stream-of-consciousness style, and while such a speaking style is a symptom of mania among people with Bipolar disorder, the film often focuses on it for comedic effect. Even though the disorder that leads to him acting like that is the same disorder that leads to him throwing a book out the window after he disagrees with how it ends.

Pat's father's OCD manifests primarily as an interesting quirk, mostly involving him having specific and arbitrary rituals while watching the football game. In reality, OCD in its most severe forms is extremely debilitating, and often those with it feel a compulsion to perform their ritual tasks over and over again even when they know they should not, and they often feel as if they have no control over much of their own lives. And while that shows up to some degree after the Eagles lose and Pat's father becomes very distressed, for the most part that harsh reality is downplayed in favor of portraying OCD in comedic terms. Even when Pat's father's OCD results in him betting all of his money on the outcome of the dance competition/football game at the end of the film, the ramifications of his untreated OCD are glossed over and it instead becomes a problem for Pat and Tiffany to solve.

What's odd is that these moments of "quirky" mental illness appear alongside much more nuanced and realistic portrayals of mental illness. The film that has Pat suffering a mental breakdown in the attic while his parents desperately try to soothe him is the same film where an increasingly irate and distressed Pat becomes immediately calm when he is distracted by his friend giving him an old Ipod. Pat's rapid stream-of-consciousness speaking exists alongside his unrealistic and damaging goals he sets for himself. Yet in both cases one of the situations is played for laughs while the other is viewed with concern, as though they were not both root of the same problem. The result is an inconsistent and overexagerrated portrayal of mental illness, where the viewer cannot always tell what is actually true mental illness, and what is exaggerated for filmic effect.

Most of the Mentally Ill Characters Are Violent

For a long time, films have portrayed the mentally ill as violent. We've all seen episodes of crime procedurals where the culprit is a someone "crazy", with untreated (or in some cases, treated) mental illness). While Silver Linings does take steps to not define the mentally ill characters by their violence, and humanizes them, it nonetheless portrays mental illness, for the most part, as accompanied by violent behavior.

Pat is sent to a mental health facility when he beats up the man his wife is having an affair with. Pat's father has a history of violence. Tiffany slaps, shouts, and destroys tableware over the course of the film. The one mentally ill character who is not violent is Chris Tucker's character, yet he has very little screen presence in the movie. 

In reality, most people with mental illness are not violent, just as the majority of the general population is not violent. In fact, people with mental illness are far more likely to be victims of violence than perpetrators.

In fairness, violence is prevalent throughout film and television, not just in those with mental illness. It's an easy, concise, and visual way to make conflicts more interesting. It becomes much more palatable to show a divorced couple battling over alimony, for example, if you include a knife fight between their lawyers. Yet while in such a scenario that violence can be more easily accepted as Hollywood exaggeration, because we know such scenarios aren't so violent in real life, with mental illness it becomes much more problematic because many of us don't have those real life scenarios to compare it to. The end result is people see those crime procedurals, those murder mysteries, and even this film, with mentally ill characters that are violent, and they conclude that mentally ill people as a whole are just as violent. 

The Ending Ignores The Mental Illness of the Characters

The most damning part of the film, however, isn't how it portrays the mentally ill and their issues, but how it sweeps those issues under the rug in favor of a typical Hollywood happy ending.

While the first two acts of the film  have been about how Pat and Tiffany grow closer to each other and struggle with their mental illness, the third act of the film is about how the two have to work past their issues to score a five in the dance competition. At the end of the film, they score that five, and Pat and Tiffany become a couple, and the issue of their mental illness is not brought up to any significant extent again.

One of the possible themes for this film that I've heard is "Anyone can find love, even broken people and misfits", which is a good sentiment and all, but the film does not support that. Suppose you knew two people in real life, both mentally ill, who became a couple. Suppose they struggled with their mental illness and how their mental illness affected each other. Suppose that, instead of focusing on treatment and therapy for their illness, they instead invest their time and energy into winning a dance competition, and put any thoughts of therapy or treatment out of their head for the entirety of the time prior to this dance competition.

We would say they were ignoring the larger problem.

That's exactly what this film does. It ignores the larger problem of these characters and their issues. Both characters are still suffering from untreated mental illness (I say untreated because, though both characters take medication and therapy, the film downplays this and neither therapy or medication seem to have a substantial effect on their well-being), and the ending of the film implies that they will be in a closer relationship with one another. As anyone who has been in a relationship with someone with untreated mental illness knows, the effects are hard enough when there is only one person. Indeed, we've already seen this in the film with how Pat's wife had a restraining order put on him. The effects are multiplied when both people are mentally ill. These are two individuals who do not know how to cope with and control their mental illness, and both have a tendency for exaggerated, violent outbursts. If their story continues as it had, their relationship will end, and none of the possible endings will be happy. 

It could be argued that the film isn't about providing a true portrayal of mental illness, that it is about other things.  Yet if that is the case, why include mental illness? Is it meant simply as an interesting backdrop to a different story? Does mental illness deserve to be used as the backdrop to a story, especially when the film does not show a full understanding of mental illness?

Or does it turn mental illness into a caricature? Does it narrow the perspective on these people and view them solely in relation to other, more "important" issues? If a film uses something only to do a disservice to what that something actually is, it shouldn't be using it.

Monday, March 3, 2014

I went four days without Prozac. Here's what happened (and thoughts on taking medication)

This is a picture of my hand.

Note the torn skin. That is the result of when I had my fist tightened for thirty minutes on Tuesday.

I was immensely distressed at the time. To give context, I had an essay paper due on Thursday. 10 to 12 pages, double-spaced. I had six pages, and at the time, I could not figure out an additional four. On a large scale, such a problem is relatively inconsequential, and normally I'm sure I would have figured out a solution.  Yet I could not get my worries and frustrations out of my head, and it led to this, along with an impulse to self-injurious behavior (head hitting, scratching, etc.). There was a period of time where I broke down crying for upwards of half an hour.

For greater context, I had run out of Prozac several days prior, and this was the day I finally got a new batch. It took another two days before I was back to normal.

I don't think it's a stretch to believe that this was caused by me running out of my medication, and that it ended in part because I got back on it.

The effects of medication differs for each of us and for every medication. But if we are taking medication it is imperative that we stay on it, unless our doctors tell us otherwise. We cannot know the proper effects of our medication unless we are taking it properly.

That said, there are many concerns and fears about taking medication that I feel should be addressed. A lot of them are addressed very well in this New York Times article, and I would encourage everyone with concerns about medication to read it. I cannot add any further to it except in terms of my own experience.

It can be difficult to ascertain the effectiveness of medication in your our life. In part because if things are going well, we often don't think to reflect on why they are. When I found out I had run low on medication, I was initially unbothered by it. I thought I could easily manage without it, in part because I had been so used to living with medication, that I couldn't imagine being without it as well. Yeah, I was wrong.

I'd had similar events in my past, where I thought it wouldn't be a problem to go off of medication until I initially went off of it. Thankfully it's resolved within a few days after I return to my medication, but it helps to remember that I am taking that medication for a reason.

When I was without Prozac, a lot of anxieties I had prior were magnified to a great extent. My future shortened before my eyes the more I thought of it. It says something that when I called my therapist during distress, that when I got to that I had been several days without Prozac, he emphasized that part above all else. And for good reason. Medication is integral to my continued mental health. It is not for everyone, but it is for me.

A few final thoughts on medication. I'd like to point out that two very common problems with medication. that of forgetting to take it on schedule, and of forgetting to refill it. Here are solutions that have worked for me:

With forgetting to take medication on schedule, it helps to place your medication in a place see every day. On a bathroom cabinet so that you see it whenever you use the restroom, for example. Or on a kitchen counter so you see it when making meals. For my part, I take my medication in the morning, and put my medication on my dresser so that I see it when I get dressed. Similarly, daily alarms can also be useful for remembering when to take medication.

With forgetting to refill medication, it helps to leave reminders ahead of time. My prescription needs refilled every ninety days, so I set a reminder for myself that after two months I am alerted that I need to refill my medication, and then take the steps so that it is refilled on time.

Finally, many people concerned about medication are worried about the side-effects of medication, and that it may not be effective. It is important to remember that medication is effective for a significant number of people, and you may very well be one of those people to whom it can benefit. The only way to find out is by taking it as prescribed by your doctor.

As far as side-effects go, it is very easy to find a list of common side-effects to medication. Remember that taking medication doesn't necessarily guarantee any or all of the possible side-effects. Even if you do have side-effects from the medication, that does not itself mean it is ineffective, or that you shouldn't be taking the medication. In some cases, it is a matter of balancing the benefits and drawbacks of the medication and determining whether or not you are willing to take the side-effects in exchange for the benefits.

Again, consult your doctor before taking any medication. And consult your doctor if you are thinking of making changes to your existing medication. Medication can be very useful in helping us get better, but it is important to approach medication as informed as we can be.

Monday, February 24, 2014

A Self-Therapy Session: Asperger's, Relationships, and Self-Loathing

This blog has served multiple purposes for me. It has helped me to make a difference in other people's lives by showing solidarity with their struggles, showing that they are not alone. It has similarly helped, or at least I hope it has helped, to destigmatize depression and mental illness as a whole. Additionally, this blog has helped given me a foothold into mental health advocacy, and it was through the publishing of this blog that I was able to later give two speeches to two different middle schools about my struggles with depression.

But what has helped me the most in the publishing of this blog has been the therapeutic effect it has had on me. Through this blog, I have been able to expose my vulnerabilities, and in doing so, heal them. By communicating my own struggles to others, I also communicate to myself that it is ok to have these struggles, and to not be ashamed of having them. I destigmatize the struggles not only to others, but to myself. And I can not overstate how valuable that has been.

Today I am exposing another of the vulnerabilities, and a complex one at that. It's one I know many young people struggle with in one form or another, but in which I seem to be on one of the tail ends of the bell curve, out of the area where they resolve naturally with time but continue to remain, sometimes coagulating and leaving scar tissue behind, sometimes festering, and sometimes doing a twisted mixture of both.

I wrote the majority of this at 4 in the morning, after a bad cold has kept me awake for three hours so far. Excuse me if I get a bit sentimental.


A friend of mine recently came to me with wonderful news: She had begun dating someone she had been interested in for a time. To hear her talk about it, he's attractive, interesting, intelligent, everything she wants in a relationship. They'd gone on their first date a few days prior and when we talked about it later she was glowing. At that moment, she felt like she was on top of the world.

And yet I was upset.

When I heard about her having such a successful relationship, I felt something, I wasn't sure what. Jealousy, perhaps. Or resentment. I was upset because she seemed to be looking at the start of a successful relationship and yet I was still single. Aside from one troubled two-month relationship the year prior, I have always been single.

At this point I find myself struggling to find a balance between a balanced analysis of my feelings and falling into indulgent self-pity. Perhaps it is hard to escape that latter aspect of it. It hurts, to put it simply. It hurts to not have someone I can be so intimate with, to put my trust into so fully and see that trust reciprocated. I know that no relationship is perfect, and that a relationship will not solve all of my problems, but it nonetheless feels like something I am missing.

I can't speak to the legitimacy of that feeling. Many people are happily single, and to some extent I am content to be single as well, and have time to focus on myself and myself alone. I am hesitant to try for relationships because I know of how much of a commitment it is, and I'm unsure if I want such a commitment now.

But then that hurt.

There is a part of me that thinks I cannot have a relationship. It is a small part, and getting smaller as I get better, but for now it is still there. It took form in High School, and it was caused mainly by my Asperger's Syndrome and my difficulty with properly expressing and controlling my own feelings. Twice I had really good friendships. Twice those friendships developed into feelings for the other person. And twice those feelings led not only to no possibility of a relationship, but it led to the friendship as a whole falling apart.

I will not be ambiguous. This was not a case of incompatible personalities. If that is anything it is a distant factor. This was the case of me, and my issues, leading to the erosion of possible relationships and fulfilling friendships.

Both followed a similar pathway. After a certain point I realized I was interested in these friends romantically. Yet, mainly because of my Asperger's Syndrome, I did not know how to express that. So I expressed it with extra attention to the person, keeping in constant contact with them, and of course, obsessing about every little action they took in relation to me.

With the first person, in freshman year of high school, this manifested through making sure I sent them a text message every night, and worrying if I did not get a response back.  I greeted them every day and said goodbye to them everyday, and panicked if their response was tepid or otherwise subdued. I would try to talk to them as much as I could in between classes, and strained trying to figure out the right words, the right sequence of syllables, that would make things work out.

With the second person, which happened when I was a junior and she a senior, it was mainly an overbearing anxiety that clouded all of my interactions with them. I worried constantly that I had said or done something that would not only bother them, but would irreparably damage our relationship. I would take them aside and ask them, again and again, if I had done something wrong, convinced that I had, and time and time again they would say I did not, that I was fine. I didn't believe them. And the next week I would be there again, asking if I had done something wrong.

You can imagine the toll this took on the both of them. They naturally retreated from me, and because they retreated, I panicked more, and tried all the harder to hold onto what seemed to be slipping through my fingers. And because I tried all the harder, they moved away all the more. The end result was two people who did not talk to me, ignored me, and tried to keep their distance from me as much as they could.

I got a happy ending to one of these. A year after our problems in freshman year, I and my friend managed to reconcile and become close friends. I helped her through some tough times, and she helped me through some of mine.

The second time was not so lucky. We never reconciled. She stopped responding to my messages over Facebook. I had to unfriend her so I would stop seeing her on my newsfeed and getting upset all over again. Then I had to block her so I wouldn't see her in the search bar when I typed in names. Even just a mention of it would bring the memories and the hurt flooding back.

There are many ways things could have been different. If I had therapy that helped me to address these problems earlier. If they were more aware of my own personal struggles and knew how to respond to it. None of these matter. I lost a wonderful friendship, and to this day it remains a barely-healed wound, waiting for something to trigger it--a dream, resurgence of an old memory, saying her name--and reopen it and bring those feelings back to me again. Sometimes I still feel the urge to send her another message, because a part of me still believes we can be friends again. But even if she would respond, I wouldn't recognize her as the person I knew those years ago. It's been over three years since then, and we've both changed far too much. I don't send her those messages because I want to be friends with who she is now. I send them to her because I want my old friend back.

I did this again in college, nearly did it another two times, saved only by my developing restraint and the charity of the other persons. With all five occurrences came anxiety, depression, and mental breakdowns. It's not hard to see that a lot of the self-loathing and relationship issues I struggle with now came from these events. As I saw these relationships fall apart in front of me, I felt a sense of powerlessness. I knew, partially, what I was doing, and what it was leading to, but at the same time I couldn't stop. I didn't want to do it, but I didn't see what else I could do. In my warped perspective, my only option was to continue my flawed reasoning, and hold onto increasingly fictitious hope that there would be a happy outcome out of it.

I felt broken. I felt like I was dysfunctional in a fundamental and unchangeable way. In my mind, when I became too invested in a relationship, it would inevitably fall apart. I could not be happy, because I would sabotage my own happiness. I still deal with these feelings nowadays, and I don't doubt it has hindered recent attempts and considerations for relationships, along with a whole host of other things. Helpfully, though, I have not gotten to the point of losing relationships this way for a time. Perhaps I'll get my one-year pin soon.

There is a happy ending to all this, two of them in fact. One is somewhere in the future, when I've gotten better enough that I can let go of these problems, where the issues become so small they no longer hinder me like they used to. The other happy ending is simply I'm getting to that happy ending. Slowly, and in fits and starts, but I'm getting there. I'm improving, and will continue to do so, so long as I continue going to therapy, take medication, and look after my body both physically and mentally.

For now it hurts, and it will hurt in the forseeable future. Perhaps it will never stop hurting. But that doesn't mean I can't get better. Because I am getting better. I know it's something I say over and over again, but it is true. I am getting better. It's a slow process, and there's a lot of problems to wade through, but I am getting there. And it's posts like this that help with that.