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Showing posts with label mental states. Show all posts
Showing posts with label mental states. Show all posts

Thursday, May 29, 2014

I Turn to My Readers for Suggestions



No one seeks out depression, especially in the springtime, when our world seems at last to be coming back to life after its long, cold sleep. But depression doesn’t need to be sought: no, it comes unbidden and unwelcome. And making it go away again can be extremely difficult. I’ve been thinking about this because people important to me struggle with the problem. Maybe you do, too, or someone you know does. Is there anything we can do to help?

One of my natural first thoughts was to survey books on the topic, but that’s not as easy as one might think, either. The authors of one site I found had done the same thing and concluded:
On [sic] the main ... we are disappointed with the majority of books on depression. They fail to distinguish between the different types of depression. They waste valuable space debating whether depression is a "disease" like diabetes or a problem of adaptation and poor coping skills. For us, the answer is that depression is a syndrome, with many different causes and solutions.
Well, fine, but then I looked at their list of books and found myself still disappointed. What I really want to do is throw the question “out there” and ask you
Is there some particular book on depression and/or bipolar disorder that you have found especially informative and/or helpful? 
You needn’t be depressed to weigh in on this question, and you can register your comment as “Anonymous” or even send it to me in e-mail, if you’d like.
Here’s another question: 
If you are sometimes depressed, is there anything you would like friends to ask or say to you during those times?

As for me, here’s what (little) I know from my own experience:

1)  Depression is not “feeling sorry for yourself.” If a depressed person could “snap out of it,” he or she surely would. In fact, the burden of what I think of as meta-depression can exacerbate the problem, as a thoughtful person compares his or her life and problems to those of others and thinks, “I shouldn’t be depressed.” Depression is not a matter of should or shouldn’t.

2)  Neither is it true that “everything is relative” because all personal experience is absolute. We can observe other people living their lives, but the only one any of us lives is our own. The only life any of us knows “from the inside” is our own.

3)  Depression is not “all in your head.” Depression is an overwhelmingly physiological experience, as much as a state of mind. During the winter of my worst and longest depression, I could only sleep two to three hours a night and would awake feeling encased in a suit of dread from head to toe. Every day and every night were draining and exhausting.

4)  There is a lot a depressed person can do to try to push depression away, but no cure is guaranteed to work. Exercise can help. (I forced myself to go to the pool three mornings a week.) A cheery environment can help. (I repainted a dull beige room a light, sunny yellow.) It’s a good idea to see a doctor. (I did.) Prescription medication helps some people. (I tried it for a while.) “Getting out of the house,” yoga, meditation – all are good ideas. Talking can help. But nothing is a guaranteed, instantaneous cure.

5)   You cannot assume that someone who continues to be depressed is “not trying” to feel better. You may have no idea how hard that person is trying or how many things he or she has tried and is continuing to practice. Second-guessing and guilt-tripping a depressed person for being depressed is no help at all.

I’ve numbered these as if they are separate “points,” but it should be clear that they are all interrelated.

A big problem with Internet “research” is that so much of what turns up in search results comes from people with something to sell, whether it’s a book or a pill or a program. When I remembered that NIH is my go-to for general health questions (thus avoiding sites focused on sales), I turned to NIMH to see what they had to say about depression, and right away I found it more helpful:
Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors. 
Depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred [emphasis added]. They also cannot be used to diagnose depression.
 To me this is helpful not because it claims to have all the answers but for the clear statement that answers are elusive. The brain of a depressed person looks different, but the difference does not reveal the cause. Is it situational? Chemical? A symptom of some other illness? Brain image can’t show answers to these questions.

Every generation, it seems, has its popular answers, but there is still so much we don’t know. 

Monday, March 18, 2013

To Worry or Not to Worry, and If Not, How Not


Today’s topic: WORRY! Why do we do it, and how can we stop? I will be very interested in responses on today’s post (if anyone has the patience to wade through the whole thing), not just agreement or disagreement, but additions, clarifications, problems, alternate hypotheses, or whatever else comes to minds.

Thesis: Worry Is Superstition

I have done more than my share of worrying, starting in childhood, but have cut back considerably in recent years. Lately, instead of worrying so much, I’ve been thinking about worrying and its role in our lives, trying to figure out what function it could possibly play — other than the very important function of getting us to take preventive and remedial measures when a problem presents itself -- and what I’ve come to believe is that we worry so much because we are superstitious.

Positive changes that worry can spark, such as changing one’s diet or wearing a seatbelt or getting enough exercise or paying bills on time, are excellent reasons for initial unease. What I’m talking about is the needless fretting we continue to engage in when we’ve done everything we can possibly do — or, worse, instead of taking positive steps to eliminate the cause for concern. Do this thought experiment: Separate worry from the action it prompts. Imagine yourself taking the logical course of action but still worrying. Why? How can worry possibly add anything to the elimination of the outcome you dread?

“I can’t help it!”

I don’t know about you, but I don’t want to be a slave to worry any more than I want to be a slave to anger or fear or alcohol or caffeine or credit card debt. Saying “No, thank you” to worry, though, isn’t as simple as turning down a beer. This is part of what prompted my thinking about the problem. (Think, think, think, think.... Maybe I should start again?)

Again, the working hypothesis I’ve come up with is that the base of worry is superstition. If you are skeptical, please play along with me a little further.

Superstitions are interesting in themselves, persisting in the most educated of countries and individuals. Why do so many tall buildings lack a designated thirteenth floor? There is no reason other than superstition about the number 13. Note that numbering the floors of tall buildings only occurs in  cultures usually considered, in other ways, “advanced” – no buildings that tall in so-called “primitive” communities – and yet the superstition persists in a very powerful way. 

Here’s how The Encarta World English Dictionary associated with my Word program defines ‘superstition’:
1.    an irrational but usually deep-seated belief in the magical effects of a particular action or ritual, especially in the likelihood that good or bad luck will result from performing it  2.   irrational and often quasi-religious belief in and reverence for the magical effects of certain actions and rituals of the magical power of certain objects
So worry, as I’m seeing it, is a mental ritualWhen we worry, we vividly imagine exactly the outcome we fervently wish will not come about. But why would we do that?

Let’s look at an example. A common response to a medical diagnosis is “How much should I worry?” or “How worried should I be?” The question is asked in all seriousness – and let’s think about that for a moment. The patient is not asking how many ounces of water he should be drinking every day or how much time she should put into an exercise program or what medications are indicated or any number of questions that would make perfect sense, but what portion of mental energy should be devoted to worrying. The more you think about it, the stranger the question becomes. The patient is seeking to proportion worry to the seriousness of his or her condition, as if the mental activity of worrying will have some beneficial effect on the physical condition. The issue here is not what the patient should do, faced with the diagnosis. That is a separate and perfectly rational question.

As I try to tease apart this mystery, it seems to me that we hold a vague, unconscious, and unreflective belief that by worrying we feel we are making time payments to ward off future disaster. Pay now, play later! The focus of a worry, remember, is an undesirable outcome (or, all too often, multiple undesirable outcomes on a variety of fronts); thus worrying is suffering in advance that we feel should be subtracted from the outcome. If my hypothesis is correct, this same unconscious belief explains our worry over loved ones, as well. If, for example, I worry myself sick over my son’s late return home, I am paying the price that might otherwise have to be paid by a terrible accident befalling him. Or so says my superstitious belief.

Here is how we might articulate the underlying, unreflective, usually unconscious line of reasoning in the case of the patient in the doctor’s office:
1. A condition or situation calls for my attention.2. Worry is a form of attention.3. The correct amount of mental energy devoted to worrying, therefore, will help to bring about a positive resolution of the condition or situation.
How many of us, if asked to defend pointless, distracted fretting, would make such an argument consciously? And yet, how else to explain the dysfunctional distraction and the pointless, narrow focus that goes way beyond constructive action and can very well get in the way of constructive action?

Is It Possible to Stop Worrying?

“Don’t worry about it!” Easier said than done! There must be something in the evolution of our brains that pulls us toward the narrow focus when we feel threatened. Focus on a problem, after all, can show us possible courses of action. So there is the old evolutionary answer to the Why? question. Worry, however, can just as easily get in the way of productive thinking, or persist beyond productive thinking and constructive action, and in that way it works against us rather than for us.

So yes, I do believe worry is natural -- and yes, I also believe it is a waste of energy. What’s the answer then? Are we just stuck in a bad evolutionary design? Is there no way out of this dilemma. Help!!!

Awareness is the first step to changing any habit. Since focus is the problem, then, it seems clear that the next step will be to shift focus. How to make the shift will vary from one individual to another. Chop firewood? Meditate? Visit an elderly neighbor? Walk the dog? Dive into a remodeling project? The possibilities are endless. Sometimes just sharing concerns with a trusted friend weakens worry’s grip on imagination. Reality check!

When are you most vulnerable to worry? For me, it strikes hardest and worst in hours of darkness, in the middle of the night. I can lie still and keep my eyes closed and try to get back to sleep, but when worry is too strong I might just as well get up and out of bed. Sometimes a cup of cocoa and a book will relax me. Spending the time I wouldn’t otherwise have had on a writing project can turn sleeplessness to good use. Anything productive, even sorting laundry, is better than being paralyzed – because worry does tend to be paralyzing – and I’ll feel better just getting up on my feet.

When morning comes, a new course of action often reveals itself. Physical movement plus daylight jogs my brain, and I see a path hidden to me in darker hours. Then, if there’s something I can see to do, I do it, and if I can’t see any course of action to take in the worrisome area, I turn my attention to something else. Sometimes, after all, the worrisome aspect of life cannot be removed, but at the very least, if worry continues to sit like a cold stone in my heart as the day progresses, I can still get a few things done and feel better for having been productive, getting back my sense of agency – because it is the powerlessness of worry that is most distressing to me.

Looking to friends or family members from worry’s paralysis, we can all too easily perceive absence of worry on their part as absence of caring, seeing the distraught parent or friend in hysterics as more loving than the calm provider of mundane necessities and comforts, but “You should have been more worried about me!” is an accusation born of superstition.

Are you pleased when others worry about you? Do you feel that worrying about others shows you care? What about that vague feeling we almost never quite see clearly, that by worrying for a loved one we are doing something to bring about a positive outcome for that person? 

Non-Worry

Here’s where I have recently come to a radical shift in my own point of view. Just as worrying about myself can imprison me negatively and get in the way of constructive action or healing or simple enjoyment of each day, I have come to believe that worrying about those I love is also a mistake and not good for them. Now, instead of showing and expressing worry, I seek to convey non-worry.

Does that sound heartless? Non-worry is not indifference. It is not telling a sufferer to “buck up and take it like a man” or “Stop whining—everyone has problems!” It is not—and I want to be very clear about this-- giving advice at all. It may accompany advice, if sufferer and comforter have that kind of relationship and wisdom, but non-worry may also be completely wordless.

Here’s an example: I was visiting a friend in the hospital and was present when she had to endure a painful blood draw. My old self, empathizing with her pain, would have clenched muscles in sympathy. I would have held my breath, my face showing nothing but worried concern. Would that have helped my friend? Would it have lessened her pain? Instead I tried something different, an idea came to me on the spot, and this is the first time I’ve told anyone about my what I did. Instead of tensing, I focused on relaxing my own body – hands, arms, breathing. What I wanted to do was to send calm to my friend. Moods can be contagious, I reasoned, and rather than add to her tension and fear, my aim was to reduce it.

Did it work? I have absolutely no idea. But could it possibly have made her pain worse? I don’t see how.

Not a Permanent Cure

What about falling back into old superstitious mental patterns? Well, of course! Over and over! Eating and sleeping and housework, mowing the grass and weeding the garden, all have to be done over and over – why should it be different with habits we want to conquer? Falling down isn’t the end of the world.

I will never be immune to worry. These days, though, acute episodes of short-lived panic (!!!) are a far more common feature of my mental life than endless days and nights of fretting. An unpleasant surprise or loss of control or difficult decision can throw me completely (if briefly) off-balance. But at least I will not be chewing it over endlessly and sinking into a bottomless pit. Anyway, if worry were a savings account, I would have millions in the bank by now!

Is that superstitious? To think I have a huge worry savings account? I said IF it were! If I’d had this insight at age 25, I don’t think I would be the poorer now for it.

But what do you think? Does my hypothesis of worry as superstition make sense to anyone else out there? Someone near and dear to me, a champion worrier, remains unconvinced, so I’m interested in what others think.

P.S. Can you tell by the length of this post how much worry I had to ward off???