The Human Brain and Mental Health Issues

I consider myself a bit of a smarty pants when it comes to the human brain. In fact I think I'm a bit of a genius when it comes to the human brain and some of the stuff that can go wrong up there but I don't have the time or space here and now to establish why I believe that, I trust that it'll be self evident when I finish writing all my thoughts on it. Anyway, that's a major, major work and for a possible future day.

When I started researching mental health issues at the beginning of this year I quickly discovered, and quite rightly as I'll demonstrate (again in the future), that the "white coats" in mainstream psychiatry are, to sum it up rather ineloquently, morons. Backwards, ill-educated, unscientific, rote thinking morons. Their "ideas" for mental health problems are at least five decades behind most recent research. I have such little time and respect for them that I'm not even sure that I want to bother explaining how they're morons. It's not that some of them aren't well meaning enough, but their backwards ideas of medicine remain what they are - unscientific, disproved and out of date. I think my time, and yours, would be much better served by furthering my studies and writing in what really counts but the sad truth is that many lives are ruined - every day - by those in the psychiatric "profession". So my thinking is that if people are to discover a better direction - and there most certainly are better directions - they'd best understand that the direction that is currently in vogue (and it is little more than that, just "in vogue") has to be exposed for what it is and what it is is a sham. Once I discovered that, I began looking elsewhere and that elsewhere is neuroscience. I became deeply, deeply interested in neuroscience. This, I saw, is the future. This, I saw, was where the hope for those with mental health issues lies. And the funny thing is that when you have a manic mind (the ability of a manic mind to work at ridiculously high levels is well documented) and a deeply curious mind and highly motivated mind, it'll absorb, assimilate, learn and create knowledge extremely quickly. Which is why I think I'm a smarty pants genius. And why I think you should listen to me when it comes to understanding all this stuff (the fact that I have myself as a study model is also reason for this). But anyway.

The point here wasn't to blow my own horn, the point was to introduce my good readers to some basic facts on the human brain.

The brain remains truly one of mankind's greatest remaining frontiers. But this is only if we include space. I'll argue (elsewhere) that is THE greatest frontier. And as mysterious as the human brain, the biological organ, is, the human mind is even more mysterious. The former is the field of neuroscience, the latter the field of psychology. [you'll note that I separate the "brain" from the "mind". A key feature of mine. You'll also note that though I included neuroscience and psychology, I left psychiatry out of the party. This was no accident.]

Evolutionary biology is – give or take – four billion years old. Millions and millions of species have come and gone in that time. All the while, life forms have continued to evolve. As life forms evolved, sensory and other organs evolved and improved. Organs to process oxygen, organs to circulate blood, the organ known as skin, organs to process food, organs to filter toxins, organs to make and distribute various body chemicals and hormones, organs of sight, sound, smell, touch and taste. All these organs evolved and improved for one reason and one reason only – to help any given species to survive and thrive in whatever environment that was, or is, dominant at any given time over those past four billion years.

When we look at the organs of the species we have on the planet today, anyone with even a passing interest in biology, or nature, has to be amazed. The sight organs, the eyes, of eagles which can spot tiny prey from great altitudes in the sky or the osprey which can spot fish underwater and adjust for the illusion of light refraction on the water's surface. The olfactory organs, the noses of bloodhounds (and most breeds of dog), a million times more sensitive than those of their human counterparts, able to sniff out the faintest of scents and trace elements of a dizzying array of substances. The auditory organs, the ears, of whales and elephants which can hear signals from their mates many, many miles away. The internal organs, while simpler, are all wonders of nature as well. How lungs can draw in air and separate life giving oxygen while disposing of fatal carbon dioxide. Amazing! How the organs of the digestive system manage to process what we humans and domesticated animals toss into it and extract everything we need to grow from a newborn into a healthy adult and all the other calories, minerals and vitamins necessary to keep us going along the way. Incredible! Just think of how these and all other various highly developed organs in the animal world have evolved over billions of years.

Yet as amazing as all these organs and their evolutionary history are, NOTHING on the planet compares to the human brain. It is far and away the most complex organ four billion years of evolutionary history has produced and witnessed. Now you may argue about what the human species has done with that brain but there is no argument against its superior complexity.

I think the brain of any species is a wonder to behold. How, for example, do the brains of certain swallow species process the information that allows them to navigate thousands of kilometers each migration season between the southern and northern hemispheres? How do the brains of orcas process their migration information (with all the factors such as food sources and birthing areas) and social structures and language? And look at the complex calculations many monkey species have to make as they navigate swinging through jungle forests not to mention their fairly evolved social structures. Cognitive science research into the brains of many animal species shows that much basic animal behaviour has many similarities to human intelligence. And sure some of these things can be chalked up to instinct passed on genetically, but more recent research has shown that a lot of this is learned behaviour that has to be modified over time and from year to year and communicated among a given pod, or flock, or group.

But whatever impressive brain functions that we can find in the animal world – and they are many and they are complex – absolutely nothing compares to what the human mind can do.

From the amazingly precise control over and training of our physical abilities in complicated, highly organized sporting events (not to mention the complex social organization required to compete as units of many people), to the strategizing required in games like chess and go (let alone those required in wars and major businesses), to conceiving of and composing great musical compositions and novels, to predictive abilities, to conceiving of and designing highly intricate and novel machines and systems, to conceiving, discovering and comprehending amazingly complicated math and science formulas that help us understand space and time (and to even conceptualize concepts such as space and time), to the incredible social and logistical organization of large cities ... we could go on and on. The abilities and accomplishments of the human brain are truly astonishing.

But those are just the “tangible” accomplishments of human brain power. The human mind is a whole other matter. This is what really sets us apart from other species. How do you explain human belief? The human spirit? The human soul? (we will set aside, for now, the beliefs of some that all living things have souls. The science on this is very incomplete and there's no tangible way to measure these things outside our own species. Whatever the case, I don't think there's much argument about the human soul being a far more complex concept) Our sense of self? The human languages? The ability to appreciate the arts? The ability to conceptualize what we cannot see? The human imagination? (which is the springboard of all the accomplishments listed in the previous paragraph) The complexity of human emotions and moods? The complexities of human sexuality? We're the only species that has taken sexual acts far and away from it being a simply biological and instinct driven function. How do we explain the wondrously mysterious human subconscious? All these intangible things seem to go beyond the “simple” biological nature and make up of the brain. How do we account for these things in the human brain? How do we explain the mechanisms for these? Science has only gotten as far as identifying the systems of the senses, motor-sensory control, where thought occurs, memory, language processing and so on. Correct me if I'm wrong, but I don't think neuroscience has discovered the mechanisms for our deeper (and unique, I'd argue) human functions, those of the human mind.

The human brain is made up of one hundred billion neurons and one hundred and fifty trillion synapses. There are one hundred thousand kilometers of wiring in the human brain, enough to stretch more than two times around the earth. Even with the most sophisticated brain mapping techniques currently available (and there are some impressive ones) and more than a century of scientific examination, we are just beginning to comprehend how this fantastically complex organ works.

One amazing discovery about our brains (and this applies to all species' brains) is its “neuroplasticity”. Neuroplasticity means that the brain is not, as long believed, set past a certain age. It can grow and contract and change form pretty much up to the day we die. It can, in effect, “rewire” itself to meet changing conditions and environmental stimuli. This was actually discovered in the late sixties by neuroscientists such as Michael Merzenich. This concept took decades to begin to reach mainstream neuroscience because of initial outright hostility against the idea from localizationists. Localization was the long head belief that brain functions were strictly localized and once the part of the brain for a particular function was damaged, that was it. But discoveries over the past five or six decades have shown that brains can actually adapt new functions in “out of the way” locations to make up for damaged areas. This is very exciting news for all kinds of rehabilitation projects – including, I believe, mental health issues (we will investigate this more in later chapters).

So not only is the brain an amazing organ in its original form, we can perform mental and physical exercises that will actually reshape the brain and allow it to rebuild or repair lost functions.

But as amazing as the brain is and as amazing as some discoveries are, the brain remains our most sensitive and least understood organ.

Those one hundred billion neurons communicate with each other through those one hundred and fifty trillion synapses through neurotransmitters, neurochemicals such as glutamate, norepinephrine, dopamine, serotonin (among others). There are hormones that play strong roles. While the roles of many of these transmitters have been basically identified, it seems their exact functions – how they actually make all those amazing brain functions of ours operate - remains a little beyond our understanding at present. The research shows many exciting discoveries and theories but it remains short on conclusive facts showing clear functionalities and mechanisms let alone explanations for the unique mind of humans.

And to further get an idea of just how vast the "inner galaxies" of the brain are, this is how it was explained by neuroscientist Dr. David Eagleman. This is, as he puts it, a “look under the hood of the brain”.

“When we look under the hood, what we find is the most complicated devise in the universe” and “it contains tens of billions of neurons” and then “each neuron is as complicated as the city of San Diego” and “these are packed together in such density that they have hundreds of trillions of connections between them.” 

You think that's something? It gets better. 

“So what this means is if you were to take a cubic centimeter of brain tissue, you'd have as many connections as there are stars in the milky way”. 

To but that in perspective, let's attempt to scale that up to the full human brain. The average brain weighs three pounds, in there there must be ... well, my math isn't that good but you can kind of imagine if you look in the mirror and guess how many cubic centimeters of brain matter you have and then multiply that by stars in the milky way. There isn't, as Dr. Eagleman goes on to say, a number in our mathematical language to express how many stars that is. 

Repeat, a cubic centimeter of human brain matter has as many connections as there are stars in the milky way.

So this is what I read. This is what I study. I follow the work of some of the top neuroscientists on the planet and there is not a one of them that will look you in the eye and tell you that they even remotely understand the human brain or mind. Which, coming back to my original point, is why psychiatrists are morons. They can - literally - have no idea what's going on "under the hood" of the human brain. None of them (at the street level medical treatment level) study the brain to that extent. Yet they attempt to "fix it" with simple concoctions of chemicals. Brain damaging chemicals (which is not opinion, but fact proven in long term studies using the most advanced brain scan equipment).

And here's the other point - if anyone thinks that among those billions of neurons, trillions of synapses, the hundreds of kilometers of wiring and among the hundred or so neurotransmitters and hormones that make it all that stuff "tick" that shit isn't going to go wrong, well, godspeed to you. It's a miracle - a literal miracle - that more stuff doesn't go wrong up there. And the point of this is that there are people - many of them, trust me on this - that doubt mental health problems. Sometimes, honestly, I want to poke people's eyes out. But of course I don't. 

So this is what we're looking at. The most complex structure in the known universe. And stuff goes wrong up there. And here's the kicker - no one, literally, knows why or how it goes wrong or how to fix it. Whatever mental health problem there is, it takes place in that organ I just described. Which is, as you can see, "complicated". So no, psychiatry does not have the answers. Not even close. 

But there's hope. I think. Maybe. Keep on reading. 

[final note - I apologize once again for formatting issues. It always happens when I cut and paste into the blog posting box. Fiddling with such things to the point of perfection just is not one of my greater priorities right now.]

A Few Thoughts

A few thoughts as I prepare to enter the hospital again.

One,

Returning to the hospital is to help stay alive. I simply cannot trust my own mind. There is darkness and then there is darkness no one can understand who hasn't either gone over the edge into death or has been right on that edge. I push it back, I push it back - I've been pushing it back for a long time now - and right now I just have no more push left in me. More on this another time. I also know what suicidal psychosis is like, how capable my mind is of having an episode and how little control one has over over psychotic episodes. Once my mind goes far enough down a certain road then I have very little control over that. Secondly, unlike before, I am losing crucial internal connections that keep me from allowing those forces to take control over my mind. In the past I could fight it off (with what little control I had left). Now the essential connections - what I call "anchors" - are disappearing which means I'll have less desire and ability to fight off the episodes when they strike (I describe this in The Inferno - A Psychotic Episode). Thirdly, I can find little desire in my heart to go on at all. No one has the right to judge that, I'm afraid, as much as there are those that think they do (which is mostly grounded in sky God stuff, which is of no interest to me). The will or desire to live is for each person to square up within themselves. I wrote a bit in some other posts why this is but I'm too tired to look them up or link back to them.

Anyway, there are things I'd like to do before that happens so I need the safety of the hospital for now.

Two,

I have to repeat and make clear that this is not the "illness" or the "the disease taking its natural course" or any of this other nonsense you read or hear from so called "experts" in psychiatry. I beat much of the illness and put much of that behind me (again, I've touched on this in prior posts). No, this is more about life winning. I fought life and lost. Life is doing this to me, not the "illness". Suffering from bipolar certainly helped grease the skids and is part of what made life difficult but what is happening today is a psychological side effect and not the illness of bipolar per se. I feel this is crucial to understand (and which I'll tell the docs in the hospital when they try - as they certainly will - to "treat" the "illness"). So for those that know me and my history with the "illness" of bipolar, no, it's not that. I'm handling that. It's what I described (in prior posts) about life difficulties that is doing me in.

Three,

That aside, my brain IS broken. I can't argue against that, obviously, only in why it's broken. I think I could, with some freaking breaks from life and some actual family support, unbreak my mind but at this point I think that may be a very large boulder to push uphill. And the truth is that I am, after all I've been through the past five years, just plain plumb tuckered out and too exhausted to push that boulder uphill. I think this is true for many (most? all?) people who battle this and succumb - in the end they're just too exhausted to fight it anymore. What I've "been through the last five years" (and much of the previous twenty) may not look like much to most. Or all. But this is irrelevant (and always the problem with those going through suicidal forces). It has nothing to do with what people can see on the outside or how "difficult" one person's life is compared to another's and everything to do with the person on the inside. But this is something I'll explore more another day. But basically it's a broken brain vs life. And life often wins.

Four,

It's hard for anyone who knows me, or has known me, to accept that I would want to die. I appear "cheerful" and "happy". And I am - much of the time. It's that corner over there <points to dark area of the mind> that's the problem. Just because I hide it well doesn't mean it's not a problem. And this is true of many people who kill themselves (either outright or slowly through drugs and alcohol). Look at John Belushi. Or lots of funny people. Happy and funny on the surface, miserable and lonely beneath it. I also appear to be "smart". Sorry, but "smart" has nothing to do with it. Lots of smart people have killed themselves. I think we could agree that Ernest Hemingway was pretty smart. But he killed himself. I could fill a book of examples like this. This is NOT something you can "out-smart". So no, being "smart" and looking "happy" have nothing to do with it. While I may appear to be "high functioning", there so happens to be some stuff under the hood that's very low functioning. But that's just the way brains roll. Work well over here, totally broken over there. What you see is what you get. I'll speak more about the human brain later.

Five,

Society and its inability to handle anything regarding death is a huge part of the problem. And not just with me specifically (though it undeniably is part of my problem), but with suicide and mental health disorders in general. For death I place the blame firmly at the feet of the cultures of sky gods. Ostensibly meant to "ease" our minds about death, religions - all of them - have instead created nothing but mass fear and ignorance and it is that fear and ignorance that further pushes one towards the edge. But I could - and will - fill several very long essays on that subject so I can't go into detail on that here. Yet non-religious people have equal difficulty it seems and that appears to be nothing more than a maturity issue. I think people are becoming less mature and able to deal with any serious issues regarding any terminal illness. So they just avoid it all together. I have lots to say on this as well which I'll address in essays in my other blog. Bottom line though is that society utterly and completely fails almost anyone dealing with suicidal issues. Including, very often, the mental health "care" system. But this takes a whole book to address. Briefly though, psychiatry is literally at least five decades behind in understanding how the brain works. Honestly. Do any research or study into the latest findings on the brain and then research mainstream psychiatry's understanding of it and their "treatment" methods based on that understanding and you'll see that psychiatry is stuck at least five decades in the past. Which is to say that if one is facing "will to live" issues, they don't have a lot of choices. Or hope. Which is why suicide  - which I believe should be the most preventable cause of death -  is one of the fastest growing causes of death.

Six,

This has nothing to do with anyone else. It's not "choosing" to hurt people or being "selfish" or any of that other nonsense you hear or read. This is a huge part of the ignorance that exists. Please, don't be a part of that ignorance. Other people's rash personal emotions and fearful ignorance is just a big part of the societal goo that makes things worse.

Seven,

There is hope. As long as a person is still drawing breath, there always is. There are of course success stories. How little or much of that there is for any one person is part of the issue, however. Just defining hope is an issue. And part of the problem. What YOU see as "hope" may not exist in the person at all. That's how minds work - they perceive things differently. But yes, there's a possibility I'll discover hope again but right now I'm just all fresh out of hope. I've built up and explored more avenues of hope in the past several years than China has tea and it always vanishes. So right here, right now, the little "hope maker" part of my brain is all worn out and broken. Maybe it can be fixed with a stay at the hospital, maybe not. But since it's not over over yet - I'm still drawing breath, after all - yes, the chance for hope still exists.

The Art - and Pain - of Letting Go

Some of my posts are written to be of a general educational nature and some are of a personal journal nature. This post is more of a personal journal nature, to tell my own story and what I'm currently experiencing at any one point. But we can learn from others and from that standpoint I still consider it to be educational as well.

Where I was going with the previous posts The Psychology of Bipolar - Loneliness and Isolation and Blue Footed Boobies, Guano Rings, the S word and Isolation and Loneliness is that when you are battling mental health problems and/or feelings of suicide, you WILL end up doing so alone, or at least without the support of family and friends. Or maybe not. Most likely. I'm trying to separate my own experience from that of others. One of the things I was most envious about when reading Kay Jamison's  memoir of her battle with bipolar disorder, An Unquiet Mind, is how much family support she got, how much support she got from her colleagues and even how much support she got from lovers. This is very rare, however, as much of my research and study would seem to indicate (as somewhat outlined in the above two posts), and is why I wouldn't recommend her book as a resource. It's unlikely one will get the kind of support she got from family and friends so to read that is to set oneself up for disappointment.

Abraham Lincoln was once suicidally depressed and talked openly about it. His friends formed a suicide watch (this back in the old days before today's alleged "progressive" openness and enlightenment about such issues) and, as history will attest, got him through it.

You assume, hope, that you'll get the same. Nope.

The feelings of isolation and rejection one will likely experience when dealing with mental health issues are many things but one of them, and maybe the most powerful one, is that it is disappointing. The disappointment alone can be crushing.

I'm not sure I'll ever forget - though I know that I ultimately must - the staggering and crushingly disappointing bewilderment I felt when I told my family of my first suicide attempt (which, as I now understand it, was a psychotic episode) via a carefully constructed email. I don't think it unreasonable to expect concern and help. I got not a word from anyone. Not a word, not a mention, not anything. To this day it's never been mentioned. Staggering in fact is an understatement. I'll never understand why no one could be bothered with acknowledging that incident. That incident and the surrounding high level of suicidal danger led to my first hospitalization and there was still not a word. Most could not even be bothered to visit. The pain of that is searing to this day. But, you forgive and carry on, right?

Things improved over the next while and I did get some indications of support from some family, most notably my twin, my sister and my oldest brother. Twin came and got me and accompanied me to the psyche ER for my second hospitalization. Sis visited me quite a bit and brought me books, magazines and newspapers. Twin visited a few times. Oldest brother and I had some good visits about it (though not in the hospital) and he was a very good listener. Of all the family, oldest brother is the best listener. Sis and twin both came through in huge ways when I had no money to pay rent and was melting down because of that. For that I am immeasurably and forever grateful (a friend has come through twice as well). But I was also told, very firmly and sternly, that this could not continue and as well that sis could "not handle this anymore".

I got lots of visits during my third hospitalization as well, mostly from sis and daughter. Oldest brother and his wife came once as well which I found very moving. He talked about helping me find a job which was very buoying to me and gave rise to much optimism.

But as things ground on for me, all this support dried up. No one ever did acknowledge the seriousness of the danger I've been in. It's hard, I know, to watch a loved one go through this. Mental illness sucks for everyone. What sucks most for the one actually going through it, however, is how their family will deal with it - and that usually with denial. When something is hard to deal with, the best way is to deny it and make up some sort of reality in one's own mind that makes it easier to deal with. Great for them, sucks for the mental illness sufferer. And hurts like fucking hell.

Three years on, three hospitalizations and still no actual acknowledgement from any member of the family about the seriousness of it aside from oldest brother.

I was told once by twin brother that this was all a "self directed path to oblivion". I'll never forget that till my dying day. Being told, in effect, that I was just making it all up and "choosing" to do it to myself.

That I have been making it all up appears to be the family line in general. This came to light recently when I was on the edge of despair and felt I couldn't take another step. I sent an email to all my siblings asking that certain things be done should I not make it. The response from sis was that I was being a "drama queen". Twin's response was something similar. Brother number 3 just thought I was "ranting". Brother number 2 was silent as usual. Oldest brother at least called, talked and listened with a sympathetic ear. Again, it was very jarring. "OK", I thought, "they just don't know all the details". So I tried to explain. I wrote several long emails using thousands of words to try to explain the seriousness of it in the best medical terms I could. I tried to explain that according to a professional suicidal danger scale conducted by my therapist that I was in the highest category possible. According to two different professional mental health clinics, I was in such danger that I should have been immediately hospitalized. I tried to explain as clearly as possible the mental illness conditions that I had. I tried to explain the psychotic episodes I experienced and how dangerous those were. I tried to explain seeing hallucinations and getting "commands" to do stuff to myself. I also made it abundantly clear that I could not afford to have people in my life who did not understand my condition and that doing so would only make it worse for me.

Still nothing. Not a word. I spent more than thirty hours in a car with brother number 2 recently and not a word. Not one single solitary fucking word. Brother number 3 still believes I'm just "ranting" and "venting". Twin acknowledged, in a couple of terse statements, that he'd "read" them. Sis presumably, though she was not privy to the emails detailing my condition, still thinks I'm being a "drama queen". But still no word of concern or any inquiry at all into my safety. Not one.

I could not even begin to explain how hurtful this all has been. This is how seriously the danger of suicide is taken by society and family. I'm sure it sucks. Any potentially terminal illness in a family member sucks for the other family members. And the easiest way to deal with it is denial. Just believe it doesn't exist, just believe the person is making it up. Or whatever. I'm tired of trying to figure it out, really fucking tired. I gave the benefit of the doubt before because I know mental illness is hard to understand. But after my detailed emails explaining everything, ignorance is no longer an excuse. No one's ever bothered to learn more about bipolar disorder. No one's ever bothered to learn more about suicide risk in a family member and learn what to do. I get that everyone has their own shit to deal with, I really do, but still, to have all this denied, and worse to be accused of  making it up and that it's just drama making for attention is beyond what I can endure. Why anyone would think that I just made up all of the last five and a half years, and the previous thirty year history of bipolar conditions, for the sake of drama is utterly beyond me.

I know I caused some confusion earlier in the year when I declared that I was "no longer mentally ill" and for that I take full responsibility. I know how much people close to me wanted to believe that. But that was a delusion. I was manic at the time - a "good" mania - and mania can give one, and others, the impression of all being well. All was well - at that time. But when the mania fades - as it always will - and the harsh reality returns it's ... well, back to reality. I know also that I've given the impression that I'm getting better. And I have been, I'm much better than before in many ways. So I'm sure it's confusing to get the different messages. But this is the reality of mental disorders like bipolar and schizophrenia; they cycle, they cycle through times of seeming to be better and then they strike again. A lot of illnesses are like that; they go into remission, everyone breathes a sigh of relief, then they jump up and get worse again. That's the way they go. It'd really help if the family at least made some effort to learn more about my conditions but apparently they haven't. Maybe they have but I've seen no sign of it (aside from oldest brother). If they had, I'd be seeing signs of it like doing the things that are recommended for family members to do.

But when I look at all the literature about bipolar and suicide and the recommendations for family and what to do, my family has done the absolute opposite. They try, I know, in their own ways to deal with it but the actual stuff that's supposed to be done doesn't get done. Just the opposite. Rather than to acknowledge, buck up, be adults and do what's necessary, they've chosen denial and to create their own alternate realities for the situation. They feel everyone has their own problems and that everyone has to deal with their own problems, so to just be a man and deal with my own shit.

You learn a lot about letting go when fighting an illness like this and all the life difficulties it creates. There is so much that I've let go or am trying to let go and now the family is another thing to let go. Maybe the family has a different view of all of this. I have no idea. All I know, or can know, is the pain it causes. The isolation it causes. The feeling of rejection and abandonment I experience. I myself try to deny these things, to push them aside and rationalize them away, but the feelings of hurt are deep and always eventually jump up and bite me in the ass. The frustration of dealing with the family's denial just makes things immeasurably worse and harder. So in the end, I have to let them go. It's easier - and far safer - to put them out of my life, to let them go. When you expect nothing, you experience less disappointment and pain. Attachment truly is suffering. So it's best just to let it go, to let them go. I have to purge them from my memory. Maybe some day I can create new memories, that's up to them. But for now the purge begins.

That's kind of what letting go is - an internal purge. I love my family, it hurts to purge them. But right now, right here, I have to be more concerned about my own health and the pain they cause me. Part of my reality is that right now I'm in danger again (and have been for about a month). I made this extremely clear by email. I made it extremely clear that their ignorance and denial was pushing me closer to the edge and even included all the science on this (i.e. that I wasn't just "making it up"). And yet still nothing. Not a word. Not a single, solitary fucking word. It hurts so fucking bad I can't describe it. I know they don't mean to cause pain but from where I sit it is pain that they cause and I cannot endure that pain any longer.

I don't know how this letting go of family will work. Is isolation harder than rejection (and by rejection I mean their denial and their refusal to deal with my situation)? I guess I'll find out. All living organisms are  designed to avoid pain and humans are no different so I'm just doing what is human. And I suppose that's what they've done as well. This causes pain for them so they avoid it. I guess we all have to let go.

I don't think this is unusual. I think most of us (those with mental health/suicide issues) end up going through the same thing, or at least that's what almost all the case studies I've read seem to indicate. It's a common pattern; end up isolated from family, struggling alone and then, if things go well, finding other people to connect with and with these people perhaps overcome it all. Maybe I can find those people, maybe not. I just know that to do so I have to let go of what I already have.

Blue Footed Boobies, Guano Rings, the S word and Isolation and Loneliness

According to the late evolutionary biologist Stephen Jay Gould, the blue footed booby of the Galapagos Islands does not build a nest in any sense of the word as we normally think of one. Instead, it merely stakes out a piece of ground then squirts guano (bird shit) in a circle and this defines the “nest” (as is so well illustrated above). Blue footed boobies lay one to three eggs depending on the abundance of food supplies in any given year or if food abundance is not apparent, two or three eggs may be laid and the siblings will sort out which gets fed the most if food gets scarce. If food is abundant, all will be well inside the guano ring. According to Gould, if food gets scarce, feedings more infrequent and portions smaller, the older (and larger) sibling will merely push the younger and smaller one(s) out of the nest so as to get more of the pie so to speak. Given that the nest is on the ground and the exiled younger sibling can merely have its parents push it back inside the nest this would not seem to be a problem. But a funny thing happens to the hapless younger booby chick once it's outside the guano ring; its parents will ignore it no matter how much it squawks and struggles. It seems the booby parents have a simple rule; if it's inside the ring, care for it, if it's outside the ring, don't care for it. Though it's only inches away from care, the exiled younger booby will die and none of its erstwhile nest mates will give it any mind whatsoever.

If this sounds cruel, this is merely the way nature works. There are no food stamps in the boobies' world nor any kind of government assistance to pick up the slack when times get tough. Nature then has evolved different ways to make sure the strong survive and the weak get culled out in times of difficulties and it is this deep instinctive process that takes place in the Blue Footed Booby's guano nest. One would like to think that humans have risen above this with our superior frontal cortex equipment and better developed emotional centers but I wouldn't be so sure. Yes, we've created social safety nets and other signs of progressive societal advancement but at our more primitive inner brain centers where most of the deeper evolutionary stuff resides I suspect we're not all that different from our distant Galapagos Island cousins. The way to test this is not by what people proclaim they believe in but in how they act when times are tough. Or when you are mentally ill.

One finds out a lot about human nature when you live with what I euphemistically term “brain wobbles” and “will to live issues”. Brain wobbles are mental health problems (the serious ones, not the many phony ones the APA cooks up for their bible of doom, the DSM) and will to live issues are the “S” word. We can't mention what the “S” word is because no one wants to know anything about it but for those who don't know, it's the act of voluntarily and prematurely removing oneself from the gene pool. People generally frown upon this act. Well, that's a bit of an understatement, isn't it? 

As I started to establish with the post The Psychology of Bipolar - Isolation and Loneliness, feelings of rejection can greatly increase one's anxiety and this anxiety can be so acute that it can trigger further - and perhaps the greatest - brain damage that comes with mental health disorders. I'll need another dedicated post - and help from my neuroscientist buddy Mani Saint Victor - to get into the details of this process. I can tell you, however, that not only is it well understood that stress hormones cause much of the break down of the brain, but that it is feelings of isolation, loneliness, rejection and ostracizing from society that are the source of the process and can greatly exacerbate it. What I want to talk about more today is how people with mental health issues and feelings of suicide will find themselves, like the rejected Blue Footed Booby chicks, outside the "guano ring" of society and that this will greatly contribute to both the course and outcome of their illness and the increased likelihood of carrying out plans or impulses of suicide. 

According to a recent piece in the New York Times,

This trend [of sharply rising suicide rates] is striking without necessarily being surprising. As the University of Virginia sociologist Brad Wilcox pointed out recently, there’s a strong link between suicide and weakened social ties: people — and especially men — become more likely to kill themselves “when they get disconnected from society’s core institutions (e.g., marriage, religion) or when their economic prospects take a dive (e.g., unemployment).” That’s exactly what we’ve seen happen lately among the middle-aged male population, whose suicide rates have climbed the fastest: a retreat from family obligations, from civic and religious participation, and from full time paying work.

 What the Times piece doesn't delve into enough is why this isolation and disconnect is happening. I'd argue, perhaps in more detail another time, that loneliness itself starts to become a mental illness. Once the despair, and likely depression, from long term unemployment begin to set in one begins to withdraw from society. Both the depression, or lowered mood, cause this plus the shame of being unemployed. And of course being separated from employment removes what is most people's greatest source of social life - their work. This starts a long downward cycle of isolation and loneliness for once the person is unemployed and down about it, how society views them begins to change. Society will hold that person in less esteem and it's this loss of societal esteem that will cause the person to withdraw even further. In other words, the person begins to experience the "outside the guano ring" effect, an active rejection by society. 

Society, I can tell you from personal experience, has very little use for the mentally ill. Even a case of depression will get you kicked "outside the guano ring". Take this example from a piece by actress Glenn Close and Queen's University professor  Heather Stuart, overcoming mental illness means overcoming stigma,

When a colleague underwent cancer surgery, she received unprecedented support from her family and friends, complete with flowers, cards and visitors. When she was subsequently treated for depression, everything went coldly silent – not a card, not a flower, not a visitor. When she returned to work, her workmates made it so difficult for her that she eventually quit.

I can't even begin to express how unbelievably fucking typical this is. When you have a "legitimate" disease like cancer, everyone is on board with you. Display a little brain loopiness however, and you'll be avoided like the plague. Or kicked out of the guano nest. And worse, it is this isolation that worsens the condition. There is absolutely no doubt that the warmth of family and friends' support can greatly assist one in overcoming any major illness yet it is this support that is withdrawn from those suffering depression, schizophrenia or bipolar. 

But why is this?

To start, look at how people are taught to view anything negative. There are countless websites that counsel people to kick negative people out of their lives. And it's hard to argue against the reasons for doing this; being around negative people sucks for sure. But the shitty thing for those with mental health issues is that it's really fucking hard to be upbeat and shiny-happy people all the time or, for many, even any of the time. And most people don't need to be taught to reject negative people, they'll do it subconsciously as well. So people with mental health issues are hooped. Just when they need empathy and companionship the most is when they're most likely to lose that and get kicked out of the proverbial societal guano ring. 

The stigma against those with mental illness is strong. It is still viewed by most as a weakness which is not entirely untrue of course. When one is not mentally fit they certainly aren't strong. But it's the belief, the myth, that mental illness is a result of weakness that is widespread. When I was first hospitalized I was told to my face, and with a tone of disdain with the plain implication that I was being a wimp, that I "have to be strong". 

Evolution has an explanation for everything and I believe that people who avoid or reject those with mental health issues are succumbing to the evolutionary forces that exist deep in the brain's limbic system which, to come back to our blue footed boobies, is the same basic system in all animals and all animals have instincts to cull out the weak. We may have evolved systems for better taking care of the less well off of society but people's baser inner instincts will still govern much of their behaviour and that behaviour is to reject and avoid the weak. 

I think it could be argued that people avoid those with mental illnesses like the plague because they think we are like the plague, that mental illness is somehow contagious. Again, this is a deeper evolutionary force that tells us to avoid those who are sick in order to stay healthier ourselves.

Regardless of how or why it happens, societal and family rejection of those of us suffering from mental health issues will exacerbate the issues and this is especially true of those with suicidal tendencies. Between being rejected because of perceptions of being negative and being avoided because they're going through mental health issues this will start a downward and re-enforcing cycle. The more you're misunderstood, the more you'll be rejected, the more you're rejected the more you'll withdraw and the more you withdraw and are rejected the more isolated you'll feel. And this isolation will, as research will show, greatly increase the person's anxiety which will further disrupt brain function which will further grease the skids for the person's downhill slide into suicide.

Update, June 28th, 2014:

I attended a webinar on bipolar on bipolar, suicide and stigmatization. It was put on by CREST.BD, a somewhat interesting department at UBC which studies, according to their website, "psychosocial issues with bipolar disorder". The guest speaker was a Dr Stephen Hinshaw, a world wide recognized and leading authority on stigma and mental illness.

The following is a very brief summary of what I learned regarding the topic of the above blog post - stigmatization against those with a mental illness designation or who are suffering through a period of mental health disorders.

Stigmatization is common throughout the world. It basically wears the same clothes as racism and prejudice (towards minority groups). Much progress has been made over the past five decades or so in reducing these (which is not to say that backsliding is not taking place and that there are not great strides yet to be made. Hinshaw went into some interesting detail on this). However, and this was the main focus of the talk, there are three areas where virtually no progress has been made - no, wait, that's not true, he demonstrated that it's gotten quite a bit worse since the 50's. These three areas are: mental illness, homelessness and drug abuse. These are the three most stigmatized groups on the planet. (and if you allow that to sink in for a bit, you'll begin to fully comprehend the enormous difficulties that face the human souls that are the mentally ill Downtown East Side homeless drug addicts)

This came as no surprise to me as I'm already extremely well read on this topic, not to mention experienced (in the former, not the latter two though it is a very small leap for me to imagine what that's like. I have had a chance to meet many of these people throughout the system and get to know them quite well. Trust me, it fucking sucks. And this is the thing - they are people. People with hopes and dreams and desires just like any of us. But anyway).

But two things that did surprise me was a) the definition of stigma and b) the effects of education on stigma. I knew, of course, about the overt prejudices widely exhibited towards these groups (and Hinshaw's books get into fascinating detail about the history of this).

I had assumed that stigma was just this overt rejection by society. But when I typed in a question that asked for further clarification (which turned out to be the first question addressed in the Q&A following the talk), I was stunned by the response - it turns out that denial is not only a form of stigmatization, but it's the worst and most insidious form of stigmatization. Actually, the answer confirmed a lot of things I already knew, it's just that I didn't quite think of them under the term of stigmatization. This is known as covert stigmatization - and it's worse because people are not even aware that they are stigmatizing against, and thus worsening the condition of, the person with a mental illness designation. 

But 'b' was even more surprising and stunning to me. For eighteen months I've firmly believed - and assiduously worked towards - the idea and premise that if I could just educate people enough about mental illness, they'd be more understanding and stigmatization reduced. This is a massive premise on which my book is based. After all, education and knowledge has been proven over and over and over to reduce prejudice and stigmatization the world over. But it turns out that with mental illness, the more people are educated, the more their levels of stigmatizing behaviour will increase. Study after study after study has been done going back decades (and this is what Hinshaw documents in his books and own academic papers) that people's negative attitudes and behaviours of avoidance increase AFTER they've been better educated about the science of mental illness. 

That's right, the more we try to educate friends, family and society about the world of mental illness and what it's like for us to live in this world, the more stigma, isolation and shame we're likely to bring on ourselves (though of course there are exceptions). 

Pretty much puts us between a rock and a hard place, doesn't it? 

And if you happen not to have a mental illness designation, are YOU guilty of stigmatizing? I think that if you examined your attitudes and thoughts honestly, you'd be surprised to find out "yes". 

Sleeping with the Enemy

I am sure that the term "sleeping with the enemy" has a history aside from that of the (terrible) movie of that name, but my search couldn't come up with it. However, my understanding of it is that it means to be willing "bed partners" with the "enemy" (a rival organization) in order to gain something. This can be seen all the time in business, international diplomacy, the spy game and, well, how many times have we seen a gold digger sleep with (IE; "wed") some decrepit old man in order to get her hands on some or all of his money (hello, overseas brides). It's distasteful but seen as worth it in order to make what's seen as a necessary or desired gain.

I've not told on this blog the story of my experience with the mental health care system since I entered it almost exactly three years ago except for touching briefly on it in The Medication Conundrum. I detail it far more in my book, Dancing in the Dark - Why? If you fully knew the background story, you'd know that to return to the hospital is very much a case of sleeping with the enemy for me. My mental state was far from rosy when I entered the mental health care system in July of 2010 but it really went in the shitter from that point on. There are people, apparently, who do  "well" on medications and those who do not (the don'ts are documented in Pulitzer Prize nominated science writer Robert Whitaker's two books). I was of the latter category with my suicidality increasing while under the care of the system and my mental faculties decreasing which is quite "normal" (meaning the norm) according to Whitaker's meticulous research. (and I will get to in future posts why medication therapy increased my,and many others', suicidality and psychotic episodes)

So why do I wish to fraternize with the enemy, an enemy which just about destroyed me? Well, a few reasons.

First, I'm at wit's end and I can feel the familiar suicidal drive of before returning (and this goes back prior to my first hospitalization so pre-pharmaceutical drug era). I understand this feeling very well and have a strong sense of how much I can control it or not or how much it's beginning to take over my mind. I feel I'm ready to let it take over complete control but not quite yet. So to stave it off for the time being I see no other recourse than to return to the only place that is safe, the hospital. It's not ideal, but I see no other way. It's true that I am in much stronger mental shape than from the past three plus years and am more aware than ever of the danger signs, but I have no real idea how much or little I can trust myself. I just know from much, much, much prior experience that once things get past a certain point deeper forces can take control and then all bets are off. I don't want that to happen - yet. There are things I want to get finished yet so it's in to the safety of the hospital I will go.

Secondly, I will very shortly have no home. I wrote in another blog post, Of No Fixed Address, how I intended to handle this but it does not appear that it will work out as I'd envisioned. This impacts me twofold. One, the stress and distress of this is greatly contributing to my declining mental state and two, well, I really will have no home. I really don't want to live on the streets (or likely out of a tent). I feel I've fallen too far already. So in strictly practical terms, I see it as a warm bed, access to shower facilities and three meals a day. Not only that, but more dignified as well

Thirdly, I have no one to talk to about this. My feelings of isolation and loneliness, the dangers and damage of which I began to touch upon here, are beginning to ramp up off the charts again. This too is greatly contributing to my increasing suicidality. So a couple of things. I've always made friends in the hospital and I'm sure I'll do that again. And they're my kind of people. People who get what this is about. There's no better feeling when going through dark shittiness than to be around peers who get you and what you're going through. Aside from that, there is sometimes very good group therapy available in the hospital. These are valuable, valuable resources, resources which I haven't, despite many efforts, been able to obtain on "the outside" (and the free therapy through UBC is still two months away).

Fourthly, I am still working on my book and would like more details about the workings of psychiatric hospitals and as well I'd like more personal case studies. So I'd look at it as going "undercover" in order to conduct research. Honestly. (my nose for journalism was honed through photography to where I'd do just about anything to get the shot, only now I'd do just about anything to get the story)

Fifthly, psychiatric hospitals in BC always provide on site social services. I hate bureaucracy with a passion and have been loathe to go to the local offices and deal with the distasteful process of getting on welfare (about which I have no choice but the shame and disgust is strong). The hospital makes this process much, much easier and more pain free. Furthermore, this may help better set me up long term with fewer hassles if I can score a long term disability pension out of it. I'd naturally prefer a proper career and income from that but at this point I have to accept the diminished possibility of that. My own mental state is not ready for it nor do I have any reason to believe that any opportunity is going to be afforded me any time soon. So I have do something to secure an income of some kind. Not only that but long term disability pays better than normal welfare and offers other better options as well. So to set up some sort of minimal financial security this is my best - and only - bet.

Sixthly, I'd like another shot at some psychiatrists. My dear readers here have no idea just how well read I am on the human brain, mental health issues and psychiatric medications. Suffice to say that I relish the chance to go toe to toe with the people who so readily and haphazardly attempt to treat the incomprehensibly complex human mind with their simple medications. They'll find me "troublesome" let's just say (and you have no idea just how troublesome I can be). I have, as one example, gone toe to toe with a neuroscientist on this - and won. He was - and I do believe the past tense is correct here - a strong proponent of the chemical imbalance theory of depression and the ability of SSRI anti-depressants to "correct" these "imbalances". We were discussing it (online) and to support his case he sent me some very recent research papers on it. I picked the papers apart and destroyed his position. This caught the attention of another neuroscientist who was reading along (and who I'll introduce later) who's been a very strong ally and research partner of mine ever since. So believe me, not only will I relish this, I'll be well armed. I'll find it highly entertaining. Trust me.

So if I can get in, I'll just game the system for as long as I can. I'll have a place to sleep and stay, I'll have my books to study. I'll have good old fashioned ring binder note books in which to write, pretty much everything I'd hoped to have as I described in No Fixed Address, albeit with less freedom, except I'll have research to conduct and peers to hang out with. It's merely a sacrifice of freedom for security and safety. Not ideal but better than the alternative. As far as the dangers of having to go back on medications go, I'm a pretty crafty old hand at the psychiatric hospital game and have more than a trick or two up my sleeves. Worst case scenario is that I may have to take a mild dose of lithium which is probably the least harmful of their brain toxins, something which I'll be able to handle for a short period.

Dancing in the Dark

Since the beginning of the year, I have been studying mental health issues and as a large part of that, suicide. Suicide is strongly linked to the three most serious mental health conditions - schizophrenia, bipolar and major depressive disorder (I'm not usually fond of most terms and mental "disorder" definitions from the DSM but I think this is an appropriate term as it is a condition quite different from situational depression or periods of sadness). 

I've not learned nearly as much as I'd have liked but combined with my own internal "data" (what I've learned from examining myself), from reading many related research papers and in depth articles (in serious publications, not just in pop media) and dozens of case studies, I'd say I know more than your average bear. There's no doubt in my mind that suicide is a form of insanity or it is for a least a large percentage of people (by this I exclude those that end their lives to escape terminal illness or the ravages of old age). If one is of reasonable physical health and under the age of about sixty to sixty-five, it is not a sane decision to end one's life.

The brain - any brain - is largely governed by subconscious forces and mechanisms. This is well understood in neuroscience, psychology and psychiatry (though there is considerable controversy and disagreement over whatever amount of "free will" we may have). The subconscious is a hodge-podge of instincts and "auto-programs" that run most of our daily activities. These happen below our conscious thought (and, most would argue, direct our "conscious" thought itself). One of the strongest of these subconscious instinctive forces is the one of self-preservation. 

The human, or any animal, is wired to do anything it can to live and not to die. Even the brain mechanisms of the simplest life form have simple senses to avoid danger and premature death. To "choose" death then is a very abnormal act. Something at a deep fundamental level of normal brain operations has gone terribly wrong. When a fifteen year old girl hangs herself with her whole life in front of her, it is not the act of a sane person but the act of a person who's been driven by forces of some kind to insanity. The brain has broken down and is not functioning as it should. Just as murder is sometimes an act of insanity, the taking of one's own life is an act of insanity.

The road to suicide can appear to be a quick one or a long one. Some would seem awfully quick. Think of someone who experiences sudden financial ruin,"snaps" and then commits suicide (people jumping from their office towers after the crash of '29 for example). For others the struggle with thoughts of suicide can continue for years before they  finally succumb. I call this latter struggle "Dancing in the Dark". The struggle is like a dance between sanity and insanity, or a dance between life and death, pain and pleasure. Darkness is the darkness that the mind finds itself in. Somewhere in the darkness there is an edge and over that edge is death. It is impossible to know where the breaking point is, the point that will push one over the edge. Why this time and not a year ago or two years ago? Who knows? The only ones with the answers are already over the edge and can no longer tell us.

Suicide is incomprehensible to 99.9% of people and even that may be a low estimate. Given how common suicide is this strikes me as surprising but there it is. I've struggled with Dancing in the Dark for many years now, have seen a baker's dozen of psychiatrists, spent dozens of hours in therapy, been hours in group therapies, taken oodles of medications (to worsening effect), spoken openly about it (or at least have written extensively on it) and yet here I still am, Dancing in the Dark once again. That nobody understands it - and I am emphatically including the mental health "profession" here - is, to me, part of the problem. It was a big part of my drive to research and better understand it.

Like all mental illnesses, there is no one size fits all explanation and this is part of the problem with the mental health profession's inability to effectively treat it for many people. Everyone's brain is different, everyone's life circumstances are different, everyone's pain tolerance is different, what causes mental pain and anguish for everyone is different. Why some of us are driven to this is as individual as the person. Why some people can overcome it and others can't is as individual as the person. Whatever it is, a searing unbearable psychic pain will be at the center of it. I think David Foster Wallace may have described  it best,

"The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.”

Jim Morrison said something similar,

People fear death even more than pain. It's strange that they fear death. Life hurts a lot more than death. At the point of death, the pain is over. Yeah, I guess death is a friend. 

And this is where I once again find myself. Here, today, the last two days, this is where I find myself. Ironically, I don't feel "ill", or at least not as bad as I have in the past. In some regards my brain is working better than ever, something I'm thrilled with. But there are other factors. And while over here my brain is working very well, over there I can begin to feel it working very not well. I  feel sane over here, insane over there. It's a dance between sanity and insanity, a dance in the darkness and I can sense that the edge is near. 

What to do about this insanity?  What haven't I done? 

What would really help is for life to work out. While "depression" is part of my mind set right now, I wouldn't compare it to some of the depressions I've suffered in the past and it is not like the abject darkness and incapacitated states of a manic depressive episode. It's just the fact that my family is breaking up, I've had no steady job or income for five and a half years, I have no more money, I will have no more home and face homelessness and I've battled severe mental illness for much of the past five plus years. So yeah, you might say I'm a bit down. And worse, I'm all out of plans. I've been through plans A, B, C, D, E, F, G ....all the way through T, U, V, X, Y and now Z. I've put my life and soul into every one of these plans and they all failed. Now I'm on Z, the very last one I have in my bag of tricks, and Z is not working out. I'm at the end of my wits and rope.

There are things that break down the brain and that's what's happening now. And even though I'm aware of it and take steps to avert those things, I cannot completely help it. That's the way the brain is, that's what mental illness along with the stress of highly distressing situations will do to a brain. It is a cumulative effect. Whatever it is, I'm fucking exhausted. An exhaustion few people can comprehend. It is a literal exhaustion - the brain's capacity to carry on is literally exhausted, there's no more gas in the tank. I can feel it breaking down and I am powerless to stop it. I'm no wimp - I'm a tough SOB - but there's only so much I can do.

So I don't know. There's stuff I want to do. There's so much I want to write. With nothing else left in life, all I'm left with is the fruits of my mind and I feel deeply compelled to leave a legacy behind, a legacy of my thoughts. My thoughts, my mind, means something to me. Despite the self-worth battles that wage in my mind, I do have an ego left and that ego feels strongly about the thoughts I create, the views that I have, my experiences in life and mostly, how I can present these. They are of value my ego believes. I have nothing to leave my daughter. At one point I had considerable assets to leave her to ease her future and life but those I pissed all away. My meager furnishings are of little use and value to her. All I have left to leave then is the fruits of my mind. I also believe my experiences, thoughts and writings on mental health issues are of value. I'd like to leave those behind.

Yet I also feel I cannot take another step. My brain's capacity for decision making and dealing with even the simplest things in life just breaks down. It has many, many times in the last five years. It just doesn't answer the bell (and is thus a reason that I've lost everything). I just simply don't have the ability to cope. 

I can't cope with my uncomprehending family any longer. The more I try to get them to understand my issues, the less they understand and the more isolated and frustrated I feel. 

I cannot cope with an uncomprehending society any longer. People's utter cluelessness - and I include most people who consider themselves very smart and well read (who are actually the worst) - in understanding issues like this are part of what literally drives me insane (something that I'm just just beginning to explore in a series of posts). 99.9% of people's utter inability to step outside their own bubble worlds and their own inner filters to understand another human being is something that will just forever baffle me. That's one part I can no longer bear. 

If plan Z would work, I think I could handle this. I planned to just get away and enjoy the solitude of study in nature but not even plan Z is working and without that, I just have no idea what to do. Not having any funds or sources of support, I will not have the means to shelter or feed myself. These are basic life things and not having these causes great distress, distress my brain cannot handle and it is breaking down. I can't deal with the needs required for this moving out process (my family and I have to be out of our basement suite by the end of the month). 

Emotionally, I'm toast and my capacity for simple life decisions is toast. There are dozens of things to do but I feel no more capacity to do any of them any longer. If you think there's a way to carry on, then you have no idea what this feels like to be at this point, to be so close to the end as this. I can feel myself again dancing in the dark, dancing towards the edge of death. The familiar obsession with it has returned. I research and look into methods every day. This is not good.

I'm thinking I may just go back and check into the hospital. I think that may be the safest thing to do. I feel so much like stepping over that edge yet I want to hold on to finish my writing, to get as much of it published online as possible. I hate the hospital, the psyche ward, I fucking despise it. When I'm there, I just want to go home. But this time there will be no home to return to so maybe it'll be different. What's helped in the hospital before is that it takes all the stress of life off. I'll have a bed to sleep in and three meals a day there. I can have my books, my notebooks and continue my studies. I'll have people to talk to. There'll be social services people to help me with some of my life needs. So as much as I hate it, it's not bad when I weigh it all out. 

This, today, is what I'm leaning towards.

The Psychology of Mental Health Disorders - Isolation and Loneliness

Update, October, 2014

I've done considerably more research into the relation between isolation and stigmatization and psychiatric disorders since first writing this piece, especially in terms of understanding isolation stress and the tangled effects of isolation in the mind. Not many researchers look into this but I am very good at connecting my own dots from studying the neuroscience of stress and case studies of those with certain forms of bipolar, schizophrenia and other mental health conditions. And everything I've found has left no doubt in my mind that not only is isolation stress a major trigger for psychiatric episodes, it is a major factor in the long term outcome for those disorders. 

There is a great deal more for me to write about regarding isolation stress and emotional pain and how they're processed in the brain and how this both triggers and contributes to mental health struggles of all kinds (from depression to psychosis to manic episodes to paranoid schizophrenia and others) but I have far too much on my plate for that now. For now then, this will have to continue to serve as an introduction to the affects of isolation on mental health. 

-BGE



In talking about isolation and bipolar, I will include schizophrenia as well. I've actually researched schizophrenia more than bipolar even. Indeed the two conditions can be confused for each other and can co-exist as well (well, according to the docs anyway). In discussing how psychological factors can affect the outcome and course of an mental health disorder, isolation may top the list.

One of the greatest blessings that helped me turn things around at the very end of last year was being given access to free therapy through a program sponsored by the psychology department at UBC in which psychologists in training would serve a sort of internship. My therapist, "B", turned out to be a perfect fit for me. Without getting into too much detail of our hours of sessions, feelings of loneliness and isolation was one of the things that B helped unearth for me. The more we talked about it, the more I could see this when I looked back on my own suffering; the more alone I felt, the more I suffered. 

As well, though B and I only touched lightly on this, among other things that I battled and was effected by, acute sensations of being rejected was one of them. (and speaking of if only, if only I'd been able to keep up the appointments with B. That would have greatly aided me in getting through some of the more recent darkness. But my free sessions ended with the end of the UBC university term. I'm able to continue them but not until a new session opens in September and then with a new therapist). 

The nature of this sense of rejection is a whole other thing to explore but I believe it's something akin to Borderline Personality Disorder which, according to Psychology Today's Taming Bipolar, is often "comorbid" with bipolar disorder (and in an interview I conducted for my book with another bipolar sufferer, this came up and we both felt many of the same things, things that are described as symptoms of BPD). In any case, these acute feelings of rejection, whether or not the feeling was justified, would also greatly contribute to feelings of isolation and worsening of the condition and I could trace this back for years, even the years before the current Struggles.

So being as highly interested and motivated as I was at the time (earlier this year) to learn everything about mental health disorders, I turned more of my attention to the role of loneliness and isolation. I had a very strong feeling that I was not alone and that isolated feelings greatly contributed to negative outcomes in mental health disorders. As I read through cases of bipolar, major depressive disorder, schizophrenia and especially suicide, isolation, loneliness and worse, ostracizing from others, showed up time and time again.

Loneliness, isolation and ostracizing are three variations on a similar theme. All three set one apart from others but stem from different situations. Loneliness is the feeling of having no one in your life. Isolation is closer to a feeling of being rejected by others. Loneliness is a passive situation while isolation is an active situation, or in other words, loneliness could be a natural course of events whereas isolation is an active rejection by others. Ostracizing is of course a whole different beast. Like rejection, it's active but with strong malicious intent. I include forms of ridicule as ostracizing as well. How these are experienced very much varies with each individual and how they're feeling at any one point. One may be stronger than others in the face of these things or one may feel stronger one day and more vulnerable the next. All, I felt, would have an accumulative effect over time.

In Sylvia Nasar's superbly written and researched biography of John Nash, A Beautiful Mind (which is not to  be confused with the movie of the same name. While I loved the movie, and it is based on the story of Nash as well, it bears little resemblance to the actual story), she does not specifically mention the effects of loneliness, isolation and ostracizing on Nash's illness (which was paranoid schizophrenia) but I could see these three things running like a thread through his life from his childhood to during the worst episodes of his illness. It may or not been any one instance of rejection and isolation but, based on my own feelings and intuition, I could well imagine all the loneliness, isolation and ostracizing he experienced over his life building up and both perhaps playing a role in triggering his episodes and worsening and prolonging them (this becomes a strong self re-enforcing cycle as well as we'll examine).

I really felt I was on to something so it was with some satisfaction that I ran across a piece in the online edition of The New Republic called Loneliness - how isolation can kill you. "Bam", I thought, "this is just what I was looking for".

In it we are introduced to Frieda Fromm-Reichman, a fifties era therapist made famous for her role in successfully treating a severely disturbed schizophrenic young woman named Joanne Greenberg, the subject of the well known autobiography I Never Promised You a Rose Garden (and pop song of the same name). From the article,

Her 1959 essay, “On Loneliness,” is considered a founding document in a fast-growing area of scientific research you might call loneliness studies. Over the past half-century, academic psychologists have largely abandoned psychoanalysis and made themselves over as biologists. And as they delve deeper into the workings of cells and nerves, they are confirming that loneliness is as monstrous as Fromm-Reichmann said it was. It has now been linked with a wide array of bodily ailments as well as the old mental ones.

And further,

 Psychobiologists can now show that loneliness sends misleading hormonal signals, rejiggers the molecules on genes that govern behavior, and wrenches a slew of other systems out of whack. They have proved that long-lasting loneliness not only makes you sick; it can kill you. Emotional isolation is ranked as high a risk factor for mortality as smoking. A partial list of the physical diseases thought to be caused or exacerbated by loneliness would include Alzheimer’s, obesity, diabetes, high blood pressure, heart disease, neurodegenerative diseases, and even cancer—tumors can metastasize faster in lonely people.

 So it would appear that beyond the purely psychological effects of loneliness and isolation, there are organic components as well, components that certainly wouldn't help one who's already battling a tough mental illness. But the thing with loneliness, and this is something I've observed and understood myself for a long time, is that one can be surrounded by people, or at least not be physically "alone", yet still feel incredible loneliness and disconnect inside. And this would appear to be born out,

Today’s psychologists accept Fromm-Reichmann’s inventory of all the things that loneliness isn’t and add a wrinkle she would surely have approved of. They insist that loneliness must be seen as an interior, subjective experience, not an external, objective condition. Loneliness “is not synonymous with being alone, nor does being with others guarantee protection from feelings of loneliness,” writes John Cacioppo, the leading psychologist on the subject. Cacioppo privileges the emotion over the social fact because—remarkably—he’s sure that it’s the feeling that wreaks havoc on the body and brain.

Mental health patients face a large enigma when it comes to their conditions. They could be suffering horribly on the inside but appear perfectly normal on the outside. Others in their lives often can't accept that there is anything wrong and/or be unable to offer compassion, understanding and support, something that is enormously frustrating. Further complicating this, the term "mental illness" and the (false) belief that mental illnesses are due to a chemical imbalance paradoxically does nothing to improve this, in fact appearing to have the opposite effect. Instead of eliciting empathy and understanding, studies show that

...the dissemination of this false belief has not led to a lessening of societal stigma toward people with psychiatric diagnoses. If anything, it has increased it. In their survey, Pescosolido and the other researchers asked a number of questions to flesh out attitudes toward the mentally ill, and in 2006, there was "no significant decrease in any indicator of stigma" compared to 1996. Moreover, "significantly more respondents in the 2006 survey than in the 1996 survey reported an unwillingness to have someone with schizophrenia as a neighbor."

Equally revealing was this: In both the 1996 and 2006 surveys, those who believed in a "neurobiological conception of mental illness" -- i.e., the chemical imbalance story -- were more likely to have a negative attitude toward those with mental disorders than those who did not. [my bold - BGE. And again, excuse the weird formatting issues]

While this study does not tell the whole story, it does give a pretty good indication of the attitudes of the general public towards those with mental illnesses. I can tell you from my own experience and from reading dozens of case studies, that this sort of stigmatization and prejudice absolutely does exist and cannot but help contribute to the loneliness and isolation those with mental health disorders experience. I've experienced that even with people who outwardly express empathy, they'll slowly edge you out of their social circle or work opportunities thus ultimately contributing to the cycles of loneliness and isolation and their damaging affects on brain and body health and thus the course of the disorder.

New Update 

This is yet another angle of understanding mental health disorders that requires much more study and outlining than I've been able to get to as yet. 

At this time I can add this, however. In the four years and some months since originally writing this piece, I have had the opportunity to listen to or observe or read the stories of dozens of people with various disorders. These may be diagnosed or undiagnosed. I look into their life backgrounds and ongoing life circumstances. Meanwhile, I have done considerably more study into available literature on isolation and the brain and the effects of becoming disconnected from understanding, support and caring and loving connection. There are, I believe, very distinct effects on the mind, thinking processes and the very reality the brain creates when one prone to psychiatric disorders experiences certain types of acute or ongoing isolation (this is not to say those without risk for more severe psychiatric disorders are not affected - I think the evidence is strong that almost all humans would be affected - but the effects manifest themselves differently in those prone to psychiatric disorders such as schizophrenia, bipolar disorder, major depressive and/or anxiety disorders along with several others).

There is, I have observed, a hideous and very difficult to arrest or reverse cycle that takes place - the more one is isolated, the less able they are able to connect with and trust others. The less able they are able to connect with and trust others, the more isolated they become. The more isolated they become the more their minds turn inward giving rise to many symptoms and disordered thinking associated with psychiatric disorders. The more and stronger the symptoms and disordered thinking the less able they are to connect with and trust others and so on and so on. 

Complicating this is the brain's own ability or inability to be self-aware of or understanding of any of these symptoms and resultant behaviours. Various types of delusions and/or denial will be present. Intervention is a very difficult task for family members or friends (if indeed any are present and involved at all). Society at present is not at all equipped to deal with individuals struggling with this cycle.

Clinically speaking it becomes a near impossible tangle to sort out and treat. I have to emphasize once again that while treatments with pharmaceutical drugs may appear to help in the short term, the evidence and track record for long term efficacy is weak and is complicated by potentially very serious side effects from long term use of psychotropic drugs. Helping any individual struggling with this cycle requires much, much more than a simple drug therapy routine, I'm afraid.

All of which I know sounds darkly lacking in hope. And it's true, I must say, after four and a half years of researching and study into the world of mental health and the brain, the big picture does not look at all promising. Many will be lost. 

Yet I do remain brightly optimistic and hopeful on individual levels. It absolutely is possible to overcome this for many and I work daily on ways to see and work on the positive possibilities for any one individual.  

So if you are reading along and all of this strikes a chord for yourself or someone you know and care for who is struggling with this, I can only leave you this - there is hope, there are positive possibilities. We just need to get you there. 

BGE - September 30, 2017