Friday, March 27, 2015

Plane Crashes, Why, Black Swans and Mental Illness Stigma

This will be very brief as the news story of the crash of Germanwings flight 4U9525 two days prior to this writing is very much at the fast breaking stage which at this point appears to be not an accident but instead something the co-pilot planned and carried out.

First of all, this is unquestionably different from a normal air crash. Losing family, friends and loved ones in any accident is very difficult to cope with; if it does indeed prove that this was a deliberate act, there is no doubt this will make it all the more difficult to accept and cope with. I of course feel great empathy for those who lost family, friends, colleagues and loved ones in this tragedy. 

However, at this point all is conjecture. Any major airline crash investigation will take at least a year or more and given the unusual circumstances of this incident, this case could take much longer. Anything, therefore, one reads in headlines and news stories in these very early stages will be pure speculation and conjecture, however factual it may appear to be at this time. As well, whatever the facts may be, it will take the full length of the investigation to establish what facts played what role in this tragedy. 

So not only have facts not as yet been firmly established, investigators have not even begun to go through them and link any given prior fact to its role in the outcome. In other words, it is simply not possible for anyone - no matter how authoritive or close to the case - to draw any conclusions at this time. 

I therefore ask anyone reading here to please refrain from unfounded speculation and the drawing of any conclusion and remind that you are neither qualified to do so nor to understand the facts in this case as they come to light. 

*  *  *  *  * 

News reports are now emerging that the co-pilot had received treatment for "depression" six years ago. 

Via Reuters:

The pilot who appears to have deliberately crashed a plane carrying 149 others into the French Alps received psychiatric treatment for a “serious depressive episode” six years ago, German tabloid Bild reported on Friday.

Citing internal documents and Lufthansa sources, Bild said Lubitz spent a total of one and a half years in psychiatric treatment and that the relevant documents would be passed to French investigators once they had been examined by German authorities.

What does this mean? 

At this point it is very easy to jump to conclusions, however readily "apparent" they may be to those not trained to understand either mental health disorders or what roles they play in human behaviour. Again, any link at this point to the copilot's past mental health issues and this incident is pure conjecture. 

But lets look to understand what if it played a role. 

There are two basic issues here. One is an airline crash, the other is someone with a mental health disorder performing acts on this magnitude. 

Air crashes are exceedingly rare in today's age. Air crashes involving deliberate actions by either the pilot or copilot are exceedingly rare among total crash statistics. 

Which makes this a Black Swan Event.

Black Swan Events

The black swan theory or theory of black swan events is a metaphor that describes an event that comes as a surprise, has a major effect, and is often inappropriately rationalized after the fact with the benefit of hindsight
The theory was developed by Nassim Nicholas Taleb to explain:

  1. The disproportionate role of high-profile, hard-to-predict, and rare events that are beyond the realm of normal expectations in history, science, finance, and technology.
  2. The non-computability of the probability of the consequential rare events using scientific methods (owing to the very nature of small probabilities).
  3. The psychological biases that make people individually and collectively blind to uncertainty and unaware of the massive role of the rare event in historical affairs.

This incident clearly scores on all three counts:

Point one is self-explanatory.

Point two. An incident of this nature is obviously very hard to compute; for all intents and purposes computing the probability of something like this virtually impossible. 

Point three is of most interest to us here. 

This is a classic black swan event in that the magnitude of the incident that sears into people's minds blows out of all proportions the probability of it happening again. 

Psychological biases are also a form of cognitive distortions. Cognitive distortions are irrational thought processes that create undo anxiety and fear. They are considered irrational because there is no logical or factual basis for them. 

As I see things developing in this case, I can see two irrational fears taking root in people's minds:

- Fear of flying

- Fear of those with mental illnesses and resultant increase in stigmatization against them. 

First of all, let's address the safety of airline travel. 

Airline travel continues to improve in safety and set all time safety records in 2011, '12 and again in '13.

In terms of casualties to passengers carried, that ratio has been steadily improving for four decades. 

This incident does nothing to change that. 

Given the purpose and nature of this blog, we now get to the real point:

As soon as I saw the news reports about the co-pilot's prior mental health condition and year and a half of treatment, I knew that this could do for mental health suffers and the stigmatization thereof what 9/11 did for the stigmatization of and prejudice against Muslims. Not on the same scale of course, but given the already dreadfully and widespread ignorance of and stigmatization of those with mental health disorders, this has all the potential to further distort in the minds of most that mental health disorders lead to violence, incompetence and other erroneous ill founded conclusions, much to the detriment and improved mental health of those with any ongoing or past history of living with a disorder.

Stigma against mental illness has devastating consequences for individuals with mental illness and their families. Empirical findings and qualitative evidence indicate that stigma against mental illness remains rampant in many nations and cultures, constituting a significant barrier to successful treatment, reducing key life opportunities, and predicting poor outcomes over and above the effects of mental illness per se.
In this article we define stigma, examine relevant theoretical perspectives, summarise evidence regarding the pervasive negative impact of stigma on individuals with mental illness, and discuss underlying mechanisms. We focus in particular on assessment issues, highlighting the need for transcending explicit attitudinal measures of stigma, which are susceptible to social desirability concerns and are likely to underestimate true levels of stigma, to include unconscious/implicit indicators and direct behavioural appraisals. A primary goal is to facilitate means of accurately measuring stigma against mental illness as an important step toward reducing its pernicious effects.

Aside from a person's inner struggles, stigma will be the worst thing the sufferer of a psychiatric disorder will endure. In fact, I'll argue at a future point in this blog (and book), it may become the most defining factor in the long term outcome of their given disorder. Along with substance abusers and the homeless, mental illness sufferers are already one of the three most stigmatized demographic groups in the Western world according to experts in the field (1). 

What role did the mental health of the pilot play in this tragedy?

In truth, at this point we have absolutely no idea. As I said, an investigation into this incident will take a year or more. 

And even if it does prove to have played a role, what does this mean?

Essentially nothing.

Again, it is a black swan event, an event of such low statistical probability it is virtually meaningless. 

Look, tens of millions of people around the world live with a mental health disorder. 

Again, the percentages of them or probability of them (or us, to my readers) performing an act like this is so statistically improbable as to have no practical bearing on society's outlook on mental health disorders whatsoever. 

But linking an event like this to people's perception of a given demographic group is exactly what happens. 

People leap to conclusions. They see a tragedy like this, the loss of life, the pain of those who lost family and loved ones and the immediate urge is to appoint blame.

And one of the greatest faults of the human brain is that it wants to appoint blame to a "them" group so as to make their own group feel better and more secure about themselves. Which is what I see happening here already. Perhaps consciously, more likely unconsciously as this link between "depression", "mental illness" and this event gets burned into their minds by 24/7 sensationalized news coverage.

This event is already a great tragedy. And I  understand people's need to make sense out of something like this, an incident that if is ultimately to have been proven true (a deliberate crash) is beyond our grasp to understand. But sometimes there just is no why. Sometimes there just is no knowable answer, no satisfying answer. 

And this is what creates fear - not knowing. 

Which is why we must apply a "black swan" explanation; there is no real answer but the occurance of the incident is so out of the ordinary, so improbable, that we must just let go of ever having an answer, let go of the fear  of it happening again.

Meanwhile, to appoint blame to an entire demographic (those with a mental illness designation) - and thus further perpetrate stigma against that group - based on irrational conclusions and statistical improbabilities would be a worse - and much greater far reaching - tragedy. 

(1) Citation source coming

Thursday, March 19, 2015

Life as a Living Hell - The Art of Living Through Hell on Earth

Every now and again I'm reminded that I'm living through hell. Or my worst nightmare (sort of the same thing in actuality). 

When I was younger, in my early twenties to be exact, and I was beginning to get serious about life (IE; stop partying, binge drinking, wasting days sitting around smoking dope, etc), I began to look around and look forward in my life and decide what I wanted, didn't want and where I wanted my life to be in the future. Pretty basic stuff. 

I did all the normal things; what career/job/vocation could I do and made some decisions there, started savings plans (long term, short term), look towards buying a home and building equity and so on. 

All of this was spurred by a sight I saw whilst pissing away a gorgeous sunny day suntanning on a popular Vancouver beach (its famous Kits Beach). On that day, among all the heart achingly beautiful young women and bronzed stud muffin young men, I saw the future. The future was a man I saw among all the golden youth, a man of perhaps sixty-five to seventy, a man who had the bearing and manner of having had a good life, and there he was picking up bottles. It was easy to see in an instant that he loathed having to do it, that he was humiliated and that he was doing it because it was the best he could do at his age to scrape together some extra income and get by. 

It took only another instant to see that that was my future if I continued to piss away my life on beaches thinking that the perfect tan was all there was to life. 

So from then I endeavored to spend my life making sure I wouldn't end up being that age and needing to spend every waking hour scrounging for bottles to exchange for 5 cents a piece just to scrape by. That was my personal nightmare, the hell on earth I had to avoid. You, of course, may have your own but that was mine.

The various effects of bipolar had yet to descend on me at that point and for the rest of my twenties I proceeded to do all the right things in building a financially secure future for the day I faced retirement. 

Fear is a powerful motivator and the fear of living that future vision of hell I saw on the beach that day never left me and I worked my ass off. 

The nineties (my thirties) saw some of the full horrors of bipolar introduced to me and things got quite challenging. At one point I returned from an ill-fated business trip to Japan flat broke with nowhere to go but my sister's couch (an arrangement that lasted only very briefly) and then my car. 

Things got a bit loopy (this is a mild understatement) for a couple of years but I forged through it, righted the good ship Brad and back to the grindstone I went. 

I managed to buy a condo, got lucky with market conditions, continued to work my ass off (this was in Taiwan where I worked as a teacher putting in twelve hour days, six days a week (and often time on Sundays). I built equity, savings, and security against having to scrounge for bottles. 

Things were never not challenging. Bipolar loopiness can spring upon one at any time (well, not any time, under times of some kind of stress but I'll get to that in enormous detail later) and that created no shortage of difficulties (though the upside of bipolar is that a nice little manic burst can get you through some unbelievable tight spots). I'd later learn that I battled a host of other mental difficulties but I muddled through them all in an ignorance is bliss sort of fashion and with the enormous support from an unbelievable network of friends. 

I came home to my daughter and her mother in 2006 and set about creating a family life (my life had no shortage of colour, but perhaps stories for another day). I bought another condo, got more savings going and generally had the best year of my life. I worked hard, played harder, got to know my daughter and things looked grand and rosy. I sat on the deck of my beautiful condo, my beautiful family around me and thought to myself, "It was a hell of a ride, old boy, but look at what you've done." I was very proud of what I'd accomplished. The hellish future I'd seen twenty-five years earlier seemed very far away.

In the summer of 2007 demons began to stir. It was barely, if at all, noticeable, but life began to change. I began to change. My mind began to change. I did not know then that the descent into hell - the nightmare I'd spent a lifetime insulating myself from - had begun. 

I struggled and fought, struggled and fought, struggled and fought. I fought hundreds of battles great and small. I won some, lost most. 

By the spring of 2009, I'd lost my home and all my savings, about a quarter million dollars of equity was gone. I also knew I was losing my ability to work. At that time I was already feeling the debilitating aspects of long term bipolar as well as - I wouldn't learn until early 2018 - Chronic Traumatic Encephalopathy (CTE). Though I didn't understand yet at that time what was causing it, I could sense it deeply. I knew I was no longer mentally or physically the man who could work twelve hours a day six days a week to work his way out of this mess. 

The insulation I'd spent a lifetime building against the hellish future was all stripped away. Hell on earth was staring me square in the face. 

But the fun had only just begun.  

I hung on through the rest of 2009 and into 2010. I managed to hold a job of sorts and to make rent, though every month was a struggle and threats of eviction a near monthly source of stress. 

Things exploded (in my mind) with my first episode of psychosis and attempt at suicide in July of 2010. 

Reasonably, I thought, I entered the mental health care system with my first hospitalization in a psychiatric facility. 

The next thirty months was a whirlwind of living on the brink of suicide, numerous episodes of psychosis, long, long periods of psychiatric drug induced fog. I suffered the drug side effects horribly. I lost all capacity to work properly (though I did manage to put in periods of work of a few weeks to a month or so). 

Many more hospitalizations were to come. A nightmare had come true. A living hell. 

Eventually I lost everything. All my loves, all my pleasure, my ability to work. And then my very mind itself, by which I mean days upon days for months being capable of little more than staring out a window all day listening to music. I could not even do my greatest love - read. 

A year after that I was living out an unheated van in a Canadian winter. 

Yet that winter I was having some of the happiest times of my life. I'd put most of the horrors of the past behind me. I was loving life. I was tackling life. 

As I sit here typing this out, I feel like the most blessed, happiest man on earth. 

I sometimes have to - as I started out saying - remind myself that I am in fact living the hell I'd feared all my life; broke, homeless (1) and alone. 

But despite being in - living - the hell I envisioned all those years ago on a gorgeous beach among gorgeous people, I am mostly at peace, content, full of industry and dreams and plans and there are some very wonderful people in my life. I am grateful for everything I have. Every day I love life as much as I possibly can. I experience great pleasures.

It's still hell I'd spent a lifetime fearing and working to avoid, but ...

Anyway, this is life. Hell may very well happen. Hell may very well be happening to you or a loved one. The trick then is to make slices of heaven out of hell. Every day. Create enough slices and one day your life is mostly heaven. Or as close to it as possible. 

There are many things that this blog is and will be. It occurred to me this morning that maybe it's mostly about the Art of Living Through Hell on Earth. 

I learned that when life puts you through hell there's not a lot you can do about it. I suffer and have suffered horribly (which you'll understand when I get into the details of things like psychosis, bipolar mixed episodes, hallucinations and voices, and the blackest black of suicidal depression) but the fact remains that there's no going back to Kansas. I - nor anyone - cannot just click my heels three times and go back to Kansas, to get out of hell. 

So you have to learn how to get through hell on earth. 

Ol' Winnie knows a thing or two about getting through hell. He not only had to guide himself through it (he reportedly often suffered great depression), he had to guide the great city of London and an entire country through the hell of the Blitz. Giving up was not an option. There are a lot of people who drop bullshit quotes who don't really know what's behind the words spilling out of their mouths (a pet peeve of mine) but not ol' Winnie. He knew what he was talking about.

So this is what we'll look at in this blog, how to keep going through your private hell. Or how to help and support a loved one through their private hell. 

It's an art form, I discovered. There's all the science behind it - and that's tremendously important, of course - but all the day to day stuff is an art form. We'll learn those arts. 

As I've said many, many times, there is not a single aspect of mental health, the mental health care system and the psychiatric/pharmaceutical approach - the whole great picture - that I have not investigated, examined and researched in great deal. 

I have also lived almost all of it - bipolar, hallucinations/psychosis and all of that, ADD, crippling anxiety, the debilitating effects of CTE, and of course some of the darkest and crippling depression you can image (or not want to imagine). I knocked on death's door many, many times (or it on my door I suppose). 

So I'll talk about how to get through all that. I'll talk about psychosis and what that is. I'll talk about depression and what that is (and more importantly, what it isn't). I'll talk about mania and what that is and how to deal with it. 

I'll talk a lot about full body health. I'll talk a lot about mental health. I'll talk a lot about spiritual health. 

I'll talk about pharmaceutical drugs, who prescribes them and why and why they are proving to be ultimately ineffective. 

I'll talk about psychiatric hospitals and how to get the most possible out of them. 

I'll talk about how to get through acute crisis situations (IE: on the brink suicidal ideation). 

I'll talk about, in short, everything you might need to know to get through that hell and into the best possible life you can still have. 

Because we can't control life, folks. We can only control our minds. 

And that's my ultimate goal - how to control, or better control, your mind. 

Yes, difficult, I know. I know. 

But we'll get there. If I can, you can too. Life is not perfect, never will be. But we'll build as close to something that will bring you more happiness, contentment and inner peace as we can. 

(1) Though I now have basic shelter under good conditions, it is a gift from strangers. I own nothing, have title to nothing, nothing on paper. I could be cast out at any moment and there'd be nothing I - nor anyone - could do about it. Home - a true and proper home - is something you have some sort of title or legal right to. 

Friday, March 13, 2015

The Zebra Storyteller

Once upon a time there was a Siamese cat who pretended to be a lion and who spoke excellent Zebraic.
That language is whinnied by the race of striped horses in Africa. 
Here now: an innocent zebra is walking in a jungle and approaching in the other direction is the little cat; they meet.
"Hello there!" says the cat in perfect Zebraic. "It certainly is a pleasant day, isn't it? The sun is shining, the birds are singing, isn't the world a lovely place to be alive today!"
The zebra is so astonished at hearing a Siamese cat speaking like a zebra that he's fit to be tied. So the little cat ties him up, kills him, and drags the better part of the carcass back to his den.
The little cat successfully hunted zebras in this manner for many months, dining on filet mignon of zebra every night, and from the better hides he made bow ties and wide belts after the fashion of the decadent princes of the old Siamese court. 
He began boasting to his friends he was a lion, and he gave them as proof the fact that he hunted zebras.
The delicate noses of the zebras told them that there was really no lion in the area, however, the zebra deaths caused many to avoid the region. Superstitious, they decided the woods were haunted by the ghost of a lion.
One day the storyteller of the zebras was ambling along and through his mind ran plots for stories to amuse the other zebras, when suddenly his eyes brightened and he said, "that's it! I'll tell the story of a Siamese cat who speaks our language! What an idea! That'll make them laugh!"
At that very moment the Siamese cat appeared before him and said, "hello there! Pleasant day, isn't it!"
The zebra story teller wasn't fit to be tied at hearing a cat speaking his language because he was just thinking of about that very thing. 
He took a good look at the cat, and he didn't know why but there was something about the cat's looks he didn't like; so he kicked him with his hoof and killed the cat. 
And that is the function of the storyteller. 

- a short story by Spencer Holst

I use this story to try to illustrate part of the role that I see this blog playing. Like the storyteller, it is my belief that if one has more knowledge and narratives about the many possibly strange things we may meet in life, the less one will be "ambushed" by them (such as a talking cat!). And so it is with scary mental health disorders like schizophrenia, bipolar, severe depressive episodes, suicidal inclinations and so on; the more we know and understand, the less we fear and the less we get ambushed by the unexpected and the better we can deal with them.

A knowledgeable mind is a more prepared mind, a prepared mind is less prone to fear of the dark aspects of life that can be encountered. As a teller of knowledge and narratives, I hope to be a candle in the dark. Or perhaps even to light the whole room. 

Mental Health Disorder in Focus - Biplar Disorder: Part I

Before I get to the next post on how brains create reality and the implications thereof, I want to introduce bipolar disorder because I am going to use it to illustrate a great deal of how realities get formed and distorted in our minds. 

Bipolar is a multi-faceted, very confusing and difficult disorder to understand. I'll start off with a quote from Yale professor Jon Lieff. Jon is an email acquaintance of mine (although infrequent, our exchanges always have very high quality). Jon's science/neuroscience blog, Searching for the Mind is considered (and was named) one of the best sources for learning neuroscience on the Internet (and it is among some very heady and distinguished company, let me tell you). He is a fantastic source of bleeding edge and intricate knowledge of how brains work and why. He's been very kind in answering questions of mine and (occasionally) reading posts from this blog.

This is what Jon told me when I wrote asking him about bipolar disorder:

There are literally thousands of neuroscientists trying to understand the neuroscience of bipolar disease*. At this point in history it is too complex for our present tools (my emphasis). Everything is speculation.

[* - I quibble with and take issue with the the term "disease", but I'll leave that for another time]

So before anyone gets any idea that they have any kind of understanding what bipolar is or isn't, bear in mind that bleeding edge neuroscience can't even explain it. I have to mention this because I get advice all the time that runs along the lines of "Oh, I worked with someone with bipolar, I know all about it …" or “Oh, I've read about that, I know all about it...”. And they proceed to tell me what they "think" (and I use that term very loosely) what I should "do" (ahem).

But let me start out with the image at the top of the page. This is one of the most common images associated with bipolar and it's unfortunately very misleading. It's misleading because it gives rise to and perpetuates the most common myth about bipolar disorder - that it means something along the lines of "being happy one day and sad the next".

Bipolar is NOT about being happy one day and sad the next, or peppy one day and down the next day nor simply about emotions at all. If that were the case, nearly everyone would be "bipolar" or experience "bipolar" in their lives. Changing emotional states are certainly involved but they are just a very small aspect of the condition. So that's myth number one to disabuse yourself of.

Bipolar is also very widely mis-diagnosed or over diagnosed. It's sort of the "mental illness de jour" these days, especially among the celebrity/artist/performer/creative set and can be used as sort of a catch all excuse for bad behaviour. Or for anyone who's "moody". It's also grossly over-diagnosed, as are almost all mental health conditions, because the psychiatric and pharmaceutical industries make a lot of money off of "treating" people with life long supplies of drug cocktails. The mass over-diagnosis of bipolar is something I will address in a future chapter when we examine the “bipolar boom” (a term coined by Robert Whitaker in his book Anatomy of an Epidemic) of recent decades.

Bipolar disorder is, as mentioned, very, very complex and a great number of things are involved or possibly involved but for this first post dealing specifically with bipolar disorder, I'll start with some basics and - over time - flesh things out from there.

There are three basic states involved in bipolar - the manic state, the depressive state and "mixed states".

My view of bipolar is closer to the classic manic depressive definition. Manic depression used to be the term used until diagnostic criteria started getting carried away. Classic manic depression would look something like:  relatively brief periods of mania followed by long periods of depressive states. The former can last from about a week up to a year but the average is probably around ten days to two weeks. Depressive states can last for weeks, months or years.

Now one thing to clear up right away in understanding the severity of bipolar is the question of "depression". I have huge issues with the semantics of this term. It is so broadly used and applied to so many clinically different conditions that the term "depression" is virtually meaningless.

One - and here's a big dirty secret revealed - is that the kind of depression most people go through is not a "mental illness". It is, in fact, a perfectly normal reaction to some sort of life crisis or difficulty. In the vast majority of cases it's closer to bereavement or grieving (think the feelings you have following the break up of a serious relationship, the passing of a loved one or beloved pet and that sort of thing). Many other people will go through episodes of very difficult sadness and low moods because ... well, life is shitty at that time. This too is perfectly natural. Some people panic themselves into a mental health tizzy for a wide number of reasons (a kind of nocebo effect that I get into in great detail in a later chapter). No question it can feel very dark and difficult (mostly because it's misunderstood and mishandled by "professionals" or friends and family) but it is a temporary state that - generally - passes as naturally as it came. (all of this is grist that I grind in future posts).

But while the depressive state of bipolar disorder bears a lot of similarities to more common experiences of depressive episodes, I'll outline (again, as we go along and explore it later) how and why it is different and in many cases much worse. So let's look at the states of bipolar in a little more detail. 


Mania is really a tough state to understand. A great number and variety of things may go on. In a small percentage of cases great creativity can be (emphasis on can be) involved and experienced. Some people become violent. It is widely associated with all kinds of bad behaviour (hence many actively seeking a diagnosis of bipolar to explain away bad behaviour ... I am always skeptical of these cases). But let's look at some of the clinical criteria used to assess a diagnosis of bipolar. 

In no particular order, we have:

  • extreme euphoria (get used to the word "extreme")
  • very impaired judgement and/or insight into one's own behaviour
  • extreme sexuality and high/obsessive sex drive
  • extreme and seemingly inexhaustible levels of energy
  • extremely high and unrealistic levels of positiveness, hopes and optimism
  • inability to sleep (Note: this is not at all the same as the kind of restless/anxious insomnia many people experience. When I say can't sleep, I mean being in the grips of bouncing off the walls energy and extreme levels of mental alertness and having no need or desire to sleep whatsoever)
  • obsessive drives and high motivation to act on one's thoughts and "visions"
  • behaviour like runaway spending and/or extremely poor financial judgement, discretion and management
  • extreme levels of "I can do anything" confidence and beliefs
  • extreme, perhaps delusional levels of optimism
  • a feeling of being on top of the world, the world is my oyster and can conquer anything
  • nothing but the most positive thoughts and self-dialogue
  • "Superman" like feelings. Like literally the belief that one can fly or cover great distances through the air. (hard to believe but this actually happens in some cases and there are cases of people in the grips of mania who jumped to their deaths because they literally believed they could fly)
  • severe delusions and/or delusional thinking
  • great clarity of thought (which may or may not be delusional ... a thorny aspect to pick through)

All of these are extremely (that word again but seriously, it cannot be used enough in describing various states of bipolar) powerful and gripping. The power of these is well, well beyond the ability of most people to imagine and are well beyond what almost anyone has experienced.

For a proper diagnosis of mania, one does not have to have experienced all these criteria in one episode. I believe (if memory serves) it requires (or used to when strict diagnostic criteria was closely adhered to) seven to ten of these conditions to be present for a minimum of four days running. How all that "plays out" in any one individual is going to vary about as much as there are personalities and personal differences (if you start to add all that up you can begin to grasp the complexity of the disorder).

A key thing I personally believe should be factored in is how much a manic episode disrupts a person's normal life. As well, how much all these behaviours/states depart from a person's normal personality. There are people who experience many of these things but aren't so put in the grip of them that they stop going to work or otherwise greatly alter their normal lifestyle. In true mania, one will completely be in the grips of and be obsessively driven by these things and their life will be greatly disrupted.

Some personal thoughts:

A young psychologist who was working with me, genuinely curious to better understand what mania feels like, once asked me what it was like. What I told her, and I'm paraphrasing from memory here, was this:

Mania is like the best drug anyone could ever make. It is beyond the best feeling in the world. You feel like you can do anything, be anything, think anything, solve anything. You have sexual energy a porn star would die for. Doubts, fears, any negative feelings whatsoever evaporate. You become God's gift to humanity. If such a drug could be made you could charge $1,000 a pop for it and people would gladly pay and line up for blocks for it. There is nothing like it on earth. Nothing.”

Until, of course, it stops.

Depressive States:

Boy, where to begin. Well, the easiest thing is to simply look at the mania list of symptoms and then try to imagine (and this is very, very hard to imagine indeed for the average person who's never experienced anything like that) the polar and extreme opposite of all those states.

Again, in no particular order, we have:

  • extremely low energy levels (to the point of literally being incapable of getting out of bed, taking a shower, preparing meals and so on)
  • extremely (again, get used to the word "extreme") low desire, drives and motivation
  • complete loss of interest in sex
  • extremely negative views of oneself
  • extremely negative and destructive "self-talk"
  • extremely persistent and intrusive thoughts and visions of self-harm and/or suicide
  • literally crushing levels of guilt and self hatred
  • extreme hopelessness
  • an obsession with the "dark side" of life and humanity
  • extremely negative views of the world and future
  • extremely impaired insight
  • and just an indescribable level of literal inner darkness

All these too are extremely powerful and quite beyond the ability of anyone to "control" without massive amounts of intervention, help, training, awareness (and yes, perhaps short term drug therapy).

And if that sounds horrible, let me introduce you to -

Mixed States:

Mixed states are completely beyond almost anyone's ability to comprehend and imagine. Even most highly experienced clinicians cannot fully grasp it. As the name suggests, it is a combination of aspects of manic and depressed states. Except it's none of the "fun" part of mania and all of the worst aspects of depressive states. It's all the dark and negative elements of depressive states except unlike the lack of energy and drive and motivation in depressive states, the person will have nuclear levels of energy and motivation to act on all those horrible, negative and distorted thoughts.

One in five cases of severe life long bipolar will end in suicide. It is widely believed and accepted that the vast majority of these will take place during mixed states. Bipolar has a reputation for violent behaviour. That violent behaviour will take place during mixed states. Mixed states are very, very, very bad news.

As much as I've experienced these states, they are beyond my ability to describe them. Very, very difficult to survive them.

Various other "fun" stuff:

  • various forms of psychosis or psychotic states - I'll have to cover this in more detail another time. This is virtually impossible to describe. Think hallucinations, voices, commands to perform harmful acts and all kinds of fun stuff like that. Extremely powerful and horrifying stuff, let me assure you. And quite beyond the experience of all but a small handful of people.
  • People with bipolar will often suffer from or experience other mental health conditions such as ADHD, Borderline Personality Disorder, Major Anxiety Disorder and a host of other fun things to try and deal with aside from all of the above.
  • there is no known cure for bipolar
  • drugs, despite what is commonly believed, do not "cure" bipolar but instead may lead to a worsening of conditions and other severe side effects (long, long topic that I will cover elsewhere) though they do “knock down” many of the drives and can give an impression of stability
  • the "illness aspect" of bipolar will worsen with each cycle through manic and depressive states and/or mixed states

So that's kind of a clinical overview. Let me leave off with a few final thoughts. 

None of these are simple "moods". We are talking massive, massive and long term changes in literally how the brain operates and takes in and processes sensory information. Huge changes in brain regions, neurochemistry and other neurobiology are involved. Over the long term, there will be actual structural changes to the brain and brain damage. There will be changes down to the cellular level and - believe it or not - the DNA level. The differences in these states are so vast that they each literally change how one views the world and acts according. One becomes, almost literally, a different person in each of these states.

These states can change in long, slow waves (the classic is one manic state and one depressive state a year). Or they can switch back and forth like a light switch (so called "rapid cycling", a truly, truly horrible and horrifying experience to go through, something I would not wish on my worst enemy).

Advanced state bipolar is considered one of the two most severe, destructive and difficult to deal with neuropsychiatric disorders on earth along with schizophrenia. I'd argue that it's worse than schizophrenia because of the wildly varying mental states (schizophrenia is certainly no fun but at least it's a consistent state).

I have, and have had for some time, the most advanced and severe form of bipolar. There is very little in the upper echelons of psychiatric experiences that I haven't lived with or experienced.

There are other aspects and behavioural changes quite different from what I've outlined here that can lead to a diagnosis of bipolar that I'll also try to explore as we go along. 

 A few further thoughts:

Bipolar disorder can decimate a person's ability to live a normal life, hold steady jobs, have steady relationships or even fit in with society at all. Personally I have never been able to keep a job long term or stay in a relationship. It can destroy you financially. It can destroy any concept you have of yourself as a human being.

Emphasis for each on "can", however. For most of my life I had no idea what was happening and thought it was just my "colourful personality". It is my view that it can be managed but the sooner in life the better. Once you're at an advanced stage and age such as myself, it gets increasingly difficult (I'll also outline the reasons for this in later chapters).

But my personal state is not what I want to focus on. I have learned - through personal experience and enormous amounts of research - that there are ways to "Tame the Polar Bears". That is what motivates me to keep going, what motivates me to write this blog. There will be numerous chapters teaching how to tame the poplar bears (1) but I always point to my Positive Difference Making Fundamentals as a place to start.  

It is also my belief that bipolar needn't become a permanent life long condition if one learns early enough to recognize and manage triggers and stress (two things that will be a huge focus of this blog in managing any mental health condition). 

There will be lots, lots more on bipolar and exploring all aspects of it so please stay tuned! (2)

(1) The "polar bears" are my term for the polar opposite states of bipolar disorder.

(2) I have a lot on the go writing and research wise so please be patient in waiting for future posts specifically dealing with bipolar. It may take some months before I get to them all.  

Wednesday, March 4, 2015

Neuroscience 202 – Brains as “Reality” Creators

    Neuroscience 202 –
    Brains as “Reality” Creators

While this blog is primarily about understanding mental health issues, over the years it (and my studies) has really become more about understanding the human mind and behaviours in general. As I move forward with the blog (and myself) it is also becoming more and more about the world around us and life itself as it is virtually impossible to separate the former from the latter. In many ways I like to think of the physical properties of the brain as “nature” and the world around us and life itself as “nurture”, AKA environmental conditions and influences. I just happen to apply what we learn and understand from those endeavours to understanding what we experience in mental health disorders in ways that will hopefully be of use to you in understanding yourself or a loved one (or, I must confess) even human behaviour in general.

Another primary purpose and goal of this blog is to fill in massive gaps in understanding “us” that exist in all the varying fields of those charged with our mental health and well being; psychiatry, psychology and mainstream medicine.

Too many, you many have observed, are obstinately stuck on single “trees” of understanding what is actually a vast and complex forest, much of which is ignored or overlooked at our peril.

One of those gaps is the subject of this post – how brains our create our individual perceptions of reality.

I'd long been interested in this topic but it's been in the nearly six years that I started the study that would go into this blog (early 2013 – how time flies!) that I have deeply studied this topic. I study the neuroscience of it (along with consciousness, which in my view is more closely related than many in the fields of human study would think) along with following what those in cognitive neuroscience may have to say about it but mostly I enjoy studying “in the field”; observing and talking to people in their daily lives or more specifically talking with and looking into those with mental health issues or reading and examining as many case studies as I can. “Lab studies” can only go so far, my dear academic and professional friends.

It was my very strong believe from the beginning that how our individual brains create reality was a major cornerstone of understanding human behaviour and mental health issues and these past six years of observation and study (now at the end of 2018 as I rewrite this piece) have only strengthened that view.

It's critical for understanding so many of the symptoms of major

psychiatric disorders, from hearing voices and hallucinations to delusions of all kinds and many cognitive distortions to extremes of overly negative or overly positive world views and mental states along with such psychological phenomenon as denial.

In a broader sense it is enormously important to understanding the human mind itself and much of the conflict, discord and disagreement we see in the world around us or even at the dinner table among families or close friends.

As well, and perhaps most importantly for many of you, it is vital to 
understanding the experiences and causes of what can be agonizing loneliness and isolation, the inability to “connect” to anyone else, the difficulties in being understood by anyone else. 

It is my fervent hope – indeed the entire premise of this piece –
that our look today at how our individual brains “create” what we experience as “reality” (which in my view is very close tied to our individual experiences of consciousness) will open up avenues of compassion and understanding of our selves as individual members of the human race or as parts of our racial, gender, cultural and national identities.

Let's get to it then.


Everything we experience when we are in an awake and conscious state and how we experience it is in a sense “created” by those three pound (3.1 lbs on average to be precise) mounds of Jello like substance between our ears and the vast majority of that process is performed by a dazzling array of subconscious programs that operate autonomously with generally absolutely no input from “you”.

As I have mentioned in numerous pieces, whoever you are, wherever you live, however you came into this world and exist in it, the exact neuroanatomical makeup of your brain is unique to you and you only; even if you are an identical twin (of which I am one; two separate entities growing from a single fertilized egg). There is literally nothing else like it in the world and indeed in the history of the world. If you like to think of yourself as special (and who doesn't on some level, however secret), there you are.

As we'll see, however, is that left completely to its own devices it
will create a “reality” unlike that of anyone else. Like your consciousness itself, it will likely be, for the most part, highly subjective; IE: very individualistic. Very important for understanding the “self” and the “ego”.

We'll set aside those autonomous programs for now and focus on what we experience as “reality” and a little bit about how that's created.

Subjective versus Objective “Reality”

What we experience day to day as we go through life – what I also like to call our “conscious experience” - is referred to (in the philosophical sense) as “reality”. Going back to Neuroanatomy 101, you'll recall a paragraph in which I mentioned how all our realities are different. What is meant by that is that we all see, perceive and experience the world around us a little differently from anyone else. Not only that, what we – homo sapiens that is – experience as “reality” is different from any other species. In other words, it's a subjective experience.

As briefly as possible for our purpose here today, subjectivity is a single minded view or perspective of a given object or concept. A subjective view or opinion could possibly be correct but is more likely to be incorrect because of “built in” biases that most brains produce (which ).

The opposite of subjective is objective. Objective views are based on “neutral” or broad based evidence or standards. Objectivity is the ultimate goal of science (1) and why scientific method and instruments were created; when our subjective minds perceive something incorrectly, we need other methods to determine and understand what we're observing.

An old and very classic example of this is the idea that the sun
revolved around the earth which ancient peoples believed was “true” because that's what their observations told them and what their simple methods of inference (drawing conclusions from abstract evidence) concluded; the sun appeared to move across the sky east to west, therefore the sun must move around the earth. Then Galileo (though Copernicus first proposed the theory) came along and used some simple instruments and more scientific methods of observation of celestial movements and recordings of what the instruments told him and then drew much different conclusions to determine the true (or objective) reality.

We can laugh about the idea of the sun revolving around the earth now (2) but our minds are still capable of such subjective biases and drawing false conclusions about the “reality” around us. Hundreds of similar examples drawn from all people from all walks of life could be found on a daily basis. This is a very, very important point to grasp – a great deal of your “reality” is quite likely not be what's actually “real”.

This is very uncomfortable for most people (which is why most will tend to dismiss the concept). As I've said before, the idea of reality has been the subject of no shortage of philosophical and scientific endeavours and navel gazing for centuries but now neuroscience can demonstrate very clearly that what our brains assemble to produce what we experience when we saunter through life may not actually be “real” in the truly objective sense.

Now I don't want you to melt down over that (some people do, you know) but it's very important to understand and critical for understanding many (if not all) mental health disorders (which I'll explain further in moment). In later chapters, when we explore and start working on cognitive distortions this will all become much clearer and you'll better understand the importance of this then.

Now, to get a better idea of why our experience of “reality” is purely subjective and not exactly the “real” reality lets first take a very brief look at some of what the brain processes to create “your world”.

You'll recall from Evolution, Life and How Our Brains Developed that brains were defined
 as devices for processing information about our environment and we're going to look at that in a little more detail and get a better understanding of that. We have five senses – sight, sound, touch, taste and smell (I must emphasize that this is merely little more detail. What I need to get across here could easily fill several large books and we're trying to digest it down to a few paragraphs).

The five sensory organs (six if we include the gut-brain axis) operate 24/7 like radar bringing in information – what I like to call “data” - from the world around you. Humans, however, are very human-centric and will believe that we can see all colours, hear all sounds and so on. But in fact our eyes can only pick up a fraction of the colour spectrum, our ears pick up only fraction of the sound waves that are out there, our taste buds do not pick up all available tastes, etc. In other words, all of our senses are too limited to fully take in all the data that's available and for good reason; each species evolved their particular data sensory equipment and relevant brain regions to process that data to best suit their own survival. So all animal species experience a different reality, a different world, than homo sapiens do. What we experience when our worlds flash awake just happens to be our human version of reality.

Not only that, each of our individual human realities differ from that of anyone else. No two of us sees, hears or otherwise experiences the world in quite the same way.

These all important individual differences start with our sensory equipment. As mentioned, there's going to be genetic variation (the driving force of evolution is genetic variation) in how we are each developed and thus how our eyes, ears, noses, tongues and tactile sensations pick up sensory information is going to vary.

As just one of hundreds of possible examples, due to one of those genetic variations, a fraction of women have not three but four colour photo-receptors in their retinas and thus are able see colours, shades and hues that the rest of us cannot differentiate. This seemingly tiny and insignificant difference alone can create a perception of the world that the rest of us cannot even imagine (and lord help the men married to these women as they try to choose colours for their home decor).

One more very interesting example, recently discovered, is how much our olfactory equipment varies from individual to individual. Noses have 900 genes for receptors with 900,000 variations. Which ends up meaning that any two individuals' scent receptors will be at least thirty percent different from one another, which means none of us smell exactly the same things in exactly the same way, or in other words, we all experience a different reality about what we are smelling. No one person's sense of smell is exactly "right" or "better", just different (caution to men and husbands: do NOT try to argue this point with your female significant other).

See more at:

And these slight variations can be present in all our sensory equipment; slight variations and defects in the tiny bones and hairs that pick up sound will alter how we each detect sounds and then damage along the way will further alter that. Defects in the lenses of our eyeballs will alter how we each pick up detail in objects (though corrective eye wear somewhat evens this out). Some people have more taste receptors on their tongues and can taste what others cannot. And so on and so on and so on and all of these variations are going to alter what each of us experiences as “reality”.

But that's just the comparatively simple external equipment part of the sensory equation. As we saw in Neuroanatomy 101 and Genetics and Environmental Factors in How Our Brains Develop, the makeup of any one brain is vastly, vastly more complex; there is far more that can go wrong or simply just develop differently in the womb and – most importantly – the brain is far, far more malleable than any other body part or organ (and is constantly rearranging itself). (3)

Let's take sight for example. As mentioned in Neuroanatomy 101, our eyes just collect light, what we “see” - that is, what we experience as sight – is all processed and assembled in the occtipital lobe, a large brain region at the back of our heads. Assembling the moving picture show that you “see” in your mind is an enormously involved and complicated process which nonetheless works something similar to the process an artist uses for doing a full colour and detailed sketch. First, basic geometric shapes are arranged, then details added, then colours, then movement accounted for and voila! - you have what you “see” when you open your eyes. And, like all of us, you “assume” that what is taking place on the “screen” of your mind is it; that's what's out there.

What you see, however, is not “it”, is not reality. Various bits of neuronal equipment in our brains are constantly filtering or adding to the "final cut" of what we think we are seeing. In truth, at any given moment we will be missing enormous amount of visual information as our minds "decide" what is important or not important for us to “see”. Not only that, all kinds of subconscious programs will be picking up visual cues that you have no conscious awareness of and using these cues to guide your short and long term behaviours and decisions this way or that.

[I outline how two different people may perceive and react to a facial expression in this piece in my neuroscience blog in you are so inclined to read more on how our brains create visuals.]

Back to brain malleability and brain self-organization, what this means is that what we experience, the experiences themselves and how we experience them, is going to alter and shape brain structures - including the occipital lobe that creates what we "see" when we open our eyes (or even what we imagine we see). Then these altered brain structures – which can be very, very slight but enough to make a difference – will further alter how we “see” the world around us and even ourselves. As just one of many possible examples, people with any one of several forms of body dysphormic disorder (anorexia would be the most well known example) have brain regions and networks that produce a distorted image of their bodies as they see themselves. What they see when they look at themselves is not the same as what others see (which is part of what makes these conditions so hard to treat)

Another very large factor in how our brain is going to assemble our given “reality” is memory and how memories are formed and stored – or not formed and stored!

Many of us assume that our “memories” of ongoing events around us are like perfect recording devices that faithfully and accurately record most of what we see and hear and experience. But research from both over the last several decades and recent cutting edge research shows that our memories are horror shows for recording information. Our brains can easily create false memories which we'll nonetheless swear are “true” or “the facts” (and research into this is opening up a huge Pandora's box about the validity of eye witness or victim testimony). Memory formation and memory retrieval is a far from perfect business (as we find out when cramming for and then taking tests) yet other parts of the brain that form what we'll term for now our “ego” (sense of self) will “decide” what is “fact” and “not fact” in a horribly biased manner. We'll return to this when we examine what Freud termed “ego defenses” and how these distort our perceptions of “reality”.

Anatomically speaking, all the sensory information that is constantly flowing into our brains will at some point or level route through the limbic region and related brain nodules and “<connectome wiring>” that make up the stress response system. Here too we are going to see innumerable anatomical and biological variations and individual differences. As these areas are greatly related to our emotions and indeed play great roles in how we “perceive” everything around us, our emotional experiences will also greatly shape how we see the world or events and thus shape our individual “reality” and conscious experience, filtering and colouring it this way or that. In a more immediate starker way, there are many experiences that will trigger great stress responses releasing jolts of several hormones and neurochemicals which absolutely will alter your perceptions at the time and may very well leave deep long lasting changes in how you perceive the world around you (think traumatic experiences of all kinds and the disorders that can arise from them).

It is the “job” of our vaunted human frontal lobes and prefrontal cortex to “analyze” and “regulate” what goes on in our oft times volatile and impressionable limbic regions but if the anatomical differences there are vast, it pales in comparison to the frontal lobes which can develop or not develop in ways too numerous to even begin to list. The interplay between these to often “warring” brain regions will wax and wane and ebb and flow a tremendous amount on a day to day and even moment to moment basis in many people, all of which will alter and shape our perceptions.

We can go right down to the nano-scale and how all of this “works” or not will depend to a dizzying degree on how individual groups of neurons and the axons between them are performing or not performing which itself depends on even finer details to do with brain energy, neurotransmitter function or malfunction and virtually countless other possibilities.

What all of that means is that our brains constantly filter the data that our senses bring in and this filtering process is going to be a big part of both of what gets stored and retrieved from our memories (which could be two entirely different things depending on circumstances) and this often wildly imperfect recording and playback of our memories is also going to play a part in creating our individual “realities” or perceptions thereof.

Another significant factor in our reality perceptions – perhaps the biggest factor – is what I'll term for now “shared perceptions” of reality which are a part of our shared or cultural belief systems. A group of people – large or small – may perceive an event or share a view that is demonstrably (through independent objective means) false, or distorted or even outright delusional. But if this group all believes the same thing or sees a certain thing the same way, this view will be absolutely “real” to each of them and because the experience is shared, it is re-enforced in each individual as "real" (which could lead to even defending their version of reality to the death). Any anthropologist could give dozens if not hundreds of examples from small tribes or groups of peoples around the world throughout history or certain scholars could give many examples from even much larger groups (which could be categorized along religious, nationalistic or racial lines).

It seems needless to say, but we must anyway, that beliefs of all and any kind will have enormous sway over how our brains create our realities or how our realities create our beliefs. It never fails to astonish me how people of all kinds feel that what they believe is absolutely “real” and that that of others is not “real” (hence all the conflict, disagreement and discord mentioned earlier).

Countless events and experiences and cultural and group input over a lifetime will shape and alter how our brains make sense of the world and those around us and thus shape how they create our individual perceptions of “reality”.

These perceptions easily can and will be manipulated to great effect by powerful emotions – either individually or en mass (a “bug” of our brains used to great effect by leaders of the sorts of groups mentioned at the end of the previous paragraph). However we may try to resist, the endless onslaught of it all and how subconsciously it's all taken in and processed makes it extremely difficult to remain outside of it all and thus having our perceptual realities shaped.

In another piece we examined the roles that imagination plays in creating our mental perceptions and it is indeed hard to overstate how much imagination – that which is “not present to our senses” - is intertwined with how our individual brains create each our experiences of “reality”. Again, very uncomfortable territory for many people yet this in fact is what happens.

Now, to restate what we saw in the beginning, no two brains are alike which means no two people's perception of reality can be exactly alike. Yet each of us will firmly “believe” (that word again) that what we perceive as we go about our day to day lives is “real” or the absolute definition of “reality”.

A great deal of it is, of course. The device on which you're reading this is very much real, the car you may be driving (or mass transit vehicle you may be riding) and all the vehicles around you are very much real and if they collide, the resulting damage will very much be real and so on. But this goes back to objective or physical reality – that which exists independent of our own being or perception of it. But our interactions with these aspects of reality tend to lull us into believing that all of what we perceive is “real”. The lines between these, as I hope I am making at least somewhat clear, are very fine, not to mention being in near constant flux. To demonstrate this with someone, take a simple example such as the colour of a car, stand at different angles to the sun and try to agree exactly on what that colour is. Or the precise shape of something or the precise nature of it and so on. It won't take long before very divergent views begin to emerge (the renowned early 20th century philosopher <Bertrand Russel> penned some excellent essays that illustrated this with wonderfully concise clarity).

Let's now then look at this business of “consciousness” and how much of brain function operates below your consciousness awareness and control.

As we saw in a previous piece, the vast, vast majority of what drives “you” and all you do and think – and perceive – takes place in and is performed by autonomously running “brain programs” that hum away 24/7 with varying degrees of fallibility, consistencies and so on which themselves depend on dozens and dozens of internal and environmental factors.

To draw from all of that then, it is impossible to overstate just how much of your – or anyone's – reality will be created by forces well below your conscious awareness and control. Much of course will depend on how much education and/or training one has received or works on with objective and logical reasoning (which ostensibly would be present in all fields of the sciences, mathematics, engineering, and so on).

Now, let's bring this back around to mental health and what we looked at in the beginning.

I believe how our brains create reality and our individual perceptions of reality has a great deal to do with “mental illness”, perhaps even everything to do with various disorders. As I illustrated in my essay piece The Nine Hundred Foot Jesus and the Man on the Street, what is termed an “unhealthy” distorted reality and what is “socially acceptable” distorted reality is very, very arbitrary and the lines far less crystal clear than most people imagine.

The concept of reality is one that neither the best scientists on earth nor the greatest philosophers in history have been able to define with absolute certainty. As of now, we have no scientific or objective method for determining whether a given brain's perception of “reality” is really and truly false or not. We can narrow it down a certain amount, but we're not there yet in any one universal test. What is “false” in one set of minds is completely “real” in another set of minds. Who's really to decide which is “right”?

This is something I'll continue to chip away at – our concepts of “reality” and whether any given one is a sign of “mental illness” or more a matter of simply being different and outside of mainstream or socially accepted “norms”.

When we more closely examine disorders like schizophrenia and bipolar – the diagnosis of both of which in large part hinge on what's “delusional” - we'll see that the concept of “reality” and “delusions” is not what it may appear.

While there are certainly cases that are probably quite clear cut and of concern to the individual's and society's safety, we'll see that many are not so clear cut.

Yet this is what psychiatry does – with very unscientific and non-concrete methods of observation - they will brand a person “mentally ill” based on what are very fuzzy definitions of “objective reality” and “delusions” and how the Diagnostic and Statistical Manual itself is a highly flawed document for providing a basis on which to make such distinctions.

However, it is also completely possible that what we are experiencing in our mind - our perception of what's going on - is not true. In many cases of so called mental illness, we can create very distorted versions of our selves and our lives. We "see" one thing, while others around us see something completely different. There will, of course, be elements of truth in both views but it takes a very open minded approach for ourselves and others to sort through it all, something that I touch on in Mindfulness Meditation Cognitive Behaviour Therapy, in which we begin to learn how to sort through our thoughts and actions in a more non-judgmental objective way.

All of this will be raised and discussed further as we go along. For now though, it is necessary for me to deconstruct the notion that our individual - or even mass - realities are "it"; that is, our realities are seldom objective forms of reality. And understanding this and further exploring how our brains create our individual perceptions of reality and how those realities can be skewed will be a big cornerstone into our look into various mental health disorders.

(1) We're going to see in later chapters, when we examine the pharmaceutical industry and the science behind their products, that there is a lot of bad science out there; that is, science that is not objective

Well, not all of us are up on this reality. Apparently, according to a poll taken in America in early 2013, some twenty percent of Americans somehow believe the sun revolves around the earth. So despite all modern means of information accessibility and education, there are a good number of people still stuck in pre-dark ages.

(3) We will cover in more detail this brain malleability and ability to reorganize itself in the enormously important chapters on neuroplasticity.