“What does it mean to be crazy? To have a disorder of the mind. But “disorder” can only exist if there is some kind of pre determined “order” set in place. And who decides on order relative to the human mind? Human society. Sane and insane is a judgment based on perspective. And according to many other perspectives within this universe, it is human society that is rampant with disorder. So there is no reason to think of yourself as insane; if the very mindset of the society that determines whether you are sane or insane… is in and of itself insane!”
by: Miriam Mogilevsky
A few days ago I came across the story of Junior Seau, an NFL linebacker who committed suicide on May 2 (2012). He shot himself in the chest and was found in his home by his girlfriend. Although little is known of Seau’s mental health leading up to his death, he had apparently suffered from insomnia for the last seven years of his life.
Sportswriter Chris McCosky wrote a beautiful column in the Detroit News about Seau’s death and continuing ignorance about depression and suicide. In the column, McCosky shares his own experiences with depression and suicidal thoughts and laments how difficult it is to explain them to people. He notes, as I’ve noted before, that one common reaction that non-depressed people have is to wonder what the hell we have to be so sad about. He writes, “It’s almost impossible to talk about it to regular people (bosses, spouses, friends). They can’t fathom how somebody in good physical health, with a good job, with kids who love them, who seems relatively normal on the outside, can be terminally unhappy.”
The unbearable frequency at which McCosky and I and probably everyone else who tries to talk about depression get this response could be a testament to the fact the most visible symptom of depression is usually sadness. So that’s the one people latch on to: “What do you have to be so sad about?” “Cheer up!” “You have to decide to be happy!”
Because of the sheer obviousness of our sadness, we’re often forced to try to use it to describe depression. We say that we’re just extremely sad, or unhealthily sad, or adifferent kind of sad. It’s sadness that never goes away like sadness is supposed to. It’s sadness that’s out of proportion to the troubles that we face in our lives. It’s sadness that we can’t stop thinking about. For those of us with bipolar or cyclothymic disorder, it’s sadness that comes and goes much too quickly.
The truth is that sadness actually has very little to do with depression, except that it is one of its many possible symptoms.
Based on the diagnostic criteria for depression, you don’t even need to be chronically sad to be considered “depressed.” Anhedonia, which means losing the ability to feel pleasure from things that you used to enjoy, could be present instead. Under the formal DSM-IV definition, you must have at least five of nine possible symptoms to have major depression–and one of the five must be either depressed mood or anhedonia–and only one of those symptoms involves sadness. (If you so some very basic math, you will notice that this means that two people, both of whom officially have major depression, might only have one symptom in common. Weird, huh?)
So, even if your particular depression does include sadness, it’ll only be one of many other symptoms. The others might be much more painful and salient for you than the sadness is. Some people can’t sleep, others gain weight, some think constantly about death, others can’t concentrate or remember anything. Many lose interest in sex, or food, or both. Almost everyone, it seems, experiences a crushing fatigue in which your limbs feel like stone and no amount of sleep ever helps. Then there are headaches, stomachaches, and so on.
So, depression doesn’t necessarily mean sadness to us. (And a gentle reminder to non-depressed folks: being sad doesn’t mean you’re “depressed,” either.)
Depression is not sadness; it’s an illness that often, though not always, involves sadness. No amount of happy things will make a depressed person spontaneously recover, and, usually, no amount of sad things will make a well-adjusted person with good mental health suddenly develop depression. (Grief, of course, is another matter.) And sadness, on its own, does not cause suicide.
We need to start talking about mood disorders as disorders, not as emotional states. McCosky writes:
Junior Seau wasn’t sad when he pointed that gun to his chest. He wasn’t being a coward. He wasn’t being selfish. He was sick. I wasn’t sad when I thought about swerving into on-coming traffic on Pontiac Trail some 20 years ago. I was sick.
Junior Seau one month prior to his death
What he’s saying is that people don’t kill themselves because they’re sad. They kill themselves because they have an illness.
There is a tendency, I think, to assume that people are depressed because they are sad. A better way to look at it is that people are sad because they are depressed. That’s why, even if we could “turn that frown upside down!” and “just look on the sunny side!” for your benefit, it would do absolutely no good. The depression would still be there, but in a different form.
Junior Seau did not leave a suicide note, so only God knows what he was thinking when he died. I would guess, though, that he was thinking about much more than just being sad.
May is Mental Health Awareness Month, so Happy Mental Health Awareness Month to you!
I intend to explore the impact of race on mental health, both individual and collective, in a few posts this month. And, of course, how biracial factors into it. Or, more accurately, how it factors into biracial. All I know right now is that it does.
May the force be with me.
To kick things off:
Ever wonder who tended to the injuries of demonstrators brutalized during the civil rights protests of the 1960s? David M. French, a former Howard University professor of pediatric surgery and one of the first African-American board certified surgeons, coordinated many of those first aid efforts, as just one piece of a long career that merged medicine and public service. He died March 31 at the age of 86.
David M. French (Ellsworth Davis/Washington Post)
After witnessing firsthand the lack of quality health care available to blacks in the South at civil rights protests (he once converted his family van into an ambulance to lead a medical unit overseeing the care of Mississippi activists demonstrating against racism), French became committed to improving the health of underserved people and began to focus on preventative and community medicine.
French founded Boston University’s department of community health in 1969. He also established a network of community health centers in Boston before moving to Ivory Coast in the 1970s. There, he led an effort to train nurses and improve public health in 20 countries across the continent.
French returned to the United States in the mid-1980s and retired to Barboursville, Va. But his work didn’t end then. He went on to serve as medical director of Helen Keller International, a New York-based nonprofit organization that runs public health programs in developing countries. More recently, he served as medical officer for the nonprofit service and development African Methodist Episcopal Church.
Read more at The Washington Post.
The following is excerpted from:
Pema Chödrön and Dzigar Kongtrül: Let’s Be Honest
A discussion led by Elizabeth Namgyel
…Dzigar Kongtrül: Self-importance is having too much attachment to one’s own well-being and freedom from suffering, without having the same kind of care and concern for others’ well-being and freedom from suffering. When we have a great deal of self-importance, we will never be able to enjoy whatever we possess that we have gathered through our hard work, wit, and cunning. It will always bring a sense of dissatisfaction. We will never feel quite ready to enjoy it, because we carry the burden of being attached to it. However, if we apply to others the same sense of loving and caring that we have in cherishing ourselves, we reduce the self-importance.
When self-importance is reduced, a door opens to your positive qualities. As you continue to reduce the self-importance, the positive qualities take deeper root in your mindstream and your heart. At that point, you have real discipline and you begin to sustain yourself with your innate positive qualities, rather than the drive to become important. The ability to love, to care, to be concerned, to be compassionate—these were all there from the beginning. Previously, they were guided by self-centeredness; now they are guided by the needs of others.
This innate love is a powerful force that is now being led by a completely noble, incredibly dignified leader. Before, this powerful force, an army with the richness of a whole kingdom behind it and the loyalty of the subjects, was being led by a crooked king, and that crookedness created a state of confusion that spread everywhere. When that crooked leader is replaced by a noble leader, with a genuine sense of dignity, everyone in the kingdom can reap the benefit of the positive qualities that are the basic nature of the kingdom in the first place.
Pema Chödrön: Is the leader self-reflection?
Dzigar Kongtrül: The noble leader is altruistic mind, and the crooked leader is self-centeredness. Self-reflection is what discriminates between the qualities of self-centeredness of the bad leader and the altruistic mind of the good leader.
Pema Chödrön: It is interesting to consider the nature of the self-centeredness that seems to be prevalent in the West. I don’t think the term “self-cherishing,” for example, is all that helpful here, because the ego twist in the West isn’t that we love ourselves too much. Rather, we tend to have a negative preoccupation with ourselves. We might go shopping, not so much to feather our own nest, but to try to overcome some very bad feeling we have toward ourselves. Rather than cherishing ourselves, we hate ourselves. So, loving- kindness toward oneself needs to be developed as the basis before you can spread it to other people.
Dzigar Kongtrül: The loving-kindness is directed to your mind, not to the self. When you redirect the love and compassion from the self-centered approach, which has never produced good results anyway, to the altruistic approach, you find you have positive feelings in great abundance. Even though these are extended outwardly to others, they don’t leave your mind and end up somewhere else. They fill your mind and sustain it.
Pema Chödrön: Shantideva talks about all the ways that we are willing to hurt ourselves, including suicide. He says, if you’re willing to hurt yourself that much, it’s no wonder you’re willing to hurt other people. It seems to me the verses in the Bodhicaryavatara that discuss this issue are key for the West, because we’re much more into self-degradation than what you call self-cherishing.
Dzigar Kongtrül: The use of language in this case is interesting. When we say self-degradation, it sounds like we don’t have much self-importance. But in reality if one were not holding tightly to the self, there would be no reason to feel such aversion to it.
Pema Chödrön: Yes, I see self-degradation as one of the main ways that self-importance manifests in the West. You are still “full of yourself,” but you are full of yourself as a negative thing.
Dzigar Kongtrül: We come to believe that there is something fundamentally wrong with us. But if you really study, if you really practice, you will find that there’s nothing fundamentally wrong. So you need to commit to a course of study and practice, and until you do that, whether one is in the West or anywhere else, there is going to be the feeling that something is fundamentally wrong with you. When you wish to be happy and free from suffering, and yet your mind is not supporting you, it’s very easy to resort to thinking that there’s something fundamentally wrong with you.
Yes, I believe they were… Disturbing.
Teen With Asperger’s Arrested: Were Callers Racial Profiling?
by Ken Reibel
Reginald Latson loves to walk.
“He’ll walk five or 10 miles, it’s nothing to him. Sometimes he walks five miles just to grab a bite to eat at Chili’s,” says his mother, Lisa, who lives in Stafford, Virginia. “Walking is his release.”
Neli, as his family calls him, is 18 and has Asperger’s, a mild form of autism. Three Mondays ago, he rose early and left home without telling his mother. “When I entered his room at 6:30 am and didn’t see him, I assumed he had gone for another walk,” she says. It was a school day.
Four hours later Stafford County authorities had ordered a lock down for eight schools, and Neli was in police custody, facing one count of malicious wounding of a law enforcement officer, one count of assault and battery of a law enforcement officer, and one count of knowingly disarming a police officer in performance of his official duties. The cascade of missteps that led to the arrest suggest a combination of public racial profiling and the over reaction of law enforcement officers who are unfamiliar with autistic behavior.
* * *
After Neli left home early that morning he walked two miles to Porter Library on Parkway Blvd. “He goes there frequently. There’s a teen room there, and he enjoys it,” says Lisa. The library was closed, so he sat under a tree, in the grass, at the front of the building. The parking lot at Park Ridge Elementary, about 400 feet to the west, was filling up.
According to officials reports, someone at the school called police at about 8:38 am to report a suspicious person sitting outside the library, “possibly in possession of a gun.” A bulletin went out with Neli’s description, and officials, concerned that a gunman was on the loose, ordered a school lockdown and set up a search perimeter.
When police arrived at the library, Neli was gone. Unaware of the report, and impatient for the library to open, he began walking in the direction of the high school. A forested green belt of trees some 500 feet-wide with a well-worn path separates the school from nearby homes. At about 9 am, a “school resources officer” who is also a Stafford County Sheriff deputy approached Neli. That’s when accounts begin to diverge.
Lisa said her son complied with a search, which failed to find a weapon. Police say Neli “attacked and assaulted the deputy for no apparent reason.”
Neli told his mother that the school officer threatened him, and that Neli said “You’re harassing me. You’re not allowed to do that. I know my rights,” then turned and walked away. According to Neli, the officer grabbed him from behind and choked him. Police reports say a scuffle ensued, during which the officer pepper sprayed Neli. The police version, which you can read here, says Neli then took the spray from the officer and turned it on him.
According to Lisa, Neli said he took the spray and ran into the woods. The deputy, Thomas Calverley, reportedly suffered a cut to the head and a broken ankle, and underwent surgery.
By this time sheriff deputies were combing the area with search dogs, and at least one TV news crew offered a breathless live report of the manhunt. Neli somehow eluded the dragnet for another 45 minutes before being spotted and arrested in the high school parking lot, shortly before 10 am.
No gun was found “and subsequent investigation has indicated that that a gun was not actually seen by the reporting parties,” according to the official report.
Lisa learned of the arrest at 10:30 am, when she called the police to report that her son was missing. “I was told that he was in custody and was currently being questioned but I was not told why,” she said. “They wouldn’t tell me anything, and wouldn’t allow me to visit him. I told the police that Neli has autism, but they didn’t seem to care.”
For the next 11 days, Neli was held without bail, and in isolation at the Rappahannock Regional Jail. Police allowed Neli’s school counselor to visit, and she relayed messages and information to Lisa, who was allowed only one visit. “He wasn’t able to speak or communicate with me. He appeared to be in a catatonic state,” Lisa says.
She is understandably frustrated and angry.
“The actions that were taken by the police that day were excessive in the least and grossly mishandled,” she wrote on a website started to counter inaccurate local media reports. “Someone says ‘I see a suspicious black male’ and he ‘could’ have a gun, while all my son was doing was sitting in the grass at the library. And you shut down six schools and go out on a manhunt for this dangerous black man who was sitting in the grass. Anyone can read between the lines and see that this just doesn’t add up.”
Neli is from a military family, and during his 18 years has lived in Florida, Germany, Oklahoma and Georgia. Seven years ago his family moved to Stafford, a sprawling bedroom community about an hour south of Washington, DC. The family struggled to find appropriate school placement, finally settling on a private school. “The public high school was crowded, with about 30 kids to a class. Neli wasn’t getting the attention he needed, and his self esteem was slipping.” But he had never been in serious trouble. Never like this.
Lisa heeded the warning signs. A month earlier, she asked Neli how he would feel about wearing a medical alert bracelet that identified him as a person with Asperger’s. “He said that he didn’t have a problem with that, but I didn’t follow up. I’m just kicking myself for that,” she said.
Lisa, who works as a defense contractor, had also asked for a two month leave of absence to spend more time with Neli. That Monday was her first day off work. Her husband, Neli’s stepfather, retired from the Army and is currently stationed in Iraq as a military contractor.
* * *
As Neli’s time in isolation dragged on, police interrogators found him non-responsive and disturbed, and a judge ordered the young man transferred to a state mental institution for 30-days of treatment and evaluation. If the case is not resolved by then, he will end up back in jail.
The hospital is a two-and-a-half hour trip from Stafford, which Lisa says she has made four times. Horrified, she watched her son’s mental state worsen with each visit. “He is locked away and doesn’t understand why,” says Lisa. “He’s been through an ordeal.”
That ordeal has also changed Lisa, and the way she thinks about race, the police, and her community. She suspects Neli’s arrest was in part racially motivated, but it is not a charge she makes lightly.
“I used to donate money to the police benevolent society. I never imagined something like this could happen,” she says.
“I don’t think in terms of ‘watch out for those kinds of people’ or ‘you need to be scared,’” she says. “I grew up in south Florida. That’s a melting pot of cultures. I know there are good people and bad of every race.” Her life in the military, she says, has brought her friends “of every racial background.”
Has the ordeal changed her views on race and racism?
“It has,” she said, her voice trailing off. “It most definitely has.”
* * *
Cross posted at AutismNewsBeat.com
…to the “race doesn’t matter” mantra. It seems to be relevant when physical health is the issue. Actually, mental health as well, but that’s a different story. Anywho, I’m happy to read of this research and find it interesting that supremacists are happy to hear of it too.
Genetic screening may redefine medical treatments
SAN FRANCISCO (KGO) – New research out of UCSF shows that tracking a patient’s genetic ancestry can improve the diagnosis of asthma and other lung diseases. The results could have broader implications for other diseases that also rely on standard benchmarks such as race, gender and age.
Doctor’s office visits are the norm for 9-year-old Shamatay Hayes. She was diagnosed with asthma at age 2, something she and her mom have struggled to keep under control.
“It is challenging,” her mother says.
At San Francisco General Hospital and at asthma clinic across the country, Shamatay’s lung function is tracked using standard benchmarks such as age, gender and race. But, researchers say there is now a better way.
“So, what we can now do with modern techniques is estimate what a person’s ancestry is or what their heritage is using a series of genetic markers,” says UCSF researcher Dr. Melinda Aldrich.
The genetic markers more accurately determine lung function rather than a patient’s self-identification as simply white, black or Hispanic.
“With increasing African ancestry, we saw a decrement in lung function,” says UCSF associate professor Dr. Esteban Burchar.
Burchard is director of UCSF’s Center for Genes, Environment and Health, and senior author of a paper just published in the New England Journal of Medicine.
“We said forget what you think you are, what people think you are, and we looked at your genetic ancestry. We were able to reclassify patients more accurately than just using self-identified criteria,” explains.
That is increasingly important because race is used to establish normal reference values for everything from diagnosing disease to establishing disability payments. For instance, a mixed-race firefighter who suffers smoke inhalation might not meet the standards for disability of what is considered normal lung function since that is based on just three racial categories right now.
“What we showed is when you use these race-based standards, you could have as much as a 10 percent error rate depending upon what your true ancestry,” Burchard says.
Burchard believes this research brings us closer to truly-personalized medicine, but he is also aware of the potential controversy.
“We’ve had people contact us who were supremacists that said you know what you’re doing is validating what we believe,” he says.
But, the research actually tells a different story.
“Most of us, all of us in fact, are racially mixed,” he says. “We have a very rich heritage and what we’re doing is acknowledging that mixture and incorporating it into our clinical assessments.”
Scientists believe their results on lung function are just the beginning.
Aldrich says, “Wherever potentially we use race now for making medical decisions, it may have an impact with other diseases.”
This would ultimately make medicine more effective for everyone. The genetic tests used by researchers at UCSF cost about $10 per patient. Scientists see it as a small price to pay for a more accurate assessment of disease, which could lead to more effective treatments for patients.
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