Saturday, October 23, 2010

Three astounding things

First, thank you for the encouragement following the last post.  Sniff.  You guys rock.

Second, about there always being a solution?  Well.  There is.  Sometimes the solution one chooses isn't pretty.  Sometimes that solution requires a lot of clean-up effort in order to pull it off.  Those solutions often result in so much sadness that it can be hard to think of them as solutions.

Third, how about those solutions?  It's been a wild week, people.  After most of the paperwork was done there were other things to attend to.  I have recently been privileged to be involved in various stages of miracles, perhaps AKA: solutions.  I sat with groups of people this week in three distinctly different contexts, and the churning of the wheels, the possibilities and likely solutions that filled those rooms were so huge as to push out the windows in search of more space to inhabit. 

The first was a bunch of people who work with various organizations concerned with or representing families and individuals dealing with an atypical set of expectations for life.  I hesitate to say "people with special needs" in part because don't we all have special needs?  That group knocked my socks off and I'm sure they will again.  Moms and Dads and Self-advocates have shown up.  No.  They have SHOWN UP.  They have skills in both the professional and empathic senses, they have commitment and a desire to make Big Progress. Undoubtedly they shall, and I plan to be there celebrating it.

The second context, chronologically, was a group of people who chose to lead with compassion instead of judgment.  They will therefore be part of an evolving miracle, one which occurs over time and will no doubt knock many pairs of socks right off.  My mouth is still hanging a little bit open from the experience, but I've pinched myself, and yes, it really did happen.  The work isn't done, but that it is supported is huge.  These things spool endlessly out on behalf of the righteous, the good, the useful which lies in each of us.  Those people who chose to be kind and to try to understand when they could have been cruel, those people have grown themselves a bit by moving past their natural comfort zone, and will grow more as they continue in this process.  Amazing, the things which become possible when we're looking for opportunities to become conduits of Grace.  (Sometimes the end result doesn't even matter - because the work/growth/joy along the way has so changed us all, but that's another story.)

The third gathering was to honor the memory of my dad's uncle.  During the telling of his life story, one of his daughters related that he experienced a condition we now call high-functioning Autism.  This is a big deal in the context of family history, in part because generations past would rather die than discuss such things.  In part, this is a big deal for certain members in younger generations, some of which have stared myriad possible diagnoses in the face for their own children:  PDD-NOS, ADHD, Asperger's syndrome, Tourette's syndrome, clinical depression and etc.  That we could sit and hear this about this kind, hardworking, talented man who so clearly meant so much to so many, and let it inform the depth of respect and appreciation we already had for him, afforded each of us an opportunity to gently let go of the portions of his personality which never quite made sense.  We were able to take these words: "he experienced a condition we now call high-functioning Autism" and acknowledge that the very literal fight for survival in a missionary family during the Great Depression was tough beyond what most of us can comprehend.  Those words removed an inappropriate moral overlay to a complex human being.  He was not lazy; he was pushing with all he had to get where he did.  He was not slow; he had a bright but differently organized brain, one which was always ready for benign mischief or to share his collection of harmonicas.  He was not stupid; he poured his love into his wife and children, even as he wished for a more "normal" connection with the rest of the world. 

So as we took in these words (which some in the group had come to believe even before they were spoken in this setting), those of us working hard to figure out the puzzles who are our own children let out a collective breath of relief.  We are not crazy.  We are not doomed.  We are not making this up.  And then with that we can acknowledge this:  There is no normal.  There is very little "optimal" or "typical" in the world, and we can demonstrate this through a ton of research, should the need arise.  We will take our people the way they are, thank you, and stand on the shoulders of those giants who have come before - like my dad's uncle: a man you would have been lucky to have known, but may also have thoroughly mystified or frustrated you.

My week has been heavy on knowledge of brain function.  Some of you are snorting as you read this.  Do try to get a grip - just because you think I live in the world of brain function...  Sheesh.  Well, okay.  I do read some (gazillion books) on the subject.  And I could recommend titles, if you're interested, she says hopefully. 

There are a couple of things that I've talked about more than once this week, things which I think are important enough to repeat here.  Feel free to share the following - I think it needs to get out there. 

Many years after Freud and his stages of development, psychology/psychiatry has moved on, hopefully into a good, solid combination of neurology and psychiatry, with a nice underpinning of cognitive behavioral therapy.  Why would I say this?  Thanks to the curious researchers who've worked in the field since Dr. Freud, we know some quite useful things about what happens in our brains.  Let's take depression as an example - because interestingly, it is somewhat easier (for me) to describe than many other commonly known neuropsych diagnoses.

First, it is useful to think of depression as a literal depression of certain levels of certain chemicals, serotonin and dopamine among them.  These neurotransmitters are what's rolling around in our gray matter when we feel content, rewarded, glowy.  Oxytocin is another, one that helps us form attachments to the people around us.  It positively floods a mama when she's nursing her infant, which as one might imagine is an especially useful feature of human function - a necessary act, feeding, furthering the bond between mother and child (and it feels a little like being hit by a big, warm, fuzzy truck).  Oxytocin is also present and available during sex, especially for those already fond of each other.  Another handy biological thing.  Dopamine pops in for a starring role in sex/desire as well. 

Back to serotonin.

Serotonin is the chemical that helps us feel buoyant enough to "do" life.  Its absence creates a literal depression within the brain, a lowered level of useful chemicals, a drop in function, sorting of priorities, and accomplishment.  Most of us are aware enough of that, cognitively at least.  But until more recently, most of society ascribed loss of ability to do the regular things of life to wrong moral choices.  Thus a horrendous stigma attached to mental health issues of any stripe.  I'm sure you can think of someone you've known who has struggled to reach his or her potential, despite being quite bright.  That person probably felt badly enough about lack of acheivement, but it's even worse to not know how to drag oneself out of such a place.  Straining against one's bootstraps will never serve to overcome depression, though it surely isn't wasted effort.  More on that in a minute. 

What we know now about how serotonin works in the brain is this.  When you feel sad for pretty much any reason, serotonin levels drop.  Loss of a loved one or job, health issues, each of these are recognized as having a fairly significant impact on one's ability to bounce cheerily along.  But even if it's a smaller life event, say, a twisted knee or having lost fifty bucks in the office pool, these things too can show up in your brain as a drop in serotonin.  For smaller life events, we certainly do give those bootstraps a good yank and expect to be back to "normal" in minutes or however long it takes us to wrap the knee in a compression bandage.  But what about for larger events?  It turns out that any more significant drop in serotonin results in a shrunken brain.  Seriously.  Without good levels of serotonin, your brain shrinks. 

We used to think that brain shrinkage was inevitable, with injury, disease, or just aging.  Nope.  It turns out that when serotonin levels drop the stem cells in the hippocampus stop turning into new neurons.  Did you know that you have stem cells that the hippocampus turns into new neurons?  You do.  It's true.  Our brains are continually pruning unused branches, but they are also continually growing new ones - unless we have insufficient serotonin levels.  Most of us can handle some of this shrinkage.  We get that there are Big, Difficult Things in life and we flail and slog and then emerge triumphant on the other side of that temporary slough.  But this isn't the case for everyone - some people's brains don't snap back.  There are also brains that do not, have not, and will never self-regulate well, in terms of neurotransmitter levels.  And perhaps the most important thing to know about this is that there is no moral component:  people struggling with depression have not chosen to be depressed and they are not screwing with your head just because they can.  (Okay - important note: sociopaths are a completely different category.  Their very own, very special category.)

So if people who struggle with depression aren't thrilled about being depressed, if those of us around them aren't thrilled for them, how do we fix this?  Surely, rather than sitting around decrying the situation and feeling tortured on behalf of our loved ones, there must be a solution.  Aha.  I'm so glad you asked.

There are lots of medications, very good ones.  It's difficult to nail this option on the first try, but not impossible.  There are supplements - amino acids are the precursors to neurotransmitters such as serotonin and dopamine and there are books which discuss appropriate dosages.  Amino acids taken individually to address particular parts of particular brains can often address depression, anxiety, ADHD, and a bazillion other issues quite nicely.  Some practitioners believe that everyone, including children, should be taking a minimum of 1000 IU of Vitamin D3 daily, with most adults needing at least 2000 IU daily just to maintain healthy levels - which drop MS risk and contribute to a healthy brain.  Omega 3 fatty acids are essential -  60% of the stuff inside your skull is made out of fatty acids.  Omega 3's are the best option to make that brain a happy one.

There is also the need to work actively to form healthy brain-support habits.  For example, not believing every negative thought that comes to mind - most of them aren't true, but they like to take root, burn pathways into your brain, and make your life miserable.  They help to create depression - and once a person has had one episode, another is more likely to occur in that person's life, and perhaps more dramatically so - because those pathways are already there and asking to be used.  If you help a negative thought sit inside your head long enough, it can seriously mess you up - nothing like talking yourself into a situation that costs you your family.  Regular, sweaty exercise also changes your brain chemistry for the better.  Eating good food - no food coloring, minimal processed sugars, good balance of nutrients, organic whenever possible - makes a huge, demonstrable difference in how our brains function.  Volunteer - even if you don't feel like it, helping someone else always lifts you. 

And what if you're doing everything you can think of and things are still kicking you down?  There's a lot of help to be had, people.  Really, really great help.  Find someone who cares about you and tell them that you need help getting to help.  Your friends and/or family cannot fix this for you, much as they wish they could.  But they can help you get to a person or place offering some relief.  You must speak the words, "I need help.  I can't do life this way anymore.  I am depressed and I need help."  People want things to be okay and they often don't hear your plea correctly the first time it's uttered.  Say it again.  If necessary, take a breath and say it again.  If there's no response, it probably has nothing to do with how much that person does or doesn't care about you - they may need to wade through their own baggage to be able to hear you.  Do. not. give. up.  And hurry up!  The world needs you, in one piece, highly functional!  You've got stuff to offer and we need you!  YOU!!!  (Aherm.)

If you're living with or know of a person experiencing depression, it's important to remember that the depression isn't the person.  It's important, if at all possible, to haul that person bodily to a place where they can get help (one excellent option).  And remember that if they've asked for help they may now be flat worn out and unable to initiate anything else on their own behalf - like getting help.  It's important to remember that depression is exhausting to those who have it residing in their heads and to those who love them.  It's important to remember that depression can present atypically - with bursts of energy, for example, followed by inactivity - and atypical patterns can still be depression because of whack-a-do neurotransmitter levels.  It's of utmost importance to take excellent care of yourself - always grab your own oxygen mask before helping others.

And for all of us working under stymieing diagnoses, be you friends, families, or persons with a diagnosis:  Rest when you need to, be kind, do good things whenever and wherever you can, and pray.  Read uplifting things, be genuine in and about your struggles, and pray.  Keep a gratitude journal - three good things every day, find or create and revel in things that make you laugh, and pray.  Be hopeful.  Know that there is truly, always, always an answer to be had.  It may be a different color than you were expecting, it may require anesthesia to survive, but solutions lie all around us.  Know this, down to the bottoms of your feet and with every electron in you, and pray.

Hope comes in the morning, baby, and dawn is about to crack.


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