Tuesday, January 28, 2014

Adventures in insanity: How some anti-depresants work - a personal interpretation

So hey, in case you didn't know, I suffer from bipolar disorder. Bipolar II, to be exact. That's the one with the mild little hypomanias (because full-blown manias are just too much fun, I can't be allowed to have me some) now and then and the monster depressions. We're in the depression part of the cycle right now and have been for more than a year.

It's getting kind of old, actually. Ally from Hyperbole and a Half explains this beautifully: the sadness for no reason, the trying to get yourself to do something (and failing miserably), the boredom and ennui. Oh Lordes, the ennui.

So anycase, it's been getting worse for a while now without me really noticing (thanks new meds! That worked out really well!) and now we have to do med-adjustment once again. Which kind of feels useless at this moment, but then so does everything else.

So I was thinking about how one would explain the chemical phenomenon of depression to someone else who wasn't familiar with it, maybe like someone who needed the meds but didn't want to take it because hey, stigma is still a thing in 2014. And I remembered parts of a pharmacology class I once interpreted that explained it really, really beautifully. But I only remember bits and pieces of it, and it simplifies things a lot. The real process is a lot more complex, but it gives one an idea of what's up with the constant damn depression, and so I thought "Hey self, we'd better get this shit written down, because our brain looses shit like that little chipmunk thing in Ice Age looses his acorns".  So here goes my extremely basic and limited understanding of the biochemistry involved.

In your brain there are stuff called neurotransmitters. Now when we're talking depression (and other psychological and non-psychological disorders like Alzheimer's and Parkinson's too! But for now we focus on depression) these neurotransmitters is where shit is at. Why? The answer is slightly complicated, so stay with me here.

Some complicated-ass picture that explains how the neurotransmitters and synapse work in transmitting a message (also called an action potential).

When the brain needs to send messages (and messages can be anything from "keep breathing" to "hey, hot pot touching = bad idea!" to whatever), the message goes from cell to cell until it reaches the place it needs to be (like the fingers, in the case of the hot pot). This happens incredibly fast, obviously, but that's neither here nor there. The important bit here is how the message goes from cell to cell in the brain.

So let's call the cell that currently contains the message the sender cell, and the cell where the message needs to go next the receiver cell. Of course you'll see that once the message reaches the receiver cell, the receiver cell now becomes the sender cell and the next cell in line becomes the new receiver cell, right? Right.

So now, when a message comes through (which happens very, very often, as you can imagine), your neurons have a set pattern of behaviour. The sender cell releases neurotransmitters that go out and fills the gap between the sender cell and receiver cell. These neurotransmitters relay the message from the sender cell to the receiver cell, and once this is done, it gets reabsorbed so that it can be ready for release when the next message comes.

There are more than 100 identified neurotransmitters, and the release of each one of them has a certain effect on the brain. When we talk about depression specifically, there are three specific neurotransmitters that seem to play a significant role: Serotonin, norepineprhine and dopamine.

Now, the reactions and  in the brain when one experiences trauma or stress is very, very complicated but once of the things that happens is that there are so many messages sent so quickly that the reabsorbtion (or reuptake) of serotonin, dopamine and norepinephrine go into overdrive, trying to reuptake them as soon as possible to deal with the burden of the stress. It's like the brain goes into a triage kind of system: doing this isn't a good thing in the long run, but it will help us survive for the short term so let's do this now and we'll sort out the long term later.

A brief overview of what the three neurotransmitters involved in depression do in the brain and how they interact with each other.

As you can see from the picture, the three neurotransmitters involved in depression each has an effect on the brain. You can also see how they interact with each other to have complex effects. So now it's easy to see how messed up shit can get when these neurotransmitters are not in the correct balance with each other, or if something else is out of whack with them, right? Right. So the effect of the stress we talked about earlier is that the brain, in order to keep up with the demands the stress place on the body, basically causes a disturbance in how much of these neurotransmitters are hanging around between the synapses, doing their thing. The longer this goes on and the more severe the imbalance is, the more pronounced the symptoms you'll show from this imbalance.

After the period of stress is relieved, the brain recognizes that it no longer needs to reuptake these neurotransmitters like a demon and gradually returns to its former functioning. If this happens, everything is fine, congratulations, collect your prize when you leave the door healthy and happy.

However, in depression, one of the things that can happen either because of a genetic predisposition, prolonged stress, or a number of other factors, some which aren't understood or known yet, this process sometimes doesn't return to normal.

The brain has gotten so used to dealing with the high stress environment and reuptaking these neurotransmitters as soon as possible, that it 'forgets' that this isn't actually the way it's supposed to do things. So now, when the cause of the the initial stress reaction is taken away, the brain keeps on following this same pattern it got used to when stress was high and fast reuptake was necessary. This means that there's not enough serotonin, dopamine and norepinephrine just lying around the brain, mellowing things out and doing what they're supposed to be doing to keep the brain functioning optimally.

This is obviously a problem, and depending on the degree in which the brain is malfunctioning and the balance of the neurotransmitters left in the brain, able to do their jobs before being reuptaken, things can get really serious really fast, to the point where the lack of appropriate neurochemicals can lead to the brain losing its number one drive: to stay alive.

When you look at the anti-depressants that are available with the knowledge you now have, you'll have a better understanding of what they do. Like SSRI's: that stands for Selective Serotonin Reuptake Inhibitors. The "inhibitor" part means that it prevents or discourages something (just as a quick, layman's explanation), so what SSRI's do is they discourage the reuptake of some ("selective", there's more than one type of receptor for serotonin, because things aren't complicated enough already) of the serotonin in the brain, meaning that there's more serotonin hanging out in the gap between synapses, able to do its thing to the brain.

And that's why taking medicine for depression is not a "weakness" or a "crutch" or any of the stygmatizing things that people like to say about this. It's taking medicine for a legitimate medical issue.

Just for interest's sake, did you know that Parkinson's is caused by a problem with the dopamine neurotransmitter in the brain? Just like depression is caused by a problem with dopamine, serotonin and norepinephrine in the brain. You wouldn't tell someone on meds for Parkinson's that they're just "weak", and that they need to pull themselves together and choose to (be more positive) tremble less and all that shit, would you? Of course not. Yet it's the same as depression!

So why is it different when it's depression?

Monday, January 21, 2008

Something borrowed, something fun, something true for me...

Are you a literature junkie? Take this test and find out! How many of these apply to you?

1. I have read fiction when I was depressed, or to cheer myself up.
2. I have gone on reading binges of an entire book or more in a day.
3. I read rapidly, often "gulping" chapters.
4. I have sometimes read early in the morning or before work.
5. I have hidden books in different places to sneak a chapter without being seen.
6. Sometimes I avoid friends or family obligations in order to read novels.
7. Sometimes I rewrite film or television dialogue as the characters speak.
8. I am unable to enjoy myself with others unless there is a book nearby.
9. At a party, I will often slip off unnoticed to read.
10. Reading has made me seek haunts and companions which I would otherwise avoid.
11. I have neglected personal hygiene or household chores until I have finished a novel.
12. I have spent money meant for necessities on books instead.
13. I have attempted to check out more library books than permitted.
14. Most of my friends are heavy fiction readers.
15. I have sometimes passed out from a night of heavy reading.
16. I have suffered "blackouts" or memory loss from a bout of reading.
17. I have wept, become angry or irrational because of something I read.
18. I have sometimes wished I did not read so much.
19. Sometimes I think my reading is out of control.

If you answered "yes" to four or more of these questions, you may be a literature abuser.

Affirmative responses to seven or more indicates a serious problem.

Once a relatively rare disorder, literature abuse, or LA, has risen to new levels due to the accessibility of higher education and increased college enrollment since the end of the Second World War. The number of literature abusers is currently at record levels.

Social costs of literature abuse: Abusers become withdrawn, uninterested in society or normal relationships. They fantasize, creating alternative worlds to occupy, to the neglect of friends and family. In severe cases they develop bad posture from reading in awkward positions or carrying heavy book bags. In the worst instances, they become cranky reference librarians in small towns.

Excessive reading during pregnancy is perhaps the number one cause of moral deformity among the children of English professors, teachers of English and creative writing. Known as Fetal Fiction Syndrome, this disease also leaves its victims prone to a lifetime of nearsightedness, daydreaming and emotional instability.

Heredity: Recent Harvard studies have established that heredity plays a considerable role in determining whether a person will become an abuser of literature. Most abusers have at least one parent who abused literature, often beginning at an early age and progressing into adulthood. Many spouses of an abuser become abusers themselves.

Other predisposing factors:
Fathers or mothers who are English teachers, professors, or heavy fiction readers; parents who do not encourage children to play games, participate in healthy sports, or watch television in the evening.

Prevention: Pre-marital screening and counseling, referral to adoption agencies in order to break the chain of abuse. English teachers in particular should seek partners active in other fields. Children should be encouraged to seek physical activity and to avoid isolation and morbid introspection.

Decline and fall: The English major Within the sordid world of literature abuse, the lowest circle belongs to those sufferers who have thrown their lives and hopes away to study literature in our colleges. Parents should look for signs that their children are taking the wrong path -- don't expect your teenager to approach you and say, "I can't stop reading Spenser." By the time you visit her dorm room and find the secret stash of the Paris Review, it may already be too late.

What to do if you suspect your child is becoming an English major:
Talk to your child in a loving way. Show your concern. Let her know you won't abandon her -- but that you aren't spending a hundred grand to put her through Stanford so she can clerk at Waldenbooks, either. But remember that she may not be able to make a decision without help; perhaps she has just finished Madame Bovary and is dying of arsenic poisoning.

Face the issue: Tell her what you know, and how: "I found this book in your purse. How long has this been going on?" Ask the hard question -- "Who is this Count Vronsky?"
Show her another way. Move the television set into her room. Introduce her to frat boys.
Do what you have to do. Tear up her library card. Make her stop signing her letters as "Emma." Force her to take a math class, or minor in Spanish. Transfer her to a Florida college.

You may be dealing with a life-threatening problem if one or more of the following applies:

*She can tell you how and when Thomas Chatterton died.
*She names one or more of her cats after a Romantic poet.
*Next to her bed is a picture of Lord Byron, Virginia Woolf, William Faulkner
or any scene from the Lake District.

Most important, remember, you are not alone. To seek help for yourself or someone you love, contact the nearest chapter of the American Literature Abuse Society, or look under ALAS in your telephone directory.

by Michael McGrortyLibrary Dust

I guess it's just too late for me now! I answered "yes" to almost all of the above, plus I have 3 cats named for poets (ancient Latin, not Romantic, but still) and I am (was?) an English major!

What about you?

Friday, January 18, 2008

When the night has come...

Ah yes. We are languishing in the dark here. A quick joke for those of you who’ll get it:

John is walking around, minding his own business and thinking his own thinks when the Devil spots him. “Ah,” thinks the Devil. “Another soul for me to capture and torture.” Devil walks up to John and says “Good day, Mortal.” John looks at him and says: “Who are you?” The Devil replies: “I am the Prince of Darkness.”

“Oh!” says John. “I know who you are. You work for Eskom!”

Another one:

Breaking News: This morning word went out that the National Anthem of South Africa will no longer be "N'kosi sikelel' i'Africa". It is being updated to "Sounds of Silence" by Simon and Garfunkle (with the famous first line: "Hello Darkness my old friend..."

For those not In the Know: Eskom is South Africa’s power supplier. This company is completely (or almost completely) state (or government, it’s hard to know what’s the right term anymore) funded, plus they charge us, as consumers, an arm and a leg (seriously, we are one of the coutries that pay the most for electricity in the world) AND THEN it turns out that they do not have enough power for all of us who are paying for our electricity and in fact, will only have enough power in PERHAPS 8 to 10 years. This is because they didn't foresee that providing electricity to all of those who didn't have any (which is a laudable goal, don't get me wrong) would mean that capacity increases, and now they have too little power to go around, and have to make plans to build new power stations. Which will take AT LEAST 8 to 10 years until we have that extra power.

What about the meantime, I hear you ask.

Well, Eskom says. For now it’s rolling blackouts and Load Shedding (which is just a nicer way of saying: "We're cutting your power when we're needing power, so solly cholly"!)

The ironic part of this is when you try to access the schedule for the load shedding, the "service is unavailable". Talk about an understatement.

UPDATE: Eskom fixed the webpage, but I still have the pictorial proof, tee hee hee. Oh, and for this weekend, apparently the schedule is 90 minutes on, 150 minutes off, 90 on 150 off throughout the days on Saturday and maybe Sunday. Now I ask you with tears in my eyes: why do we even have electricity? And why are we paying between 18 and 14% more for this *lack* of electricity this year?

Thursday, January 17, 2008

Taking a break... from sleeping

Another fun thing about having kids is that sleep goes on a vacation... and sometimes it feels like it'll never return.

Just to sketch the scenario: we have two girls, one aged 4 months and one aged 2 and a half years. Sleep in our house (at least as done by me, as my husband would sleep through an explosion once he falls asleep) is pretty much non-existent in units of more than 1 hour at a time. And the horrible thing is, it's the older one that's having the trouble. I get up 3 times for her for every one time I get up for the baby.

The sad thing is, there was a time not so long ago when I thought she’d start sleeping through... and then she got chickenpox about 5 months ago, and ever since then her sleeping and mine have been demolished.

She wakes, crying, on average 6 to 12 times a night (from 7pm to 6 am). I’m going nucking futs here, and so is she! Any suggestions? Because pretty soon I’m going to go crazy!

Wednesday, January 16, 2008

Wanted: calm and sanity - Reward Offered

I don’t know about you, but here mornings are the very definition of craziness. Oh, it starts innocently enough: huge brown eyes popping open and announcing to the world in general and me in particular:

“Time for get up, Mammia”. I reluctanty pry open my protesting eyes while she’s already holding a full-length conversation with the cat, including replies from said feline. I try to grumble (softly, so as to not wake the baby) “Logia, sleep some more, let’s sleep a little bit more,” but I know it’s useless. With an embattled sigh I pick up my cellphone-slash-alarm clock and peek at the time.

At this point, I fly out of bed, muttering expletives all the while, trying with very little success to prevent Logia from hearing it because of course I had meant to “snooze” the darn thing and instead had turned it off, so it is now 30 minutes later than it’s supposed to be.

“Farg!” Logan chimes happily. “Crêpe!”

Get the toddler, try to get her dressed. Consider buying some of those restraints they have in mental hospitals, the kind where you strap the patient to the bed. For those of you who’ve never had one: dressing a toddler is like putting clothes on a hyperactive and giggling squid who thinks escaping and running naked through the house is the absolute height of hilarity, and therefore puts all energy and resources to the achievement of that goal.

Finally, Logan is dressed. By this time I am dripping with the sweat of exertion, so into the shower we go, with helpful comments like “Mama naked” and “look your breast” to cheer me on. Should I try to keep her out of the bathroom, nuclear meltdown mode ensues, so I try to shower as quickly as is humanly possible.

The baby is still sleeping like, well, like a baby. With Logan in tow, I go into the spare bedroom, where I have set up my hair and make-up station. I did this so that the baby won’t wake when I dry my hair and apply my make-up, since Logan’s default volume seems to be “ear-piercing”. Trying to prevent the baby from waking is an excersize in futility, once Logan is up, so I haven’t even started drying my hair when the baby wakes and needs attention. So, I leave my hair the way it is and go to dress and diaper Katya.

Eventually I dress myself, and it’s usually only when we finally reach the car (having already locked the house, with Logan staring at everything and still trying to escape at each and every opportunity) that I realize that I never did my hair or make-up. Ah well. Into the car we go, and off to start a new day, and I am already exhaused. Again.

Ah well, it could have been worse. I could have had kittens in the house, causing the toddler to chase and terrorise them everywhere without end, meaning I have to look after them as well as her... oh wait. I do have that.
Am I the only one whose universe is run by a 2 and a half year old?

Friday, May 11, 2007

And I thought school was bad...

Apparently teachers in Britain feel that students waste too much time on totalitarian trivialities like academics and not nearly enough time on important life skills like the different applications of walking, according to the following article from This is True.
"DON'T TRY THIS WHILE CHEWING GUM: Martin Johnson, the acting deputy general secretary of the Association of Teachers and Lecturers, a teachers' union in Britain, says the national school curriculum is "totalitarian" because it focuses on academics. What should schools teach, then? "Other" types of knowledge, he said. Like what? Like learning how to walk properly. "There's a lot to learn about how to walk. If you were going out for a Sunday afternoon stroll you might walk one way," he says. "If you're trying to catch a train you might walk in another way and if you are doing a cliff walk you might walk in another way." (London Guardian) ...And if you're thinking of sending your kids to ATL-led schools, run! "

Can’t say that I blame them, really. I mean, who wants to spend time educating the very people who will one day run the world in something as boring as mathematics, politics and English spelling and grammar when the fascinating and hitherto unexplored world of everyday activities await!

Thursday, May 10, 2007

Kicking Butt

I want to know who created this stupid idea that health is your most precious commodity, because that really just isn't true. At this stage, I would have really loved, adored, begged for being ill.

You see, I'm trying to quit smoking, being pregnant and all that. And if you've never smoked or had to quit smoking, you'll have no idea how hard it is to kick butt while you're disgustingly healthy and hale.

Right now, I've managed to cut it down to about 2-5 a day and I'm still feeling an amount of guilt that you simply can't imagine, but the truth is I'm having a real hard time with the quitting. It's ironic, since I had no problem quitting with my previous pregnancy… though come to think of it, by the time I found out I was pregnant I'd already quit for about two or three months.

The story goes like this. I became horribly, violently, terribly ill during the winter (remember, winter here is from march/april to august/September). So there I was, hacking my lungs out (or what was left of it after ten years of light to moderate smoking, which at the time felt like it couldn't be larger than two pin heads) with my breast so congested and tight that I couldn't breathe air properly, nevermind smoke. So I just simply wasn't physically able to smoke until I got better, which took about a week to ten days, at which time I decided that a) I never wanted to feel like that again, and b) I had already quit, actually, for ten days and should be over the worst of the cravings and withdrawal, only I missed it because I was too busy being ill and consumed in self pity to notice. Simple as that, non?


You can imagine how superior I was feeling, having quit the coffin nails with no trouble at all, no cravings, no irritation, nada. I was insufferable. Smirking at everyone who complained about quitting smoking in a "I'm-better-than-you" kind of way, I'm sure many people wanted to just wring my neck. People who are coming off the nicotine are very, very easily irritated, as I can well attest now. The only thing I can think is that they didn't want to harm a pregnant woman, so they tried to avoid me, which of course made me feel even more superior, because I thought that they were avoiding me because they were feeling inferior about their inability to quit.

Someone should have just killed me there and then. God knows, if I should run into the me of that time, I would at the very least slap myself silly. Come to think of it, that would be an excellent idea. I could beat myself up and in that way never start smoking again, leading to a present of freedom.

So, anyone got a time machine? If you don't, I'd be happy to take your germs instead.