Daily Archives: December 26, 2015

Adjusting to Midnight

There are 3 positions on my bicycle. There is my impersonation of the sprinter in the final 200 metres, hunched over the handle bars, aerodynamic. There is me more upright, hands on the ‘hoods’ – that’s the drop handlebars by the gear shifters – as I climb the hills. And finally, there’s me with my hands draped over the centre of the handlebars, rolling along on the flat with no place I need to be.

Those 3 options cover everything when I’m sitting in the saddle. Other bicycles have fewer options. Most bicycles have just 1 option. You hold the handlebars and steer using one posture. Take the ‘sit up and beg’ model. The handlebars are further apart and, crucially, they turn inwards towards the rider which forces him/her (usually her, for some reason), to sit upright. No begging involved, in fact. This posture, while much kinder to the back and shoulders, means that it is much, much harder to go really fast; which is kind of the point for these machines. They’re a more Mindful ride, I guess.

Bicycles force us to change our posture, which is so far from how change in mental health recovery happens.

 

It reminds me of what that hairy, flouncy shirt wearing, agrarian scribbler Leo Tolstoy wrote about the distinctiveness of distress in his 1878 novel, Anna Karenina: ‘Happy families are all alike; every unhappy family is unhappy in its own way.’

I’m thinking, really, of individuals, rather than families, here. Ever since I was first set adrift on choppy waters, under a moody sky, I have attended peer – led support groups. They have been a key part of my journey of recovery from then on. While these groups – in my case a depression support group, and since 2010, one for people with Bi Polar Affective Disorder – are aimed at supporting people with certain mental illnesses, the members of such groups share a certain amount of experience. This means that there is a basic level of acceptance amongst members – even those new to such groups, or who choose not to say much about what’s going on for them. As someone who has facilitated such groups from time to time over the years (currently a weekly depression support group under the umbrella of the U.K. charity Depression Alliance (www.depressionalliance.org.) I am a firm believer that there is a residual benefit to such groups. Simply attending such groups has a therapeutic effect.

However, I have always been struck, each and every time, by the diversity of experience. Sure, there are universal themes: triggers such as anniversaries, for example. But there is always the personal. There is always what happened to me – and not anyone else, no matter how much others’ experiences resonate. It is in the telling and the retelling of our stories that change emerges. For the retelling is like water washing over pebbles and stones, for millennia: it smooths shapes in ways we cannot anticipate.

Like this, I check my lights, touch the handlebars and step on the pedals again, and again, and again.

 

We grow accustomed to the Dark –
When light is put away –
As when the Neighbor holds the Lamp
To witness her Goodbye –

A Moment – We uncertain step
For newness of the night –
Then – fit our Vision to the Dark –
And meet the Road – erect –

And so of larger – Darknesses –
Those Evenings of the Brain –
When not a Moon disclose a sign –
Or Star – come out – within –

The Bravest – grope a little –
And sometimes hit a Tree
Directly in the Forehead –
But as they learn to see –

Either the Darkness alters –
Or something in the sight
Adjusts itself to Midnight –
And Life steps almost straight.

Emily Dickinson (1830 – 1886)


Adjusting to Midnight

There are 3 positions on my bicycle. There is my impersonation of the sprinter in the final 200 metres, hunched over the handle bars, aerodynamic. There is me more upright, hands on the ‘hoods’ – that’s the drop handlebars by the gear shifters – as I climb the hills. And finally, there’s me with my hands draped over the centre of the handlebars, rolling along on the flat with no place I need to be.

Those 3 options cover everything when I’m sitting in the saddle. Other bicycles have fewer options. Most bicycles have just 1 option. You hold the handlebars and steer using one posture. Take the ‘sit up and beg’ model. The handlebars are further apart and, crucially, they turn inwards towards the rider which forces him/her (usually her, for some reason), to sit upright. No begging involved, in fact. This posture, while much kinder to the back and shoulders, means that it is much, much harder to go really fast; which is kind of the point for these machines. They’re a more Mindful ride, I guess.

Bicycles force us to change our posture, which is so far from how change in mental health recovery happens.

 

It reminds me of what that hairy, flouncy shirt wearing, agrarian scribbler Leo Tolstoy wrote about the distinctiveness of distress in his 1878 novel, Anna Karenina: ‘Happy families are all alike; every unhappy family is unhappy in its own way.’

I’m thinking, really, of individuals, rather than families, here. Ever since I was first set adrift on choppy waters, under a moody sky, I have attended peer – led support groups. They have been a key part of my journey of recovery from then on. While these groups – in my case a depression support group, and since 2010, one for people with Bi Polar Affective Disorder – are aimed at supporting people with certain mental illnesses, the members of such groups share a certain amount of experience. This means that there is a basic level of acceptance amongst members – even those new to such groups, or who choose not to say much about what’s going on for them. As someone who has facilitated such groups from time to time over the years (currently a weekly depression support group under the umbrella of the U.K. charity Depression Alliance (www.depressionalliance.org.) I am a firm believer that there is a residual benefit to such groups. Simply attending such groups has a therapeutic effect.

However, I have always been struck, each and every time, by the diversity of experience. Sure, there are universal themes: triggers such as anniversaries, for example. But there is always the personal. There is always what happened to me – and not anyone else, no matter how much others’ experiences resonate. It is in the telling and the retelling of our stories that change emerges. For the retelling is like water washing over pebbles and stones, for millennia: it smooths shapes in ways we cannot anticipate.

Like this, I check my lights, touch the handlebars and step on the pedals again, and again, and again.

 

We grow accustomed to the Dark –
When light is put away –
As when the Neighbor holds the Lamp
To witness her Goodbye –

A Moment – We uncertain step
For newness of the night –
Then – fit our Vision to the Dark –
And meet the Road – erect –

And so of larger – Darknesses –
Those Evenings of the Brain –
When not a Moon disclose a sign –
Or Star – come out – within –

The Bravest – grope a little –
And sometimes hit a Tree
Directly in the Forehead –
But as they learn to see –

Either the Darkness alters –
Or something in the sight
Adjusts itself to Midnight –
And Life steps almost straight.

Emily Dickinson (1830 – 1886)


Disoriented

It doesn’t matter how old I get or how many hellidays I survive…I always end up feeling disoriented. Holidays throw a wrench into the normal suckage workings and then I get confused as to what day of the week it is. Today feels more like a Monday than a Saturday and I am confused as what to do with myself. What do I normally do on Saturday? Oh, right, not much unless it’s yard sale season.  It’s a little like waking up from a Trazadone coma. Yet I won’t take that shit anymore.

Yesterday was utterly boring yet peaceful and that was needed. I finally showered, Spook got to test out her bath paints.(She only had one warbling fit the entire day, but it was disturbing when she started bashing her head against the wall.) We ate leftover chicken and noodles (I siphoned some from the family batch cos we never get any, they go so fast.) Mom and dad both called to do the polite “merry christmas” thing. Otherwise…Absolute blissful mommy-and-spook time. It just felt so…boooring. I mean, she had all that new loot to entertain her. With my mental state as of late, I could win the lottery and buy an old school Pac Man arcade game and still be disinterested and meh. Because what I really want is a quiet brain with some semblance of organized thought and that cannot be purchased.

Mostly I binged on Scrubs (enjoyable but certainly didn’t “cheer” me up) and fretted about my shrink appointment on Thursday. I always get nervous right before an appointment and especially with this doctor and his “you’ve tried everything” attitude. Like I am unaware of that factoid. Like I don’t live and breathe and die a little with each med failure. So round and round my brain  went all evening trying to rehearse an assertive  but polite argument in favor of going back on Lithium. (Hell hath frozen over indeed.) Geesh, I miss the days with Dr. M who never made me nervous or feel like a failure. That’s fucking sad. ONE decent psychiatrist in 23 years of treatment, out of TEN doctors. And sadder still is how common this is with a mental health diagnosis.

Not sure what is on the agenda today. The child is on rapid fire mode, Uzi style,  and already the noise has me ready to chew my arm off. I should totally clean but I am thinking  maybe another day of holiday recovery is required. THIS. This is why I am such a loner, such a homebody. Because existing in the dish, at the fast pace that is normal to others, basically melts me down and it takes so much time to bounce back. It’s like having elective surgery you’ll need six months to recover from even though the condition isn’t going to kill you. Can you just live with it or do you really want to spend six months recovering from what isn’t necessity? I don’t know how better to explain it. Maybe my family is right and I am just anti social.

Though their usage of the term is very different from the clinical diagnosis. Lots of people are very social but cannot abide by social customs of morality and manners. Just because one favors time alone does not make them anti social. I’m fairly sure getting fired from a job and signing your final paycheck “fuck you” is anti social behavior even if you have six friends over every night.(My brother in law.) Maybe I spend too much time alone but the cost of socializing just makes it not worthwhile when I am not in a stable place.

Pfft.

Now I am gonna go insert bbq skewers into my ears so I don’t have to listen to the Chipmunks sing “Bad Day” for the thousandth time.

 


Ok, yes I’m posting at the airport…

Ok, yes, I’m posting. Yes I’m on my way to Karachi, via Atlanta, New York, and Istanbul. I am traveling alone because my sister, brother and I didn’t book our tickets at the same time, or even with the same airline, so I confess, I am a bit bored. Started from home in Louisville at 10:00 am, got to JFK at 5:30 pm. My flight for Istanbul doesn’t leave till 11:50 pm, no such luck, it’s delayed to 12:30 am. Then I don’t get into Karachi till about 3 pm EST tomorrow, barring any delays. It once took me 3 days to get to Karachi, 3 days that I spent in Heathrow because they had 1/2 an inch of snow… yes 1/2 an inch.

I’m not planning on spending 3 days at Atatürk Havalimani (Airport), I’m hoping to get to Karachi on time. But even on time is a hell of a long trip, especially alone. Oh fine, I’ll stop whining, wait, one more thing, the airplane is as big as a sardine can, I asked, because in June, when I had gone to Istanbul, it was a sardine can, so I asked, and I was informed that it was tiny :-( Ugh, trip, can you please be over now.

On a positive note, I saw the most adorable, little, miniature, poodle, walking with its human with shoes on. Yes, the human had shoes on, but I’m talking about the little puppy. I almost ran up to take a picture, but then I didn’t. But I seriously have to get one of those adorable, little pups.

puppy

I also indulged in a little, just a tiny bit, of retail therapy, mostly I got gifts… ummmm and a purse for my self… ummmm a really nice one… ok I’ll go away and take a nap or something. Actually I’m sort of hungry, I’ll go eat. But first look at the killer shops they have in this terminal!

image image bulgari cartier michael

Wow! Right?

I’ll post lots of pictures from Pakistan.

<3 <3

 

http://www.wsj.com/articles/the-effects-of-chronic-heavy-drinking-on-brain-function-are-underdiagnosed-1450722803?mod=e2fb&sf17561871=1

The Effects of Chronic Heavy Drinking on Brain Function Are Underdiagnosed

Here’s a sobering thought for the holidays: Chronic heavy drinking can cause insidious damage to the brain, even in people who never seem intoxicated or obviously addicted.

Experts say alcohol-related brain damage is underdiagnosed and often confused with Alzheimer’s disease, other forms of dementia or just getting older.

Now, brain imaging is revealing how long-term alcohol abuse can change the structure of the brain, shrinking gray-matter cells in areas that govern learning, memory, decision-making and social behavior, as well as damaging white-matter fibers that connect one part of the brain with others.

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“As we get older, we all lose a little gray-matter volume and white-matter integrity, but in alcoholics, those areas break down more quickly. It looks like accelerated aging,” says Edith Sullivan, a professor of psychiatry and behavioral science at Stanford University, who has studied alcohol’s effects for years.

Long-term alcohol abuse also changes how the brain regulates emotion and anxiety and disrupts sleep systems, creating wide-ranging effects on the body. Increasingly, clinicians are diagnosing “alcohol-induced neurocognitive disorder” and “alcohol-related dementia.”

How much is too much? The National Institute of Alcohol Abuse and Alcoholism says the probability of serious health issues is low for men who have no more than 14 drinks a week, or 4 on a single day, and women who have no more than 7 drinks a week, or 3 on a single day. ENLARGE
How much is too much? The National Institute of Alcohol Abuse and Alcoholism says the probability of serious health issues is low for men who have no more than 14 drinks a week, or 4 on a single day, and women who have no more than 7 drinks a week, or 3 on a single day. PHOTO: GETTY IMAGES
How much is too much and over what period of time? Researchers are reluctant to say, because alcohol’s effects are highly individual and based on genetics, age, sex, patterns of consumption and general health. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) says the probability of serious health issues is low for men who have no more than 14 drinks a week, or 4 on a single day, and women who have no more than 7 drinks a week or 3 on a single day. Some people, though, experience severe effects at much lower levels.

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Meanwhile, some studies show that people who drink moderately (generally defined as 1 drink a day for women, 2 for men) have a lower risk of cardiovascular disease, depression and some cognitive issues than those who don’t drink at all. But the risks of harm rise sharply the more alcohol people consume. “Low levels of alcohol may improve blood flow to the brain—but there’s a tension between that and reduced white matter,” says Ian Lang, a dementia expert and senior lecturer in public health at the University of Exeter Medical School in England. “At some levels, there may be a tipping point where the harmful effects outweigh the benefits.”

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Also unclear is whether heavy drinking during a person’s teens and 20s, when important brain connections are still forming, has a lasting effect on brain function in later life.

Some researchers are bracing for a wave of cognitive problems as baby boomers age. “Sad to say, we think their increased exposure in the 1960s has put them at substantially higher risk for alcohol-related mortality and morbidity than the generation before them,” says Gary Kennedy, chief of geriatric psychiatry at Montefiore Medical Center in Bronx, N.Y.

Imaging studies show that while long-term heavy drinking impacts the entire brain, the greatest damage occurs in the frontal lobe that controls executive function, which includes planning, controlling impulses and modifying behavior. “The very part of the brain that you need to change your alcoholic intake may be most impacted by drinking,“ says Catherine Fortier, an assistant professor at Harvard Medical School and researcher at the VA Boston Healthcare System, who has led many of the imaging studies.

THE GOOD, THE BAD, THE DANGEROUS

While the effects of alcohol consumption are highly individual, government researchers suggest these general guidelines.

‘Moderate’: Up to 1 drink a day for women, 2 for men. Drinking at this level can lower the risk of cardiovascular disease and depression, and help maintain cognitive function, according to some studies.

‘Low risk’: Up to 3 drinks a day and 7 a week for women; 4 a day and 14 a week for men. Staying within both the daily and weekly limits has a low risk of short- or long-term health issues. Experts say pregnant women, and people under 21, planning to drive, or taking certain medications should abstain.

Heavy or ‘High Risk’: More than 3 drinks a day and 7 a week for women; 4 a day and 14 a week for men. Exceeding these levels regularly runs the risk of long-term cognitive damage, memory loss, depression, cirrhosis of the liver, high blood pressure, stroke, Type 2 diabetes, cancer of the throat, esophagus, breast and colon, as well as drowning, falling and being hurt in motor vehicle accidents

Source: NIAAA, U.S. Dietary Guidelines

Many of alcohol’s effects on the brain and behavior are similar to cerebral-vascular dementia, the second most common form of dementia, which reduces blood flow to the brain and affects thinking and reasoning more than memory, as Alzheimer’s disease does.

That’s important for families to keep in mind, says Dr. Kennedy. “A person may have only minor impairments in memory, so families can’t understand why they aren’t taking care of themselves, can’t manage a checkbook, can’t get out of the house or stay on a task.”

Such damage to executive function is more subtle than the severe forms of alcohol-related brain damage known as Wernicke-Korsakoff Syndrome, in which chronic alcohol consumption causes a deficiency in thiamine that can lead to hallucinations, amnesia, psychosis and difficulty walking. Wernicke-Korsakoff is rarely seen today, experts say, because alcoholics are routinely given thiamine to prevent it.

Researchers are also shedding new light on alcohol’s long-term impact on depression, stress and anxiety.

While it isn’t clear whether heavy alcohol use also causes depression, or vice versa, experts say there is clearly a vicious cycle: “People often drink because they don’t feel good, but drinking makes them feel worse, so they drink more,” says NIAAA director George Koob.

Dr. George Koob, director of the National Institute for Alcohol Abuse and Alcoholism, is one of the researchers who have shown how heavy alcohol use hurts the ability of the brain’s frontal cortex to control the amygdala, the center of emotions—which explains why drinkers often have mood swings and outbursts. ENLARGE
Dr. George Koob, director of the National Institute for Alcohol Abuse and Alcoholism, is one of the researchers who have shown how heavy alcohol use hurts the ability of the brain’s frontal cortex to control the amygdala, the center of emotions—which explains why drinkers often have mood swings and outbursts. PHOTO: ERIN BRYANT
Dr. Koob and other researchers have shown that heavy alcohol use hurts the ability of the frontal cortex to control the amygdala, the center of emotions—which explains why drinkers often have mood swings and outbursts.

“One minute you’re putting your arm around a friend, and the next minute, you’re crying or saying something you didn’t intend,” says Dr. Koob. With long-term heavy drinking, the amygdala becomes increasingly oversensitive to stress, he says.

Chronic imbibers might also become stuck in a state of high anxiety and fear, much like post-traumatic stress disorder, according to studies at the Bowles Center for Alcohol Studies at the University of North Carolina, Chapel Hill. In classic “fear learning” experiments, mice can be trained to freeze when a light cue is followed by a mild shock, and learn to relax again if the shock is discontinued. But mice fed the equivalent of six drinks a day for weeks were never able to feel safe again and were constantly fearful. “In short, chronic alcohol can block this form of learning and can negatively impact how you go through life,” says Thomas Kash, an associate professor of pharmacology at UNC School of Medicine.

Researchers are also studying to what extent alcohol-related brain damage is reversible and finding mixed results. Some former alcohol abusers show permanent damage to the hippocampus, a region that regulates balance. But longitudinal studies tracking life-long drinking patterns show that some white- matter damage can repair itself—particularly if people stop drinking before age 50. “Fifty seems to be a critical threshold, probably because brain tissue is less able to recover after a certain age,” says Dr. Fortier.

Studies at Stanford found that former alcoholics and people with no history of alcoholism can perform equally well on cognitive tests, although brain scans showed they used different brain pathways to do so. “The alcoholics used wider and additional areas of the brain to get the job done,” says Dr. Sullivan. “My worry is that this may come at a cost. If you are recruiting different areas of the brain, it might be harder to switch your attention from one activity to another.”

Studies have also found that for people who aren’t dependent, even a five-minute conversation with a doctor about the risks of drinking can reduce problem drinking by about 25%.

Alcohol researchers say more health-care providers—and family members—should broach the issue with patients and point out the dangers. “One of the biggest problems in alcoholism is denial,” says Dr. Sullivan. “Getting over that is the first step to recovery.”


Gift Shop Glee @ Donner Memorial State Park

We had a glorious time at the new Donner Memorial State Park Visitors Center! Built for $9.6 million dollars, I was expecting a day spa and amuse-bouche as part of our visit, but ’twas not to be. :( Years ago in my pre-bipolar diagnosis/pre-child days, I worked at a nonprofit called Friends of Santa Cruz … Continue reading Gift Shop Glee @ Donner Memorial State Park