The silent battle

Today, from the "Who Could Have Predicted This Besides Everybody?" department, we have: a study by psychologist David Blanchflower of Dartmouth College et al. that found that in the United States, the mental health of young people has shown enough of a decline that it has eliminated the "unhappiness hump" -- the former pattern that younger and older people were overall the happiest, with dissatisfaction ratings peaking in middle age.

Now, the lowest levels of happiness are in those between ages thirteen and twenty-five, and show a slow but steady increase with increasing age thereafter.

I don't know about you, but this came as no surprise to me.  I've often thought that I would not want to be a teenager today.  Some things have improved markedly -- opportunities for women and acceptance of minorities and LGBTQ+ people, for example -- but so many new factors have cropped up making life riskier and more difficult that it's hardly to be wondered at that young people are anxious.  

Let's start with the fact that the current regime (1) is doing its level best to strip rights from anyone who isn't a straight white Christian male, (2) shows little regard for protecting what's left of the environment, and (3) is in the process of wrecking the economy with the ongoing tariff craziness.  (About the latter, Trump and his cronies have taken the toddler-ish approach of "I'll just lie about it and everyone will believe me!" by declaring that the deficit is gone, jobs are surging, and the economy is booming.  And don't believe the cash register; the prices of groceries and gasoline are down across the nation.  Oh, and these are not the droids you're looking for.)

I mean, I'm retired, and I find it all depressing.  A college student today facing the current job market would have to be willfully blind not to be anxious about their future.

What gets me, though, is how much you still hear the "suck it up and deal" response from the adults.  To take just one example -- why should recent graduates be asking for student loan forgiveness?  After all, we paid our student loans when we were that age, right?

Yep, we did.  There's a reason for that.  Between 1978 and 1982, my tuition to the University of Louisiana, along with all my textbooks, came to a total of about a thousand dollars a semester.  Now, the average for tuition alone is around twelve thousand dollars a semester -- four times that if you go to a private school.  Housing prices have gone up drastically as well -- in 1980, the average house sale price was seventy-five thousand dollars; now it's four hundred thousand dollars.  The truth is that purchasing a house shortly after entering the job market was a realistic goal for someone in my generation, but for the current generation, it simply isn't.  In fact, owning a home in the foreseeable future is out of reach for the majority of today's college graduates.

It's no wonder there's a "looming mental health crisis" -- to quote Blanchflower et al. -- amongst today's young people.

This crisis is exacerbated by people who seem bound and determined to paint this entire generation as "lazy" or "entitled," when in fact they are reacting the way just about any of us would when faced with impossible odds.  Just yesterday I saw someone post on social media how infuriating it was that the emergency room was "clogged" with teenagers having emotional breakdowns now that the fall semester of college has started, and that they were sick of these needy kids expecting everyone to drop everything and minister to their whims.  The truth is grimmer than that, and I can say this with some authority, as a person who has struggled with crippling anxiety and depression my entire life.  Depressed people don't fake being mentally ill to get attention; we fake being okay to avoid it.  When you see someone actually having a crisis, it is almost always because they have spent hours or days or weeks trying to suppress it, and eventually simply couldn't any more.

[Image licensed under the Creative Commons Sander van der Wel from Netherlands, Depressed (4649749639), CC BY-SA 2.0]

Might there be people who fake an episode in order to get care they don't really need?  Sure.  It's called Munchausen syndrome.  But it's really uncommon.  And in any case, isn't it better to give unnecessary care to one person who is pretending to be ill than to deny care to a hundred who do need it because you've decided they're all malingerers?

Maybe try having a scrap of fucking compassion.

Most of us mentally ill people are struggling along, trying to find a way to cope with a world that seems increasingly engineered to drag us down, while relying on a mental health care system that is drastically inadequate -- understaffed, overworked, and in general spread far too thin for the need.  For myself, I manage most days.  Some days I don't.  On those days I lean hard into something a therapist told me -- "the biggest lie depression tells you is that the lows are permanent."

But as far as the way we treat others goes, that we can fix.  We can work toward changing our society to lower the stressors on the upcoming generation.  We can support our mental health care professionals, who are trying the best they can under extreme difficulties.  And -- most of all -- we can recall what a family friend told me when I was six years old.  I'd come home from school with my knickers in a twist over some perceived wrong by a classmate, and our wise friend blindsided me by saying, "Don't be so hard on your friend.  You should always be kinder than you think you need to be, because everyone you meet is fighting a terrible battle that you know nothing about."

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Unleashing the tsunami

Today I have for you two news stories that are interesting primarily in juxtaposition.

The first is a press release about a study out of Stanford University that found LGBTQ+ people have, across the board, a higher rate of mental health disorders involving stress, anxiety, and depression than straight people do.  Here's the relevant quote:

New research looking at health data of more than a quarter of a million Americans shows that LGBTQ+ people in the US have a higher rate of many commonly diagnosed mental health conditions compared to their with cisgender and straight peers, and that these links are reflective of wider societal stigma and stress.  For example, cisgender women who are a sexual minority, such as bisexual or lesbian, had higher rates of all 10 mental health conditions studied compared to straight cisgender women.  Gender diverse people, regardless of their sex assigned at birth, and cisgender sexual minority men and had higher rates of almost all conditions studied compared to straight cisgender men, with schizophrenia being the one exception.  A separate commentary says these differences are not inevitable, and could likely be eliminated through legal protections, social support, and additional training for teachers and healthcare professionals.

The second is from Newsbreak and is entitled, "Trump Signs Sweeping Executive Orders That Overhaul U.S. Education System."  The orders, as it turns out, have nothing to do with education per se, and everything to do with appeasing his homophobic Christofascist friends who are determined to remove every protection from queer young people against discrimination.  Once again, here's the quote:

The executive order titled Ending Radical Indoctrination in K-12 Schools threatens to withhold federal funding for "illegal and discriminatory treatment and indoctrination in K-12 schools," including based on gender ideology and the undefined and vague "discriminatory equity ideology."

The order calls for schools to provide students with an education that instills "a patriotic admiration" for the United States, while claiming the education system currently indoctrinates them in "radical, anti-American ideologies while deliberately blocking parental oversight."...

"These practices not only erode critical thinking but also sow division, confusion and distrust, which undermine the very foundations of personal identity and family unity," the order states.

So how is it surprising to anyone that we queer people have a higher rate of depression, stress, and anxiety?  Funny how that happens when elected officials not only claim we exist because of "radical indoctrination," but are doing their damnedest to erase us from the face of the Earth.

If you think I'm exaggerating, take a look at this:

It's a good thing I retired in 2019 (after 32 years in the classroom), because if anyone -- from a school administrator all the way up to the president himself -- told me I couldn't call a trans kid by their desired name or pronouns, or had to take down the sticker I had on my classroom door that had a Pride flag and the caption "Everyone Is Safe Here," my response would have been:

FUCK.  YOU.

And I'd probably have added a single-finger salute, for good measure.

Mr. Trump, you do not get to legislate us out of existence.  You do not get to tell us who we can be kind to, who we can treat humanely, whose rights we can honor, who we can help to feel safe and secure and accepted for who they are.  I lost four damn decades of my life hiding in the closet out of fear and shame because of the kind of thinking you are now trying to cast into law, and I will never stand silent and watch that happen to anyone else.

So maybe your yes-men and yes-women -- your hand-picked loyalist cronies who do your bidding without question and line up to kiss your ass even before you ask it -- are jumping up and down in excitement over enacting this latest outrage, but you (and they) can threaten us all you want.

I'm not complying.  I will never comply.  And I know plenty of high school teachers and administrators who feel exactly the same way I do.  You may think you've picked an easy target, but what you are doing has unveiled how deeply, thoroughly cruel your motives are -- and it will unleash a tsunami of resistance.

LGBTQ+ people and minorities and the other groups you get your jollies by bullying will always be safe with me.  And if you think any stupid fucking command from on high will change that, you'd better think again.

To put it in a way even someone of your obviously limited intellectual capacity can understand: you can take your executive order and stick it up your bloated ass.

Sideways.

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All the lonely people

I'm a big fan of the band OneRepublic, but I don't think any of their songs has struck me like their 2018 hit "Connection."

"There's so many people here to be so damn lonely."  Yeah, brother, I feel that hard.  This whole culture has fostered disconnection -- or, more accurately, bogus connections.  Social media gives you the appearance of authentic interaction, but the truth is what you see is chosen for you by an algorithm that often has little to do with what (or whom) you're actually interested in.  A host of studies has documented the correlation between frequent social media use and poor mental health, anxiety, depression, and low self-esteem -- but as usual, the causation could run either way.  Rather than social media causing the decline in emotional wellness, it could be that people who are already experiencing depression gravitate toward social media because they lack meaningful real-life connections -- and at least the interactions on Facebook and TikTok and Instagram and whatnot are better than nothing.

Whichever way it goes, it appears that social media, which has long billed itself as being the new way to make friends, has left a great many people feeling more isolated than ever.

I know that's true for me.  I'm pretty shy, and don't get out much.  I volunteer sorting books for our local Friends of the Library book sale once a week; I see my athletic trainer once a week; I have a friend with whom I go for walks on Saturday mornings.  That's about it.  My social calendar is more or less non-existent.  And despite my natural tendency toward introversion, it's not a good thing.  I've had the sense -- undoubtedly inaccurate, but that doesn't make it feel any less real -- that if I were to vanish from the face of the Earth, maybe a dozen people would notice, and half that would care.

It's a hell of a way to live.

Sadly, I'm far from the only person who feels this way.  Disconnection and isolation are endemic in our society, and the scary part is the toll it takes.  Not only are there the obvious connections to mental health issues like depression and anxiety, a study out of Oregon State University published this week in the Journal of Psychology found that chronic loneliness is connected to a slew of other problems -- including poor sleep, nightmares, heart disease, stroke, dementia, and premature death.  The study, which involved 1,600 adults between the ages of eighteen and eighty, was absolutely unequivocal.

"Interpersonal relationships are very much a core human need," said psychologist Colin Hesse, director of the School of Communication in OSU’s College of Liberal Arts, who led the study.  "When people’s need for strong relationships goes unmet, they suffer physically, mentally and socially.  Just like hunger or fatigue means you haven’t gotten enough calories or sleep, loneliness has evolved to alert individuals when their needs for interpersonal connection are going unfulfilled...  Quality restorative sleep is a linchpin for cognitive functioning, mood regulation, metabolism and many other aspects of well-being.  That’s why it’s so critical to investigate the psychological states that disrupt sleep, loneliness being key among them."

The open question is what to do about it.  Social media clearly isn't the answer.  I don't want to paint it all as negative; I have good interactions on social media, and it allows me to keep in touch with friends who live too far away to see regularly, which is why I'm willing to participate in it at all.  But to have those interactions requires wading through all of the other stuff the algorithm desperately wants me to see (including what appear to be eighteen gazillion "sponsored posts," i.e., advertisements).  The bottom line is that people like Mark Zuckerberg and the other CEOs of large social media organizations don't give a flying rat's ass about my feelings; it's all about making money.  If it makes MZ money, you can bet you'll see it lots.  If it doesn't?

Meh.  Maybe.  Probably not.  Certainly you shouldn't count on it.

So the alternative is to try to get out there more and form some authentic connections, which is much easier said than done.  All I know is that it's important.  There may be people in this world who are natural loners, but I suspect they're few and far between.  The majority of us need deep connection with friends, and suffer if we don't have it.

And the Hesse et al. study has shown that there's more at risk than just your mood if you don't.

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Trying to escape

There's long been an association between creativity and mental illness.  Certainly there's plenty of anecdotal evidence -- people like Sylvia Plath, Robert Schumann, Virginia Woolf, Pyotr Ilyich Tchaikovsky, and Vincent van Gogh are commonly-cited examples -- and a few controlled studies have suggested that there is at least some degree of correlation between the two.

The question, as always, is whether this correlation is indicative of causation, and if so, which direction the causation points.  Does the underlying physiological problem that causes mental illness create, as a side effect, a greater degree of creativity?  (A recent study supports this conjecture, at least in some cases.)  Or does mental illness cause a desire to cultivate creative outlets as a way to assuage the pain?

This latter possibility was the subject of a paper that came out this week from Ohio State University, authored by psychologist Joseph Maffly-Kipp.  The research had two parts.  The first was a cross-sectional study of people from ages 18 to 72, in all walks of life, that assessed their experience of depression and mood disorders, and also scored them for fantasy-proneness -- to what extent did they find themselves escaping into fantasy worlds, whether through reading, watching television or movies, creative endeavors, or daydreaming?  The other was a longitudinal study took a group of college students and tracked them for six weeks to see how both of those measures changed over time.

Both groups were also assessed for their perceptions of "meaning in life" -- to what extent did they find any kind of meaning behind their daily experiences?  This, like fantasy-proneness, might take many forms, from conventional religiosity, to spirituality, to connection with other human beings, to dedication to a higher purpose.

The results are fascinating.  The people with higher levels of depression and high fantasy-proneness scored higher on assessments for meaning in life than the ones who were high on measures of depression but low on measures of fantasy-proneness.  Apparently for depressed individuals, our ability to maintain a sense of meaningfulness in life is boosted by our capacity to escape now and again into fantasy worlds.  Interesting, too, is the piece of the sample that showed negative results; individuals low for depression-proneness had no significant correlation between fantasy-proneness and meaning in life.

It seems like if you're not depressed, your capacity for finding meaning doesn't depend on your finding that sense of meaning in the imaginary.

"We found across several studies that the tendency to engage in vivid mental fantasies was related to greater perceptions that life was meaningful, but this was only true for people with high levels of depression," Maffly-Kipp said.  "We speculated that, because depressed people are struggling to find meaning in more typical ways (e.g., religion, social relationships, careers, community, etc.), they might resort to finding it through the engagement with fantasies.  Fantasies are less constrained by reality, more controllable, and might be free from the negativity biases seen in depression.  They could help a person find a sense of belonging and purpose, even if it is imaginary."

Nøkken Som Hvit Hest by Theodor Kittelsen (1907) [Image is in the Public Domain]

Of course, it immediately made me think of my own case.  I have struggled with depression and anxiety for as long as I can remember, and ever since I was a child I've not only voraciously read escapist fiction (reading Madeleine L'Engle's A Wrinkle in Time when I was about ten was a transcendent experience), but I've written it, too.  Not that everything I read or write is cheerful, mind you -- if you pick up one of my novels, don't expect that every character is going to have a happy ending, or necessarily even survive to the end.  But what my writing does consistently embody is that there is hope, that there are still selfless, brave, good people in the world, that a powerful cause is worth fighting for, and that love, loyalty, and friendship are the most important things in life.

That some of what I write is spurred by my own attempts to escape the dark, chaotic whirlwind of my own brain, I have no doubt whatsoever.  Maffly-Kipp's study doesn't settle the question of whether we mentally ill people have a higher capacity for inventing fantasy worlds because of some underlying common cause, or if the mental illness came first and trying to escape from it into fantasy worlds evolved later as a coping mechanism; and of course, it could be both, or be different in different people.  Mental illness, like anything having to do with our cognitive apparatus, is a complicated matter, admitting of few easy explanations.

But it does highlight that even those of us who live with depression and anxiety on a daily basis can find ways to manage it -- even if it means leaving the real world at times.

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Anxiety and stigma

I am mentally ill.

I say it that openly, and that bluntly, for a reason: mental illness still has a significant and entirely undeserved stigma in our society, a stigma shared by virtually no other group of illnesses.  I've never heard of someone ashamed to say they have bronchitis, high blood pressure, arthritis, heart disease, or cancer.  While no one would question the gravity of any of those or the impact on the patients and their families, none of those carry the same sense of shame -- the underlying feeling that somehow, it requires an apology, that it's the sufferer's fault for "not trying hard enough."

"Suck it up and deal."  "Just focus on the good things."  "Let go of the negatives."  All, perhaps, well meant, and all entirely useless.  Whatever the underlying cause of the anxiety and depression I've battled my entire life -- whether they're from a neurochemical imbalance, a genetic predisposition (there is good evidence that depression, at least, runs in both sides of my family), trauma from the emotional abuse I endured as a child, or all three -- what I experience is just as real as any symptoms coming from a purely physical illness.

I've gone to hell and back trying to find a medication that helps; none of the standard meds made much of a difference, and several gave me horrible side effects.  Right now the depression is reasonably well in check from the combination of the compassion and support of my family and friends and a set of coping mechanisms (exercise being top of the list).  The anxiety is tougher because it can come on without any warning, and is often triggered by activities that "should be positive" -- getting together with friends, engaging in creative pursuits, even leaving the house.

Edvard Munch, Anxiety (1894) [Image is in the Public Domain]

The reason this comes up is a pair of studies I ran into last week that resonated so strongly with my experience that I found myself saying, "Why didn't the researchers just ask me?  I coulda told them that."  The first, that appeared in the International Journal of Psychophysiology, investigated fear responses -- specifically, how quickly startle reactions ceased once a person realized something surprising wasn't actually a threat.  What they did was show test subjects photographs of two women, then suddenly substituted one with a photograph of a woman showing fear and accompanied it by the sound of a woman screaming at 95 decibels, delivered through headphones.  (I'm so sound-sensitive that just reading about this made me anxious.)  What was fascinating is that (of course) all the test subjects startled, but the ones without anxiety disorders very quickly learned that it wasn't a threat -- on repeated exposures to the same stimulus, they stopped reacting.  The people with anxiety disorders didn't.  Every time the photo changed and the scream came, they reacted, even when they knew it was coming.

This is all too familiar to me.  I once lamented to a therapist, "Exposure therapy doesn't work on me."  I have dreadful social anxiety; I take a long time to open up to people, and when I'm in a large group I tend to shut down completely.  I've been at parties where all night long, I've said exactly two sentences: "Hi, how are you this evening?" and "Good night, thanks for inviting me."  It doesn't seem to matter how many social gatherings I go to where nothing bad happens; I still get overwrought the next time, and spend the lead-up to the event hoping like hell there'll be a dog there to socialize with.

The second study, that appeared in the journal Behavioural and Cognitive Psychotherapy, looked at the ways that people with social anxiety cope, and found that those same "safety behaviors" -- such as rehearsing ahead of time what they'll say, avoiding eye contact, shying away physically if they feel like they're in the way, and not talking unless spoken to -- cause others to perceive them as less likable, more standoffish, aloof, and superior, and less authentic.

Which, of course, is the most vicious of vicious cycles.  I know I do all of those things, not to mention finding an excuse to leave early.  I also have a tendency to get tongue-tied when people do speak to me directly, which probably is why in short order they decide that they'd be better off finding someone else to chat with.

Both studies had me saying, "Yeah, exactly."  Even so, I'm glad these sorts of papers are appearing in well-respected journals.  All of it is a step not only toward finding out what underlies mental illness, but toward reducing the stigma.  Sufferers from disorders like depression and social anxiety aren't simply weird, and we're certainly not doing it for attention (something I was accused of pretty much continuously when I was a kid).  We're just struggling, in the same way that someone with a physical illness might struggle.

I have some hope that the stigma is diminishing.  I've been heartened by the support Senator John Fetterman of Pennsylvania has received following his revelation that he was entering the hospital for treatment for clinical depression.  We still have a long way to go -- there are still people who look at Fetterman's actions as evidence of weakness or instability -- but far more are responding with empathy, with an understanding that we sufferers from mental illness are every bit as deserving of compassionate care as someone dealing with any other kind of illness.

And while understanding that won't cure us, it certainly goes a long way to making us feel like we're not so alone.

(IMPORTANT NOTE: if you, or someone you know, are considering self-harm, please call the Suicide Hotline number now.  The number is 988, and there are people there who can help you and provide the emotional support you need.)

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The will to fight

If you're fortunate enough not to suffer from crippling depression and anxiety, let me give you a picture of what it's like.

Last week I started an online class focused on how to use TikTok as a way for authors to promote their books.  So I got the app and created an account -- it's not a social media platform I'd used before -- and made my first short intro video.  I was actually kind of excited, because it seemed like it could be fun, and heaven knows I need some help in the self-promotion department.  (As an aside, if you're on TikTok and would like to follow me, here's the link to my page.)

Unfortunately, it seemed like as soon as I signed up, I started having technical problems.  I couldn't do the very first assignment because my account was apparently disabled, and that (very simple) function was unavailable.  Day two, I couldn't do the assignment because I lacked a piece of equipment I needed.  (That one was my fault; I thought it was on the "optional accessories" list, but I was remembering wrong.)  Day three's assignment -- same as day one; another function was blocked for my account.  By now, I was getting ridiculously frustrated, watching all my classmates post their successful assignments while I was completely stalled, and told my wife I was ready to give up.  I was getting ugly flashbacks of being in college physics and math classes, where everyone else seemed to be getting it with ease, and I was totally at sea.  When the same damn thing happened on day four, my wife (who is very much a "we can fix this" type and also a techno-whiz), said, "Let me take a look."  After a couple of hours of jiggering around with the settings, she seemed to have fixed the problem, and all the functions I'd been lacking were restored.

The next morning, when I got up and got my cup of coffee and thought, "Okay, let me see if I can get started catching up," I opened the app and it immediately crashed.

Tried it again.  Crash.  Uninstalled and reinstalled the app.  Crash.

[Image licensed under the Creative Commons LaurMG., Frustrated man at a desk (cropped), CC BY-SA 3.0]

I think anyone would be frustrated at this point, but my internal voices were screaming, "GIVE UP.  YOU SHOULD NEVER HAVE SIGNED UP FOR THIS.  YOU CAN'T DO IT.  IT FIGURES.  LOSER."  And over and over, like a litany, "Why bother.  Why bother with anything."  Instead of the frustration spurring me to look for a solution, it triggered my brain to go into overdrive demanding that I give up and never try again.

When I heard my wife's alarm go off an hour later, I went and told her what had happened, trying not to frame it the way I wanted to, which was "... so fuck everything."  She sleepily said, "Have you tried turning your phone completely off, then turning it back on?"  Ah, yes, the classic go-to for computer problems, and it hadn't occurred to me.  So I did...

... and the app sprang back to life.

But now I was on day five of a ten-day course, and already four assignments behind.  That's when the paralyzing anxiety kicked in.  I had told the instructors of the course a little about my tech woes, and I already felt like I had been an unmitigated pest, so the natural course of action -- thinking, "you paid for this course, tell the instructors and see if they can help you catch up" -- filled me with dread.  I hate being The Guy Who Needs Special Help.  I just want to do my assignments, keep my head down, fly under the radar, be the reliable work-horse who gets stuff done.  And here I was -- seemingly the only one in the class who was being thwarted by mysterious forces at every turn.

So I never asked.  The more help I needed, the more invisible I became.  It's now day seven, and I'm maybe halfway caught up, and I still can't bring myself to tell them the full story of what was going on.

Adversity > freak out and give up.  Then blame yourself and decide you should never try anything new ever again.  That's depression and anxiety.

I've had this reaction pretty much all my life, and it's absolutely miserable.  It most definitely isn't what I was accused of over and over as a child -- that I was choosing to be this way to "get attention" or to "make people feel sorry for me."  Why the fuck would anyone choose to live like this?  All I wanted as a kid -- all I still want, honestly -- is to be normal, not to have my damn brain sabotage me any time the slightest thing goes wrong.  As I told my wife -- who, as you might imagine, has the patience of a saint -- "some days I would give every cent I have to get a brain transplant."

So re: TikTok, if Carol hadn't been there, I'd have deleted my account and forfeited the tuition for the class.  But I'm happy to report that I haven't given up, and I've posted a few hopefully mildly entertaining videos, which I encourage you to peruse.

The reason all this comes up, though, isn't just because of my social media woes.  I decided to write about this because of some research published this week in the journal Translational Psychiatry which found that a single gene -- called Tob -- seems to mediate resilience to emotional stress in mice, and without it, produces exactly the "freak out and give up" response people have when they suffer from depression and anxiety.

Tob was already the subject of intense research because it apparently plays a role in the regulation of the cell cycle, cancer suppression, and the immune system.  It's known that in high-stress situations, Tob rapidly switches on, so it is involved somehow in the flight-fight-freeze response.  And a team led by Tadashi Yamamoto of the Okinawa Institute of Science and Technology found that "Tob-knockout mice" -- mice that have been genetically engineered to lack the Tob gene -- simply gave up when they were in stressful situations requiring resilience and sustained effort.  Put another way, without Tob, they completely lost the will to fight. 

When I read this article -- which I came across while I was in the midst of my struggle with technology -- I immediately thought, "Good heavens, that's me."  Could my tendency to become frustrated and overwhelmed easily, and then give up in despair, be due to the underactivity of a gene?  I know that depression and anxiety run in my family; my mother and maternal grandmother definitely struggled with them, as does my elder son.  Of course, it's hard to tease apart the nature/nurture effects in this kind of situation.  It's a reasonable surmise that being raised around anxious, stressed people would make a kid anxious and stressed.

But it also makes a great deal of sense that these familial patterns of mental illness could be because there's a faulty gene involved.

Research like Yamamoto et al. is actually encouraging; identifying a genetic underpinning to mental illnesses like the one I have suffered from my entire life opens up a possible target for treatment.  Because believe me, I wouldn't wish this on anyone.  While fighting with a silly social media platform might seem to someone who isn't mentally ill like a shrug-inducing, "it's no big deal, why are you getting so upset?" situation, for people like me, everything is a big deal.  I've always envied people who seem to be able to let things roll off them; whatever the reason, if it came from the environment I grew up in or because I have a defective Tob gene, I've never been able to do that.  Fortunately, my family and friends are loving and supportive and understand what I go through sometimes, and are there to help.

But wouldn't it be wonderful if this kind of thing could be fixed permanently?

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An act of faith

Over the last couple of months I've been dealing with a health problem that is one of those collections of symptoms that falls somewhere on the spectrum between "mild inconvenience" and "I'm going to be dead in three months."  Fortunately, at the moment the doctor is leaning strongly toward the former.  (I won't go into further details because I hate it when People Of A Certain Age begin every conversation with what my dad called "the organ recital" -- telling everyone they talk to intimate details of their various health-related issues.)

In any case, this kind of thing absolutely plays hell with someone who has chronic anxiety.  Frankly, over the last two months the anxiety has been far worse than the symptoms themselves, and I have no doubt that it's actually made the symptoms more severe.  But it's put making any firm summer plans on hold, given that my brain keeps shouting at me that I might not be able to follow through on them on account of being incapacitated, hospitalized, or dead.

But it started me down a line of thought that, for once, was productive instead of irrational and paralyzing.  It brought to mind the word faith.  I realize this is not one you'd expect to hear from a skeptical atheist type.  But it struck me that faith is what's invoked any time we make plans -- faith that we and the ones involved will still be around when the plans come to fruition.

That seems pretty dark and pessimistic, but actually it's the opposite.  None of us are guaranteed another day, another hour, another minute, so the only option is to act as if we do, to be right here in the moment and let the future take care of itself.  It's like what Jean-Luc Picard -- then in the mind of the character Kamin -- said to his daughter in the beautiful episode of Star Trek: The Next Generation called "The Inner Light:" "Seize the time, Meribor – live now.  Make now always the most precious time.  Now will never come again."

Being ill has made this thought come back to me again and again.  It occurred to me a couple of weeks ago when I bought a couple of tropical plants to replace some of the ones I lost this past winter when my greenhouse heater malfunctioned on one of the coldest nights in January, and I heard a sepulchral voice in my mind say, "Maybe I won't be around to see them flower."  When I saw the daffodils blooming in April and it occurred to me that this might be the last time I ever would.  When I was outside playing with my dogs and wondered how many more opportunities I'd have.

I know these thoughts are coming from my mental illness; I do trust the doctor that I'm probably going to be okay.  But really, isn't that the situation we're all in?  It's all an act of faith.  Getting out of bed in the morning is an act of faith.  We maneuver our way through this dangerous, unpredictable, endlessly weird world and plan for meeting some friends at the pub day after tomorrow, for a vacation this summer, for visiting with family during the winter holidays, simultaneously knowing that none of it might happen.  But that's what we have to do.  The only other option is to descend into panic now because of what might or might not occur later, to willfully destroy our present because our future isn't guaranteed.

My grandma used to tell me, "Worry is like a rocking chair; it keeps you busy but it doesn't get you anywhere."  I'd make it even stronger, though.  Worry wastes what we've got right here in our hands.  I'm not going to say it's easy to conquer; I've had anxiety disorder my entire life, and I'm not expecting it to go away magically.  But I have -- and so does everyone -- control over deliberately choosing to live life the best I can regardless of how much of it I have left.  It's all a risk; every action we take, or decide not to take.  As J. R. R. Tolkien wrote, in The Fellowship of the Ring, "It’s a dangerous business, Frodo, going out of your door.  You step into the road, and if you don’t keep your feet, there is no knowing where you might be swept off to."

The question is not whether you want to take a risk; the question is which risk you want to take.  For me, I'd rather risk the possibility of my plans and aspirations not coming to fruition than risk giving in to my anxiety, then getting to the end of the path and realizing what I missed.

So my advice: carpe the absolute fuck out of every diem you've got left, whether it's one or ten thousand.  I'm completely agnostic about whether there's an afterlife; maybe there is, maybe there isn't.  But as far as what I know for sure, this right here, right now, is all I've got.  And right now the sun is shining and the weather is warm and pleasant and there are people who love me.  There's music to listen to and stories to write and dogs to play with and books to read.  Okay, it won't last forever.  But I'll hang on to the sweetness I've got right now for all I'm worth, and have faith that whatever happens tomorrow, I'll have made the most of today.

**************************************

Moodscrolling

I think one of the reason I have a love/hate relationship with Twitter is that my feed sounds way too much like my brain.

I do a lot of what I call "hamster-wheeling."  Just sitting there -- or, worse, lying in bed at night trying to sleep -- I get a running litany of disconnected thoughts that leap about my cerebral cortex like a kangaroo on crack.  Think about that, and look at this selection of tweets that I pulled from the first few scroll-downs of my feed this morning, and which I swear I'm not making up:

• I'm putting everyone on notice that I'm not taking any shit today.
• Wow, I've got bad gas.  My apologies to my coworkers.
• I'm on vacation why am I up at 6 AM scrolling on Twitter
• In England in the 1880s, "pants" was considered a dirty word.
• I wonder how Weeping Angels reproduce.  Do they fuck?  I'd fuck a Weeping Angel, even though I'd probably regret it.
• Super serious question.  Does anyone still eat grilled cheese sandwiches?
• A stranger at the gym just told me I should dye my beard because it's got gray in it.  WTF?
• Doo-dah, doo-dah, all the live-long day

The only tweets I didn't consider including were purely political ones and people hawking their own books, which admittedly make up a good percentage of the total.  But if you take those out, what's left is, in a word, bizarre.  In three words, it's really fucking bizarre.

Me, I find my hamster-wheeling thoughts annoying and pointless; I can't imagine that anyone else would want to hear them.  For criminy's sake, even I don't want to hear them.

So why the hell do I stay on Twitter?

I think part of it is insufficient motivation to do what it would take to delete my account, but part of it is that despite the weird, random content, I still find myself spending time just about every day scrolling through it. 

[Image licensed under the Creative Commons MatthewKeys, Twitter's San Francisco Headquarters, CC BY-SA 3.0]

I've noticed that my tendency to waste time on social media is inversely proportional to my mood.  When I'm in a good mood, I can always find more interesting things to do; when I'm low, I tend to sit and scan through Twitter and Facebook, sort of waiting for something to happen that will lift me up, get me interested, or at least distract me.

Moodscrolling, is the way I think of it.

I'm apparently not the only one.  A team at Fudan University (China) found that social media use and depression and anxiety were strongly correlated -- and that both had increased dramatically since the pandemic started.  It seems to be an unpleasant positive feedback loop; the worse things get and the more isolated we are, the more depressed and anxious we get (understandably), and the more we seek out contact on social media.  Which, because of its weird content, often outright nastiness, and partisan rancor (you should see some of the political tweets I decided not to post), makes us feel worse, and round and round it goes.  Breaking the cycle by forcing yourself to stand up and walk away from the computer is hard when you're already feeling down; especially so now that it's all available on our phones, so the option of consuming social media is seldom farther away than our own pockets.

It's not that I think it's all bad.  If it was, I would delete my account.  I've met some very nice people in Twitter communities I've joined -- fellow fiction writers and Doctor Who fans are two that come to mind.  Facebook, on the other hand, lets me stay in touch with dear friends whom I seldom get to see.  But there's no doubt that if you did a cost-benefit analysis -- the amount of time I spend on social media as compared to the positive stuff I get from it -- it would show numbers that are seriously in the red.

Walking away, though, takes willpower, and that's exactly what depressed and anxious people tend to lack.  The study I linked above, though, makes me more certain that's what I need to do.  The random, disjointed thoughts my own brain comes up with are enough; I don't need to see everyone else's.

Although I have to admit that the guy who posted about the Weeping Angels asks a good question.  Not only are they made of stone, they all appear to be female.  And if you watch Doctor Who, there certainly seems to be a lot of them.  For the record, though, I am not in the least interested in having sex with one, even if it turns out they're somehow capable of it.  Those things are seriously creepy.

**************************************

The merry-go-round of self-blame

Depression is, at its heart, a completely irrational condition.

One of the (many) therapists I've seen during my life told me that the way to deal with depression and/or anxiety was to do a reality check.  Is this feeling I'm having right now consistent with what I know reality to be?  It sounds good, but in practice, it's extraordinarily difficult to do.  Depression and anxiety make it harder for you to be certain what reality is.  The problem is that the depressed and/or anxious response feels just as real as reality does.  You can analyze those feelings in as dispassionate a way as you want, but when the things you're trying to discern seem to be equally plausible, you're in trouble.

One good example is my continual fear of talking too much or calling attention to myself in social situations, especially when I've had a drink or two.  If I'm stone-cold sober there's usually no question, because I hardly ever say anything, much less too much or the wrong thing.  But the inhibition-releasing tendency of alcohol consumption blurs the ability to self-perceive accurately, and afterward, I'm always convinced that I said more than I should have or something I shouldn't have, and nearly every time I have to appeal to my wife to do my reality checking for me.

This is why my reaction to a piece of research that appeared last week in the Journal of Psychiatric Research made me say, "Well, duh."  Not, understand, that I am at all critical of research to support what are honestly anecdotal claims; more that what they found is essentially how I live.  A team at King's College London, led by clinical psychologist in mood disorders Roland Zahn, studied the reactions of a group of test subjects -- some of whom had a history of suffering from depression, and others who did not -- to various hypothetical social interactions, and had them identify what would be their most likely responses if it were a real situation.

[Image licensed under the Creative Commons Sander van der Wel from Netherlands, Depressed (4649749639), CC BY-SA 2.0]

What the team found was that people who have depression tend to blame unpleasant social interactions on themselves, even if the circumstances make it unlikely that they were at fault.  "Self-blaming feelings such as guilt, self-disgust and self-directed anger are key symptoms of depression and Freud is widely credited for pointing to the importance of excessive self-blame in depression," Zahn said, in an interview in PsyPost.  "Social psychologists have done research into these so-called ‘action tendencies’, i.e. implicit feelings of acting in a certain way, such as hiding or creating a distance from oneself, which are entailed in complex feelings.  This is why my PhD student Suqian Duan set out to investigate this question.  In this study, we investigated blame-related action tendencies for the first time systematically in people with depressive disorders."

The response Zahn describes is strikingly similar to my experience of clamming up completely in social situations.  "Many people with a history of major depression, despite having recovered from symptoms, showed an action tendency profile that was different from people who had never experienced major depression and are thus at a lower risk of depression overall," he said.  "They were more likely to feel like hiding, creating a distance from themselves and attacking themselves when faced with a hypothetical scenario of acting badly towards their friend whilst being less likely to apologize.  Interestingly, we showed that the label of the emotion did not map one-to-one on specific action tendencies as was often assumed but rarely tested.  Feeling like attacking oneself was specifically associated with self-disgust/contempt, a feeling which we had previously found to be the most common form of self-blaming feeling in depression."

Zahn points out (correctly) that one of the difficulties is there is such a thing as reasonable guilt.  Purging oneself of all guilt feelings shouldn't be the goal; sometimes we feel guilty for a very good reason, and those feelings can prompt us to make amends for mistakes we've made.  "There is... a controversy around how to measure and define healthy forms of guilt, which help us to apologize and try to repair the damage we might have done from unhealthy forms of self-blame, where we take responsibility for things that are out of our control and feel paralyzed by our guilt or sense of failure, so that we hide away from the situation," Zahn explains.

The trouble is, with depression and anxiety, the ability to discern between justified and unjustified guilt or self-blame gets blurred, and depression and toxic narcissism lead to opposite and equally damaging false conclusions; the former, that every negative interaction is our fault, the latter that none of them are.

It's hard to see, in the absence of someone like my wife to do an external reality check, what you could do to get off the self-blame merry-go-round.  When the heart of the problem is an inaccurate but compelling view of oneself and the situation, trying to do any kind of internal reality check is likely to meet with limited success.  That's certainly been my experience.  I can even go into a social situation with the mantra, "I know I don't talk too much, everything is going to be fine, I should loosen up and just chat with people," but afterwards the inclination to self-blame anyhow is awfully powerful.

No wonder we feel like hiding a lot of the time.

**************************************

The fear loop

I have serious anxiety disorder.  Serious enough that some days, I am barely functional.

I have had it pretty much as long as I can remember.  People who know me only casually might find this hard to believe.  I taught high school science for thirty-two years, with apparent confidence.  I seem pretty good at getting out and doing stuff, trying new pastimes, talking with people.

The reality is that I've just become very skilled at hiding it, and pretending I'm okay when I'm very much not.  Of course, this works well until it doesn't.  Sometimes just an ordinary day's activities are enough that when I get home, I collapse.  And any pressure or stress or unpleasant situation that's beyond what's normal in terms of intensity or duration, and I get dangerously close to panic attack territory.

Like with many sufferers from anxiety, it's coupled with depression.  On its surface, this is kind of odd, because they're almost like opposites -- one a dampened emotional state, the other a heightened emotional state.  Both, though, have the effect of stopping you in your tracks.  Depression tells you "don't bother, nothing you do will make a difference;" anxiety tells you "don't do anything, because whatever you do will make it worse."

[Image is available through the Creative Commons courtesy of Rehab Center Parus http://rebcenter-moscow.ru]

A lot of us with mental and emotional disorders have found them amplified since the pandemic started.  I've always been an introvert (social anxiety being one of the ways my illness manifests), so you'd think that the opportunity to be a recluse would be wonderful; but far from being a welcome respite, I've found the isolation has made things significantly worse.  In the last two years it feels like my world has folded in on itself, leaving me cut off from activities that used to make me feel better.  I was telling my wife just yesterday that I'm vanishing -- I'm a writer who doesn't write (other than Skeptophilia, I've barely written anything since the pandemic started), a runner who doesn't run, a musician who rarely plays.  I've lost my grip on most of the things that define me as a person.

What got me thinking about all this -- other than the fact that I live with it every day -- is a fascinating piece of research that appeared last week in Science.  It looked at the fear response in mice, and found that a specific region of the brain (the insular cortex) seems to act as the mediator for emotional regulation, especially with regards to fear.  What's intriguing is the researchers found that the insular cortex does this based upon feedback from the body.

Think about what happens when you're given a bad scare.  Your heart and breathing rate speed up, your blood vessels constrict (raising your blood pressure), you sweat, you tremble.  At least some of these responses serve a useful purpose; accelerating your pulse and breathing allows you to deliver oxygen to your muscles faster, making the fight-or-flight reaction more efficient and therefore more likely to save your life.  But if it is too powerful, or goes on too long, it can lead to a potentially deadly paralysis.

The insular cortex apparently keeps tabs on your heart rate and other autonomic responses, and moderates your emotional reaction to fear when the physical responses start to ramp up.  It made me wonder if this is why some people -- the ones who often become first responders -- find their brains unusually clear when they're in a dangerous emergency.  They're the ones who can stay calm, pretty much regardless of what's happening -- the ones who "keep their heads when everyone else is losing theirs."

And, of course, it left me questioning if that's what's going wrong in people like me, who take an ordinary, non-emergency situation and let it wind up our emotional state to the point of panic.  "Since dysfunctions of the insular cortex in humans are associated with various types of anxiety disorders, this research opens up exciting new perspectives," said study lead author Alexandra Klein, of the Max Planck Center of Neurobiology, in an interview with Science Daily.  "Can we use behavior and its bodily feedback to actively regulate emotions?  For a long time, neuroscience has ignored the fact that the brain does not work in isolation.  The body also plays a crucial role in emotion regulation.  Our study suggests that we should consider the importance of bodily signals when trying to understand how emotions are regulated."

I can only hope that the discovery of this looped brain-body connection in the regulation of fear might lead to more effective treatments for anxiety disorder, because the ones we have now range from mediocre to useless to actively bad (such as drugs like Xanax that do work to relieve anxiety, but are dangerously addictive if overused). 

I feel like I should add that I'm not bringing all this up to elicit sympathy.  I've blogged before about my own experience with mental illness; then and now, what I want is to add my voice to those trying to destigmatize it.  That, and to encourage you to be careful when you rush to judgment about someone else's behavior.  Keep in mind what a family friend told me when I was about six years old -- which I've quoted here before, but it bears repeating. "Always be kinder than you think you need to be, because everyone you meet is fighting a terrible battle that you know nothing about."

**********************************

I've always loved a good parody, and one of the best I've ever seen was given to me decades ago as a Christmas present from a friend.  The book, Science Made Stupid, is a send-up of middle-school science texts, and is one of the most fall-out-of-your-chair hilarious things I've ever read.  I'll never forget opening the present on Christmas morning and sitting there on the floor in front of the tree, laughing until my stomach hurt.

If you want a good laugh -- and let's face it, lately most of us could use one -- get this book.  In it, you'll learn the proper spelling of Archaeopteryx, the physics of the disinclined plane, little-known constellations like O'Brien and Camelopackus, and the difference between she trues, shoe trees, and tree shrews. (And as I mentioned, it would make the perfect holiday gift for any science-nerd types in your family and friends.)

Science education may never be the same again.

[Note: if you purchase this book using the image/link below, part of the proceeds goes to support Skeptophilia!]

The cost of personal courage

I have been following, from some distance, the hue-and-cry over Simone Biles's removing herself from competition on the U.S. Olympic gymnastics team.  Biles was completely up-front about why.  "You have to be there 100%," she told reporters.  "If not, you get hurt.  Today has been really stressful.  I was shaking.  I couldn't nap.  I have never felt like this going into a competition, and I tried to go out and have fun.  But once I came out, I was like, 'No.  My mental is not there.'  It's been a long year, and I think we are too stressed out.  We should be out here having fun.  Sometimes that's not the case."

Well, immediately the pundits started weighing in.  Charlie Kirk called her a "selfish sociopath" and bemoaned the fact that "we are raising a generation of weak people like Simone Biles."  Clay Travis suggested she be removed from future competition because she couldn't be relied on.  Piers Morgan was perhaps the worst -- not surprising given his ugly commentary in the past.  "Are 'mental health issues' now the go-to excuse for any poor performance in elite sport?  What a joke...  Sorry Simone Biles, but there's nothing heroic or brave about quitting because you're not having 'fun' – you let down your team-mates, your fans and your country."

And so on.  The criticism came fast and furious.  There were voices who spoke up in support of her decision, but it seemed to me the nastiness was a lot louder.

[Image licensed under the Creative Commons Agência Brasil Fotografias, Simone Biles Rio 2016e, CC BY 2.0]

Or maybe I'm just sensitive.  Other writers have spoken with more authority about the rigors of Olympic training and gymnastics in particular, not only the physical aspects but the mental, topics which I am unqualified to discuss.  But whatever the context, there is one thing I'm dead certain about.

If someone says they're struggling mentally and/or emotionally, you fucking well believe them.

I have fought mental illness all my life.  I've been open about this here before; I have come to realize it is no more shameful than any other chronic condition.  I do know, however, first-hand how debilitating anxiety can be.  I've also suffered from moderate-to-severe depression, fortunately now ameliorated by medications and a family who is understanding and supportive.  So at present, I'm doing okay.

But it hasn't always been that way.  For much of my life, I was in a situation where "suck it up and deal" and "be tough, be a man" and "you should be thankful for what you have" were the consistent messages.  Therapy was for the weak; psychiatric care (and meds) were for people who were crazy.  There's nothing wrong with you, I was told.  You just spend too much time feeling sorry for yourself and worrying about things you can't control.

The result?  Twice I was suicidal, once at age seventeen and once at age twenty, to the point that I had a plan and a method and was ready to go for it.  That I didn't -- fortunately -- is really only due to one thing; I was scared.  I spent a good bit of my first marriage haunted by suicidal ideation, and there the only thing that kept me alive was my commitment to my students, and later, to my children.

But I thought about it.  Every.  Single.  Damn.  Day.

That a bunch of self-appointed arbiters of proper behavior have told this remarkable young woman "No, I don't care how you feel or what you're going through, get back in there and keep performing for us" is somewhere beyond reprehensible.  I don't even have a word strong enough for it.  If you haven't experienced the hell of anxiety, panic attacks, and depression, you have zero right to criticize someone else, especially when she's doing what people in a bad mental space should be doing -- advocating for herself, setting her limits, and admitting when she can't manage to do something.

I wish I had known how to do that when I was twenty-four (Simone Biles's age).  But I was still a good fifteen years from understanding the mental illness I have and seeking out help -- and unashamedly establishing my own personal boundaries.

So to all the critics out there who think they know what Simone Biles should do better than she does -- shut the fuck up.  I presume you wouldn't go up to a person with a serious physical illness and have the temerity to tell them what they can and can't do, and to pass judgment on them if they don't meet your standards.  This is no different.  We have a mental health crisis in this country; skyrocketing incidence of diagnosed mental illnesses and uncounted numbers who go undiagnosed and unaided, and a health care system that is unable (or unwilling) to address these problems effectively.  What Simone Biles did was an act of bravery, and she deserves unequivocal support for it.  The cost of personal courage shouldn't be nasty invective from a bunch of self-appointed authorities who have never set foot on the road she has walked.

And those who can't understand that should at least have the good grace to keep their damn opinions to themselves.

**************************************

One of the characteristics which is -- as far as we know -- unique to the human species is invention.

Given a problem, we will invent a tool to solve it.  We're not just tool users; lots of animal species, from crows to monkeys, do that.  We're tool innovators.  Not that all of these tools have been unequivocal successes -- the internal combustion engine comes to mind -- but our capacity for invention is still astonishing.

In The Alchemy of Us: How Humans and Matter Transformed One Another, author Ainissa Ramirez takes eight human inventions (clocks, steel rails, copper telegraph wires, photographic film, carbon filaments for light bulbs, hard disks, scientific labware, and silicon chips) and looks not only at how they were invented, but how those inventions changed the world.  (To take one example -- consider how clocks and artificial light changed our sleep and work schedules.)

Ramirez's book is a fascinating lens into how our capacity for innovation has reflected back and altered us in fundamental ways.  We are born inventors, and that ability has changed the world -- and, in the end, changed ourselves along with it.

[Note: if you purchase this book using the image/link below, part of the proceeds goes to support Skeptophilia!]