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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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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Folie à deux

One of the long-standing unanswered questions in medical science is the role of the mind in physical health.

A well-known example is the placebo effect, the reduction or elimination of symptoms in an ill person from taking a "medicine" with no active ingredients.  Less known, but also well documented, is the nocebo effect, where someone believes they will come to harm, often from supernatural means -- as in voodoo curses -- and then actually does.  (Placebo and nocebo come from Latin, and mean "I will please" and "I will harm," respectively.)

The mechanism by which this could occur is poorly understood at best.  We do know that in situations of high emotional or mental stress, the body produces hormones like adrenaline and cortisol, which can have long-term deleterious effects (thus the connection between stress and inflammatory diseases), but it seems like there must be more to it than that.

And that's not even as complicated as it gets.  Consider, for example, folie à deux -- also called shared psychosis -- when two people experience the same strange delusions.  How this happens and the mechanism by which it works are unknown, and the results can be nothing short of bizarre.

[Image is in the Public Domain courtesy of its creator, Chitrapa]

The best example I've ever heard of folie à deux is the case of June and Jennifer Gibbons.  The two were identical twins, born in 1963 in Yemen to British subjects originally from Barbados.  By 1974 the girls, their parents, and three other (completely normal) siblings were living in Haverfordwest, Wales, where their father worked as a Royal Air Force technician and their mother was a homemaker.

The twins started exhibiting odd behavior as toddlers.  They rarely spoke except to each other, and their conversations were conducted in a largely invented language based in part on a sped-up version of Bajan Creole.  (Siblings inventing their own private language isn't that uncommon, and is called idioglossia; but here, the twins seemed entirely unwilling to speak in English, nor to anyone but each other.)

The parents, and the girls' teachers, tried everything they could think of to break this strange link.  Sending them to separate boarding schools completely backfired; both girls became catatonic, refusing to eat or move until they were reunited.  The one way they would let anyone else know what was happening in their minds was through writing.  Given a gift of diaries when they were sixteen years old, they began writing elaborate stories -- but filled with violence and disturbing imagery.

In 1981, following a string of petty crimes they were accused of, the twins were committed to Broadmoor Hospital, where they were eventually to spend twelve years.  And this is where things took an even more peculiar turn, because they told the staff at Broadmoor that the only way one of them would live a normal life is if the other died.  It didn't matter which; to break the spell required one of them to die, after which the other would go on to speak, act, and live normally.

In 1993, they were transferred to Caswell Clinic in Bridgend, Wales, and upon arrival, Jennifer was found to be unresponsive.  She was admitted to the hospital where she lingered, comatose, for a week, but finally died due to what an autopsy found to be acute myocarditis (inflammation of the heart).  Strangest of all, there were no drugs, poisons, or infectious agents in her system that could be found to explain the illness, and the inquest ended with a finding of "ultimate cause of death unknown."

A week after her sister's death, June told a therapist, "I'm free at last, liberated, and at last Jennifer has given up her life for me," and described the moment of Jennifer's death as hitting her "like a tsunami."  She was monitored by psychiatric services for several years, but eventually was discharged, because -- exactly as the sisters had predicted -- the survivor had begun living an entirely normal life.  By 2008 June had a flat near her parents in a small village in western Wales, and was working and socializing like any ordinary person would.

What on earth could have caused this bizarre situation?

The simple answer is "we have no idea."  There is nothing in what is known of the Gibbons family's background that could account for it; judging by statements from the twins' siblings, they seem to have been a completely ordinary working-class family.  Strangest of all is the circumstances that severed the connection between Jennifer and June.  Did Jennifer Gibbons actually "will herself to die" to free her sister, or was there something more sinister going on?  What was the nature of the link between them -- and how can we account for the medical and psychological manifestations of it?

Once again, there are no clear answers.  We're left with more questions -- particularly, how the mind creates the world of perception we live in, and how it can go so drastically wrong for certain unfortunate people.  The treatment of psychiatric illness is certainly far better than it was even forty years ago, when the Gibbons twins started their decade of life in Broadmoor, but we're still largely in the dark about how the mind works -- and how it can so profoundly affect the body in which it resides.

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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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A tincture of madness

There's long been a supposed connection between being highly creative and being mentally ill. The list of individuals who were both is a long one.  Ernest Hemingway, Georgia O'Keeffe, Hermann Hesse, Maurice Ravel, F. Scott Fitzgerald, Pyotr Ilyich Tchaikovsky, Edgar Allen Poe, Jackson Pollock, Cole Porter, Vincent van Gogh, and Robert Schumann all suffered from varying degrees of mental problems, most of them from severe depression, schizophrenia, or bipolar disorder.  More than one of these spent the last years of life in a mental institution, and more than one committed suicide.

People who have expressed their creativity in technical fields show the same tendencies.  Physicist Ludwig Boltzmann killed himself; Charles Darwin seems to have had severe agoraphobia, and spent most of the later years of his life in virtual isolation; and the wildly brilliant mathematician Kurt Gödel was a paranoid schizophrenic who became so convinced people were poisoning his food that he finally stopped eating completely and starved to death.

"The only difference between myself and a madman," Salvador Dalí famously quipped, "is that I am not mad."  Two thousand years earlier, the Roman writer Seneca said, "There is no genius without a tincture of madness."

[Image licensed under the Creative Commons Mental illness silhouette, Paget Michael Creelman, Creative Commons Attribution-Share Alike 4.0 International license]

Research has supported that there is a fundamental connection between creativity and mental illness.  One of the chief investigators into this link is Fredrik Ullén, of the Karolinska Institutet of Stockholm, who not only showed that creativity correlates with genetic markers for both schizophrenia and bipolar disorder, but demonstrated a connection between creativity and the dopamine (pleasure/reward) system in the brain -- the same system that is implicated in several forms of mental illness, including schizophrenia, obsessive-compulsive disorder, and tendency to addiction.

Ullén administered a test that was designed to measure a subject's capacity for creative thinking, specifically for developing more than one solution to the same problem or using non-linear solution methods to arrive at an answer. He then analyzed the brain activity of the individuals who scored the highest, and found that across the board, they had lower amounts of dopamine receptors in a part of the brain called the thalamus, one of the main "switchboards" in the higher brain, and responsible for sorting and processing sensory stimuli.

The implication is that creative people don't have as rigid a sorting mechanism as other, less creative people -- that having a built-in deficiency in your relay system may help you to arrive at solutions to problems that others might not have seen.

The connection between the thalamus, creativity, and sorting issues is supported by a different bit of brain research that found that a miswiring of the thalamus is implicated in another bizarre mental disorder, called synesthesia.  In synesthesia, signals from the sensory organs are misrouted to the incorrect interpretive centers in the cerebrum, and an auditory signal (for example) might be received in the visual cortex.  As a result, you would "see sounds." Other senses can be crosswired, however -- the seminal study of the disorder is described in Richard Cytowic's book, The Man Who Tasted Shapes.

Synesthsia is apparently also much more common among the creative.  Alexander Scriabin, the early twentieth century Russian composer, wrote his music as much from how it looked to him as how it sounded.  He describes a sensation of color being overlaid on what he was actually seeing when he heard specific combinations of notes.  The colors were consistent; C# minor, for example, was always green, Eb major always magenta.  And although Alexander Scriabin's synesthesia was perhaps the most intense, he is not the only composer who was synesthetic; the evidence is strong that Liszt, Rimsky-Korsakov, and Olivier Messaien also had this same miswiring.

The studies by Ullén and others have now taken the first steps toward connecting these physiological manifestations with the phenomenon of creativity itself.  "Thinking outside the box," Ullén said, "may be facilitated by having a somewhat less intact box."

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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!]

The power of relentless positivity

I have a friend whom I frequently take out for walks.  I'll call him Jim.  Jim doesn't have it easy; he's of normal intelligence but has a lot of serious developmental disabilities, and things that most of us don't even give much thought to -- brushing teeth, shaving, showering, changing clothes -- are time-consuming and arduous chores for him.  His only living relative is a five-hour drive away, so he is completely reliant on non-family members for his care.

Despite this, Jim is the single most positive person I've ever met.  Whoever coined the term "sunny disposition" must have known him.  Whenever we get together, he always tells me how much he appreciates my help and companionship.  At the end, he thanks me again, and says, "I had a lot of fun.  It was a good outing.  Thank you so much."

He also cares deeply about the people around him.  He always asks me how I'm doing, and unlike with some people -- for whom "how are you?" is a perfunctory and rather meaningless greeting -- Jim honestly seems delighted when I tell him what's going on in my life.  

He's like that about almost everything.  One Friday I told him I wouldn't see him till Monday, but I hoped he had a good weekend.

He gave me a big smile and said, "Gordon, I hope you have a great weekend more than you hope I have a great weekend."

Yesterday we went for a walk in Cass Park, a big, sprawling piece of parkland along the west shore of Cayuga Lake.  We'd only been out for a few minutes when Jim said, "It sure is a beautiful day.  Isn't it a beautiful day?"

For the record, at the time he said this it was about thirty degrees Fahrenheit, spitting snow, and there was a stiff breeze off the lake.  Here's a photo I took of Jim's beautiful day:

Okay, the Finger Lakes region of New York, where we both live, is pretty gorgeous even in midwinter, but I was immediately struck by the fact that no one I've ever met -- other than Jim -- would have characterized the day as "beautiful."  We were both well-wrapped with coats, scarves, and gloves, so we were comfortable enough, but it was still gray, chilly, and windy.

But for Jim, it really was a beautiful day.  For him, a beautiful day is a long walk with a friend out in the fresh air in a place he loves.  He's not impervious to discomfort; when we got back to the car, I turned the heater up, and he said, "That feels nice.  My hands are cold."  But what stands out to me is that Jim chooses to accept the discomfort because he appreciates what he has so deeply.

As we walked, it came to me that there was a descriptor for Jim: he's relentlessly positive.  There's nothing forced about it.  It's completely genuine.  He doesn't do it to be polite, or because it'll get me to come back and walk with him another day, or to make me feel good.

He's relentlessly positive because he chooses to focus on the beautiful things in his world rather than the (many) difficulties.

I wonder what it'd be like if more of us were like Jim.  Recognizing the problems we face and doing what we can about them, but first and foremost appreciating what we have.  As a lifelong sufferer of depression and anxiety, I know that telling a person "just be happy" is the opposite of helpful; and that's not what I'm saying.

What I'm saying is make the choice to look at the positive things first, and be grateful for them.  Make a practice of aiming for relentless positivity.

Jenny Lawson puts it differently in her amazing book Furiously Happy: A Funny Book About Horrible Things, which should be on everyone's reading list.  Lawson has struggled with serious, debilitating mental illness her whole life, and this memoir (and her first book, Let's Pretend This Never Happened) are the only books I can think of that made me ugly cry and howl with laughter, sometimes on the same page. 

Hell, sometimes in the same damn paragraph.

Lawson writes:

I’ve often thought that people with severe depression have developed such a well for experiencing extreme emotion that they might be able to experience extreme joy in a way that “normal” people also might never understand, and that’s what Furiously Happy is all about.  It’s about taking those moments when things are fine and making them amazing, because those moments are what make us who we are, and they’re the same moments we take into battle with us when our brains declare war on our very existence. It’s the difference between “surviving life” and “living it”... To all who walk the dark path, and to those who walk in the sunshine but hold out a hand in the darkness to those who travel beside them: Brighter days are coming.  Clearer sight will arrive.  And you will arrive too.  No, it might not be forever.  The bright moments might be for a few days at a time, but hold on for those days.  Those days are worth the dark.

It's like my walk yesterday with Jim.  There were probably people walking that same path in Cass Park yesterday who spent the entire time focusing on how miserable the cold is, how gray it all was, how a cold snap on the first day of April was a bummer.  Jim chose to look instead at the stark beauty of the lake under the gray clouds, the way the wind was making the fallen leaves tumble and rattle under our feet, how pretty the snowflakes looked swirling past our faces.

All of us were cold, out there in the park.  But some of us were cold and miserable; Jim was cold and relentlessly positive.  And I'm guessing that despite the continuous difficulties he lives with, he's the only one who got home and grinned and said, "Nice to be in a warm house again... but wasn't that fun?"

I'll end with one more quote from Jenny Lawson, that captures what I'm trying to say better than I ever could: "I see that there is dust in the air that will eventually settle onto the floor to be swept out the door as a nuisance, but before that, for one brilliant moment I see the dust motes catch sunlight and sparkle and dance like stardust.  I see the beginning and the end of all things.  I see my life.  It is beautifully ugly and tarnished in just the right way.  It sparkles with debris.  There is wonder and joy in the simplest of things."

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

The sad truth of our history is that science and scientific research has until very recently been considered the exclusive province of men.  The exclusion of women committed the double injury of preventing curious, talented, brilliant women from pursuing their deepest interests, and robbing society of half of the gains of knowledge we might otherwise have seen.

To be sure, a small number of women made it past the obstacles men set in their way, and braved the scorn generated by their infiltration into what was then a masculine world.  A rare few -- Marie Curie, Barbara McClintock, Mary Anning, and Jocelyn Bell Burnell come to mind -- actually succeeded so well that they became widely known even outside of their fields.  But hundreds of others remained in obscurity, or were so discouraged by the difficulties that they gave up entirely.

It's both heartening and profoundly infuriating to read about the women scientists who worked against the bigoted, white-male-only mentality; heartening because it's always cheering to see someone achieve well-deserved success, and infuriating because the reason their accomplishments stand out is because of impediments put in their way by pure chauvinistic bigotry.  So if you want to experience both of these, and read a story of a group of women who in the early twentieth century revolutionized the field of astronomy despite having to fight for every opportunity they got, read Dava Sobel's amazing book The Glass Universe: How the Ladies of the Harvard Observatory Took the Measure of the Stars.

In it, we get to know such brilliant scientists as Willamina Fleming -- a Scottish woman originally hired as a maid, but who after watching the male astronomers at work commented that she could do what they did better and faster, and so... she did.  Cecilia Payne, the first ever female professor of astronomy at Harvard University.  Annie Jump Cannon, who not only had her gender as an unfair obstacle to her dreams, but had to overcome the difficulties of being profoundly deaf.

Their success story is a tribute to their perseverance, brainpower, and -- most importantly -- their loving support of each other in fighting a monolithic male edifice that back then was even more firmly entrenched than it is now.  Their names should be more widely known, as should their stories.  In Sobel's able hands, their characters leap off the page -- and tell you a tale you'll never forget.

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