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Sporadic photos and notes from a Psyche-midwife, cheerleader, anthropologist--aka clinical social worker in therapy practice. Photos are usually mine except for those of historical events/famous people. Music relevant to the daily topic is often included in a web video embedded below the blog. Click on highlighted links in the copy to get to source or supplemental material. For contact information, see my website @ janasvoboda.com or click on the button to the right below. Join in the conversation.

Wednesday, April 18, 2012

Marked for Depression? Maybe an Implant Could Help

The Big Black Dog (W. Churchill's nickname for the depression that plagued him) is big in the news this month.
News icon Mike Wallace's death (from old age, instead of suicide) brought tributes to his bravery in outing himself as a sufferer.  In doing so he helped lead the way in destigmatizing a disease that was long seen as a weakness or a lifestyle choice.

CNN published two interesting articles this week about identification and treatment of depression.  Researcher Eva Redei has been working with rats specially bred with "depressive traits" for 25 years to search for biological differences that can be isolated as markers of genetic predisposition to depression.  .  While you can't exactly interview a rat about its emotional state, these specialized breeds show classic signs of the functional markers of depression, such as difficulty with planning, problem solving and decision making, poor persistence and adapability, and a helpless response to stress. Redei reports she has identified 26 unique markers in the blood of the unhappy rats.  In recent experiments with human volunteers, she found 5 of these markers present.  Possible implications include screening tests to identify markers-- and perhaps intervene before the cascade of depression issues become a self-replicating problem.

Also in the news was an update, with Real-Life Anecdotes, of the use of deep brain stimulator implants to treat depression.  Used for years with Parkinson's sufferers, these devices act like a pacemaker for the brain, ramping up underactive areas that seem to be responsible for the troublesome symptoms of depressive disorders.  These surgeries must be performed on a conscious patient, so they can report what happens in their mind as different areas of the brain are stimulated.  I first read about this a while back, and if I can locate the article I'll print it here.  What I vividly remember and found compelling for the idea that depression is truly a brain disorder is a patient's reported during DBS surgery that she experienced a sudden and profound melancholia in the absence of any other change except the stimulation of a certain part of her brain.
The world instantly turned dark and hopeless.  She described in detail her mental experience for the few moments it lasted.  Then the surgeon moved or turned off the device, and as suddenly as it had come on, it was completely gone.  She exclaimed in puzzlement on how her emotions could have taken this veer without her, first toward despair and then to a baseline of normalcy.

 In the article, the authors also were puzzled, and thought "if it can be turned on, perhaps it can be turned off."  Preliminaries support that.  Patient Edi Guyton found relief from her suicidal depression after forty years of medications, electroshock and talk therapy via electrodes implanted in "area 25" of her brain.  Her surgical team, headed by researcher and neurologist Helen Mayfield, knew they'd hit the sweet spot when she spontaneously smiled, and then chuckled, for the first time in years.  Like many persons with mood disorders, she blamed herself for not being able to snap out of it:  "After all, what did I have to be depressed about?"  She tried to fake her way through life, but was miserable, and when the opportunity arose to volunteer for this experimental procedure, she felt she had nothing at all to lose, even when faced with a consent form that listed "Death" as a possible outcome.

She hasn't looked back.  She still has the normal ups and downs of the average person, but no longer the paralyzing depressions that made death itself look like the best option.  She is profoundly grateful to Dr. Mayfield's research, which Mayfield herself admits is very early on in its understanding.

While now seen as a standard treatment for reducing symptoms of Parkinson's, DBS is only now gaining respect for outcomes in treating intractable and interfering Obsessive Compulsive Behavior, and Mayfield's work is still in the very early stages of experimentation.  I applaud the dedication and bravery of the team and even more of the volunteers who risk God-knows-what in hopes of escaping the hell that is major depressive disorder.  Their willingness to put their lives on the line is evidence of the debilitation they suffer.  To my knowledge there are no local or instate providers exploring this treatment.  But the early results are promising, and I hope we will be hearing more about this work.

Related articles about depression:
The incredible Heaviness of Being
Understanding and Dealing with Depression
Fading the Blue Gene:  Cognitive-Behavioral Approaches to Treating Depression
More Bytes on the Black Dog

Saturday, April 14, 2012

Loving Your (World-Wide) Neighbors

Photo by Nazar Iqbal, Pakistan
A perk to living in a university town: for entertainment on a Friday night, you can go see a Nobel Peace Prize laureate.  Each year Oregon State University hosts an amazing gathering of young people for a weekend of inspiration, headed by a winner of the award.  "The mission of the PeaceJam Foundation is to create young leaders committed to positive change in themselves, their communities and the world through the inspiration of Nobel Peace Laureates who pass on the spirit, skills, and wisdom they embody."   
Cork, Ireland courtesy James Clancy

This year's speaker was Argentine artist and activist Adolfo Perez Esquivel.  Born into poverty, he relinquished his teaching career in 1977 to focus his energy on nonviolent resistance through El Sevicio de Paz y Justicia foundation.  He was imprisoned a year later.  Despite his harsh treatment, he continues to espouse the importance of peaceful community activism as a response to oppression and injustice.  

Here are remarks from his speech tonight (paraphrased, abbreviated and collected, not verbatim):

Artist Yoshiko Yoshida, Japan
"Peace is often confused with passivity, but there is nothing more contrary to the notion of peace than being passive.  There is conflict in our world, and we all live in the world.  It is, in a sense, conflict in our living room.  How do we build peace? When we face conflict, we have to resolve it.  We have to resolve the obstacles to peace in ourselves, our families, and our community.
Berlin Wall, photo by Anit Zrab, Germany

Just as a wall was built in Berlin that separated Germans from other Germans, we  see that there are walls in our world that divide us.  Israel from Palestine, Mexico from the US, North and South Korea.  We could go on and on naming the walls that divide people from themselves.  

But the most important walls we have to tear down are those within ourselves, within our own hearts and minds.  If we are unable to tear these down, we cannot build peace.

There's no reason to avoid conflict-- that won't build peace.  We have to resolve it, to open channels of dialogue even with those who are opposed
to us, and seek out and support dialogue in our own communities and those abroad.  

painting by Jón Bjarti, Iceland
We have many examples of people who faced this head on.  Martin Luther King, Caesar Chavez.  They were repressed, violently.  And they persevered against oppression in a nonviolent way.  They took concrete action.  In Latin America, in Argentina, we took this same sort of action in the face of repression.  But what is happening now?  

Profound changes are taking place in the world.  Often we don't see them, but we are acting in the face of them.  (paraphrased heavily:  Take the concept of time).  There is an earthquake in Indonesia, and two seconds later we are immersed in a sports match.  We have been subjected to that accelerated mode, that (concept of) mechanical time.  And we don't think we have time to process, to reflect.  This impacts our behavior-- in our family, community and throughout the world.
Raija Silvennoinen, Finland
Peace is a dynamic of relations among people.  It has to be built.  Nobody can offer something they themselves do not have.  If we are not at peace with ourselves, if we do not have an internal peace, do not have peace with those with whom we live, we cannot hope to build peace with others.   

by photographer Ahmad Nasirpour, Iran
We have to build a CULTURAL resistance, to develop critical consciousness (critical thinking), to encourage and teach values of caring for each other and for our planet.  (We have to ask the tough questions, such as) why it is a country (United States) can spend  $2.5 billion on a single bomber plane, yet says it cannot afford to care for its own sick and hungry.  In a world in which 35,000 children die each day from hunger, we need to separate the reality from what we have been told is true-- and not accept as normal what is fiction and can change."

 photo mosaic, artist Wolfe Nkole Helzle

Esquivel ended his remarks with a call for conscious action in increasing peace and resisting injustice through personal reflection and change, and nonviolent social movements.  Even in the face of imprisonment, he has kept his feeling of hope about our possibilities to achieve these changes.  He cited numerous groups doing just this throughout the world. 

In the past few weeks, I have been privileged to be part of a global community art project.  Led by German artist Wolf Nkole Helzle, artists and regular folk like me from all over the world have been submitting daily photos from their corner of the world's living room.  This Spring, I have "met" persons from Pakistan, Finland, Iran, Japan, Turkey, Greece, Brazil, Indonesia-- to name just a few.  I have seen pictures of their daily lives, and suddenly the world seems much smaller, and my desire to make it safe for all of us has grown in return.  

We're all in this together, brothers and sisters.  Let's do our part to make it work.

Note:  the illustrations for this article come from my new friends around the globe.  Thanks, Wolf, for bringing them into my life.

Want to be part of a global community of photo-diarists?  Check out Wolf's project and sign up at  www.interactive-image.org

Monday, April 9, 2012

RIP Mike Wallace, Newsman and Depression Survivior

American lost a hero this week.  News icon Mike Wallace passed away at 93 years of age, after a long and amazing life.  He was a voice of reason and intelligence for generations.

He was also a very brave man.  In 1984, he experienced a life-threatening depression.  He and his wife sought help, but were soundly discouraged.  His physician told him he was a tough guy and didn't need it.  Others were adamant that seeking it would end his career.  He had examples of the latter-- he was a witness to McGovern running mate Thomas Eagleton's rejection from political life when Eagleton's own history of seeking counseling was revealed.  Mike gave up.  He wrote a letter indicating how his assets should be distributed, swallowed what he hoped would be a lethal amount of sleeping pills, and laid down to die.

If his wife hadn't found him, his death would have come 28 years sooner.  Before he had time to tell the world that depression happens, even to the wise, the lauded, the strong.  Recovery took a while-- therapy, three medications to find one that worked, lots of therapy.  In 2009,  he told the world about his journey out of the darkness.

Depression can be a lethal illness.  Politicians, housewives, children-- no one is immune.  Mike Wallace inspired many others to speak out and seek help in addressing this devastating disorder, in hopes that his example would help decrease the stigma many associate with it.  Among his many lifetime accomplishments, this was perhaps his bravest.

You can watch Mr. Wallace talking about his depression and his recovery by clicking here.

More on depression: 

Sunday, April 1, 2012

For Shame

Had a pleasant though mostly incoherent chat tonight with a homeless guy in front of the post office.  I was apparently looking pretty ragged myself, because when I said I thought I had a dollar, he said "That's ok, sister, just talk to me a little."  But I did have a dollar, one of those shiny new gold ones.   I'd found it when cleaning my office just before coming to the PO, and stuck it in my pocket.  I pressed it into his hand, and he said "That's ok, you can keep it if you need it," but I didn't.  Neither of us was exactly sure it was a real dollar or who was on it.  He remembered the Sacajawea ones; said "I get her, I know things about her.  I'm full blood (tribe withheld) myself."  He kept searching my face.  He seemed uncomfortably sober.  "I'm a sun dancer.  I don't go to the dances.  My tribe, it's hard for some of us, so I don't go now.  But I am a Sun Dancer."  "So you're a dancer who doesn't dance?"  He gave me a look, and said "You know how it is."  "It's never too late to go back, is it?", I asked, and got the same look, amplified, along with "Don't even start, sister, don't start."

"OK, I'll shut up now," I told him, and turned to leave.  He stopped me with a "Listen, sister."  He was quiet a minute.  He looked so vulnerable. He waited until I was looking him full on.   "Sister, I love you."  "I love you too, brother", I told him, and went on my way.

My heart felt heavy and lightened by our brief conversation.  Heavy because of the shame which blanketed him, and me some too for first thinking maybe I should turn the corner and just stick the envelope in the outside box.  Lightened because of our shared vulnerability in risking a real conversation, even if one of us was hungover from drugs, alcohol or just being a dancer who's kicked out of the dance and the other of us hungover from a long rainy winter of losses.  I didn't mind that he told me he loved me, and it felt fine to tell him back, even though if we'd known each other "better" we might not like each other all that much.  When he said that , I felt the part that was true for him as a suffering human, both broken and whole, talking to the part that was true in me and not all that much different.  The devil's in the details, right?  And the details of the moment were blessedly absent; just two people in a big old rattling world, connecting for a moment and then on our way.  I think we felt seen.  I think it felt good, for both of us.

Researcher and author Brene' Brown has a new TED talk on shame and vulnerability, those human unifying conditions.  If you've not seen her original TED talk, listen to it first at this link:
She's got some powerful things to say about how we can get out of our own way when connecting in the world.  Her new talk focuses on the shame aspect, and how it literally dis-courages us from being innovative, creative and making needed changes. 

Watch it here (if it's working), or at the link.  There's important wisdom here, and work for us.


1)  Vulnerability is not weakness  (emotional risk, exposure and uncertainty-- our most accurate measure of couarge.  To be seen, to be honest.  Vulnerabilty is the birthplace of innovation, creativity and change)