Breaking down mental illness

Mental illness comes in three major categories: cognitive disorder, mood disorder and/or positive/negative symptoms. While these aren’t the technical boundaries, this is the way that I consider mental illness to help break down the many subtleties into manageable portions. Mental illness isn’t just character trait, or a bit of an oddity. It is where the symptom, for various reasons, interferes with the smooth running of your life.

 

Cognitive disorder is about how we understand, what we think is real about the world and what we conclude from the evidence that we think is real. A component of this is perception, which comes in two flavours. Is the thing present and what is the threshold of meaning for the thing. If the unicorn is present, then it is something that I need to assess as far as risk and benefit. If it seems present but isn’t, then my assessment is automatically going to be in error. The assessment of risk vs benefit adjusts my behaviour towards the unicorn. If it is a risk to my health, then I need to be careful of it, while if it is there to charm those pesky fairies away, then I don’t need to be worried about the risk of the unicorn, I need to be worried about the risk of the fairies and the benefit the unicorn is going to have because of that risk. If we swap the unicorn, in this thought experiment, to a car, a risk of the car is that it will run me over. A benefit of the car is it can take me places very quickly. If I underestimate the risk of the car, I am in danger of being run over by it. If I overestimate the risk of the car, it may hinder the benefit the car can give me.

 

Another common cognitive error is faulty pattern recognition such as false beliefs and unclear/confused thinking. We humans are pattern recognition machines. This ability allows us to predict what comes next, such as when the gap in traffic will happen before we cross the road. We try to identify patterns and create heuristics to predict the next occurrences and the best way to deal with them. This gap is too small, this one is taking too long, etc. Sometimes we create patterns where there aren’t patterns. Every time I score beyond 5,000 in this game, a gap in the traffic appears. It may coincidentally happen a few times, but if my crossing the road relies on me scoring over 5,000, then my thought is in error and it hinders my life. Here I have equated to disparate things as if one things causes another, when really it doesn’t. Humans make these mistakes all of the time and only slowly let them go. The difference between a human trait (making this mistake) and a mental disorder is the magnitude of both the gap in connecting the disparate items and the consequence of doing so. As with most human traits, they don’t become a disorder until it creates significant disorder in your life.

 

Sometimes we create links that are very concrete but wrong, as described above. Sometimes we create links that are very short lived but wrong, such as this pen is a demon that is sucking my soul and spilling its life ink onto the paper. The paper is made from the tongue of a troll which was killed by Jesus when he was walking across the water to make the red sea into blood. When he did this, his finger fell off and was transmuted into a pen, which I now hold. This chain of story is trying to make all the elements that do exist fit into the ever shifting fantasy that is running through my thoughts. It is like trying to reconcile the real world on a dream understanding. This fails the real world test, thus making it very hard to actually make plans for how to better my or other’s lives.

 

Mood disorders are where the feelings we have are either too low, too high, and/or too rapid to be useful to our ability to work out an appropriate action to the event we are experiencing. First of all, let us separate the feeling from the emotion. We feel things internally, such as anger, fear, sadness, disgust, joy, and surprise. Feelings inform us of the environment and prime us to a default action based on the feeling. We emote (display) emotions, such as anger, fear, sadness, disgust, joy and surprise. Emotions communicate our feelings assessment to others. Be aware that people frequently mix the two up.

 

Consider something you are seeing. What you are seeing is light photons passing through your eye and hitting your retina. Your retina does some basic processing and passes the signal electrochemically into your brain. It goes via two channels. The fastests is to your danger pattern recognition centre, the amygdala and hypothalamus, located at the top of your spine inside your skull, just above the nape of your neck. It tries to quickly identify potential harm to you. If detected it gives you a suitable feeling and default action to manage this danger. If not detected, then you either don’t feel much, or if the assessment is of general benefit, you feel joy and again have a default action to deal with this. A few fractions of a second later the second channel kicks in.

 

This second channel is in your occipital region. Place your horizontal hand flat on your skull above the nape of your neck so that your hand is touching that bit that your spine touches your skull. Now place your other hand above that, higher on the back of your skull. That second hand is your occipital region. This is the light processing part of your brain. It is trying to work out what you are seeing and creating a three dimensional (3D) map of the world. It identifies that the thing you are seeing at the moment is a computer screen and what it’s basic use is. This report goes to the thinking part of your brain (ok, the whole brain is thinking, but this is simplified, right?) which is around your forehead. That part of your brain works out what to do based on the feeling and the report from your sensory translation – in this case of light the occipital region, but each sensory input has its own processing centre. So long as it isn’t an emergency you get to chose what to do.

 

When it is an emergency, the feeling is dialled right up by your danger sense and you automatically do the recommended action, like dodge or run. If it isn’t an emergency then you get a chance to think about your actions in light of the feeling driven recommended reaction. In a mood disorder this feeling is too low, so no warning comes and there is no motivation for you to do anything, no sense of urgency. If the feeling is too high, it is hard to think clearly and you find yourself reacting to everything instead of rationally acting. When the feelings cycle too fast, you can’t settle down on anything concrete for long enough to make a good choice.

 

We touched on positive symptoms a little earlier when talking about unicorns. If you experience something that most humans don’t, then it is considered a positive symptom. Most humans don’t see the unicorn, but you do. Testing the existence of the unicorn will show that it isn’t actually there, however most people experiencing positive symptoms are incredibly reluctant to test their belief. Other examples of positive symptoms include feeling insects crossing your body or crawling inside your body when they aren’t there, or perceiving people’s faces as whirlpools of smeared colour. Thought positive symptoms can include paranoia (unknown things are out to get you), conspiracy thinking (there is an evil plot by reptiles to control the ape people) and so on. Generally these positive symptoms are referred to as hallucinations and frequently respond very well to medication.

 

Negative symptoms are things that are missing when compared to the average human. The inability to feel joy, the absence of wanting to speak and no desire to form relationships with people are common examples. Not seeing peoples heads would be a positive symptom rather than a negative one (as it adds to perception rather than being an absence of perception). Unfortunately medication doesn’t help this one as much, so the solution is more complex than “here, take this pill”.

 

Each of these three branches can lead to mental ill health if they feed a behaviour that interferes with your life in a significant way. That is what changes the trait or experience into a disorder – that you find your life in dis-order. Many people feel the presence of god, which some would argue to be a positive symptom, yet lead perfectly average lives. The presence of this feeling does not mean that they have mentally ill health. Having strong feelings can mean that I am passionate without meaning that I am ill. Believing that the world is flat doesn’t stop me from going on a plane to attend a global conference of flat earthers – it might define me as odd, but not ill.
So, in a nutshell, three different ways that our thought process can hinder our lives. However the processes aren’t the only defining factor for mental illness, the consequence to us for that process is.

Torture – An Exposé

Torture is used by humans on humans to achieve two main outcomes. Dominance and manipulation. These are frequently related to each other.
Dominance is about the perpetrator demonstrating that they are in charge, that the perpetrator has choice and that the victim is not in charge and does not have choice. The perpetrator needs to do this because they do not feel that the victim is powerless or lesser and therefore must prove it on them by the application of various torture techniques. This torture repositions the power dynamic between the two to demonstrate the perpetrators power over the victim.
Manipulation is where the perpetrator wants the victim to change. That is, the perpetrator wants the victim to do something different to what they were going to do, behave in a way that is different to how they were going to behave and think in a different way to how they were going to think.
Both of these tell us a great deal about the perpetrator. A perpetrator doesn’t need to dominate a person that they already overpower or manipulate a person into doing what they were already going to do. All it proves is that the perpetrator feels inadequate or out of control, whether they are or not is irrelevant.
There are some fairly common techniques used in torture. The fundamental underlying aspect of torture is to change the core value of the victim from strength to compliance. If you are a victim, always remember you had to be seen as strong by the perpetrator for them to want to torture you. Mainly because they feel weak.
Physical punishment has two key elements, using pain to illicit fear as motivators. The first element is to weaken the will. This pain and fear fills part of our attention making it harder to think clearly. Consider when you have stubbed your toe, hit your thumb with a hammer, or slammed your hand in the door. I am pretty sure that most of your attention was on the pain and choice of swear words rather than considering the implications of astrophysics or any of your fields of interest. Your attention is on the pain, or fear of pain. It is not on thinking logically.
The second key element is fear avoidance. Ivan Pavlov is considered the first published scientists to discuss classical conditioning. His thought experiment regarding dogs, food and bells created an association in the dog’s reflexes between the ringing of the bell and the expectation of food via reward. Punishment is another form of conditioning. We don’t want to get hurt, so we do the thing (or don’t do the thing), in order to avoid the predicted pain. The torturer will ensure that you know what it is you are avoiding. The torturer will also use rewards as relief from the pain and fear to increase certain behaviours.
The perpetrator can inflict pain on the victim at will, thus demonstrating their physical dominance. The more sadistic perpetrator will want to leave marks to prove their power and ongoing dominance in a more permanent way. However it is rarely physical dominance that the perpetrator is after, they are just using it as a tool for what they really want. Psychological dominance.
Psychological manipulation uses similar techniques to the above. Overloading the mind and conditioning reflexes. This can be done via a host of techniques such as sleep deprivation, food deprivation, deprivation of liberty, creating an environment of fear, bombarding the victim with information, social isolation, financial deprivation and manipulating their emotions.
There is another aspect that is really important to all of these techniques. Convincing the victim that what they thought they were doing, thinking or feeling was wrong. This can be done via gas lighting (undermining core beliefs), emotional manipulation, invalidating the person’s integrity, changing goal posts (you can never be right) and making it not worth arguing. There are many more techniques than these, of course. The common underlying principle is to make the victim doubt the fact or value they knew and trusted, and replace it with the fact or value the perpetrator wants the victim to take on board.
Overloading the victims mind means that the victim can’t evaluate the information before storing it. Think of it like putting groceries away. When you realise you are about to put some rotten food in the cupboard, you stop, put it aside and throw it out. If I give you several tons of food to store in big boxes with a tight time limit, you won’t check all the food, you’ll just put it in the cupboard. By overloading the thinking mind, the victim can’t analyse and judge the information coming in and will just store the rotten idea without critical analysis.
Isolating the victim from safety, other trusted people and time is all about giving the person no good reference point to compare the new information to. If you are in a boat on the ocean on a cloudy night, you don’t know which way you are going. If you have a compass, you might have a clue, but if the perpetrator discredits the compass then you are lost again. The perpetrator needs to make the victim distrust all their means of finding themselves. This means discrediting friends, authorities and repositories of knowledge. By undermining the idea of right and wrong, the victim finds it hard to judge the idea for whether it is good or rotten.
When we feel stressed we pull back from life a little to help manage the important situations better. This is prioritising and on a short term basis makes sense. We deal with what we can and shrug off what we can’t. When the problem isn’t solved, we pull back more, and then more and so on as the problem persists. We isolate ourselves from friends because we just can’t deal with that distraction, from going out because it seems too hard and frequently find ourselves under resourced in many ways. We begin to doubt ourselves and avoid those who can help us. We frequently find our sleep pattern and food pattern become broken, messing with our bodies sense of rhythm. Sometimes we subconsciously do this to push us into crisis, where we are willing to take on new solutions to problems that aren’t being solved using our usual methods. Sometimes these are great solutions, sometimes they are bad. Sometimes we don’t find a solution and just crash and burn.
In effect, we torture ourselves when we are stressed. Those who perpetrate torture on others have hijacked this normal self-change process in humans for their own purposes. Torturers come in three major categories. Professionals are rare, hobbyists are also rare (that is, they know what they are doing and have tried to get good at it, also quite rare) and then there is the unwitting torturer who is just automatically compensating for their low self-image by harming others (very common). This last category have evolved their techniques out of a need to survive their own mind.
Once we know the process of torture and the reasons why people do it, we can recognise it in the wild. This gives victims the ability to interfere with the process, either by defending themselves from the tools used against them, avoiding the perpetrator or getting help from counsellors, police etc. It also gives the unwitting perpetrator the ability to recognise what they are doing and look go through a similar method to undo their methods. I highly recommend that unwitting perpetrators to get some good counselling to help change their behaviours and, very importantly, address the underlying reason why they are doing this.

Taking time

When our brains are running efficiently, we plan complicated processes out quite well and parallel process things efficiently.
 
Consider making a cup of tea.
1) boil the kettle
2) wait for it to boil
3) get a cup out
4) get a bag out
5) put the bag in the cup
6) pour the boiled water into the cup
7) get the sugar out
8) get a spoon out
9) use the spoon to put one spoon of sugar into the cup of water and tea bag
10) wait for a few minutes
11) get the milk out
12) pour the milk into the cup
13) put the sugar away
14) put the milk away
 
This is a serial process. Only one thing happens at a time. Nothing in parallel.
 
1) boil the kettle – 2) get a cup out – 3) get a bag out – 4) put the bag in the cup -5) get the sugar out – 6) get a spoon out – 7) use the spoon to put one spoon of sugar into the cup of water and tea bag 8) wait for the water boil 9) pour the boiled water into the cup – 10) get the milk out – 11) put the sugar away 12) wait for a few minutes 13) pour the milk into the cup 14) put the milk away
 
Be reordering the process a little, the same steps are taken, the same result is gained, but the steps with the “-” are taking no “time” because in the series version you would just be sitting idle instead of doing something. This parallel version saves a few minutes from the entire process. It is parallel tasking (mutli tasking is trying to do two things at the same time, instead of allowing autonomous processes to continue, like the kettle boiling without supervision).
 
With increased efficiency, there is still idle moments. I tend to use these to make breakfast, pack my lunch, put my shoes on etc.
 
There is only so many diverse tasks your brain can track before making mistakes. On good days I can track a good many tasks. On bad days I can’t even make a cup of tea efficiently.
 
Different things contribute to a “bad day”. Lack of sleep, medication, grief, illness, a significant cognitive distraction (thinking about an unrelated task), pain and so on.
 
Once you recognise that you are doing this, slow down the amount of parallel tasking to be more serial. Yes it will make each task take longer, but with less errors, it will lead to less overall frustration and less fixing the mistakes.
 
We are allowed to have times where we are less efficient. If it persists, then it is worth doing something about it. Figure out what is the cause and make the appropriate change.

Mental Illness Diagnosis: A Learning Opportunity

A mental illness diagnosis is a description of the behaviour(s) and trait(s) you are using to manage your life such that you or someone else is in significant discomfort or distress. If the beavhour(s) and/or trait(s) change to reduce said discomfort/distress to negligible amounts, the diagnosis can be removed. You heal.
Mental illness diagnoses are not given to people who have alternative behaviour traits that make life awesome. Only the opposite. Being different and unique is not a symptom of mental illness, just the discomfort and distress caused by poor behaviours and traits are.
It is quite possible to change the way you behave. Behaviour is a learned thing. We learn new skills all of the time. Some behaviours are due to ill fitting reactions to stimuli. These can be re-learned to be different. Instead of having to act in a certain way to a presented stimuli (life event), we can learn to act in a different way. Our emotional reaction is separated from our chosen physical action. Given some practice, our emotional reaction will adjust to our new survival methods.
No two brains are the same, although many fall within the definition of “neruo-typical”. Each person has their own subtly different way of doing things. Consider how many different ways people make 2-minute noodles. Ask around, you’ll find a whole host of answers (mine is the best, by the way). No solution is definitively wrong (unless it explodes or kills someone). You can make 2-minute noodles on the stove, in the microwave, out camping, using a solar oven, eat them raw… all depending on personal preference and current access to equipment. Similarly, the way we chose to act to life events will be different and unique. Sometimes we need to learn better ways. Doing things differently to me doesn’t mean you are wrong, just different. Wrong is not measured as different, it is measured by the amount of discomfort and distress it causes. Even then, it isn’t wrong, there is just better available.
That brings us to “right”. Right ways (note the plural) are ways that progress you with minimal discomfort and distress. Substituting a poor solution with a better one doesn’t make you faulty, wrong or ill. It means you have learned, evolved and grown. There is nothing wrong with that. Every time we learn, we evolve and grow. That’s the point of life. If you stayed the same as when you were born, you certainly wouldn’t be reading this!
A solution is right when it is good enough. Perfect is nice, but it isn’t needed (and perfect doesn’t actually exist anyway). Good enough is when your solution works for you and your group (family, friends, society etc). A behaviour that works just for me at the expense of others is less good when compared to one that works for me and others. Once I have learned a behaviour, or preferably heuristic (rules that mostly work most of the time so it isn’t one solution for one problem, but a way of solving life problems with good enough solutions), that is good enough, I need to keep at it.
We are frequently tempted to view a behaviour that leads to discomfort and distress as an indication of a fault within ourselves. This is natural but faulty. Any skill you develop will include failure. The failures as you learn don’t mean you are a failure, it means you are learning. If you are learning, then you are awesome. So don’t stop because you are afraid to make a mistake. Heck, if you’ve received a mental illness diagnosis, it just means you have some specific learning to do to grow to change that diagnosis.
You aren’t alone in your learning journey. Sometimes a teacher or guide is helpful, sometimes gaining some education, and or sometimes some medication can help. If you are stuck, get some help.
So work out what you need to learn and go out and learn it!

Problems

Problems crop up all of the time. A problem is something that affects our lives adversely. When we win $100 in a raffle, we don’t consider it a problem, unless that winning is going to lead us to be tempted to purchase something bad for us. It is at the point that the thing harms us that the thing becomes a problem. In this example, winning the $100 is not the problem, purchasing harmful things is.

Understanding the Problem

Frequently we identify that a problem exists and then go about trying to fix the problem. Yet the point of identifying that a problem exists may mislead you in identifying what the actual problem is. In our example above with winning $100, one could consider that the problem is receiving $100, which enables a bad habit, or the purchasing of the harmful things, which is the outcome of the bad habit. However the problem is the habit and what drives that habit.

If we misidentify the problem, we can spend a great deal of effort in trying to fix what isn’t actually contributing to the problem. Wouldn’t it be better to be able to hold $100 and not spend it on harmful things? Avoiding $100 is not a good long term solution. However it may be a good short term step while addressing the long term problem.

Sometimes we want to lay the blame at someone else’s feet – they shouldn’t have given me the $100 – when the problem is actually our own. Sometimes we take ownership of a problem this is actually someone else’s fault – I shouldn’t have worn that outfit, or walked down that hallway – as if we can control their actions by what we do. Frequently though, we miss-estimate what share of responsibility we own vs the other, or try to give blame in a blameless situation.

It is important to not get caught in the blame game. Blame helps us identify what some of our strategies should look like, but it doesn’t actually fix the problem. So it’s their fault. Or your fault. Or both of your fault. Or an unforseen circumstance. Great. Now what are you going to do about it?

Evaluating the Problem

Once we have identified some of the causal components of the problem, we need to evaluate the problem. Is it an immediate life problem (not being run over by a truck), a life changing problem (such as renal failure), a social crisis (a fight with one’s partner or best friend), or a momentary problem (purchasing the wrong book at the store) and so on. Each of these requires a different level of personal resources to address it.

Where is the best location to spend those personal resources and how much should you expend? Should they be on surviving the moment? After all, there is no point in saving your money for tomorrow if you aren’t alive to use it… however you also shouldn’t put everything into surviving this momentary speed bump if you don’t need to either. It is also important to note that this isn’t a dichotomy. You can spend some personal resources now and more later on this problem.

Personal resources includes financial, social, psychological/emotional, and material resources. There are more, but these are the major categories. It is worth noting your personal resources for the bigger problems so you have a clear understanding of what you might bring to bear on the problem if it is needed.

I frequently see people burn their social bridges out by not addressing the real problem and being caught in a nasty loop, or over spend their finances on something that is actually fairly trivial, or fail to put enough resources into finding housing as their lease expires and so on. Many crises could be averted by carefully putting your resources into the solution more intelligently.

Evaluating the Solution

This is an important task to perform as you are implementing your solution and at the end of your solution intervention. Is your intervention working? Are your personal resources going to the right place and having the desired result? Do you need to adjust your plan? Did it actually work?

If you find your resources running out  faster than expected, or no change is being noted in the problem, or you seem to be in a loop of repeat similar problems, then your solution is failing. It is time to stop, go back to the beginning and try again. Did you actually figure out what the problem was and a suitable solution?

If your solution was to change the world – good luck. It’s really big and you are but one person. There are many things that need to change in this world to make it better, and slowly they are changing because of the number of people putting effort towards that change. Feel free to join them for a long term solution. However between now and that long term, what are you going to do to adjust yourself to the world and situation you find yourself in? It is through changing ourselves that we change the world.

Social media

Sometimes I post very trivial humours things. They are mostly “that was cute and I smiled” things. Sometimes they are geek/nerd references, sometimes they are pictures chosen to bring a smile to my face and remind me that this world is a lovely place after all. Let’s call this section fluffy posts.

Some things I post are because I don’t understand, or want to verify. Some things I post are because I want to provoke thought and discussion. Some things I post are educative. This section is what I consider serious posts. They have a purpose beyond just “look – cute/funny”.

Generally I get a lot of positive response to what I think of as fluffy posts. People seem to not really want to think, consider, discuss or change. They just like to watch entertainment. That is fine by me. I tend to think of that as more background rather than intent.

The posts with intent are where my heart is mostly at. I have a fuzzy boundary post that crosses both section – “Today’s cute”. I have an intention when I post that – I want people to soften a little and smile about the day. I love it when people have caught onto the pattern and share their cute picture of today with me, so that I can re-share it to others.

The other serious posts are about learning. I don’t mind if it is I that learns, or others. What I am after is discussion about an issue that helps someone (me or someone else) go “oh … I see, I get that now”. I am certainly no expert in all thing, or even many things. Even the things that I consider myself to be an expert in leaves much room for alternative explanations, new information and heck, I can be wrong. The truth is how you measure something, not the messenger.

There are many paradigms. A paradigm is a way of seeing this world and a set of rules that work within that paradigm to help make predictions of what comes next, or to help ease the understanding of what has come before. No single paradigm can answer all questions, and many paradigms will conflict in certain areas.

As a spiritual athiest I have an odd perspective. I value evidence and logic. I also recognise that not all of the universe has been cataloged and not all evidence was measured equally. I have witnessed and continue to witness things that I do not understand and do not have a clear explanation of. I have an insatiable appetite for knowledge and understanding.

I was quite amused when going to university about 15 years ago to have three different courses uses the same term to mean very different things (I really wish I could remember what that term was… I have forgot sooooo much!) If I had used the meaning of the term in one unit in a different one, I would be considered wrong or in error. This is why it is key to understand and recognise the paradigm that one is in.

Richard Dawkins proposed a scale of thiestic probability. Feel free to wiki “Spectrum of theistic probability” when you get a chance. An interesting read. In summary it says that at level 1, there is a god who created all, that it isn’t belief, it is certainty. At level 7 there is no god and never can be. In between is a range of levels of belief about god. I am at level 6 – I don’t believe their is a god as defined by most religions, but I don’t discount the possibility that there might be one and if suitable evidence were put forth then I would change my mind. To my perspective, saying their cannot be a god is the same as saying the reverse – there must be a god. I prefer to look at the evidence, and no evidence has yet satisfied me that there is one. Nor can I figure out what evidence I would need to believe that the being I am meeting is an actual god rather than a powerful daemon. Descartes strikes again.

From a thiest paradigm, there was a creation of all, a creation of the world and an interaction of god or gods with people. Each thiest (god believer) has a set of evidence and logic to justify their particular belief. A comedian pointed out that most religions state that their way is right and believing anything else will send you to a hell like environment upon death, thus most of the world is going to hell. They can’t all be right. I’m not interested in pitting one thiest perspective against another. What I am interested in is understanding each thiest perspective internally. How is item A justified within this belief system when item B also exists which seems to contradict item A? When I have asked the question, I get many band wagon people stating “it’s all crap, don’t bother”, and I wonder how if they have actually looked at the question. Many people believe this stuff, and that belief shapes this culture of ours, the laws of the land and how we treat each other. Not because I necessarily believe it, but because they do. To ignore their belief is to ignore the oncoming truck about to hit me, because I like to drive a motor bike. We exist on the same road, even if we are driving in different directions.

Sometimes I have learned that the premise of Item A and Item B within the same paradigm are actually false, either because my source misquoted / exaggerated / made stuff up, or because it was out of context and misrepresents the point of the paragraph or chapter. I love learning that. For example, there was a gripe that the Jesus history strangely resembles that of Horus, thus stating that the Jesus story is fiction. A closer look at the known history of Horus demonstrates that this is full of crap. They aren’t any more similar than comparing Jesus to any other historical figure. Not to mention, some of the statements about Jesus are contrary to recognised standards of the story. Does that mean that Jesus really lived? Irrelevant to the question.

Sometimes Item A and Item B are correct, yet a thiest of that paradigm still persists in accepting both seeming contradictions. I want to know why. Cognitive dissonance is a well known psychological concept – the ability to hold a contradiction because of emotional investment (it’s more complex than that, but hey, a single sentence explanation can be useful) – and is held by all people about a range of topics. It is really hard for people to accept that there is a clash and that their concept is wrong for some reason when they have spent a large amount of energy in trying to uphold that clashing concept despite the evidence. A great example of that is the scientists who resisted accepting that the lead in petrochemicals was a problem. Check out the story, it’s fascinating. (Sadly, once the scientific community backed the findings the governments of the world acted together to ban lead as a stabaliser, while in anthropogenic climate change, the governments of the world are in denial despite the evidence – oh the power of media and money!)

Thiest contradictions aren’t the only things I want to understand though. I have occasionally posted, for example, quantum physics contradictions and have enjoyed reading the responses from my more ‘learnered’ friends. Much like the thiestic queries, I have enjoyed finding out how much initial items are wrong, misrepresented, or my understanding of their meaning of these seeming contradictions aren’t actually contradictions. I was talking to a chemistry PhD a year or so ago and complaining about why chemistry isn’t a real science because to make it work requires all the exceptions to the rule. He explained to me that actually, the rules we were being taught were old and over simplified thus needed the exceptions, but the real rules always work, they are just to hard to teach high school students… so I have re-evaluated chemistry.

The universe is big. You just won’t believe how vastly, hugely, mind- bogglingly big it is. I mean, you may think it’s a long way down the road to the chemist’s, but that’s just peanuts to space. While I am paraphrasing Douglas Adams, he has an excellent point. We have sent probes out to the furthest planets of our solar system, observed through telescopes exploding stars incredibly vast distances away and smashed tiny particles together to see what tinier particles they contain at such vastly small scales it is quite literally impossible for the human mind to truly understand (we use tricks to make it digestible). In all the places we have looked, we have observed patterns and created rules, tested those rules and observed better patterns and created better rules. This is the scientific process.

There are two fundamental philosophies underlying science. The Principle of Universal Nature (PUN), and Induction. Neither of them can be proven. PUN (I know it is tempting to get sidetracked here, but stick with me) in brief states that the rules that apply here are the same rules that apply over there. If there seems to be a difference, then clearly we have not truly understood the rules properly. This breaks down when shifting from the quantum level to the macro level, partly because we don’t understand gravity (I look forward to the corrections). Induction is about assuming that time moves in a forwards direction and that the past leads to the future. This instant that you are reading the last word in this sentence might be the only instant in the universe, and that instant comes with a mistaken belief that there was a past… you just can’t know. The next instant could be completely different with a complete alternate past. We assume this is not the case and that the trigger causes the event, not the event pulls the trigger.

What if these are wrong? It was thought that electricity moved from the positive terminal to the negative terminal. That makes sense and aligns with all of the prior thinking about directions and charge. Yet when we learned more, it was discovered that electricity is moving charged particles, specifically electrons. They move from a negative terminal to a positive terminal. Yet the electronics still works… Imagine trying to flush your toilet backwards. The assumptions you built the device on are back to front, but some things aren’t, like gravity. What if we discover that nature is not universal, or that time does not flow in just one direction? What if other fundamentals of science are wrong? What if the lead in the fuel is an ecological disaster and causing brain damage to our kids?

The idea of science is to recognise errors and evolve around and through them. As such, a good scientist is willing to embrace the evidence on its own merits, but within the context of the body of knowledge. As such, there are many instances where fields of science have changed to slowly and surely embrace the more accurate knowledge despite the reticence of old paradigms. Fantastic solutions require phenomenal evidence.

Scientists have not measured everything. There is still more to learn. Perhaps one day they will discover a thing called magic. However magic is defined as that which science does not explain, and science is an explanation of magic. Consider what you are reading this on – if you took that device back in time only 200 years, it would be considered magical. Arthur C Clark said it best “Any sufficiently advanced technology is indistinguishable from magic.” Similarly our understanding of the worlds old magic is now called science.

Yet there is so much more to learn. We humans recognise patterns all the time and we use these patterns to make predictions which often either help us survive, or fail to kill us. Until we get a better pattern predictor, we keep the old ones. Part of my work as a social worker, when being a counsellor, is to help people identify sucky survival patterns and replace them with superior models. Harder than it sounds.

We often justify our patterns and prediction mechanism, creating interesting explanations that are just plain measurably wrong. The position of the planet seems to match this pattern, so it must be the gravitational force, or the mystical energy, or 4 was always a lucky number and is dominant. When I feel bad, I eat a banana and I feel better – perhaps you should too? Some of these solutions have been turned into medicine. Consider aspirine came from willow bark. Who the heck eats willow bark? Yet when you don’t get sick from making a tea from it, and you find it makes you feel better in some circumstances, you continue to use it. When scientists checked it out, they discovered and distilled the ingredient in will bark that now is the active ingredient in aspirine. Can you just drink willow bark tea to get the same effect as popping an aspirine pill? No – the willow bark is a variable dose with a poor targeting system and a whole bunch of impurities. Take the damn pill.

Many of the explanations given to why a certain pattern works have been tested, proven to be wrong and thus the pattern is discarded. That is bad science. First step should be to measure if the pattern actually exists. Then check if there is a causal or correlative chain. Steve Martin’s movie “All of me” had a Swami pull the chain on the toilet just as a telephone rang. He didn’t know about toilets and telephones (sticking to the idea that he was a hermit in some very remote and primitive country). From there on, whenever the phone rang, he went and flushed the toilet. Correlation, not causation. (Okay, the Swami was the causal link, but look at another toilet and phone system and the two are unrelated, so trying to work out the link between toilets and telephones is stupid).

I often here people using out dated explanations for patterns they have recognised that have clearly been discredited and band wagon people stating that patterns don’t exist because of the discredited explanation. Yet neither talk about the validity of the pattern. It frustrates me.

There are many patterns that just have not been tested yet. That doesn’t make them real, or false. Just not well tested. It is too easy to jump to a conclusion of certainty if you aren’t familiar with a decent investigative process, or you don’t have the resources.

For example, Mercury is in Retrograde. I looked it up yesterday out of curiosity. I looked it up because I’m feeling pretty emotionally bad at the moment. (Don’t worry, it will pass). I tend to feel this battered only a few times per year. When my emotions get past a certain point, I wonder where Mercury is relative to earth (poor phrasing, I mean which direction it is moving in the sky relative to our perspective). Due to the nature of two circling bodies around a fixed (ish) point, Mercury happens to be going in the opposite direction to its usual orbit (it still is going the same way as the Sun perceives it, but the illusion on Earth is of a counter spin). Pretty much every time I feel this crap, Mercury happens to be in retrograde. So what does that mean? I have no idea. It’s a pattern. It might be causative, or correlative. I just don’t know. All of the justifications I could come up with (gravity, electromagnetic interference, space aliens) don’t actually match any reasonable scientific explanation. That is, the effect would be so small as to be laughable and other factors would be far more impressive (gravity – a local mountain has more gravitational effect, the moon certainly etc, electromagnetic – this computer I am typing on puts out more ionising radiation at this range than Mercury does in retrograde – and why would the perceived direction have an effect on me anyway? Aliens – lol ).

More important is to look at the pattern. Do I really always feel emotionally crap when Mercury is in retrograde? Reading back through my journals indicates this is so far true for the last few years. Are these the only times I feel bad? No, but bad is a poor scale. Do others feel bad during Mercuries retrograde? Insufficient reliable data, but I’m guessing no as most people are not going through this else the world’s economy would be collapsing right now and other noticeable factors. So it is mostly just me and a planet would not have a single target, or a massively minor target population of humans. That just makes no sense. So, it’s an interesting observation, but not a cause or a real pattern as yet. I’m still acquiring data.

It is common for people to take one incomplete study out of context and try to apply that to too much. Most media science reporting is like that. Eat this food, avoid that food, try this diet, avoid that substance because its a poison, use these light globes, buy my product. Mostly it is all crap trying to look legitimate through either bad science (which just shouldn’t get labelled science at all), or misrepresented and misreported science. A great example of this is vaccinations. Andrew Wakefield was paid to falsify a report to justify a woman’s mistaken correlation of her child being vaccinated and the doctors recognising that her child had autism. This one study of less than 10 candidates that was heavily tampered with was used to win a case despite hundreds of other studies and experiments. Subsequently the scientific medical community went into a frenzy of more studies to see if there was any legitimacy behind Wakefield’s findings. And found none. By none, I mean thousands that said “strongly no” and a half dozen that said “maybe yes”. Those few “maybe yes” reports, added to anecdotal correlations of adverse reactions to occasional vaccinations lead to an anti-vacc movement. To justify themselves, these people worked hard to promote their views to others despite the clear evidence (for those willing to see it) that it was false. Yet their cognitive dissonance (emotional investment in a belief) outweighed their logic and the validity of the evidence. It was easier to believe their was some vast conspiracy than to accept that hundreds of millions of people get vaccinated with no real ill effect (beyond a sore arm and some local irritation). All medical procedures have some risk, even if that risk is that some equipment falls on you during the procedure. The doctor’s job is to weigh up the factors. If this proceedure has a 10% chance of killing you, but not doing it has a 100% chance of killing you, then it is worth doing. The risk factor of vaccinations is incredibly small. The risk of catching small pox, rubella, measles, tetanus, etc if the population is not vaccinated is incredibly high. The chances of death from vaccination are even smaller, while the chance of death from these diseases is reasonable. As such, vaccinate your kids. Heck, get it yourself.

There are a small subset of the population for which the risk of taking the vaccination is too high. The doctors will recommend against it, aiming for herd immunity to protect these people. To get an idea of how this works, look up the phrase “Herd immunity simulator” and have a play.

I was speaking to a med student about 15 years ago, who said that 90% of what they are learning now will be replaced with new knowledge in 10 years time, yet what they know now is the best information they have for saving peoples lives. The new knowledge will mostly be an improvement of the old knowledge and only a few things will be found to be complete wrong. I spoke to a med student a year or so ago and they said the same thing.

The point is we (humans) are discovering things all the time. The popular professional wisdom is the learned wisdom that is worth following. It will be updated, it will be improved on, and sometimes it will be wrong. But the safe bet is with the current learned wisdom.

Yet I still want to learn everything, whether it is my way of believing things or not. Oh, and I want to minimise the harm I do others, but that’s another blog post.

Depression

Frequently people mistake depression for other problems and think they are depressed when they are merely sad, down or lacking in some physiological way. Depression is a significant life affecting disorder that is more than just transitory. Sometimes depression has the pre-word “clinical” to help differentiate it from when people feel down and misidentify themselves as being depressed. There are things you can do to address depression including lifestyle change, medication and cognitive therapies. People diagnosed with depression of a significantly higher likelihood to suicide.

Diagnosis

First of all, let us define depression. Depression is a clinical diagnosis given to people who find their emotions depressed, find they are despondent, are amotivational (without motivation), and or lacking in energy to the point of incapacity. According to the DSM V (the Diagnostic and Statistics Manual 5, formed in the USA):

“A. Five (or more) of the following symptoms have been present during the same 2- week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.
• Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
• Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
• Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
• Insomnia or hypersomnia nearly every day.
• Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
• Fatigue or loss of energy nearly every day.
• Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
• Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
• Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

B. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).” – DSM V

Let’s pull that apart a little. First of all, there need to be some significant symptoms in multiple categories – physical, psychological and ontological. At least one of the symptoms needs to be a depression of mood or joy. These symptoms should not be due to another aspect of a different disorder. For example, a negative trait (a trait missing from most people) of schizophrenia can be anhedonia, an inability to find or feel joy. Because it is part of the diagnosis for schizophrenia , it should not also be used to also diagnose depression (but only, in this case, if you are diagnosed with schizophrenia).

Secondly these symptoms have to be significant enough that they are causing distress in your life. Significant is measured externally by the effect the symptoms are having on your social interactions, necessary work or another major, externally measurable effect. When we humans have an emotional reaction to something, we can easily misperceive a molehill as a mountain. Other external people may not see it the same way. Internal psychology is hard to measure, but the effect of what we are feeling on our lifestyle is quite easy to measure. This gives an objective measure to severity via the impact it has on our day to day existence. This does not mean to belittle how horrid we feel, it just contrasts it to how well we cope or manage. Each human has traits (happy, sad, guilty etc). When a trait becomes an extreme it generally becomes a problem and we change its classification to a clinical disorder.

Thirdly these symptoms cannot be caused by a physiological disorder such as nutritional deficiency (vitamin D or B12, iron etc), a side effect of medication, or some other specific biological disorder such as a hypothyroidism (where the thyroid doesn’t produce enough of certain hormones). When all of these factors are considered, what is left is a disorder that is debilitating and isn’t caused by the presence of another substance, isn’t a deficiency in nutrition and isn’t caused by another diagnosis.

Depression is a description of symptoms, but not of causes. Exactly what is the source cause for depression is not really known. Some fMRI (functional Magnetic Resonance Imaging) scans of peoples brains have shown suppressed activity in areas generally associated with joy and happiness, others have lower levels of serotonin or serotonin re-uptake inhibitors in their brains and some have all the signs and symptoms with nothing showing in any of the tests. Yet they are all labelled as depression even though it is thought that each of these has variable causes. As medical knowledge advances, this will get teased out and specific causes will be identified which lead to specific treatments. Until then, the simple method of treating depression is to brute force attack (that is systematically try the best combinations) the known treatments.

Medication

The most common first step is to start on some antidepressants. There are a host of common ones that work on the most common forms of depression. These drugs are directly targeting the chemistry in the brain for the most common things that are out of balance that lead towards depression. Because each person is different, different forms of the medication may have a greater or lesser affect on an individual.

Balance comes in three flavours:

  • Excessive neuro transmitters, which need to suppressed.
  • Deficit transmitters, which need to be boosted.
  • Errors in the cycling of the transmitters, which need correction.

People can have a combination of two or more of the above. Keep in mind, this is a vastly simplified explanation.

Even if two people have the same form of depression caused by the same problem, their differences in weight, gender, genetics, diet and lifestyle can affect the efficacy of taking the same drug. Some find that one brand works better than another, or that an alternate pharmacological method of eliciting the same end result (such as increasing the amount of serotonin) is more efficient, or that the dose needs to be higher or lower to get the same results. In summary, the first medication you go on may not be affective, and it will most likely need to be tweaked to get the best results.

Medication works well for roughly 1/3 of people diagnosed with depression. Initially it allows them to get back on track with how their lives were before the depression hit (if it is a recent thing), or find their lives if they never experience a depression free life (lifelong depression is fairly rare, but can happen). It is not intended as a solo solution.

For another 1/3 of people diagnosed with depression, it has some positive effect, but is not enough to get back to the old life (or for some a new life). This might be because the right combination hasn’t been found, or the symptoms are being caused by a combination of both chemical imbalance and poor psychosocial patterns. More on this later in the section about changing your life.

For those who are doing the maths, you will note that roughly 1/3 of people are left – they experience no positive effect of the medication. For them, this seems like a massive waste of time, each time hoping for being saved, only to have the hopes dashed when a few weeks later the medication again has no positive result. This is both true (as described) and false, because you are missing the bigger picture. There is no easy method of measuring if you are going to be responsive to medication or not until you try and are successfully – or not. Also medication should not be given in isolation, it should be coupled with non pharmacological therapies. And lastly you have now ruled out a treatment method that won’t be effective for you.

All medications have listed side effects. A side effect is an effect the medication can have on a percentage of the people who take it that is not the primary effect desired from the medication. Side effects are fairly minimal and generally safe, or vary rare if unsafe – else the medication would not be allowed for public use for long. It is important to know what the side effects can be so that if you are affected you know that the likely cause of the effect is the medication you are on. Report to your treating doctor the side effects (if any) you experience. Sometimes these side effects are rough and make being on medication worse than not being on medication. This is not common, although you will hear a great deal of people talk about it, giving a distorted prevalence of this via their poor confirmation bias. Basically the vast majority of people who have no significant side effects don’t talk about all the lack of side effects, so you only hear the occasional squeaky wheel in the dark and assume that all wheels are squeaky.

Cognitive Therapies

There are a number of cognitive therapies that are available for depression. Cognitive therapies rely on a person being able to analyse their existing behaviour patterns (sometimes with help), identify positive and negative patterns, then adjust their lives to promote positive patterns and address negative patterns. This doesn’t work for people who lack the insight needed to analyse the patterns, or people who are unwilling to change their lives.

Many people think that talking to someone is stupid and ineffective, a sign of weakness, or exposing themselves to scrutiny and judgement. There is an element of truth to this, but it’s the wrong angle.

  • Stupid and ineffective – If you are talking to someone that you don’t connect with, or is not qualified to help you then you make no progress and you resent the discussion. You don’t have to be pally with the therapist, but you need to feel a level of trust in your discomfort. Discomfort is actually a good thing, but terror is not. Often people lie to their therapists and that just doesn’t help at all. The qualification of your therapist is important. While there are some naturally good conversationalists, having a plan on how you are going to work collaboratively on your problems to overcome and defeat them takes training. Anyone can call themselves a therapist or counsellor – so beware of what actual qualifications the practitioner actually has.
  • A sign of weakness – it is a sign of weakness. If you were able to help yourself, you wouldn’t need help. You need help. Avoiding admitting you need help by avoiding therapy is like admitting you are falling from a plane and refusing to pull the cord on the parachute, as if that last step is going to stop you from the nasty end you are heading to. Dramatic, I know. But really, go talk to some professional.
  • Exposing yourself to scrutiny and judgement – this is absolutely true. If you aren’t willing to examine yourself in front of someone who can help you, why are you there at all? The point is to examine and jointly judge what is working, what is not and discover what needs to change. The fear is that the therapist will judge that you are faulty, a failure, a horrid person and so on. Generally the therapist will see that you are someone who needs help to make it on your own, the rest doesn’t matter. Even if they do see you as those things, isn’t that why you are there? To get help to not be that any more?

It is important that you develop a comfortable relationship with your therapist. This is referred to as “rapport”. It is a professional relationship built on trust and a desire to achieve a goal – your independence. If you can’t trust your therapist, then find someone you can trust. The therapist is not your friend, they are your employee. Unless you are court mandated to work with the therapist, you can always chose another (with the minor exception of small towns – and even then, if you have the internet or phone, you have access to more).

There are three main components to therapy:

  • Identifying and understanding the problem
  • Making change
  • Evaluating the change

A lot of therapy gets stuck in the first or last stage and forgets the middle. Also keep in mind it is not a linear thing – you don’t just do the three steps and you are “cured”. You repeat with your therapist until you can do this on your own.

Changing Your Life

If you don’t make changes in your life, then you won’t make any changes in your life. It amazes me how such a simple sentence can sum up the power you have in your life and your future. There are four main components you can manipulate about your life and they are summed up in four categories.

  • Biological
  • Psychological
  • Social
  • Spiritual

I have written about this before. In short:

Biological – may mean taking medication, doing exercise, managing your sleep cycle, changing your diet and or change in your weight. Without your body motor running efficiently, how can you work with your feelings and motivation? It’s like trying to hammer a nail into wood with a twisted nail and a broken hammer.

Psychological – This is about working out your patterns and modifying them. Patterns include how we perceive our environment, how we react to things, our habits and tool kit of coping mechanisms and strategies.

Social – Humans are social animals and we need to factor in our interaction with others. Do we have friends, and if so do we like them and do they bring out the best in us? Who are the professionals in our life and what are we using them for – is their a plan to become independent of them? Do you hide from people or just pretend while around them? Who do you turn to when you need help and how are they coping – is it just one or many?

Spiritual – We live in a world of people, animals, plants and things. Without any of these life is not possible. We are influenced and influence other things. How we see ourselves in this mix is vital to our health. When we forget our importance (and we are all important), then we diminish our worth in our own priorities and stop doing things like eating, doing activities, seeing friends and so on. When we stop doing these things, we stop living. It is only a matter of time before we stop being alive. It is vital to rediscover our worth, not only in our own eyes, but in the eyes of others. It is easy to hide from the system and be missed – but you are so much more than that. You can make a difference, and it is a good difference.

Examine each of these things – judge yourself against them, identify some things (no more than 3 at a time) that you are going to work on, define what basic step you can take to adjust these and how to tell if it has succeeded. Then, most important of all, act. Do it.

Suicide

People who are depressed are 10-2o times more likely to suicide than those who have no diagnosis (or could be diagnosed). While this sounds horrid, it isn’t quite as scary as it seems. Most people who are depressed do not suicide, but many people who suicide are depressed. That’s statistics for you. We still need to look at suicide square in the face though.

There are three major types of suicide.

  • Hopeless suicide
  • Angry suicide
  • Accidental suicide

Hopeless suicide is attempting to end the pain. The victim has concluded that this is the only escape because nothing can help. This is the last ditch escape from an intolerable situation. They have lost their self worth and have succumbed to the belief that there is no way out. Often this is hallmarked by gifting self identified meaningful things to those who they think were good to them or they cared about. It is important to get help before this happens, because it is not true. Just because you can’t see a way out doesn’t mean there isn’t one, hence why you get help to find a way.

Angry suicide is generally sending a message to others. Most depressed people do not have the energy to maintain enough anger to suicide for this reason. There is a danger when people start on medication and begin to get better. They still see the horror of depression but now have the energy to do something about it. This is a crucial time to seek strategies to hold on until the medication has a stronger effect and you pass this danger point.

Accidental suicide usually comes from those who are calling for help. Calling for help is a method of externalising the internal pain, frequently through self harm (cutting, substance abuse, self harming sexual relationships, financial harm etc), or “suicide attempts” that are timed for people to find them. Either the self harm goes to far, or the people didn’t come, or didn’t come on time. These behaviours are an attempt to get people to see that help is needed and to invite them in to do so. It is better to ask directly than to use these methods, or to identify that this is what is happening and get help to manage.

As an aside, it is frequently the wrong thing to go cold turkey (total cessation) on self harm. The idea is to introduce harm minimisation strategies around this safety valve, change your life so you no longer need the safety valve, then delete the self harm.

Suicidal ideation is talking and or thinking about suicide without actually enacting any further steps to achieve suicide. We humans always consider options and given grim times some of those options are unpleasant. Contemplating suicide can be a powerful incentive to change, or to feel like we do have a choice – “I could always kill myself – aka I choose to be alive”. Flirting with the idea of suicide is a good time to get some counselling. When the flirtation with the idea becomes planning, this is a good time to call suicide help lines for help and go and see your doctor.

Every major country has suicide prevention numbers (Australia Life Line – 13 11 14), talk to your therapist, and talk to your general doctor. Once you have a strategy, involve key friends. Generally friends are not trained to help with suicide and it is better to get professional help.

Conclusion

Depression is a diagnosis that is given due to a significant negative impact to an individual’s lifestyle. It describes a life that is quite literally depressed from what would be commonly expected. Most depression is treatable with a combination of medication, therapy and lifestyle changes. Many people recover from depression while some people manage it. While suicide is an important consideration in conjunction with depression, it is not inevitable and has well researched methods to address it too.

Explaining Mental Illness to Children

I was asked recently wow do you go about explaining mental health to children, especially if it is your own?

It will vary from child to child. The very young need simpler concepts, while the older ones can deal with greater detail. However here is approximately how I explained mental illness and health to my child when she was about 4 years old. I have changed it a bit with hind sight.


 

You know how there are tall people and short people, dark haired people and light haired people, dark eyed people and light eyed people? You know how some people are fat and some are skinny, and with all of those people are many other people fitting in between? That is because people are all different from each other. We can easily see those outside differences.

Even so, most people have hair, most people have two eyes and most people have the same number of limbs. For all our differences, we all work roughly the same way.

Some people have differences inside them, some are based on bits that are different – do you remember that your mother had her gallbladder taken out? You still have yours, as do I. One of my friends was born with an extra half kidney, which is rare, while some people are born with less bits. These are still physical differences.

Your mother and her father are terrible at following street directions and will often get lost, while you have seen me glance at a map and know where I am going. This is a difference in how we think. We all have difference in how we think, much like how people are different in their height – how tall and short they are. These differences are not physical, but can sometimes have physical reasons. Do you remember that party we went to and how Bobbie was acting all strange? That was because he drank something called alcohol, and that can mess with how your body and mind work for a short time (unless you use too much for too long, then it can become permanent!) Some things can make permanent changes, because they make a permanent damage.

You know how Niki’s family are all tall? That is because they all have inherited being tall. You get your dark eyes from me, and your blond hair from your grand mother. Jenni colours her hair with a chemical called hair dye and that is because she likes to have red hair rather than her brown.

So long as all of the differences are not interfering with us living our lives, no one really cares too much. Sometimes a difference can interfere with how we live our lives. Like that man we saw yesterday with only one leg – he needed to either use a wheel chair to get around (can you imagine trying to use stairs with that? That’s why he uses the elevator) or he needed a prosthetic like a pirate’s wooden leg so he can walk (it’s still hard to skip though). He uses these tools to help him live a more ‘normal’ life.

When our bodies have problems like that, we call it a disability. When our minds have problems like that, we call it mental illness. It’s often managed by making changes in our lives, like the man in the wheel chair avoiding stairs and using the elevator, or using a tool like medication, much like the man with the wooden leg (they are usually made of metal and plastic these days) and the wheel chair.

Sometimes these methods aren’t enough and we just have to put up with it being really awkward. That is why sometimes I have troubles creating stories to tell you, I’m using all my effort to hold my mind together so I do the things I need to do and some of the things that can wait just have to wait until I can concentrate better. At those times, I’m very grateful that you can tell me stories instead. My mind, that is my thoughts, can be doing very strange and unhelpful things in those times. I can be very angry for no reason, or really tired when I shouldn’t be, I can be too happy, or I can start thinking very strange and weird thoughts. At those times I need to recognise that I’m thinking strangely and decide to act normal anyway, because you need it, my life needs it, and your mother needs it.

You know that thing you did at school where you wore a blind fold and had someone tell you where to step and which way to turn and you had to find the items around the school? That was a good introduction to some of the challenges of being blind. Imagine if the person telling you which way to go didn’t like you, or didn’t care about the task, or you had a bunch of them yelling at you all at once. Sometimes that is what it is like in my head. I can’t trust what I am feeling, or sometimes what I am thinking, so I have to consider everything that I do very carefully. That can be very tiring and slow me down, or make it impossible to make decisions. At those times, I put off the big decisions and rely on habit – this is what I did before.

For me there is no handy tool to manage this situation, there is just avoiding the problem and holding on until it goes away. Fortunately it always goes away. It doesn’t for all people. This is like the man with only one leg choosing to take the lift instead of the stairs, or deciding that going up that extra floor wasn’t really needed right now. It can mean going without a few things, but it’s better than having nothing.

Other people experience different things, like hearing voices of people that aren’t there, seeing things that no one else does, or finding it really hard to get out of bed for days – not just the morning! Just like there being lots of differences in what people look like, there are lots of ways we can think, and many ways that it can go wrong for lots of reasons. But only when those difference cause a problem do we need to do something about it. The problem is called mental illness, the solution (the thing we do about it) is called mental health. While it is important to understand what is going wrong, it is just as important to work out how to manage it so our lives work out all right. Many people forget that second part.

I think that some of what is going on in my head is because of what I grew up experiencing, and some of it also comes from my family (like the tall family). Our experiences shape us. You know how Katie does gymnastics, and how she can do all of those flips and bend her limbs in interesting ways? She couldn’t do that if she didn’t do gymnastics. Her life experience has lead to a good thing for her. Some of our life experiences lead to bad things. That is how that man lost his leg, he was in a fight called war. In that fight his leg got very badly damaged and he lost it to save his life. Sometimes the damage is not just outside our bodies. For me, some of the damage was in my mind.

Do you remember when you fell and hurt your ear? The doctors were able to fix it up and now you just have a scar. Some of what is going on in my mind is the hurt that is healing, some of it is the scar of what is left. Most of my mind works great though. I believe that if I keep practising, like Katie, I will get a more flexible mind and I can heal the hurt better.


And I did. It took 10 years of effort to heal. I still sometimes get problems, but it is so rare now that they are mere blips on my otherwise sunny life. Each time I blip, I just think “oh, this. I know what to do.”

 

Time enough

Tragedies happen. It is sad and often painful. Eventually though, we heal from that event and get on with our lives.

The phases of grief have already been covered, describing the common processes that people go through towards adjusting to the changes that have happened in the world with the changes that must occur within. At the end of grief is a time of remembering that the world is different and a time of moving on. This length of time varies from person to person.

For some it can be fairly quick, not because they don’t care, but because they have simply adjusted quickly to change. Perhaps they have more practice, perhaps they are more resilient, perhaps, perhaps, perhaps. Some take a long time to heal, measuring months, years or decades. Usually if months or more is where you find yourself, looking for some professional help is advisable.

At some point we are going to find ourselves experiencing the emotion known as “fun” and “joy”. We may reflect on this and feel guilt because we can’t believe that we are enjoying ourselves when we consider the tragedy we have experienced. We may berate ourselves for allowing ourselves to have fun as if this disrespects the memory of those we have lost. There is a danger here, if we continually associate fun with tragedy we lead ourselves to a path of potential clinical depression.

It is okay to laugh, okay to smile, okay to enjoy ourselves. This is not disrespecting those who have gone, it is acknowledging that we have healed. We don’t owe a fixed time of mourning, nor do we prove ourselves the more deeply affected because we mourn for longer or deny ourselves enjoyment.

Sometimes we are still grieving while those around us are done. We can look at them and feel anger that they didn’t mourn for long enough, as if they didn’t truly care. We can mistake their resilience as a sign of hollow grief, or their coping mechanisms as disrespect. While it is normal to feel this, it is mistaken.

Each of our grieving is its own path. We must accept that others follow a different path and that at some point it is okay for us to begin enjoying life again. We must trust ourselves as much as we trust others to be true to themselves without reading disrespect and disregarding into their actions.

Grief – Adapting to change

When things change, we grieve. The bigger the change, the more sudden the change, the harder the change, then the deeper is the grief.
Grief is an adjustment in the way we see the world. The harder that adjustment is, the more complex our grief end up being.
We humans go through many predictable stages. They can be in any order, and we don’t have to go through them all.
* Shock – This is the recognition of change. It often sets us back and we can demonstrate this phase by running around trying to get facts, or sitting in stunned silence. We can’t plan – we just have to get it through our heads this happened.

* Anger – We feel helpless that this has happened and we feel violated. Anger is the emotion that tells us this. We typically become aggressive to others, or to those we have lost, or we try to find someone or something to blame. We frequently aren’t very subtle. We find reasons to sustain our anger.

* Denial/disbelief – This is a little related to shock – where we first learn of the change, but this is a different as we have had this information for a bit and we know intellectually that it is so, yet we emotionally can’t accept it and so we try to find a way to prove it isn’t so, or just point blank refute the “in the cold of light” evidence.

* Bargaining – We try to find a way to change what has happened so it returns to the old model. This stage makes more sense when you can see change coming (someone is leaving, the task is over) yet we do it with sudden loss too (what if I did this, or if that happened, what if we tried this other thing). Change is inevitable and you can never go back. You can just make a new thing. Yet we want the old familiar, comfortable old, even if we loved or hated it.

* Pain / guilt – It hurts. Change does that. We miss those who have gone and we can express this in the form of weeping, crying, keening, sleeping, silence and so on. To justify this pain, we often try to find someone to blame – when we can’t blame others, we blame ourselves. We try to find a reason to justify our guilt, seeking minor things we might have done wrong, escalating them to things that we did do wrong and would have staved off this thing that created change. This is false. People make decisions and you aren’t responsible for them. If it isn’t a person’s choice, then it is another random factor (rock falling on someone’s head, car accident, animal attack etc) that no one could have affected. Only if you point the weapon and pull the trigger can you be held responsible, and that is a legal matter we aren’t getting into. In the vast majority of times, it wasn’t you.

* Depression – When the emotions are too much for us to bear, we shut down. This is kind of like the automatic cut off switch in electrical goods – it’s too much, so rather than being damaged, we shut down. We do less, we avoid stimuli, we find it hard to feel (whether it is emotional, sensory or taste etc), and we just seek to escape. This is okay. It just means the rest is too hard right now and you need to regather your strength. Avoid too much stimulation, either physical or emotional. Avoid getting stuck in here – you have to go out sometimes and do a bit even if you don’t feel like it, but aim for bite sized portions and give yourself leave to back off and take a break.

* Acceptance – Once the mind has reoriented to the change we have a new pattern of seeing the world and behaving installed. We have accepted the change and processed how we need to change as a result. We accept that this is as it is and we feel at peace. Hopefully this is the end of the journey, but often times it is a temporary reprieve as we realise that there is more to process. Don’t be disheartened, it is natural to bounce between feelings.

Each of these is a stage. One can experience multiple stages together and frequently we will revisit stages. Each is important in processing the external change that has occurred and how we will internally change as a result.

We don’t have to be alone in this. We can talk to others. If experiencing significant difficulties with any stage or the whole process, seek professional help. Why have them all trained up and not used? Seeking professional help is a sign of wisdom, not weakness.

It is a mistake to think that because you know these stages it will be easier. No, the emotions are just as deep, the pain just as sore, the feeling of being lost just as acute. It is a hard journey. Knowing these stages exist and are likely to be travelled helps us see that we are progressing, or recognise why we are doing what we are doing. It helps us to feel less like we have lost control and see that we are in fact making our way to the change we need to make to adapt to this new world we find ourselves in.