Amy Winehouse

So another celebrity (by social standards) dies, and everybody has an opinion. People who didn't even know this woman are saying things like "she was an addict and was asking for it", "she was sick and died of her disease", "celebrity got the best of her"....

Who are we to decide this?

There probably is truth to all of those, but the real question is this, WHERE WERE YOU?

A lot of the same people who criticize and even those who sympathize with Winehouse's plight are the same people who openly take enjoyment in the shenanigans of Charlie Sheen, Paris Hilton, and Lindsay Lohan.

It's all fun and games until some dies isn't it.

Where are you when someone close to you has those same issues?

When someone close to you succumbs to substance abuse or mental illness, do you have the absolute reason why it happened, or is it "different"?

Do you ask yourself "Where was I?", or do you victimize yourself by thinking "why did this happen to me?", and justifying yourself with "I just didn't know".

"IT" did not happen to you but to them, and you "should have known".

As a society we all know that Amy Winehouse dug her own grave, but as individuals we excuse ourselves as "not knowing".

Why do we "not know" when it hits close to home?

Humble recognition

Sometimes recognizing a person's depression can suffice to help them, even if temporarily.

Some of the reading I'm currently doing makes me feel better as it acknowledges depression as a disease we know very little about, in fact we know A LOT LESS THAN WE LIKE TO THINK WE DO.

That last part is the most important part; the recognition must be done with the modesty that we do not know.

The all too common patronizing "recognition" which goes something like "I haven't had it so I don't know" (IE. "We're not interested, just get back to functionality and we can all forget about it.") is hollow at best, disingenuous at worse.

To recognize that someone else is suffering something we do not know and that our concern is two-fold:
A) That the person is suffering.
B) That we are ignorant about that suffering, and that that ignorance is a faultof ours.

Pretending we know what depression entails and how to "treat" it in order to make the sufferer feel better can often have the opposite effect, because the simple "go see your doctor - take some meds - do some CBT - get more active - socialize more" is just that, overly simplistic. The simplicity of it can make the depressed person feel even more depressed.

Taking meds, doing therapy, getting active, and socializing doesn't take away that a person may genuinely feel depressed about things like the dysfunctional world we live in, about how their life (as active and social as it may be) does not make them content.

So yes, depression is a disease with biological components, but it is much more than that, and that much more is what we don't know.

Manufacturing Depression - By Gary Greenberg

Is a fascinating book which looks at the history of the disease we know as depression.

Greenberg details how the "scientific" community (in)directly with pharmaceutical companies purposely strayed away from Freudian-style analysis in diagnosing depression because of it's "unreliability". (IE. One man's self-criticism is another man's self-awareness.)

In order to give psychiatry it's proper place in "scientific" medicine (and pharmas to make profit), they came up with "Reliable criteria" which defines (and diagnoses) a person who is truly depressed.

One of my biggest beefs has long been the simplicity with which depression is diagnosed and treated. It is commonly held by medical professionals (who consider this "scientific") that the best treatment for Major Depressive Disorder is for the patient to regularly take their prescribed medication and goes through Cognitive Therapy.

My beef with this is the over-simplification. Taking anti-depressants and "changing my way of thinking" does not address philosophical questions like what consists contentment and "happiness".

A person may not feel "happy" despite having a "normal life". Many a lay person does not (or chooses not to) comprehend this (IE. "There are lots of people "worse off" than you, therefore you SHOULD be happy).

As for modern "scientific" psychiatry and psychology, the person is clinically depressed if they have 2 or more of these symptoms for 2 or more consecutive weeks:
- depressed mood (such as feelings of sadness or emptiness).
- reduced interest in activities that used to be enjoyed, sleep disturbances (either not being able to sleep well or sleeping to much).
- loss of energy or a significant reduction in energy level.
- difficulty concentrating, holding a conversation, paying attention, or making decisions that used to be made fairly easily.
- suicidal thoughts or intentions.

Listening to a list of symptoms and diagnosing is relatively easy, listening to what TRULY MAKES A PERSON UN-HAPPY is a little more difficult, so by calling it "un-reliable", the "scientists" wiggle their way out of the tough part.

In the book, Greenberg elaborates on the rise of psychiatric medicine in the past 100 or so years as well as an entire chapter on Cognitive Behavioural Therapy (CBT) which he doesn't dismiss, but makes it clear that the "scientifically proven" tag it attaches to itself is not quite accurate.

Acceptance

Acceptance is often presented as an easy catch-phrase answer when we don't know what to do.
"You lost your job?, just accept it and move on."
"Someone lied / stole / hurt you, just accept."

Of course dwelling on past events is not healthy, but neither is just "accepting" without dissecting said event and resolving it (as much as possible) in our hearts and minds.

For the depressive person, "accepting" negative outcomes often turns out to be unwarranted self-criticism.

Sometimes losing a job, getting lied to, getting robbed, or hurt is NOT the victim's fault, and "simple acceptance" that "nothing can be done about it" becomes "it must be my fault / I must have done something wrong..."

As much as the situation can not be modified, how we see it and judge those involved can make all the difference between truly moving on and simply "accepting".

Using the Internet (and social media) in a healthy manner

Below is a link to a recent interesting article on how social media may exasperate depressive symptoms in those who are already prone to depression.

The gist of the article is that social media's (mostly Facebook) "skewed view of reality" may make an already depressed person even more depressed.

Seeing others have more "friends", posting positive (whether true or not) status updates, posting pictures of having fun (as if it's a constant) (can) make a depressive's symptoms worse.

Have you experienced "Social Media Depression"?

Felt the need to have your life be better due to others' Facebook profiles / statuses / pics?

How would you suggest a person deal positively with depression while at the same time using Social Media in a healthy matter?

http://ca.news.yahoo.com/facebook-depression-among-harms-linked-social-media-sites-20110327-211050-004.html

Who knows best?

If you want advice on bringing up children, ask someone who's never had any they'll tell you everything you're doing wrong.

The same applies to depression, if you suffer just ask those who haven't had it, they have all the answers. The best one is still "I haven't had it so I don't know" (IE. "I don't believe you".)

Of course I'm being facetious. People always want to appear knowledgeable, but when we don't know (or believe) something it doesn't mean it doesn't exist or isn't true.

Having an opinion is absolutely acceptable, but with it comes responsibility (a word very popular with "know it alls"). True responsibility includes respect; respect for others opinions, feelings, and realities (which are different than ours).

This entails (on a deeper level) that responsibility requires humility which is (unfortunately) not a very common trait.

The person who has never experienced depression has the responsibility (although rarely the behaviour) to accept their ignorance without dismissing the reality of depression.

Am I whining? In the eyes of many, absolutely.
Do I care? No, because their ignorance is bound to show elsewhere.
Am I better than anyone? Definitely not because I don't know half of what I think I do.
Am I worse than others? Of course not, we all have our failures.

When I'm tired

Depression brings people down and when you’re down, you’re tired.

One of the most common (yet misunderstood) symptoms of depression is fatigue. In my depressive episodes I was often extremely tired and people around me did not seem to understand that.

Although most non-depressives say the right things about depression (IE. “We know it is real”, “you are suffering”), the acknowledgement, and proper understanding of symptoms is extremely rare.

When I was (it still does occur) tired, I knew it was not “normal” to be that tired, but also that this fatigue was not just a simple case of short night’s sleep, change in schedule, or any other common reason. Depression was (coming) back, and getting (extra) rest would make me stronger to face it (depression) the next day.

I have tried “toughing it out” and ended up unable to leave the house for three days.

Unfortunately our society’s over-preoccupation with getting things done “yesterday”, the person who takes a day off from work, school, or any other activities is seen as weak or low-functioning. Of course when said person does make the effort to get up and go to work / school, the effort is not recognized, but if they indeed over-exert themselves and end up with another serious sickness, they are practically made out to be guilty of “not taking care of themselves”.

I have read articles about how taking time off work can be beneficial for both a person’s mental and physical health. Unfortunately, most employers (that I have known) treat absenteeism like it was the plague. Openly criticising an employee’s absenteeism rate by comparing them to others, and holding it against them in performance reviews even when they (the employer) have been made aware of the employee’s condition.

Luckily (or not), this is not (usually) the case for employees with organic illnesses, but when it comes to depression and other mental illnesses, the prejudice is still very prevalent.

What have you done for me lately?

People are often “proud” of those who suffer from Depression when they (the sufferers) are doing something for these others or at least not being a nuisance.

The number of people (employers, family members, friends, and others) who say they “understand depression” and “do what they can for people who suffer from it”, yet where are they when the person is suffering?

It’s easy to “understand” and “help” someone when they are doing what we consider “normal”.

What about when the person is sick? Only helping people “when they help themselves” is weak. True “help” occurs when it is needed.

It is common knowledge (and if it’s not, educate yourselves) that depression sufferers know themselves better than anyone else. If that is true (or at least believed), how come people are so quick to criticize when a depressive passes up on an invitation, or takes a day off work?

Would we be as critical of the cancer patient or AIDS sufferer who had the same behaviour?

Medication

In Canada, antidepressant medication is the most prescribed medication, and for good reason....People are depressed.

The question I'd like to raise is whether antidepressant medications (SSRI's being the most common) truly help people live happier lives or if they help people be happy "enough".
My experience with SSRI's has been so-so, and not because of the medication itself (IE. It never made me exuberant, but I've also never had significant negative side effects).

The first time I was prescribed an antidepressant, I had no clue I was depressed, went to a walk in clinic and the doctor (seeing me for the first time and I was in the office maybe 10 minutes) prescribed "Fluoxetine". It sounded good that a medication good be prescribed, but when I got home (and yes, I should have done this at the doctor's office which I now diligently do) I looked up "Fluoxetine". It's Prozac.

The fact a doctor (who knew nothing about me or my previous history (medical or otherwise)) prescribed Prozac truly through me off. How dare he medicate me for depression when he knows nothing about me. Would he have sent me to chemo if I'd said I'd smoked for 10 years?

After a couple more prescriptions (Paxil and Effexor) which I took A) Reluctantly and B) With false hopes, I didn't get much better.

Back on Effexor I am much better, but I also had some talk therapy, group therapy, a better understanding of depression, and solid relationships in which I'm comfortable discussion my issues.

I believe I will be depressive my whole life, but not necessarily depressed.

Medication helps stabilize my mood and my functioning, but it's talking about it with therapists, family and friends, blogging, looking inwardly, and understanding myself that makes me happy.

Internal life

A person's internal life is essential, when we ask others how they are feeling do we truly (want to) listen to the expressed emotion, or do we have a (or series thereof) ready answer(s) such as "This too will pass"?

Unfortunately, a person's functionality takes precedent over their internal life.

Being functional (which infers outside influences) is necessary for social survival.

Being self aware is necessary for personal survival.

Combining both is living.

Where were you?

Have you ever felt the urge to tell people they were not "there" for you? Did you feel they were actively present when you really needed them?

Worse, did they become present when you were better and somehow take credit or make you feel inadequate?

In our society which calls itself open and accepting are people genuinely available when needed?

Do people just "not know" or do they choose to "not know"?

What makes you depressed?

Do you get bored, angry, and eventually depressed by repetition? I know I am.

I recall going to the doctor's (same doctor!!), and I would be asked the same questions I had the last 10 visits ("Do you want to harm yourself or others?", "Do you find enjoyment in things you used to?", "On a scale from 1-10 where would you put your happiness?")

If this is the criteria for "treating" depression, why aren't sufferers simply given a set of questions they can review every four weeks?

How can anyone claim medically "treating" someone if all they do is ask the same questions and interpret the answers?

Freud has been dismissed because he was not "scientific", how is today's psychiatric medicine "scientific"?

Is it all about the money?

A recent study trying to establish which countries are "happiest" found a correlation between wealth and happiness (IE. Countries which rated higher levels of "happiness" were generally countries with higher income earning populations.).

I looked up some statistics myself trying to see if income discrepency played a role in LESS happiness, and although very limited sampling, (first world) countries with higher income discrepancy DID rank lower than countries with more equal distribution of wealth.

Surprisingly (to me), Norway has the highest proportion of millionaires (per capita), yet ranks 3rd in "happiness".

The Gini coefficient is a measure of the inequality of a distribution which has been used to measure inequalities in different disciplines including economics.

Using the Gini coefficient, Norway ranks higher (IE. Less inequality) than countries such as Japan, USA, and Canada. Not surprisingly, these countries rank lower in happiness.

So as much as money is a major contributor to happiness, (a sense) of (more) equality may be even more influential.

Doing V. Being

To simply say one doesn't like their job is selfish. Even I (of all people!!!) would say "If you don't like it do something else".

Now if someone says "I feel I have more to offer (myself and the world)than my current occupation does", that's different.

Our culture of "immediacy" doesn't promote self-fulfillment or even social fulfillment. It is more important to "do" than to "be".

Go to any dinner party, what's the first question? "What do you do?" We judge others worth by their socio-economic status. It's even part of the English language (IE. I AM a lawyer, accountant, doctor...)

When we are what we do, no wonder thousands of us are depressed. We know we have much more to offer, but social conventions insist that simply "doing" something is all that matters regardless of how fun / boring, useful / useless, real or fake it may be.

Wanting to want more is portrayed as selfish.

Pedestrian clichés like "Be grateful of what you do have", and "Just work hard and the rest will follow" are just that, pedestrian.

We are socialized to believe that happiness occurs after (hard) work, on evenings and weekends. That happiness is somehow earned, as if happiness is a commodity.

If "working hard" means slaving away at a job which doesn't maximize my skill set (how's that for a buzzword?!), is what I'm expected to do to "earn" my happiness, I'm not interested.

I know I'm not alone.

What are we doing to our boys?

I've been reading where my (original) hometown of Montréal has the highest rate of high school drop out (almost 45%), and close to 80% of those are boys.

Firstly, I'd like to say that calling them "dropouts" is hypocritical. When an adult leaves a job of their own volition, they "resign". We no longer say they "quit" because that hurts our sensitive ears. But calling 16, 15, 14, and even younger children "drop outs" is fine.

Calling them "drop outs" puts the emphasis on them, and removes responsibility from teachers, school directors, school boards, and parents.

I specify boys in the title because of the disproportionate number they represent, and that discrepancy makes it easier to diminish the problem. By that I mean that if there were a more even number of girls "dropping out", more would be getting done to address the problem.

Now before you call me a knuckle-dragging Neanderthal, let me explain. If the discrepancy were more along the line or 55-45 or even 50-50, it would be affecting the same number of people, but more equally spread out in the population, hence more opportunity for people to get involved.

As well, since it is mostly boys, this can (more than likely does) lead to ghettoizing these "drop out" boys, while at the same time isolating the girls who "drop out" since they are the "exception".

When the "drop out" rate as high as it is in Montréal, it is time they looked at the education system. Not necessarily "what" they are teaching because after all math remains math, French is French, and so on. But how are we teaching it, and more importantly what are we teaching our children about themselves and life. Instead of shoving down their throats that "High education is the best way to have a better life", maybe we should explain that a better way to a potential good life is for them to think critically and logically about what they want, weigh the pros and the cons, explain how "life" or "society" works, and that a "successful" life includes balancing social expectations with personal needs and wants.


P.S. The French term for "drop out" is "décrocheur" which is just as derogatory.

Just don't be a nuisance

This morning at a neighbourhood coffee shop I overheard an interesting conversation between 2 scruffy looking men. One asked the other "are you still clean?", the second answered "yup, going on 7 months", the first congratulated him. They went on to talk about work, the first man saying he was working construction 7 days a week, when the second man said he was looking for work, the first said he would see with his employer if they need extra help and hopefully they would have work for his friend.

As ordinary and common as this conversation probably, it lead me to think about social expectations.

What first hit me is the hypocrisy of our society which would appreciate how these 2 men have straightened out their lives, yet where were we (society) when they needed help?

At a deeper level, I recognized that socially, we don't care that these 2 men might still be going through difficulties financially, work wise. That they don't really have choice about what they do for a living, they have to take the first thing which comes along. When they do, they will be expected to be grateful. As if "doing something", regardless of what it is, how (un)important, or boring it may be, is all that's important.

What matters to us a society is not that people have happy, fulfilling, and complete lives; we only don't want others to be a nuisance.

So in order to function in our society, one must simply "not be a nuisance". Not very mtivating is it?

Adapting is a sign of mental health

The society I am part of does / accepts things that I find atrocious such as (despite being one of the most prosperous societies in the world) letting it's own citizens live on the streets (often even blaming them!!)

My society is also hypocritical in that it condones (even encourages) unhealthy habits such as cigarette smoking, gamblind, and (to a lesser extent) consuming alcohol. While at the same time there's grandstanding about how marijuana and prostitution are horrible sins.

These socially accepted behaviours and hypocrisy bother me. It bothers me because if "adapting" to a society which chooses to remain flawed rather than making an effort to better itself is being mentally healthy it's time we re-consider what constitutes mental health.

How to think is not What you think

I touched on this on a previous thread, but How one thinks is different than What they think.

Cognitive Behavioral Therapy (CBT) is extremely beneficial in how it teaches a person to change their "way" of thinking, but it doesn't changes their thoughts themselves.

For example, when I began therapy I was extremely angry and told the counsellor "I'm angry because people don't do enough to genuinely help people with depression".

I learned through therapy that my way of thinking was flawed in that I let my anger prevent me from moving forward. That doesn't mean that WHAT I thought was wrong;people do not do enough.

What is important is that what we think is not wrong, it may only need to be re-framed.

How adapting and functioning are not enough

I recently completed reading a book which I purposely am not posting the title of since it can be interpreted as controversial and that in itself may influence people's opinion (positively or negatively). On practically every page I would go "that's exactly what I've always believed". I never sought a public platform per se, but even getting people to just listen (never mind understand or agree!!) has been excruciatingly difficult (IE. Impossible).

This reluctancy of others to listen has partially lead to a long-standing bout of chronic depression. I refer to this as my "existential depression".

Perhaps people don't want to hear me because it's not very "positive", maybe it's "too deep" for them, or maybe the truth of their own fallibility makes them uncomfortable.

Regardless, my pre-existing depressive condition has been magnified with this (perceived by me) lack of understanding / caring by others.

I control my condition through various ways such as medication, counselling, and educating myself about it, but there still seemed to be something missing.

Reading this book has helped me understand that I'm not "wrong" in my beliefs, just that they are not commonplace, and that most people are uncomfortable hearing such truths.

Reading is therapeutic. I have done hours of Cognitive Behavioral Therapy (CBT), which basically helps a person change their throught process. CBT has been extremely beneficial, but it strictly targets "How you think", not "What you think (and truly believe)".

It's very easy for me to think "I live in an industrialized country where corporations and money influence / decide how people (ought to) behave; therefore I simply need to adapt to that and I'll be "happy"".

My "problem", has been that I go further and say "but that is wrong, and if I "adapt" to (what I believe is) a wrong, that doesn't make me happy, it actually makes me feel worse".

The therapeutic part of reading (this particualr book) is that it confirms that I'm not "wrong" (nor alone) in my beliefs; that other people belief very similarly, in fact (some) get published and have public forums (IE. They fucntion).

Don't ask what others can do....

Most of us have heard part of the JFK inauguration speech in which he said "Don't ask what your country can do for you, ask what you cn do for your country".

I would modify it somewhat and say "Don't ask what others can do for THEMSELVES, ask what you can do for them".

I say that in reference to the lame excuse which states that people "need to help themselves". What if someone can not help themselves? What if they have not been taught proper life skills? Is it their fault, the fault of their underwhelming education, or is it the fault of the society which tolerates this without doing anything about it?

If the person suffering depression doesn't have the energy to "help themselves", is it appropriate to expect them to "find it" (the energy)?

Is it the right thing to "tolerate" someone who's not helping themselves (to our liking of course!!), or are WE keeping everyone at a lower level of functioning?