One of the first things that I was taught when I started studying science at a higher level (in junior high school) was a lay man's explanation of the null hypothesis. The teacher wanted us to construct a hypothesis and test it, but wanted to make sure that we didn't make one which was asserting that something didn't exist. The real explanation of the null hypothesis is more complex, but the simplistic version is that you can't prove something does not exist. You can support the idea that it does exist or has a relationship with something else, but you can't prove a negative.
If you think about this, it makes perfect sense. It is impossible to test and rule out every possible relationship between two things/concepts/etc. This is one of the reasons why science and religion don't play nice together. You can't prove God doesn't exist and scientists have little interest in proving that said entity does exist, particularly when the only means of doing so is to make indirect inferences between natural phenomena and a hazily defined deity.
To give a less emotionally loaded and concrete example, let's say that my hypothesis is that there are no unicorns on earth. Unless I can search every single place on earth simultaneously including any hidden spaces and show that there are no unicorns, then I can't prove that there are none. I can, however, say that there is no evidence of them. I can attempt to prove that they do exist by looking for forensic evidence (rainbow poop, bones, discarded horns, etc.), but I can't prove that they don't exist. While the conclusion to a hypothesis that they exist is essentially the same as they one that asserts that they don't exist, the bottom line is that basic scientific method suggest that you don't look to prove non-existence as it is impossible to do so credibly.
I'm offering a refresher on this topic because it relates to a conversation that I had over dinner with my father-in-law, a man who often picks at research and claims to be a person of science. We were talking about intoxication, and when I use that word, I don't mean simply consuming alcohol. I use it to mean the ingestion of any substance in order to alter ones emotional or cognitive state and am including intoxication by cannabis. Since my father-in-law has a history of intermittent use of marijuana (including a stint in which he grew his own), this is something that he has a vested interest in validating.
Before I get any further, I should assert that I have never been intoxicated through the use of any substance because I have never consumed anything which has a known consequence of changing my emotional or cognitive state. You might be able to count caffeine from soda, coffee, or tea, but my consumption of those items is incredibly modest. I drink one cup of coffee in the morning, cut in half with almond milk, and another similarly diluted cup in the afternoon most days. I drink two cups of tea most days, but sometimes none at all. I drink one to two cans of diet soda, but not only or always caffeinated ones. Sometimes, it'd ginger ale or root beer. Sometimes, I don't drink any at all. I have never gotten an energy boost or buzz from the beverages I drink, and I've never touched an energy drink.
I don't have any moral issues with modest consumption of substances because one likes the taste of something. My husband drinks one drink of some sort each day; he sometimes has a single small bottle or beer or a mixed drink with rum. He has never gotten drunk and extremely rarely consumes more than one drink. His personality does not change, though he never drives after even a small amount of alcohol consumption as we both know that even one beer can affect the ability to perform critical tasks.
While I don't have any moral issues with substance use, I do have some other problems with it. My father is an alcoholic, so I know what it is like to be around someone who is intoxicated.
The primary one is that I don't like how intoxication changes people's personalities. They become mean, stupid, lazy, childish, slow, etc. If someone wants to get high and sit in a room alone, I don't care, but I don't want to be around someone who isn't fully present with me when they are talking to me. I should add that I don't want them to be in that state in a way which cannot be altered on a moment's notice. Someone can be watching T.V. or using the internet and not be "present" with me, but that can change in a second if needed. They can change the focus of their attention or turn off the device. It doesn't work like that with substance-induced intoxication. You can't simply change on a dime.
The other issue that I have with a lot of substance use is that many people use it instead of developing real coping mechanisms. The answer to boredom, anxiety, depression, etc. becomes consumption of a substance. My sister-in-law's youngest son has been using cannabis for so long that he has developed a philosophy of, 'If I'm home, I might as well be high.' He doesn't have any other concrete mechanism to turn to to make him feel better in whatever way he needs to feel better because he's never had to trouble himself. His use of substances started at a relatively young age and now it's just what he uses all of the time. He's not even troubled. He's mainly using it to moderate boredom/enhance how he spends his free time. The problem is that he does it so much and that he is, from all external appearances, on a road to strong addiction that he won't be able to break free from when he finishes college and has to be more present in daily life. I'm not worried about this, mind you, as he is not my responsibility, but his mother is concerned.
Now that I've made my position clear, I will say that the reason my sister-in-law's son was using from such a young age was that their family history was one in which substance use was viewed as inevitable, innocuous, and "normal". My discussion with my father-in-law over dinner ended up being one in which my take threatened all of these notions so he gave a very irrational and unscientific explanation. My basic assertion for why I have never tried substances is that I don't know when I use one if I will be the type of person who is prone to addiction. With my family history, I view it as a not insignificant risk. With my depression, I view it as an even greater risk as any substance which may instantly ameliorate my suffering would be very hard to resist. My feeling is that there is that the risk of becoming addicted is not worth the sating of curiosity or the temporary and false emotional elation that sometimes accompanies such substance use.
My father-in-law's argument for this was that we might be addicted to anything once we try it, including sex. My answer to that is that we have a drive for some behaviors. That is, there are biochemical processes in our bodies that compel us to act on certain impulses. Drives include eating, sleeping, and sex. We are compelled through processes related to survival to do these things and suffer various types of distress if we don't act on them. Men get erections without bidding them to come. Your stomach hurts if it is empty. You can't resist nodding off if you deprive yourself of sleep for too long. These are manifestations of the processes fueling human drives.
When I talked about drives, my father-in-law said, "you don't know that we don't have a drive to get high." I said that, I do indeed know that we lack such a drive. There is absolutely no evidence that humans have a biochemical process that compels them to become intoxicated. He insisted that I couldn't know that, but I have studied psychology and human biochemistry for 30 years. I'm no expert, but I haven't once run across a study, theory, or experiment which suggests a "drive to get high." And, as my husband pointed out on our drive home, not only is there no evidence that we have a drive to become intoxicated, it would go against the grain of evolution and survival. If we ever had such a drive, those who acted on it would likely have been more susceptible to predators, less likely to tend to their needs, and more likely to waste time and energy seeking out intoxicants. There is a reason that tribal cultures use substances for ritual rather than recreation. They can't afford for everyone to be getting hepped up on goofballs all of the time.
My father-in-law, obviously losing ground, blurted out that there was no evidence that we don't possess such a drive. Um, well, yeah, because you can't prove non-existence. My husband said, "I thought you couldn't prove a negative." I mentioned additionally that this is the problem with religion and proving God is/is not real. My father-in-law then changed the subject.
This situation annoyed me because my father-in-law is incredibly pedantic about studies. He won't believe them unless he vets them, and speaks as if he is strict about science, but then he totally tosses science out the window when he needs to validate a lifestyle choice. I realized that this is what happens when you toss a question into the narrative that a person uses to construct his notions of what is "normal". No matter what their asserted orientation is vis a vis "science", it all goes out the window when it doesn't fit the preferred worldview.
Saturday, December 20, 2014
Tuesday, December 9, 2014
Stupid Facebook Arguments
I post a lot of silly thoughts on Facebook because I want to amuse people rather than simply talk about my day. I'm not afraid of being wrong nor am I afraid of making a fool of myself. One way you learn is by making mistakes.
Unfortunately, there will always be people who have sufficiently low self-esteem that they cop an attitude if they believe they "catch" you in making an erroneous assertion. I try not to do that, though I'm sure I have come across poorly in such cases as well. Such is the weakness of on-line communication, especially that designed to embrace brevity. In fact, I often wonder how many people bother to click the "see more" link when I write longer posts. My guess is very few.
Yesterday, I remembered something that happened while I was taking a graduate psychopharmacology class at my husband's school and making a presentation on depression. We (my husband and I did the presentation together) were talking about treatment and medication. One of the medicines that is commonly prescribed is an SSRI (selective serotonin reuptake inhibitor). This drug keeps the brain juices that you are deficient in that are possibly causing your depression dancing in the synaptic gaps longer.
A fellow, known for his lateness, self-centeredness, and general disruptiveness in order to bring attention to himself, raised his hand and said that SSRIs were shown to create suicidal ideation in users. I said, and the teacher supported this assertion, that the people who took the drug were depressed and it was impossible to know if the drugs caused it or if they would have had them anyway. As a depressed person, I can say I've had plenty of thoughts of suicide. Generally, they were escape fantasies and I would not have acted upon them. In moments of misery, you can turn to them like a comfy blanket. No matter how bad it gets, there is always this one way out.
This guy wasn't happy that I wasn't on board with his attitude that the drug made things worse instead of better for people with depression. I don't know if they create suicidal thoughts or simply sometimes fail to inhibit the depression which causes one to turn to them. I was simply unwilling to conclude that they cause them.
Yesterday, for some reason, I remembered this exchange from about two years ago and thought about how they'd test for this issue. It occurred to me that the only way to do that would be to do something dangerous and unethical. That would be to give SSRIs to people who were not depressed and see if it made them suicidal. My understanding of drug tests based on whatever journal articles I've read in psychological documents is that the most common way to test them is to get a bunch of people suffering from an illness, give some of them a new drug, some of them an old drug (sometimes), and some of them a placebo. I had never read that drugs (except possibly OTC drugs) were given to people who were healthy to see how it affected them and I've read a fair amount.
I posted my thoughts on Facebook and a Canadian woman who I met through blogging (and who lives in Japan) rather flatly and with what I perceived to be a tone of "you're so stupid, how could you not know this," said that SSRIs were tested on healthy people. I granted that I did not know the data, but that, to me, that seemed akin to giving insulin to people with diabetes. It shocked me that this might be the case. That is not only because I'd never heard of it before, but because there are possible long-term consequences to giving medication that messes with neurotransmitters to people who don't need them. For one thing, any neurotransmitter that plays around between your neurons for a longer time may create more receptors on the neuron. In essence, it makes your neuron "hungrier" for a bigger "meal" of that neurotransmitter now that it's had a chance for a bigger taste. You can take people who are fine and mess them up for good as, once those receptors are formed, they never go away and they may need more serotonin than their body previously produced. Since SSRIs are long-term drugs (they often need to be taken for weeks to get any effect), you wouldn't just take them for a short time in a test situation and stop or the test would be useless as a comparison of the reaction of a healthy population to an unhealthy population.
To me, it makes very little sense to test all drugs, and particularly ones which target very specific problems, on healthy people as they aren't the population that it will be interacting with. What could be discerned from it? It's possible that side effects could be seen, but those same effects would be seen in unhealthy populations as well. Besides messing up the bodies of a healthy person, I could see no reason to test on healthy subjects. It's one thing to test aspirin. It's another to test an SSRI or a drug that affects dopamine (like Parkinson's disease drugs). It seems insanely unethical and of extremely dubious value. It's also a violation of the Hippocratic oath.
This woman misread what I said about it being a shock to me as umbrage at the unethical nature of such tests and got snarky with me. I repeated that I did not know the data, but would appreciate a link in order to educate myself. I was sincere about this. If this is the practice and the studies I've read fail to mention it (not bloody likely), I'd like to know. She ignored the request at first and smugly said, "now you know," as if her saying it made it true to which I replied that I'd still appreciate a link. She finally gave me links, but not to any studies of SSRIs that said they tested on a healthy population. She linked to a general site and three studies which did not describe the testing conditions at all. Either she was too lazy to provide concrete support or she didn't have it. I was not impressed, but I simply said, "thank you" in reply to the links and let the matter drop.
I still don't discount the possibility that I somehow missed this testing practice. I also don't discount the possibility that the testing conditions are different in Canada or other countries than the U.S. and this woman was speaking as a Canadian with the knowledge she gained there. I also know that disadvantaged populations (prisoners, poor students, poor people) are used at times as guinea pigs and accept or take potentially harmful drugs in exchange for cash. I just never heard of it for SSRIs.
This exchange illustrates one of the things about stupid Facebook exchanges which annoys me and I'm sure others as well. Part of the problem is the tone and degradation in civility. This woman needed to be "right". I didn't need to be "right", but I wasn't going to take her word for it because this is how stupid things become "truths". It's why Snopes exists - people pass around stories long enough for others to believe they're facts. I genuinely wanted to learn something new, if indeed there was something to be learned. What was more frustrating was that she smugly acted as if she was "educating" me, but then when I asked for that education, she either got lazy and provided sloppy links or found out she was wrong and couldn't produce the goods and pretended what she offered was sufficient.
In the end, though I thanked her for the links and let it drop, my husband, who also was skeptical, commented on the lack of substance of the links. He also couldn't believe what she said made any sense. Of course, life doesn't always make sense and companies often don't behave ethically. However, in this case, unless I get pointed at some studies which explain their methodology clearly and say they tested a specific SSRI on a healthy population, I'll remain skeptical that what she said was true.
Unfortunately, there will always be people who have sufficiently low self-esteem that they cop an attitude if they believe they "catch" you in making an erroneous assertion. I try not to do that, though I'm sure I have come across poorly in such cases as well. Such is the weakness of on-line communication, especially that designed to embrace brevity. In fact, I often wonder how many people bother to click the "see more" link when I write longer posts. My guess is very few.
Yesterday, I remembered something that happened while I was taking a graduate psychopharmacology class at my husband's school and making a presentation on depression. We (my husband and I did the presentation together) were talking about treatment and medication. One of the medicines that is commonly prescribed is an SSRI (selective serotonin reuptake inhibitor). This drug keeps the brain juices that you are deficient in that are possibly causing your depression dancing in the synaptic gaps longer.
A fellow, known for his lateness, self-centeredness, and general disruptiveness in order to bring attention to himself, raised his hand and said that SSRIs were shown to create suicidal ideation in users. I said, and the teacher supported this assertion, that the people who took the drug were depressed and it was impossible to know if the drugs caused it or if they would have had them anyway. As a depressed person, I can say I've had plenty of thoughts of suicide. Generally, they were escape fantasies and I would not have acted upon them. In moments of misery, you can turn to them like a comfy blanket. No matter how bad it gets, there is always this one way out.
This guy wasn't happy that I wasn't on board with his attitude that the drug made things worse instead of better for people with depression. I don't know if they create suicidal thoughts or simply sometimes fail to inhibit the depression which causes one to turn to them. I was simply unwilling to conclude that they cause them.
Yesterday, for some reason, I remembered this exchange from about two years ago and thought about how they'd test for this issue. It occurred to me that the only way to do that would be to do something dangerous and unethical. That would be to give SSRIs to people who were not depressed and see if it made them suicidal. My understanding of drug tests based on whatever journal articles I've read in psychological documents is that the most common way to test them is to get a bunch of people suffering from an illness, give some of them a new drug, some of them an old drug (sometimes), and some of them a placebo. I had never read that drugs (except possibly OTC drugs) were given to people who were healthy to see how it affected them and I've read a fair amount.
I posted my thoughts on Facebook and a Canadian woman who I met through blogging (and who lives in Japan) rather flatly and with what I perceived to be a tone of "you're so stupid, how could you not know this," said that SSRIs were tested on healthy people. I granted that I did not know the data, but that, to me, that seemed akin to giving insulin to people with diabetes. It shocked me that this might be the case. That is not only because I'd never heard of it before, but because there are possible long-term consequences to giving medication that messes with neurotransmitters to people who don't need them. For one thing, any neurotransmitter that plays around between your neurons for a longer time may create more receptors on the neuron. In essence, it makes your neuron "hungrier" for a bigger "meal" of that neurotransmitter now that it's had a chance for a bigger taste. You can take people who are fine and mess them up for good as, once those receptors are formed, they never go away and they may need more serotonin than their body previously produced. Since SSRIs are long-term drugs (they often need to be taken for weeks to get any effect), you wouldn't just take them for a short time in a test situation and stop or the test would be useless as a comparison of the reaction of a healthy population to an unhealthy population.
To me, it makes very little sense to test all drugs, and particularly ones which target very specific problems, on healthy people as they aren't the population that it will be interacting with. What could be discerned from it? It's possible that side effects could be seen, but those same effects would be seen in unhealthy populations as well. Besides messing up the bodies of a healthy person, I could see no reason to test on healthy subjects. It's one thing to test aspirin. It's another to test an SSRI or a drug that affects dopamine (like Parkinson's disease drugs). It seems insanely unethical and of extremely dubious value. It's also a violation of the Hippocratic oath.
This woman misread what I said about it being a shock to me as umbrage at the unethical nature of such tests and got snarky with me. I repeated that I did not know the data, but would appreciate a link in order to educate myself. I was sincere about this. If this is the practice and the studies I've read fail to mention it (not bloody likely), I'd like to know. She ignored the request at first and smugly said, "now you know," as if her saying it made it true to which I replied that I'd still appreciate a link. She finally gave me links, but not to any studies of SSRIs that said they tested on a healthy population. She linked to a general site and three studies which did not describe the testing conditions at all. Either she was too lazy to provide concrete support or she didn't have it. I was not impressed, but I simply said, "thank you" in reply to the links and let the matter drop.
I still don't discount the possibility that I somehow missed this testing practice. I also don't discount the possibility that the testing conditions are different in Canada or other countries than the U.S. and this woman was speaking as a Canadian with the knowledge she gained there. I also know that disadvantaged populations (prisoners, poor students, poor people) are used at times as guinea pigs and accept or take potentially harmful drugs in exchange for cash. I just never heard of it for SSRIs.
This exchange illustrates one of the things about stupid Facebook exchanges which annoys me and I'm sure others as well. Part of the problem is the tone and degradation in civility. This woman needed to be "right". I didn't need to be "right", but I wasn't going to take her word for it because this is how stupid things become "truths". It's why Snopes exists - people pass around stories long enough for others to believe they're facts. I genuinely wanted to learn something new, if indeed there was something to be learned. What was more frustrating was that she smugly acted as if she was "educating" me, but then when I asked for that education, she either got lazy and provided sloppy links or found out she was wrong and couldn't produce the goods and pretended what she offered was sufficient.
In the end, though I thanked her for the links and let it drop, my husband, who also was skeptical, commented on the lack of substance of the links. He also couldn't believe what she said made any sense. Of course, life doesn't always make sense and companies often don't behave ethically. However, in this case, unless I get pointed at some studies which explain their methodology clearly and say they tested a specific SSRI on a healthy population, I'll remain skeptical that what she said was true.
Saturday, December 6, 2014
5-HTP
At some point within the last week, I had a situation which I have had many times since returning to the U.S. I was at a breaking point emotionally and I told my husband that I just didn't feel like I could continue as I have been any longer. This was the culmination of my diminished psychological resources as a result of all of the stress, changes, and difficulty I've experienced since leaving Japan, an overall sense of hopelessness coupled with no strong sense of what is to come in the future (not concrete goals, dreams, or expectations), my own particular nature based on the damage I've incurred throughout an extremely hard life emotionally (especially in the first 20 years), and the more immediate issue that I'd been having with noisy neighbors. I have felt for some time that I'm long overdue for a break from the constant upheaval in my life and the drain on my psychological resources, but no such reprieve seems to be coming. It does often seen that there is one thing after another and my resilience, which was never great to begin with, is constantly a well that is repeatedly drained dry.
After this most recent bout of tears and feeling overwhelmed, my husband, who is doing his internship now as a therapist, told me that, if I were a client instead of his wife, he'd recommend that I consider taking anti-depressants. Taking medication for emotional problems is something that I have resisted for my entire life. There are many reasons for this. One is that I worked with seriously mentally ill people and saw what happened to them when they took such medications. Another is that I'm not someone who ingests medications lightly. I know from my understanding of human biology that many of them are toxic and processed by the liver as poisons. They are not "good for you", though they can be good at alleviating symptoms or protecting the body from further damage when its systems are imbalanced due to degradation, damage, or unlucky genes.
Mood-related medications in particular "scare" me because they can often have a sledgehammer effect. You can end up unlike yourself. You can also end up with terrible side effects. There can be a slingshot effect over time as well as dependence which is hard to break in some cases. Benzodiazepines, which are often prescribed for anxiety, can become enormously difficult to free oneself of once they are taken.
I'm 50, and after about 30 years of resisting any medical intervention for depression, I told me husband that I'd consider it seriously if he could find a psychiatrist for me to see. That is a reflection of how at the end of my rope I am. I have managed for many years in large part through the application of my orderly mind - I use behavioral techniques and try to build up my capacity to cope over a long period of time. This is a very difficult thing to do, and I could only do it in the past because I had just enough inner resolve to do it. That resolve, which like California, seems to be in drought status is just not there anymore.
About five days ago, my husband and I were driving to Costco and it occurred to me that they sold St. John's Wort at one point. I mentioned that we could buy that supplement in the hopes that it might do me some good in the interim between this point of distress and seeing someone who could assess me and consider prescribing medication. When we got there, we scanned the supplements section and found that they no longer carried it. They did, however, carry SAM-e and 5-HTP. Like St. John's Wort, these are both non-prescription supplements believed (but not proven) to help people who are suffering from depression.
I had received a free sample bottle of SAM-e last year and it didn't really do anything for me so I had no interest in trying it. The more intriguing option was 5-HTP for a couple of reasons. First of all, I knew that it was a chemical precursor of serotonin, the neurotransmitter that is often manipulated by stronger anti-depressant drugs in order to help people with depression or anxiety. Second, it was pretty economical. For $20, I could have a 75-day supply. Third, I hadn't tried it before so there was at least hope that it might have a positive effect.
The first day after I took 5-HTP, I had a short time of what can be described as "mellowness". It's probably what most people feel like when they are genuinely relaxed and a feeling I only tend to experience in the day or two preceding a cold when my whole body seems to just lay down its arms and say, "Yay, we'll have no choice but to rest now!" That's actually a good feeling and a reason I'm sometimes happy to catch a cold - that feeling was so rare.
During the five days that I have taken 5-HTP, I have experience between a half hour and an hour of that feeling within a few hours of taking it. It seems to be having at least that impact on me. It also sometimes makes me a little tired, but the truth is that I've been suffering from crushing fatigue at times and this is nothing compared to that. In fact, it's a nice mellow tired which doesn't make me want to lie down or sleep. It makes me feel lazy, which is something else that I never generally feel. My husband has remarked that he wishes I could just "relax". This sort of tired puts me in a place in which I feel fine doing that. In fact, I feel good about just doing nothing during this relatively short time (again, usually a half hour to an hour).
The second day that I took 5-HTP, I experienced my first (and so far only) side effect. When I was looking at my computer screen, everything took on a "high definition" look. The whites were super bright and strangely soft. The text looked crisper and the contrast between the words and white screen was sharper. I figured that it may be some change in my cheap display so I looked at my husband's laptop and it looked the same. The Christmas lights, when turned on, also had a brighter, softer look to them.
Some online searches revealed that this sometimes happens, along with a plethora of other side effects which are more uncomfortable and mitigate the value for some people like feeling sleepy/overly tired, upset stomach, and fogginess. Since some prescription drugs have similar effects, it's no shock that 5-HTP could have them as well.
When I read negative experiences, I have no doubt that they are all real. However, for me, so far, things have been going well. This morning, I woke up and told my husband that I felt better than I have in a very long time. It may be coincidence. It might even be the placebo effect (though I doubt it since the mood changes are concrete and distinct and I'm hyper-aware of my body and moods from years of tracking them in an attempt to manage both). I could also just be in some sort of cyclical upswing in my moods for the time being and that coincided with my starting to take 5-HTP.
I don't want to be misleading. I don't think 5-HTP was a miracle cure for me. I think that it was enough to take my depleted reserve and add a few cups to it such that all of the other things that I'm doing on top of taking this supplement are having more effect. In essence, I've been doing the therapy, and now I've also got some sort of "medication" to help it work more effectively.
I'm not sure if this will last. I hope it does. The body has a way of acclimating to medication or supplements. It will only continue to work (if indeed it works at all - which I think it does, but I can't "prove" it) if my brain had some inability to produce or properly metabolize serotonin and the added boost to 5-HTP righted a "wrong". It will only continue to work if my brain doesn't figure out that it's getting more of something it used to do by itself and decide to get lazy and stop doing what it used to do (which brains are inclined to do). At any rate, for now, given the terrible state I was in not too long ago, I'll take this and be grateful rather than worry about the future.
After this most recent bout of tears and feeling overwhelmed, my husband, who is doing his internship now as a therapist, told me that, if I were a client instead of his wife, he'd recommend that I consider taking anti-depressants. Taking medication for emotional problems is something that I have resisted for my entire life. There are many reasons for this. One is that I worked with seriously mentally ill people and saw what happened to them when they took such medications. Another is that I'm not someone who ingests medications lightly. I know from my understanding of human biology that many of them are toxic and processed by the liver as poisons. They are not "good for you", though they can be good at alleviating symptoms or protecting the body from further damage when its systems are imbalanced due to degradation, damage, or unlucky genes.
Mood-related medications in particular "scare" me because they can often have a sledgehammer effect. You can end up unlike yourself. You can also end up with terrible side effects. There can be a slingshot effect over time as well as dependence which is hard to break in some cases. Benzodiazepines, which are often prescribed for anxiety, can become enormously difficult to free oneself of once they are taken.
I'm 50, and after about 30 years of resisting any medical intervention for depression, I told me husband that I'd consider it seriously if he could find a psychiatrist for me to see. That is a reflection of how at the end of my rope I am. I have managed for many years in large part through the application of my orderly mind - I use behavioral techniques and try to build up my capacity to cope over a long period of time. This is a very difficult thing to do, and I could only do it in the past because I had just enough inner resolve to do it. That resolve, which like California, seems to be in drought status is just not there anymore.
About five days ago, my husband and I were driving to Costco and it occurred to me that they sold St. John's Wort at one point. I mentioned that we could buy that supplement in the hopes that it might do me some good in the interim between this point of distress and seeing someone who could assess me and consider prescribing medication. When we got there, we scanned the supplements section and found that they no longer carried it. They did, however, carry SAM-e and 5-HTP. Like St. John's Wort, these are both non-prescription supplements believed (but not proven) to help people who are suffering from depression.
I had received a free sample bottle of SAM-e last year and it didn't really do anything for me so I had no interest in trying it. The more intriguing option was 5-HTP for a couple of reasons. First of all, I knew that it was a chemical precursor of serotonin, the neurotransmitter that is often manipulated by stronger anti-depressant drugs in order to help people with depression or anxiety. Second, it was pretty economical. For $20, I could have a 75-day supply. Third, I hadn't tried it before so there was at least hope that it might have a positive effect.
The first day after I took 5-HTP, I had a short time of what can be described as "mellowness". It's probably what most people feel like when they are genuinely relaxed and a feeling I only tend to experience in the day or two preceding a cold when my whole body seems to just lay down its arms and say, "Yay, we'll have no choice but to rest now!" That's actually a good feeling and a reason I'm sometimes happy to catch a cold - that feeling was so rare.
During the five days that I have taken 5-HTP, I have experience between a half hour and an hour of that feeling within a few hours of taking it. It seems to be having at least that impact on me. It also sometimes makes me a little tired, but the truth is that I've been suffering from crushing fatigue at times and this is nothing compared to that. In fact, it's a nice mellow tired which doesn't make me want to lie down or sleep. It makes me feel lazy, which is something else that I never generally feel. My husband has remarked that he wishes I could just "relax". This sort of tired puts me in a place in which I feel fine doing that. In fact, I feel good about just doing nothing during this relatively short time (again, usually a half hour to an hour).
The second day that I took 5-HTP, I experienced my first (and so far only) side effect. When I was looking at my computer screen, everything took on a "high definition" look. The whites were super bright and strangely soft. The text looked crisper and the contrast between the words and white screen was sharper. I figured that it may be some change in my cheap display so I looked at my husband's laptop and it looked the same. The Christmas lights, when turned on, also had a brighter, softer look to them.
Some online searches revealed that this sometimes happens, along with a plethora of other side effects which are more uncomfortable and mitigate the value for some people like feeling sleepy/overly tired, upset stomach, and fogginess. Since some prescription drugs have similar effects, it's no shock that 5-HTP could have them as well.
When I read negative experiences, I have no doubt that they are all real. However, for me, so far, things have been going well. This morning, I woke up and told my husband that I felt better than I have in a very long time. It may be coincidence. It might even be the placebo effect (though I doubt it since the mood changes are concrete and distinct and I'm hyper-aware of my body and moods from years of tracking them in an attempt to manage both). I could also just be in some sort of cyclical upswing in my moods for the time being and that coincided with my starting to take 5-HTP.
I don't want to be misleading. I don't think 5-HTP was a miracle cure for me. I think that it was enough to take my depleted reserve and add a few cups to it such that all of the other things that I'm doing on top of taking this supplement are having more effect. In essence, I've been doing the therapy, and now I've also got some sort of "medication" to help it work more effectively.
I'm not sure if this will last. I hope it does. The body has a way of acclimating to medication or supplements. It will only continue to work (if indeed it works at all - which I think it does, but I can't "prove" it) if my brain had some inability to produce or properly metabolize serotonin and the added boost to 5-HTP righted a "wrong". It will only continue to work if my brain doesn't figure out that it's getting more of something it used to do by itself and decide to get lazy and stop doing what it used to do (which brains are inclined to do). At any rate, for now, given the terrible state I was in not too long ago, I'll take this and be grateful rather than worry about the future.
Thanksgiving 2014
While I was living in Japan, my husband and I didn't always celebrate Thanksgiving. If we happened to have the day off, we would arrange to buy a turkey from an importer (turkeys are not commonly consumed in Japan and can't be purchased in regular stores). Most of the time, we just didn't bother as we preferred to save the expensive turkey for Christmas. Though we had to work most of the time on Christmas day as well (as it is not a national holiday in Japan), we would often arrange to celebrate the nearest day off before or after the holiday.
It wasn't until we came back to America that we really returned to Thanksgiving as a traditional holiday. I can't remember what we did the first year after returning, but I think we bought our own turkey and I cooked it. It was a small celebration and, obviously, not memorable.
The second Thanksgiving was spent at my sister-in-law's home. She and her husband host a big dinner every year and invite some of their friends and family. They didn't ask us to come the first year because we didn't really mesh with them at that point. I think they didn't really feel comfortable with us until later and they had their routine in place from the more than two decades in which we were in another country and had nothing to do with them.
This year is our third Thanksgiving in America and things between my sister-in-law and I have grown much closer in the past year. She has come to visit several times and usually stays for many hours (rarely fewer than four, often as long as six) and we talk about things which are quite deep and personal. So, this year was the first time that we felt like we really belonged with their family to a fair extent.
I know that people often tell Thanksgiving stories as if they were always full of family fights and animosity. I have to say that this past holiday seemed to pass without drama. In fact, I thought it was a lot of fun. The group included my sister-in-law, her husband, her two college-age sons, a long-time friend of the family and his girlfriend, my father-in-law, my husband, and me.
My sister-in-law's husband came from a family which built a fair bit of affluence and, when his father died, they inherited some beautiful silver and porcelain pieces which they use on special occasions. They set a lovely table and the husband is a great cook. He makes a gorgeous turkey, superior stuffing, and gravy that his kid's can't praise enough. The meal was excellent and full of varied traditional delights. One of the reasons that I prefer to go to their place rather than make my own Thanksgiving meal (something that I did for many years even in Japan) is that it isn't worthwhile to make a lot of dishes for two people, especially when my husband doesn't care for stuffing or sweet potatoes. I'd be making certain dishes for just one person (white mashed potatoes for him, sweet for me, stuffing for me, but not him, etc.).
After the meal, I noticed that my sister-in-law's husband eventually went into their living room and sat in front of his PC. That was no big deal to me as he's retired to that space in the past when I've carried out short visits. He's social enough, but he's also a bit of a geek. I assumed that he was exhausted after all of the effort that went into the occasion. An e-mail message from my sister-in-law informed me otherwise the following day.
It seems that her husband was incredibly stressed out because he was in the unfortunate position of being seated next to my father-in-law. My father-in-law could get a series of posts about his character if I ever chose to go into it all, but I'll try to just offer a brief description here. He is 77, selfish, self-involved, and hard of hearing, especially in one ear. He loves to be the center of attention, but his social skills mainly consist of talking about banal matters of interest only to him. He is actually a very intelligent person and capable of speaking about matters of depth, but he lives such a small life with little intellectual curiosity that he tends to not bring up any weighty topics of his own accord.
Sitting next to my father-in-law is a sufficiently tedious experience that my husband made sure last year to put himself between the two of us. He essentially took the bullet so I wouldn't have to. There was a reason for this beyond the self-centered smalltalk. My father-in-law had had a childish fit over some small thing last year and yelled at my husband the moment we walked into his home after going through some exhausting moving of our furniture and whatnot into our new apartment. We had been coming off of several weeks of incredible stress and pressure trying to find a place at all and my husband was super sick with bronchitis all the while starting his internship as a therapist. The pettiness of the reason for the attack had me not answering the phone when my father-in-law called for over a year. I just didn't want to deal with him alone.
At any rate, my sister-in-law's husband was seated on the "bad ear" side of my father-in-law while her husband's friend and his girlfriend were on the other side of said father-in-law. The father-in-law kept talking over the husband when he tried to converse with his guests and seemingly ignored him when he spoke directly to him. I witnessed my sister-in-law's husband try four times to talk to him and be blithely ignored or go unheard. I suggested he tap his shoulder and that seemed to work.
Even all of this may have been overlooked except that my sister-in-law and her husband live in attached housing with my father-in-law. Starting about six or seven years ago, my mother-in-law started to steeply decline because she suffered from a form of dementia which is similar to Parkinson's disease. During that time, my father-in-law increasingly relied on his daughter for help without expressing much gratitude and he has always taken his family for granted while providing very little in the way of support for them when they are in need. My sister-in-law once said, "He has always been selfish and stingy," and that sums it up pretty well. There's much more to tell on this front, but I will move along and cover that at a later time.
With the long history of being unhelpful and selfish as well as the father-in-law's increasing obtrusiveness, my sister-in-law's husband has grown less patient with everything. My sister-in-law said that there was an incident after Thanksgiving in which her dad came over to their house to borrow butter and he stood in front of the open refrigerator and asked where it was. The husband said, "We keep it close to the sun," and "It's in the oven." This response was offered because my father-in-law is so lazy that he doesn't take any time to think or look. He just asks his daughter to think and look for him. It's not that he is so absent-minded (though he has gotten more forgetful, of course). He's just accustomed to someone doing everything for him (as his wife did for many years until she grew too ill to meticulously care for him and dote on his every wish and need).
I should note that there was a little incident of this type of thing while I was there on Thanksgiving. My sister-in-law needed foil to wrap up leftovers for us and she asked her dad to get it from the pantry. He walked into the pantry. Looked in one spot and one spot only (directly in front of him on the shelves) and said he couldn't find it. I went in and actually looked around and found it on top of the dryer that was under the shelving. It was right on top. You just had to scan the space quickly to see it, but he just looks where he thinks it might be and gives up. She puts up with this nearly every day, sometimes up to six times per day.
At any rate, I thought this was a great and drama-free holiday, but it turned out that it was incredibly bile-raising for my sister-in-law's husband. To his credit, he didn't act out on his anger and frustration. He just walked away and tried to calm down. Under the circumstances, I thought that was really the best possible choice and I imagine that, if that's the most drama a person is going to witness at a family gathering, then I got off super easy. My sister-in-law's husband, unfortunately, did not.
It wasn't until we came back to America that we really returned to Thanksgiving as a traditional holiday. I can't remember what we did the first year after returning, but I think we bought our own turkey and I cooked it. It was a small celebration and, obviously, not memorable.
The second Thanksgiving was spent at my sister-in-law's home. She and her husband host a big dinner every year and invite some of their friends and family. They didn't ask us to come the first year because we didn't really mesh with them at that point. I think they didn't really feel comfortable with us until later and they had their routine in place from the more than two decades in which we were in another country and had nothing to do with them.
This year is our third Thanksgiving in America and things between my sister-in-law and I have grown much closer in the past year. She has come to visit several times and usually stays for many hours (rarely fewer than four, often as long as six) and we talk about things which are quite deep and personal. So, this year was the first time that we felt like we really belonged with their family to a fair extent.
I know that people often tell Thanksgiving stories as if they were always full of family fights and animosity. I have to say that this past holiday seemed to pass without drama. In fact, I thought it was a lot of fun. The group included my sister-in-law, her husband, her two college-age sons, a long-time friend of the family and his girlfriend, my father-in-law, my husband, and me.
My sister-in-law's husband came from a family which built a fair bit of affluence and, when his father died, they inherited some beautiful silver and porcelain pieces which they use on special occasions. They set a lovely table and the husband is a great cook. He makes a gorgeous turkey, superior stuffing, and gravy that his kid's can't praise enough. The meal was excellent and full of varied traditional delights. One of the reasons that I prefer to go to their place rather than make my own Thanksgiving meal (something that I did for many years even in Japan) is that it isn't worthwhile to make a lot of dishes for two people, especially when my husband doesn't care for stuffing or sweet potatoes. I'd be making certain dishes for just one person (white mashed potatoes for him, sweet for me, stuffing for me, but not him, etc.).
After the meal, I noticed that my sister-in-law's husband eventually went into their living room and sat in front of his PC. That was no big deal to me as he's retired to that space in the past when I've carried out short visits. He's social enough, but he's also a bit of a geek. I assumed that he was exhausted after all of the effort that went into the occasion. An e-mail message from my sister-in-law informed me otherwise the following day.
It seems that her husband was incredibly stressed out because he was in the unfortunate position of being seated next to my father-in-law. My father-in-law could get a series of posts about his character if I ever chose to go into it all, but I'll try to just offer a brief description here. He is 77, selfish, self-involved, and hard of hearing, especially in one ear. He loves to be the center of attention, but his social skills mainly consist of talking about banal matters of interest only to him. He is actually a very intelligent person and capable of speaking about matters of depth, but he lives such a small life with little intellectual curiosity that he tends to not bring up any weighty topics of his own accord.
Sitting next to my father-in-law is a sufficiently tedious experience that my husband made sure last year to put himself between the two of us. He essentially took the bullet so I wouldn't have to. There was a reason for this beyond the self-centered smalltalk. My father-in-law had had a childish fit over some small thing last year and yelled at my husband the moment we walked into his home after going through some exhausting moving of our furniture and whatnot into our new apartment. We had been coming off of several weeks of incredible stress and pressure trying to find a place at all and my husband was super sick with bronchitis all the while starting his internship as a therapist. The pettiness of the reason for the attack had me not answering the phone when my father-in-law called for over a year. I just didn't want to deal with him alone.
At any rate, my sister-in-law's husband was seated on the "bad ear" side of my father-in-law while her husband's friend and his girlfriend were on the other side of said father-in-law. The father-in-law kept talking over the husband when he tried to converse with his guests and seemingly ignored him when he spoke directly to him. I witnessed my sister-in-law's husband try four times to talk to him and be blithely ignored or go unheard. I suggested he tap his shoulder and that seemed to work.
Even all of this may have been overlooked except that my sister-in-law and her husband live in attached housing with my father-in-law. Starting about six or seven years ago, my mother-in-law started to steeply decline because she suffered from a form of dementia which is similar to Parkinson's disease. During that time, my father-in-law increasingly relied on his daughter for help without expressing much gratitude and he has always taken his family for granted while providing very little in the way of support for them when they are in need. My sister-in-law once said, "He has always been selfish and stingy," and that sums it up pretty well. There's much more to tell on this front, but I will move along and cover that at a later time.
With the long history of being unhelpful and selfish as well as the father-in-law's increasing obtrusiveness, my sister-in-law's husband has grown less patient with everything. My sister-in-law said that there was an incident after Thanksgiving in which her dad came over to their house to borrow butter and he stood in front of the open refrigerator and asked where it was. The husband said, "We keep it close to the sun," and "It's in the oven." This response was offered because my father-in-law is so lazy that he doesn't take any time to think or look. He just asks his daughter to think and look for him. It's not that he is so absent-minded (though he has gotten more forgetful, of course). He's just accustomed to someone doing everything for him (as his wife did for many years until she grew too ill to meticulously care for him and dote on his every wish and need).
I should note that there was a little incident of this type of thing while I was there on Thanksgiving. My sister-in-law needed foil to wrap up leftovers for us and she asked her dad to get it from the pantry. He walked into the pantry. Looked in one spot and one spot only (directly in front of him on the shelves) and said he couldn't find it. I went in and actually looked around and found it on top of the dryer that was under the shelving. It was right on top. You just had to scan the space quickly to see it, but he just looks where he thinks it might be and gives up. She puts up with this nearly every day, sometimes up to six times per day.
At any rate, I thought this was a great and drama-free holiday, but it turned out that it was incredibly bile-raising for my sister-in-law's husband. To his credit, he didn't act out on his anger and frustration. He just walked away and tried to calm down. Under the circumstances, I thought that was really the best possible choice and I imagine that, if that's the most drama a person is going to witness at a family gathering, then I got off super easy. My sister-in-law's husband, unfortunately, did not.
Hypervigilance
In a previous post, I mentioned that I didn't like the word "hypervigilant" because it sounds like a person is on alert every moment. It evokes the image of a soldier scanning the horizon with intense scrutiny for enemies, ready to react at the smallest sign of invasion. Because of my sense of the word, I have generally rejected it as a description of myself. It turns out that I was wrong. I am hypervigilant.
For those who don't know this word, it often applies to people who are much more sensitive than average, read meaning into small things, and tend to spin out theories and ideas about things to an extent that others may not. A lot of people would tag them as "over sensitive", thin-skinned, and too easily "worked up" about little things. They would also be people who may get hung up on some small comment or action and take it very personally.
I've spent many years changing myself so that I am less of all of the qualities mentioned in the previous paragraph. In fact, I've spent quite some time trying to build emotional Teflon. One of the ways that I've done this is to accept myself for who I am and to gain as close to total self-awareness as possible. I know I take things seriously and that bugs people. I know that I can come across as harsh and intellectual and that can be off-putting. I know that the way in which I embrace complexity and can often "win" arguments or debates by making more points (due to my education and reasoning) annoys people. I know I'm fat, have a big nose, and my skin is drooping and wrinkly. I'm okay with all of these things because I know me and accept me now. Note that "accepting" myself is not the same as being 100% happy. I continue to try to improve, but I no longer experience self-loathing about points that I wish were different and I no longer take offense if people "attack" me or note these points. It took a lot of work, but here I am. You can't attack me with these facts if I don't find them unacceptable truths about myself.
With all of that being said, I'm still hyper-vigilant. I don't dissect every word someone utters to see if I'm being insulted or ruminate on whether people are trying to tell me something in a round-about way. Part of the reason for this is that I know what people are doing without having to wring my hands and perform an internal debate. It's not something that involves much process anymore. When an acquaintance of mine who was an acupuncturist who I accidentally pissed off told me that he thought all of my stress registered in my stomach, I knew he was doing that to try and hurt me by letting me know he noticed that I was fat. I didn't have to analyze it. I knew. However, it didn't matter because it's now a Teflon area of my psyche. Insult understood. Insult ineffective. Move along.
I've done some research on hypervigilance as a result of my misophonia (which is getting better thanks to various behavioral techniques - it's not over, but it's improving pretty quickly). I learned that people who have it often develop it because they grew up in "unsafe environments". I grew up verbally abused at home, in public, and in school. I was bullied, often quite badly, everyday for most of my life between the ages of 10-20. If it wasn't my mother shrieking and telling me I was a horrible person for not safe-guarding her emotions at every moment, it was kids taunting me at school or on the bus. If it wasn't kids laughing at my bulky clumsiness, it was a gym teacher who smirked as I struggled to cross a balance beam (surely, a sadistic device) without falling off. Once I crossed the threshold to puberty, it was men and boys screaming insults from their cars at me.
I grew up feeling completely unprotected by everyone around me. The bus driver didn't stop kids from taunting me during the 90 minutes of time I spent on his conveyance each day. My mother didn't stop making me feel as if it was my fault that everything that upset her happened and that made me a terrible person. My teachers didn't stop kids from making fun of me. There was not one person who protected me when I was growing up. Is it any wonder that I wanted to kill myself when I was 15 and put a gun to my head? Obviously, I was too scared to pull the trigger.
Living in that environment is what cultivated my ability to "read" people rapidly and fairly accurately. If you are constantly under siege, you learn to find a way to survive. To reduce the chances that I'd be harmed, I had to detect the signs of attack. The better I could read a crinkle in the corner of an eye or the change in the set of a jaw, the faster I could get out of harm's way. Friends who weren't really friends or kindness that was a mask for an act of cruelty could be determined with tone of voice or the set of the brow. My mother's moods and whether she was interested in lashing out at me could be picked up by tone of voice or volume. I didn't have to wait for her to reach the point of frustration. I could see it coming from the start and escape in some cases before she built up a head of steam.
These days, I'm not walking around in a state of fear, but I realized that I still have all of my hypervigilant abilities. I read people and situations fast because I can't not see what I see. I had so much practice that it is a transparent and automatic behavior now. And, as I said before, I don't necessarily enjoy it.
However, I realize now that the reason that I wouldn't want to live without these skills is because I'm afraid not to have them. They continue to be a form of protection against a world that I will never trust because the only one who protects me is me. There is only one person that I am safe with and that is my husband. That is the legacy of the bullying and bad upbringing that I endured. No amount of understanding or awareness will strip me of these feelings. I can't simply "get over it" now that I'm free of the environment because this is how my brain has been wired through years of experience. While I may have escaped the neuroses, I'll never lose the hypervigilance and the skills that came with it.
For those who don't know this word, it often applies to people who are much more sensitive than average, read meaning into small things, and tend to spin out theories and ideas about things to an extent that others may not. A lot of people would tag them as "over sensitive", thin-skinned, and too easily "worked up" about little things. They would also be people who may get hung up on some small comment or action and take it very personally.
I've spent many years changing myself so that I am less of all of the qualities mentioned in the previous paragraph. In fact, I've spent quite some time trying to build emotional Teflon. One of the ways that I've done this is to accept myself for who I am and to gain as close to total self-awareness as possible. I know I take things seriously and that bugs people. I know that I can come across as harsh and intellectual and that can be off-putting. I know that the way in which I embrace complexity and can often "win" arguments or debates by making more points (due to my education and reasoning) annoys people. I know I'm fat, have a big nose, and my skin is drooping and wrinkly. I'm okay with all of these things because I know me and accept me now. Note that "accepting" myself is not the same as being 100% happy. I continue to try to improve, but I no longer experience self-loathing about points that I wish were different and I no longer take offense if people "attack" me or note these points. It took a lot of work, but here I am. You can't attack me with these facts if I don't find them unacceptable truths about myself.
With all of that being said, I'm still hyper-vigilant. I don't dissect every word someone utters to see if I'm being insulted or ruminate on whether people are trying to tell me something in a round-about way. Part of the reason for this is that I know what people are doing without having to wring my hands and perform an internal debate. It's not something that involves much process anymore. When an acquaintance of mine who was an acupuncturist who I accidentally pissed off told me that he thought all of my stress registered in my stomach, I knew he was doing that to try and hurt me by letting me know he noticed that I was fat. I didn't have to analyze it. I knew. However, it didn't matter because it's now a Teflon area of my psyche. Insult understood. Insult ineffective. Move along.
I've done some research on hypervigilance as a result of my misophonia (which is getting better thanks to various behavioral techniques - it's not over, but it's improving pretty quickly). I learned that people who have it often develop it because they grew up in "unsafe environments". I grew up verbally abused at home, in public, and in school. I was bullied, often quite badly, everyday for most of my life between the ages of 10-20. If it wasn't my mother shrieking and telling me I was a horrible person for not safe-guarding her emotions at every moment, it was kids taunting me at school or on the bus. If it wasn't kids laughing at my bulky clumsiness, it was a gym teacher who smirked as I struggled to cross a balance beam (surely, a sadistic device) without falling off. Once I crossed the threshold to puberty, it was men and boys screaming insults from their cars at me.
I grew up feeling completely unprotected by everyone around me. The bus driver didn't stop kids from taunting me during the 90 minutes of time I spent on his conveyance each day. My mother didn't stop making me feel as if it was my fault that everything that upset her happened and that made me a terrible person. My teachers didn't stop kids from making fun of me. There was not one person who protected me when I was growing up. Is it any wonder that I wanted to kill myself when I was 15 and put a gun to my head? Obviously, I was too scared to pull the trigger.
Living in that environment is what cultivated my ability to "read" people rapidly and fairly accurately. If you are constantly under siege, you learn to find a way to survive. To reduce the chances that I'd be harmed, I had to detect the signs of attack. The better I could read a crinkle in the corner of an eye or the change in the set of a jaw, the faster I could get out of harm's way. Friends who weren't really friends or kindness that was a mask for an act of cruelty could be determined with tone of voice or the set of the brow. My mother's moods and whether she was interested in lashing out at me could be picked up by tone of voice or volume. I didn't have to wait for her to reach the point of frustration. I could see it coming from the start and escape in some cases before she built up a head of steam.
These days, I'm not walking around in a state of fear, but I realized that I still have all of my hypervigilant abilities. I read people and situations fast because I can't not see what I see. I had so much practice that it is a transparent and automatic behavior now. And, as I said before, I don't necessarily enjoy it.
However, I realize now that the reason that I wouldn't want to live without these skills is because I'm afraid not to have them. They continue to be a form of protection against a world that I will never trust because the only one who protects me is me. There is only one person that I am safe with and that is my husband. That is the legacy of the bullying and bad upbringing that I endured. No amount of understanding or awareness will strip me of these feelings. I can't simply "get over it" now that I'm free of the environment because this is how my brain has been wired through years of experience. While I may have escaped the neuroses, I'll never lose the hypervigilance and the skills that came with it.
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