Six Ways to Heal the Holes in Your Head

Do you ever feel like you have holes in your head? Actually, you do. Ventricles are the spaces between the grey matter (brain cells) and white matter (wiring that connects the brain cells) in your brain. Depressive episodes, manic episodes, and psychosis all burn up brain tissue, leading to bigger ventricles. (Image: Effects of Western diet on the brain. See companion image, Effects of Mediterranean diet below.)

This loss of brain cells hits the hippocampus (in charge of memory and emotion regulation) particularly hard. In the early years after my last mental health crisis, I talked about my “Swiss cheese brain.” At my worst, I lost bills, I lost words, I lost everything my wife said to me on the way out the door in the morning. She took to writing down what I said I would do before she got home, never more than two items.

I lost the list.

Holiday Shopping for Your Diagnosed Someone

Black Friday, the traditional start of the Christmas, Hanukkah and Kwanzaa shopping season has left us in the dust. Are you still wondering what to get for your neuro-diverse friend or relation? Here is Prozac Monologues' attempt ever to be helpful to my dear readers.  As my therapist said, Virgo -- your destiny is service.  Get used to it.  (I once had a therapist who said stuff like that.) The following is a holiday shopping list to guide neuro-typicals who want to please their loved ones.

This is a repost from ten years ago. So the pricetags have probably changed. But the links have been checked.

Crazy Meds can be your one stop shopping for Straight Jacket T-shirts, when you're crazy enough to let your medication do the talking, with a range of messages for any diagnosis, medication or level of in your face. The lettering is made by arranging real medication capsules for that homemade, from the heart touch. If you are shopping for me, medium size, long-sleeved, and black, of course.  My favorite message: Bat Shit Crazy.  In three years nobody ever took the hint, so I finally bought it myself.  If you are shopping for me, today I'll go with Mentally Interesting.  I'm still into black, and still refusing antipsychotics, so still a medium.

The following gift suggestions are targeted to differential diagnoses.

Spiritual Practices for the Dark Night - Giving Thanks. Again.

This post transitions from a month dedicated to PsychiatricTimes.com  to a month dedicated to gratitude. In short, I am grateful for Psychiatric Times. When I needed to figure out what the hell happened to my brain and how do I fix it, this online magazine for psychiatrists and other mental health professionals began my slow, steady self-education with its research reports, book reviews, philosophical discussions and occasional rants.

Mmm, sort of like Prozac Monologues: information, provocation, entertainment, and an occasional rant. That's how Google describes this blog. What do you think?

In the month of November, I will write posts about other resources and people for whom I am grateful. Today I repeat a post from ten years ago, part of a series on Spiritual Practices for the Dark Night. Those were dark nights, indeed, for me. These days, I think they are dark nights for everybody. But I digress...

NAMI Camino - BDNF Meets 5K

Exercise and learning new things -- two of the most powerful tools in the Recovery Toolbox.  They came together in my NAMI Camino, April 28, 2012.

NAMI Walk/NAMI Camino gave you the set up.  NAMI Johnson County held its annual walk/fund-raiser last week, when I was in Costa Rica.  It would be my fourth and last time participating.  But I would be in Costa Rica!  Inspired by the San Diego Walk in 2010, when a battalion in Iraq ran while San Diego walked, I decided to do Johnson County's Walk long distance -- though I would not be running in full battle armor and in the heat of the day.  My extra effort was confined to carrying a laptop to record the event.

With the following results:

So what follows is a series of installments, stopping at each kilometer marker.  This series shows you what you can do with Photo Booth, Youtube, not much skill, and a willingness to experiment.  Everything is reversed, left and right, which won't confuse you unless you are trying to read t-shirts or street signs.

Grief/Depression IV - Not the Same/Maybe Both

So a woman goes into the doctor's office, three weeks after her husband died. I got through the funeral just fine. But now I feel awful. There is this ten ton weight on my chest. I'm exhausted; I don't have the energy to wash the dishes. I'm trying to pack up my husband's things, and I am too weak to pick up his shoes. I can't eat. Sometimes I get hit so hard with this wave of anxiety, I think I'm going to throw up.

What are the chances the doctor will say, Of course you feel awful. These are all very natural symptoms of grief. You just need time. But if you still feel like this a month from now, call my nurse and set up an appointment. What are the chances the doctor will not pull out the stethoscope and listen to her chest?

Answer: It depends on whether the doctor is stupid.

Or a psychiatrist.

These are classic symptoms of heart disease. There is significant overlap between the symptoms of heart disease and the experience of grief. But there is no Bereavement Exclusion for a diagnosis of heart disease. Instead, family physicians and cardiologists take the time to examine whether the person presenting these symptoms may have both.

Sleep -- The Real Antidepressant

Your sink has backed up three times in as many weeks.  This time the plunger won't work, and it's beginning to stink.

The hardware salesman says you need a new garbage disposal -- $169.00.

Your plumber takes the pipes apart and clears the plug.  Depending on the plumber, she might show you how to do it yourself next time.  (My plumber is a woman.) -- $60.00 in my neighborhood.

Your brother says, stop putting banana peels in the garbage disposal.  (My brother owns rental property, and tells me what the plumbers almost always find in the plug.) -- $0.00.

The hardware salesman says a better garbage disposal could handle banana peels, and whatever else might also be causing that plug -- $249.00.

All of them are trying to help.  Each of them is working with the tools at his/her disposal.

Okay, now let's look at your depression.

Remember last week's list?

DSM On Depression -- The Chinese Menu

Mood Disorders -- Tolerable, Bad and Downright Ugly, Part I

A friend recently asked me for a short description of the difference between Major Depressive Disorder and Bipolar II. I didn't keep it short.  This will not surprise my regular readers, and warn my newer ones.

But here is the short answer.  Normal mood cycles within a normal range, sad/okay/glad.  Major depression has bigger distances, between normal and really sad.  Bipolar has the biggest distances.  Bipolar I ranges from really sad to really really up, with more time spend down than up.  Bipolar II moves the base line down from bipolar I.  It goes up, though not so far, and way, way down, lower than the others.

There are other aspects to mood disorders, affecting thought, desire, motivation, energy, sleep, digestion, appetite and even physical pain.  But this astonishingly short answer says way more than your common perception that depression means you are sad; bipolar means you are crazy.

Since I regularly write about these and the other mood disorders in Prozac Monologues, it may be helpful to give the longer answer here.  So today begins another three-part series.  I do seem to like these three-part series.  Things stretch out when I want to make Prozac Monologues both clear and entertaining -- though I suspect that it's mostly people with diagnoses who get the entertaining part.

Spiritual Practices for the Dark Night -- Giving Thanks

I don't believe in New Year's resolutions. They tend to be such cliches. Quit smoking. Exercise. Lose weight. Well, if you are serious about losing weight, you gather information, you set goals, you plot a course, you prepare your house, you find a buddy (just like in AA), you plan each day, you think a lot and you practice. It's worth doing, and I did. The point of all of the above is to change the way you eat. Permanently. So I did all of the above and I feel great (at least about the way I eat). I wish you all the success in the world.

Christians get a second shot at the diet thing in Lent, which begins sometime in the middle of February. It doesn't fare any better than New Year's diets, because so few people want to change their life. They want a quick fix for that swimming suit or class reunion. That's why Lent. It's time limited, forty days, with Sundays not counting. Sundays are free days, for all the bad habits you resume once Lent is over.

Me, I am interested in changing my life. You may be, too, if you too have peered into the dark abyss and something still holds you back from the edge. We are tired of living on that edge. It's just too scary. It wears us out.

So I take advantage of whatever reflecting you might be doing on your life this time of year to introduce some spiritual practices that could change it.

Now don't get twitchy because I use the word "spiritual." Yes, I am a priest; and yes, I have a charge on my life; and yes, I do my best to follow Jesus. It causes me pain that many of you do not have access to that most powerful juju, because of how badly Jesus is represented by some people who have such strange ideas about how to follow him. And I ask him and you also to forgive me for how little I ever do about that.

But give me a hearing. I even changed the title for you. I could have called it "spiritual disciplines," which is how I think of them, and which connects these practices to their deep roots in my own and other religious traditions that have been around a lot longer than you or I, so that you might give them a chance to find out why they have stuck around so long.

Anyway, "practices" gives the sense that if you mess up one day, well, that's what people who are practicing do. Then they practice some more.

Having spent so much space on the title, I can't get to all three practices today. For which I am glad, because I do better when I don't have to figure out what I will write about, and now I know for three weeks, because I have just created another series. I hope I will remember the second practice, which I don't right this minute.

I try, I don't always succeed, but I try to start each day with three things for which I am thankful. I am not particularly profound, nor even moved.  I just notice three things. Today I am thankful that the sun came up. It didn't come out, but I can cut it slack some mornings. I haven't been out yet either. But it came up. That's a start, for which I am thankful.

I am thankful that I have a psychiatrist who listens to me. Let's not spend any time on the one who didn't. Let's focus on the present, for which I am thankful, because she listens to me.

I am thankful that my sweet Mazie is still alive. She has renal failure, and every day we notice more signs. It began with weight loss, then bad breath. Now she needs to go out several times a day, instead of three. I am the one who takes her for two long walks, and that gets me out, as well as up, whether the sun is joining us or not. Which is good for my mental health and for my heart, and so I am thankful.

Three things for which to give thanks makes me mindful, makes me pay attention to the present, which is a gift, which is why it is called the "present." For those of us who have peered into the dark abyss, the present is indeed a gift. Because we can imagine not receiving it.

Sometimes I forget to practice this practice. But I almost always give thanks at mealtime. That covers me three times a day. I give thanks for the food, for the hands that prepared it, and sometimes for those who grew it and picked it, and those who packed and delivered it. When appropriate to the menu, I might thank the chicken or the pig, and while I am at it, I apologize to them that I am not yet a vegetarian.

When I am in Central America, I hear my friends giving their thanks in quiet and rapid Spanish, so rapid that I can barely pick out a few words. But I hear them pray for those who do not have food, and for a world in which everyone will have food every day, like we pray in the Lord's Prayer: Thy will be done. Another word for this kind of prayer is mindfulness.

I was at a restaurant once on "A Day Without Mexicans," when lots of people from Central America stayed home from work to demonstrate how much the rest of us depend on them. I overheard a woman ranting at this demonstration, and how "they should go back to where they came from." All the while, she was eating a big beautiful salad.

Since that day, sometimes I pray, "Bless this food and the hands that prepared it. May it bless us or curse us, according to how we treat those who brought it to us." That is mindfulness, too.

I treat this practice gently. Once in a while I wonder who I am thanking, and that reminds me how mad I still am at God about this disease. I don't know how to give thanks for that yet. Part of my dark night is this alienation from God. Even alienation is a relationship. But it's not one I want to press too hard.

Don't press it too hard.  Thankfulness will do its work over time.  Treat it as an experiment, to find out what it will work in you.

Happy New Year.