Dopamine - Can't Live Without It

Dopamine -- It's what gets the lab rat turn to left at the T, race down the hallway, make a flying leap at an 18" wall, snag the ledge with its little claws, and struggle over to fall to the other side and win those four food pellets.  If you artificially deplete the lab rat's dopamine, it will turn right at the T and settle for the two pellets lying on the floor.

Dopamine -- It's what got you out of bed this morning and to work on time.  Or if your dopamine levels are depleted, you pulled the covers over your head, while your spouse pleaded with you to go back to your therapist.

Dopamine -- It's what got you out of the house early to redeem that two-for-one mocha coupon at your favorite coffee shop on your way to work, and as long as you were there, might as well order that banana chocolate chip muffin.  Bananas are good for you, right?  Or if you just never got into the habit of that particular coffee shop, and it's not on the way to work, and you really like the French Roast you have at home anyway, then your dopamine never got you fired up, and the coupon went to waste.

Changing Food Habits - Contemplation and Preparation

Do you have any idea how complex the neuroscience of your food habits are?  Cinnabon, Chili's, General Mills, et al know way more about your brain than you do.  David Kessler, former FDA Commissioner, pediatrician and Dean of Yale and UC San Francisco Medical Schools, tells the story in The End of Overeating: Taking Control of the Insatiable American Appetite.

Neuroscientists know how the salt/sugar/fat triple whammy messes with the brain circuitry, taking offline the I have had enough now sensors and replacing them with More, please.  Reward centers, neurotransmitters, HPA axis, limbic system, operant conditioning -- they are messing with you.  Neither your meds nor an aluminum foil hat will protect you.

My Food Autobiography and the Stages of Change

This is not a post about dieting.  If you are looking for the quick fix for the upcoming wedding, reunion or beach vacation, move on to the next page on Google's list.

Before life so rudely interrupted, I was doing a New Year's series on the Stages of Change.  Since then I have rewritten my profile, reflecting on change as a theme.  I don't particularly care for change, but I am fascinated by how people manage to pull it off.  And I am astounded that at age 54 I changed a basic health practice, that being my eating habits, and have maintained that practice for six years.

Let me repeat.  This is not about dieting.  Who wants to DIE-t?  This is about changing the pathways inside your brain, retraining it, creating new synaptic connections that serve you better than the ruts (automatic reflexes) your thoughts and behaviors now travel.


Not in one leap.  One step at a time.

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.

Grief/Depression III - Telling the Difference

Once, when I was seriously under and still headed down, a friend said to me, There have been times in my life when I was sad, so sad I couldn't imagine being any sadder. But it seems that what you and others with depression are describing is a whole different level that I know nothing about.

See, that's what would be helpful, instead of, I know just how you feel. I remember when [fill in the significant loss]... I knew that he knew times of deep sadness, because I knew some of those times, and because he is a person is thinks and feels deeply. And listens deeply. Everyone should have such a friend.

It was Social Hour. We were in a corner to protect me from all those people being social. I leaned against a wall, because I was very tired. I guess the wall gave me the idea. I said, Yes, there are times I have been so sad I couldn't imagine being sadder. It's like the sadness became a wall I could lean against, because I was so tired. But Depression IS different. Imagine if the wall gives way. Imagine there isn't a limit. You lean and the wall gives way.

Grief/Depression II - Rise in Rates of Mental Illness

Are we really getting sicker?

A New York Times article, When does a broken heart become a diagnosis? sells papers with its usual technique - latch onto a fringe element and substitute good writing skills for substantive analysis.

I am all for good writing skills, and perhaps stumble in the same direction at times. But depression is my beat. So God willing and the brain permitting, I am going to beat this bit to the ground. Two weeks ago I discussed three contexts for the discussion, the cost of health care, the scientific value of the DSM and the hobby horse of the author featured in the Times article. I promised more contexts to come.

Are We Getting Sicker? - Context IV

James Wakefield's thesis is that we are turning natural human emotions, (the ones we want to get rid of, because they are unpleasant), into a diagnoses. His beat is depression, as well, but the Times is on this bandwagon with autism and no doubt other diagnoses to come.

Well, I grant some validity to the concern in general. Is it shyness or Social Anxiety Disorder? Is it artistic nonconformity or Attention Deficit Hyperactivity Disorder? Is it the sleep disruptions of normal aging or Overactive Bladder Disorder? Was it all those wings, doritos and beer you guzzled Superbowl Sunday (and most Sundays), or Gastroesophageal Reflux Disease?

For When Your Therapist Goes on Vacation

I have two therapists and they were both on vacation the week I got home from my mother's funeral and all those issues and all the family and all those issues.  And still on vacation the week after that!  My brother-in-law subbed - thank you, Darryl - with the following email.  I offer it as a resource for when your therapist picks a lousy time to go on vacation.

For extra entertainment value (my entertainment, anyway), I have identified which one I hear Michael telling me with >>, and which ones I hear Liz telling me with **.  One of them regularly irritates me.  I'll let you guess which one.  I have to keep both, because the double-teaming seems to help.

Wisdom Learned From the Seat of a Tractor


Your fences need to be horse-high, pig tight, and bull-strong.

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