In 1969 Elizabeth Kubler Ross published On Death and Dying. It described the grief process of dying patients and how family and medical personnel could help them toward a good death. You probably know what came to be called the stages: denial, anger, depression, bargaining, acceptance. They were never intended to describe a straight line process, more like a series of way stations to be visited on the way. They came from her work with people who were dying, and were part of the foundation of the Hospice movement, to take dying back out of the hospital where the focus is on preventing death, and put it on a more humane basis. We all die. Let's do it without the violence of extreme measures. Kubler Ross has been on my mind lately, as it becomes clear that the planet is dying. We all are dying. But so are the polar bears, as a species, the black rhinos, the bees... And when Monsanto kills off what remains of the bees... We are facing the sixth mass extinction of the planet. Unlike the earlier five, this one is on us humans. And evidently we have eighteen months to turn it around. No, that BBC report was written last month. Make that seventeen months. The rest of the planet is addressing that deadline, while the US is set to spend the last months we have to make a difference locked in our own coming storm. We have one last chance to prevent a white nationalist totalitarian regime. The issues are tied, fascism and climate change, since the regime is doubled down on a nineteenth century energy policy. So, there we have it. We are screwed. I am seeing those stages play out in social media and every day interactions. How about you? Denial I don't mean the old white guys who have a financial interest in denying climate change. I mean the determined optimism of those who still believe in the last minute reprieve. "Science will solve it." Science did solve it, years ago. We ignored them. Do you think maybe Marvel Comics has tapped into the denial zeitgeist? Our obsession with comic book heroes testifies to our continued expectation that just when the game appears lost, somebody else will save us. Maybe that girl from Norway...
Anger Ouch - right? You don't have to read the nightly body count. Look no further than your Facebook feed. Somebody started a thread with Birdcage gifs. Here was my contribution: What I think I sound like on Facebook:
What I really sound like on Facebook:
Do you have people who pre-irritate you? I do. Before they open their mouths, I already feel irritated. Maybe we have eighteen - no, seventeen months on climate change. But have we already passed the tipping point on anger? Angry at all the angry people around us - how do we reverse that one? Depression
A quarter of us in the US are on psychotropic meds. That doesn't count all the self-medicators out there. This is the golden day for legal marijuana. Bargaining
I think this is what the straw fetish is about. We sit in our SUVs at the fast food drive-through, motors running, and berate the poor kid who handed us our beverage with a plastic straw. Like, if we give up our plastic straws, we will dodge the bullet. Acceptance
In Kubler Ross's original idea, with acceptance comes peace. I don't really see any peace about the death of the planet out there, nor in here. The closest I come is acknowledgement. That's the word I substituted years ago in the Serenity Prayer, when acceptance carried just too much baggage. God, grant me the serenity to acknowledge what I cannot change.
But these predictions of demise are not for the short term. The seventeen month deadline is for the tipping point. After that, carbon levels will be so high there's only one direction to go. The melted polar caps don't freeze up again, (90° in Anchorage on the 4th of July this year), the icebergs disintegrate, releasing more carbon into the atmosphere, raising the temperature more rapidly, causing ocean levels to rise. Salt water is already infiltrating fresh water aquifers, destroying arable farm land and causing water shortages... What with environmental refugees, starvation, and the inevitable military responses, civilization is finished thirty years from now. Some say twenty. The thing about these predictions, the only mistakes the predictors make is to predict we have more time than turns out to be the case.
Even so, in the face of environmental refugees, starvation, water shortages, and military intervention, twenty years is a long time to stand on one foot, pulling off that serenity thing about a good death. We need another stage. David Kessler, Kubler Ross's coauthor on a later book provides one in Finding Meaning: The Sixth Stage of Grief. I walked into my therapist's office last week after a month's absence and caught her up. "The book is going great. If it weren't for my existential despair, my life would be terrific." This was pure gift to her. My issues are usually cognitive therapy issues. But she says she does existential therapy. "Maybe ultimately there is no meaning. Maybe you have to find your own." Finding Meaning Well, there's plenty of that going around. From Trump as the Second Coming to Paul Ryan's blatant embrace of Ayn I-don't-owe-anybody-anything Rand (he's a Catholic of all things!), to Spiritual-but-not-Religious, to tattoos, to My Family is Everything and the Only Thing, to...
I just took this photo on a walk which included a sample of CBD tincture (self-medicating) and a swing by my favorite shoe store. They're red! They're mine! What does it matter that my portfolio is predicted to carry me to my end-of-retirement date, when my end-of-retirement date is anticipated to be later than the end-of-civilization date? Life is short, buy shoes. So I choose a meaning. The family of God. As we all go down the tubes, I want to go down together, loving my neighbor as myself, welcoming the stranger, protecting the widows and children. Not the new-fangled heretical Christianity. Give me that old-timed religion, the Biblical Judeo-Christian thing that the Muslims embrace, too. It's not about power. It has stood up to Pharaoh, to Caesar, to Hitler. It will stand up to what comes next. Sounds nice, but it's not about being nice, is it. For at least two thousand years, choosing a meaning that goes deeper than the embrace of power, choosing to stand with the dispossessed, the meek in the language of Jesus, has given people something to die for. Not kill for. Die for. To pull that off is going to take the energy I have left, and more. It will take a community of people to support such a decision - to be willing to die. I don't know what you call it. In my shop we call it the Body of Christ. It will take the Body of Christ to be the Body of Christ, broken together. Together with our nonChristian sisters and brothers, too. Damn, this ended up a sermon. Well, here's the bottom line. If we're all going to die, I don't want to be an asshole.
Captain Marvel image from pyramidinternational.com
Negative emotion differentiation (NED) refers to the ability to identify and label discrete negative emotions. Are you the mom who says to your tantruming toddler, Use your words? That's good parenting in so many ways. Well actually, I found it quicker to turn the critter over and hold him up by his ankles, so he could ponder his universe from a different perspective. You could call that reframing. But that technique is more difficult to execute on a teenager. Here is the latest reason why Use your words is good for your kid: the folk who get paid to come up with new things to research have discovered a relationship between teenagers and words. The more words they have to describe precisely their negative emotions, the less risk they have to develop depression in the face of high stress. And conversely: Results suggest that low NED is primarily depressogenic in the context of high stress exposure. That's from "The perils of murky emotions: Emotion differentiation moderates the prospective relationship between naturalistic stress exposure and adolescent depression," by Star, Hershenberg, Shaw, Li, and Santee.
That's what I'm here for. I find cool stuff in the scientific research world and translate it into English for you, dear reader. The more words you have for negative emotions = the less depression you get when stressed.
I'm all over this. I use words like my sister uses broken bits of tile, to turn loss into beauty. There's a bit of Mama's good china that hit the floor in this photo of the tabletop coming together in my sister's workshop:
So one of the things that pleases me about this research study is that I have discovered a new word, depressogenic: causing or tending to cause depression. Google doesn't recognize euthymigenic. I made it up: creating or sustaining a normal, tranquil mental state or mood. In a sentence: Turning the broken bits of our lives, turning our losses into beauty is euthymigenic. My sister does this with tile. I do it with words.
Here's an excerpt from Prozac Monologues: What If It's More Than Depression?
The DSM has its checklists. People
with depression have poetry. People with diabetes discuss about
their diet, their feet, their retinas. They check glucose levels. Put two
diabetics at a table, they compare numbers. People with depression talk in
metaphor. We talk about the cloud, the curtain, the weight, the darkness. When
it goes away, we say, “It lifted!” That lift is a physical sensation, actually,
of lightness or elevation... If I could just find the right
words, maybe I could break the spell... See, I always knew that increasing my vocabulary would help me. Turns out increasing my kid's will help him, too.
cartoon from memedroid.com
photos from the Pato Loco, Coco, Costa Rica by the author
Manic episodes burn up brain cells. So do depressive episodes. So do panic attacks. Cortisol run amuck leaves you with potholes in your head. Not to worry -- the brain has a built-in repair system, Brain Derived Neurotrophic Factor, BDNF.
They've been trying forever to reverse engineer antidepressants. If they can figure out how they work, they figure they will know what causes depression in the first place. At first they thought it was low serotonin levels, the proverbial "chemical imbalance." A more recent thought is that a low serotonin level is not the cause, after all; it's the effect. Fix the problem farther upstream by stimulating BDNF to repair the brain damage, and the serotonin level sorts itself out.
But the natural thing that gets this hormone humming to patch your potholes is learning! There's this big deal about seniors doing Sudoku to ward off dementia. But it only works until you get good at it. You have to keep doing new stuff that you don't already know how to do.
And what better than learning to play a musical instrument? You have no talent? You tried it as a kid and you were lousy? Hear me out. If you were good at it, it wouldn't build your brain. Seriously, it's like exercise. If you don't feel the struggle, you're not building the muscle. Making music turns out to be a full body/brain workout.
So go get yourself a ukelele! Your brain will be glad you did.
photo of pothole in public doman
photo of road repair taken by US Air Force and in public domain
Could we have prevented this suicide? - Every survivor asks the question in the aftermath of a loved one's death. In Searching for Normal: The Story of a Girl Gone Too Soon, Karen Meadows traces through her daughter Sadie's entire life, reexamining every decision that affected Sadie's illness. No, Karen, for God's sake, you even paid professionals to find the best options out there for Sadie's care. Sadie was a bright, lively, inventive child with obvious gifts and potential. A victim of bullying, things turned dark in middle school. The school's routine screening for depression yielded an awkward phone call to her parents - they should get her treatment.
Depression is the DSM's junk drawer. Lots of people start their sojourn in diagnosis by getting slotted into it. Lots of them get moved to another drawer when antidepressants prove less than helpful. Sadie's first suicide attempts followed closely upon beginning treatment with antidepressants. Another doctor said bipolar. Another doctor said, no. A treatment center said she shouldn't be on meds at all... Meanwhile, Sadie's parents struggled with their own concerns about medication. What does it do to a developing brain? Or was it because she was on the wrong meds? Or because they withheld meds? Or because she wasn't monitored when she started them? Or because she was adopted? Or because they moved? Or because she got rejected by schools? Or because they couldn't find the wrap around services that had been recommended? Or because... Beyond the second guessing is a thorough listing of what help is available to families facing severe mental illness and what help is not. The author moves from grief to advocacy for better care, better services, better understanding of mental illness and what this epidemic of suicide costs us -- lives of promise and brilliance. Sadie was one such person of promise and brilliance whose life ended too soon. One of the heartbreaks in the story for me is that the Meadows family went through this alone. They didn't know that there were others who have walked this path before, who could have supported them, helped them. National Alliance on Mental Illness, NAMI offers classes, Family to Family for family and friends of those with mental health conditions and now Basics, specifically for family and caregivers of young people. Alas, these programs are not available everywhere. But the websites can help you find the ones closest to you.
Karen Meadows didn't find NAMI until after Sadie's death. The last chapter of the book is a wide ranging list of resources. Out of tragedy came a determination to help others. That will be Sadie's legacy, one of them, if those whose stories are beginning like hers can come to a different ending.
Ten years ago I retired on a mental illness disability. It was a relief. It was dreadful. It was a heartbreak. And I was pretty sick. Being a priest is a public job, and mine had been more public than most. So between retirement and the mental illness that led to it, I felt isolated and had a serious case of Who the hell am I, anyway?
But I sat down, signed up for a blog, wrote my first post, and there it was, my new life, Prozac Monologues: Reflections and Research on the Mind, the Brain, Mental Illness, and Society.
This is the place where I have recorded my learning about what happened to me: genetic variation, childhood trauma, wonky wiring, unhappy mitochondria, that broken internal clock... followed by misdiagnosis of Major Depressive Disorder, inappropriate antidepressant medication, a bit of psychiatric manipulation, a new diagnosis of Bipolar 2. And then recovery. Not cure, but recovery, as in the way I live the rest of my life. It is where I have puzzled through philosophical issues about mental illness and its treatment, political issues about society's response, stigma/prejudice, the use of language, how art can soothe the savage brain, how mental illness comedy can give voice to what cannot otherwise be said. It is where I have discovered psychiatrists and others whose work I admire: Ronald Pies, David Conroy, Hagop Akiskal, Jill Bolte Taylor, John McManamy, Nancy Andreasen, Nasser Ghaemi, and some others... not so much.
My readers have read my rants, my musings, and even my sermons. And some of you have made comments that told me I needed to keep going. Which I did. Thank you for that. To mark the occasion, Prozac Monologues, the blog has been given a facelift. There may be a few more tweaks in the days to come. Actually, I'll invite you to make suggestions. Broken links have been removed from the Mental Health Break list on the right. I could use some new ones. What are your favorite videos and sites that would fit the category? Click the link for comments at the bottom of the post. One more thing: Prozac Monologues: Are You Sure It's Just Depression -- promised so long ago in that first post will be coming to your local bookstore in September 2020! Published by She Writes Press, distributed by Ingram Publication Services, you can follow its progress on my author page. And Twitter, that thing into which authors are dragged kicking and screaming by their publicists (mine is JKS Communications), yes, I am on Twitter, too @WillaGoodfellow. Again, thank you for reading. That will be my dedication in the book: I wrote this for you.
