Mental Health Blogs

Archive for April, 2010

This is for Victor, who sent us the link to a CNN article looking at mood and chocolate consumption: Chocolate and Depression Go Hand and Hand by Denise Mann. So here’s the scoop, people eat more chocolate when they are depressed. Mann writes:

Although gorging on chocolate and sweets to beat the blues has become a cliché thanks to sitcoms and romantic comedies, there’s been “little prior scientific literature linking chocolate and depression,” says the lead author of the study, Dr. Beatrice Golomb, a professor of medicine at the University of California at San Diego School of Medicine. The study, she says, provides evidence to support “the popular perception that when people need a pick-me-up, they pick up chocolate.”

It’s unclear, however, whether depressed people eat more chocolate simply because they crave it, or whether chocolate consumption itself somehow contributes to a depressed mood.

In the study, Golomb and her colleagues surveyed more than 900 people about their weekly chocolate consumption and their overall diet. They also gauged the moods of the participants using a standard questionnaire used to screen for depression. (People who were taking antidepressants were excluded from the study.)

It’s not really clear from the article if the article is talking about people with transient sadness or people with clinical depression, but if there’s any link between chocolate and emotional states, then we’re happy to link to it on Shrink Rap.

Victor: may your salsa win the contest this weekend. And I don’t want to hurt your feelings but I’ve never been able to eat that chocolate bacon bar you gave me.

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They laugh, lest they cry, I think is how it goes.

My son, 21 years old, is starting to think about marriage. He asks,

“What do I look for in a girl? I want someone who thinks, but too serious isn’t good, right? To fit in with this family she has to have a sense of humor.”

I tell him look for someone with a sunny disposition. We all get dark, eventually. Into every life, a little rain must fall. Fine, I’ll stop.

But it’s true, isn’t it? If you have a choice going into it, why not look for happy?

Too bad Niecy Nash is taken.

I knew absolutely nothing about this comedienne until the postman dropped off my People magazine last week. I keep People magazine in the waiting room for people who get tired of waiting for people like me, although the cleaning staff throws them away, prefers Russian newspapers. I don’t know why.

This is in the April 26 issue, the one with Phoebe Prince on the cover. Phoebe, 15, killed herself because she couldn’t tolerate the bullying at her high school.

Life is beautiful, right? This has got to stop, this bullying in school, on the Internet. You’re supposed to outgrow it in middle school. Tell the kids.

But let’s talk about Niecy. She’s host and producer of Clean House and is known as no-nonsense Officer Raineesha Williams on Comedy Central’s Reno 911. My mom loves her on Dancing with the Stars, which I’m sure to be watching someday soon.

The story on this comedienne is powerful.

At age 15 she watched as her mother’s boyfriend shot her mom, “like a dog in the street,” in the back. . .Her mom survived, but eight years later Nash’s younger brother Michael, 17, was shot to death at his high school over a love triangle.

“My mother said, ‘I give up,’” says Nash, who refused to let her do that. Instead, she stood at the foot of her mom’s bed every day telling jokes until she finally cheered up. “that’s when I realized comedy was a gift.”

Oy va voy, what a world view. Make ‘em laugh. Eventually they’ll break down. I have a friend like this, Sarelle. She’s the one who scours the Internet for jokes and emails them to everyone she knows. When my father was hardly breathing, we got him to gasp until he liked it with jokes like these:

A rabbi was walking down the street when, suddenly, a strong gust of wind blew his streimel (fur hat) off his head. The rabbi ran after his hat but the wind was so strong it kept blowing his hat farther and farther away. He just couldn”t catch up with it.

A young gentile man, witnessing this event and being more fit than the rabbi, ran after the hat and caught it. The young gentile man handed the hat over to the rabbi. The rabbi was so pleased and grateful that he gave the man twenty dollars, put his hand on the man”s head and blessed him. The young man was very excited about both the tip and the blessing.

The young gentile decided to take his new found wealth to the racetrack. He bet the entire $20 on the first race that he could.

After the races the young man returned home and recounted his very exciting day at the races to his father.

“I arrived at the fifth race,” said the young man. “I looked at the racing program and saw a horse by the name of Top Hat was running. The odds on this horse were 100-to-1. It was the longest shot in the field.”

After saving the rabbi”s hat, having received the rabbi”s blessing, gotten the $20, and seeing Top Hat in the fifth race, I thought this was a message from God. So, I bet the entire 20 dollars on Top Hat. An amazing thing happened. The horse that was the longest shot and who did not have the slightest chance to even show, came in first by 5 lengths.

“You must have made a fortune,” said the father.

“Well yes, $2000. But wait, it gets better,” replied the son.

“In the following race, a horse by the name of Stetson was running. The odds on the horse were 30 to 1″ Stetson being some kind of hat and again thinking of the rabbi”s blessing and his hat, I decided to bet all my winnings on this horse.”

“What happened?” asked the excited father.

“Stetson came in like a rocket. Now I had $60,000!”

“Are you telling me you brought home all this money?” asked his excited father.

“No,” said the son.

“I lost it all on the next race. There was a horse in this race named Chateau, which is French for hat. So I decided to bet all the money on Chateau. But the horse broke down and came in last.”

“Hat in French is “Chapeau” not “Chateau” you moron,” said the father.

“You lost all of the money because of your ignorance. Tell me, what horse won the race?”

The son answered, “A long shot from Japan named Yamaka.*”

The following aren’t as clean, but they would probably still get a PG-13 rating if there were such things. They’re wife jokes worthy of Henny Youngman, for those of you who remember him. If you have politically-correct-sensitivity, change the word “wife” to “partner.”

My wife sat down on the settee next to me as I was flipping channels. She asked,
‘What’s on TV?’

I said, ‘Dust.’

And then the fight started.
****
My wife and I were watching “Who Wants To Be A Millionaire” while we were in bed. I turned to her and said, “Do you want to have sex?”

“No,” she answered.

I then said, “Is that your final answer?”

She didn’t even look at me this time, simply saying, “Yes.”

So I said, “Then I’d like to phone a friend.”

And then the fight started.
****
My wife was hinting about what she wanted for our upcoming anniversary. She
said, ‘I want something shiny that goes from 0 to 150 in about 3 seconds.’

I bought her a bathroom scale.

And then the fight started.
****
When I got home last night, my wife demanded that I take her some place
expensive… so, I took her to a petrol station.

And then the fight started…
****
My wife and I were sitting at a table at my school reunion, and I kept staring
at a drunken lady swigging her drink as she sat alone at a nearby table.

My wife asked, ‘Do you know her?’

‘Yes,’ I sighed, ‘She’s my old girlfriend. I understand she took to drinking
right after we split up those many years ago, and I hear she hasn’t been sober
since.’

‘My Goodness!’ says my wife, ‘who would think a person could go on celebrating
that long?’

And then the fight started.

The truth is, probably Ms. Nash has got to be funnier.

therapydoc

* A yamaka is a skull cap. Some Jewish people wear these to remind them that there’s always something above.

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I heard Irvin Yalom speak today. He’s a psychiatrist/writer/ very famous shrink at Stanford, and he was at Johns Hopkins today to give the Jerome Frank lecture. The title of his talk was “Staring at The Sun: Overcoming the Terror of Death.” It’s also the title of his latest book. The auditorium was packed—no surprise here. When I heard Dr. Yalom was coming, maybe a month ago, I made a point to block off the time to be there– I’ve never heard him speak and I was looking forward to this. Please let me share the experience with you.

Dr. Yalom is a gifted writer. He writes about his work in colorful and accessible ways, and he speaks about it this way as well. He lectures an audience of hundreds as though he is talking to a single friend. No notes, no hesitation, and he seems so at ease as he talks openly about work that is quite intimate. His specialties are group psychotherapy and existential psychotherapy, and he classifies the existential issues as death, isolation, freedom (as in freedom to make decisions and to steer the course of one’s life, not political freedom), and meaning. “We are unfortunately meaning-seeking creatures heralded into a universe that has no meaning.” Now he tells me!

Dr. Yalom started by talking about Dr. Jerome Frank (for whom the lecture is titled)–one of his mentors –and talked about a poignant visit with him near the end of Dr. Frank’s life. Dr. Frank was also one of my psychotherapy supervisors, perhaps at a time in my training when I took such things for granted and had no true appreciation of what an amazing gift it was to be his student. Dr. Yalom talked about his memories, and I revisited my own.

Dr. Yalom talked about his own psychotherapy experiences: his three years in psychoanalysis in Baltimore “There was so much attention to the distant past and so little to the future and our death.” Later in life, in California, he spent two years in therapy with Rollo May.

Death anxiety, Yalom contends, is an issue for many people–one patients won’t necessarily bring up on their own, one they avoid if they sense the therapist is uncomfortable, one that, indeed, makes therapists uneasy as they, too, have their own death anxiety to face. Perhaps it’s easier to avoid the topic; after all, there’s nothing to do about it. We’re all going to die. The therapist, he says, has a role in discussing death, and therapy can diminish the anxiety.

He talked a little about his work with cancer patients and how facing death can have a transforming effect; people get a better sense of priorities. “What a pity I had to wait until now to learn how to live,” one dying patient told Dr. Yalom.

By far, the most interesting parts of the talk were when Yalom talked about specific examples of his own work with patients and the interactions that transpired. He talked about a patient–a psychotherapist— who asked him about his own death anxiety (he responded) and who talked about his concerns about how Dr. Yalom might judge him. One nice thing about being Irvin Yalom is that you can get up in front of an audience of hundreds and talk openly about your work, boundary violations and all. He ended with the statement, “To become wise, you must listen to the wild dogs barking in your cellar.” –a version of a quote by Nietzsche. I’m still thinking about that one.

It’s been a while since I’ve heard a lecture like this. We’ve become so focused on psychiatry as the treatment of illnesses, of which drug at what dose, for how long, or which type of psychotherapy, and certainly we assume that what goes on in therapy includes talking about issues that having meaning to patients–including things that evoke anxiety, and the nuances of life that include meaning. We know we talk about these things behind closed doors–but we don’t often talk about the process of such transactions.

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Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail.

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A scene from Sunday night’s Desperate Housewives. A do-gooder neighbor reminds an alcoholic single mom that kids need their mommies home, not out looking for men in bars.

Yeah, there are spoilers.

I suppose it’s the stuff of forensics and other fields, and even though I rarely have a murderer telling me his problems, I do hear a kid say, on occasion, “I want to kill someone.” Even, so and so. “I want to kill so and so.”

This is never a good moment, hearing this, because you have to decide who to call, and among the calls is the one that warns the potential victim. That’s the law. There are very few situations in which a mental health professional has to break confidentiality, but this is one of them.

So last night, about 8:00 pm, we’re eating dinner. I watch as FD reads the paper, watch the fork hit the mouth, and in another corner, a kid, biologically related, the other eater, is staring at a computer screen, trying to find the error in his code, hundreds and hundreds of lines of program code. He’s feeling a little homicidal himself.

I don’t feel much like sitting, and as luck would have it, Desperate Housewives is about to begin. I like the show, mainly because I like some of the actors, and I like that the women, the wives, are forced to make quick decisions that will affect just about everything important in family life. And I like that when the story ends, somebody’s trying to do something nice for somebody else.

There’s always at least one really creepy, dangerous person on the show, which helps me raise my anxiety threshold. I’m reading a slasher novel, too, just to do that.

Anyway, the cringe, the tension in Desperate Housewives is generally well-done, not gratuitous, and the plot can keep my interest. Like last week a teenager (we like him) is working a counter, pouring a latte in the corner coffee shop, talking to a customer old enough to be his father. Actually, the guy really is his father, but the boy doesn’t know this. His mother has made sure to hide this information, has run away, assumed a new identity. She knows bio-dad is a dangerous man.

So bio-dad is befriending the kid in the coffee shop and has confided the story line of a novel he’s supposedly writing. Now he asks his innocent son, “So what should I have him (the spurned father in the novel) do for revenge, now that he’s caught up with them?”

The kid thinks. The pause is pregnant.

“To get to the mother,” he suggest, “I’d have him get to the kid, get to her through the son.”

“That‘s what I’m thinking,” his father replies.

Cringe stuff. Anyway, this week we get a new plot, a completely new set of characters, one that is going to tie up many of the unsolved, ongoing mysteries on the show. “Epiphany” takes us through the life of a little boy, Eddie, whose father has left him at the age of four to his mother, a verbally abusive woman who is addicted to alcohol.

No matter what Eddie does, no matter what he thinks or says, she’s contemptuous and ridiculing. Having Eddie has ruined her life. She laughs at him, smirks at him, belittles him. It’s so well-done, so real, what you see, even if it is television, is actually a fine enactment of what happens in emotionally abusive, verbally abusive homes. We don’t call these homes toxic for nothing.

Eddie searches for nurturing people, and on Wisteria Lane there’s no shortage of these. But he makes the mistake of taking the relationships too seriously, thinking older women might really like him, or might like him for their daughters. And when he risks intimacy, when he tells a female, any female, about his feelings for her, she inevitably laughs, too. Like his mom.

Nobody takes him seriously. He just needs someone to love him. You think this is trite? I wish it were.

And wouldn’t you know? He’s had some very serious anger problems for a long, long, time. He’s a good kid, just can’t manage his anger very well. And yeah, he’s the killer in the neighborhood. One of them.

All I can say is, I liked it. And if I were on the jury, I’d go with the insanity defense. For some reason, my guess is, they’ll never pick me.

therapydoc

Here’s the summary from the ABC website, but if you have time, watch the whole show:

We meet Eddie’s mom Barbara, a mean, slovenly drunk. She raids his room, looking for a bottle of Scotch, but instead finds his scrapbook with the clippings about the Fairview murders.

We flashback to when Eddie was just four, and his father left his mother — after loudly proclaiming that he’d never wanted any of this, including Eddie. Mary Alice tries to befriend her, but Barbara isn’t interested. Mary Alice stops by one day to give Eddie a teddy bear and finds him home alone while his mom is out drinking. She lectures Barbara about not putting her needs ahead of her son, but the lesson clearly doesn’t take.

Gaby first meets Eddie when she moves to Wisteria Lane and finds a lonely Eddie inside her empty house — he’d been sneaking in to play there since the previous owners moved out. He ends up coming over every day because Barbara has a new boyfriend. When he surprises Carlos and Gaby in the tub, Carlos orders Gaby to “cut him loose” and start making friends with other women, not nine-year-old boys. Gaby wants to go talk to Barbara, but Carlos advises her, “We don’t want to be known as the nosy neighbors.” After Gaby tells him they can’t be friends anymore, Eddie grabs a BB gun and shoots a bird.

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In Dinah’s post Fly Those Friendly Skies she talks about the new FAA policy regarding pilots on antidepressant medication. We found out something about pilot life span. Retired pilots live five years longer than their non-flying peers.

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Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail.

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We like to bicker about Electronic Medical Records here at Shrink Rap. They give Roy’s life meaning. Clink and I are more ambivalent.

In An Unforeseen Complication of Electronic Medical Records, Dr. Paul Chen (NY Times, April 22nd) writes about trying to pay attention to the patient and the computer at the same time:

“EMRs are a phenomenal contribution to care,” said Dr. Ann S. O’Malley, lead author of the study and a senior researcher at the center. But there is often so much information available — some of which requires a direct and immediate response from the physician — that “some doctors liken the presence of EMR to having a 2-year-old in the exam room.”

As all parents can attest, while a 2-year-old can create chaos in any situation, a setting that is as delicately balanced as the clinical one runs the risk of falling into complete disarray. Doctors often must consider several issues simultaneously when seeing a single patient — all the potential diagnoses and possible treatments, the patient’s history and list of medications, any possible adverse effects or interactions, the limits of that patient’s health care coverage and numerous preventive health issues, to name just a few of those considerations. The addition of an electronic records system can push some doctors into what one EMR expert refers to as “cognitive overload.”

“The whole point of EMR is to simplify the process and to enhance and facilitate communication,” Dr. O’Malley said. “But in order for that to happen, EMR needs to be more user-friendly and more responsive to the clinical needs of patients and clinicians.”

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Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail.

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Make no mistake. Flu season isn’t over. I was in my doc’s office the other day for something routine, and he’s still pushing the H1N1 vaccine. I don’t know why the other patients were in the waiting room, but I do know a few of them were sniffling and sneezing. There was a video on the TV about the importance of hand washing during flu season, to prevent the spread of germs. My throat started to feel a little sore.

I’m fine. I apparently escaped without exposure to anything sickening. But my mind was on high alert the entire time I was there. Such waiting room vigilance is not unusual, and indeed has long been recognized as a kind of behavioral immune system. Simply seeing signs of disease triggers thoughts and emotions that motivate us to take extra precautions around any possible contagion.

And it may trigger our bodies as well, according to new research from the University of British Columbia. Psychologist Mark Schaller and his colleagues suspected that psychological defenses might be just part of a broader immune response—one involving the natural killer cells and cytokines and other biochemical defenses that fight off invading germs. They decided to test this idea—by seeing if they could trick healthy bodies into action. Here’s the study:

The scientists recruited healthy men and women and had them watch slide shows. All of the volunteers watched a 10-minute slide show about furniture; this was deliberately boring, to act as a control condition. Then a bit later, half the volunteers watched a fairly disgusting slide show, with images of skin lesions and oozing pox, in addition to garden variety sneezes and coughs. The other volunteers watch a slide show about guns—not just guns, but people brandishing firearms, and mostly pointing the weapons directly at the viewer.

The guns were important, because guns are very threatening—especially when they’re aimed at you—but they’re not related at all to disease or infection. The scientists wanted to rule out threat—any threat—as the cause of any immune response they measured. And that’s just what they saw. They drew blood from the volunteers before and after each slide show, and measured the levels of a cytokine called IL-6, a major fighter in the immune war. Those who had viewed the depictions of sickness showed a dramatic jump in IL-6 production—more than 23 percent. These same volunteers had no biological response to looking at furniture and—more important—the volunteers who looked at brandished weapons also showed no significant immune response.

One possible interpretation of these results is that looking at pox and sores is stressful, and that the stress triggered the immune response. But the scientists ruled that out. They measured self-reported stress, and in fact those who had watched the guns were under more—not less—stress. The psychologists also ruled out personality as an explanation: They measured traits like neuroticism and agreeableness as well as the volunteers’ perceived vulnerability to illness—none of these traits distinguished the gun viewers from the disease viewers. The only explanation, it appears, is that simply seeing other people’s sickness prompted the volunteers’ immune systems to act as if they were under attack.

Is this a good thing? Perhaps not as good as it sounds. As the researchers explain this week in the on-line version of Psychological Science, a direct link between perception and immune response may have helped our ancient ancestors respond quickly and efficiently to pathogens. It may even have helped us evolve as a social species by permitting early humans to gather in groups. But that doesn’t mean it’s still a good thing. All sorts of social cues can today mimic actual disease threats, causing the immune system to respond aggressively even when there is no real threat. Too many false starts could compromise immune function over time, with serious consequences for human health and welfare.

Excerpts from “We’re Only Human” appear regularly in The Huffington Post and Scientific American Mind. Wray Herbert also writes the “Full Frontal Psychology” blog at True/Slant.

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I am reading the August 2009 edition of Yoga Journal and there’s an interesting article about practicing yoga as a couple entitled, “Grow Your Love”. I’m a firm believer in the healing and restorative powers of yoga for mental health, but I’d never thought of using to strengthen a relationship.

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When talking about the problem of homelessness there seem to be two ways of thinking about the problem: 1) that people are homeless strictly because of social problems (i.e. not enough affordable housing) and 2) that the people are homeless strictly because of their personal shortcomings (i.e. not working). I think the truth lies somewhere in between and I would like to propose a third way of viewing the problem.

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I think the worst thing about depression is the insidiousness of its symptoms; all of which further contribute to the ever deepening spiral into the dark abyss of meaninglessness.

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