kw: observations, thinking, mental health
My father has received some help with his balance and other problems from a hypnotist. He repeated a statement made by the hypnotist that we make about a thousand conscious decisions daily, while our unconscious makes a million decisions a day. That got me thinking.
Firstly, what is a decision? Upon reflection, I concluded that it is a sequence of brain activity that leads to an action or to refraining from an action. By "action", however, I don't mean just a bodily motion, but I include a mental state that differs from before, such as a realization, a word choice for a sentence one may soon speak or write, or a "mental note" to do something in the future. Do we count the sub-decisions that lead to something more major? Sure, why not?
A thousand decisions amounts to about one per waking minute. Let's consider this as a starting point. While I am writing, I can type 50-60 words per minute, but I don't always think this fast. Nonetheless, I am capable of sustained burst of "word choice" and "sentence-concept choice" in the range of one per second. When I play a computer card game such as Freecell or Spider Solitaire, I may think about a move for a minute or several minutes, and at other times make several moves per second. My hand speed limits me to about three per second. Nobody can do that all day, however.
Speaking with someone, we make one or two decisions per second, and some of us spend a lot of time conversing. Of course, half of the conversation a person spends listening, but they will be thinking, often planning what to say next, the while. So sustained decision making can approach one per second. In 16-18 hours of waking time, the number of seconds is 54,600-64,800. Thus I conclude that most of us make fewer than 50,000 conscious decisions daily, and that nobody exceeds 100,000.
What counts as an unconscious decision? When some part of the brain builds a dream image in your sleep, how many decisions are involved, and how long did it take? The visual cortex operates in parallel, and I recall dream images, just from last night, that were rather complex, containing dozens to hundreds of objects. For an image sequence to seem continuous, they must occur at about twenty per second. That is one kind of decision-making we need to consider. It parallels the recognition process that makes us aware of dozens to hundreds of items in our visual field, also at a rate of about twenty per second. In either case, a minute of visual activity is sustained by as many as several hundred thousand recognition or recall decisions. Watching an hour-long movie, which I've noticed is often visually less rich than a "real" experience, let's just guess that each minute requires 100,000 decisions (hundreds are made in parallel at every instant), so that movie prompts six million decisions by our visual processing system.
There is a lot more going on in our body; regulation of heart, liver, stomach and other organ rhythms, for example. I don't know how to analyze the number of decisions this takes, but I think it is safe to say that it does not require the sustained level found in visual processing. Then let us consider that the visual cortex is one-third of the total cortex, and the cortex is a fifth of the total brain. The cortex may then be capable of twenty million decisions per hour. The rest of the brain runs at different rates. The largest portion of the limbic system involves emotional responses, another kind of decision entirely. There may be some parallelism in this as well, but it is more mysterious overall. Then there is the memory system. Again, it is hard to decide how to count activity, and harder still to figure out what is a "decision".
Instead, let us back off and consider. The cortex alone is capable of twenty million unconscious decisions per hour, which is probably a few thousand per hour (one or two per second) in each of thousands of regions. Conscious decision making requires getting more of the brain into gear, and seems not to run in parallel.
It seems the hypnotist had his ratios about right, but the figures were wildly conservative. I suspect it is more accurate to say that we make 10,000-50,000 conscious decisions daily, while unconsciously the whole cortex makes around a third of a billion decisions…during waking hours. During sleep, the rate of activity is hardly changed, so that another hundred million or so decisions get made.
In all the above, I have considered only the cerebrum, not the cerebellum and brain stem, which regulate bodily states and mediate our decisions to perform bodily actions. I don't think I need to. The hypnotist was using the thousand-to-one figure to make the point that if we can influence how the unconscious functions operate, even a little, we can make big changes in bodily and mental states, and perhaps even rates of healing. Now that takes more consideration.
Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts
Sunday, February 20, 2011
Tuesday, May 19, 2009
Gaining on Insanity
kw: book reviews, nonfiction, mental health, quests
Mental health, or its lack, runs in families. Not all offspring of an afflicted person, or couple, will manifest the disease, but the chances are higher. Being bipolar (thankfully at a moderate level), I recognize that my mother was also bipolar, but my father and brothers seem to be unaffected, and my son is remarkably stable, thank God!
Patrick Tracey is not so fortunate. Several of his family members are schizophrenic, though he himself is not. In Stalking Irish Madness, Searching for the Roots of My Family's Schizophrenia he chronicles the disease in his grandmother, two sisters and an uncle, and his grandmother's great-grandmother. His grandmother was a Sweeney, of a family in which madness is well known, and the earlier ancestor was an Egan, probably the most-afflicted surname. The variant Madigan actually refers to the "Mad Egans".
The author is not schizophrenic, though his writing shows evidence of paranoid tendencies. However, knowing his family history, is it paranoia to decide against having offspring, who'd have a great chance of mental illness? This is similar to a cousin of mine, who had her tubes tied because she didn't want to have offspring who might carry or suffer her extreme allergies.
By the way, not all schizophrenics are paranoid; the designation "paranoid schizophrenic" is a distinct category. Schizophrenics in general are those who are so troubled by various kinds of hallucination that they cannot function normally. Many hear voices, but not all. The afflicted among Egans and Madigans are so troubled by voices that they cannot pay much attention to "real life" around them. The author's sister Austine is almost catatonic, being so overwhelmed with voices that she seldom hears anything else, while his other afflicted sister, Michelle, cheerfully carries on dialog with her voices, but can include "outside persons" in the conversation.
Other schizophrenics see things others don't see, or hallucinate other senses such as touch, taste or smell. In all cases, the diagnosis is typically given when the hallucinations dominate the person's life. Whatever the sort of hallucination, in schizophrenics it rises to the level of obsession, and is typically accompanied by delusional thinking.
Sometimes the delusion is itself the affliction; this is the case with paranoid schizophrenics such as a friend of mine. He is able to function normally for various periods of time, but unless he takes his medications, he frequently "flips out" and may flee imagined persecution. He once held a steady job as an electronic engineer, and was doing side jobs. When he found out that some of the devices he was making were being used for illegal gambling, he became convinced that he was a target of organized criminals, and fled halfway across the country. Later checking uncovered that the supposed "mafiosi" were in no way organized, but were a couple of petty criminals. But he has not moved back, nor has he obtained long-term employment since.
The stereotypical schizophrenic is the raving, voice-ridden "nut" that one might see on a street corner. Considering that one person in a hundred is afflicted by overpowering voices, we all know at least one. However, not all who hear voices are schizophrenic. I'll offer myself for an example. In the hypomanic phase of my bipolar cycle (I seldom experience full-blown mania), I hear voices whenever I shut my eyes, but not with my eyes open. I can seldom understand the words, or at least I don't recall what they say. In quiet circumstances, particularly with subdued light (like a business meeting with PowerPoint in progress!), I tend to drift into a state of lucid dreaming, with both visual and auditory sensations. I can usually tell the difference between such hallucinations and reality…usually.
Thus, it seems Pat Tracey is saner than I, or perhaps more circumspect. Much of the book's content narrates his travels through Ireland, seeking information about his ancestors and their sanity, and the prevalence of madness among the Irish. He is drawn eventually to a well in farthest western Ireland, called Gleanna-a-Galt. Its waters are reputed to heal the mentally afflicted. He gathers some of the water to take to his sisters. He finds that the water contains a high level of lithium. That is known to help bipolar people, and can help many schizophrenics also, so the well's reputation is probably well founded.
When he returns home, he slips some of the water to each sister, but gives no report about its effectiveness. It is sad to think they got no help from it, but it is better for bipolar. Among those I know who have bipolar disorder, lithium salts are the most consistently effective treatment, though the therapeutic dose is a nearly toxic level; it has to be watched. The amount in Gleanna-a-Galt well water is much lower than the amount given medically.
The author's conclusion is that schizophrenia's cause is not wholly genetic, but rather that certain genetic types are more likely to react to stressful circumstances by "flipping" into a hallucinatory state, and they never flip back. I see the affliction in all its forms as several extreme manifestations of ordinary variations of human experience, particularly in the tendency to dream lucidly.
Some people, like my solidly stable wife, seldom remember dreaming in sleep, though sleep researchers assure us that everyone dreams for part of every night's sleep. People like myself dream frequently, often remember the dreams, and may begin dreaming before being fully asleep. Others find dreams popping up while they are fully awake. When such dreams cause trouble, they become symptoms of schizophrenia.
Although schizophrenia means "divided mind", the experience is really one of being divided from common experience, because of the distractions of the hallucination/dream. Dissociation of a personality into more than one seeming entity is a different condition entirely, though it often happens that one or more of the dissociated fragments becomes a distraction to the "main person", leading to a condition that is schizophrenic in effect, whether that is the correct DSM diagnosis or not (DSM is the acronym for the Diagnostic and Statistical Manual of Mental Disorders).
While Patrick Tracey could not find out everything he sought, nor effectively treat his sisters, he did come to terms with the disease and its history in his family. His trek to Ireland was a kind of flight, and at its end, he is at peace to return home, to help his family cope as best they can with the incurable. While I hope and pray for his sisters, as well as others I know who are so afflicted, I know that the disease seldom leaves, and is quite resistant to all treatments. Pray with me for continued medical progress, and perhaps breakthroughs!
Mental health, or its lack, runs in families. Not all offspring of an afflicted person, or couple, will manifest the disease, but the chances are higher. Being bipolar (thankfully at a moderate level), I recognize that my mother was also bipolar, but my father and brothers seem to be unaffected, and my son is remarkably stable, thank God!
Patrick Tracey is not so fortunate. Several of his family members are schizophrenic, though he himself is not. In Stalking Irish Madness, Searching for the Roots of My Family's Schizophrenia he chronicles the disease in his grandmother, two sisters and an uncle, and his grandmother's great-grandmother. His grandmother was a Sweeney, of a family in which madness is well known, and the earlier ancestor was an Egan, probably the most-afflicted surname. The variant Madigan actually refers to the "Mad Egans".
The author is not schizophrenic, though his writing shows evidence of paranoid tendencies. However, knowing his family history, is it paranoia to decide against having offspring, who'd have a great chance of mental illness? This is similar to a cousin of mine, who had her tubes tied because she didn't want to have offspring who might carry or suffer her extreme allergies.
By the way, not all schizophrenics are paranoid; the designation "paranoid schizophrenic" is a distinct category. Schizophrenics in general are those who are so troubled by various kinds of hallucination that they cannot function normally. Many hear voices, but not all. The afflicted among Egans and Madigans are so troubled by voices that they cannot pay much attention to "real life" around them. The author's sister Austine is almost catatonic, being so overwhelmed with voices that she seldom hears anything else, while his other afflicted sister, Michelle, cheerfully carries on dialog with her voices, but can include "outside persons" in the conversation.
Other schizophrenics see things others don't see, or hallucinate other senses such as touch, taste or smell. In all cases, the diagnosis is typically given when the hallucinations dominate the person's life. Whatever the sort of hallucination, in schizophrenics it rises to the level of obsession, and is typically accompanied by delusional thinking.
Sometimes the delusion is itself the affliction; this is the case with paranoid schizophrenics such as a friend of mine. He is able to function normally for various periods of time, but unless he takes his medications, he frequently "flips out" and may flee imagined persecution. He once held a steady job as an electronic engineer, and was doing side jobs. When he found out that some of the devices he was making were being used for illegal gambling, he became convinced that he was a target of organized criminals, and fled halfway across the country. Later checking uncovered that the supposed "mafiosi" were in no way organized, but were a couple of petty criminals. But he has not moved back, nor has he obtained long-term employment since.
The stereotypical schizophrenic is the raving, voice-ridden "nut" that one might see on a street corner. Considering that one person in a hundred is afflicted by overpowering voices, we all know at least one. However, not all who hear voices are schizophrenic. I'll offer myself for an example. In the hypomanic phase of my bipolar cycle (I seldom experience full-blown mania), I hear voices whenever I shut my eyes, but not with my eyes open. I can seldom understand the words, or at least I don't recall what they say. In quiet circumstances, particularly with subdued light (like a business meeting with PowerPoint in progress!), I tend to drift into a state of lucid dreaming, with both visual and auditory sensations. I can usually tell the difference between such hallucinations and reality…usually.
Thus, it seems Pat Tracey is saner than I, or perhaps more circumspect. Much of the book's content narrates his travels through Ireland, seeking information about his ancestors and their sanity, and the prevalence of madness among the Irish. He is drawn eventually to a well in farthest western Ireland, called Gleanna-a-Galt. Its waters are reputed to heal the mentally afflicted. He gathers some of the water to take to his sisters. He finds that the water contains a high level of lithium. That is known to help bipolar people, and can help many schizophrenics also, so the well's reputation is probably well founded.
When he returns home, he slips some of the water to each sister, but gives no report about its effectiveness. It is sad to think they got no help from it, but it is better for bipolar. Among those I know who have bipolar disorder, lithium salts are the most consistently effective treatment, though the therapeutic dose is a nearly toxic level; it has to be watched. The amount in Gleanna-a-Galt well water is much lower than the amount given medically.
The author's conclusion is that schizophrenia's cause is not wholly genetic, but rather that certain genetic types are more likely to react to stressful circumstances by "flipping" into a hallucinatory state, and they never flip back. I see the affliction in all its forms as several extreme manifestations of ordinary variations of human experience, particularly in the tendency to dream lucidly.
Some people, like my solidly stable wife, seldom remember dreaming in sleep, though sleep researchers assure us that everyone dreams for part of every night's sleep. People like myself dream frequently, often remember the dreams, and may begin dreaming before being fully asleep. Others find dreams popping up while they are fully awake. When such dreams cause trouble, they become symptoms of schizophrenia.
Although schizophrenia means "divided mind", the experience is really one of being divided from common experience, because of the distractions of the hallucination/dream. Dissociation of a personality into more than one seeming entity is a different condition entirely, though it often happens that one or more of the dissociated fragments becomes a distraction to the "main person", leading to a condition that is schizophrenic in effect, whether that is the correct DSM diagnosis or not (DSM is the acronym for the Diagnostic and Statistical Manual of Mental Disorders).
While Patrick Tracey could not find out everything he sought, nor effectively treat his sisters, he did come to terms with the disease and its history in his family. His trek to Ireland was a kind of flight, and at its end, he is at peace to return home, to help his family cope as best they can with the incurable. While I hope and pray for his sisters, as well as others I know who are so afflicted, I know that the disease seldom leaves, and is quite resistant to all treatments. Pray with me for continued medical progress, and perhaps breakthroughs!
Monday, January 16, 2006
Exposing our most devastating affliction
kw: book reviews, nonfiction, depression, bipolar, mental health
I think of it as having lost seven years. Not at the end of life. I don't know when that might be. Rather, two major periods that total seven years were spent unfeeling, in sadness beyond weeping, vascillating between paralyzing lassitude and desperate attempts to feel good, or feel anything.
I underwent psychoanalysis as a pre-teen because I was considered "withdrawn." That was before. As a youngster, I didn't feel so numb; I felt a lot, just most of it was bad, or mixed at best. Yet, there were times of great energy, when I was just the opposite. This became important later. As a young adult, and into middle age, I simply thought I was depressive.
When a third very low period arose in my 50s, I realized I was thinking about suicide quite a bit, so I talked to my doctor. He prescribed Zoloft. That made me rather sluggish, then set me off. On my next visit, I was a full-blown maniac. He suggested I was really cyclothymic, a diagnosis also called Bipolar 3. Bipolar 1 is the worst, the well-known Manic-Depression, and 2 is in between. A couple of other medicines were tried, but had very distressing side effects.
I went to a Psychiatrist. She determined Bipolar 2, with some Social Anxiety thrown in. The more common medications hadn't worked, so I saw one of her colleagues for cognitive therapy and learned to cope, to observe any trend in mood and compensate for it. However, I am now considering that further trials with medication may be in order.
A large part of my change in thinking came through reading Against Depression by Peter D. Kramer. His earlier, better-known book was Listening to Prozac. Let us hope that this new book becomes at least as well-known and -read.
Dr. Kramer's book clearly shows two things, which run parallel courses through the volume. He performs a very valuable service by demolishing the various myths of depression as somehow noble or enlightening. Many people have asked him, "What if Van Gogh (or pick your favorite agonized artist) had used Prozac?" He can clearly state, "We would have a much larger body of even better artwork."
He performs an even more valuable service by showing that depression is, as he states early in Chapter 12, "the most devastating disease known to humankind."
Have you heard or read about the view by AA leaders that Alcoholism is a progressive, terminal illness, that cannot be cured or reversed, but can be treated. That holds in spades for depression. Contrary to a number of other chronic diseases, depression is found to be one thing, a progressive decrease in resiliency of the central nervous system; a brain disease that progressively reduces the size of those portions of the brain that retain memories, enable higher thinking, and feel our most precious emotions.
Dr. Kramer dares to hope that we can eradicate depression, without eliminating ourselves. Someone may have a melancholy or introverted personality. That doesn't guarantee depression, though it is a pretty likely result. Someone properly medicated for depression can still feel sadness at sad events, without the consuming, obsessive anhedonia that many experience.
All told, about 16% of people experience major depression; and twice as many women as men. As mentioned, it is progressive and terminal. These 16% not only have a high risk of suicide, they have more heart disease, diabetes, and tendency to strokes. Their lives are measurably shortened. Using MRI, doctors now can observe the progressive destruction of brain tissue as the disease progresses.
The 18th chapter parallels depression with bipolar disorders. The chapter title is "Art," because of the common belief that depressive and bipolar artists produce more profound and creative art. Here is where the rubber hit the road for me. One writer stated, "When I am manic I write; when I am depressive, I edit." I have known for years that I get most of my creative work done in a few days each month or so, and the rest of the time, I am better doing stuff where I can sit alone and plod away at less demanding work.
However, the author made it clear that bipolar disorder is also progressive and terminal. Some of the brain areas affected are different than in depression, but there is progressive damage in either case. While brutal medications such as Lithium definitely dull the creative edge—and working artists will purposely go off Lithium when they need to make a buck—others of more recent vintage do not.
It may take another generation or longer for society to view depression in a clear light, as a disease with no nobility about it whatever, and set about making life better for one-sixth of the population (and the much greater number of those who love them). A smaller number are bipolar, but need similar levels of help. Until then, if I can get one doctor to take bipolarity as seriously as Dr. Kramer takes depression, I may be able to make life better for at least myself and those who love me best.
I think of it as having lost seven years. Not at the end of life. I don't know when that might be. Rather, two major periods that total seven years were spent unfeeling, in sadness beyond weeping, vascillating between paralyzing lassitude and desperate attempts to feel good, or feel anything.
I underwent psychoanalysis as a pre-teen because I was considered "withdrawn." That was before. As a youngster, I didn't feel so numb; I felt a lot, just most of it was bad, or mixed at best. Yet, there were times of great energy, when I was just the opposite. This became important later. As a young adult, and into middle age, I simply thought I was depressive.
When a third very low period arose in my 50s, I realized I was thinking about suicide quite a bit, so I talked to my doctor. He prescribed Zoloft. That made me rather sluggish, then set me off. On my next visit, I was a full-blown maniac. He suggested I was really cyclothymic, a diagnosis also called Bipolar 3. Bipolar 1 is the worst, the well-known Manic-Depression, and 2 is in between. A couple of other medicines were tried, but had very distressing side effects.
I went to a Psychiatrist. She determined Bipolar 2, with some Social Anxiety thrown in. The more common medications hadn't worked, so I saw one of her colleagues for cognitive therapy and learned to cope, to observe any trend in mood and compensate for it. However, I am now considering that further trials with medication may be in order.
A large part of my change in thinking came through reading Against Depression by Peter D. Kramer. His earlier, better-known book was Listening to Prozac. Let us hope that this new book becomes at least as well-known and -read.
Dr. Kramer's book clearly shows two things, which run parallel courses through the volume. He performs a very valuable service by demolishing the various myths of depression as somehow noble or enlightening. Many people have asked him, "What if Van Gogh (or pick your favorite agonized artist) had used Prozac?" He can clearly state, "We would have a much larger body of even better artwork."
He performs an even more valuable service by showing that depression is, as he states early in Chapter 12, "the most devastating disease known to humankind."
Have you heard or read about the view by AA leaders that Alcoholism is a progressive, terminal illness, that cannot be cured or reversed, but can be treated. That holds in spades for depression. Contrary to a number of other chronic diseases, depression is found to be one thing, a progressive decrease in resiliency of the central nervous system; a brain disease that progressively reduces the size of those portions of the brain that retain memories, enable higher thinking, and feel our most precious emotions.
Dr. Kramer dares to hope that we can eradicate depression, without eliminating ourselves. Someone may have a melancholy or introverted personality. That doesn't guarantee depression, though it is a pretty likely result. Someone properly medicated for depression can still feel sadness at sad events, without the consuming, obsessive anhedonia that many experience.
All told, about 16% of people experience major depression; and twice as many women as men. As mentioned, it is progressive and terminal. These 16% not only have a high risk of suicide, they have more heart disease, diabetes, and tendency to strokes. Their lives are measurably shortened. Using MRI, doctors now can observe the progressive destruction of brain tissue as the disease progresses.
The 18th chapter parallels depression with bipolar disorders. The chapter title is "Art," because of the common belief that depressive and bipolar artists produce more profound and creative art. Here is where the rubber hit the road for me. One writer stated, "When I am manic I write; when I am depressive, I edit." I have known for years that I get most of my creative work done in a few days each month or so, and the rest of the time, I am better doing stuff where I can sit alone and plod away at less demanding work.
However, the author made it clear that bipolar disorder is also progressive and terminal. Some of the brain areas affected are different than in depression, but there is progressive damage in either case. While brutal medications such as Lithium definitely dull the creative edge—and working artists will purposely go off Lithium when they need to make a buck—others of more recent vintage do not.
It may take another generation or longer for society to view depression in a clear light, as a disease with no nobility about it whatever, and set about making life better for one-sixth of the population (and the much greater number of those who love them). A smaller number are bipolar, but need similar levels of help. Until then, if I can get one doctor to take bipolarity as seriously as Dr. Kramer takes depression, I may be able to make life better for at least myself and those who love me best.
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