Amends 2

Today I responded to A regarding her apology from last week.

 

Hey A,

I appreciate your message, and it’s ok. You didn’t know any better, and neither did anyone else, really, including me–fortunately studying neuroscience helped to answer a lot of the questions my doctors couldn’t or didn’t have time to answer… Mental illness, especially chronic and recurring mental illness, is surrounded by misunderstanding on all sides. I remain hopeful though that we’ll find some permanently effective treatments in the future.

I’m not yet finished with my degree, but because of the pictures I posted and being back in LA and all I’ve been getting congratulated. 🙂 DOK and the academic review board permitted me to march at the graduation ceremony because I had completed 30 of my 32 units. I had taken two years off in 2013-2015 to recover from another severe depression, only I didn’t recover, and I essentially lied saying I was healthy again so I could come back in 2015 and finish my degree. So unsurprisingly I wasn’t able to finish my senior year without dropping a couple courses, and now I need to make up those units elsewhere. But I don’t ever have to set foot on the Wellesley campus again, so that’s good. 😉

Your Facebook timeline tells me you’re having a good time, and I’m glad to see that. I hope it reflects truth. 🙂 First year I remember was also a very difficult time for you, and we hadn’t talked much after that. For the most part I have created distance between myself and many people, including people from high school, people from Wellesley, and my parents. Some of this was to avoid negativity or people around whom I feel sad, and the rest was because I just can’t relate to certain people anymore because I’ve changed so much. I have tested my emotions by occasionally socializing with some of these people, to try to make myself adapt and be less sensitive. I have found this to not work very well and after so much testing of the waters outside my comfort zone and becoming more anxious as a result, I have learned that taking cover and accepting one’s vulnerability can in some cases be better than facing fears. I hope you can understand if I keep my distance from you. I begrudgingly respect my limitations.

Thank you for reaching out, A. It is a reminder of the fact that you have always cared. 🙂

Take care,
Nikita

 

 

Neuropharm presentation on bupropion this Friday :)

So… I have a straight-up D in my neuropharmacology class, even though I’ve been looking forward to this class for years, because I’m unable to stay focused enough to complete assignments due to depression and anxiety. (I’ve also dropped two of my three courses this semester!) But I’m pleased to say that my 10-minute presentation on a medication of my choice this Friday is one of the few assignments that I’ve started working on before the day it’s due. That’s because I already know a substantial amount about the drug from my personal experience with it, and therefore I don’t need to muster as much motivation to get started.

I’m also pleased because my telling the class that I’ve used Wellbutin (bupropion) in the past and that I’m currently on it should make the presentation a little more interesting for everyone. Hopefully I can prepare enough to the point where I can be proud of the final result.

You might be thinking, Is it really a good idea to disclose that you’re taking bupropion? Isn’t it… unprofessional? 
I used to think like that. I’ve had a therapist tell me it may be best to not let anyone know at my neuro internship that I struggle with depression, to keep business and personal life separate. A friend and former classmate who has bipolar disorder also suggested it might be best to not tell the class that I’m actually on the medication. But I feel strongly about my role in destigmatizing mental illness. Anytime there seems to be any discomfort either on my end or on another’s part regarding the knowledge of my depression, I feel the need to face the discomfort head-on instead of trying to avoid it. I think that’s exactly what destigmatization requires. As long as I am privileged in the sense that despite being mentally ill I have the confidence to be open about it, I’m going to actively use it to bring mental illness into conversations and awareness because it’s an extremely important issue facing the entire world today.

A degree does count for something.

The last time I seriously considered dropping out of college (one of many, many times over this past year) was around January 16th. I was in danger of not completing my fall semester coursework despite being given an extra five weeks. The problem was not that I lacked the knowledge necessary to accomplish the work, but that I lacked the motivation to start work and to continue working. So with my neuroscience research grant proposal due in under two weeks,  my mom and sister managed to find me a tutor who based on some initial email correspondence seemed to them not just extremely well-qualified (an MD-PhD candidate at UCLA who had worked in a neurobiology lab for some years in New York; Rhodes scholar nominee… The list goes on I was told) but also compassionate and understanding of the issue of depression (I later learned that he suffers from bipolar disorder).

With only ten days left before my grant proposal was due, we got started. Despite a productive first session, though, I tried to cancel the second meeting. I felt like I still wasn’t going to get anywhere given that I still had no motivation to work on my assignment on my own. I called up my tutor saying that I had to cancel, as I was going to drop out of college. When he asked why, I tearily explained that a college education these days is overvalued by society, not to mention that the pay-off is pathetic–it can be extremely expensive, and student debt can be staggering. I said that I could instead write a book telling my experience with depression while arguing this point that college degrees are overvalued, and thereby circumvent the potential problem of unemployment due to the lack of a college degree. And as any normal person is supposed to do in response to my sentiment, my tutor told me that I should just come to the session and that things would get better. I ended up going for the sole reason that if I hadn’t, my tiger mom would have been pissed. So even if I failed my courses, no one could say it was because I refused to comply. I told him that that was my reason for going, and he was fine with that.

We met in a Coffee Bean and first spent thirty minutes discussing my depression, the option of suicide, the fact that he had friends who had committed suicide, his belief that it’s a waste of great potential when someone commits suicide, my opinion that really one should feel good for the person who commits suicide because he/she is no longer suffering. I explained the plans for my book in some more detail, telling him that I was going to expose and critique the weaknesses of America’s mental health care, mentioning that there are tons of well-meaning quacks out there and that I don’t trust any psychotherapist who doesn’t have a PhD.
“I don’t either,” he said, locking onto that. “That PhD counts for something. You use that as a way to distinguish between qualified and unqualified people. And what about your book? People will be more interested in reading a book by a Wellesley College graduate than a high school graduate.”
“That’s a good point,” I had to admit. If I’m going to write a book, I want to be perceived as having some credibility. I knew that if I were someone picking up my book, I would take it less seriously if it were written by a drop-out. A college drop-out trying to argue that college is overrated… Where’s the surprise in that? The idea brings up the image of a bitter, unsuccessful person who instead of admitting that she should have completed her degree, wants to place the bulk of the blame on institutions. Although the image is false, its effect would be contrary to the goal of destigmatizing mental illness, which is a fundamental part of my writing the book in the first place.

I felt satisfaction, relief, and assurance. I do love it when someone is able to provide a strong rebuttal to my anxiety-provoking ideas. The idea of dropping out of college is perhaps just as terrifying to me as staying. It is a big, wide unknown. For all I know, quitting could just make depression an even stronger presence in my life. (By the way, I want to note that being able to effectively counter my arguments is something I require of and have trouble finding in a therapist. Essentially, the therapist must be intelligent and appreciating of logic and cohesion. I need to be shown why my thinking is wrong and provided with a feasible alternative. Granted, only one of the four or five therapists I’ve had in the past has a PhD; the rest were a couple MFTs, an LCSW, and an intern. However frustrating therapy has so far been, I’m glad that I have at least learned something about what to avoid in a therapist and can from here on narrow down my searches.) After those first 30 minutes, we were able to move on to the assignment and I made some good progress. We accepted that I was most productive during the sessions than on my own, so we arranged to meet for two hours a day for the rest of the week before my flight to Boston. My tutor basically acted as the prefrontal lobe of my brain, taking on the executive functions that my depression had barred my access to. Those functions included things like getting started (It was ok if I hadn’t gotten anything done since we last met, as long as I showed up for the next session; this made everything way less stressful and daunting for me), managing time, remembering what I was supposed to attend to next, and doing things step by step. Frequently I was overwhelmed thinking about how much more had to be done to complete the proposal; at these times my tutor would take me through the baby steps by having me focus on the specific questions that I needed to address and helping me come up with new ones.

At the end of the week my mom was left with a hefty bill to pay, and she’s probably still paying it off, but she’s a tiger mom as I said and it was all worth it to her. It was worth it to me, too. At least, I feel less anxious now. I finished the proposal for that course and took my final exam for the other, got passing grades for both, and am now focused on this last semester. As of now I don’t think that getting a degree in the end will have been worth the seven years of hell I have experienced since starting here in September 2009. But given that I can’t change the past, and provided that I keep living, a degree is better than no degree.

Artist-Neurophilosopher Warren Neidich

Back on January 5th or 6th of this year, I was sitting in the waiting area of an orthopedic office in Los Angeles, reading a scientific paper for one of my previous semester’s neuroscience courses (I had taken an incomplete and instead of taking my final exam in December, I was allowed to take it at the end of January) while waiting for my boyfriend to be finished with his appointment. A man came and sat near me, asked if he could read the newspaper next to me, asked me what I was reading. I briefed him on my school situation, mentioning that I struggle with depression, and showed him the paper on a schizophrenia drug trial. It turned out that he was a neurophilosopher (or artist according to Wikipedia) by the name of Warren Neidich who was working on a book titled The Psychopathologies of Cognitive Capitalism, and the chapter he was writing had something to do with neuroarchitecture and epigenesis (not epigenetics). Being someone interested in the intersection of psych, neuro, and philosophy, naturally I was interested.

A couple things were especially interesting, though. In response to hearing that I have depression, he said he had always woken up in a good mood, all his life, and so had his brother and father. His average day-to-day mood, he said, has always been about an 8/10. The other interesting thing was when he suggested that having kids might help relieve my depression. My response was that if anything, having kids might make things worse because parenting as we all know is a highly stressful job, and I also am not certain about whether I want to pass on my genes. “I wouldn’t wish this kind of suffering on anyone,” I said. I know that for depression, genes aren’t the whole story, but of course they’re an important factor.

All in all, that gave me something to think about, and it was pretty cool to meet someone from that area of academia that I was once so crazy about and still have a soft spot for now. If I had met him back in 2012, I would have been freaking OUT because I was taking Philosophy of Art at the time and was extremely excited about neuroscience (I had declared it as my major that year), and consequently thinking a lot on the subjects of neuroaesthetics, cognitive psychology, emotional cognition, etc. In 2013 I wrote a partial research proposal for a study on the effect of oxytocin (the “love hormone”) on motor cognition in dancers. I had to finish that spring semester assignment over the summer because I had sunk into depression again (and that depressive episode continues today), but I managed to get an A in the class because I cared so much about the subject. In my other courses, I got a B, a C, and a C-. I digress.

Very, very exciting breakthrough in schizophrenia research!

To cure a disease, you first have to identify its root cause, and researchers from the Broad Institute believe to have done that for schizophrenia. It appears that the culprit is the previously unsuspected C4 gene.

Watch the video above, and for more information, visit http://www.broadinstitute.org/news/7823.

The research was published yesterday, January 27, 2016, in Nature. Here’s the link to the paper, if you’re interested in the exact science behind the discovery: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature16549.html.

Also, follow the Broad Institute of MIT and Harvard on Facebook to get this kind of exciting news in your feed!
This news makes me so happy. It feels like not only a leap forward in schizophrenia research but also for neuropsychiatric research in general and the destigmatization of mental illness. I fucking love neuroscience, you guys. (I apologize for the profanity.) I fucking love it.

The authors of the January 27, 2016 Nature article, titled “Schizophrenia risk from complex variation of complement component 4“, are Steven McCarroll, director of genetics for the Stanley Center and an associate professor of genetics at Harvard Medical School; Beth Stevens, a neuroscientist and assistant professor of neurology at Boston Children’s Hospital and institute member at the Broad; Michael Carroll, a professor at Harvard Medical School and researcher at Children’s Hospital; and Aswin Sekar, an M.D./Ph.D. student at Harvard Medical School.

Optimism, Pessimism, and Depressive Realism

Yesterday my friend Tiffany sent me the link to a Reddit thread titled “Depression feels more “real” – optimism feels like a delusion”. Many people agreed with the top commenter, HELPFUL_HULK, who discussed the difference between depressive realism, optimism, and pessimism. The problem I had with his comment was that he finished by asking the original poster, “[D]o you want to be a pessimist, and simply wallow in the bleakness of depression for the sake of seeing the darkness in reality, or do you want to fight it with confidence and control?” It was as if there were then only two choices, pessimism and optimism, and that if anything, realism was being equated with pessimism. The other commenters seemed to miss this completely.

Naturally I was annoyed and this led me to Google “optimism pessimism depressive realism”. What I found was a Health Central article titled, “Are you an Optimist, Pessimist, or Depressive Realist?”, Nov. 1, 2010. When I read it, I agreed with it 100%, and I rarely agree with anything I find on the internet 100%.

… It goes on. I recommend checking it out.

I’ve always been a truth seeker. It’s what made me an agnostic and a science major interested in philosophy. I don’t care for optimism or pessimism, except where an optimistic bias can only help me and I don’t have to consciously engage in optimism, which feels just like lying to myself. You can argue that there is no true reality, that reality is subjective, but whatever the case is, I try to see “my” reality for what it is, because certainty is what breeds efficiency. In cases where things are uncertain, a realistic perspective enables one to take the best calculated risks. Life isn’t a gamble and I don’t treat it like one unless there isn’t much to lose and/or I see an opportunity to learn from failure.

Do my issues stem from cognitive dysfunction or negativity? I think not. Is depression a good thing, then? No. It sucks. I’m currently of the position that depression is a byproduct of psychological adaptations that normally work in our favor, but become out of balance due to genetic variability and environmental influence. Does anxiety counteract any optimism I might otherwise have? I think so. Hello, Prozac.

Thoughts? What do you think of the quote below? To me it sounds somewhat appealing, but at the same time my bullshit alarm is going off. Things aren’t always so dandy and black-and-white as inspirational quotes can make them out to be.

Spoke Too Soon + Finals Are Over For Now

Lol, a couple or so weeks ago I thought I was on an “upward spiral”. I had indeed spoken too soon. Sometime it’s not over ’til it’s over. Nine days ago I was back to “I want to die, I want to die, I need a bottle of pills or a gun”. What triggered this despair was the fact that I had managed to sleep through my psychology exam after having studied for it all night. Fortunately, though,  I wasn’t too far gone not to call people close to me to give them a teary status update. I called my boyfriend, then my dad, then my friend Tiffany, then my sister. It definitely helped. Through talking to them I was able to get myself from “ABANDON SHIP! I DON’T NEED A COLLEGE DEGREE TO PROVE MY WORTH! I DON’T WANT TO LIVE IN A WORLD THAT VALUES A COLLEGE EDUCATION TO THIS INSANE DEGREE! COLLEGE HAS DONE PERMANENT DAMAGE TO MY MENTAL HEALTH! BEING HERE DISAGREES WITH MY PRINCIPLES! I’LL NEVER BE HAPPY! KILL SELF!” TO “Ok, finals week. I’ll do the best I can.” I emailed professors and my dean again to give them an update as well, and yesterday I was able to get a second incomplete for my other neuroscience class. This means I can take the final for that class at the end of January rather than yesterday. So over winter break I need to write a 13-15 page single-spaced grant proposal for NEUR 300 and study for my NEUR 305 final exam.

I’m flying back home to Los Angeles today at 1pm. I have been feeling anxious and depressed and somewhat guilty tonight about something I’d rather discuss later. The good thing though is I’m very good at forgiveness (I think) and tend to readily forgive others and myself. What a saint, I know.

Had fun watching episodes IV-VI of Star Wars with friends tonight, by the way. Darth Vader didn’t look like a burn victim, just saying. And Luke, what a dumb-dumb. Other than those two things it was NICE. 🙂

I AM YOUR FATHER

Obsessed with Robert Sapolsky and this quote right now.

I was sitting in my evolutionary psychology class today, listening to a lecture on the intimate relationship between socioeconomic status and stress-related disease in modern Western societies, and how the same relationship between social status (subordinate vs. dominant, beta vs. alpha, that kind of thing) and stress has been shown in primates by Robert Sapolsky, who has studied primates for over 30 years, maybe 40 years, now. And all this talk about glucocorticoids and stress and lack of control and hierarchy was making me feel stressed. Of course, it was still an enjoyable lecture because Robert Sapolsky is awesome and has not only discovered this crazy and extremely relevant, important stuff but also has compassion to match, hence his lecture on depression at Stanford University in which he says, “Depression is, like, the worst disease you can get.” He also says that depression is just as biological and serious as diabetes, which is a fact not new to me, but thinking about the fact that it would be new to and even argued against by so many people out there makes my blood pressure rise, and has led me to obsessively edit photos of Robert Sapolsky with his quote overlaid on them. Talk about psychosocial stress. Ugh. The purpose of these photos is to spread awareness by my sharing them on social media, and whoever else wishes to can feel free to post them as well. I was thinking about posting one to Instagram, but nowadays I seem to post so much about mental health that I wonder whether I should make a separate account for that, and really build it up. The upside to keeping my personal and “mental health” accounts the same is that more people who know me personally can stay tuned to my struggle, and I’m sure that hearing from someone with depression whom you know is more impactful than hearing from someone you don’t know. But idk, idk, idk. I’m stressing too much about this. Shoot, I haven’t worked out since I ran on Friday! That was FOUR DAYS AGO. I must exercise.

Be a Smart-Ass Hero: Study the neurobiology of depression for self-esteem, self-confidence, and setting the fools straight.

I think about and analyze depression on a daily basis. There are so many ways to approach the disease and analyze its causes—different levels of analysis (biological, psychological, environmental), different categories of analysis within those levels of analysis (systems/computational, cellular/molecular, cognitive, hormonal, physiological, behavioral, social-cultural, evolutionary, developmental, familial, etc.), and depression rarely if ever is caused by any one thing. And so it is also a disease that has to be treated in a variety of ways at once. It can be a pain in the ass to think about let alone experience, but as long as I’m experiencing it in some form, I can’t help but think about it.

Studying neuroscience and thinking about my issues scientifically has given me a sense of control and acts as a buffer against hopelessness. I often feel helpless, but I am never completely without hope. Even if scientific progress is slow in any one area, it is ALWAYS progressing. We are ALWAYS getting closer to the arrival of more effective treatments. It is actually IMPOSSIBLE to move backward in science, unless, say, someone destroys the internet and all published research. Won’t happen.

Learning the biological basis of depression in particular has been my cognitive-behavioral therapy, and I highly recommend it as a means of elevating your self-esteem and empowering  yourself to resist and combat the stigma surrounding mental illness. For example, if you’re in conversation with some poor ignorant soul who is telling you that depression is a luxury, an excuse to be lazy, a privileged white people’s disease, something that is “all in your head”, or whatever, having studied depression from at least two levels of analysis (I recommend neurobiological and one other) will make it all-too-easy to come back with a powerful, effective, informative, smart-ass retort. (Alright, it doesn’t have to be a “smart-ass retort”, but basically you can set the fools straight.) I’ve gotten a lot of practice with this from conversations with my parents, but that’s another story. I’m not saying you should be disrespectful, either, but it is important that inaccurate talk regarding mental illness is put to an end wherever it is encountered, so that people with mental illness who aren’t as informed as you are don’t have to suffer from unfounded criticism. Remember that no one has the right to make you suffer for no reason, and you have the right to be a bitch about it. By being a bitch, you can be a true hero. A bitcho. Bitchero. Idk, I’m sure you can come up with a better term than mine!

Disclaimer: There are many ways to be a mental health hero, and obviously I’m very biased as a neuroscience major. But I strongly believe that everyone would benefit from learning more about the brain, especially in regards to the effort to destigmatize mental illness.

Depressive disorders are the 2nd leading cause of disability worldwide. It’s time to get serious about the search for a cure.

This is a snapshot from one of my readings for a grant proposal I’m writing as a class assignment. It’s just a glimpse of the extent to which depression research needs improvement.

According to Global Burden of Disease (GBD) studies, in 2010 depressive disorders became the 2^nd leading cause of disability worldwide. In 2000 it was 3^rd, and in 1990 it was 4^th. Depression is on the rise everywhere. Yet despite how very common depressive disorders are, depression research and awareness as well as the field of psychiatry are horrendously behind to the point of being embarrassingly pathetic. These disorders are extremely misunderstood, shrouded in stigma, and not talked about nearly enough. The vast majority of people including those who have never experienced depression, those who have, and even many (or most) mental health professionals (with good intentions) continually perpetuate misunderstanding with the ingrained idea that the brain and the mind are ultimately separate and distinct from each other—and that “will power” is what is necessary and sufficient to overcome the disease. The problem, however, is that depression is fundamentally a disease that attacks and reduces or eliminates this “will power”. Consider these facts: Depression is an organic, physical disease. Depression is deeply biological. Every thought and every feeling you and I have ever had has a physiological basis in the brain. Depression can be crippling, life-changing, and life-terminating. All of the current treatments combined, including psychotherapy, medication, electroconvulsive therapy, and transcranial magnetic stimulation, help only 85% of patients. The other 15% are screwed. Don’t even get me started on today’s antidepressants, most of which are still of the type that were discovered by chance in the 1950s.

I urge everyone who reads this to think critically about the problem of neuropsychiatric disorders and talk openly about it when the opportunity arises. If YOU are struggling or have struggled with mental illness to whatever degree, please speak up. Your voice is desperately needed and there is nothing to be ashamed about. Participate in a research study if you can (and earn some extra cash!). Human lives and quality of life literally depend on you, and you’ll be helping yourself as well. Thank you very much in advance.

– Nikita