to my birthday.
I am going to the beach.
silly animated gif:
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We are moved into the new home. It’s weird- a townhome I think they call it. I’ve not lived in an apartment kind of place in, oh, 25 years or more.
News items- not that new but still of note:
Capsules of Fluoxetine, the generic name for Prozac. Photograph Joe Raedle/Getty Images
“Perhaps the next time half a million people gather for a protest march on the White House green,” wrote Elizabeth Wurtzel in her bestselling book Prozac Nation, “it will not be for abortion rights or gay liberation, but because we’re all so bummed out.”
Or it might be to protest that the antidepressants so many of them had been prescribed might, after all, be dud.
Today, a major new study shows that Prozac, taken by 40 million people worldwide, does not work and nor do similar types of drugs. For a profession normally diplomatic, the words today of one of study’s authors are damning. “Given these results”, Professor Kirsch of Hull University says, “there seems little reason to prescribe antidepressant medication to any but the most severely depressed patients.”
But prescribed they have been. If Wurtzel called America the United States of Depression, statistics published last year cast the UK as the “Unhappy Kingdom”. According to mental health charity MIND, using information supplied by the NHS, 31 million batches of Prozac were prescribed in 2006 in England alone, up 6% on the year before.
Spread evenly over the UK’s 37 million people of working age, that’s nearly one prescription per adult.
And what does it cost? Antidepressant prescriptions cost the health service £3.3bn last year. One thirty-fifth of the entire NHS budget.
The class of drug called selective serotonin reuptake inhibitors (SSRIs), which includes Prozac, became available in the late 1980s. By 1994 the taking of such drugs was widespread and Wurtzel’s book marked the point at which they completed the journey from the shrink’s couch to the living room sofa where they have stayed. Since the early 90s the Mental Health Foundation says the number of prescriptions written for antidepressants has tripled.
GPs seem to recognise the problem. Responding to a recent survey by the Mental Health Foundation, 57% of GPs said that antidepressants were over-prescribed and that even though they had been recommended not to by the National Institute for Clinical Excellence, 55% of them used the drugs as their first response to mild or moderate depression.
More than three-quarters of GPs said they had prescribed an antidepressant in the last three years, despite believing that an alternative treatment might have been more appropriate, most commonly because there was a long waiting list for the alternative.
Oliver James, who has worked as a clinical psychologist both on and off television screens for over 30 years, doesn’t think such ready Prozac prescription will fall in the future.
He argues that diminished government funding for mental health services may explain the rise in prescriptions. “There is nothing else [GPs] can do. There just isn’t any alternative in too many parts of the country. The government try to use cognitive behaviour therapy. This just isn’t enough.”
It’s hard to tell how a Wurtzel of 14 years ago or even a Britney Spears of today would respond to being told to go for a bracing walk, but GPs are now being encouraged to prescribe “ecotherapy” instead of drugs. On this there seems to be progress.
The Mental Health Foundation claims that 22% of GPs now prescribe exercise therapy as one of their most common treatments for depression compared with only 5% three years ago.
Marjorie Wallace, chief executive of the mental health charity SANE, wants to see more evidence before discarding SSRIs, drugs that she says were once the “great hope for the future” allowing people release from the “crippling effect of the old tricyclic antidepressants which could be fatal”. If the research is validated in future Wallace fears psychological therapies will become the new prescription of choice, even though they do not work for everyone.
“These findings could remove what has been seen as a vital choice for thousands in treating what can be a life threatening condition.”
For now, Wallace pleads for sufferers to carrying on taking their medication.
Todays animated gif:
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I would have to say that the last couple weeks have not been the best I’ve had. They have probably been the most unpleasant by far for quite a while. It’s not all bad, even so. It’s just that much of the time lately I am confronted with visceral, ugly feelings in myself. I want to push them away but also know they are here to reach me something(s).
One thing about pain, especially the animal level of pain, even emotional, it presents a kind of clarity that cuts through other things that would otherwise seem important. It doesn’t necessarily provide a clear view- it can obscure the the things that you most need to understand. I see the image of Manjushri- the Buddha depicted with a sword, who cuts away delusion. The problem is that if you cling to the delusion, you feel like you are dying.
I cling and let go alternately, back and forth, sometimes see some balance as it swings by.
I am finding challenges in both my personal life and my work that seem to work together to make me feel confused. So, what is there to do with hard feelings? With gut level pain? With uncertainty?
Here is my image that I am cultivating. Instead of pushing away the thing that hurts or causes stress, I try to touch it- feel it in my body and heart, and hold it up to the light. By holding it up to the light I mean that I try to see it’s origins, purpose, meaning. Much of the time I find that it has at it’s roots a kind of lie- or at least a clinging to that which is untrue. It may represent the dying of an act of grasping that has no basis in reality. At the same time, I try to see it with some tenderness- grasping and clinging to things is human and a basis for our grief. Knowing this doesn’t make it less painful. Tenderness may even make it more painful- if I’m really open to the experience.
Then, after holding it tenderly in the light, I try to put it down gently. And let go.
It’s a process that happens many times through my day. It is like the directions on the shampoo bottle- Rinse, repeat. It often provides a few moments of near-joy (I haven’t mastered it enough to get that last part very well but I am inching toward it).
I’m working on a new song. I haven’t written a song in years. I don’t know much about it yet but I feel it coming.
Today my work was satisfying mostly but ended on an overwhelmed note. Then I went to an Interactive Theater workshop (From the Inside Out/ Theater for all). I went because I knew I’d benefit from being around people. Part of me was reluctant- like it was maybe some bad tasting medicine. Like I’m a social misfit and I need to get out and be around people as some kind of treatment. Two odd things happened (or three).
First I got a call from the workshop organizer asking me to pick up someone who couldn’t get to the workshop by herself. The address where she lives is far on the other side of being on my way. I was told that I could say no; I was told that if I didn’t pick her up she would miss the workshop and it was important to her. I agreed. It meant that I had to leave an hour earlier than I would have otherwise. It meant that I would not see my wife when she got home. I went.
About halfway there I got another call saying that I didn’t have to pick her up after all. That someone who lived closer to her could do it. I was already well on my way and I went ahead- driving to the address I was given. When I got there it was familiar. Then I realized that the person I was picking up was someone who I had met and worked with years ago. Someone I had helped. I felt a very positive sense of synchronicity/ congruence talking with her on the way.
At the workshop I ran into another person who I had met at previous events. It’s someone who every time I see him I find out more stuff that we have in common. His name is Tom Widdick and he is sort of famous in the mental health consumer movement as one of the founders of possibly the first modern psychiatric rights group- the Insane Liberation Front, back in 1969 or so. I just met him a few months back but I have since found that we went to the same high school (one that no longer exists), used to sell the same underground newspaper, both have diabetes, both have mental problems, know a bunch of the same people. Tonight I learned that he attends the Bridge City Friends Meeting- a sister community to the Multnomah Monthly Meeting of which I am a member. Wild. “Am I going to the family retreat this month?” he asked. “I’m not sure we can afford to go,” I said.
Oh, yes, this Friday night is MLBM- Mad Liberation by Moonlight. 1 a.m. on KBOO 90.7 or streamed at KBOO.org
All that aside- my latest favorite Rumi poem (I’ve left out the last lines because I am too tired to type it all):
No Room for Form
On the night when you cross the street
from your shop and your house
to the cemetery,
you’ll hear me hailing you from inside
the open grave, and you’ll realize
how we’ve always been together.
I am the clear consciousness-core
of your being, the same in
ecstasy as in self-hating fatigue.
That night, when you escape the fear of snakebite
and all irritation with ants, you’ll hear
my familiar voice, see the candle being lit,
smell the incense, the suprise meal fixed
by the lover inside all your other lovers.
This heart tumult is my signal
to you igniting in the tomb.
So don’t fuss about the shroud
and the graveyard road dust.
Those get ripped open and washed away
in the music of our final meeting.
And don’t look for me in a human shape. I am inside your looking. No room
for form with love this strong.
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I had a scary experience today-
I’m a type one diabetic and take two different insulins to live. One of them is a slow-release, 24 hour shot (Lantus, 48 units in the morning), that provides a background level of insulin that helps keep things level from the sugar that my liver naturally adds to my blood throughout the day. The other is a fast acting insulin that helps me deal with food intake (Humalog). In using the Humalog I may over the course of the day approximate the same amount as the Lantus but it depends on my food intake and other factors. Since I generally don’t eat a lot of breakfast, my morning Humalog is in the neighborhood of 6-8 units.
Today I got them mixed up. I was distracted. Partly it was because I was reading a poem I really like to my wife- a devotional poem by the Persian mystic, Rumi. Partly I was distracted because I’ve been under a lot of stress (don’t want to go into that now- very complicated). Basically, I took an accidental overdose of the Humalog. I wasn’t really sure what I had done, still distracted, but noticed that the vials were not in the “order/ position” where they should be when I have just taken Lantus. I couldn’t be sure if I had taken the wrong insulin or if I had just messed up my usual practice of how I kept the vials(my strategy for avoiding this kind of mix-up). I felt fine- my blood sugar level had been moderately high this morning- 220 just before I took the insulin. I took a shower, my wife left for work. I figured I would know soon enough if I had made a mistake.
While in the shower I was thinking of this passage from the Teachings of Don Juan. Not that I have that great a memory (hadn’t read those books for almost 40 years) but I remembered the gist of a certain passage. I really don’t recall the exact words but the point was that death is your constant companion; “Always standing to your left, an arms length away. Usually you don’t notice him until he taps you on the shoulder.”
What I remembered was the description of how this companion could be an ally in times of confusion or indecision. The advice went something like this: “When you find yourself in doubt about how to behave/ decide in a certain situation, look to your left and ask your companion. Sometimes you will hear what he has to say and can learn something about how to respond. If instead you find that your companion turns and looks your way, you will know in a moment the triviality of your problem.”
Thinking along this line I was going about my business of the morning. Very suddenly I became disoriented, sweaty, weak- I knew what had happened and I knew I was in some serious trouble. I grabbed a liter of Sprite that I keep in the fridge for blood-sugar emergencies. I started slamming in while simultaneously dialing 911 and trying to take a blood sugar reading. I was becoming so dizzy I wasn’t sure I would be conscious for long. I got through to 911 immediately, they were very helpful, very fast and said that an ambulance would arrive soon because one was in my neighborhood. I managed to wake my son so that he could let in the EMTs when they arrived if I was incapacitated. Before I was done waking him, they were at the door. By this time I was barely conscious. and had consumed most of the Sprite.
Next thing I knew I was in the hospital with an IV getting pumped full of sugar. I was beginning to feel okay, my blood sugar readings were climbing at an acceptable rate. They kept me there for as long as it took to know that the Humalog had been depleted from my body- several boring hours. My wife Julie left work and came to keep me company. This had never happened before but we figured out a strategy to make it even more unlikely in the future. I missed work for the day, my boss/ co-worker had to cancel my appointments.
Most of the experience was boring but there was that brief moment when my “companion” turned toward me and made everything I’ve been worried about seem very trivial.
Here’s the rest. The poem I was reading to Julie when I mixed up my insulin vials:
Rumi: The Seed Market
Can you find another market like this?
Where,
With your one rose
You can buy hundreds of rose gardens?
Where,
For one seed
You get a whole wilderness?
For one weak breath,
The divine wind?
You’ve been fearful
Of being absorbed in the ground,
Or drawn up into the air.
Now, your waterbead lets go
And drops into the ocean,
Where it came from.
It no longer has the form it had,
But it is still water.
The essence is the same.
This giving up is not repenting.
It’s a deep honoring of yourself.
When the ocean comes to you as a lover,
Marry at once, quickly,
For God’s sake!
Don’t postpone it!
Existence has no better gift.
A perfect falcon, for no reason,
Has landed on your shoulder,
And become yours.
and I may as well throw in a stupid animated gif:
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Here is a page with a nice collection of space pictures:
http://heritage.stsci.edu/gallery/gallery_category.html
Some interesting medical animation:
An animation I made back when W was running for president:
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I’m still recovering from staying up past my bedtime. I thought I would upload this animation I did several years ago. We’ll see if the blog editor knows how to animate it.
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