Editorials from Today’s Times-Picayune

Treat Us Fairly, Mr. President

Looking Back, Looking Ahead

2nd Anniversary

Two years and about 40 minutes ago (at the time of writing), Katrina had just made landfall to the east of New Orleans.

We had stayed up all night, glued to the TV, waiting to see where the eye of this monstrous storm would actually land. Would it go to the west and carry my idiot relatives who decided to stay in Morgan City out to sea, or to the east and destroy the largest city in the state?

Katrina hit New Orleans all right, but amazingly enough, it seemed that the city had dodged the bullet. There was severe wind damage, but the worst-case scenario was still a scenario, and New Orleans was still there.

Once the the dread had faded and the the knot in my stomach had loosened, relieved and weary, I was finally able to sleep, never mind that the storm had yet to hit Baton Rouge–where I was. Knowing that New Orleans–and my relatives–had survived, I slept right through the hurricane’s flight through Baton Rouge.

I don’t remember whether it was later that day or early the next that we heard the levee (at first, just one) had broken. It was like hearing that someone close to me had died. The bottom dropped out of my stomach, I started pacing around, saying, oh my god, this is it.

That day and the weeks that followed were absolutely unreal.

Here we were in a house filled with at least 20 people: refugees from New Orleans, five cats, three dogs, girlfriends, boyfriends, elderly, misbehaving children–chaos, in short–with no electricity (for several days in the Louisiana August wet heat), getting what we could from battery-powered TVs and radios, listening helplessly for news from the drowning city.

By the time the national news was airing the horrors of the aftermath, the electricity was back on at my apartment, across town from the house in which we had taken shelter. To see the condition of New Orleans, the helplessness of the state and local governments, and the asinine resistance of the federal government to send help was beyond infuriating. The response of the federal government was anemic at best, criminal at worst.

One family that stayed just one night at the overcrowded house had actually fled the city in a chicken coop truck. WTF? Nice family that had to stay because one of the parents was a nurse and had to report to work the day of the hurricane–leaving town in a chicken coop?

How could this happen in an American city? Politics. Demented, pathetic, misguided politics.

The sad fact is that all of those who came through that house were the most fortunate ones, despite the flooding, despite the emotional trauma, despite the nearly complete destruction of their city, one of the greatest cities in the world.

I know the rest of the country either doesn’t know or doesn’t care that New Orleans is still dying, but don’t mock us for being bitter about the festering wound that Katrina and the federal government left on Louisiana.

Lithium on the Brain

A recent UCLA study finds that lithium therapy actually increases grey matter in the areas needed for attention and controlling emotions.

“Although other studies have measured increases in the overall volume of the brain, Bearden said, this imaging method allowed the researchers to see exactly which brain regions were affected by lithium.”

“Unfortunately, said Bearden, there is no evidence that the increase in gray matter persists if lithium treatment is discontinued.”

This is where I found the link to this study.

And here is the main page of that site.

Aphasia?

I’m not sure if it’s because of the meds or the breakdowns, but…

I have limited or delayed comprehension of spoken language. I often have to ask people to repeat what they’ve said to me. I also sometimes have trouble constructing sentences, and must speak slowly and deliberately to compensate. I also have moderate paraphrasia, more severe when I’m tired.

I also do this: “A phenomenon called press of speech also characterizes Wernicke’s aphasics. Patients may speak very rapidly, interrupting others. It may seem as though the patient is striving for a sense of closure or a sense that he has actually communicated what he intended to say (Goodglass and Kaplan, 1983).”

I have excellent reading comprehension skill at most times; sometimes I can barely read (usually when depressed). During and for some time after my worst and most recent episode, I couldn’t read at all, which was a caused me a great deal of despair and dismay.

And all of this improves greatly when I’m in a very good mood (right before and during a hypomanic episode).

Previous to my first major depressive mode and probably before getting on meds and definitely when speaking in public or to people I don’t really know, I have always spoken very slowly and deliberately. I also spoke very, very infrequently before getting on antidepressants because I thought I sounded “stupid,” but I don’t know if this is related to the problems I have now.

Related question:
How does this affect foreign language acquisition?

I can learn to read and write new languages, but not speak them, and have limited or delayed comprehension of spoken language. I can read complicated literature in Latin, but I can’t comprehend or have delayed comprehension of Latin when it is spoken (by geeks) or when confronted with spoken famous Latin phrases (because I can’t process the sounds).

Foucault on Writing

In Foucault’s introduction to volume two of hisHistory of Sexuality

As for those for whom to work hard, to begin and begin again, to attempt and be mistaken, to go back and rework everything from top to bottom, and still find reason to hesitate from one step to the next–as to those, in short, for whom to work in the midst of uncertainty and apprehension is tantamount to failure, all I can say is that clearly we are not from the same planet.

This Began as an Update on Lamictal, Oddly Enough

It’s been a little more than a year now since I switched from lithium to Lamictal to control my mood swings. So far, so good. I am alert, productive, and think clearly on most days. Of course I still have ups and downs in response to various stressors, and until now have not really been able to read anything terribly complicated (like philosophy or serious history) or write anything at all (as you might notice from the entry dates on this blog). But much of that is because of my own stubbornness in refusing to seek treatment, in the form of not wanting to try to find a new psychiatrist even though I was on the depressed side of things.

The switch from lithium to a different mood stabilizer seems common, with lithium being the drug of first choice to quell the turmoil during a severe episode or at the very beginning of treatment for those who have only recently been diagnosed. Most patients begin a different drug regimen once the severe symptoms subside, switching to the newer alternative medications to avoid the long-term side-effects possible with lithium.

Unfortunately, to many people (probably most) the use of lithium is still controversial and stigmatized. It still conjures horrific images of crazy people in asylums and patients becoming zombies, but it is still the most effective mood stabilizer out there. The psychiatric profession, bowing to the pressure of common misconceptions and the pure ignorance of non-specialists, avoided its use once alternatives were developed. Medical research concentrated on the risks and disadvantages of taking lithium and touted the miraculous results in studies of the newer drugs.

But problems with the newer medications began to surface over time. The alternatives to lithium span from anti-seizure drugs to atypical anti-psychotics, the use of which was (and still is in some cases) a so-called “off-label” use, a practice that can present ethical issues. But in most cases, the drugs used are widely accepted alternatives, and they are effective and safe.

Lithium does have some serious side-effects, and the blood lithium levels of those who take the drug must be closely monitored. However, many of the side-effects of other medications used as mood stabilizers are just as harmful and inconvenient as those of lithium, and can also result in death in the case of overdose. And, while the effects of the long-term use of lithium can be scary, there is very little research on the effects of long-term use of alternatives because the medications have not been in use long enough to know what they might be.

Psych patients should be closely monitored regardless of the medication used, and each individual will respond differently to each medication. Some mood stabilizers make some people anxious, some drowsy, some forgetful, some even drool, along with the more serious effects like seizures or deadly rashes (seriously, Lamictal can cause both). Others may work wonders for some, but not at all for others. The therapeutic processes of mood stabilizers is less understood for other psychiatric medications than for lithium. In fact, because of lithium’s age, its effects on the brain and body are better known.

There is no debate that much more is known about lithium than its alternatives. Its use is once more the first choice in treatment of bipolar disorder, and is now often used to compliment SSRIs, especially in the treatment of drug-resistent uni-polar depression. Again, it is unfortunate that there is still a stigma attached to the drug and those who use it.

One of the comments on this blog is, “lithium is crap- every person on it is a guinea pig.” The fact of the matter is that any and all psych patients are guinea pigs, their own if they refuse treatment, and society’s no matter which medicine they take or treatment they accept.

Uh…

Ever since 2004, when I had an absolute, honest-to-god nervous breakdown (aka major ’sode), I have found it frustratingly difficult to find the words for what I want to express. The oddest thing is that, often, when I am groping to find the most appropriate word for what I am trying to express, I come up with words in the same category and with similar pronunciations. For example, “depreciation” for “deprecation.” Now while this is not exactly basic vocabulary, I have this problem with even simple nouns, but it has become so frequent that it’s hard to remember a specific instance. And the spoonerisms…oh my.

And, if there were no spell check, no one would understand me at all. I have been writing by hand, taking notes on some of the books I’m reading, and I find myself asking my husband how to spell the most common words, to the point where yesterday, he responded with, “are you kidding?”

What I am curious about is, is this a result of the breakdown, the meds, or both. I have read that the breakdowns themselves destroy brain function, especially memory, and I have even encountered some studies saying that major episodes actually shrink bits of the brain and that this can sometimes be mitigated by meds, particularly SSRIs. But as for other meds, as we all know, memory loss is often one of the most common side-effects. I have read a good bit on this type of thing, but was usually too apathetic to bookmark or otherwise note the location of the articles. And, well, my memory isn’t quite what it used to be.

So, anyway, what instigated this post was a NY Times book review on this type of problem, although it doesn’t take into account the mental illness bit.

So check it out:
UM…
Slips, Stumbles, and Verbal Blunders, and What They Mean.

P.S. I don’t sound like the blithering idiot I often am because I’m on a bit of an upswing (can you tell?), another interesting aspect of a mood disorder’s influence on language and language ability.

Comfort Foods

There can never be enough peanut butter & syrup in the world. Then there’s the Ben & Jerry’s “Half-Baked,” the pursuit of which will actually get me out of bed and into the cruel world.

My downstairs neighbor needs to go back to whatever dorm he came from. How can you believe that loud video games and/or music is ok at 3:30 in the morning? Granted, I am very often just going to bed at that time, but grow a brain, dude. And then there’s the not answering the door when we go to complain–what is that about?