Depression Symptoms Quotes

The trouble is, depression doesn't come with handy symptoms like spots and a temperature, so you don't realize it at first. You keep saying 'I'm fine' to people when you're not fine. You think you should be fine. You keep saying to yourself: 'Why aren't I fine?

Me: “I refuse to attend Support Group.” Mom: “One of the symptoms of depression is disinterest in activities.” Me: “Please just let me watch America’s Next Top Model. It’s an activity.” Mom: “Television is a passivity.” Me: “Ugh, Mom, please.” Mom: “Hazel, you’re a teenager. You’re not a little kid anymore. You need to make friends, get out of the house, and live your life.” Me: “If you want me to be a teenager, don’t send me to Support Group. Buy me a fake ID so I can go to clubs, drink vodka, and take pot.” Mom: “You don’t take pot, for starters.” Me: “See, that’s the kind of thing I’d know if you got me a fake ID.” Mom: “You’re going to Support Group.” Me: “UGGGGGGGGGGGGG.” Mom: “Hazel, you deserve a life.

In those pamphlets that they give at mental health centers where they list the ten or so symptoms that would indicate a clinical depression, 'suicide threats' or even simple 'talk of suicide' is considered cause for concern. I guess the point is that what's just talk one day may become a real activity the next. So perhaps after years of walking around with these germinal feelings, these raw thoughts, these scattered moments of saying I wish I were dead, eventually I too, sooner or later, would succumb to the death urge. In the meantime, I could withdraw to my room, could hide and sleep as if I were dead.

You know how most illnesses have symptoms you can recognize? Like fever, upset stomach, chills, whatever. Well, with manic depression, it's sexual promiscuity, excessive spending, and substance abuse - and that just sounds like a fantastic weekend in Vegas to me!

Wanting to die (or 'suicidal ideation'as the experts would have it) goes hand in hand with the illness. It is a symptom of severe depression, not a character failing or moral flaw. Nor is it, truly, a desire to die so much as a fervent wish not to go on living. All depressives understand that distinction.

Who would not want an illness that has among its symptoms elevated and expansive mood, inflated self-esteem, abundance of energy, less need for sleep, intensified sexuality, and- most germane to our argument here-"sharpened and unusually creative thinking" and "increased productivity"?

When our grief cannot be spoken, it falls into the shadow and re-arises in us as symptoms. So many of us are depressed, anxious, and lonely. We struggle with addictions and find ourselves moving at a breathless pace, trying to keep up with the machinery of culture.

The return of the voices would end in a migraine that made my whole body throb. I could do nothing except lie in a blacked-out room waiting for the voices to get infected by the pains in my head and clear off. Knowing I was different with my OCD, anorexia and the voices that no one else seemed to hear made me feel isolated, disconnected. I took everything too seriously. I analysed things to death. I turned every word, and the intonation of every word over in my mind trying to decide exactly what it meant, whether there was a subtext or an implied criticism. I tried to recall the expressions on people’s faces, how those expressions changed, what they meant, whether what they said and the look on their faces matched and were therefore genuine or whether it was a sham, the kind word touched by irony or sarcasm, the smile that means pity. When people looked at me closely could they see the little girl in my head, being abused in those pornographic clips projected behind my eyes? That is what I would often be thinking and such thoughts ate away at the façade of self-confidence I was constantly raising and repairing. (describing dissociative identity disorder/mpd symptoms)

Ultimately, forgiveness is usually about one thing—“This is for me, not for you.” Hatred is exhausting; forgiveness, or even just indifference, is freeing. To quote Booker T. Washington, “I shall allow no man to belittle my soul by making me hate him.” Belittle and distort and consume. Forgiveness seems to be at least somewhat good for your health—victims who show spontaneous forgiveness, or who have gone through forgiveness therapy (as opposed to “anger validation therapy”) show improvements in general health, cardiovascular function, and symptoms of depression, anxiety, and PTSD. Chapter 14 explored how compassion readily, perhaps inevitably, contains elements of self-interest. The compassionate granting of forgiveness epitomizes this.41

Magnesium deficiency can produce symptoms of anxiety or depression, including muscle weakness, fatigue, eye twitches, insomnia, anorexia, apathy, apprehension, poor memory, confusion, anger, nervousness, and rapid pulse.

Rape and war, she explained are among the most common causes of post-traumatic stress disorder, and survivors of sexual assault frequently exhibit many of the same symptoms and behaviors as survivors of combat: flashbacks, insomnia, nightmares, hypervigilance, depression, isolation, suicidal thoughts, outbursts of anger, unrelenting anxiety, and an inability to shake the feeling that the world is spinning out of control.

Chronic trauma (according to the meaning I propose) that occurs early in life has profound effects on personality development and can lead to the development of dissociative identity disorder (DID), other dissociative disorders, personality disorders, psychotic thinking, and a host of symptoms such as anxiety, depression, eating disorders, and substance abuse. In my view, DID is simply an extreme version of the dissociative structure of the psyche that characterizes us all.

And all this talk, over and over, of bravery: it would be nice one day if a public figure could talk about having depression without the media using words like 'incredible courage' and 'coming out'. Sure, it is well intentioned. But you shouldn't need to confess to having, say, anxiety. You should just be able to tell people. It's an illness. Like asthma or measles or meningitis. It's not a guilty secret. The shame people feel exacerbates symptoms. Yes, absolutely, people are often brave. But the bravery is in living with it, it shouldn't be in talking about it.

Married women are far more depressed than married men -- in unhappy marriages, three times more; and -- interestingly -- in happy marriages, five times more. In truth, it is men who are thriving in marriage, now as always, and who show symptoms of psychological and physical distress outside it. Not only their emotional well-being but their very lives, some studies say, depend on being married!

No one needs to hit rock bottom to change. And yet so many people do, only because most of us are unskilled in communicating with ourselves. Stress, depression, anxiety, insomnia, headaches, illness ... these are all symptoms of a bigger problem. You're trying to tell yourself something. Loudly. Listen now or listen later. There is no ignoring the call.

Anxiety and depression, and the physical symptoms they cause, are merely distractions and smokescreens to “protect” you from dangers, which are usually, imaginary.

Lincoln's story confounds those who see depression as a collection of symptoms to be eliminated. But it resonates with those who see suffering as a potential catalyst of emotional growth. "What man actually needs," the psychiatrist Victor Frankl argued,"is not a tension-less state but rather the striving and struggling of a worthwhile goal." Many believe that psychological health comes with the relief of distress. But Frankl proposed that all people-- and particularly those under some emotional weight-- need a purpose that will both draw on their talents and transcend their lives. For Lincoln, this sense of purpose was indeed the key that unlocked the gates of a mental prison. This doesn't mean his suffering went away. In fact, as his life became richer and more satisfying, his melancholy exerted a stronger pull. He now responded to that pull by tying it to his newly defined sense of purpose. From a place of trouble, he looked for meaning. He looked at imperfection and sought redemption.

The dirty little secret of biological psychiatry is that every single drug in the psychopharmacopoeia is palliative. That is, all of them are symptom suppressors, and when you stop taking them you’re back at square one.

Inequality breeds depression, addiction, resignation, and physical symptoms including premature aging, that affect the entire population. In other words, the well-being of individuals, rich or poor, is mutually dependent.

It doesn’t occur to me that alcohol might be unhinging me, that drinking at the rate I am can induce depression, impulsive behaviour, and symptoms of bipolar and borderline personality disorder.

They sent the shrink round yesterday. He's put me on Prozac. Prozac! He thinks I'm depressed.' 'Aren't you depressed?' 'I wasn't depressed.' 'You did try to kill yourself,' I pointed out. 'Yes. That's what he said too. Apparently that's a classic symptom. It's not thought a sane plan of action for someone in my situation.

The symptoms are a messenger of a deeper problem. Let’s get to the deeper problem.

Cutting, and suicide, two very different symptoms of the same problem, are gaining on us. I personally don’t know a single person who doesn’t know at least two of these victims personally.

As it stands, the diagnostic criteria for depression are so loose that two people with absolutely no symptoms in common can both end up with the same unitary diagnosis of depression. For this reason especially, the concept of depression as a mental disorder has been charged with being little more than a socially constructed dustbin for all manner of human suffering.

It isn't depression, or anxiety, though it can sometimes appear as a symptom of these better—known conditions. Often, it emerges with cruel ferocity as a chronic disorder completely unto itself. Its destructive impact on an individual’s sense of self is implied in its very name—depersonalization.

There is no cell culture for depression. You can't see it on a bone scan or an x-ray. Not everyone with depression will show the same behavioral symptoms.

Yes: we have arrived at our common thread, the underpinning factor that lets us answer our tangled questions about causes and treatments, symptoms and overlaps. Mental disorders—all of them—are metabolic disorders of the brain.

In the last twenty-five years, the borderline patient, who confronts the psychiatrist not with well-defined symptoms but with diffuse dissatisfactions, has become increasingly common. He does not suffer from debilitating fixations or phobias or from the conversion of repressed sexual energy into nervous ailments; instead he complains "of vague, diffuse dissatisfactions with life" and feels his "amorphous existence to be futile and purposeless." He describes "subtly experienced yet pervasive feelings of emptiness and depression," "violent oscillations of self-esteem," and "a general inability to get along." He gains "a sense of heightened self-esteem only by attaching himself to strong, admired figures whose acceptance he craves and by whom he needs to feel supported." Although he carries out his daily responsibilities and even achieves distinction, happiness eludes him, and life frequently strikes him as not worth living.

The elders were very patient with my curiosity, and gently amused at my Western medical-model formulations of “disease” when I asked how they handled depression, sleep problems, drug abuse, and trauma. They kept trying to help me understand that these problems were all basically the “same thing.” The problems were all interconnected. In Western psychiatry we like to separate them, but that misses the true essence of the problem. We are chasing symptoms, not healing people.

I can't see the logic in medicating a grieving person like there was something wrong with her, and yet it happens all the time... you go to the doctor with symptoms of profound grief and they push an antidepressant at you. We need to walk through our grief, not medicate it and shove it under the carpet like it wasn't there.

[Hot flashes] are the prime cause of sleep disruption in women over age fifty, Suzanne Woodward of Wayne State University School of Medicine reports. Her studies show that hot flashes in sleep occur about once an hour. Most prompt an arousal of three minutes or longer. Independently of their hot flashes, women who have them still awaken briefly every eight minutes on average. The sleep process dramatically blunts memory for awakenings, Woodward said, and in the morning women seldom realize how poorly they slept. Instead, they often focus on the daytime consequences of poor sleep, which include fatigue, lethargy, mood swings, depression, and irritability. Many women and their doctors, Woodward said, dismiss such symptoms as "just menopause." This is a mistake, she suggested, because treatment can reduce or eliminate hot flashes, aid sleep, relieve other symptoms, and improve a woman's quality of life. Treatment also helps keep frequent awakenings from becoming a bad habit that continues after hot flashes subside.

The study demonstrated that people suffering from symptoms of depression used the Internet more. Why is that? One hypothesis is that those with depression experience negative emotions more frequently than the general population and seek relief by turning to technology to lift their mood.

Food allergy is one of the least diagnosed and most prevalent causes of symptoms, especially depression.

One of the first symptoms of depression, even before your mood drops to new lows, is sleep disturbance. Either you can’t get up or you can’t get to sleep or both.

Although relatively speaking the right hemisphere takes a more pessimistic view of the self, it is also more realistic about it.457 There is evidence that (a) those who are somewhat depressed are more realistic, including in self-evaluation; and, see above, that (b) depression is (often) a condition of relative hemisphere asymmetry, favouring the right hemisphere.458 Even schizophrenics have more insight into their condition in proportion to the degree that they have depressive symptoms.459 The evidence is that this is not because insight makes you depressed, but because being depressed gives you insight.

I can't stand THE DEPRESSED. It's like a job, it's the only thing they work hard at. Oh good my depression is very well today. Oh good today I have another mysterious symptom and I will have another one tomorrow. The DEPRESSED are full of hate and bile and when they are not having panic attacks they are writing poems. What do they want their poems to DO? Their depression is the most VITAL thing about them. Their poems are threats. ALWAYS threats. There is no sensation that is keener or more active than their pain. They give nothing back except their depression. It's just another utility. Like electricity and water and gas and democracy. They could not survive without it.

If we try to ignore the inner world, as most of us do, the unconscious will find its way into our lives through pathology: our psychosomatic symptoms, compulsions, depressions, and neuroses.

Misinformation about the Bible's answers to these issues has led to much wrong teaching about boundaries. Not only that, but many clinical psychological symptoms, such as depression, anxiety disorders, guilt problems, shame issues, panic disorders, and marital and relational struggles, find their root in conflicts with boundaries.

Physical symptoms such as muscle tension, back problems, stomach distress, constipation, diarrhea, headaches, obesity or maybe even hypertension can be caused by suppressing your emotions. Suppressed anger may also cause you to overreact to people and situations or to act inappropriately. Unexpressed anger can cause you to become irritable, irrational, and prone to emotional outbursts and episodes of depression.

Dissociation is numbness and nothingness; it is a feeling of being lost; it is floating on a cloud that threatens to suffocate; it is automatic speech and action without awareness or control; it is looking at the world and blinking to try to remove the blurry fog; it is hearing and seeing the immediate world and simultaneously feeling very far away; it is raw fear; it is unfamiliarity in familiar places; it is possession; it is being haunted everyday by unknown monsters that can be felt but not seen (at least not by others); it is looking in the mirror and not knowing who is looking back; it is fantasy and imagination; and, above all else, it is survival. Dissociation is all of these things and none of them at once.

Most emotional and physical symptoms of stress and depression are not typically caused by the circumstances themselves, but instead by how our minds perceive what is going on and how our hearts hold up under the pressure.

To be sure, depression, anxiety, and prolonged stress can cause specific physical symptoms, but these symptoms are not limitless, nor are they actually unexplained. When doctors invoke these labels for symptoms as diverse as vomiting, paralysis, and sever, unending pain, it is the concept of the somatoform disorders--hysteria dressed up in modern garb-- that allows them to do so.

When a manic-depressive personality begins to slide deeply into a depressive period, he had written, one symptom he or she may exhibit is acts of self-punishment: slapping, punching, pinching, burning one’s self w/ cigarette butts,

While I was able to rise and function almost normally during the earlier part of the day, I began to sense the onset of the symptoms at midafternoon or a little later- -gloom crowding in on me, a sense of dread and alienation and, above all, stifling anxiety.

One in two recently evicted mothers reports multiple symptoms of clinical depression, double the rate of similar mothers who were not forced from their homes. Even after years pass, evicted mothers are less happy, energetic, and optimistic than their peers. When several patients committed suicide in the days leading up to their eviction, a group of psychiatrists published a letter in Psychiatric Services, identifying eviction as a “significant precursor of suicide.” The letter emphasized that none of the patients were facing homelessness, leading the psychiatrists to attribute the suicides to eviction itself. “Eviction must be considered a traumatic rejection,” they wrote, “a denial of one’s most basic human needs, and an exquisitely shameful experience.” Suicides attributed to evictions and foreclosures doubled between 2005 and 2010, years when housing costs soared.

It was in this state that I first heard the term bipolar disorder. I was sitting in psychology 101 when the professor read the symptoms aloud from the overhead screen: depression, mania, paranoia, euphoria, euphoria, delusions of grandeur and persecution. I listened with a desperate interest. THIS IS MY FATHER, I wrote in my notes. HE'S DESCRIBING DAD.

What I am describing here is entirely realistic. It is possible to find out one’s own truth in the partial, non-neutral company of such a (therapeutic) companion. In that process one can shed one’s symptoms, free oneself of depression, regain joy in life, break out of the state of constant exhaustion, and experience a resurgence of energy, once that energy is no longer required for the repression of one’s own truth. The point is that the fatigue characteristic of such depression reasserts itself every time we repress strong emotions, play down the memories stored in the body, and refuse them the attention they clamor for. Why

Although it is important to be able to recognise and disclose symptom of physical illnesses or injury, you need to be more careful about revealing psychiatric symptoms. Unless you know that your doctor understands trauma symptoms, including dissociation, you are wise not to reveal too much. Too many medical professionals, including psychiatrists, believe that hearing voices is a sign of schizophrenia, that mood swings mean bipolar disorder which has to be medicated, and that depression requires electro-convulsive therapy if medication does not relieve it sufficiently. The “medical model” simply does not work for dissociation, and many treatments can do more harm than good... You do not have to tell someone everything just because he is she is a doctor. However, if you have a therapist, even a psychiatrist, who does understand, you need to encourage your parts to be honest with that person. Then you can get appropriate help.

Girls in virtual networks are subjected to hundreds of times more social comparison than girls had experienced for all of human evolution. They are exposed to more cruelty and bullying because social media platforms incentivize and facilitate relational aggression. Their openness and willingness to share emotions with other girls espouses them to depression and other disorders. The twisted incentive structures of social media reward the most extreme presentations of symptoms.

The German psychologist Jutta Heckhausen, now in California, studied a group of childless middle-aged women who were still hoping to have a baby. As they approached menopause, their emotional distress became more and more intense. But after menopause those who gave up their hope for pregnancy lost their depression symptoms.81 The irony is deep: hope is often at the root of depression.

When we encounter a friend who's depressed or afraid, we automatically try to take that distress away and to cheer the person up. While we may be operating with the best of intentions, this Band-Aid approach only reinforces the condition. Unless people experience their pain completely and begin to undrstand it, they will not only fail to overcome it, they'll also lose the opportunity of using it to advance their own growth. Pain can get you somewhere, and that somewhere can be a life-enhancing experience. We all tend to forget that pain can signal change. Alleviating the symptoms of pain in someone, without helping them to get at its underlying source, robs them of an important to for self-exploration. It's also a way of placating that reinforces the person'S need to cave in and succumb to another. This attitude undermines healthy character development and contributes to psychospiritual, moral, and ultimately social decay.

Of the many dreadful manifestations of the disease, both physical and psychological, a sense of self-hatred—or, put less categorically, a failure of self-esteem—is one of the most universally experienced symptoms, and I had suffered more and more from a general feeling of worthlessness as the malady had progressed.

I can't stand THE DEPRESSED. It's like a job. It's the only thing they work hard at. Oh good my depression is very well today. Oh good today I have another mysterious symptom and I will have another one tomorrow. The DEPRESSED are full of hate and bile and when they are not having panic attacks they are writing poems. What do they want their poems to DO? Their depression in the most VITAL thing about them. Their poems are threats. ALWAYS threats. There is no sensation keener or more active than their pain. They give nothing back except their depression. It's just another utility. Like electricity and water and gas and democracy. They could not survive without it.

There was another silence. I felt, above all, tired. Tiredness: if there was a constant symptom of the disease in our lives at this time, it was tiredness. At work we were unflagging; at home the smallest gesture of liveliness was beyond us. Mornings we awoke into a malign weariness that seemed only to have refreshed itself overnight.

If everyone has the capacity for some measure of depression under some circumstances, everyone also has the capacity to fight depression to some degree under some circumstances. Often, the fight takes the form of seeking out the treatments that will be most effective in the battle. It involves finding help while you are still strong enough to do so. It involves making the most of the life you have between your most severe episodes. Some horrendously symptom-ridden people are able to achieve real success in life; and some people are utterly destroyed by the mildest forms of the illness.

Depression’s defining symptom is anhedonia, the inability to feel, anticipate, or pursue pleasure. Chronic stress depletes the mesolimbic system of dopamine, generating anhedonia. The link between childhood adversity and adult depression involves both organizational effects on the developing mesolimbic system and elevated adult glucocorticoid levels, which can deplete dopamine.

My name is CRPS, or so they say But I actually go by; a few different names. I was once called causalgia, nearly 150 years ago And then I had a new name It was RSD, apparently so. I went by that name because the burn lived inside of me. Now I am called CRPS, because I have so much to say I struggle to be free. I don't have one symptom and this is where I change, I attack the home of where I live; with shooting/burning pains. Depression fills the mind of the body I belong, it starts to speak harsh to self, negativity growing strong. Then I start to annoy them; with the issues with sensitivity, You'd think the pain enough; but no, it wants to make you aware of its trembling disability. I silently make my move; but the screams are loud and clear, Because I enter your physical reality and you can't disappear. I confuse your thoughts; I contain apart of your memory, I cover your perspective, the fog makes it sometimes unbearable to see. I play with your temperature levels, I make you nervous all the time - I take away your independance and take away your pride. I stay with you by the day & I remind you by the night, I am an awful journey and you will struggle with this fight. Then there's a side to me; not many understand, I have the ability to heal and you can be my friend. Help yourself find the strength to fight me with all you have, because eventually I'll get tired of making you grow mad. It will take some time; remember I mainly live inside your brain, Curing me is hard work but I promise you, You can beat me if you feed love to my pain. Find the strength to carry on and feed the fears with light; hold on to the seat because, like I said, it's going to be a fight. But I hope to meet you, when your healthy and healed, & you will silenty say to me - I did this, I am cured is this real? That day could possibly come; closer than I want- After all I am a disease and im fighting for my spot. I won't deny from my medical angle, I am close to losing the " incurable " battle.

When clients relinquish symptoms, succeed in achieving a personal goal, or make healthier choices for themselves, subsequently many will feel anxious, guilty, or depressed. That is, when clients make progress in treatment and get better, new therapists understandably are excited. But sometimes they will also be dismayed as they watch the client sabotage her success by gaining back unwanted weight or missing the next session after an important breakthrough and deep sharing with the therapist. Thus, loyalty and allegiance to symptoms—maladaptive behaviors originally developed to manage the “bad” or painfully frustrating aspects of parents—are not maladaptive to insecurely attached children. Such loyalty preserves “object ties,” or the connection to the “good” or loving aspects of the parent. Attachment fears of being left alone, helpless, or unwanted can be activated if clients disengage from the symptoms that represent these internalized “bad” objects (for example, if the client resolves an eating disorder or terminates a problematic relationship with a controlling/jealous partner). The goal of the interpersonal process approach is to help clients modify these early maladaptive schemas or internal working models by providing them with experiential or in vivo re-learning (that is, a “corrective emotional experience”). Through this real-life experience with the therapist, clients learn that, at least sometimes, some relationships can be different and do not have to follow the same familiar but problematic lines they have come to expect.

Given that narcissists can often be quite vulnerable, again, because their self-esteem is so fragile and reliant on the judgments of other people, depression is not a surprising part of this picture. At times when they are depressed, especially for men, it is quite possible that their mood will be even more irritable than usual, or they will become more withdrawn, and seemingly more focused on themselves. The big-ticket symptoms we would like to see changed—the lack of empathy, the chronic entitlement, the grandiosity—tend to be most resistant to change, since they are linked so strongly to the core deficits of the disorder, such as an inability to regulate self-esteem.

Rape and war, she explained, are among the most common causes of post-traumatic stress disorder, and survivors of sexual assault frequently exhibit many of the same symptoms and behaviors as survivors of combat: flashbacks, insomnia, nightmares, hypervigilance, depression, isolation, suicidal thoughts, outbursts of anger, unrelenting anxiety, and an inability to shake the feeling that the world is spinning out of control.

Classifying depression as an illness serves the psychiatric community and pharmaceutical corporations well; it also soothes the frightened, guilty, indifferent, busy, sadistic, and unschooled. To understand depression as a call for life-changes is not profitable. Stagnation is not a medical term. The 17.5 million Americans diagnosed as suffering a major depression in 1997 were mostly damned. (Psychobiological examinations confuse cause and symptom.) Deficient serotonergic functioning, ventral prefrontal cerebral cortex, dis-inhibition of impulsive-aggressive behavior, blah blah blah: the medical lexicon boils emotion from human being. Go take a drug, the doctor says. Pain is a biochemical phenomenon. Erase all memory.

Things weren’t always as good as they are now. In school we learned that in the old days, the dark days, people didn’t realize how deadly a disease love was. For a long time they even viewed it as a good thing, something to be celebrated and pursued. Of course that’s one of the reasons it’s so dangerous: It affects your mind so that you cannot think clearly, or make rational decisions about your own well-being. (That’s symptom number twelve, listed in the amor deliria nervosa section of the twelfth edition of The Safety, Health, and Happiness Handbook, or The Book of Shhh, as we call it.) Instead people back then named other diseases—stress, heart disease, anxiety, depression, hypertension, insomnia, bipolar disorder—never realizing that these were, in fact, only symptoms that in the majority of cases could be traced back to the effects of amor deliria nervosa.

A friend will soothe, like a cough drop smooth, Making the symptoms of our condition not so bad. You will soothe me, like a cough drop thick, Making the pain go away while I'm still sick. There's nothing we can do to close our interval, But celebrate your flavor that makes a sore life bearable.

Failure per se is not a disease but it can trigger anxiety, depression and even suicide. If failure can strike anyone, how can we handle it? Medical science has a well-defined mechanism in place for dealing with diseases – it identifies the symptoms and then prescribes a methodology for their management. Psychologists and Psychiatrists have management practices for dealing with anxiety and depression. But do we have a method for dealing with failure?

Further studies on humans have shown that certain probiotic treatments can reduce symptoms of depression, anxiety, and the occurrence of negative thoughts (Mohajeri et al. [2018] and Valles-Colomer et al. [2019]). However, a multibillion-dollar probiotics industry hovers around the field of neuromicrobiology, and a number of researchers have pointed out the tendency to overhype findings. Gut communities are complex, and manipulating them is a challenge.

Our “increasing mental sickness” may find expression in neurotic symptoms. These symptoms are conspicuous and extremely distressing. But “let us beware,” says Dr. Fromm, “of defining mental hygiene as the prevention of symptoms. Symptoms as such are not our enemy, but our friend; where there are symptoms there is conflict, and conflict always indicates that the forces of life which strive for integration and happiness are still fighting.” The really hopeless victims of mental illness are to be found among those who appear to be most normal. “Many of them are normal because they are so well adjusted to our mode of existence, because their human voice has been silenced so early in their lives, that they do not even struggle or suffer or develop symptoms as the neurotic does.” They are normal not in what may be called the absolute sense of the word; they are normal only in relation to a profoundly abnormal society. Their perfect adjustment to that abnormal society is a measure of their mental sickness. These millions of abnormally normal people, living without fuss in a society to which, if they were fully human beings, they ought not to be adjusted, still cherish “the illusion of individuality,” but in fact they have been to a great extent deindividualized. Their conformity is developing into something like uniformity. But “uniformity and freedom are incompatible. Uniformity and mental health are incompatible too. . . . Man is not made to be an automaton, and if he becomes one, the basis for mental health is destroyed.

The Serzone is a gift from God that frees her from the immobilising depression that would otherwise surround her and seep into her body like a poisonous fog. The drug distances the depression from her, although it is never out of sight. ... The depression she battles is not the newly acquired symptom of a young woman now living in Los Angeles on her own. It was first set in the bow in Vermont, where she grew up, and fired as a companion arrow that has travelled with her ever since.

I now believe that virtually all my problems could be attributed to my brain’s being configured differently from those of the majority of humans. All the psychiatric symptoms were a result of this difference, not of any underlying disease. Of course I was depressed: I lacked friends, sex, and a social life, because I was incompatible with other people. My intensity and focus were misinterpreted as mania. And my concern with organization was labeled as obsessive-compulsive disorder.

Physiologically, everything ugly weakens and saddens man. It reminds him of decay, danger, impotence; it actually deprives him of strength ... Whenever man is depressed at all, he senses the proximity of something 'ugly.' His feeling of power, his will to power, his courage, his pride - all fall with the ugly and rise with the beautiful ... The ugly is understood as a sign and symptom of degeneration: whatever reminds us in the least of degeneration causes in us the judgement of 'ugly.' Every suggestion of exhaustion, of heaviness, of age, of weariness; every kind of lack of freedom, such as cramps, such as paralysis; and above all, the smell, the color, the form of dissolution, of decomposition - even in the ultimate attenuation into a symbol - all evoke the same reaction, the value judgement 'ugly.' A hatred is aroused ... the decline of his type. Here he hates out of the deepest instinct of the species ... it is the deepest hatred there is. It is because of this that art is deep.

Many survivors of relational and other forms of early life trauma are deeply troubled and often struggle with feelings of anger, grief, alienation, distrust, confusion, low self-esteem, loneliness, shame, and self-loathing. They seem to be prisoners of their emotions, alternating between being flooded by intense emotional and physiological distress related to the trauma or its consequences and being detached and unable to express or feel any emotion at all - alternations that are the signature posttraumatic pattern. These occur alongside or in conjunction with other common reactions and symptoms (e.g., depression, anxiety, and low self-esteem) and their secondary manifestations. Those with complex trauma histories often have diffuse identity issues and feel like outsiders, different from other people, whom they somehow can't seem to get along with, fit in with, or get close to, even when they try. Moreover, they often feel a sense of personal contamination and that no one understands or can help them. Quite frequently and unfortunately, both they and other people (including the professionals they turn to for help) do misunderstand them, devalue their strengths, or view their survival adaptations through a lens of pathology (e.g., seeing them as "demanding", "overdependent and needy", "aggressive", or as having borderline personality). Yet, despite all, many individuals with these histories display a remarkable capacity for resilience, a sense of morality and empathy for others, spirituality, and perseverance that are highly admirable under the circumstances and that create a strong capacity for survival. Three broad categories of survivorship, with much overlap between them, can be discerned: 1. Those who have successfully overcome their past and whose lives are healthy and satisfying. Often, individuals in this group have had reparative experiences within relationships that helped them to cope successfully. 2. Those whose lives are interrupted by recurring posttraumatic reactions (often in response to life events and experiences) that periodically hijack them and their functioning for various periods of time. 3. Those whose lives are impaired on an ongoing basis and who live in a condition of posttraumatic decline, even to the point of death, due to compromised medical and mental health status or as victims of suicide of community violence, including homicide.

Instead, when you have a symptom—when you feel cloudy, sad, sore, gassy, weepy, tired, or unnecessarily anxious—bring some wonder to it. Ask why and try to make the connections. Your body’s symptoms are telling you something about equilibrium. Your body is trying to tell you that it has lost balance. Stand back and appreciate the infinite complexity of your organism. Know that fear will only drive you to treat your body like a robotic machine that needs oil and gear changes. We are so much more than buttons and levers.

Because of media portrayals, clinicians may believe that dissociative identity disorder presents with dramatic, florid alternate identities with obvious state transitions (switching). These florid presentations occur in only about 5% of patients with dissociative identity disorder.(20) How ever, the vast majority of these patients have subtle presentations characterized by a mixture of dissociative and PTSD symptoms embedded with other symptoms, such as post-traumatic depression, substance abuse, somatoform symptoms, eating disorders, and self-destructive and impulsive behaviors.(2,10)

Bad habits can be ingrained in our neurons as easily as good ones. Pascual-Leone observes that “plastic changes may not necessarily represent a behavioral gain for a given subject.” In addition to being “the mechanism for development and learning,” plasticity can be “a cause of pathology.”35 It comes as no surprise that neuroplasticity has been linked to mental afflictions ranging from depression to obsessive-compulsive disorder to tinnitus. The more a sufferer concentrates on his symptoms, the deeper those symptoms are etched into his neural circuits. In the worst cases, the mind essentially trains itself to be sick.

In 1970, when Dr. Edgar Berman said women’s hormones during menstruation and menopause could have a detrimental influence on women’s decision making, feminists were outraged. He was soon served up as the quintessential example of medical male chauvinism.12 But by the 1980s, some feminists were saying that PMS was the reason a woman who deliberately killed a man should go free. In England, the PMS defense freed Christine English after she confessed to killing her boyfriend by deliberately ramming him into a utility pole with her car; and, after killing a coworker, Sandie Smith was put on probation—with one condition: she must report monthly for injections of progesterone to control symptoms of PMS.13 By the 1990s, the PMS defense paved the way for other hormonal defenses. Sheryl Lynn Massip could place her 6-month-old son under a car, run over him repeatedly, and then, uncertain he was dead, do it again, then claim postpartum depression and be given outpatient medical help.14 No feminist protested. In the 1970s, then, feminists

The first thing you need to know if you are a survivor is that parts of you have probably been trained to create a variety of symptoms and behaviours. Abusers actually train child parts to cut the body, to make other parts cut, to attempt suicide, to create flashbacks by releasing pieces of visual or auditory memories, to create body memories of pain or electroshock, and to create depression, terror, anxiety, and despair by releasing the emotional components of memories to the rest of the personality system. The front person and most of the rest of the system do not know that this is the source of these feelings and behaviours. p126

One of the obvious implications is that a person will have to face the fact that she cannot meet other people’s expectations. This signals the end of what might be called the “camel” phase of human development. I believe it was Nietschze who suggested that for the first part of life, we are camels, trudging through the desert, accepting on our backs everybody’s “shoulds” and “don’ts.” Camels only know how to spit; they don’t think for themselves or talk back. As the camel dies, a lion is born in its place. Lions discover both their roar and the art of preening. The lion may be a little shaky at first, so support and encouragement are vital. But once the camel begins to die (e.g., signaled by depression), there is no turning back. Symptoms occupy the space between the death of the camel and the birth of the lion. A therapist can be a good midwife during this liminal phase.

Instead of showing visibly distinct alternate identities, the typical DID patient presents a polysymptomatic mixture of dissociative and posttraumatic stressdisorder (PTSD) symptoms that are embedded in a matrix of ostensibly non-trauma-related symptoms (e.g., depression, panic attacks, substance abuse,somatoform symptoms, eating-disordered symptoms). The prominence of these latter, highly familiar symptoms often leads clinicians to diagnose only these comorbid conditions. When this happens, the undiagnosed DID patient may undergo a long and frequently unsuccessful treatment for these other conditions. - Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision, p5

That question became even more salient to me as I began my clinical work with troubled children. I soon found that the vast majority of my patients had lives filled with chaos, neglect and/or violence. Clearly, these children weren’t “bouncing back”—otherwise they wouldn’t have been taken to a child psychiatry clinic! They’d suffered trauma—such as being raped or witnessing murder—that would have had most psychiatrists considering the diagnosis of post-traumatic stress disorder (PTSD), had they been adults with psychiatric problems. And yet these children were being treated as though their histories of trauma were irrelevant, and they’d “coincidentally” developed symptoms, such as depression or attention problems, that often required medication.

Often, women's symptoms are brushed off as the result of depression, anxiety, or the all-purpose favorite: stress. Sometimes, they are attributed to women's normal physiological states and cycles: to menstrual cramps, menopause, or even being a new mom. Sometimes, other aspects of their identity seem to take center stage: fat women report that any ailment is blamed on their weight; trans women find that all their symptoms are attributed to hormone therapy; black women are stereotyped as addicts looking for prescription drugs, their reports of pain doubted entirely. Whatever the particular attribution, there is often the same current of distrust: the sense that women are not very accurate judges of when something is really, truly wrong in their bodies.

shocking conclusion. It suggested that there appears to be one common pathway to all mental illnesses. Caspi and Moffitt called it the p-factor, in which the p stands for general psychopathology. They argued that this factor appears to predict a person’s liability to develop a mental disorder, to have more than one disorder, to have a chronic disorder, and it can even predict the severity of symptoms. This p-factor is common to hundreds of different psychiatric symptoms and every psychiatric diagnosis. Subsequent research using different sets of people and different methods confirmed the existence of this p-factor.25 However, this research was not designed to tell us what the p-factor is. It only suggests that it exists—that there is an unidentified variable that plays a role in all mental disorders.

Then there were all the diseases one is vulnerable to in the woods — giardiasis, eastern equine encephalitis, Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, schistosomiasis, brucellosis, and shigellosis, to offer but a sampling. Eastern equine encephalitis, caused by the prick of a mosquito, attacks the brain and central nervous system. If you’re lucky you can hope to spend the rest of your life propped in a chair with a bib around your neck, but generally it will kill you. There is no known cure. No less arresting is Lyme disease, which comes from the bite of a tiny deer tick. If undetected, it can lie dormant in the human body for years before erupting in a positive fiesta of maladies. This is a disease for the person who wants to experience it all. The symptoms include, but are not limited to, headaches, fatigue, fever, chills, shortness of breath, dizziness, shooting pains in the extremities, cardiac irregularities, facial paralysis, muscle spasms, severe mental impairment, loss of control of body functions, and — hardly surprising, really — chronic depression.

Getting better is even more important. It consists of clients’ (1) feeling better; (2) continuing to feel better; (3) experiencing fewer disturbing symptoms (e.g., depressing and needlessly inhibiting themselves); (4) making their distressing seldom recur; (5) knowing how to reduce it when they partly cause it; (6) using this knowledge effectively; (7) being less likely to disturb themselves when new adversities occur in their lives; (8) accepting the challenge of making themselves minimally undisturbing, even when unusually aversive events occur.

To the contrary, they frequently desire only relief from the symptoms of their depression “so that things can be as they used to be.” They do not know that things can no longer be “the way they used to be.” But the unconscious knows. It is precisely because the unconscious in its wisdom knows that “the way things used to be” is no longer tenable or constructive that the process of growing and giving up is begun on an unconscious level and depression is experienced. As likely as not the patient will report, “I have no idea why I’m depressed” or will ascribe the depression to irrelevant factors. Since patients are not yet consciously willing or ready to recognize that the “old self” and “the way things used to be” are outdated, they are not aware that their depression is signaling that major change is required for successful and evolutionary adaptation. The

When conventional medicine fails, when we must confront pain and death, of course we are open to other prospects for hope. And, after all, some illnesses are psychogenic. Many can be at least ameliorated by a positive cast of mind. Placebos are dummy drugs, often sugar pills. Drug companies routinely compare the effectiveness of their drugs against placebos given to patients with the same disease who had no way to tell the difference between the drug and the placebo. Placebos can be astonishingly effective, especially for colds, anxiety, depression, pain, and symptoms that are plausibly generated by the mind. Conceivably, endorphins -the small brain proteins with morphine-like effects - can be elicited by belief. A placebo works only if the patient believes it’s an effective medicine. Within strict limits, hope, it seems, can be transformed into biochemistry.

The A.W.E. Method A.W.E stands for Attention, Wait, Exhale and Expand. Attention means Focusing your full and undivided attention on something you value, appreciate or find amazing. Wait means slowing down or pausing. Exhale and Expand amplifies whatever sensations you are experiencing. A.W.E. is a quick and easy intervention that can cultivate awe in the ordinary, at any time and in any place. Cultivating awe for less than a minute a day reduces symptoms of depression and anxiety, improves social connection, decreases loneliness, reduces burnout, lowers stress, increases wellbeing and reduces chronic pain. The capacity to help heal the mind and body is only one of awe's superpowers.

In 1944-1945, Dr Ancel Keys, a specialist in nutrition and the inventor of the K-ration, led a carefully controlled yearlong study of starvation at the University of Minnesota Laboratory of Physiological Hygiene. It was hoped that the results would help relief workers in rehabilitating war refugees and concentration camp victims. The study participants were thirty-two conscientious objectors eager to contribute humanely to the war effort. By the experiment's end, much of their enthusiasm had vanished. Over a six-month semi-starvation period, they were required to lose an average of twenty-five percent of their body weight." [...] p193 p193-194 "...the men exhibited physical symptoms...their movements slowed, they felt weak and cold, their skin was dry, their hair fell out, they had edema. And the psychological changes were dramatic. "[...] p194 "The men became apathetic and depressed, and frustrated with their inability to concentrate or perform tasks in their usual manner. Six of the thirty-two were eventually diagnosed with severe "character neurosis," two of them bordering on psychosis. Socially, they ceased to care much about others; they grew intensely selfish and self-absorbed. Personal grooming and hygiene deteriorated, and the men were moody and irritable with one another. The lively and cooperative group spirit that had developed in the three-month control phase of the experiment evaporated. Most participants lost interest in group activities or decisions, saying it was too much trouble to deal with the others; some men became scapegoats or targets of aggression for the rest of the group. Food - one's own food - became the only thing that mattered. When the men did talk to one another, it was almost always about eating, hunger, weight loss, foods they dreamt of eating. They grew more obsessed with the subject of food, collecting recipes, studying cookbooks, drawing up menus. As time went on, they stretched their meals out longer and longer, sometimes taking two hours to eat small dinners. Keys's research has often been cited often in recent years for this reason: The behavioral changes in the men mirror the actions of present-day dieters, especially of anorexics.

Antidepression medication is temperamental. Somewhere around fifty-nine or sixty I noticed the drug I’d been taking seemed to have stopped working. This is not unusual. The drugs interact with your body chemistry in different ways over time and often need to be tweaked. After the death of Dr. Myers, my therapist of twenty-five years, I’d been seeing a new doctor whom I’d been having great success with. Together we decided to stop the medication I’d been on for five years and see what would happen... DEATH TO MY HOMETOWN!! I nose-dived like the diving horse at the old Atlantic City steel pier into a sloshing tub of grief and tears the likes of which I’d never experienced before. Even when this happens to me, not wanting to look too needy, I can be pretty good at hiding the severity of my feelings from most of the folks around me, even my doctor. I was succeeding well with this for a while except for one strange thing: TEARS! Buckets of ’em, oceans of ’em, cold, black tears pouring down my face like tidewater rushing over Niagara during any and all hours of the day. What was this about? It was like somebody opened the floodgates and ran off with the key. There was NO stopping it. 'Bambi' tears... 'Old Yeller' tears... 'Fried Green Tomatoes' tears... rain... tears... sun... tears... I can’t find my keys... tears. Every mundane daily event, any bump in the sentimental road, became a cause to let it all hang out. It would’ve been funny except it wasn’t. Every meaningless thing became the subject of a world-shattering existential crisis filling me with an awful profound foreboding and sadness. All was lost. All... everything... the future was grim... and the only thing that would lift the burden was one-hundred-plus on two wheels or other distressing things. I would be reckless with myself. Extreme physical exertion was the order of the day and one of the few things that helped. I hit the weights harder than ever and paddleboarded the equivalent of the Atlantic, all for a few moments of respite. I would do anything to get Churchill’s black dog’s teeth out of my ass. Through much of this I wasn’t touring. I’d taken off the last year and a half of my youngest son’s high school years to stay close to family and home. It worked and we became closer than ever. But that meant my trustiest form of self-medication, touring, was not at hand. I remember one September day paddleboarding from Sea Bright to Long Branch and back in choppy Atlantic seas. I called Jon and said, “Mr. Landau, book me anywhere, please.” I then of course broke down in tears. Whaaaaaaaaaa. I’m surprised they didn’t hear me in lower Manhattan. A kindly elderly woman walking her dog along the beach on this beautiful fall day saw my distress and came up to see if there was anything she could do. Whaaaaaaaaaa. How kind. I offered her tickets to the show. I’d seen this symptom before in my father after he had a stroke. He’d often mist up. The old man was usually as cool as Robert Mitchum his whole life, so his crying was something I loved and welcomed. He’d cry when I’d arrive. He’d cry when I left. He’d cry when I mentioned our old dog. I thought, “Now it’s me.” I told my doc I could not live like this. I earned my living doing shows, giving interviews and being closely observed. And as soon as someone said “Clarence,” it was going to be all over. So, wisely, off to the psychopharmacologist he sent me. Patti and I walked in and met a vibrant, white-haired, welcoming but professional gentleman in his sixties or so. I sat down and of course, I broke into tears. I motioned to him with my hand; this is it. This is why I’m here. I can’t stop crying! He looked at me and said, “We can fix this.” Three days and a pill later the waterworks stopped, on a dime. Unbelievable. I returned to myself. I no longer needed to paddle, pump, play or challenge fate. I didn’t need to tour. I felt normal.

How are psychiatric and neurological disorders different? At the moment, the most obvious difference is the symptoms that patients experience. Neurological disorders tend to produce unusual behavior, or fragmentation of behavior into component parts, such as unusual movements of a person’s head or arms, or loss of motor control. By contrast, the major psychiatric disorders are often characterized by exaggerations of everyday behavior. We all feel despondent occasionally, but this feeling is dramatically amplified in depression. We all experience euphoria when things go well, but that feeling goes into overdrive in the manic phase of bipolar disorder. Normal fear and pleasure seeking can spiral into severe anxiety states and addiction. Even certain hallucinations and delusions from schizophrenia bear some resemblance to events that occur in our dreams.

If your boundaries have been injured, you may find that when you are in conflict with someone, you shut down without even being aware of it. This isolates us from love, and keeps us from taking in safe people. Kate had been quite controlled by her overprotective mother. She’d always been warned that she was sickly, would get hit by cars, and didn’t know how to care for herself well. So she fulfilled all those prophecies. Having no sense of strong boundaries, Kate had great difficulty taking risks and connecting with people. The only safe people were at her home. Finally, however, with a supportive church group, Kate set limits on her time with her mom, made friends in her singles’ group, and stayed connected to her new spiritual family. People who have trouble with boundaries may exhibit the following symptoms: blaming others, codependency, depression, difficulties with being alone, disorganization and lack of direction, extreme dependency, feelings of being let down, feelings of obligation, generalized anxiety, identity confusion, impulsiveness, inability to say no, isolation, masochism, overresponsibility and guilt, panic, passive-aggressive behavior, procrastination and inability to follow through, resentment, substance abuse and eating disorders, thought problems and obsessive-compulsive problems, underresponsibility, and victim mentality.

For nearly a hundred years, psychiatry has been striving to apply medical model thinking to psychiatric disorders. In this model, the symptoms besieging patients are sorted into specific disease entities and the causes then identified and removed. For doctors of internal medicine, this works. In the case of diabetes mellitus, for example, the symptoms of urinary frequency, fatigue, and confusion often lead to suspicion of the underlying cause, which is confirmed by blood sugar monitoring and then treated by insulin replacement. But psychiatric symptoms are much harder to sort into diagnoses. People with depression sometimes become paranoid. People with schizophrenia sometimes become depressed. Some people who hear voices have no other symptoms whatsoever, and others who hear voices also fall victim to terrible mood swings. Thus far, the hope that psychiatry would be able to identify homogeneous disease states, uncover the biological underpinnings, and remedy them has been largely a barren one. Kappler's symptoms, however, evolved when the hope for psychiatry's becoming a true medical specialty was bright to the point of being blinding. Over the years he would collect over a dozen diagnoses and cavalierly take a myriad of medicines, but no one would be able to bring him close to confronting the past he had disowned, to stand a chance of making peace with it and, ultimately, overcoming it. (46)

No doubt you will be delighted to hear from an adept who has undertaken the operation of his H.G.A. in accord with our traditions. The operation began auspiciously with a chromatic display of psychosomatic symptoms, and progressed rapidly to acute psychosis. The operator has alternated satisfactorily between manic hysteria and depressing melancholy stupor on approximately 40 cycles, and satisfactory progress has been maintained in social ostracism, economic collapses and mental disassociation. These statements are mentioned not in any vainglorious spirit of conceit, but rather that they may serve as comfort and inspiration to other aspirants on the Path. Now I'm off to the wilds of Mexico for a period, also in pursuit of the elusive H.G.A. before winding up in the guard finally via the booby hotels, the graveyard, or—? If the final, you can tell all the little Practicuses that I wouldn't have missed it for anything. —No one. Once called 210

In psychiatry, patients don't produce information as easily as they do in other medical settings. Most patients with physical disorders are frightened by their pain and eager to give information about it. Psychiatric patients have a very different relationship to their symptoms and don't always want to answer questions. Gertrude's patient probably found his rituals deeply embarrassing. He probably wanted the help, but he also probably wanted to tell this stranger as little as possible to get it. The paranoid patient, who has an unrealistic fixed belief that people are out to get him, may not feel, at the time, that it is of any relevance to the doctor that there is a conspiracy of aliens against him. The manic-depressive patient, whose judgment is usually quite poor during periods of illness, may take a dislike to the doctor and say that she has been behaving perfectly normally. Interviewing a psychiatric patient can be like trying to catch fish with your hands.

A book is open in front of me and this is what it has to say about the symptoms of morphine withdrawal: '... morbid anxiety, a nervous depressed condition, irritability, weakening of the memory, occasional hallucinations and a mild impairment of consciousness ...' I have not experienced any hallucinations, but I can only say that the rest of this description is dull, pedestrian and totally inadequate. 'Depressed condition' indeed! Having suffered from this appalling malady, I hereby enjoin all doctors to be more compassionate toward their patients. What overtakes the addict deprived of morphine for a mere hour or two is not a 'depressed condition': it is slow death. Air is insubstantial, gulping it down is useless ... there is not a cell in one's body that does not crave ... but crave what? This is something which defies analysis and explanation. In short, the individual ceases to exist: he is eliminated. The body which moves, agonises and suffers is a corpse. It wants nothing, can think of nothing but morphine. To die of thirst is a heavenly, blissful death compared with the craving for morphine. The feeling must be something like that of a man buried alive, clawing at the skin on his chest in the effort to catch the last tiny bubbles of air in his coffin, or of a heretic at the stake, groaning and writhing as the first tongues of flame lick at his feet. Death. A dry, slow death. That is what lurks behind that clinical, academic phrase 'a depressed condition'.

Nothing is beautiful, except man alone: all aesthetics rests upon this naïveté, which is its first truth. Let us immediately add the second: nothing is ugly except the degenerating man — and with this the realm of aesthetic judgment is circumscribed. Physiologically, everything ugly weakens and saddens man. It reminds him of decay, danger, impotence; it actually deprives him of strength. One can measure the effect of the ugly with a dynamometer. Wherever man is depressed at all, he senses the proximity of something "ugly." His feeling of power, his will to power, his courage, his pride — all fall with the ugly and rise with the beautiful. In both cases we draw an inference: the premises for it are piled up in the greatest abundance in instinct. The ugly is understood as a sign and symptom of degeneration: whatever reminds us in the least of degeneration causes in us the judgment of "ugly." Every suggestion of exhaustion, of heaviness, of age, of weariness; every kind of lack of freedom, such as cramps, such as paralysis; and above all, the smell, the color, the form of dissolution, of decomposition — even in the ultimate attenuation into a symbol — all evoke the same reaction, the value judgment, "ugly." A hatred is aroused — but whom does man hate then? There is no doubt: the decline of his type. Here he hates out of the deepest instinct of the species; in this hatred there is a shudder, caution, depth, farsightedness — it is the deepest hatred there is. It is because of this that art is deep.

Everyone has had the experience of suddenly feeling intense physiological and psychological shifts internally at trading glances with another person; such shifts can be exquisitely pleasurable or unpleasant. How one person gazes at another can alter the other’s electrical brain patterns, as registered by EEGS, and may also cause physiological changes in the body. The newborn is highly susceptible to such influences, with a direct effect on the maturation of brain structures. The effects of maternal moods on the electrical circuitry of the infant’s brain were demonstrated by a study at the University of Washington, Seattle. Positive emotions are associated with increased electrical activity in the left hemisphere. It is known that depression in adults is associated with decreased electrical activity in the circuitry of the left hemisphere. With this in mind, the Seattle study compared the EEGS of two groups of infants: one group whose mothers had symptoms of postpartum depression, the other whose mothers did not. “During playful interactions with the mothers designed to elicit positive emotion,” the researchers reported, “infants of non-depressed mothers showed greater left than right frontal brain activation.” The infants of depressed mothers “failed to show differential hemispheric activation,” meaning that the left-side brain activity one would anticipate from positive, joyful infant-mother exchanges did not occur — despite the mothers’ best efforts. Significantly, these effects were noted only in the frontal areas of the brain, where the centers for the self-regulation of emotion are located. In addition to EEG changes, infants of depressed mothers exhibit decreased activity levels, gaze aversion, less positive emotion and greater irritability. Maternal depression is associated with diminished infant attention spans. Summarizing a number of British studies, Dale F. Hay, a researcher at the University of Cambridge, suggests “that the experience of the mother’s depression in the first months of life may disrupt naturally occurring social processes that entrain and regulate the infant’s developing capacities for attention.

Telling a depressed person things like “Pull yourself out of it” is cruel and may reinforce the feelings of worthlessness, guilt, and failure already present as symptoms of the illness. Telling a manic person, “Slow down and get hold of yourself” is simply wishful thinking; that person is like a tractor trailer careening down a mountain highway with no brakes. So the first challenge facing family and friends is to change the way they look at behaviors that might be symptoms of the illness—behaviors like not wanting to get out of bed, being irritable and short-tempered, being “hyper” and reckless or overly critical and pessimistic. Our first reaction to these sorts of behaviors and attitudes is to regard them as laziness, meanness, or immaturity and to be critical of them. In a person with bipolar disorder, criticism almost always makes things worse: it reinforces the depressed patient’s feelings of worthlessness and failure, and it alienates and angers the hypomanic or manic patient. This is a hard lesson to learn. Don’t always take behaviors and statements at face value. Learn to ask yourself, “Could this be a symptom?” before you react.

There's a psychologist called Mary & Diamond who at Brooklyn in California, in the 80s studied rats. And they took rats at different ages. Newborns, some of whom they deliberately brain damaged, adult, middle-aged, elderly rats. And they exposed these rats to different levels of environmental stimulation, better food, more playmates, toys to play with and so on. They found out a couple of months later that the rats, at any age, including the brain-damaged rats, who had the better stimulation, they were smarter. But in the autopsy then they also found that in the front part of their brain they had larger nerve-cells with more connections with other nerve-cells and richer blood supply. In other words that environmental stimulation actually caused a change in the state of the brain, even in the older rats. And that's called neuroplasticity. The capacity of the brain to develop new circuits. So whether it comes to ADHD, addiction, depression or other childhood disorders or any other issue with adults as well, if we recognize them not as ingrained, genetically-determined diseases, but as problems of development, then the question becomes very different. Then the question becomes not just "how do we treat the symptoms?" (and addiction itself is a symptom, depression is a symptom), but "how do we help people develop out of these conditions?" In other words, it is not a medical question, purely, but a developmental question. And development always requires the right environment. Now, if you're a gardener you know that. If you are growing plants in your backyard and you want them to grow into healthy, functioning beings, botanical beings, you want to provide them with the right nurturing, the right nutrition, minerals, water, sunlight and so on. So the real question is how do we provide the conditions for further development for people whose development was impaired in the first place? Now we know how to do that. We are just not doing it.

When you are depressed, you may have a tendency to confuse feeling with facts. Your feelings of hopelessness and total despair are just symptoms of depressive illness, not facts. If you think you are hopeless, you will naturally feel this way. Your feelings only trace the illogical pattern of your thinking. Only an expert, who has treated hundreds of depressed individuals, would be in a position to give a meaningful prognosis for recovery. Your suicidal urge merely indicates the need for treatment. Thus, your conviction that you are "hopeless" nearly always proves you are not. Therapy, not suicide, is indicated. Although generalizations can be misleading, I let the following rule of thumb guide me: Patients who feel hopeless never actually are hopeless. The conviction of hopelessness is one of the most curious aspects of depressive illness. In fact, the degree of hopelessness experienced by seriously depressed patients who have an excellent prognosis is usually greater than in terminal malignancy patients with a poor prognosis. It is of great importance to expose the illogic that lurks behind your hopelessness as soon as possible in order to prevent an actual suicide attempt. You may feel convinced that you have an insoluble problem in your life. You may feel that you are caught in a trap from which there is no exit. This may lead to extreme frustration and even to the urge to kill yourself as the only escape.

It was a sad fact that the commonest complaint in the outpatient department was “Rasehn . . . libehn . . . hodehn,” literally, “My head . . . my heart . . . and my stomach,” with the patient’s hand touching each part as she pronounced the words. Ghosh called it the RLH syndrome. The RLH sufferers were often young women or the elderly. If pressed to be more specific, the patients might offer that their heads were spinning (rasehn yazoregnal) or burning (yakatelegnal ), or their hearts were tired (lib dekam), or they had abdominal discomfort or cramps (hod kurteth), but these symptoms were reported as an aside and grudgingly, because rasehn-libehn-hodehn should have been enough for any doctor worth his salt. It had taken Matron her first year in Addis to understand that this was how stress, anxiety, marital strife, and depression were expressed in Ethiopia—somatization was what Ghosh said the experts called this phenomenon. Psychic distress was projected onto a body part, because culturally it was the way to express that kind of suffering. Patients might see no connection between the abusive husband, or meddlesome mother-in-law, or the recent death of their infant, and their dizziness or palpitations. And they all knew just the cure for what ailed them: an injection. They might settle for mistura carminativa or else a magnesium trisilicate and belladonna mixture, or some other mixture that came to the doctor’s mind, but nothing cured like the marfey—the needle. Ghosh was dead against injections of vitamin B for the RLH syndrome, but Matron had convinced him it was better for Missing to do it than have the dissatisfied patient get an unsterilized hypodermic from a quack in the Merkato. The orange B-complex injection was cheap, and its effect was instantaneous, with patients grinning and skipping down the hill. T

When we reflect on our daily lives, we might look back at a day that was very stressful and think, “Well, that wasn’t my favorite day this week.” When you’re in the middle of one of those days, you might long for a day with less stress in it. But if you put a wider lens on your life and subtract every day that you have experienced as stressful, you won’t find yourself with an ideal life. Instead, you’ll find yourself also subtracting the experiences that have helped you grow, the challenges you are most proud of, and the relationships that define you. You may have spared yourself some discomfort, but you will also have robbed yourself of some meaning. And yet, it’s not at all uncommon to wish for a life without stress. While this is a natural desire, pursuing it comes at a heavy cost. In fact, many of the negative outcomes we associate with stress may actually be the consequence of trying to avoid it. Psychologists have found that trying to avoid stress leads to a significantly reduced sense of well-being, life satisfaction, and happiness. Avoiding stress can also be isolating. In a study of students at Doshisha University in Japan, the goal to avoid stress predicted a drop, over time, in their sense of connection and belonging. Having such a goal can even exhaust you. For example, researchers at the University of Zurich asked students about their goals, then tracked them for one month. Across two typically stressful periods—end-of-semester exams and the winter holidays—those with the strongest desire to avoid stress were the most likely to report declines in concentration, physical energy, and self-control. One particularly impressive study conducted through the U.S. Department of Veterans Affairs, in Palo Alto, California, followed more than one thousand adults for ten years. At the beginning of the study, researchers asked the participants about how they dealt with stress. Those who reported trying to avoid stress were more likely to become depressed over the following decade. They also experienced increasing conflict at work and at home, and more negative outcomes, such as being fired or getting divorced. Importantly, avoiding stress predicted the increase in depression, conflict, and negative events above and beyond any symptoms or difficulties reported at the beginning of the study. Wherever a participant started in life, the tendency to avoid stress made things worse over the next decade. Psychologists call this vicious cycle stress generation. It’s the ironic consequence of trying to avoid stress: You end up creating more sources of stress while depleting the resources that should be supporting you. As the stress piles up, you become increasingly overwhelmed and isolated, and therefore even more likely to rely on avoidant coping strategies, like trying to steer clear of stressful situations or to escape your feelings with self-destructive distractions. The more firmly committed you are to avoiding stress, the more likely you are to find yourself in this downward spiral. As psychologists Richard Ryan, Veronika Huta, and Edward Deci write in The Exploration of Happiness, “The more directly one aims to maximize pleasure and avoid pain, the more likely one is to produce instead a life bereft of depth, meaning, and community.