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Suicide in the Blood

A friend sent me a fascinating article yesterday about medical advancements in which a person’s severe depression and suicide could possibly be predetermined by biomarkers in their blood.

Mood music:

The article in Nature outlines how six biomarkers in blood can conceivably identify people at risk of suicide. Indiana University psychiatrist Alexander Niculescu and six of his colleagues published their findings in Molecular Psychiatry.

They identified nine men with bipolar disorder who are part of a larger, separate study. Between testing visits, the men had gone from no suicidal thoughts to strong suicidal thoughts.

These men’s blood samples were compared to blood samples from nine men who had committed suicide. According to the article, “This enabled [the scientists] to narrow their list of candidate biomarkers from 41 to 13. After subjecting the biomarkers to more rigorous statistical tests, Niculescu’s team was left with six which they [were] reasonably confident were indicative of suicide risk.”

The researchers have a lot of work left before they can prove beyond reasonable doubt that suicidal tendencies are detectable through blood tests. Still, I’m for any medical research that might speed the process of identifying people before they’re too far along in their suffering to be helped.

I don’t think it’ll ever replace the hard work a person now goes through to achieve mental wellness. Imbalances in blood and brain chemistry are problems that must be addressed. But it’s just as important for someone to identify the environmental and historical triggers that put them at risk.

My own challenges with depression have been shaped by personal history. I went through stuff as a child and young adult that will forever color how my mind perceives and reacts to life’s everyday trials. To get to where I’m at today, I had to talk to therapists about what I was feeling and untangle the web of memories that left me prone to out-of-control OCD and long stretches of melancholy.

Changes in diet and medication were also required.

To be fair, despite vicious bouts of depression, I don’t recall ever being suicidal. Whether my blood had the warning signs is anyone’s guess. It could be that I was lucky enough to get help before my problems became suicidal material. Or it could be that suicide was never something I was at risk for. Between my depression and watching more than one friend’s life end by suicide, it is a subject I’ve become obsessive about.

Maybe a blood test could have found signs of trouble in my friends and me earlier on. I’m not sure we’d have escaped the hardships that developed, but maybe we could have gotten treated sooner. Either way, it doesn’t matter now for us. They’re gone and I’ve found ways to manage my mental health through other means.

But if it makes a difference for people in the future, then the work of these researchers is something to celebrate.

Blood Viscosity

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Years Wasted, by Things Large and Small

When writing about depression, it’s easy to go into so much depth about the myriad causes and effects that the bigger picture is lost on some people.

Mood music:

http://youtu.be/fvVFg1wLtBs

My last two posts about a sleep apnea diagnosis and the its probable effects on my depression over the years led one friend on Twitter to say this:

I think there might be confusion about cause and effect here. Also, depression is not just a mood you experience some times.

I bristled at that for a moment, because I’ve been pretty open about my long battles with depression and, to my recollection, have never suggested it was a little mood I sometimes find myself in. We went back and forth a bit more on Twitter and reached a consensus of sorts. He thanked me for clarifying, adding, “Too often I see people treating depression like a paper cut.”

It’s easy to feel that way when someone starts picking at the various causes of depression from around the edges. In the case of sleep apnea, the lack of proper sleep isn’t the primary trigger for my bouts of melancholy. For me, a variety of triggers feed the larger monster.

But over time I’ve found it important to stop and ponder every little piece of the puzzle. The sleep apnea is just one more discovery, and the treatment could be a new arrow in a quill that’s grown fatter over time.

Along the way, I believe I’m improving myself and making the depressive episodes smaller as I go. I’m getting a constant education and I try to apply those lessons to my daily life.

I’m not going to stop doing so, even if people occasionally suggest I’m letting small details get in the way of the bigger picture. I know the big picture all too well.

The depression I’ve experienced amounts to wasted years, long periods where I hid indoors, lying in front of the TV, eager to escape the real world. I missed out on a lot of quality living in those years.

Thanks to the right mix of medication, years of intense therapy and other lifestyle changes, I’m a different man today. I don’t fear things like I used to, and I’ve racked up many priceless experiences in the last half-decade as a result.

I still suffer from periods of depression, especially in winter. But my time no longer goes to waste.

If picking around the edges keeps me from sliding backwards, so be it.

Depression

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Depression Causes: Add Sleep to the List?

Yesterday’s post on my sleep apnea diagnosis got a lot of response. Two big lessons from all the feedback: Far more people have sleep apnea than I knew, and those who have since been treated recall the huge mental distress caused by inadequate sleep.

Mood music:

Said one friend: “BIll, I too have sleep apnea. It’s a vicious, horrible physical problem. You don’t even realize how badly the lack of REM and deep sleep is changing your behavior and your emotional stability. Also impacts you physiologically in many and varied ways, including poor metabolism and blood pressure.”

I’ve attributed a lot of things to my occasional bouts of depression: past battles with addictive behavior, the OCD when I let it run hot for too long, personal experiences with illness and death and lack of daylight in the winter. I never really considered the sleep angle, though I suppose I’ve known about that all along.

Getting to the bottom of my sleep patterns started as an effort to deal with snoring and was more for Erin’s sanity than mine. (She’s a light sleeper, which means my snoring really messes with her own sleep quality.) But the benefits of this experience may turn out to be much deeper.

I’ve also gotten a lot of feedback on the usefulness of CPAP machines. A couple of readers reported that it was of little help. Many more readers said the device changed their lives.

Said another friend: “The first night I slept with the CPAP machine was the best night of sleep I’d had in two decades — no exaggeration.”

I’ve been told the success or failure of this depends on how accurately the sleep doctors fit me for the mask. You can bet I’ll keep that in mind when I have it done.

I thank you all for the responses. I’ll keep you posted on how the machine works.

CPAP Masks

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Pushing It to 11 with a Better Night’s Sleep

According to the results of my sleep study, I have something called sleep apnea. I stop breathing for a few seconds or a little over a minute and then snore ferociously as the breathing kicks back in. I’m told mine is moderate to severe.

Scary, you say? Not really.

Mood music:

I know a few people with this condition, including my father. It afflicts people from all walks of life: the fat, the thin, the short, the tall, the young and the old. In my case, the root cause is a nose and sinus cavity full of bad plumbing. My snout is almost always clogged, and if I’m trying to breath through the nose everything stops until the mouth breathing takes over.

The doctor showed me a computer screen full of squiggly lines that measured brainwave activity, blood oxygen levels, REM vs. light sleep, etc. Throughout the night the study was done, the squiggly lines flattened out. Most of the time it was for 8–15 seconds. In a few cases, it lasted more than a minute. Wherever the breathing flatlined, another column of lines showed my blood oxygen levels dipping below the preferred level.

It explains a lot.

That it instigates my snoring is obvious. But I’ve always had a tendency to get sleepy in the middle of the day, and I admit to occasionally falling asleep while staring at my laptop. It also explains why I’m usually out cold within minutes of lying down and opening whatever book I’m reading. I’m never adequately rested, so my body sneaks in whatever rest it can throughout the day.

By extension, it’s almost definitely making any depression I get along the way worse than it would otherwise be. I know I had a shitty night’s sleep Saturday, and I spent much of yesterday cranky as a result.

I’ve had two surgeries in recent years to deal with the snoring. One was to correct a deviated septum (I’m convinced the procedure only made it worse). The other was to snip off the uvula. Both times they also installed pillar implants in the soft palate to prop things up. Being overweight is often cited as a root cause, and there’s surely some of that in my case. But I’ve also lost a ton of weight over time, especially since kicking flour and sugar.

The solution to all this?

I’m going to endeavor to drop another 10 or 15 pounds because that can’t hurt. But the bigger solution is that I’m getting a machine to help keep the airways open at night. The continuous positive airway pressure (CPAP) machine uses mild air pressure to keep an airway open. The devices are smaller than they used to be. Mine will be about the size of a tissue box.

I’m excited to see what a full night of uninterrupted sleep is like. Despite the breathing trouble, I’ve managed to function at a vigorous level. With better sleep, I’m hoping to push it to 11.

Frustrated CPAP Patient

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Learning to Live with Difficult Colleagues

You see it in every office: People who become enemies because they can’t reconcile their conflicting agendas. I’ve allowed myself to get sucked into it more than once in the last two decades. But I eventually found another approach.

Mood music:

http://youtu.be/56vLS_KPp9I

I used to let difficult colleagues get to me. If someone criticized my work or blocked my efforts, a spiral into long bouts of rage and depression came on, which usually gave way to illness. I clashed with one boss so badly that it drove me to the edge of a nervous breakdown. He may have been an asshole, but I lacked the tools to deal with someone like him.

Along the way, I’ve worked with other people who loathed co-workers. One such person would spend the first hour of the day detailing how this person and that person were out to destroy what our team was building. As she saw it, they were enemies, hell-bent on invading our little island and taking over with brutal efficiency. I never saw it that way, but it became increasingly difficult to keep the poison vibes from infecting me.

When your success or failure at work hinges on how well you meet the various goals bosses have set out for you, it’s easy to become that person. But over time, I’ve come to see that the people who seem to be against you aren’t usually acting out of malice. They’ve been handed their own list of goals and are just as worried about what will happen if they fail. They too have families to feed, college tuition to afford and debts to pay off. Some are also burdened with their own illnesses — physical, mental or both.

One eye-opener was in the last job, where one boss — a laid-back, friendly, kind soul — made an observation about difficult people that went something like this: “It’s all good. People with issues are always more interesting to me.” To him, dealing with difficult people was a worthy challenge, which might explain his decision to work with me. If you could work past the difficulties and turn adversaries into friends, you were onto something excellent.

With those words, I found my own approach changing. Instead of giving people with conflicting agendas the stink eye, I tried getting to know them. I sought out our common interests and used those to break the ice. Then we could get past our differences and find ways to compromise.

I’ve also worked hard to see the other person’s side of things: who their boss is, which goals they’re being judged by and where their goals can intersect with mine.

We’re all human. We all carry stress. No matter how much we love what we do, there’s still the occasional, nagging feeling that we might not succeed.

That uncertainty is a simple fact of life. Better to roll with it than drown in its depths.

Milton Holds

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Treat Red Bull Like Alcohol and Cigarettes

I’m an avid consumer of sugar-free Red Bull and have been known to down more than one can a day. I see it as one of the only vices I have left after quitting booze, flour and sugar a few years back. So when I saw online protests about the government looking to regulate the sale of such energy drinks, I balked.

Mood music:

I was originally going to write a post blasting government for trying to control us yet again. Then I read about ER visits skyrocketing and children dying. According to ABC News:

Fourteen-year-old Anais Fournier of Hagerstown died in December of 2011 after drinking two 24-ounce Monster Energy drinks. Her family is suing that company. Fournier had a heart condition — her family’s attorney, Kevin Goldberg, tells ABC-2 News one problem is that many children are too young to have ever gotten that diagnosis.  And consuming highly-caffeinated beverages is like pouring gasoline on a fire they don’t even know is there. The US Department of Health and Human Services found that in 2007, there were about 10,000 emergency room visits related to energy drinks.  By 2010 that number doubled to 20,000.

As a confessed addict, I know it’s ultimately my choice whether to consume the stuff that drives me to madness. My addictive behavior has historically centered around binge eating. I started using wine as a crutch when I decided to bring the binge eating to heel. More than a year after quitting booze, I started smoking again to keep from taking a drink. And so the vicious cycle goes.

Today I cling to my caffeine and e-cigs. Not what one would call a solution, but I consider these the lesser evils of addiction.

The government can regulate food and drink all it wants. If you’re an addict hell-bent on getting your fix, you will find a way. That belief has driven much of what I’ve written about past efforts at regulation. But I’ve come to realize the bit about energy drinks is different.

Red Bull, Monster, Rock Star and other drinks are sold out in the open in any convenience store, right next to the Gatorade and Pepsi. There’s no age restriction on making the purchase that I know of. Energy drinks come in cans with cool, sleek artwork and color schemes, which attracts kids as a red cloth would attract a raging bull. That’s how you get deaths like that of Anais Fournier.

The government would be going way overboard if it decided to ban these drinks outright. But there are simple measures I think would be fair. For example:

  • Put the energy drinks in the same refrigerated cases and sections as the alcoholic products.
  • Sell them behind the counter, just like the tobacco products.

Those moves wouldn’t cut off my access to Red Bull. But it would control access to children, and I’m fine with that.

Red Bull

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The Paul Revere Owl of Rage

A friend of mine from Revere found a drawing I did in junior high school. I had totally forgotten about it, but once I had a look yesterday, I remembered what it was about.

Mood music:

http://youtu.be/JCGvONbVCa0

I was asked to draw something that could be used for the Paul Revere School eighth-grade graduation program. I was a misfit back then, a fat, slovenly kid who sucked at sports and verbally fought with just about everyone. But I could draw, and my peers appreciated the skill. My drawings were one of the few things I’d get praise for. So, naturally, I drew a lot of pictures.

This one was modeled after the scholarly owl in the 1970s kids program New Zoo Review. I decided to inject my attitude into the creature’s face, however, and you can see it best in his angry eyes. The picture is a bit blurry, but the eyes come through clearly enough:

Bill drawing from 1984
To be fair, I was just getting into heavy metal music at the time, and that had some influence on this “owl of rage.” But 1984 was also the worst year of my life up to that point. My brother had just died, and it was the first of my two years at Paul Revere School, where I didn’t fit in the way I had at the Roosevelt School in the Point of Pines.

One thing I remember clearly: My drawings always reflected how I was feeling. And at that time, I was feeling rage.

More on this time period in “Seeds Of Rage At The Paul Revere School

The rage lasted all through high school and beyond, though it moderated and mixed with the chaotic emotions found in all teenagers.

I eventually found God, a stable family life and a career, and today I can’t relate to the look in that owl’s eyes as well as I used to.

This makes me happy.

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A Night in the Sleep Lab

I’m a chronic snorer. Hardly a week goes by where I’m not banished to the living room couch at least once for making a racket. My oldest son gleefully tells his buddies that I sound like a “busted chainsaw” at night. Erin has also observed that I sometimes stop breathing for short spurts.

It’s an old problem, and two surgeries to the nose and throat failed to fix it. A hefty weight loss didn’t help much, either.

So last week, I went for a sleep study.

Mood music:

I expected to spend the night in one of your average hospital beds in an average hospital room. Instead, I walked in to discover something not unlike the business-class hotels I frequent. A big flat-screen TV was mounted on the wall, the bed was big and comfortable and the color scheme of the room relaxing, unlike the white, sterile hospital environment I expected.

sleep study

The tech kept an eye on me all night through the camera above the TV.

The technician, John, came in and had me sit in a chair, while he spent the next hour hooking me up with a bunch of electrodes. As he worked, the two of us howled with laughter at the over-the-top drama of The Discovery Channel‘s Shark Week, which played on the TV overhead.

Sleep study 2

The wires that protruded from my head, chest and arms as I slept

Then it was time to retire. I crawled into bed gingerly, worried that I’d knock out some of the wires John had painstakingly attached. I brought the book Black Mass — a must-read about James “Whitey” Bulger’s decades-long reign of terror in Boston — and I got through three pages before I passed out. That’s not unusual. At home, I usually fall asleep after just a few pages of whatever book I’m reading.

Sleep study 3

This bed was damn comfortable.

I only remember John coming into the room once overnight, to tighten an electrode on the chest that had come loose.

He woke me up at 6 a.m. I asked him if I did anything interesting overnight. Did the busted chainsaw make an appearance? “You did snore a bit,” he said, smiling. Did I talk in my sleep, stop breathing or make any bizarre movements? Nope. In fact, he said, I failed to make the top 10 of interesting case studies.

Truth be told, that bummed me out a little bit. First, because that raises the possibility that the real sleep problems I’m having decided not to make an appearance that night. Second, because I don’t like to bore people.

Thursday I’ll get the results of the sleep study. If it proves inconclusive, I may be sent back for another sleep test.

Given the first experience, that wouldn’t bother me at all.

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Sending Our Kids to Another School

After weeks of agonizing, debating, praying and researching, Erin and I made the painful but necessary decision to move the kids from the only school they’ve ever known to someplace new.

Mood music:

In three weeks, Sean and Duncan won’t be starting school at St. Joseph’s in Haverhill. Instead, they’re going to St. Augustine’s in Andover.

We love the St. Joe’s community and always will. But the bottom line is that both boys have extra needs the school simply isn’t equipped to provide. Sean needs more of an academic challenge in the next two years, as he sets his sights on getting into a prestigious, private high school. Duncan needs an environment better equipped to meet the needs of his IEP (Individualized Education Program). St. Joe’s has struggled to do what’s needed for a child with ADHD.

We’re excited to send them to St. Augustine’s, which has many more resources to meet those needs. But getting to that decision was hard. And telling the kids was even harder.

Like many parents, we instinctively want to shield our children from trauma. Few traumas are greater to kids than being sent to another school, particularly when they’ve been in the same place since pre-school. As expected, they were upset when we told them. There were tears and protests. We were emotionally spent by day’s end.

The next morning, we took them to the new school for admissions testing and a tour. We spent more than half the morning there, and by the time we were done, the kids were smiling. They still have their anxieties about the unknown. They are not jumping for joy, and they won’t be. But by the time we left, I think they knew this was for the best and that they were going to be just fine.

They know they’ll make new friends, and we’ve made it clear that we’ll help them stay connected to their St. Joe’s friends. Doing so won’t be difficult. We’re still parishioners of the school’s parent church, All Saints. Sean is still part of the church youth group and will see many of his friends there. And both boys are still Scouts, which will ensure another level of continuity.

In the final analysis playing it safe was unacceptable to us. Kids are going to have tough experiences in their lives and need to learn to roll with it. As parents, we have to give them our time and attention and help them stay on the right path. But we also must take occasional risks, upsetting the balance in the face of opportunity, teaching them to do the same.

And so we have.

The New School

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Plot Twist!

Someone on Facebook recently suggested that when life hands us curveballs, we yell “Plot twist!” and adjust to the unexpected, often inconvenient scenarios that throw the days off course. Take it from someone whose OCD makes schedule changes seem like calamities, that’s good advice.

Mood music:

http://youtu.be/xeBKOVK8eUg

In more recent years, I’ve gotten better at quickly adjusting when things don’t go as planned, though sometimes it still throws me into a foul mood.

When I was a kid, I’d throw epic tantrums if we went to the movies and the film we wanted to see was sold out. That’s typical childhood behavior, but it followed me to adulthood. I’d rage if a traffic jam threw off the timing of when I’d get from point A to B (I still hate that, but my reaction is more muted). If plans for a night out with friends or a quiet night at home suddenly changed, I’d sink into a depressive funk.

Thinking of these things as plot twists goes far in changing that kind of attitude for the better. There’s a certain fun to yelling “Plot twist!” It injects humor into the situation and calms the other people with you who are being equally inconvenienced.

During a recent camping trip with the family in Maine, the power went out while dinner was cooking on the camper stove. It was hot as hell and we suddenly had no AC to escape to. Erin yelled “Plot twist!” and we proceeded to make the dinner preparations that didn’t require electricity. It also led me to see humor in the fact that electricity had become a requirement on camping trips. To be fair, it wasn’t tent camping. We use campers that hook into such home comforts as water and sewer access, Wi-Fi and cable TV.

Yelling “Plot twist!” doesn’t always work, however. If you’re working and a deadline is hanging over you, it’s hard to find the amusement when your Internet access goes down. If there’s a death among family or friends, nothing is going to blunt the sadness.

But if it helps you through at least some of life’s unexpected turns, that’s more than you had before.

Plot twist!