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Archive for the ‘depression’ Category

In a recent article  “Dosing Down” published in O Magazine, writer Robin Rinaldi states, “. . . nearly 23 percent of American women between the ages of 40 and 59 take antidepressants.” That’s a helluva lot of women. According to psychologist Dr. Bob Murray, “recent research has shown that men are actually just as likely to be depressed [as women], if not more so.” That’s a helluva lot of men. What’s going on here?  Why so much distress?

The answer is complex. This blog is not the forum to unravel all those threads. But what is important to note is that a good percentage of these folks, I’m sure, have depression due to unresolved infant trauma. It’s just not a subject that we talk much about. But there are those rare moments.

After dinner one evening, my friend’s husband and I were chatting. He asked me about my blog, so I told him about my infant surgery for pyloric stenosis, likely without anesthetic, and the years I spent depressed in my early twenties as a result. As I talked, he was leaning more and more forward and his facial expression was changing from interested to shocked. Next thing I knew, he was telling me about his inexplicable bouts of deep depression and the details of the surgery he had as an infant. It was astonishing. Fireworks were going off inside him, and I had the privilege of watching his sky light up with insight after insight.

One of my theories is that the rage a baby feels from an early medical assault is sublimated and unable to boil to the surface, and it doesn’t go away. The life-threatening situation takes precedence and, as Dr. Peter Levine puts it in his book Waking the Tiger, we go into freeze mode since babies can’t defend themselves or run away. We cut ourselves off from our bodies and emotions in order to attend to the emergency but then don’t circle back to shake off the somatic shock and recover our connection to ourselves. Post-traumatic stress can result, which reminds me of another story.

I was teaching a unit in medical humanities at a community college when a student had the insight that the nightly crying of her infant might be due to the 6 attempted, and the one successful, spinal taps he had recently endured. When I asked her if he had gotten adequate pain control, she stated that she did not know. She had assumed  her baby was given an anesthetic. Don’t we all?  My mother certainly had.

The groundbreaking research revealing that newborns do feel pain (see my previous blog post) did not appear until 1987. There’s a whole lot of people out there who as infants were subjected to invasive medical procedures and/or surgeries without anesthesia and/or adequate pain control. (And it’s still going on!) Could this be one factor in the epidemic of depression that we see today?  Absolutely.

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I painted this self-portrait when I was 25 years old and very depressed, can you tell? I was so down, lost, and  unaware one drizzly, chilly east bay morning that I left a pillow over the heating duct in the floor after I turned on the heat, which started a fire in my apartment. I crawled under the cloud of living room smoke to the safety of the porch while the fire engine arrived.

Some of the quotes below, taken from the article “The Long Life of Early Pain” published in On the BrainThe Harvard Mahoney Neuroscience Institute Letter Winter 2011, Vol. 17, No. 1 explain why, as a survivor of infant surgery,  I was in such pain.

Scan 2

It was a centuries-old notion that had profound ramifications for medicine: Infants, especially those born prematurely, felt little or no pain. As recently as the late 1970s, physicians in the United States and other countries used pain-killing medications on infants only sparingly; the common practice was to provide infants with a sucrose solution to quiet and soothe. . . . Few researchers had challenged the premise that infants did not respond physiologically–or neurologically–to surgical incursions (1).

A pivotal study in 1987 by Paul Hickey, MD, . . . and Kanwaljeet Anand, MD, PhD . . . showed not only that babies exhibited stress responses to invasive procedures, but that these troubling, even dangerous, responses were reduced when anesthesia was used (1).

Medical professionals began noting an array of psychological and psychosomatic troubles linked with the experience of pain or impending pain in adolescents and adults who, as infants, had undergone surgery without anesthesia (2). 

According to Frederick J. Stoddard Jr., MD, . . . early-life traumatic stress and untreated pain may seriously affect a child’s development, contributing to lifelong emotional disorders, including anxiety and depression, learning disabilities, and other problems in growth and development (3).

Although studies have documented post-traumatic stress disorder (PTSD) in survivors of child abuse, few have looked for a connection between the disorder and early-life surgical pain. PTSD, a severe anxiety disorder that can develop after exposure to a psychologically traumatizing event, often overwhelms an individual’s ability to cope (3).

Need I say more?

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Lots of good changes coming to myincision!  By January 2013, this blog will be part of my website ReStory Your Life. This website will not only house my blog but will announce my speaking engagements, workshops, and publications and showcase my poetry, prose and artwork.

I am excited to announce my first presentation of 2013, which will take place Saturday, January 5th at the Fair Oaks Library, 11601 Fair Oaks Blvd, Fair Oaks, California 95628 from 1 – 3 pm. Griffin Toffler of the Women’s Motivational Meetup Group is hosting me. Everyone is welcome, and I would LOVE to see YOU at this event. Please email me to RSVP at wendy@wendypwilliams.net.

Here are the details from Griffin’s meetup post:

ReStory Your Life ! 

What personal story holds you back?
What belief falsely shapes who you are?
What is the real story, the one that tells of your inherent worth?
Rewrite your Life Story the way YOU want it to be!.

In this interactive lecture, Wendy will tell how she reshaped her own story of despair into one of empowerment and freedom. Then it’s your turn to ReStory Your Life as she guides you through a brief writing exercise. Materials provided.

It is my privilege to introduce you to Wendy Williams, a writer, speaker and blogger whose blog, https://myincision.wordpress.com/enlightens the world about finding freedom after trauma. She has an MFA in Creative Writing and has published numerous short stories and poems. For over 30 years she has been speaking and leading workshops about Writing as a Healing Art. This is an amazing opportunity to converse up close with a phenomenal and talented woman. It’s all free! (but donations are accepted to help pay meetup costs)

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Here is a portrait of me that I drew May 15, 1976. I had left Synanon, a rehabilitation community, six months earlier and was living in East Oakland, California  with a small group of artists and students. In drawing this image with a magic marker, I was not aware of any issue regarding the trauma of my infant surgery. I was drawing because I felt depressed and hoped for relief and clarity.

What’s clear though is my inner knowledge of my pyloric stenosis surgery. The left side of my face is basically intact. The right side, however, is completely absent of facial features! Depicted instead is a series of sharp edges. The obvious one in the center is a meat cleaver and resembles exactly, hole in the blade and all, a knife that I used to juggle in my early teens.

My mother went back to work when I was eleven years old, and so often after school I was alone in the house. At that time, I engaged in some risky behaviors. I would take out the meat cleaver and a huge steak knife and juggle them. I wasn’t very good at it and once, believe it or not, I actually stuck my knee out to break the fall of the cleaver so I wouldn’t scar my mother’s kitchen linoleum. My body wasn’t real to me, in many ways; my feelings had hardened toward it and so, it was like an object.

The black mark below the cleaver on my face looks somewhat like a disposable razor and the shape above reminds me of a barber’s straight razor. In any case, all the images have sharp edges and are black. Something was excised. Something was missing. Something was troubling me of which I was unaware. This portrait is an example of the power of visual art: We know things that we don’t know that we know.

Interestingly, I titled the piece “Appreciation.” At the time, I was trying to validate myself. When this image arrived on the page, I felt mixed feelings. While I liked the depiction of the left side of my face in which I am focused, insightful, and authentic–not smiling, trying to please–the right side bothered me.  I eventually attributed the black spaces and absence of facial features to mean that I was still unaware of myself in many ways. I felt a bit of compassion for myself. Though I did not understand what my subconscious was getting at. I did not see the sharp edges in the portrait when I was 23.

Now I see the blades clearly and the message they were trying to convey: Your infant surgery–go back to what was cut away. Explore it and integrate what you find. It’s essential to becoming a whole portrait and leaving depression behind. Fill in those excised spaces with your story. Not the story that was told to you, the one that you adopted–your parents’ words, your pediatrician’s words–but your version, your truth. Then, you’ll be able to face yourself.  

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An article by Dr. Bruce D. Perry et al is a must-read for all those trying to understand the impact of infant trauma on a person’s life:  “Childhood Trauma, The Neurobiology of Adaptation, and ‘Use-dependent’ Development of the Brain: How ‘States’ Become ‘Traits.'” I became interested in this article because I believe that there are aspects of my character that, rather than simply being my personality, are actually qualities shaped by early trauma. These so-called “traits” are behaviors, somatic patterns, and thought ruts that no longer serve me. In fact, while they may have saved me long ago, they disempower me now.

The article is somewhat complex, so I’ve selected some quotes to help you see what Perry et al are getting at.

“Traumatic experiences in childhood increase the risk of developing a variety of neuropsychiatric symptoms in adolescence and adulthood ” (273).

“Ultimately, it is the human brain that processes and internalizes traumatic . . . experiences. It is the brain that mediates all emotional, cognitive, behavioral, social, and physiological functioning. It is the human brain from which the human mind arises and within that mind resides our humanity. Understanding the organization, function, and development of the human brain, and brain-mediated responses to threat, provides the keys to understanding the traumatized child” (273).

“. . . traumatized children exhibit profound sensitization of the neural response patterns  associated with their traumatic experiences. The result is that full-blown response patterns (e.g., hyperarousal or dissociation) can be elicited by apparently minor stressors” (275).

In this article, Perry et al make the case that “reactivated” fear coming from an oversensitized brain stem and midbrain due to trauma can cause hyperarousal: “hyperactivity, anxiety, behavioral impulsivity, sleep problems, tachycardia [abnormally fast heart rate], hypertension, and a variety of neuroendocrine [hormonal] abnormalties” (278). These conditions and behaviors are states NOT traits.

On the other hand, oversensitized brains can be  result in “dissociation.” For example, if an outside  stimulus evokes the trauma, a person may freeze or numb him or herself. A child may “disengag[e] from stimuli in the external world and attend [. . . ] to an ‘internal’ world” (280) as in daydreaming or fantasizing. As a result, a child may falsely be understood to be extremely shy or uncooperative. Dissociation and hyperarousal are “states” created by early trauma. In adulthood, many of us have wrongly come to accept them as our personality “traits.”

Another major point from the article is that traumatized infants and children do not simply get over their traumas. According to Perry et al, “children are not resilient, children are malleable” (285). In fact, to assume infants and children were not affected by the trauma or will grow out of it is not only incorrect but destructive. Perry et al leave us with this final point: “Persistence of the destructive myth that ‘children are resilient’ will prevent millions of children, and our society, from meeting their true potential” (286).

For me, I just want my real self back.

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In the Realm of Hungry Ghosts –  Close Encounters with Addiction,  a book by Dr. Gabor Maté, provides new information about addiction. “He locates the source of addictions in the trauma of an emotionally empty childhood, making it a relational rather than a medical problem,” according to Dr. Harville Hendrix. Maté contends that our brain chemistry is altered by early trauma, making addictions of all sorts more likely. Here’s some quotes to interest you in the material. I’d love to hear your thoughts about it.

“From a medical point of view, addicts are self-medicating conditions like depression, anxiety, post-traumatic stress, or even attention deficit/hyperactivity disorder (ADHD)” (36).

“A hurt is at the center of all addictive behaviors. . . . The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden—but it’s there. As we’ll see, the effects of early stress or adverse experiences directly shape both the psychology and the neurobiology of addiction in the brain” (38).

“We shouldn’t underestimate how desperate a chronically lonely person is to escape the prison of solitude. It’s not a matter here of common shyness but of a deep psychological sense of isolation experienced from early childhood by people who felt rejected by everyone, beginning with their caregivers” (45).

“‘Recent brain imaging studies have revealed an underlying disruption to brain regions that are important for the normal processes of motivation, reward, and inhibitory control in addicted individuals. This provides the basis for a different view: that drug addiction is a disease of the brain, and the associated abnormal behavior is the result of dysfunction of brain tissue, just as cardiac insufficiency is a disease of the heart–Nora Volkow, MD'” (133).

“Three-quarters of our brain growth takes place outside the womb, most of it in the early years. By three years of age, the brain has reached 90 percent of adult size . . .” (191).

“The dynamic process by which 90 percent of the human brain’s circuitry is wired after birth has been called neural Darwinism because it involves the selection of those nerve cells (neurons), synapses, and circuits that help the brain adapt to its particular environment, and the discarding of others” (191).

“The three environmental conditions absolutely essential to optimal human brain development are nutrition, physical security, and consistent emotional nurturing. . . . The third prime necessity–emotional nurture–is the one most likely to be disrupted in Western society. . . . emotional nurturance is an absolute requirement for healthy neurobiological brain development” (193).

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Rather than post this piece last Wednesday on National PTSD Awareness Day, I wanted to leave Melissa Matheney’s powerful story, One Person Can Make a Difference, front and center for a few more days. I am so grateful to know her and be able to share her work. Moving on, in the spirit of PTSD (post-traumatic stress disorder) Day, here are a few quotes to think about from Dr. Judith Herman’s classic book Trauma and Recovery: The Aftermath of Violence–from Domestic Abuse to Political Terror:

“The many symptoms of post-traumatic stress disorder fall into three main categories: These are called ‘hyperarousal,’ ‘intrusion,’ and ‘constriction.’  Hyperarousal reflects the persistent expectation of danger; intrusion reflects the indelible imprint of the traumatic moment; constriction reflects the numbing response of surrender” (35).

Hyperarousal

“After a traumatic experience, the human system of self-preservation seems to go onto permanent alert, as if the danger might return at any moment. Physiological arousal continues unabated. In this state of hyperarousal, which is the first cardinal symptom of post-traumatic stress disorder, the traumatized person startles easily, reacts irritably to small provocations, and sleeps poorly (35) . . . Patients suffer from a combination of generalized anxiety symptoms and specific fears . . . their bodies are always on the alert for danger” (36).

Intrusion

“Long after the danger is past, traumatized people relive the event as though it were continually recurring in the present. They cannot resume the normal course of their lives, for the trauma repeatedly interrupts” (37).

“Adults as well as children often feel impelled to re-create the moment of terror, either in literal or in disguised form. Sometimes people reenact the traumatic moment with a fantasy of changing the outcome of the dangerous encounter. In their attempts to undo the traumatic moment, survivors may even put themselves at rick of further harm” (39).

Constriction

“When a person is completely powerless, and any form of resistance is futile, she may go into a state of surrender. The system of self-defense shuts down entirely. . . . A rape survivor describes her experience of this state of surrender: ‘Did you ever see a rabbit stuck in the glare of your headlights when you were going down a road at night. Transfixed–like it knew it was going to get it–that’s what happened” (42).

“. . . traumatized people run a high risk of compounding their difficulties by developing dependence on alcohol or other drugs” (44).

“In an attempt to create some sense of safety and to control their pervasive fear, traumatized people restrict their lives” (46).

PTSD is a disorder that many people endure: combat veterans; rape survivors; victims of domestic violence; witnesses of drive-by killings; car crash survivors; those who have experienced invasive medical procedures, especially if administered without adequate pain relief; the list goes on and on.  Do you have PTSD?  You may and not even know it. Or someone you know may be suffering from its symptoms but be entirely unaware of their source.

I believe the brain can heal from this disorder. In any case, awareness is the first step in coping in a positive way. Let’s help each other.

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