‘Metabolic syndrome’ in the brain: deficiency in omega-3 fatty acid exacerbates dysfunctions in insulin receptor signalling and cognition

‘Metabolic syndrome’ in the brain: deficiency in omega-3 fatty acid exacerbates dysfunctions in insulin receptor signalling and cognition.

The Metabolic Syndrome http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004546/is a phenomenon having to do with insulin resistance, meaning that the body’s utilization of insulin in the process of converting sugars to energy is blunted, and the energy is instead stored as fat. The abnormal conversion to fat also causes clogged arteries, leading to an increased risk of heart disease and stroke.

This article describes how rats which are fed a high fructose (fruit sugar) diet develop insulin resistance in the brain. Since the brain can only utilize glucose as its sole fuel, a malfunction of the insulin-glucose system is disastrous for cognition. This corroborates what we see in “real life,” that eating a bunch of sugary stuff makes us feel like crap after the high wears off.  And mind you, this study used fruit sugar, which supports my rant to parents that the fruit juice they pour into the little darlings is no better for them than sugar water (gasp).

Interestingly, rats whose diet was lacking omega-3 fatty acids had a much worse time dealing with sugar-on-the-brain than rats who had normal omega-3 intake.  And even better, rats who were supplemented with omega-3s showed a protective effect from sugar overdose.

Does this mean that if we plan to pig out on chocolate (or grapes!) we should pop a few omega-3 caps beforehand to avoid the post-sugar crash?

Not really, but it does mean that we should take our intake of sweet foods seriously, and that includes fruit, which has always had such a good reputation as a “good for you” food. It is, in moderation, like everything else.

And it provides us with yet another good reason for eating foods high in omega-3 fatty acids, like fish and nuts (in moderation). Truly “brain foods.”

 

Barter sex

My sex life began with a bang (no pun intended) on April 22,1970.  I was a sixteen year old virgin.  I will tell the story of that rape on my new blog, the one I keep threatening to start, any time now.  I’m working the kinks out of it.

After that, I ran away from my artsy-fartsy home on the east coast, ran all the way to California to be a hippie, and promptly got raped again, in a big white metal bed at the home of a friend and her family. Guy walked right through the door, climbed on top of me: “Don’t make any noise and you won’t get hurt.” Where DO they learn that pick-up line?  I left the next day, thingy chances on Highway One heading south to Santa Monica, where my friend had a friend who said she knew of a place I could crash. Only that didn’t work out the way it was supposed to.

After a few days of abject homelessness, too scared to sit down anywhere, too scared to go to sleep on the side of the road for fear I’d get raped again, I was offered a great deal: I could sleep on a cot in a crowded garage where a rock band practised, provided that I would sleep with the band members.

At that point it seemed like the best possible arrangement, since I would have a guaranteed place to sleep, and the people I would be having sex with were a known quantity and not just random people grabbing me off the street or coming in my window when I was asleep.

One kind of sweet thing was that the bass player took a shine to me and asked all the others to stay away, after they had each had a turn or two.  So I “belonged” to Spacey Tracey.

There wasn’t a bathroom in the garage so I used the yard.  The lady who lived in the house left her back door open for a while, so I would sneak in there when she was at work and use the bathroom, take a quick shower (I got to stinking pretty bad with all that sex and no shower).  Also I had no food and no money.  The cot in the garage was the barter deal. Tracey didn’t seem to notice or care that I was getting pretty gaunt.

On one trip through the dark kitchen of the lady’s house on my way to the bathroom I noticed that there was a bowl of those pastel poufy after dinner mints on the kitchen counter.  I grabbed a handful and stuffed them in my pocket.  That whole day I sucked on them very slowly, feeling them dissolve on my tongue, feeling the surge of sugar into my blood, a tiny flicker of energy enlivening my flesh.  My mind was dead, though.  Gone.

Once I discovered the mints I made sure to grab a handful every day.  That was all  I had to eat.  The band tried to get me to drink some Boone’s Farm Apple Wine one night.  It barely hit my stomach before coming up again.  Didn’t make much mess, though:  nothing in there.

Well, the lady finally wised up that I was helping myself to her bathroom and mints.  One day the back door was locked.  I told Tracey, sadly, that I would have to move on, or starve to death.  I was terrified at the prospect of leaving, because every night for a couple of hours I had Tracey’s body to cling to, and that was my whole world.  Yet I was truly starving, and had to find a saner situation where there might be both shelter AND food in the offing.

What’s interesting to me in retrospect is that I never asked Tracey for food.  I felt too ashamed and worthless to ask for anything more than what was offered: a place out of the rain, reefer when offered, the companionship, such as it was, of the band, and the barter arrangement with Tracey.

Later, when Tracey found out I was pregnant, he offered me money to help with the abortion.  I tried to reassure him by telling him it wasn’t his, but his face fell apart and I realized that maybe he had loved me, a little.

Copyright 2012 Laura P. Schulman all rights reserved

PTSD Redux

Let me first inform you that you almost never find me sitting in a public place –restaurant, bar, hotel room–with my back to the door.  I will already have made note of all the signs that say “exit” and memorized their locations, against the need of a discreet back door disappearance:  my friend in so many tight situations.

If you should find me comfortably seated with my back to the door, you will inevitably find that I am facing a mirror, perhaps the one behind the bar, or a TV screen that reflects what lies behind me.  I have been trapped too many times to allow that to happen on my shift again, at least not without maximum preventive measures.

I am the queen of the quiet back door disappearance.  Situation getting tense?  I don’t like tension.  Loud voices cause me to panic.  They’re associated with soul-crushing punishment.  So I take the back door out.

Where to?  What, you expect me to actually tell you that?  Fat chance.  I don’t want to be found.  I’m out of here.  You might see me when things chill out.  Or not.  I’ve got nothing to lose, remember?  “When you ain’t got nothin’, you got nothin’ to lose.”  I just don’t want to get raped any more, or trapped for any man’s pleasure.  I’m already full up with that kind of shit.

If there ain’t a physical back door exit, my brain creates one, real quick, before I even know it’s happening.  I havea suspicion that it’s always there, on standby, in case my beaten, punished brain thinks it’s needed.  In that case, all that’s needed is the proper trigger and poof, I’m gone, nobody home for days, complete amnesia for the intervening time.

Why does my brain do this?  It goes back to childhood issues, which I might go into on another, anonymous blog.  I’ll let you know.  But I’ll give you an example here.

WARNING:  RAPE TRAUMA TRIGGER POSSIBLE

1971.  I was 17 years old and had returned from a year on the street in California and New Mexico.  I was pretty numb from the whole thing but still desperately hoping to find somebody to trust.

I was at an antiwar rally on Boston Common.  There was a network of medic stations set up and I was allegedly attached to one of them as a volunteer.  As things started heating up at the rally–tear gas, water cannons, pigs with riot gear– I started getting stomach pains.  I had been stuck in the middle of the Isla Vista riots the year before, which you will have the opportunity to read about in my new blog coming up, and my body was not happy about this revisitation of riot conditions.

I mentioned my discomfort to a young man in my medic unit, who claimed to be an intern at one of the local hospitals–might have been, probably was.  He told me he lived a block away from where we were, we could go to his place and get out of the scene, and he could check me out medically and make sure everything was ok.

Like the innocent I was, I followed him there.  He led me straight to a bedroom and told me to undress and lie on the bed.

“Just don’t make any noise and you won’t get hurt,” he hissed.  How many times had I heard that already?  My soul left my body and went up to hover around the ceiling.

She (my soul) watched him take a doctor’s pen light from his pocket and rape me with it, then climb on top of my naked body, himself fully clothed, and hump me till he came in his pants.  My body remembers the discomfort of all the junk in his pocket protector rubbing against my breast.

When he finished, still breathing hard, he ordered me to get dressed again and lead me, numb and dissociated, back into the riot scene.

I felt very ill, so I slipped away from the demonstration/riot and went to a nearby hospital emergency room.  When the male doctor came to see me, all I could say was “I don’t feel well.”  I couldn’t say, “Help, I’ve just been abducted and raped with an object by a person who called himself a physician!”  So I was sent away with a lecture about misusing valuable medical resources.

Copyright 2012 Laura P. Schulman all rights reserved

I have to reblog this amazing post. Although I never “officially” prostituted, the same feelings of entrapment, terror, and helpless enslavement to a way of life applied to my teenage years of homelessness, mental illness, and vulnerability to sexual predators. I thank G-d every day that I never fell into the hands of a pimp the way so many trafficked girls did. I knew some of them, and somehow managed to escape every situation that could have ended me up in Stella’s horrible situation. Thank G-d, even though I was abducted several times, I always found a way out. Not by any means unscathed, but not traumatized to the catastrophic extent that so many girls and women are. I’m not normally a vindictive person, but I hope that every pimp, madam, and others who facilitate trafficking of girls, women, boys, and men, come to a suitably ugly end.

Judge Rules In Favor of Fired Employee With Bipolar Disorder – ABC News

Judge Rules In Favor of Fired Employee With Bipolar Disorder – ABC News.

This is great.  Guy gets fired because he needs a few days off to get himself back on track, takes his employer to court for ADA violation, wins.  In the meantime he goes back to college and gets a degree in physical sciences.  No dummy, and quite functional.

I love this.  On the other hand, there are so many people with bipolar disease and other mental illnesses who are too sick to advocate for themselves the way this guy did.  Most of us would not have the focus, orientation, drive, or even enough positive self image to search out a proper lawyer and sue the bastards.

Lawyers usually want to be paid for their services.  Some will take a case on contingency, so that they get paid a percentage of the settlement if they win the case.  Therefore they will only take the case if they are very sure they will win.

I am not aware of any advocacy organization that helps people with mental illness who have lost their jobs or been denied employment due to their disabilities.  If any of you, dear readers, know of such a thing, please educate me and everybody else who reads this blog.  What we need is a one-phone-call hotline that can match people who have been discriminated against with appropriate legal resources.

I’m sure that if this were the case, employers would be much more careful about discriminating against people with mental illness, especially when the people in question are perfectly capable of doing the job in question.  Yes, we may need some accommodation, such as sick day allowances, but this certainly does not differ from the needs of anyone with a chronic illness of any kind.

It’s true that there is discrimination against people with chronic diseases of the “physical” kind.  I know of people with kidney disease who need to go to dialysis two or three times a week, who have been terminated from their jobs.  True, they are physically incapable of holding down a 40 hour a week job, but there are many cases where part time positions have been available yet the persons were denied.  Of course the reasons for denial are trumped up, because it is officially illegal to deny someone employment strictly on the basis of a disability, as long as they are capable of performing the tasks of the job.

The result of the denial of employment to people with mental and physical illness is the staggering epidemic of people on disability.  As a person who relies on disability payments for my livelihood, one would think that I would be the last person to complain.  However, if my work environment and the culture of my profession were tolerant of my needs to attend therapy, observe regular working hours rather than shift work and an 80 hour work week, and take a day or two off every once in a while (and by this I mean every 6 or 8 months) to get my center of balance back under me, I would still be working.

However, the world of medical doctors is built upon a mythology of superiority:  physical, intellectual, and psychological.  Thus, medical residents are subjected to the hazing ritual of 36 hour shifts and 120 hour work weeks.  If you survive that, you are welcomed into the hallowed halls of the elite.

I will never forget running into one of my former teachers at a medical conference, long after I had graduated and was running a large pediatric emergency center.  She asked me how I was doing.  I replied, “To tell you the truth, I’ve been suffering a bit from depression.”  Her face closed up as if a curtain had come down.  She turned on her heel and walked off without saying a word.  From that moment I knew that having a mental illness was taboo in “our world,” and I never mentioned it again, to my great detriment.

A few years later, a colleague who worked alongside me came up to me and whispered that he was feeling a bit depressed, and could I write him a prescription?  This was a man who was an Air Force veteran of the first Gulf War.  He had headed up a commando unit that had rescued premature babies from a hospital in Kuwait that had been occupied and all the doctors and nurses killed.  He was a hero of the highest order.

I told him I would give him a week’s worth of Prozac on the strict condition that he see a psychiatrist.  He said he was afraid that the administration would find out and fire him.  I told him he had no choice but to see a psychiatrist, and that I would keep an eye on him and make sure he did.

The following week I was called in to work early, to cover this young doctor’s shift.  He had locked himself in a motel room and shot himself, because he was depressed and felt helpless and hopeless, and he was afraid of losing his job because of his condition.  It was a senseless tragedy, a loss of a wonderful human being and a brilliant doctor, because of a hostile professional culture.

I’m looking forward to seeing an article in the paper about a physician successfully suing their employer for discrimination against them due to mental illness.

PTSD and isolation

One of the classic traits of PTSD is isolation.  PTSD sufferers often feel unable to relate to other people.  Sometimes this results from a feeling that others can’t possibly understand them, and sometimes it’s not a conscious thing at all, just an uncomfortable or even aversive feeling around other humans.

I say “other humans” because people with PTSD often feel comforted by animals.  Animals will love you unconditionally, and often will protect you during an episode of symptoms.  The mere presence of an animal can sometimes be comforting enough to head off a full-blown episode.

One problem with isolation is that it is self-perpetuating.  Who the hell wants to be around a touchy individual who tends to disappear off the map for reasons most people cannot fathom?  And if concerned individuals ask why, they are not likely to get a straight answer, because who wants to go through the whole “I have PTSD” explanation to somebody who is not on the “need to know” list?

As for people who are on the “need to know” list, their job is so difficult that many of them bail out.  Here you are with this lovely person, going along just like usual, and something you do sets them off, and all hell breaks loose.

Granted, the triggering behavior often resembles the original wounding behavior itself: aggression, threats, or actual acts of violence. And there are, unfortunately, individuals who thrive on the power trip of controlling a person with PTSD, as is seen in domestic violence, and in the pimp-prostitute relationship.

Among returning veterans with PTSD, the rates of divorce outstrip the rates of marriage success, among preexisting marriages. Likewise, the rates of homelessness among vets with PTSD are astronomical. Much of this is due to simply being unable to reintegrate, unable to relate to civilian society.

Other groups that show similar social isolation patterns are domestic abuse survivors, rape survivors, and survivors of prostitution and human trafficking. Much like combat veterans, these people find it hard to integrate into a society that not only has never had to deal with the traumas they have been through, but also may look at them as pitiful, dirty, or damaged people. In addition, survivors of domestic abuse and sexual trauma have difficulty knowing who to trust. Repeated experience of betrayal of trust erodes the foundation of the ability to trust, making isolation preferable to being abused once again.

Suicide is the ultimate act of social isolation. I don’t have the numbers handy at this moment, but the relative risk of suicide is much higher in people with PTSD than in the general population. This is greatly multiplied if the person with PTSD also has an additional psychiatric diagnosis such as Major Depressive Disorder or Bipolar Disorder.

I’m breaking my head trying to come up with a good closing sentence, but I’ve depressed myself writing this post such that I can’t think of one. So that’s the way it odds, today.

Copyright 2012 Laura P. Schulman all rights reserved

DSM-IV-TR criteria for PTSD – NATIONAL CENTER for PTSD

http://www.ptsd.va.gov/professional/pages/dsm-iv-tr-ptsd.asp This is a good link to check out if you want to refresh your memory about PTSD. It’s geared toward veterans, but it contains the DSM criteria, so it applies to everyone unfortunate enough to live with this crippling illness. There are three major classifications or groupings of symptoms. A person can have symptoms that cross groups, too. If you’re one of my regular readers, you might notice that my writing style is not its usual sparkling self. That’s because my personal PTSD demon got let out of its cage yesterday, and I haven’t managed to get back into the world enough to get it corralled. My PTSD falls mostly into the avoidant group. I get numb and totally leave my body, even as I scramble to try to grab onto something to keep it from happening. This time, I felt myself slipping, tried to stop it, and then got totally knocked off my pins by a second, larger trigger. When I was younger and had fewer resources, I would ends up depersonalized a great deal of the time. I had a lot of severely traumatic experiences, running the gamut of childhood abuse to multiple rapes to multiple trauma from being hit by a car while riding my bicycle. But the worst was being the helpless target of childhood verbal and emotional abuse. I’ve done a huge amount of work on this stuff, and got a lot of it under control. From my own work as a pediatrician I have observed that abuse that happens to preverbal kids just does not get integrated and has little hope of being erased. Prior to language development, a kid just has no way of processing what happened. So when they’re confronted by a similar situation, even as an adult, boom, you’re right back there in that same place of no-escape terror. For me, the only way out was to leave my body and let the chips fall where they may. So yesterday I got triggered. I’m still trying to find my way back. My dog helps, but I think I’m even freaking her out a little. Time is the only healer for this.

Copyright 2012 Laura P. Schulman all rights reserved

Love and transformation: Fail

My psychiatrist, bless him, has this to say about bipolar disorder:

“Some people have sensitive stomachs.  Some have sensitive lungs.  And people with bipolar?  They have sensitive brains.”  And that’s how he approaches the whole therapeutic process of treating people who live with bipolar disorder.

Now I have wondered, often sadly, how it could be that “other” bipolar people had partners, husbands, wives, who loved them in spite of and because of their specialness, their sensitive brains.  How could it be that anyone could stand that level of intensity, of hypersensitivity, of hyperawareness, and even be attracted by it, and, even more incredibly, love that person who lives in such an idiosyncratic and sometimes hectic brain?

I know from my own experience that bipolar people often have a kind of “crackle” that sets us apart from the dull masses: an electric attraction, a fascination that by turns attracts and repels the “mere mortal.”  I have watched in horror as these well-meaning “muggles” are chewed up and spit out by the intensity of my truth.  I really don’t mean them harm.  They get caught up in the gravitational field of my aura and can’t let go, and I can’t let them go until the polarity of the magnetic field flips and they are propelled beyond the boundaries of my attraction.

Seven years ago I said “Enough.”  Enough of these mutually destructive relationships based upon fascination, power plays, purely sexual attraction, games.  I found that I had become unable to handle both my illness and another person who was vying with my illness for a piece of real estate inside my brain.  So I set relationships aside, and decided that perhaps Temple Grandin is right after all, in deciding for herself that she is incapable of handling a love relationship (she is a very high functioning autistic) because of the demands of her special brain.  I thought that for myself, in the interest of damage control, it would be best to emulate her.  I devoted myself to a life of religious asceticism within the framework of Orthodox Judaism, which is by nature anything but ascetic;  yet I found a refuge in closeting myself in the world of Torah study, setting aside the normative Jewish feminine dedication to home and family life, not being possessed of a family, after all, and not remotely likely to have one.

In the service of honesty,  I admit that I gave the Orthodox Jewish tradition of matchmaking a try;  but after a few rounds (which did result in a couple of lifelong friends, but no husband), I gave it up.  Life was better alone.  I got used to it and found freedom in it.  Seven years flowed by.  I was content and happy with female and male friends, an exciting intellectual milieu, and no lover.

And then:  the unexpected.  He appeared, as it seemed, out of nowhere.  Brilliant, intense, idiosyncratic, fiercely individualistic, sweet, sensitive, tender, loving, accepting, passionate: and he loves me.  And I love him.

It does not seem to bother him that I must take 5 (five!) different kinds of pills to control my disease.  At night, he asks me with genuine concern, in his dear, gentle English accent: “Have you taken your medicines?”  I revel in his caring.

I think it did give him a jolt to discover that if I am sleep deprived I dissolve into a wailing puddle of pain, spewing tears and snot like a pot boiling over.  That happened once, when he accidentally woke me early in the morning before I had had enough sleep.

Yet, with his soothing patience, I found I was eventually able to lie down and take a nap, and woke up feeling much better.  And he was still there: he had not taken to his heels, as a lesser man might.  And he loves me anyway.  I am amazed and proud to say that he now protects my sleep, as he knows how important it is to my health.  A lesser man might have taken it as a challenge to try to change the unchangeable, as if it were something I could control “if I wanted,” as if I was being manipulative etc., etc. (you can see, dear reader, that I have been through this kind of pointless struggle and am more than a bit jaded with it.)  Instead, he sees it as it is: a physical need that I have.

I catch myself being apologetic about my brain’s need for sleep.  How I have struggled with it!  Now I must let myself rest, let it be a non-issue, for I have fallen into loving arms, and there is no need to struggle.

This love:  the experience of being loved unconditionally, loved as I am, for who I am:  this love is transformative.  Simply knowing that if my brain is hurting, I can turn to him and tell him, and his love will surround me, hold me, support me without having to make it all go away, has already changed my neurology.  I find that I am less irritable, more clear-headed, less likely to fall into dark places.

By nature I am reluctant to allow myself to become dependent on another for support.  In large part this is due to the fact that I have not previously had anyone whom I trusted to catch me if I fall.  It’s becoming more and more clear that this man, this one, is flesh of my flesh and bone of my bone, and I know I can trust him with my 360.

Baruch Ha’Shem (Bless G-d)

Postscript: unfortunately, the man described in this post tuned out to be a sadistic opportunist.  If I had not been the person I have learned to be through life experience and willingness to learn from it, I might have been caught up in yet another round of psychological (and possibly physical) beatings, followed by “heartfelt” apologies, forgiveness, a honeymoon period, then repetition of the abuse cycle…thank G-d I recognized the signs after only three rounds.  I am not at all sure that I can see this coming in advance.  I might be better off foregoing.