I wrote about the issue of bipolar diagnosis and whether it matters for a presidential candidate. Check it out here.
liz | 12:52 PM | Uncategorized
When I was a kid, I was aware that my grandmother was frequently sick as a result of something called “sprue.” It meant she had a weird diet, and was very thin. Sadly, she also had no sense of smell, so the world of food was entirely unremarkable for her. No one else we knew had sprue, an autoimmune disorder, but it made sense because she had other autoimmune stuff going on too.
In 11th grade I went on a trip to what was then the Soviet Union. I made the mistake of eating something from a street vendor. I got very sick, and the sickness lasted through senior year. Regular ol’ tourist bacteria was quickly ruled out, but when the gastroenterologist found out my grandmother had sprue, he got excited: It skips a generation, he said, and might be the cause of my problems. I underwent endless tests and then a biopsy of my small intestine. The results were inconclusive. But a gluten allergy has very specific symptoms—very. Trust me, you don’t want to know what they are, because they’re related to poop, but they are pretty unmistakable and I had them. The doctor diagnosed sprue.
I was put on a gluten-free diet. In high school, that kind of sucks. It’s hard to go to pizza joints and Burger King with all your friends and be so limited. My parents took me to a celiac sprue support group, and I can only tell you that we laughed all the way home. This was 1985, remember, and the delicious! “cornbread” they served to prove that it wasn’t so bad to be gluten-free was not encouraging. The conversation was unintentionally hilarious.
The weird thing was, I got better. My symptoms disappeared. Then, at my high school graduation party, I unthinkingly plucked a piece of macaroni from a bowl of macaroni salad on the sideboard and popped it into my mouth. As soon as I realized it was gluten, I started to cry. What had I done? I told my mom in a panic and she said she thought it was okay. And it was. Gradually, I introduced gluten back into my diet. And you know what? Nothing happened. From that day to this I’ve been eating gluten and never had a problem again.
Nowadays the mysterious sprue is known as gluten allergy and it’s everywhere. It seems half the people I meet are allergic to wheat, and the allergy has spawned an industry of foodstuffs and cookbooks. (For a funny take on this kind of thing, check out the Allergy Pride Parade on the new season of Portlandia.)
Dealing with allergies of any kind can get you down, but when the allergies pertain to something we do every day—something as fundamental as eating—it can truly be a pain in the ass. Now a new study says it’s rather more serious than that for women. From MedPage Today:
In celiac disease, ingested gluten can damage the surface villi and impede nutrient absorption, but 37% of women with the condition met the clinical threshold for depression on the 20-item Center for Disease Studies Depression Scale, according to Joshua M. Smyth, PhD, of Pennsylvania State University in University Park, and colleagues.
Moreover, 22% also met the criteria for disordered eating assessed on a 29-item questionnaire, the researchers reported online in Chronic Illness.
Following a gluten-free diet is the usual recommended treatment for celiac disease, however, because of the near ubiquity of gluten in common foods, many patients with the immune disorder have difficulty keeping to their diet.
And even those who do adhere to the diet can remain symptomatic, which can interfere with normal functioning and lead to psychological difficulties.
Unsurprisingly, women who are forced to focus on food due to the disease can get consumed by the worry, and segue into eating disorders like anorexia and bulimia. Given that eating disorders are frequently about control issues, this makes sense—you have no control over your celiac diet but you exert control otherwise. Also, women who are on the celiac diet have excessive concerns about weight, according to the study. On the other hand, I don’t know one single woman who doesn’t worry about her weight.
Worse celiac symptoms were associated with poorer physical functioning and mental health (P<0.001 for both).
Correlations also were seen between different areas of psychiatric functioning, such as depression and stress (r=0.54, P<0.001), as well as stress and eating concerns (r=0.85, P<0.001).
The average level of depressive symptoms was 14.93, with a cutoff for clinical depression of 16.
The 65 women whose depression scores were at or above the cutoff had worse celiac symptoms (P<0.001), greater stress (P<0.001), lower dietary adherence (P<0.05), and worse quality of life for both physical and emotional domains (P<0.001 for both). ....
The study confirmed that women with celiac disease are at risk for psychiatric distress, implying that screening may be useful and that psychosocial support may be an important aspect to overall care for these patients, they observed.
Lesson to be learned from the study? Women who adhere to the diet and do not obsess about their weight are far less likely to experience depression.
I had never read the books or seen the other films. I knew very little about the movie except that David Fincher (whose work I respect) directed it and the person I live with wanted to see it. Someone warned me there was a rape scene, which was kind of them. I’m a rape survivor (weird term, but it does the job) and I generally avoid seeing movies with rape scenes. If you don’t know ahead of time, it generally means it’s a small plot point and it’ll go by very quickly and stupidly. But I heard David Fincher tell an interviewer that he deliberately made the rape scene more graphic than it was in the book. I should have heeded my better instincts and not gone to the film. But because social plans were made around seeing the film on New Year’s Eve, I felt uncomfortable asking everyone to change the agenda. I felt likewise unable to say I couldn’t go. I was apprehensive but decided to tough it out. How bad could it be?
Very bad. It was, without question, the most brutal rape scene I’ve seen in an American movie. It was agonizing. It wasn’t just a rape; it was a particularly violent and sadistic rape involving hand and ankle restraints, a mouth gag and vicious anal penetration. The victim is screaming. The chains that attach her to the bed rattle as she tries to free herself. It seems to go on FOREVER.
Then, as if that weren’t enough, there’s a Clockwork Orange-style revenge-rape scene, in which the victim returns to her rapist and restrains him, gags him and anally rapes him. She also tattoos him. It’s great to imagine she gets revenge, but frankly, if you’re disturbed by images of rape and sexual violence, it doesn’t much matter if it’s happening to a man or a woman. It’s still going to be traumatic. One rape scene was really hard for me. Two was almost unbearable.
Then there was the overall plot, which focuses on the investigation of a serial killer who disfigures women’s corpses in the most gruesome ways. Photos are shown.
It’s a funny thing about trauma, the way the body remembers. I went through several stages of feeling when I saw that rape scene, and even writing about it now I can feel my body responding: my heart rate is up and my legs are shaky. In the theater, when it was happening, I started to feel so panicky. My muscles got tense and it was hard to breathe. Tears filled my eyes. I kept squeezing my toes together and reminding myself to breathe. I found it hard to focus on the rest of the film. I tried, but I kept hearing her screams and then I’d have to squeeze my fists and toes and breathe. As soon as the credits came up, I fled to the bathroom. I was overwhelmed with nausea but didn’t throw up. It was hard to pee because I was starting to dissociate and leave my body. I felt so angry too. I sent some really evil text messages to a friend who’d texted something benign. I was furious. I wanted to tear down the stalls and kill people. It was such a fierce anger.
As the evening went on, the anger got less and the distance between myself and my body got more acute. By the time I got home, I was completely gone. Nothing was real, I wasn’t real, I wasn’t there. I sat staring into space for a really long time, but it wasn’t a long time because there was no such thing as time. My hands, when I looked at them, were freakish bony protuberances just sitting there on my lap. What were they? I knew there were things in front of me, but I couldn’t see them.
I tried to talk about what was going on, but it made me too sad. Then I started to get weepy. After all, after I was raped, my life went to hell. I blame it for everything. Nothing was ever the same because it brought on the illness. I can’t think of it separately. I lost my mind after that rape. I was a lost girl.
Trigger warnings can’t be placed anywhere and everywhere. The world is a hard place and we just have to take our chances. But I’m still feeling the aftereffects of the film. So I would say if you’ve been a victim of sexual violence, DO NOT SEE THIS FILM. It’s just too hard.
From one of my most beloved organizations, MindFreedom, comes an effort to challenge notions of normalcy as the American Psychiatric Association meets to unveil the DSM-5. From MindFreedom.org:
Free thinkers unite in an international campaign to question how psychiatric corporations try to control us and our democracy through their misguided idea of “normal.”
Be part of peaceful protest of the American Psychiatric Association, everywhere, especially Philadelphia, on 5 May 2012.
Occupy the American Psychiatric Association!
MFI calls on mental health consumers, psychiatric survivors and allies to Boycott Normal in response to the American Psychiatric Association’s preparation for a fifth edition of Diagnostic and Statistical Manual of Mental Disorders.
DSM-5 would be the latest edition of what is widely known as psychiatry’s “label bible,” used to determine if people can be diagnosed with mental ‘disorders’ or ‘illness.’
Today, we challenge normality and celebrate creativity and diversity. Please join us!
Want to get involved? If you’re in Philly, email Susan Rogers at firstname.lastname@example.org. She’s the nicest person on earth, so you won’t be sorry. Also, click HERE.
I was in CVS the other day waiting to fill my prescription for Dexedrine, when I overheard the guy in front of me being told they were out of Adderall. The pharmacy tech suggested he go to another store, but the guy said he’d been to every place in the city and couldn’t get Adderall anywhere. Fortunately, CVS did have Dexedrine, but the fact that there is a shortage of drugs for attentional issues is completely appalling and unacceptable in a supposedly first-world healthcare system.
The problem is that the Drug Enforcement Administration only allows a certain amount of Ritalin and Adderall to be produced because of the abuse potential, particularly by college kids who take the stuff like candy to stay up at night studying. The FDA, which monitors supply of the meds, is particularly distressed by the shortages and has tried to get the DEA to change its quotas. But the DEA is claiming there’s no problem, and that patients who encounter a shortage can just switch meds.
Ooh boy. I think we all know how that goes. Yeah, sure, just switch from Adderall to Ritalin–that’ll work. I remember the only time I tried Ritalin, my tongue swelled up and I ended up flat on my back in a CD store, having passed out with some weird allergic reaction. Adderall, however, was benign in terms of side effects for me. The DEA seems to be oblivious to the fact that children (who are the majority consumers of these drugs) can’t just switch around.
While there are more branded meds in supply, not everyone can afford them. This means people go without treatment, another devastating problem for kids (and for adults too, of course).
The article detailing all of this is by Gardinar Harris in the New York Times and can be found HERE.