September 10th – World Suicide Prevention Day

This is for you.  Did you know that suicide is now responsible for more deaths than automobile accidents?  You’re more likely to lose someone to depression than drunk driving, and there are plenty of warning signs for depression.  We’re only starting to come into an age where depression is seen as a disease, and people begin to realize that sufferers aren’t just lazy and making their own bad situations.  To someone outside the situation, the solutions seem so simple.  You don’t have a job? Well keep looking until you find one, even if it’s flippin’ burgers.  You have a job, but you can’t pay your bills?  Get a second job, or look for a better one.  You’re lonely? Make an attempt to be sociable for a change instead of locking yourself up at home.  Can’t stand the things you’ve done? Can’t change the past, so start doing good things; good deeds for other people will make you feel better about yourself. Depression can suck the life out of you.  Telling someone with depression to just get a second job can be like asking someone who has just given everything they had to win a race that they’re only halfway done. Your simple suggestion doesn’t feel like constructive criticism or support.  It feels like rejection.  Another person just trying to fix the side effects with trite suggestions.  And on the other hand, if you try to suggest treatment for depression, the subject comes up about the cost of therapy and drugs, which seem like another great burden on an already tight situation.

It was July 2008 when I got the very last email from my dad.  He had been struggling with his studies and with work ever since his dad died the previous November.  If I had kept in touch with his ex-girlfriend (who he was still living with) we both would have known he was using us to get him through his college courses, and might have realized how severe the situation was.  He wrote me one more email to tell me that he was lonely, because she had time for everyone but him, and that he was almost out of money and couldn’t pay his truck payments.  They’d be repossessing the truck soon and he needed to move out as soon as possible because he wouldn’t be able to haul his horse trailer without a truck, and where could he go with a horse?  At the time, I had no idea he was getting medication again.  I thought he was still taking classes and wondered what had happened to the last job.  I suggested he sell the horse and trailer and use that money to find a place closer to school, and maybe a job within walking distance.  I also recommended he find a church he liked, because church had always been very important to him.  I couldn’t offer him more than a spot on the floor beside my bed, a package of ramen made from a single-cup water heater, and cold showers.  There were other people in the family that were well-off who would have taken him in, but not without making him feel utterly worthless.  It was bad enough when I took some time off from college and still wasn’t married at 22, and if your job doesn’t pay twice minimum wage, just don’t even mention you have one.  I can understand why he wouldn’t want to go to them, but god help anyone who needs ME.

He had sent the email at night, and I didn’t see it until the next morning, but apparently enough time had passed that he thought I was ignoring him and downed a whole bottle of sleeping pills.  He felt so awful from it that he begged his ex to take him to the hospital, and spent most of that time sleeping off what was still in his system, so I didn’t call him.  When he woke up, he signed himself out of the hospital AMA, and because his ex was working a 14-hour shift in preparation for her upcoming family reunion vacation, she had to leave work to take him home and then get right back.  He said he was okay and just wanted to sleep, so she trusted him and left him there alone.

In the middle of the night, my phone rang.  It was the sheriff calling to tell me that my father had passed away.  It was hard to know how I felt.  Not really surprise, because part of me expected that to happen, but on the other hand, I didn’t believe it, because it was not within his character.  I would not have thought this was something he would finish, because my uncle has done the sleeping pills thing many times when he just wanted somebody to fix things.  My dad had always been able to fix his own problems.  I asked the sheriff how it happened.  “He took his life with a firearm.”

The seriousness of intent in using a gun was undeniable.  He’d meant to die the first time, and wasn’t going to wait around in a hospital.  He had something to finish and this time he had to succeed.

I was 25.  My parents had been divorced for 10 years, and it always broke my mother’s heart that I didn’t have a closer relationship with him like she did with her dad.  I’d gotten used to his coming back and leaving again that first year.  I’d gotten used to his periods of depression where he’d move back to town in a trailer and go back to his old job for a few months, then patch things up with his girlfriend and walk out on his job again to go back to her.  That’s just the way things would go for him, so when my mom would ask if we’d talked lately and I’d coldly say I hadn’t heard from him in months, she couldn’t help crying.

The signs were there, y’know, the depression, the clues in the email about loneliness.  I, like so many others, ignored the loneliness and tried to fix the side effects.  Doled out the same suck-it-up advice that I would have expected if I’d written that email.  I might have expected worse, like “Tough break! You knew you couldn’t afford a horse.  Sell it and keep looking for work.  How many applications have you filled out since you lost your last job?  You should have been out there the same day looking for work.  And put on a smile.  Nobody is going to want to hire you if you show up looking depressed.  Maybe you’ll just do without a vehicle for a while.  And you really need to move out of your ex-girlfriend’s house.  She wants to get on with her life, and that’s really hard to do with you still living there.  Of course she’s got time for everyone but you, you’re split up and she’s got her own family to tend.”

Am I starting to sound like every heartless argument you’ve seen on facebook?  Because I didn’t even say those things, and my father killed himself.  Can you imagine what people feel like when someone actually does say those things?  Sure, it’s true, but it’s not helpful.  The person is not going to suddenly see how they’ve been making simple mistakes and start putting their life back together logically.

So the next time someone comes to you, not asking advice for what they should do to fix a messed up situation, but TELLING you they have a messed up situation, consider how recently your local paper reported a drunk driving death.  Evaluate the emotion behind the plea and handle with care.  You might be the last resort.
Blogging For Suicide Prevention Badge

USC’s MSW Programs Blog Day.

Lucid Dreaming: Part 1

I really hate it when a dream seems so real that I believe the events actually happened. I’ll do something terrible or embarrassing, and the next day I will feel like everybody remembers I did those things (only, of course, to realize that it never happened and they don’t know why I’m acting strangely). If only there was a way to tell myself that I’m just dreaming, I could have some control over the situation.

Well, some say there is a way. Lucid dreaming is the phenomenon in which the dreamers become aware that they are dreaming and are able, in some cases, to assert themselves over the content of the dream. If you are not making a conscious effort to achieve lucidity, it may happen infrequently, but you have probably experienced it at some point in your life. I remember my most vivid lucid dream. I became aware I was dreaming, but I still didn’t grasp the potential for experimentation. My dream still had to follow a story, so I created transitions instead of abrupt changes.

It went like this: I was walking down a highway and off to my left was this great prehistoric forest. Huge vines and massive trees set down in a valley. I was amazed and thought “I wish I could show this place to my friends…but it’s a dream.” With this realization, a light rain started to fall. I didn’t try to stop the rain. Instead, I created a place to escape the rain. On the other side of the highway, a strip mall opened up. The signs were all spinning like counters waiting for me to choose what kind of store each belonged to. What did I want? “Hmm, I could really go for some frozen yogurt.” A sign stopped on the TCBY logo and I went in to dry off and enjoy my dessert.

I hadn’t been trying at lucid dreaming; I wasn’t expecting it. I was unprepared for it, so I feel like I didn’t make the most of it. It’s hard to say if I could have controlled the dream any more if I had been expecting it, because our minds are wired to believe what they see. This is why hallucinations are so dangerous. Even if you rationally understand that your friend’s face couldn’t turn into a pile of squirming maggots, if that’s what you see, it will be hard to convince you it’s not real. For the same reason, no matter how strange and surreal the dream becomes, our brain is willing to accept it as reality.

EEG readings show higher amounts of beta-1 waves during lucid dreaming, which seems to indicate conscious thought. It can begin during a dream (dream-initiated), or you can transition directly from awake to dreaming without losing self-awareness (wake-initiated). I believe on occasion I’ve been able to transition through wake-initiated lucid dreaming, but it is very difficult to maintain conscious focus once you cross that threshold. I will close my eyes and begin dictating my environment, only to realize in a few minutes that my attention has wandered, wake and try again. Truly, if you need to get to sleep and your body/mind won’t let you, just close your eyes and really try to build a story. Don’t just think about things you have to do, visualize yourself doing them step by step. You’ll be dreaming in no time. Probably not lucid dreaming, but you’ll at least be sleeping.

A fair amount of research has been done on lucid dreaming, and one observation has been that the perception of time seems to be about the same during lucid dreaming as while awake. How do we gauge this? Eye signals. During REM sleep, our eyes jump around quite a bit, but imagine for a moment that you realize you’re dreaming and you have the ability to control where you look. Yes, you’re actually just looking at your eyelids, but your brain is still telling you what you see, so without breaking from the dreamscape, you are able to give messages to the waking world where scientists with electrooculograms record your activities.

The eyes are our best bridge for communication with the dreamer. In fact, devices have been marketed to lucid dreaming hopefuls that produce a blinking red light which is visible through the eyelid as a signal to the dreamer. Many of these devices were discontinued due to discomfort and poor success rate. The manufacturer says that success will dramatically increase if you follow the instructions on reality checking, but if you’re able to reality check in a dream, congrats you’re already expressing conscious control. They will lead you to believe that if you couldn’t do the reality check, the device isn’t working because you’ve failed to do your part. Sounds like a snake oil to me.

Awareness in dreams has been recorded and given names throughout history, especially early Buddhism. The term lucid dreaming wasn’t used until 1913 when Frederick van Eeden used it in a commentary article on sleep. It would be interesting to know, based on yesterday’s entry about the chemicals of sleep, what role adenosine plays in lucid dreaming. If you remember, adenosine is responsible for suppressing arousal, so would it also be responsible for keeping us dreaming once we’ve realized we are dreaming? Would higher levels of adenosine allow us more conscious control over the dream for a longer time or would it simply prevent us from realizing we’re dreaming?

Aside: Seriously, you need to watch Inception if you haven’t already. It’s pretty dark, but very relevant, especially with the inclusion of reality checks.

When I asked about the most interesting facet of sleep/dreaming, lucid dreaming topped the list of responses, so I would like to spend more time on this subject. Consider this Part One and check back soon for the continuation where I will discuss some methods used to achieve lucidity. Tomorrow’s free topic is just around the corner. Are you prepared?

REM Sleep: Introduction

REM is such a huge topic to cover, I’m going to put down some key points and probably revisit them in detail in later entries.

Rapid eye movement (REM) sleep is the stage of sleep we generally associate with dreams, but as we’ve seen in the July 10th entry on slow-wave sleep, there are actually two dream stages. During REM, named for the random darting of the eyes, the body loses muscle tone and an EEG registers quick, low-voltage readings.

Scientists have some theories as to the function of REM sleep, and the most common being taught in psychology is that the brain is trying to process and store information that may not fit into a clear category, and so dreams are very surreal and disjointed because your mind is trying to give structure to the memories. It’s trying to make a story. According to some studies, REM establishes procedural memory, though there have been conflicting studies that would suggest that this is a function of slow-wave sleep (in reference to the repetitive dreams of games that seem to improve performance upon waking).

REM is important not only for humans, but all land mammals and also birds. Evolution has done us a favor by including a mechanism for tonic immobility during this important stage of sleep. At our most vulnerable, can you imagine how easily a predatory would pick us off if we all acted out our dreams? That’s not to say it never happens. Watch any dog dreaming and you’ll probably notice some foot movement; what I like to call “chasing rabbits.” When functioning ideally, this paralysis (REM atonia) is akin to feigning death. When not functioning ideally, it can result in sleep walking, or sleep paralysis if it continues to suppress movement as the person begins to regain awareness.

REM atonia is produced by the release of monoamines (norepinephrine, serotonin, and histamine). Norepinephrine is partially responsible for fight-or-flight response, activating parts of the brain such as the amygdala. This explains why REM dreams are often very emotional, and also why it is so dangerous to try to wake someone who is sleep walking. The synthesis of norepninephrine depends on the amino acid tyrosine (found in meat, nuts, eggs and cheese). Tyrosine can be synthesized by phenylalanine, but you’ve probably heard all sorts of warnings about that. You find it in many diet drinks containing aspartame. Some people are sensitive to phenylalanine and may suffer seizures, but the same natural sources of tyrosine also contain phenylalanine.

A typical night of sleep involves many cycles through the stages of sleep. A cycle is about 90 minutes, and with each consequent cycle the duration of REM increases while slow-wave tapers off. It is sometimes referred to as paradoxical sleep because brain waves are very similar to those of an awake, alert brain. While it has similar brain waves, the body does a poor job of regulating things like temperature and heart rate during this time. It is also the stage of sleep with increased blood flow to genital areas of both sexes (which could total anywhere from 1 to 3.5 hours during sleep).

As I’ve said, REM is such a huge topic, I will be revisiting more specific elements in future entries. Tomorrow, I will be discussing time-lapse video studies, with which I have had some limited personal success.