How nurture changes nature

I attended the Society for Neuroscience 2008 annual conference for work, as a member of the media. Although I didn't formally write anything up, I did attend two press conferences. One of which Tiptoe wrote about here on addiction and impaired insight (via press release, which was accurate to what was said during the conference), and one that I'm going to summarize here.

In some sense, your genes are your genes. You're born with 'em, you die with 'em. Other than in cases like cancer, they don't change. Clearly, however, our environment effects us. When fair skinned people stand out in the sun, they get tan (or they burn). When we diet, our metabolisms slow. If we keep dieting, they stay slow. And, researchers are finding out, traumatic experiences early in life can permanently change the brain.

The body can turn genes on and off via different environmental cues by adding and subtracting methyl groups (teensy little molecules) that they attach to the DNA. Because DNA is super-long, it has to coil around itself like a huge ball of yarn. But if a gene is going to make a protein, it can't be in the tightly wound part, or else all of the other proteins in the cell can't get to the gene. Adding a methyl group (among other things) alters the ability of the cell to read the gene, literally silencing it and preventing access to the protein-making machinery of the cell.

This whole process is known as epigenetics. Some genes that have been epigenetically changed during fetal development (and therefore before the formation of the sex cells) can be inherited. Most aren't.

And it turns out that trauma in early life can prevent a specific gene (BDNF- brain derived neurotrophic factor) from ever turning on. BDNF is one of the big master switches in the brain. Among other things, BDNF is active in areas of the brain responsible for learning, memory and higher thinking. Abused rats showed decreased levels of BDNF long after abuse and neglect had stopped, and they also showed many anxiety traits. These epigenetic changes were primarily found in the amydala, the center of the brain that controls anxiety and fear.

For a full summary click here and scroll down to page two.

Earlier, unrelated research on the brains of people who had died by suicide found numerous epigenetic changes in the GABA genes when compared to those who had died from other causes. GABA is a neurotransmitter linked to mood regulation.

Writes Peter Kramer in his blog, In Practice:

"...in the face of adversity, certain genes in the brain will be methylated, effectively shutting them down. Once they occur, these changes are difficult to reverse, creating stable disabilities, perhaps for the remainder of a life. Bad experience gives mammals a different genetics and different brains."

Childhood abuse is generally thought of as a HUGE risk factor for pretty much any sort of mental illness. It has also been tentatively linked to bulimia and bulimic behaviors. These studies, among many others, only help to emphasize that a biologically-based illness can be influenced by the environment. And with this research, they're finding out how it might happen at the biochemical level, and how these changes might one day be reversed.

Your Mind Sheriff

In a book I was reading (about which I will blog more about later), a therapist talked about having to play "mind sheriff" with some of her more difficult patients, imposing order on the chaotic Wild Wild West that was their thoughts.

And I thought, what a fantastic idea!

I will never deny that my thoughts are chaotic--they can be gun drawing outlaws that want to run the town. Much of therapy has been bringing order to the chaos, sorting out which of these "thought outlaws" might have a genuine gripe (them thar cows are grazin' on my land, pardner!), and which are just screwy little buggers that have no good purpose.

I beat myself up a lot for having a lot of these anxious, depressed thoughts--not to mention the eating disordered ones. Letting these thoughts run the show is not okay (maybe not my fault, but not okay), but I can't help it if they decide to show up.

I'm being a sheriff to my thoughts. I get to decide which thoughts make sense and which don't, which thoughts I let live in my mind, and which thoughts I let slip away. I'm not always good at that, mind you. Ed does a mighty good sheriff impersonation at times. I need to remind myself that Ed is just one of those gun-toting outlaws, wanting to be sheriff, and usurping my power.

Sometimes it feels nice to let him be in charge in my brain. He does bring some minimal amount of order, often by ruthlessly suppressing any other thought outlaws. But it's MY brain, NOT his. Wherein lies the problem. He treats ME like I'm a thought outlaw. He wants to run ME clear out of town.

Not cool.

I am working to make Ed a permanent outlaw in my head. But even if it doesn't work, even if all of those "WANTED- DEAD OR ALIVE" posters fail to scare away his mangy ass forever, I'm the sheriff. I can have him hunted down and arrested, and tossed out again.

Because I'm the sheriff in my mind.

It's a twofer!

Do some good this holiday season by participating in the NEDA Online Auction. Among the many items you can bid on is an autographed copy of my newest book, Next to Nothing.

Help NEDA, buy gifts for people. Seriously. It's that easy.

The bidding ends on December 1st.

Gathering on the internet, around their disorder

When I was first diagnosed with OCD, almost 9 years ago now, I remember finding someone else who also had fears of AIDS contamination. I gasped, and then giggled a bit, in relief. I wasn't alone. For the seven years between the onset of my symptoms and my diagnosis, I thought I was living in a delusional world, Population: One.

I wasn't. And it felt pretty good.

Many people diagnosed with a mental illness (or other condition) find great solace in virtual gathering places where they feel less alone, where their daily trials and tribulations are understood and honored. These places--websites, blogs, bulletin boards, chat rooms--can be incredibly healing.

They can also keep an individual stuck in their illness.

An article in this week's New York Times discussed a disturbing trend of websites that support the idea of mind control. In this case, sufferers of paranoia or schizophrenia who believe they are being stalked or that their minds are being controlled gather together on websites, where they swap stories and provide evidence of how they are all being stalked or controlled.

In the article, Dr. Ralph Hoffman, a psychiatry professor at Yale is quoted as saying:

“The views of these belief systems are like a shark that has to be constantly fed,” Dr. Hoffman said. “If you don’t feed the delusion, sooner or later it will die out or diminish on its own accord. The key thing is that it needs to be repetitively reinforced.”

You could easily argue, as was mentioned in the paragraph after this quote, that the pro-eating disorder websites are exactly the same thing.

A person with an eating disorder isn't generally delusional, except on the subject of food and weight. Then, all bets are off. And this gathering of people only feeds and reinforces the "shark" of the eating disorder. The solace of knowing you aren't the only person afraid of potential calories in Chap Stick is lost to the swapping of weight loss tips and out-and-out competition to lose the most weight.

Some have argued that these websites can be the only support these sufferers get, and so leave them up. But these websites aren't supporting sufferers. They're supporting the illness.

And that is the difference. It's why I participate in this blogging community, and not other message boards, including those deemed "pro-recovery." There, I often feel I am shouting into the wind, and that those sites only reinforce the illness. Why is this community different? Perhaps its people in recovery or actively pursuing it. Maybe it's because we don't just talk about the eating disorder.

Speaking of people believing they are being stalked or controlled: "These people lead quietly desperate lives,” said Dr. Jeffrey A. Lieberman, chairman of the Department of Psychiatry at Columbia University. “And if they are reinforcing each other and pulling people toward something, if they are using the Internet and getting reinforcement, that’s good."

And in this little corner of the blogosphere, I think, we are are really reinforcing recovery.

"The Journey"

I try not to quote stuff verbatim on my blog, but every now and then, I read something that takes my breath away, and I must share. I found this on a friend's Facebook profile.

The Journey
by Mary Oliver

One day you finally knew
what you had to do, and began,
though the voices around you
kept shouting
their bad advice --
though the whole house
began to tremble
and you felt the old tug
at your ankles.
"Mend my life!"
each voice cried.
But you didn't stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do --
determined to save
the only life you could save.

Please stop

When I see headlines like this: "What some students will do to achieve a skinny figure," I want to throw things at my laptop. Please, stop with the stereotypes. Stop making an eating disorder out to be something so seemingly trivial.

An eating disorder is NOT about being thin. It's not about anything. It's an illness, not a choice.

Parts of the article were actually quite good- there was a decent amount of good, factual information in there, based on science and research. I also know several of the people, as this high school was right near where I grew up (though I did not attend this school). However, despite the statements that a lot of the illness was genetically based, there was also plenty of beliefs that it was "about" control, and needing to know why you got sick in order to get better.

Knowing your vulnerabilities will help you stay better, but they won't really help you get there.

I did like, however, that the article had a good focus on bulimia without being gory, and it didn't glamorize any of the symptoms.

I wish the article had said: "What an illness will drive someone to do."

I wish the article had said: Don't wait for the person to get sicker while they try and help themselves. Tell an adult NOW.

But I'm glad it ended with the real hope of recovery.

Assumptions and definitions

I have two very lovely green bell peppers in my possession, and I was poking around the internet, trying to find a good recipe for stuffed peppers.

On one of the sites, I noticed a section called "Light and Healthy," which made me stop.

How did low fat get defined as healthy?

I mean, yes, it's somewhat obvious, if you read a newspaper these days: we're all freaking the hell out over obesity. And the underlying assumption there is that fat=unhealthy. Then, we take the assumption one step further and equate foods with fat with fat people. Ergo, low fat is healthy.

Right?

The obvious corollary is that everything else is unhealthy. I mean, if it's not in the section labelled "healthy," what what in the hell else are you going to define it as? When you're looking at a site with thousands upon thousands of recipes, and one small section labelled "Light and Healthy," then surely we're all doomed.

Not so much. Your health is very personal- when I had to gain weight, low fat wasn't healthy for me. Even now, the number of fat grams in a recipe doesn't say anything about how nutritious it might be. Or if it's what my body needs.

It's a pernicious little assumption, and on every cooking site, the low fat/low cal/low carb recipes are all in the "healthy" section. Other sites will "healthify" a recipe for you, by taking out as many "extra" or "unnecessary" calories and fat as they can and still leave you with a product that vaguely resembles the original. I don't care if there are sections labeled "low fat," because that's a description, not an assumption.

We need to stop assuming that low fat or diet food means healthy, and start defining food and health in different ways.