Women Living Well Seminar 2002
Mind and Body Connection

Or (better?)
Thinking About Mood

The Medical ModelThe Biological/Neurobiological Model
presumption of "illness" as distinct category

presumption of perfectibility

presumption of all people as aspiring to same "ideal"

presumption of "patient" as object

search for efficient "quick fix" therapies

neglects (particularly for "mental health") to deal with important issues of personal responsibility

accepts existence of continuous variation among individuals, both now and in future - indeed encourages diversity

emphasizes importance of innate influences, as well of experience and of personal choice

acknowledges that some kinds of changes take extended time at best, may not be achievable at worst

incorporates cultural context dependence

helps to define both potentials and limits of personal responsibility

  • Genetics
  • Diversity
  • Continuity
  • Adaptiveness

  • Influence of experience/culture
  • Influence of drugs
  • Influence of self

Some further implications of the biological/neurobiological model:
  • We are all "experts"
  • We are all explorers
  • PG not "authority", may have some relevant experiences
  • Need to think/learn about mood together, now ... and in future

Re individual differences and continuity and genetics ...

  • I only had a headache once in my life that I recall ... Jennifer
  • I'm definitely more prone to get headaches ... Kate
  • I have always suffered from very painful migraines since the age of seven ... C.
  • Headaches run in my family ... Marie
  • When I get a hedache,I take an aspirin ... Ana
  • When all else fails, a trip to Starbucks is a sure and quick way to rid myself of headaches ... Greta
  • When I have a headache, I usually drink some honey ... Rabia
  • I have found it to be true that I get fewer headaches now that I'm not "taking something" every time I think I have a headache ... Lois
  • I have been very fortunate in that anxiety has never been a major concern for me ... Ana
  • I have never really suffered extreme stress or anxiety before, but after listening to Wed lecture I am definitely more sympathetic to my friends that have ... Jennings
  • I've actually paid a lot of attention to my patterns of anxiety this year. Although the anxiety I experience is not at the level of a disorder, I have noticed that I tend to worry about things a little more than I really need to, and there were a few characteristics that were pointed out in the talk today that I have noticed in myself, such as irritability/restlessness/needing things to be very neat and symmetrical/etc. ... Hedya
  • Anxiety is always a factor in my life. i don't think there is really a time when it is never not there; there are only relative degrees of its presence. ... anxiety has kind of normalized for me so that i've come to feel like it's a part of me ... Aeronwy
  • Anxiety related disorders run in my family and I have been on and off medication for panic attacks as well as a general anxiety disorder ... Natalie
  • Call me crazy, but I am addicted to anxiety. I love the rush ... Alice
  • My boyfriend and i get into fights about anxiety. I say anxiety is important, not even just the kind of adrenaline anxiety you get when you need to save your life or something, but normal anxieties. It kind of makes me feel creative and makes me highly aware of my surroundings and and all the sensual details ... Molly
  • My job in the near future is not, I dont think to elimate anxiety from my life--it is practically a part of my personality!-- but to learn how to manage it ... Rachel
  • Anxiety is a common problem, especially at a place such as Bryn Mawr and should be discussed more frequently ... Sara
  • If, for example, the events of September 11th have made you anxious, perhaps educating yourself into the range of possible causes for those events, and acting to intervene to change them...might help your anxiety. And help to "heal" some much larger issues along the way ... Anne

Continuum, genetics plus, culture, personal action ... Mood?

... I have of late - but
wherefore I know not - lost all my mirth, forgone all
custom of exercises; and indeed it goes on so havily
with my disposition that this goodly frame, the
earth, seems to me a sterile promontory, this most
excellent canopy, the air, look you, this brave
o'erhanging firmanent, this majestical roof fretted
with golden fire, why, it appears no other thing to
me than a foul and pestilent congregation of vapors.
What a piece of work is man! how noble in reason!
how infinite in variety! in form and moving
how express and admirable! in action how like an angel!
in apprehension how like a god! the beauty of the
world! the paragon of animals! And yet, to me,
what is this quintessence of dust? man delights not
me; no, nor woman neither, though by your smiling
you seem to say so.
.... William Shakespeare, Hamlet

I felt a funeral in my brain,
And mourners, to and fro,
Kept treading, treading, till it seemed
That sense was breaking through.

And when they were all seated,
A service like a drum
Kept beating, beating, till I thought
My mind was going numb.

And then I heard them lift a box,
And creak across my soul
With those same boots of lead, again,
Then space began to toll

As all the heavens were a bell,
And Being but an ear,
And I and silence some strange race,
Wrecked, solitary, here.
.... Emily Dickinson, #112

I have notic'd in the Writings of the French Mysticks, & in those of our fanatics here, that, when they give a History of the Situation of their Souls, they mention a Coldness & Desertion of the Spirit, which frequently returns, & some of them, at the beginning, have been tormented by it for many Years. As this kind of Devotion depends entirely on the Force of Passion, & consequently the Animal Spirits, I have often thought that their Case & mine were pretty paralel, & that their rapturous Admirations might discompose the Fabric of the Nerves & Brain, as much as profound Reflections, & that warmth or Enthusiasm which is inseparable from them
... David Hume, Letter to Dr. George Cheyney, 1734

My daughter Ashley, an engaging, highly intelligent, beautiful, and artistically talented teeanger, suffers from a life threatening genetic illness. It is an illness of extremes with a high, some estimates are as much as 20%, mortality rate. It is sometimes, as with my daughter, difficult to treat. It is always difficult for those so afflicted and their families. The contemporary nomenclature for this disease is Bi-Polar Disorder. But I prefer the more descriptive, no longer politically correct name, Manic Depression.
.... Debbie Plotnick, 1999

Today I am a strong, healthy woman who, quite frankly, did not expect to live to see adulthood ... Manic-depression is part of my life. I cannot deny that. It is encoded in my genes. But that doesn't mean it has to rule my life -- and I haven't let it.
.... Ashley Plotnick, 2002

"a sterile promontory ...man delights not me, nor women either"
"Wrecked, solitary, here"
"a Coldness and Desertion of the Spirit"

Experiences familiar?

  • In own life?
  • Among friends?
  • Among family?
  • Varies in severity - may be life-threatening
  • Is quite common
  • Is a brain state
  • Does reflect genetic influences (among others)
Mood variations?
Why? How influence them?

Depression and bipolar syndrome

  • Are extremes of a normal adaptive process
  • May be dealt with by altering experiences/expectations/choices
  • May require professional help (no guilt/shame)
  • May be helped psychotherapeutically or psychopharmacologically, frequently are best helped by both
Relation to stress/anxiety/culture? "... I cou'd think of no other way of pushing my Fortune in the World but that of a Scholar ... I was infinitely happy in this Course of Life for some Months; till at last, about the beginning of September 1729, all my Ardor seem'd in a moment to be extinguisht ... I ... never imagined there was any bodily Distemper in the Case, but that my Coldness proceeded from a Laziness of Temper, which must be overcome by redoubling my Application ... I was continually fortifying myself with Reflections against Death, & Poverty, & Pain, & all the other Calamities of Life. These no doubt are exceeding useful, when joined with an active Life; because the Occasion being presented along with the Reflection, works it into the Soul, & makes it take a deep Impression, but in Solitude they serve to little other Purpose than to waste the Spirits, the Fource of the Mind meeting with no Resistance, but wasting itself in the Air, like our Arm when it misses its Aim. This, however, I did not learn by Experience, & till I had already ruin'd my Health, tho' I was not sensible of it.
... David Hume, Letter to Dr. George Cheyney, 1734

Culture can contribute to depression/mania by generating anxiety, unachievable aspirations

Depression may sometimes be an adaptive response to unreasonable expectations, a way of coming to understand the need for change either in oneself or in culture or both.

Are depression/mania "good" things?

I have often asked myself whether, given the choice, I would choose to have manic-depressive illness. If lithium were not available to me, or didn't work for me, the answer would be a simple no... and it would be an answer laced with terror. But lithium does work for me, and therefore I can afford to pose the question. Strangely enough, I think I would choose to have it. It's complicated... I honestly believe that as a result of it I have felt more things, more deeply; had more experiences, more intensely; loved more, and have been more loved; laughed more often for having cried more often; appreciated more the springs, for all the winters... Depressed, I have crawled on my hands and knees in order to get across a room and have done it for month after month. But normal or manic I have run faster, thought faster, and loved faster than most I know."
... Kay Redfield Jamison, An Unquiet Mind

Individuals need to be free to most effectively recognize their own strengths and limitations

Classifying individuals as deviant has some positive features; stigmatizing them does not.

Cultures need to be supportive of individual self-discovery and the resulting diversity. Individuals need to contribute to making cultures so, for the well-being of both

NEVER discount the capacity of the brain to paint different versions of a given "reality"

To go on exploring ...

Charles Nemeroff (1998) The Neurobiology of Depression, Scientific American, June

Kaye Redfield Jamison, An Unquiet Mind, Vintage Books, 1995

Kaye Redfield Jamison, Touched with Fire, Free Press, 1993

T.M. Luhrman, Of Two Minds, Vintage, 2001

Casey, Nell (ed), Unholy Ghost: Writers on Depression, Perennial, 2002

Mental Health, an extensive set of resources from the Center for Science in Society and Serendip

Brain and Behavior, resources from Serendip

Topics in Brain and Behavior, index to student web papers on topics including depression and bipolar syndrome

Who's Afraid of Emily Dickinson? Or ... How I Learned to Stop Worrying and Love the Brain, an article on the brain and psychotherapy

Paul Grobstein, 10 April 2002
With special thanks to Jarl Dyrud and Warren Hampe