Some Interesting Tools for Depression

Elsewhere on this blog, I’ve written/drawn about my mental and other health problems, and in particular about how I found out, 15 years into treatment, that I had a B-12 deficiency. What was so frustrating to me about this discovery was that:

  • B-12 deficiency has been a known cause of depression for 70 years
  • The test is simple
  • The treatment is simple, cheap, and has no side effects — it’s a water-soluble vitamin

and in particular,

  • NO ONE tested me for this over the course of 15 years!

And now, having experienced B-12 deficiency for a long time, I find I need massive amounts of B-12 shots just to get me back up to “normal.” **

In Applied Grace, I suggested a simple protocol that all mental health providers should use to Rule Out the Simple Stuff. But if your health care isn’t up to par, what then?

Enter: 23andMe.

There are a million different potential causes for mental health issues. BUT, a LOT of mental health issues have a genetic component.

Right now, you can get a test on 23andMe, and download the zip file with raw data. You can then upload that data to Promethease, Genetic Genie, and Found My Fitness (among others). They’ll tell you things like whether your body is bad at methylation and needs more B-12 and methylfolate. Whether you don’t absorb or process Vitamin D very well. And other useful stuff!

When I did these tests, I think I spent a total of about $30 after my 23andMe testing, and it was very useful. Some of the results even indicate things like, “probably responds poorly to __________ SSRI.” Wouldn’t that be great to know, before trying to take that SSRI!?!? Seems like the kind of thing it would be useful to know before going on medication, amirite?

So, this is what I recommend to all people struggling with mental health issues. Worst case scenario, you find out something else that’s useful, like a tendency towards diabetes or celiac. Best case, you’ve equipped yourself with the tools for a real change in how you feel.

Should actual “doctors” being doing this for everyone these days? Yes. Are they? Hell no.

So do it yourself, you’ll be happy you did.


** Pretty much the same exact story in non-cartoon form is told in a Wall Street Journal article this year. Long story short: chronic B-12 deficiency makes certain functions in your body deteriorate, which makes you need even more B-12. After a lifetime of deficiency you’ll end up in catch-up mode.

Lead and Fate

There’s an interesting article in Mother Jones, or more accurately a meta-article, which discusses the research that’s been done linking the decline in childhood lead exposure in the 1970’s and onwards to the decline in crime rates in the 1990’s, when those kids would have hit adulthood. It’s sobering reading.

I was born in Europe, which banned lead paint far before America, and I was past the whole eating-paint-chips phase of life by the time I moved here. So, by an accident of birth, I got to spend my most vulnerable brain development years safe from lead paint, while my age cohort peers in the US did not. This is especially true for kids in my age range who lived in substandard housing.

I was a smart kid. All the adults praised me and complimented me for being smart, as if it was an accomplishment, rather than an accident of birth. But now I see that, in addition to winning the genetic lottery for math ability, I also won a “right time and place” lottery for avoidance of lead. All these things I had literally nothing to do with, helped me to excel in school and get whatever success I’ve had in life.

America is a country with a strong mythos. It’s a fairy tale made by corporate backers, and then spun into the fabric of our society until its origins are obscured in the mists of time. The fairy tale says, You are more than just your circumstances, You can accomplish anything you set your mind to, Random misfortune is not going to defeat You, You can overcome anything with Pure Grit.

We’re fed these stories ad infinitum.

But if the quintessentially American truth – or should I say “truth” – is  about excelling in spite of adversity and not being defined by circumstance, the quintessential truth  keep coming back to is the opposite: how much of one’s life is circumscribed by random chance. How things that happened decades ago, in childhood, over which we had no control, can still limit our lives right now, today.

The can-do Americanism holds within it a darkness, which is the seed of judgement and rejection. If anyone can overcome anything, then your failure to overcome must be a character flaw. And if you’re just making bad decisions, then I don’t have any responsibilities to help you, as a fellow human being.

But being aware that random circumstances can have profound after effects creates the opposite feeling. There but for the grace of God go I. And with that feeling comes the responsibility to help our fellow humans, in whatever circumstance.






The Five Stages of Health

In an earlier post, How Things Got Better, I talked about the process I went through to choose Boise, Idaho as a place that would help support my health. I thought I would write a few more posts this summer about my (mis)adventures dealing with health problems.

From the time I contracted Lyme Disease in 2009, to the time I moved to Boise in 2014, I struggled a lot with my health. The most difficult thing for me was not the pain, weakness, chills, or fever, but rather the sense of isolation I experienced. The Austin social scene was all about the moveable feast; by not being mobile or healthy, I missed out on the sense of community I’d come to rely on. I began to feel as if life was like a beautiful circle, and I’d been somehow cast outside of its bounds, into a shadowy nether realm. The only people who seemed to make the effort to reach out to me now were Netflix, Amazon, television advertisers, and mail order catalogues.

And a few very dear friends. Thank you.

All this is to say: there were two aspects to getting through this time; the emotional / spiritual, and the purely logistical. The emotional/spiritual was comprised of questions like, “If I used to have friends before illness stripped my talents away, and my friends don’t come see me anymore, did I ever really have friends in the first place?” ***

The logistical was more like this: “If I don’t get out of this house soon, I promise you I will lose what little grip on sanity I have left!”

The challenge I had with my illness was that my health was extremely variable, and I was too ill to drive safely in car-centered Texas. This led me to articulate the 5 Stages of Health:

#1: I am too weak to get out of bed.

#2: I am too weak to leave the house.

#3: I am feeling well enough to do something easy, as long as I have a way to get there and back.

#4: I am feeling well enough that I could do something energy-intensive, such as walking in a park, as long as I have a way to get there and back.

#5: I am strong enough both to do an activity, and to transport myself there and back.

So, as you can see, if you are at Stage #5, you are more or less independent. You may still have health problems, but they are not holding you back from mobility or activity. I was rarely in Stage #5.

On the other hand, if you’re at Stage #1 or #2, mobility isn’t even a problem because it’s not really an issue. If your head is split in two with a horrible migraine, you don’t really care whether, in theory, you’d be well enough to drive today.

The problem is when you’re at Stage #3 or #4 — well enough to engage in activity, but not well enough to be independent. Too often, when I lived in Texas, I would be stuck inside even when I was at a “4” level, because of a lack of appropriate transportation.

What do I mean by this? Well, a person with ok health but no car can plan to take a taxi to a special event. However, a person with extremely variable health may spend $20 for a taxi to an event, only to realize 20 minutes later that a dizzy spell is coming on and she has to get home right away. Maybe by now the taxis are all taken and she must wait, extremely sick, out in public, at the event.

Or maybe the taxi arrives promptly, and she goes home, having spent $40 to exhaust herself, and take a round trip straight back to her home, and not go to an event.

Because of this variability, and also the expense and inconvenience, the person with poor variable health really needs either a loved one who is willing to put her first — to drive her and take her home when she needs — or some form of transport that’s under her control. Otherwise, the fear of collapse while out in a public space is too great, and she stays home. Again.

This is particularly frustrating because healing from illness is a mental game as well as a physical one. If you spend all month being diligent and cautious, and finally have a day where you’re at Stage #4, you want to experience some positive reward for your efforts. If, however, the only reward is that you are merely well enough to feel even more keenly the bars of your prison, then there is almost no incentive towards getting better. In such a scenario, there are no repetitions of success when you improve, only repetitions of failure, and it can be extremely difficult to crawl one’s way towards a better life.

The wonderful thing about moving to a walkable city like Boise is that I finally get to build on my successes, rather than only suffer from them. I have things I can do when I can only walk 3 blocks, things I can do when I can walk 8, and even other places I can get to when I can walk a mile or more. As I’ve mentioned before, the dry climate is very supportive of my health, but so too is the knowledge that, if I can get just a little stronger, I can experience even more success. That in itself is an incredible incentive to work even harder at my recovery.

If I were to suggest a takeaway from this experience, it would be that if you or someone you know is struggling with something very hard — whether it’s recovery from an illness or learning a difficult subject in school — make sure that, for each measure of progress you gain, you also gain a commensurate reward. If you have to achieve perfection before you can even start living your life, you’re playing the wrong game.


*** It can lead to even deeper (and more confusing) trains of thought, such as,

“Aren’t all relationships, at their source, mere transactions?”

“Do we ever really ‘love’ anyone, or do we just love what they can do for us?”

“When even something as fundamental as someone’s personality can be changed in an instant by illness or accident, how can we promise to love someone ‘forever?'”