Stan’s Journal 7-29-10

Dear Lord,

Be by my side as a friend and guardian.  Watch as I pull myself from this darkness.  This hole.  This hell.  Do not lead me, as my path is my own, a path to be forged by my hands alone.  Do not follow, as my mistakes need not be forgotten, washed away by your hand.  Walk beside me.

Let the light from your eyes shine upon me.  Illuminate my potential and smile upon my successes. Fore whatever I may achieve is better shared with a loving friend than either a master or slave.

Through your love I am empowered.  I am capable.  I am able to conquer life’s demons.

If ever I stumble, bruised and bereaved, lost unto myself, whisper your strength within my soul  fore even the darkest of times I will promise to love with honesty and forgiveness, certain to always rely upon the wisdom and understanding of an open mind, never to fall victim to my pride.

E.U.H. + M.B.S.

Well, I find it very interesting that we may be on our way to understanding depression from a different perspective – especially for those who have been on antidepressants and have not found lasting effective treatment.  This new knowledge has led to a natural vitamin treatment without side effects!

GENERAL INFORMATION ABOUT THE GENETIC TEST

The genetic test – which can be done from a simple blood draw- is called the MTHFR test.  The official name of this gene is “5,10-methylenetetrahydrofolate reductase” (NADPH).  MTHFR is the gene’s official shorthand symbol – and now you know why!  Just for an interesting clarification, the gene is located on the short (p) arm of chromosome 1 at position 36.3.

The normal function of this gene provides instructions for making an enzyme called methylenetetrahydrofolate reductase.  This hormone plays a key role in processing amino acids, the building blocks of proteins.  If a mutation occurs in the MTHFR gene, folate/B vitamins may not be broken down in such a way that the body can utilize them.

(Let it be known that this research and information is very difficult to understand and translate; in fact, it is nearly indecipherable to this lay person!  I have struggled with it and the following is hard won information which I hope will help you to understand this complex and emerging field.)

From a review of some of the literature and research on the MTHFR genetic abnormality, mutations of this gene may be implicated with the following:

• elevated homocystiene levels (a potentially toxic amino acid) leading to heart problems
• venous thrombosis
• blood clotting issues
• certain types of severe birth defects (for example, neural tube defects)
• miscarriages
• high blood pressure in pregnancy
• coronary heart disease and stroke
• mental illness, most often connected with depression and possibly schizophrenia

Researchers from all over the world are publishing studies searching for additional connections; a lot more information is on the way

Depression

In reference to my focus on mental health, The Hordaland Homocysteine Study is the one most quoted for their research connecting the MTHFR 677C-T mutation with difficulty metabolizing folate and B12; this leads to issues of elevated homocysteine, anxiety and depression.   Another important study is entitled:   “The Thermolabile variant of the MTHFR is associated with depression in the British Women’s Heart and Health Study and a meta-analysis.”

Both of these studies suggest that due to the body’s inability to metabolize folate/ B- 12  there is a greater risk of depression.  Here is how it appears to work:

• Depressive symptoms may be linked to insufficient neurotransmitters or  imbalance of one or more of the three neurotransmitters:

1. Serotonin (linked to obsessions and compulsions and memory)
2. Nor-epinephrine (linked to alertness, concentration and energy)
3. Dopamine (linked to pleasure, reward, motivation and drive)

• When these three neurotransmitters are in sufficient quantity and in balance, anxiety is reduced, impulse control and irritability is minimized, there is a capacity for positive mood and good cognitive function, attention can be maintained, and appetite is in normalized.  There is also normalized sexual drive and reduced aggression.

• Your doctor or other health care provider may prescribe  antidepressants to treat the imbalance of these neurotransmitters.  However, what we have come to see is that a significant portion of the population that does not respond successfully to antidepressants.

• This research may point to the reason for ineffective treatment of depression by antidepressants alone.  The theory here is that the brain may not be producing enough neurotransmitters due to insufficient amounts of L-methylfolate in the brain.  L-methylfolate is needed to regulate serotonin, nor-epinephrine and dopamine production.   Without enough L-methylfolate it may be difficult for the brain to produce enough neurotransmitters for the antidepressant to work fully.

• An abnormality in the MTHFR gene prevents the breakdown of folate/B vitamins; as a result, the neurotransmitter building blocks are not available for health brain function. By taking an activated, or metabolized form of folate/B vitamins the body is then able to produce sufficient neurotransmitters . This alone may improve functioning for some;  for others, by combining the activated form of folate/B12 with antidepressants, improved results follow.

• 70 percent of those with a diagnosis of depression may have a specific genetic factor that limits their ability to convert folic acid or folate from food or supplements to L-methylfolate.

• The prescription Deplin is actually L-methylfolate in an active, metabolized form that can cross the blood brain barrier to help the brain regulate these important neurotransmitters associated with mood.  This is a prescription item only, and  is not available in drug or health food stores off the shelf.

• There are no side effects with this product (as reported by the company that produces Deplin); patient surveys have shown 86 percent symptom improvement.

Test results show that if there is a positive genetic mutation  it may be what is called homozygous or heterozygous.  Here is a more detailed explanation of the definition of these terms.    These definitions are taken from http://medical-dictionary.thefreedictionary.com:

• Two copies:  Homozygous

• One copy: heterozygous

“having two different alleles at corresponding loci on homologous chromosomes. An individual who is heterozygous for a trait has inherited an allele for that trait from one parent and an alternative allele from the other parent. An individual who is heterozygous for a genetic disease caused by a dominant allele, such as Huntington’s disease, manifests the disorder. A person who is heterozygous for a hereditary disorder produced by a recessive allele, such as sickle cell anemia, is asymptomatic or exhibits reduced symptoms of the disease. The offspring of a heterozygous carrier of a genetic disorder have a 50% chance of inheriting the allele associated with the disorder if the other parent does not carry the allele.”

(While this level of detail is not easily understood, I wanted to insert it here since this is the language that geneticists use in sharing the results of the genetic tests administered.)

What all this complex information means is that it is now possible to effect positive emotional changes by identifying these genetic abnormalities and adding to the treatment regimen an activated (metabolized) B vitamin, thereby aiding in the production of neurotransmitters, which are the basis for health brain function.  These are the potential benefits to this protocol:

• motivation
• alertness
• initiative
• concentration
• improved mood
• sociability

This is new information and much more research is needed to understand how the genetic mutations of the MTHFR gene affect us; what is exciting is that the introduction of a natural vitamin may provide the key to improved mental health in over 70% of people with depression.

Does genetics determine our fate?  Not necessarily.  Some genetic predispositions can be altered by understanding and altering our diet and lifestyle. This is called Epi-Genetics!  Above and beyond genetics.   Welcome to the new world.

I will keep you posted as I gain more knowledge of this critically important emerging field.

Cynthia

Stan’s next session was so fascinating that I just had to share it with you.  How wise can a 21 year old be?  Find out by reading this (condensed) session:

Therapist:  How are you doing today Stan?

Stan:  I’m good.  I woke up to the sound of birds.  I’ve been waiting all winter for this.  Spring can come now.  I just love it.

I’m good.  I guess I’m kind of sad though.  Looking from the outside in I see that my mother and father are just so different.  They are two people that developed in their careers and professions.  They both love what they do.  They couldn’t be happier in what they are doing.

But after 30 years together they are so distant from each other.  I feel like they wasted so much of their lives with each other.  It makes me really sad.  They are always upset with each other.  They go through the same fights over and over.  For as long as I remember it’s the same cycle over and over.

When they were younger they focused on us kids.  It was family work.  Now they are left with each other and they are either fighting or are distant.  I see now that it is not just my brother’s passing.  It’s the choices they made in their life.

People go through so many changes in 30 years of marriage.  They tried but in the end it was such a waste of time.  Me and my brother know it.  I wish I could make them happy, but I can’t.

The way she is, I know what I can and can’t say.  And that is kind of sad.

Therapist:  When you and your brother move out of the house they will be left alone to face each other.  There will be no distraction.  We will see what they do with each other then.

Stan:  Even as a couple they are very lonely people.  Especially Mom.  She wants more out of Dad and he just doesn’t have the emotional capacity.

Mom always looked for more.  Look, it’s not my relationship, but it’s depressing to see such good people living out their lives of misery.

Therapist:  Do you think their unhappy marriage was in any way connected to your brother’s suicide?

Stan:  No.  He wasn’t happy with himself, his medical condition.  He loved his girlfriend but he felt he could never provide for her the way he wanted to.  Maybe the family stressors played a part, but it wasn’t the cause.

He wanted our parents to be proud of him.  It meant so much to him – not so much for me.  I never needed that, but he relied on them.

I wish Mom could see the reality of her relationship.  You know the truth?  Their relationship wasn’t a waste.  The two of them raised three good kids!  It’s just so lonely to watch them.

Therapist:  What lessons have you learned from how your Mom and Dad have conducted their relationship?

Stan:  It keeps me reminded.  It’s why I’m not dating.  It reminds me that I won’t marry because it’s “time” or because other people my age are getting married.  I will know when it’s right.  If it’s not there, it’s not there.

Therapist:  I know what you mean!  That’s what happened to me when I met my husband.  It truly was love at first sight.

Stan:  That’s what I want.  I don’t want to waste my time.  I feel that a lot of people choose comfort over love.  I want to experience love to its fullest potential.  Most people don’t really think about what they are doing and why they are doing it.

If “society” says it time to get married, I like this person enough, I am comfortable, let’s get married – what does this really have to do with the real you?  It’s like society “dumbs us down”.  Am I over-thinking here?

Therapist:  Not at all.  You are looking deeply into your feelings and what really matters to you.  You are considering the long term.

Stan:  Like my brother’s friend.  He’s been with this girl for 10 years, since Junior High School.  Their relationship already shows signs of dysfunction. He is so easy going.  He jokes around and is so much fun.  That’s the very thing that she hates about him.  Sooner or later he is going to resent her for sucking the life out of him.

I just want to shake him.  “Don’t do it!”  “What are you doing?!”

Yes, I know marriage is work. You will have ups and downs, but if you make the wrong choice, you are divorced and you just haven’t signed the papers yet!

If you don’t see it, I can’t make you see.  As for me, It would be nice for me to get married and have kids, but if I don’t I will be fine.  It’s OK.  There are plenty of kids to adopt.  Marriage is not something I expect of myself.

Therapist:  You are very wise.

Stan:  What I wish is that if I want to marry that I ask my family and friends to give me the most honest appraisal of what they see, and what they recommend for me.  They may see something I don’t.  I will listen and take seriously into account what they see.

You know what I think?  Comfort is dangerous!  It is the enemy to being true to yourself if you don’t really love at the same time.

The sun is shining today.  Summer is on the way.   Haa-haa.  I love the sun.  I love living…..

This young man is determined to find his truth and follow it.  Through the pain, suffering and loss he has gained a deep wisdom that has allowed him to forge a path of integrity and authentic love.  He has found a way to honor himself in a way that will not compromise his need for true and honest love.

What a joy to see him grow and find his true self.

Cynthia

Many of you have never been in therapy.  Maybe you wonder what it would be like.  You may be curious about the kind of interactions that take place, and what can be expected.  Here is one example of a successful therapy.  If you noticed my write-up on the home page of this website, I outlined the trends associated with the beginning, middle and end phases.  This is an example of a session in the latter phase of therapy where lessons have been learned and integrated.  The learning is not over, the challenges will continue, but this person has the tools that he was missing before.

So here is an inside look at the process.  Remember, each person is unique, each session is unlike any other.  Here is one hour in the life of a therapist and patient:

Therapist.  Hi Stan.  How are you doing today?

Stan.  I’m still doing well.  Though it has been difficult to adjust to a life without chaos.  I actually feel selfish because things are going so well.  The one thing I wanted I’m getting.  I have my mother back in my life and we are getting along just like we used to, only better. Better now than ever…. It’s hard to live without stress.  It’s a learning curve.  Ironically, it’s the hardest part!

T. Harder than the chaos that you lived through?

S.  It’s like climbing out of the mental web that I built. I became so accustomed to  chaos dominating my day.  It’s weird now.  I have to be conscious all the time or I get caught back up in how I was, in how I reacted and felt then

It’s hard being here now because my mind constructs a pattern of  how to deal with the pain and chaos, even though my present life is good.

Like I drank this weekend.  I stopped for so long and it felt good, but then I got together with the guys and I went for it.  I drank.  I had a decent time but yesterday I felt so bad that I wasted my time.  I felt bad about myself.

Last night Mom and I talked.  She was rational and made so much sense.  She was calm and listened to me.  She walked me through it just like she used to.  It was so helpful.  She said, “Don’t worry” and I felt better! I told her I need reminders that it’s OK, that I’m OK.

At times I feel like I’m 30 or 40 years old.  The last three years felt like a lifetime.  With my brother’s suicide I went crazy, and the whole family broke down.  Now I see kids my age and they have moved on, they are farther along in college than me.  My life spiraled down into the depths, while their educational life took off.

That’s what I told Mom, and she told me, “What is the alternative?”  It made me stop.  She said it all evens out.

T.  That is so wise.  And you took it in?

S.  Yea, but I’m impatient.   I realize I have so much work to do.  And Mom kept on reminding me, “You’re only 21″.  But I don’t feel 21.  I’m in a mental marathon and it consumes me sometimes…. I guess I’m a work in progress….  But I did one thing right:  I asked for help before I started to spiral out of control.  I knew I started to freak and I just asked for help.

T.  Good for you.  You are starting a new pattern.

S.  Sometimes I feel like I live two different lives.  I’m here, then I jump ahead in my mind.  Like, where will I be in two years?  How will I ever do it?  When I said that to Mom, she said, “Be here now, be in this semester, breathe.”

T.  Great advice again.

S.  Now I have room to breathe.  I have room to think because we aren’t in the misery and anger and chaos anymore.  Ever since I wrote her that letter about how I really felt, it all changed.

Now I have a desire.  I am starting to think about being in a good relationship.  Before this, I was so messed up I felt I couldn’t put a woman through the complications.  My life was just too complicated.  So I decided just not to be with anyone.  For years, it wasn’t even a choice.

T.  But something is happening to you now, something is opening up so you are starting to want a connection, a real connection.

S.  But is it really possible?  And would it be positive?

T.  Absolutely!  If you are thinking these thoughts, then you are getting ready to let in someone special.  In some areas “if you don’t use it you loose it.”  Not in this area.  You have the capacity to love, and now that you have worked through your loss, you are beginning to move on, and you are ready to open up to love.  And to Now!

S.  Really??!!  This makes me feel hopeful that you say that.

T.  Yes, and when you feel ready you will send out a wavelength, a vibration – just like you can feel the energy of someone who quietly stands behind you.  And you will attract someone of the same wavelength.

S.  Ahh…  Just like in the song, “Wavelength,” by Van Morrison!

T. Right!!!  It took healing with your mother and accepting the loss of your brother to be ready and open for a relationship.

S.  I want to marry a woman who is like the best of my mother;  someone who is strong, assertive, who is an individual with her own thoughts.   I don’t want a passive and compliant woman.  The way my Mom brought me up I have a healthy respect for women.

I realize that lately I’ve been thinking about writing about my experiences and what a young person goes through when they loose a family member to suicide, and what the family goes through.  Then I wonder, who would care?  But then I say, wait, so many people have to deal with the suicide of a family member or friend.  I could write from the perspective of a young person who had to live through it.

T.  I didn’t realize that you had thoughts of writing about this.  I encourage you to start taking notes.  It doesn’t have to be in sequence, just jot down what comes to mind and you can pull it together later.  That is a fantastic idea.

S.  Yea, I have this urge to visit high schools and to be real and talk about my experiences, to give kids an idea about the consequences of a suicide, how it affects others.  Coming from a young person it could be more powerful.

T.  Absolutely!

S.  Even if I changed one mind, it would be worth it

T.  You have transformed your own pain into the gift of giving to others your hard won wisdom and love. I am so proud of you.

S.  And I realize that I need to learn how to become a man!  I like that my Mom taught me and was the one who brought me up.  I feel that that transformation will be complete when college is done.  Then I will enter life as a man.  I know I have the perfect formula.

I want to become a wise person who is positive and helpful.  I feel like I’ve already done the hard part.  The next part is in accepting how well things are going.  Now I need to accept the calmness.

I see that If I can put it together I have the potential to be a positive force in the world.  It’s hard as hell.  All I can do is hope and stay focused.  I couldn’t have done it without you.

T.   Congratulations.  You are transforming now into the person you have always wanted to be.  I am so honored to have helped.

So that is one session.  This is one hour in the life of a therapist and one patient!  Sounds too good to be true?  Actually, no.  This session is the culmination of years of hard work.  So young, yet he has worked through so much pain and loss, and transformed in a most amazing way.  This session is a literal transcription.  Amazing isn’t it?  Amazing but true.

Cynthia