Mental Health Monday: Physical Evidence

October 25, 2010

Ed. Note:  This is Part One of a two part series on medical imaging and mental illness.

Once upon a time, before I had borne my own children, I was Building a Career.  I was VERY Type-A; I had ambitions for my ambition.  I didn’t have a timeline, per se, but I generally figured I’d be in middle management by about my mid-40s, and that I’d doing something extremely lucrative and exciting by the time I was 50.  Or so.

Did I mention I’m currently 42?  I did make CEO – of my family.  I tell myself that there’s no less pressure in my job than a corporate CEO experiences; however, the compensation is dramatically different.  Instead of stock options and pay-for-performance, my position is randomly compensated in hugs and kisses.

Yep, circumstances conspired.  Shit happened.  Good stuff happened.  And here I am.

But I digress.

Back in the late 1990s, I was a communications project manager at GE Medical Systems (I believe they now, no doubt upon the recommendation of some over-paid consultant, call themselves GE Healthcare).  It was a grueling, demanding job, with endless details and confusing politics and copious amounts of technical info to absorb each and every day.  Sixty hours a week for months on end.  And I loved it.

But this post isn’t about that point in my career.  Honest.

All “In Your Head”

Forgive me, but I have to take a step back for a minute.

I had been diagnosed with chronic depression in the mid ‘90s, and let’s just say it wasn’t a diagnosis I embraced.  Cognitively, I fully understood how all the pieces fit:  my long-running symptoms in the context of family genetics couldn’t really be denied.  But many days, even on some of my worst days, I couldn’t emotionally process or accept a diagnosis I couldn’t see physical medical-test-type proof of.  Before learning a little (and to qualify, a VERY little!) about PET scans, I wondered regularly whether having “depression” was just a synonym for being lazy.  Or perpetually worn-out and ready to cry at the drop of a hat.  Or feeling gray (all the time).

As I grappled with my diagnosis, and what that meant for me short- and long-term, my respect for and curiosity about human biology kept me thinking that there had to be some way of empirically validating my diagnosis.  Being labeled an ongoing chronic depressive seemed inevitable (all other tests had turned up normal) and smothering and horror-film-like all rolled into one.

Viscious Cycle

Without scientific validation of some sort, I waffled.  And I would stop taking my meds every so often.  I’d take them faithfully for six months, and then, convinced the medication had cured my mental health ills like amoxicillin cured my sinus infections, I would toss the translucent orange-y plastic bottles into the trash and embrace what I perceived to be The World of the Normal People.  Which, except for my seriously, unquestionably mentally ill uncle who had bounced between the basements of my aunt’s and my grandma’s homes for most of his life, included everyone in the world.

Ed. Note:  At some point during the Mental Health Monday series I’ll expanding upon all the fun brought on by freaking out your already-messed-up brain chemistry in this way (the medication roller coaster).  For now, let’s just say:  doing this was pain laced with stupid wrapped in a box of uncertainty.

A few days, weeks, or maybe months later I’d inevitably end up back at my insurance-recommended psychiatrist of the year, with my head down, telling the tale once again:

“Uh, I think I really needed that medicine that I tossed into the trash a few weeks back.”

And:

“Are you really, REALLY SURE you cannot show me why I need it?  Because all these reasons that I think I need it… well, I freak out regularly wondering whether they’re not some creative and self-defeating figment of my hyperactive imagination.”

PET Scans

Fast forward to my job at GE.  Somewhere amid the information matrix at the Education Center where I worked, I heard about PET scans.  Mind you, my job had absolutely NOTHING to do with this area of medical imaging, but I worked with people who knew those in the PET scan division.  Volunteers were being sought for a few different kinds of PET scans, and though my schedule didn’t allow me to participate, I got really curious about what exactly this kind of imaging “PET” was all about.

So, I read.  And I read.  And I researched.  And then I researched some more.  I couldn’t forget that I had overheard something about the advancement of PET scans and how their potential might well influence future treatment for maladies that occur in the brain, such as Parkinson’s and Alzheimer’s.

I couldn’t help thinking:  how about mental illnesses?  Could it demonstrate physical evidence of those?

I remember so vividly reading for that first time that PET scans literally revealed a view into the chemical statuses and reactions going on in your brain; I could hardly believe it.  And then I stumbled upon photos:  REAL PROOF!

It was a silver-lining moment more profound than anything I had ever before experienced.

Depression is Undeniably Real

The PET scan info gave me hope, a glow of light in the rocky, unpredictable path I had been walking.  Finally!  Here it was:  doctors and patients had found a tool with which to actually SHOW how the brain chemistry of a “normal” person’s brain from a depressed person’s brain.  Gaining this knowledge felt like Christmas and the County Fair and Easter and the first day of school all packaged in one gigantic, beautiful, hand-embellished package.  With glitter and sequins.  And a lollipop taped to the top.

In case my wordiness has numbed you a bit, let’s clarify the purpose of this post:  there are ways to “see” these very real chemical differences that constitute mental illness (depression, ADHD, bipolar, etc.).  I still couldn’t (and don’t) have something as obvious as a cast on my arm or a brace around my neck, and I don’t have scars from heart surgery or symptoms readily recognizable to just about anyone as, for instance, asthma.  All understandable, recognized, unquestioned illnesses that can threaten health by shaking you within an inch of your life.  And now, now I could say:  THERE WAS – IS – PROOF of my problem, too!

The Whole Point

I have spoken to people over the years about depression, both my own battle with it, and the battles those around me have fought.  And the majority of the general population still doesn’t understand it at all.  They don’t GET that it’s as real and measureable as a heart attack, or a stroke, or diabetes.

My hope is that the next time you look at yourself in the mirror, or hear about someone’s mental health diagnosis, or start to feel the dread of putting up with crazy Aunt Frannie and all her quirks and craziness over the holidays, well, my hope is that you will remember this post, and the images in it, and you’ll remember that just because you cannot readily see mental illness?  Doesn’t mean it’s not very, clearly, undeniably real.

{ 6 comments… read them below or add one }

1 Mary LaVick October 26, 2010 at 5:46 pm

We know so much about other things – but the brain? That is relatively new territory. With such imaging our learning curve is going exponential. This is really cool stuff. It tells us things like learning to play a video game is good for the brain but playing the same game over and over is not really doing anything for brain development.

Your whole blog post makes me think of a few years ago when I was at a science teacher training thing. It is pretty funny because we were sitting at a table during a day all about brain stuff and we started talking about depression. We had all decided on ordering in lunch so that we could get an extra lesson in – of all things – lettering – so that we could make nice posters. For some reason, there weren’t any men at this event. It was pretty funny as the discussion somehow revolved around antidepressants…and, of many middle aged teachers, teachers with small children, and single teachers (all female), I was one of two (of like 30) that did not take an antidepressant. Everyone was amazingly open after the first person spoke. What the heck? Is this a career thing? An age thing? I felt odd that I didn’t take some form of antidepressant meds. That’s how common it was. (I realize, though, that I take ADD meds and those have an antidepressant effect.) It was so dang common that I was shocked. It was almost like you were odd if you weren’t taking prozac or something similar…what the heck? This is one of the events that made it acceptable for me to start taking ADD meds….after all, it hurts my guts a lot worse to take in a lot of caffeine in the form of Diet Coke!

I am also brave enough to post this quote from my sis-in-law, which is sad but true, “The LaVick women take antidepressants because the LaVick men refuse to take them.”

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2 Micki Romanzow October 26, 2010 at 7:56 pm

Mel, I can’t wait to read “part 2”. I worked in the mental health field on and off for 30 years. All I can say is, “thank you” for this.

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3 Hubby October 26, 2010 at 8:16 pm

This is really ground breaking stuff. This is really something I thought would evoke more response from your readers. Offing a potentially disease-carrying possum evoked emotional responses that I personally can’t understand; however kicking this sleeping dog evokes virtually nothing.

Basically as I see this situation you are presenting the evidence that mental illness can be seen, like a broken arm and can be shown in real images (with the proper equipment of course), which essentially makes mental illness a real health ISSUE. (To reinforce my point, look at your health insurance sometime and the limits that are placed on mental health care). Here you have taken this illness that most people will hide in the closet like some embarrassing family photo and reveal it to be something that can be more rationally explained and more openly discussed – just like a broken arm or Uncle Bobbie Jo’s limp. A real live definable condition that, while not fully explainable, can be diagnosed and monitored scientifically, and perhaps opens people’s minds to the reality of this condition. I would think the discovery of knowing that depression or other mental illnesses can now be “seen” would lead to more open discussion and more empathy for those suffering from the illness. How many times have you heard someone mock someone with a visible injury? Not very often with mature adults. Yet how many times have you seen the bizarre or unexplainable behavior mocked. What you have done here, from my perspective, is broken the paradigm of mental illness from “crazy” and revealed it to be someone who has an actual injury or dysfunction that can finally be seen and measured. I for one will stand up and applaud your courage and praise your efforts to bring a broader understanding to this issue. Maybe one of your readers who may be struggling will understand that their issue or the issue of someone they know or love is a bona fide physical issue within the brain and will treat it without shame as they way they would treat a broken bone. Perhaps they may even be motivated help raise the general awareness of mental health such that more research is done using tools like PET to further the research. This is huge! I once heard a psychiatrist say the only way to look at a brains was posthumously. Now a tool exists that allows the psychiatric community to actually monitor the success of their treatment while the patient is still living.

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4 Roxy October 30, 2010 at 3:01 pm

i’m a radiologist and like that you found those PET images!

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5 Emmy November 1, 2010 at 11:18 am

Don’t you wonder, however, why the diagnosis of Depression is so rampant today? Do you think it’s because we didn’t notice it decades ago, without knowledge of what it is? Or do you think the condition of the world today makes us more susceptible to it? I grapple with this a lot, myself suffering from major depression.

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6 Beth @ Recruiting for Clinical Trials August 14, 2011 at 8:40 pm

Great discovery. This could lead to a new way of fighting depression.

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