No doubt you have noticed that my shareposts this year are framed as conversations with you, the readers here at BipolarConnect. You are the experts in what is important to you. My shareposts here address the hot topics you have raised across these pages over the week.
This week is different. I spent the last five days in San Francisco as a journalist at the American Psychiatric Association's annual meeting, which meant my contact with you here was limited. Nevertheless, from your past questions and comments I know that you are seeking greater insights into your illness and that you are looking to translate these insights into tools for your own well-being and recovery.
It turns out that the speakers at this year's meeting had a lot to say about all that. So why don't we break down what I came away with into three overlapping themes?
Genes and Environment
The topic of genes never comes up in a vacuum these days. Neither does environment. It's all about how the two interact to influence our behavior. We have known this for years, but the old view went something along these lines:
Say we have a genetic makeup that renders us vulnerable to stress. We experience a stressful event - perhaps a financial crisis, perhaps a traumatic memory - and our limbic system overreacts. We flip. The thinking cortical areas of our brains go offline. There is no gray matter standing in the way of our current system overload and our next action.
But legendary psychiatric geneticist Kenneth Kendler offered this take:
Our environment can neutralize our genes. Say, we are genetically vulnerable to alcoholism. But if we can control our environment - such as hanging out with the right company - those genes may never kick in. Place ourselves in harm's way, however, and those genes take over.
But it also works the other way. "Our brains have feet." Our genes may influence us in seeking out bad environments.
This dynamic interaction between genes and environment is a very complex two-step. Our goal as patients (and loved ones) is to "reduce the impact of the gene."
Developing a Positive Well-Being
Personality expert Robert Cloninger also referred to the complex interactions between multiple gene and environmental factors. We are shaped by our genes and environment, but what separates us from the rest of the animal kingdom, he said, is our self-awareness that allows us to write our own stories.
As opposed to habits (based on the strength of our synaptic connections) and other logical orderings of the brain, our self-awareness gives us flexibility about our future and hope. We can change. We can surprise people.
Change can happen very quickly, Dr Clonninger concluded.
Changing our Lifestyle
Dean Ornish is a celebrity doctor, but he is also a rigorous and pioneering scientist. "Changing our lifestyle actively changes our genes," he advised. For instance, in one study involving cancer patients, at baseline the disease-promoting genes were switched on. A year later, in the group of patients on smart lifestyle regimes, these same genes were switched off.
The body, he said, has a remarkable capacity to begin healing itself. And the same lifestyle regimes - nutrition, stress-management, support - apply across virtually all diseases, including cardio and depression.
Dr Ornish has expert professional experience in the former and profound personal experience in the latter, and notes there is a two-way connection between both.
But there is a catch to getting well, Dr Ornish observed. We often lack the incentive. Patients don't adhere to their meds. They lose interest in lifestyle changes.
Too often, we see things in terms of "do this or else bad things will happen in the future." The problem is, Dr Ornish said, is patients are too busy coping day to day to worry about their futures. If you take away the temporary feel-good of bad food what are you going to replace it with?
"What is sustainable," Dr Ornish said, "is not fear of dying but joy of living." Look at it this way: "Doing the tango makes your brain grow."
Some of the things that are most fun are good for you.
A lesson Dr Ornish learned from a yoga master. Two words:
What separates the two? The "I" in Illness and the "We" in Wellness.
"Anything away from the ego-driven "I" is healing, Dr Ornish concluded to an unprecedented standing ovation.
Cutting edge science is validating ancient recovery principles. This is a theme I have been writing about for the last two years, but never have I seen the point brought out to such great effect as at this meeting. Doctors are "getting it." So are patients. This translates into a lot of support for you in changing your lives, provided you know where to look.
You are not alone. We often view change as difficult, but with the right people around us we can create our own healthy environments. Be encouraged. We are here to help each other.
Published On: May 22, 2009
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