From the comments to last week's sharepost on the gene-environment connection, it's clear we need to continue the discussion. This isn't mere esoteric chicken vs egg stuff. What we're talking about is absolutely essential to how we view whatever ails us and the choices we make in our recovery, as Angie's comments so forcefully and eloquently highlight:
"My father was a professional athlete, and dealt with my personality quirks and teenage defiance by hitting me, sometimes to the point of knocking me out. My mother felt that not fighting with her husband was the best strategy for dealing with my father's aggression, and did not defend, help or protect me in any way. In fact, she even would tell me to lie about the bruises on my face and body. (In those days, there were no child abuse numbers to phone). My father was also a respected professional and university professor. When I finally sought help for the deep mood swings I was experiencing at age 16, the psychiatrist minimized my problem, because I came from such a 'good home'."
Six years later, Angie experienced postpartum psychosis. The same doctor diagnosed her with schizophrenia and put her on heavy doses of medications. Later, she ended up in the "psych ward from hell", was given huge doses of Thorazine and ECT by a doctor "who was definitely crazier than any of the patients."
Angie's story, fortunately, has a happy ending: "It took a tremendous amount of counseling, a new and very good pdoc, who assisted me in solving the many physical health issues, a lot of research and support on line and in community groups, as well as a renewal of my faith in God to get to the place where I am now."
Do you ever get the feeling that Freud was right, after all? Ironically, today's brain science is validating a lot of Freud. The intricacies of the gene-environment stress connection means that we can no longer look at mental illness in isolation. Yes, we may have bipolar, but where the hell does it come from? As Knowthyself, in another comment, points out:
"We do see early childhood trauma as a precursor for some individuals that develop bipolar disorder. Childhood trauma can affect an individual in different ways that could have an impact on coping with stress. Children can become withdrawn and not develop good social skills, limiting friendships and support. Their behavior in the home can become disruptive and parent-child relations may suffer. School performance may be decreased. And all of these could lead to low self esteem and contribute higher stress levels."
Can you get a taste of how complex this is getting? It's way more complicated than chicken vs egg. It's more like the egg using the chicken to create another egg. As Knowthyself in another comment says, "the days of the delineation between object and observer are clearly past."
Our genes help create our brains, but so does our environment. Our genes predispose us to how we react to our environment, but our environment plays a major role in switching these same genes on and off.
Perhaps it's best to think of the brain (together with its relation to the environment) as a "non-linear" and "self-organizing" system, very analogous to the ecosphere of the planet. I've heard brain scientists discuss "homeostasis" the same way ecologists do.
"Allostasis" is how we adjust to predictable and unpredictable events. We get upset. We settle down, back to homeostasis. But what if we don't settle down? Now were talking "allostatic overload," as in the proverbial straw that broke the camel's back. For instance, this time if we're upset we may start drinking. This may trigger genes that predispose us to alcohol. We start hanging out in environments that encourage drinking. The brain starts laying down new neural connections ...
Eventually the brain finds a new homeostatic "set-point." As Knowthyself explains:
"The winds of change are ever present and blow in all directions. An unpredicted storm can easily take a sailing ship off course. It is much more difficult to get back on course and make way to port." Nevertheless, "we can get back on course by how we interact with the environment and what environment we choose to interact with."
Why don't we leave the last word to Knowthyself:
"We can sort through the psychological issues and change how we view the world. We can learn to cope with stress and avoid or decrease its presence in our environment. We can exercise and engage in fullfilling activities and surround ourselves with supporting individuals. We can take medications which can counteract the chemical imbalances and allow the brain to heal.
"Remission is what we can achieve. We can live a life free of symptoms but we have to remain vigilant. The genes that were turned on by that first stressor and activated again by others can still awaken. We can change it and stability is possible. It may not be easy to get back on course but it is well worth it to arrive again in port."
Published On: June 12, 2009
Living With6 Chronic Condition Guidelines to Live By
Facing the challenges5 Rules for Bipolar Relationships