May 4

Autism and the Glycemic Index

“Autism, or autism spectrum disorder, refers to a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences. We now know that there is not one autism but many types, caused by different combinations of genetic and environmental influences.” —Autism Speaks

I’m on the autistic spectrum. As a child, I was hopeless in social situations, always saying the wrong thing and unable to read body language. I also grew up on Tang, Frosted Flakes, Milky Way bars, and Kool-Aid. In my late twenties, I cut sugar out of my diet because I found that when I ate sugar, I couldn’t talk. It was like my brain locked up and wouldn’t process input. Recently, I ate a muffin that had a reduced amount of sugar in it. Within minutes, I began stuttering and floundering for words. This was during a discussion in a seminary class, so the timing was poor.

Is there a link between autism symptoms and sugar intake? A 2015 study suggests there is, and anecdotal stories from parents of autistic children abound. Other parents of ASD kids say their kids aren’t affected–and maybe they aren’t, though often the parents say their kids don’t “get hyperactive” from sugar. My own experience indicates that hyperactivity is not the only visible response. From the outside, I look like I’ve been sedated after I eat sugar. Someone who didn’t know better might think this is a good thing. But inside, I’m churning, trying unsuccessfully to process and respond to the stimulus coming in. It’s miserable.

But I do like something sweet now and again. Can you imagine going through life never having another dessert? Sugar-free commercial products are an option, though almost all contain artificial sweeteners, which I try to avoid. And the ones with sugar alcohols (like sorbitol and maltitol)– well, I won’t gross you out by describing the intestinal symptoms they cause me.

For home-baking, stevia is an option. It’s a natural plant extract with no sugars and no calories, but it’s a little too sweet and has a weird aftertaste when used alone. Stevia requires just a tiny amount, so it doesn’t bulk up a recipe like sugar does. That doesn’t matter if you’re sweetening fruit, but a cake requires the bulk and consistency of sugar to come out right. Ask me how I know. There is a 1:1 stevia product, which is stevia mixed with maltodextrin so it performs in recipes like sugar. The only store I’ve found in my area that carries it is Walmart. Amazon carries an equivalent, Stevia in the Raw, which is a bit more expensive but delivered to your door. Like stevia itself, I find the 1:1 mix has that weird aftertaste.

(Also beware of baking mixes that contain stevia and sugar, like Truvia or SugarLeaf for example, because they sort of defeat the purpose.)

So what’s the answer?

Enter the glycemic index.

“The Glycemic Index (GI) is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels.” —University of Sydney

In other words, the higher the glycemic index ranking, the faster the food item causes blood sugar to rise. Glucose is rated 100. The Glycemic Index website recommends a rating of 55 or less for general health. A Harvard website ranks table sugar (sucrose) at 65, honey at 61, and fructose at 15. Clearly fructose is better for those sensitive to sugar. (Studies have shown that excessive use of fructose can raise triglyceride levels, particularly in men, so it’s not something one should eat all the time.)

The other day I was looking at a carrot cake recipe that called for a total of four cups of sugar (including the cream cheese frosting). Even using fructose, that’s a lot of sugar. But it’s easy to cut that in half while still making the recipe work. I use half fructose and half 1:1 stevia. The stevia provides sweetness with no calories or glycemic effect, and the fructose is a slow-absorbing sugar that moderates the flavor of stevia. I see the 50/50 mix as a “best of both worlds” approach.

In the frosting, I substituted neufchatel for cream cheese. That’s just a lower-fat version made with milk instead of cream. I did that not because I’m autistic, but because I’m trying to eat healthier. I also added an extra package of cream cheese to the frosting to increase the protein and further cut back on the sugar concentration. I also thought the cake might need more frosting than the recipe called for, as is sometimes the case, but I had frosting left over.

Herein lies another helpful hint: A lot of recipes can be modified a little, or sometimes a lot, to reduce the sugar content. For pies, the volume of sweetener can be cut in half and a 50/50 stevia-fructose combination can be used instead. So if your pie calls for 1 cup of sugar, skip the sugar completely and try it with 1/4 cup 1:1 stevia and 1/4 cup fructose instead. Imagine: where a recipe calls for a whole cup of brain-scrambling sugar, you may find it works just as well with 1/4 cup of slow-absorbing fructose bolstered with stevia.

If my experience is any indication, your autistic loved will thank you!

 

December 29

Video: Somatic Experiencing for PTSD

As a person who struggles with PTSD, I found this video amazing. The “nature” background is interesting. The marine’s story is all too familiar: doctors relied on medications to treat symptoms rather than addressing causes. Watch it all the way through: the marine’s progress using these techniques is incredible!

September 22

This Is the Day

This is the day that the Lord has made! (Psalm 118:24)

I’ve been thinking lately of my friend, Margarita Mike. We called him Margarita Mike because he got sober when he was in college, stayed sober five years, went out and drank one margarita, and came back. He stayed sober another five years.

Then Mike decided he could have another margarita. This time, things didn’t go as well. He couldn’t stop. He’d been drinking for eight months when I called him about a business situation for a mutual client. I asked him how he was doing.

“I’m not doing well at all,” he replied. “I can’t stop drinking. Would you have coffee with me sometime?”

I readily agreed. Helping people get sober as I got sober is one of the top priorities in my life. We agreed to meet the next afternoon at a local coffee shop.

That night, I got a phone call. Mike had wrapped his car around a telephone pole. My friend was gone.

I have always wondered whether things would have been different if I’d met him for coffee the day we spoke. Maybe they would have. Maybe they wouldn’t. The point is, I’ll never know–because I didn’t. I know from experience that alcoholism is a deadly disease. I almost died from it. I’ve been to more funerals than I can count on my fingers and toes.

No one expects that today is the last chance. Sometimes it is.

I’ve been thinking about this lately because of a couple of situations I’ve run into. One was a woman I rode the elevator with at the hospital. I didn’t know her and didn’t speak to her. Yet I could feel that she was toxic, so oppressed by darkness that it was rolling off of her. We got off the elevator and went our separate ways, and I said nothing. Surely she’ll realize her torment and seek help when she’s ready… right?

The other was someone I know fairly well and consider a friend, but not a close friend. As we were praying together, I felt a deep heaviness from this person. As I focused on it, I realized it was a curse. (Yes, curses exist. And Jesus died cursed so that our curses may be broken.) I brought up the subject of curses as an invitation, but my friend said nothing. We parted with no further discussion.

I have some knowledge of the ways of darkness. My family was tormented for five years. We experienced accidents, depression, psychosis, substance abuse, and illness, not to mention a ridiculous series of random setbacks in our lives. We became self-destructive. More than once, I was close to suicide. My wife nearly died twice from reactions to benign medications.

The torment of darkness can be fatal. And it’s surely miserable, especially compared with reconciliation to God. Moreover, if we believe what Christianity teaches us, the repercussions of what we do today can follow us beyond death. I’m not talking about merely accepting Jesus as Christ to avoid going to Hell. There’s far more to it than that. Sometimes, as any addict will attest, Hell follows us.

Yet most of us, including myself, don’t approach our religion with the urgency this suggests.

There are those who stand on street corners wielding a Bible and a hand-made sign proclaiming that you need to find Jesus today. I wonder if anyone listens to them. I hope so, but I never did.

There are those who go door-to-door and teach [their version of] what the Bible says. They are committed, loving people, and I think sometimes they do some good.

Most of us accept that other people are responsible for their own spiritual health. Yet when my own spiritual health was in jeopardy, I was unable to solve the problem myself. I needed help. This was as true last year when I sought deliverance as it was 32 years ago when I got sober. In both instances, I had no idea how to solve the problem. I needed someone who did.

Since Mike’s death, more than five years ago, I never put off meeting with an alcoholic or addict who asks for help. I also confront someone who appears to need help but not be willing to admit it. It often doesn’t help. Statistically, some 90% of alcoholics and addicts die from their disease. But I’m one of the 10%, and I want them to have every chance to be one, too. And never again do I want to be a day too late.

Why don’t I take the same approach with those who are suffering spiritually? I hate confrontation. I don’t have the confidence; after all, I’m new to this myself. Maybe I’m afraid of being labeled a religious nut. Maybe I’m afraid of damaging a friendship.

Would I damage a friendship to save someone’s life from addiction? Risk being labeled a nut? Step out on a limb and take a risk? You bet I would.

But religion is a private thing… right?

In a nation in which suicide rates are rising, violence against people unknown to the perpetrator is rising, drug overdose rates are rising, and antidepressant use is rising, I’m not so sure that’s true. We are a spiritually sick culture, and that sickness affects us all.

I’m tired of going to funerals of people who died too young, and seeing misery on the faces of people who are materially well off compared with much of the world. Not when there is an answer.

The challenge set before me, then, is to take the same attitude with those who suffer any kind of spiritual malady as I do toward those dying of addiction. I have been saved from misery, and it’s my responsibility to pass that on, today.

It’s a challenge I set before you, too.

 

 

July 23

The Irrationality of Alcoholics Anonymous: A Response

Gabrielle Glazier’s article in The Atlantic, “The Irrationality of Alcoholics Anonymous,” is an interesting read–thought provoking, despite the fact that it contains misrepresentations and misconceptions about AA and a good deal of irrational thought itself. I’ll come back to those points.

Let’s begin by noting the question, stated more than once, that if alcoholism is a disease, why don’t we treat it medically? The answer, obviously, is that medicine has little to offer the true alcoholic. As Glazier notes, alcoholism is a complex set of symptoms. Psychiatry has advanced a great deal since AA was founded in 1935, but it remains basically alchemy. What is known about the workings of the human brain is dwarfed by what is not known. And in practice, psychiatry itself ignores scientific method (and the well-being of the patient) in favor of generalized strategies untailored to the individual and unreliable in the hands of individual practitioners. Some time ago, over a three year period, four professionals diagnosed me with four different psychiatric conditions, each indicating a very different course of treatment. All four were wrong. We must remember that there is no test for chemical imbalance. There is no test for alcoholism.

It is also ironic that at a time when religious people and even scientists are rediscovering the power of prayer for healing, psychiatry is dismissing God as unscientific. Well, yes, it is. But science is beginning to admit that it does not have all the answers, and psychiatry in particular should be at the forefront of that admission.

Glazier notes that there is not a bright line division between alcoholic and nonalcoholic. That is true in a sense. Yet we know from scientific research that there are physical characteristics associated with alcoholism, including changes to liver cells that result in processing alcohol differently, resulting in physical addiction to alcohol. Part of the problem with the article is its fallacy of equating alcohol abuse with alcoholism. Our society has largely adopted this attitude: people who get in trouble because of alcohol are sent to AA by judges, by parents, and by treatment centers. Not all of them are alcoholic. Some may become so, and some are just going through a period of heavy drinking due to negative or positive conditions in their lives. (My brother had to “re-evaluate his drinking habits” while in college; he’s never had a problem since.)

But the main complexity in treating true alcoholics– those who have both the physical addiction and a mental compulsion to drink– is that alcohol is a treatment for an underlying condition. Despite Glazier’s assertion to the contrary, AA well recognizes this fact: “Our liquor was but a symptom. So we had to get down to causes and conditions” (Alcoholics Anonymous, 64). Of the twelve steps, only one of them even mentions alcohol. The others speak of finding a higher power, admitting fault, forgiving others, and setting things right.

The underlying condition of an alcoholic is difficult to identify. When I was drinking, I would have told you I was drinking to kill the pain. But it wasn’t physical pain. It was a deep, psychic pain. I might have told you it was the pain of living. Today, I would characterize it as a deep spiritual dissatisfaction with life that only alcohol (and various other drugs) could relieve. Until I found AA.

Therein lies the problem: Glazier relates that doctors in Finland are using a drug called naltrexone to block the components of alcohol from reaching the receptors in the brain. This would work for a person who drinks for the effect of getting drunk. Why drink if alcohol does nothing for you? But imagine for a moment that alcohol is the only thing you’ve found that makes life bearable. Take it away and life becomes unbearable. Naltrexone makes the alcohol not work. Will you live in agony, or stop taking the blocker? For an alcoholic, the answer is obvious. Absent some other way to ease the pain, we will return to alcohol again and again, regardless of the cost to our health, our families, and our careers.

Glazier, a self-described non-alcoholic, relates that she tried naltrexone and found that her desire to drink diminished. My wife (a recovering alcoholic thanks to AA) relates that to trying my prostate medication to see if it makes a difference. Absent the mental and physical addiction to alcohol, which non-alcoholics can’t grasp, an experiment like that is meaningless. Can Glazier imagine wanting a drink so badly that she would leave her baby alone in a crib while she went to a bar or liquor store, or drive drunk with her child in the car? So badly that she would drink the night before she was scheduled for a court-ordered urinalysis test to verify she was still sober? So badly that she’d drink even while taking antabuse, which would make her vomit violently and uncontrollably when she did so? So badly that, like my uncle, she would drink even if her liver had failed and the doctor told her that one drink would kill her? I seriously doubt it. I wonder of she can imagine the efficacy of naltrexone in those situations?

How can this underlying pain of an alcoholic be addressed? Carl Jung said a massive psychic change was required. AA suggests a spiritual experience. Buddhist practitioners have had success with intensive meditation. There’s been some success with Cognitive Behavioral Therapy (CBT). But in general, psychology and psychiatry have little to offer. Psychology too often fails because alcoholics themselves do not tell the truth. We fear giving up the only thing that makes life bearable, and we lie and obfuscate to ensure that doesn’t happen. Psychiatry fails because, well, it’s a science only when compared with astrology. They don’t know why an alcoholic is so maladjusted to life. How can you fix something when you don’t understand its cause?

AA offers a simple (but not easy) approach that creates a spiritual experience in the practitioner. Yes, it works. I’ve been sober 32 years. But does it work for everyone? Obviously not.

As an aside, I’ll be the first to admit that AA is difficult for atheists. I was an agnostic when I got sober, and that was a challenge. The difficulty for atheists is obvious if you go to a meeting in Buddhist countries like Sri Lanka or Thailand: there aren’t many sober Buddhists. Using AA as an atheist can be done. I’ve known atheists who have. (They often don’t remain atheists, though; the spiritual power of the process eventually causes them to acknowledge faith in God, though it may take years. I myself, formerly agnostic, am now a seminary student.) But I agree that AA is not necessarily for everyone.

Here we run into one of the first misconceptions about AA: the claim cited in the article, originally made in the 1955 version of the book Alcoholics Anonymous, that 75% of the people who came to AA stopped drinking. That number is now closer to 5-8%. But that’s not what the original claim says.

“Of alcoholics who came to A.A. and really tried, 50% got sober at once and remained that way, and 25% sobered up after some relapses…” (Alcoholics Anonymous, xx, emphasis added)

Two things are of note: first, they were dealing with alcoholics, not problem drinkers. Oldtimers who got sober in the 1950s told me that back then, hospitals wouldn’t take an alcoholic, and health insurance wouldn’t cover their treatment. People detoxing would often go into seizures in a meeting, and no one called an ambulance because it wouldn’t come. The social stigma against alcoholism was so strong at that time that you had to be pretty far gone to go to AA. You just didn’t see the casual DUI driver or tippling college student in meetings.

The second point is the phrase “really tried.” The Twelve Steps are not rocket science. AA wisdom says that no one is too dumb to work them but some of us are too smart. They demand a level of honesty and willingness that most people just can’t muster. They demand a level of commitment that comes from the certainty that there is no other possible way to survive. The dying alcoholic is a good candidate for this program. The DUI driver trying to stay out of jail or the binge-drinking college student trying to please his or her parents is not.

As more and more sources send drinkers to AA, the proportion of alcoholics who are willing to “really try” drops. Obviously, so does the success rate. What is AA’s success rate among “true” alcoholics? No one knows, because there’s no effective way to measure them. It’s an anonymous program, after all. Clearly it’s higher than 5-8%, but no one knows how many of the people being sent to AA are actually alcoholics.

It is also noteworthy that not all step-based recovery centers take the steps seriously. During my bout with mental illness, I attended one that had patients read the first three steps while undergoing therapies, CBT, and various other activities. We didn’t actually work the steps. Meetings were optional. Perhaps it was coincidental that many of my fellow patients were there for the second or third time.

Here’s one of the more frightening things I read in the article: the statistic that some 22% of those treated for alcohol dependency could return to moderate drinking. I’m not against drinking–for the nonalcoholic. But for the alcoholic, the risk is so great, why would I take a 4 out of 5 chance that I can’t  drink moderately? I’ve been told by certain ministers that if I’ve accepted Christ into my life, I can drink socially. Maybe so. But if they’re wrong, I would lose my career, my family, and probably my life. Why would I even try? That’s irrational.

Herein lies another irrationality in the thinking behind the article: that drinking is normal, and that normal is good. That idea alone drives many who struggle with alcohol back to the bottle. We desperately want to be “normal.” The truth is, from the time I first got drunk at age 16, I never wanted to just “have a drink with dinner.” I wanted to get as drunk as I could as often as I could. Yes, I’d lie to you, both about how much I wanted and how much I’d had. But honestly, I wanted to be shitfaced drunk as much of the time as I could. Periods of sobriety were miserable. (They usually lasted about ten hours while I went to work.) Why would I think that even after 32 years sober, it would be any different? More to the point, why would I take the chance? That would be irrational.

This thinking also blurs the lines between those who struggle drinking responsibly for whatever reason, and those who are alcoholic. That line can indeed be blurred, as some of the former work their way along the spectrum into the letter category. But by failing to distinguish between those who truly have an addiction and those whose drinking habits we just don’t approve of, we do both a disservice.

Glazier highlights one fact that is undeniably true: abstinence alone will not work in the treatment of alcoholism. An untreated alcoholic will crave that which gives him or her relief until he or she eventually gives in and drinks again.

Let’s put this another way: unlike the problem drinker, alcohol is not the problem for an alcoholic, it’s the self-prescribed treatment of the problem. The problem is far deeper, and is as yet unidentified by science.

Something has to change if an alcoholic is to get sober. This article, while trumpeting the scientific method, highlights that science has so far failed in the treatment of alcoholism. In the absence of real answers (or even real understanding) from the psychiatric community, and with the increasing respect for the role of God in healing, why take aim at AA? It’s not the only answer, but it has gotten million of alcoholics like me sober.

Surely that’s a good thing.

February 20

Enter Autism

I’ve posted in the past (here and here) about my struggles with mental health. During my adult life, I’ve been diagnosed with anxiety disorder, attention deficit disorder, obsessive compulsive personality disorder, major depressive disorder, bipolar, and psychotic episodes. All of these conditions “required” medication, which in every case made the problem worse. (Not to mention ten years of self-medication with alcohol, cocaine, and opiates, which nearly killed me.)

A year ago, our toddler (then 18 months old) was diagnosed with autism. It was too early then to assign a severity; he’s now been diagnosed Level 2 & 3– pretty severe. At the time, neither my wife nor I knew anything about autism.

My wife is quite the researcher, so she went to work. She would come back with these “revelations.”

Her: “Did you know that people with autism often can’t see faces?”

Me: “Wait, I can’t see faces.”

Her: “No, I mean they can’t read nonverbal cues, like even body language.”

Me: “Yeah, I can’t read body language.”

Her: “Did you know that people with autism often see the world in patterns or pictures?”

Me: “Um, that’s not normal?”

The more she learned the more I realized that there was something going on with me that I had never realized. In fact, I have most of the symptoms of autism (though some of them I’ve learned to manage fairly well).

For example, I’m face-blind. I recognize people by their voices, shapes, contexts, and hairstyles. I don’t read nonverbal cues. I have trouble identifying and expressing my emotions. I don’t read emotions well in others. I’m extremely sensitive to audio and visual chaos. (My wife says that what I call “chaos,” most people call normal sensory input.) I struggle with being aware of social appropriateness– I have a tendency to say the wrong thing at the wrong time and have no idea why it’s inappropriate. I tend to understand verbal expressions literally. (“Look at my face!” “OK, I did.”) I have no idea how to navigate a conversation with more than one person at a time.

It’s better now than it was when I was a child. I’ve learned to compensate in basic social situations. Still, when I read the DSM-V description of communications difficulties, I felt like they were writing about me:

A.      Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text):

1.       Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

2.       Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.

3.       Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

I remember, when I was in elementary school, planning out conversations before I approached someone. I would think, “I’ll say this, and they’ll say that, and I’ll respond like this…” and so forth. I could never understand why conversations went off the rails or what to do about it. And I couldn’t understand why, in the middle of a softball game, the other kids didn’t want to hear about dinosaurs or math.

And yes, I do have repetitive behaviors, but they’re subtle. I didn’t even realize I was doing them until I learned what “stimming” was. I fidget with my fingers, play computer solitaire, and pace.

My mind sees the world in processes, so I strive to understand why something is true. That makes it difficult for me to learn disconnected facts, like vocabulary or names, but easy to learn grammar and dates. If I can fit it into a “system,” I can learn it. Abstract ideas tend to make my head hurt.

I often look at a situation and see patterns that are not obvious to other people. The most obvious example of this was my response to the civil war in Sri Lanka. It was the most written-abut war since World War II, and yet no one ever seemed to ask what made it tick. To me, that was the obvious question. I spent a year studying, interviewing, and analyzing, and came up with a paradigm that explained the political relationships that drove the war. This became the basis for the Peace Initiative that started in 1999, and eventually led to a Cease Fire Agreement in 2002 that lasted for six years.

I think this helps me be a good writer. I “see” the story that I’m writing before I begin. I may not have all the pieces yet, but I know where it needs to go. And I can see how the plot elements contribute to the whole (and what’s missing).

As I’m learning, autism offers challenges that have greatly affected my life. My adolescence was an extremely painful experience of isolation and feeling different from everyone else.

But it also offers some unusual benefits. I see the world differently than most other people, and that means I have something unique to offer.

August 25

Why Domino Theory?

Cover Preview1

Most of my books explore in some way the topics of spirituality and peace work. Domino Theory is different. It tells the story of a drug addict named Danny McCabe who’s been framed for murder. And it explores the workings of the brain of an addict in frightening, first-person honesty. I know this, because I was there.

I don’t want to use.  I really don’t.  For one thing, heroin and alcohol is a bad mix.  You never know when you’ve done too much.  You’d suddenly pass out and quit breathing, and if there isn’t someone around to wake you up again, you’re dead.

I remember the first time it happened.  I came to and my buddy Pete was slapping me in the face.  I was like, “What the f***?”

“You weren’t breathing,” he said.

I thought about that for a sec.  Then I told him the truth.

“So what?  I don’t care.”

I think that’s what scared me the most when I woke up the next day.  I almost died and I didn’t care.

What does it matter if I do some while I’m drinking?  Even if I died, it would just end the misery.

But the misery isn’t as bad now as it was when I kicked.  I’ve been off the sh*t for three weeks.  Well, almost three weeks.  Two and a half, anyway.  My body doesn’t ache any more.  I’m starting to be able to sleep at night, if I drink enough.  Yeah, I drink more, but I’m off the dope.  I’m clean, and that’s something to be proud of.

So what am I doing with a bag full of dope in my room?  I don’t want to use it.  Really, I don’t.  It was too hard to get off of it.

But the sh*t is calling to me.  That goddamn heroin is calling my name.

I drain the third Moosehead and reach for the fourth.  Two thirds gone now.  I’m pretty drunk, but not drunk enough to ignore the dope calling me.  I suck down half the bottle in one swallow.

Damn it, I hate that shit!  F***ing heroin.  For months I couldn’t not do it.  Now I’m clean, and it still wants me back.  It’s like an evil woman that won’t let go of me, and I can’t say no. 

That’s the thing.  I know I can’t say no.  I always go back to it.  I always have, and I always will.  Yeah, I’m clean right now, but that’s temporary.  I know it.  You know it.  The dope knows it.  It’s calling my name.  It knows that sooner or later I’m going to give in.

I drain the fourth bottle and reach for the fifth.  Only one left after this, and I’m still not drunk enough.  I light another cig.

The heroin calls.  I hate being dope sick.  I f***ing hate it.  I don’t want to go back.

But we all know I’m going to.  I can’t say no.

I chug the fifth beer and open the last one, desperate to block out the Siren’s call.  That’s exactly what it is, calling me to jump back in the dark, cold water.  Calling me to die. 

I can’t say no.

I reach under the mattress and pull out my works.  I thought about throwing it out, but I couldn’t.  I knew, even then, that I would come back.  The dope is too strong.

I could throw it away now.  I could open the window and throw the spoon and the syringe out into the alley with the rats.

But I won’t.  I can’t.  No matter how much I try to deny it, I’m a junkie.  Once you cross that line, there’s no going back.

I drain the last beer, slide the empty back into the six-pack, and reach for my knapsack.  I pull out the zip lock bag and look at it.  I feel my soul drain out of me.  Once again I am hooked.  I haven’t even opened that bag yet, but I’m going to. 

I don’t have a choice.

Why did I write such a seemingly uncharacteristic novel? The answer is simple. All my books seek to overcome misunderstanding. They seek to reconcile. For many people, a drug addict is unpredictable, incomprehensible, and not worth spending time on. I sought to show the interior workings of the addict mind in the hope of helping people understand why we do what we do.

I tried to do this without glorifying the addict lifestyle. Danny’s life is miserable. He has nothing to live for but his next fix, and the vague hope that someday things will be different. But, at least in his mind, he has no choice. Regardless of the consequences, and even though he knows it will make him more miserable, he continues to use. The lies addiction tells him are so deeply ingrained that he believes them without question.

Despite Danny’s hopelessness, I also tried to write a novel that provides hope, because there is hope. I’ve been clean over thirty years. There are millions of people like me who finally got clean and sober, and who are now productive members of society. A lot of people don’t believe an addict can change. Even Danny doesn’t believe it at the beginning. And admittedly, it usually takes a huge upheaval, usually a terrible loss, for an addict to take the chance of really trying to get clean. Sure, they make promises. There was a period when I made such promises every day, but I almost always broke them before the day was over.

But once in a while, something changes. Something gets in through the lies, and we hear hope.

Up jumps the cute girl who read Chapter Five.  She’s way too perky.  I listen to see if her name is Teresa or Shawna.

“I’m Jamie and I’m an alcoholic,” she says.  I wasn’t even close.  Anyway, she’s way to pretty to have anything good to say.  She probably sipped wine after class at the university, maybe got a DUI or something.  I don’t care what she has to say, I just like the way she looks so clean.  I bet she smells nice.

“Sixty-four days ago I was lying on the floor of a jail cell down the street here,” she says, gesturing.  “I was puking my guts out, dope-sick, and wishing I could die.  They arrested me for writing bad checks, but I don’t remember doing it,” she says.  “All I know is, I was driving down PCH, and I was driving too fast because I needed to get loaded.  This cop pulls me over and takes me in.  My car got impounded, I lost my job, and my family wouldn’t bail me out.

“At the time, I thought it was the worst day of my life.  But it wasn’t.  It got worse for a couple more days.  And I finally came to laying on the floor of that jail cell, covered in my own puke.  That was the worst day of my life.

“When the cop came to let me out, I was crying,” she says.  “I told him I didn’t know how I got that bad, and I asked him, ‘What can I do?’  He gave me some change and told me to call Alcoholics Anonymous.  He even looked up the number for me.  So I called.  They told me there was a meeting here.  I walked over from the jail.  I looked like sh*t, and I was still shaking pretty bad, and I know I must have stunk.  Clint was sitting in that chair right there,” she gestures toward the front row.  “When he saw me come in, he came over to me and shook my hand and welcomed me.  And he told me it was going to be alright.

“I didn’t believe him.  But he was telling me the truth.  Because, you know, my family doesn’t want to have anything to do with me now, and I still don’t have a job, and I can’t afford to get my car out of the impound yard yet, and that costs more every day.  But I haven’t had to drink or use since I got out of jail.  For someone like me, that’s a big deal.  I haven’t had to sleep with anyone for drugs or alcohol.  I haven’t woken up in a place I didn’t know, with a person whose name I couldn’t remember.  That used to happen a lot.  Not every day, but a lot of days.

“That cop saved my life.  I don’t know how this is going to work out, but I believe it’s going to work out.  Preston, you mentioned hope, and that’s become an important word to me.  I know some of you guys were a lot worse than me, and this worked for you.  So I know it can work for me, too.  But I have to be the one who does it.  No one is going to do it for me.

“Thank you,” she finishes.

The room applauds, as they always do.  I find that my mouth is hanging open.  I close it, and I clap too.

Somehow, I believe her.  I know she didn’t just say all that for my benefit.  She’s real.

But Danny doesn’t get struck sober. He struggles with his demons. Despite the mess he’s in, he’s terrified to give up the only thing that ever made him feel better. He knows he needs to get clean. But he hasn’t yet gotten to the point where he’s more afraid of using than he is of being clean.

Unfortunately, there are no guarantees when it comes to drug addicts, except one: in the absence of some kind of spiritual intervention, they will continue to do what they’ve been doing, and it will get worse. The disease of addiction is deadly, and most addicts die from it.

But there is also hope. A lot of addicts do get clean. I’m one of them.

If you want to know whether Danny is one of them, too, read the book!

December 5

Mental Health and Me – Part 2

I learned to manage my depression without the use of medication.  Meditation, therapy, twelve step meetings, and volunteer work helped keep me balanced.  I put my life back together, remarried, moved from Los Angeles to rural Utah, and began making cheese.  There were periods of depression, and I tried low doses of a few antidepressants, but found that they rarely helped and often made things worse.  I also learned that psychiatrists don’t listen well, and they don’t understand drug addicts.  One told me that I just needed to be addicted to Valium and my depression problems would be over.  Another decided I had ADD and wanted to treat me with Ritalin, a drug I had abused extensively before I got sober.

In general, I managed to get my depressive periods without taking the medications that made it worse.

Last year, a series of events unfolded that changed all that.  After my son was born in May, my wife struggled for several weeks with postpartum psychosis.  It was a traumatic few weeks in which I wasn’t sure at times if I would be raising my child as a single parent in his fifties.  As she recovered, the aftermath left me prone to depression.  Then I got bronchitis.  A seemingly-benign medication to help clear my lungs interacted badly with my triglyceride medication– a reaction for which there was a warning on the drug information sheet and the FDA website, but which was not in the pharmacist database.  Within weeks, I became suicidal.  I called for help, and was told to go to the ER.  There, they found me a bed at a mental hospital in Provo.  It was a very good hospital, I have to say.  But my experience that psychiatrists don’t listen well was once again confirmed.  They put me on an anti-depressant.  I told them of my experience on Prozac twenty years earlier, and they assured me that this one was different.

It wasn’t.  Within two weeks of returning home, I began to lose my mind.  First, I lost my ability to feel emotions.  I couldn’t feel sadness or joy, or even love for my family.  I faked it for a couple of days, but it was quickly apparent to my wife that something had changed.  Then my reasoning began to falter.  What seemed obvious to me made no sense to anyone else.  Finally, I began hallucinating.

It is unsafe to stop a therapeutic dose of antidepressants abruptly.  You’re supposed to taper off.  But my condition was so severe that my doctors recommended I stop immediately, that the risk of the progressing psychosis outweighed the risk of stopping the medication cold turkey.

What followed was a month of absolute hell.  I realized most of the time that I couldn’t rely on my perceptions, nor could I rely on my reasoning to make even basic decisions.  I could converse about things I knew about, like hobbies, but couldn’t make new thoughts happen.  I couldn’t follow complex sentences in conversation.  I told my wife she wasn’t allowed to use sentences that required commas.  My head hurt most of the time.  And it wasn’t getting better.

Finally, I couldn’t take it anymore.  I was suicidal, but not the variety where I wanted to put a gun in my mouth.  Instead, I decided to take all the emergency cash and three changes of clothes and head for North Las Vegas to get loaded.  I didn’t know anyone there, but I was sure I could find the people who had the drugs I wanted.  It would have been a one-way trip.  I figured I’d be dead in a week.

That’s when God intervened.  First, my wife realized what I was about to do and called 9-1-1.  Then two sheriffs deputies showed up and treated me as the potential suicide that I was.  Seriously, can you imagine LAPD taking seriously a hysterical woman who called in and said her husband was on his way to get loaded?  Thank God for the Iron County Sheriff!

They took me to the hospital, and I got sent to the mental health unit in St. George.  There, they diagnosed me as bipolar and gave me new meds.  In three days, I became so agitated and angry that I almost got in a fist fight with one of the male nurses.  My shrink said I was improving.

Up to that point, I’d been planning to jump through all their hoops, and then continue with my plan to use drugs until I died.  But on the third day, I realized that if I didn’t get out of there, I was going to end up in a dark room in a straight jacket for the rest of my miserable life.

I called my wife and begged her to find somewhere for me to go.  She found only one facility west of the Mississippi that was willing to take me without administering medication.  It was in Culver City, CA.  Two days later, I was on a plane to a thirty-day inpatient program, where they helped me get my shattered mind back together.

When I got out, it took me a while to readjust to “real life.”  But I did.  It’s now a year later, and with the help if intensive therapy and weekly DBT (Dialectal Behavioral Therapy) I have returned to a reasonably normal life.

I thank God for the events that saved me from the conventional mental health system and its effects.  It may work for some people, but it nearly killed me.  I am acutely aware of how broken our system is.  Medication is not the answer to all mental illness, and perhaps not even most mental illness.  My DBT facilitator’s slogan is, “Skills, not pills.”  And for that I am forever grateful.

I am mentally ill.  I struggle with depression and anxiety.  I have been hospitalized twice for psychosis.  Yet I am able to live a fairly normal life.  I am not a danger to myself or others.

I also rarely talk about my struggles.  My bio-family only hears about the crises, not the daily struggles.  My friends don’t hear much more.  I remember trying to explain my depression to a friend, who replied that he just couldn’t understand.  “I have bad days,” he said, “but I don’t understand having bad months or bad years!”

This seems to be the way most people with mental illness live.  We don’t talk about it.  It’s taboo.  It scares people.  And the more we don’t talk about it, the more isolated and misunderstood we feel.   When a mentally-ill person shoots up a school, some folks lump all mental illness together and we become potential criminals.

It’s time to break the silence.  When one in four Americans suffers from some form of mental illness in any given year, that’s too many people to have it misunderstood.

I hope you don’t find my confession in bad taste, but if you do, maybe that’s the point.

November 24

Mental Health and Me, Part 1

Some 25% of Americans struggle with some variety of mental health issues.  Only a small handful are driven to pick up a gun and kill people. Yet the struggle remains, often misunderstood and stigmatized.  Too often, we struggle alone.

Here’s what I know about mental health: It’s better to have it than to not have it.  Ask me how I know.

Mental health and I have had an on-again, off-again relationship over the years.  As a child, I suffered from severe depression.  At 15, I thought of suicide and made practice cuts on my wrist.  I also snagged a quill pen from the art department and wrote a poem in blood.  Clearly, I was a well-balanced individual ready for adulthood.

Fortunately, I learned to manage my depression through medication.  Unfortunately, my meds were neither prescribed nor managed by a doctor.  I started with pot, speed, and LSD.  (The latter made things worse, but it was entertaining.)  I graduated to alcohol, then cocaine and heroin, supplemented with anything else I could get.  I figured I could live that way until I was about 20.  All my heroes were dead poets and dead musicians, and I didn’t mind the idea of joining them.

By 25, I’d exhausted my options and was afraid I wasn’t going to die.  Then I got sober, which is another story.

That’s where my struggles with mental health really began.  The initial exhilaration at getting off drugs faded.  Real life kicked in.  My depression returned with a vengeance.  Therapy didn’t seem to help.  I was 32 when a psychiatrist put me on Prozac.  The first week it didn’t do much.  Then came two weeks of ecstasy.  I realized that I hadn’t known how depressed I was because I had nothing to compare it to.  I’d never been not depressed.

Prozac seemed too good to be true.  And it was.  As my dose increased, I became more and more anxious.  One day I woke up paranoid, psychotic, and suicidal.  No one knew what to do with me.  The shrink wanted me to keep taking the Prozac.  My GP wanted me to take Valium.  My wife just wanted her husband back.

It took four months before someone decided I should be hospitalized.  During that time, I wore a winter parka in the summer, rarely went out without a teddy bear, and had a secret hand signal for my wife in case the anxiety of a social situation pushed me close to melt-down.  I don’t remember any of that; she told me about it years later.

I spent a month inpatient in a mental health facility.  But it took over a year for me to begin to really function again.  In the mean time, I lost my home, my marriage, and my business.

That’s how I learned that psych meds were not an option for me.  Instead, I had to manage my depression and anxiety by other means.  Meditation replaced medication.  Volunteer work gave me a sense of purpose I’d never had.

I continued to struggle from time to time, but that first experience of losing my mind to psychosis motivated me to try to live differently.

October 10

Let’s Start Talking

It’s time to start talking about the elephant in the living room.  I refer to our national mental health problem.  It’s not about mass shootings, though they are a symptom.  It’s not about the homeless, though they too are largely a symptom.  It’s about 1 in 4 Americans suffering from mental illness each year, and our inability to acknolwedge that there’s a problem.

Furiously Happy by Jenny Lawson is a great place to begin the conversation.  In this series of essays and blog posts, Lawson explores her own mental illness, as well as society’s reaction to mental illness.  The book is hilarious, and also enlightening.  I’m listening to the audiobook, narrated by the author, and it is extremely listenable.  It’s also available on Kindle, although this is one of the few books in which the performance makes it hard to imagine “merely” reading it.

From the description:

Furiously Happy is about “taking those moments when things are fine and making them amazing, because those moments are what make us who we are, and they’re the same moments we take into battle with us when our brains declare war on our very existence. It’s the difference between “surviving life” and “living life”. It’s the difference between “taking a shower” and “teaching your monkey butler how to shampoo your hair.” It’s the difference between being “sane” and being “furiously happy.”

There’s plenty of mention that most of those who live with mental illness “suffer in darkness.”  There’s the note that cancer sufferers get recognized when they survive, but those with severe depression often get ostracized when they survive.

And there’s plenty of profanity, but get over it.  This book is worth a little discomfort, whether at the subject matter or her colorful language.