Paging Dr. Mario

There's a fascinating piece in the Washington Post today about the possible therapeutic uses for video and computer games.

As I have alluded to previously, this doesn't really come as much of a surprise to me.

Looking back, I've been using computer games (and, to a lesser extent, arcade games and consoles) to manage my mood going back at least as far as college, and probably longer. When my high school sweetheart broke my tender young heart Freshman year, I sought some solace by sobbing dramatically in front of friends and classmates, but also by spending some time in the arcade at the Student Union. Far more serious chunks of time than I might spend otherwise... and given how hard I used to hit the Tekken machine, that's saying something.

Just as with any other artistic medium, gaming can lead you to a host of different emotional states, but there are some that are more common and consistent:

There's the heart-pounding, adrenaline-pumping Jesus-Christ-shoot-all-the-zombies kind of excitement.

There's creeping, Jesus-Christ-I-just-know-there's-a-zombie-behind-that-door-and-I-only-have-three-bullets-left dread.

There's the sudden shock of abject JESUSCHRISTITSAZOMBIEBLAMBLAMBLAM terror.

There's the pleasant panic of the Jesus-Christ-how-can-I-make-a-stack-of-blue-zombies-when-all-it-gives-me-are-red-ones variety.

There's the addictive sweetness of Jesus-Christ-my-zombie-just-leveled!

Occasionally, there's even the jaw-dropping emotional pang of the Jesus-Christ-my-SISTER-is-the-zombie?-type plot twist.

This extended metaphor has been brought to you by Zombie Kitty, and the fact that video games have a crapload of zombies in them.

There's also the Zen-like no-thought state the Washington Post article above refers to; where you're balanced right on the edge of being challenged just enough but not too much, so that your mind is occupied but you don't have to think. It's a pleasant absence of thought and feeling that you can access most easily with varied-repetitive-action games like Tetris or Bejeweled, but that you can get from almost any genre if the game is good and you're good enough at it. Your mind and self slip away... it's actually quite a bit like a meditative state.

Which makes it a highly desirable way to be if you don't want to think or feel. Which, if you're depressed, you often don't.

This is not to say that it addresses any of the underlying causes of an imbalanced mood, but it gives you time, which is all you need if you're furious and need to calm down, or need to get over that high school sweetheart without crying in public so much, or are thinking about killing yourself and your doc won't pick up the phone until the morning.

People have used emotionally-numbing pharmaceuticals and activities like this for centuries, the most obvious example probably being booze. Video games have the benefit of not destroying your liver, and not being physically addictive.

Although, as my parents can attest, psychological addiction is another matter entirely.

This is not to say that the way I've used games has always been healthy - far from it - and I certainly have taken some long-term physical damage in terms of my carpal tunnel issues. But compared to booze or coke or even sex, gaming looks pretty good as a way to self-medicate. Which we all need from time to time.

I'll be interested to see what the medical community does with it, especially as our understanding of the way the brain works gets deeper and more specific. Who knows? Maybe someday, someone will hand you a prescription that says Take 2 Hours of Dawn of War 5 and Call Me In the Morning.

And what a sweet day that'll be. Talk about not needing a spoonful of sugar...

-- The Prolix Wag
Jesus-Christ-IS-a-Zombie!!!

AAAAAAH!!!

Morbid Thoughts

The human mind cannot conceive of its own mortality very well. Oh, I mean we can comprehend the fact that we're going to die someday, but apprehending that fact, really grokking it, being in the presence of the fact that we will end someday... our brains aren't so much built to do that.

Which is a good thing, really, since constantly being aware of one's own mortality is a pretty quick road to being mostly useless as a living being. Mind you, being aware of it occasionally is not only okay, but can actually be a pretty wonderful and transcendent experience.

It is hard to get your mind to focus on its own ceasing, though. Your mind slips off of it and on to other things as soon as it can possibly get away with it. There are a few works of art that I know can get you there, at least for a moment: Six Feet Under, taken as a whole, has at least half a dozen moments where the whole thing just drops in, click-bang, and you know you're going to die, and there's no avoiding it. It lasts about thirty seconds, tops. Stephen King's The Green Mile has about a page and a half right at the end that take me there without fail every time. I once saw a really good production of King Lear that did it, too, right where Lear is fussing with Cordelia's button after she's been hanged.

I used to treasure those moments. I loved holding the thought of my own death in my mind, like a brief and slippery fish that was somehow also a precious jewel. It may seem strange for an atheist -- who has, as far as he knows, not much to look forward to after this life (well, not anything, really) -- to say that, but it's true. The perspective an understanding of your own transience gives you on the rest of your life can be energizing, even intoxicating. It can be beautiful.

I used to treasure those moments. I used to treasure them because they used to be rare.

I've been very fortunate that suicidal ideation has never been a part of my Mood Disorder. I've never felt a desire to kill myself, never felt the need to end it all, never heard voices telling me to do it. I have no intention of ever going gentle in to that good night.

I have a frying pan at my bedside for just such an occasion.

People that have to deal with suicidal thoughts have my sympathies; that must suck, big time. I'm thankful I don't have to put up with them.

Unfortunately, I have a similar, less potentially deadly, but still incredibly annoying symptom: morbid thoughts.

There are periods (anywhere from once to a dozen times a week, lasting anywhere from a minute or two to several hours), when I can't get the fact of my own death out of my head. It's incredibly present and real for me, and colors everything I see and feel.

Again, it's not a desire to die, but an awareness that I will, and a fear that time is slipping away far too fast. Sometimes I'm able to jump my mind off the track with conscious effort, but sometimes, not so much. At those times, my death is a big, obnoxious, noisy house guest that just won't take a fucking hint.

"I'll just be over here in the corner. Try and forget I'm even here."

This... awareness is incredibly annoying in general. But I especially hate how it colors the way I see my children. You know that slightly bittersweet tinge of "oh, they're growing up so fast" you get when they do something adorable you know they won't always do? That little undercurrent of "time flies" that leavens your love for them, and makes it even sweeter? Yeah. Imagine reversing the proportion of love and dread in that equation.

Catching a glimpse of your own death is empowering. Seeing your own death in everything sucks.

"I will show you fear in a handful of yarn..."

It comes and it goes, and fortunately it goes more than it comes. But it's interesting to me that it's a symptom I haven't heard much about from anything else I've read about mental illness, although my doc seemed to know what I was talking about when I said "morbid thoughts".

Now, if you'll pardon me, I'm going to go put some Blue Oyster Cult on repeat.

-- The Prolix Wag
You're gonna miss me when I'm gone. I know I will.

Me and My Mood Disorder Not Otherwise Specified, Part 5

Part 1 is here.

Part 2 is here.

Part 3 is here.

Part 4 is here.

Mental illness carries a stigma for two reasons: first, as I've already discussed, we often confuse it with a personality or character flaw because, well, it profoundly affects personality and character. Second, it disturbs us (even more than other illnesses) because it fucks with our ability to read other people. Your social instincts and skills, honed over millions of years in an evolutionary sense and over your whole lifetime in a more personal one, often spit out a big DOES NOT COMPUTE when confronted with someone with a mental illness because, well, their responses and social cues don't make a lick of sense. And people that don't make sense are unpredictable, and that's scary.

Is he going to kiss you or bite you? Hug you or eat you? You just don't know.

My problem with the stigma attached to mental illness isn't that it isn't fair -- although it often isn't -- it's simply that it often keeps people from getting the treatment they need. People don't want to admit to themselves that they're crazy or broken, that the essential them they know and love is nuts. And so they put off getting treatment, and wind up miserable at best and dead at worst. Which is why I try and be as open as possible about my own condition.

I don't wear "Has a Mood Disorder" like a merit badge, and I don't tell everyone on the street about how well my meds are working. But I do try to treat it casually, like any other chronic, treatable medical condition. Like diabetes, say. It's not necessarily everyone's business, but I'm not afraid to mention it in conversation if it's relevant.

The couple times that people have opened up to me about their own experiences with mental illness because I was open about mine have been extremely gratifying. Let me tell you, it doesn't get much better than having one of your students tell you you "saved their life" by being a friendly ear, and a hardass about making sure they kept going to treatment.

If you have a mental illness, my advice is, wait until you've got it handled -- until you're getting treatment, until you feel like you're starting to master the beast. And be careful about it at work. I work mostly in the performing arts and academia, where the reaction is usually not "You have a mental illness?", but rather "What's your dosage? Because I had some real problems with Restless Leg Syndrome when I was taking 250 mg". Not having a mental disorder of some kind is looked on with just a hint of suspicion. But in other industries, people can be real dicks about it. So watch your back.

But that aside? Pay it forward. People are dying from this every day, and living the kind of lives where they might as well be dead. I don't know if you owe them anything, but you can help.

Oh, and if there's anyone out there wondering how the people close to you will react if you "come out of the closet", as it were? Trust me, you were the last to know.

"What would they think if they knew the real me?"

Finally, I'd like to close with a little bit of advice for people who have to deal with people who are mentally ill:

1) It will take time. A lot of time. Like, years.

2) It is perfectly normal to want to beat them to death with their own leg. Mentally ill people are irritating as fuck.

3) Be prepared to forgive anything but avoiding treatment or not taking meds. Someone with a mental illness cannot be responsible for a lot of their behavior... but draw a line in the sand when it comes to doing what it takes to get better. My wife puts up with a lot... but if I skip meds, accidentally or not, her wrath comes down like the fist of an angry god. As well it should.

The last time I skipped meds.

4) Talk of harming oneself or others is not to be fucked around with. If you're asking yourself if they really mean it or not, they do. Call someone.

Get well, be well. Remember, Better Living Through Chemistry is still Living Better.

-- The Prolix Wag
Better Living Through Being Smarter Than You

Me and My Mood Disorder Not Otherwise Specified, Part 4

Wherein we try to discuss depression in a way that isn't depressing.

Part 1.

Part 2.

Part 3.

A couple years ago, I saw a truly stellar production of Sarah Kane's play Crave at Signature Theater in Arlington. It was acted with tremendous skill and passion by all involved, and the design and direction were impeccable.

For those of you not familiar with the play, it involves four nameless characters talking to themselves, the audience and each other in a largely plotless exploration of the human psyche. It's written with no small measure of poetic and lyrical skill. Kane, who struggled with severe depression for many years before killing herself at the age of 28, makes depression manifest theatrically through the play. For the hour-or-so running time, you really get what it is to be depressed, to deal with a depressed person, to be in the presence of depression. Speaking as someone who's dealt with depression, I've never seen a more accurate portrayal.

Which is why it's the worst play ever written.

Here's the thing: depression is stupid. Depression is boring. Depression is incredibly annoying.

Depression is incredibly difficult to depict artistically because, if you really get it right, your audience is going to want to punch your depressed character in the face after about five minutes. And not in the good, gee-I'm-really-mad-at-Willy-Loman-for-being-such-a-schmuck kind of way. No, I mean they'll really, truly want to punch the characters in the face. They'll have difficulty staying in their seats and not doing just that. Just like, if you're ever around a depressed person for more than five minutes in real life, you'll start looking around for heavy objects to bludgeon them with.

Crave does for depression what Irréversible did for rape -- which is to say, it gives you way too goddamn much of it. If Kane had managed to give you maybe two minutes of that pure, mainline shot of what it is to be depressed, and then written an actual play around it, she would have had something pretty brilliant. Instead, she barfs it out onstage and makes the audience wallow in it. Because, like all depressives (myself included), she was addicted to the deliciousness of her own misery.

Actor John Lescault fondles the pulverized hopes and dreams of the Signature Theater audience.

The funny thing is, a lot of the time when you're depressed, you can see how annoying you are; you can see how little sense your own emotional state makes, how out of step it is with the reality of your life.

But you can't help it.

For me, the thing that's horrifying about depression isn't just that it feels like you're in the grip of some evil, alien force that distorts the entire world... it's that the evil, alien force is you. It's your own brain. Your own personality.

And on some level, it feels... well, not good, but... yours. It's addictive, in the way that teenagers find their own overblown emotional drama way more interesting than anyone else ever could.

That's it, actually -- you want to know what it's like to be depressed? Imagine all the emo parts of your teen years, then multiply them by ten. Oh, and you can't get out of bed.

WHYYYYYYYYYYY?!?

Note that I said can't get out of bed, not won't. There were mornings, back before I got treatment, when I wanted nothing more than to be able to roll over enough so that I would fall out of bed on to the floor, never mind actually being able to get up to do anything. And while getting up would have been about as hard as bench pressing three or four tons, I felt incredibly guilty, because all that was keeping me in bed were feelings. Like, the feelings that make it hard to get up on a Monday morning... but turned up to 1000.

I could go on, but... well, I don't want to be Sarah Kane. It's bad enough they keep rewarding her for killing herself by producing her plays. Suffice to say that depression sucks, in the way that having your collarbone broken "hurts". You really can't describe it much better than that, but the word doesn't quite do it justice. Thank god for Wellbutrin.

I'd just like to state once more for the record that the folks I saw do Crave at Signature did an incredible job with it. It's just that the play itself is a theatrical abortion.

Girls, girls... you're both... incredibly depressing.

Next time, the politics of mental illness, or "Why I'm Telling You All This Crap".

-- The Prolix Wag
I have an obligation to share my brilliance. It's like noblesse oblige, only a little less noblesse.

Me and My Mood Disorder Not Otherwise Specified, Part 3

Part 1 is here.

Part 2 is here.

I can remember the exact moment I figured out that my psychiatrist (the one who diagnosed me) knew what the hell he was doing. It was when, in the course of asking all the usual psychy-psychy questions ("Do you ever think about hurting yourself or others?", "On a scale of 1 to 10, how severe would you say your depression is?", "Do you like the new couch?", etcetera), he asked this one:

"Do you like puns?"

Which took me aback a little bit. Because I do. Quite a bit. Especially when I'm in a good mood.

"You're kinda freaking me out, doc. What gave it away?"

See, it turns out an enjoyment of/engagement in/freakishly annoying obsession with puns and wordplay is one of the symptoms -- or, shall we say, "characteristics" -- of a manic episode. And here I always thought it was just part of who I was.

"Fortunately, they have a pill for that now."

As I noted in Part 1, if it were up to me, I would stay in my manic mode all the time. My wife is very glad I can't. When I'm manic, I talk faster; I use more words; I do weird, spazzy things (nothing too crazy -- I might, say, do the Safety Dance around the living room apropos of nothing -- but... spazzy); I focus obsessively on somewhat grandiose tasks (I once dug and built a stonework path in our backyard "just because", and wrote an entire play in a month); overall I get a little... intense. For those of you who've been around me and thought I was just a little too much, now you know why. As my wife will be happy to tell you, I can be very, very annoying when I'm manic.

But, like I said, I love it. I talk faster because I think faster. I'm smarter and funnier. Almost all of my good writing gets done when I'm manic (the editing is another story, but that's neither here nor there). If you notice a post that goes on and on and on just a hair too much, then I was probably manic when I wrote it. I've got just a little bit of an edge right now, for example.

When I get depressed, I get stupid. I can't think of the word for incredibly obvious things (like "cabinet"), and whatever I try to write comes out clumsy and off, especially if I'm trying to be funny. It's incredibly frustrating. If you've ever read a post or a message from me that felt forced, and just plain wasn't funny, I was probably depressed when I wrote it.

Blech.

So, like I said, I'd be manic all the time if I could help it. Fortunately for my wife, I'm not.

How I feel when I'm manic...

....and what my wife actually gets to deal with.

It's interesting to me that, essentially, what I'm doing when I take my meds is regulating my personality. Changing it. Frankly, there's some stuff about the pre-medicated me I miss. I was weirder, for one thing. Most other people didn't seem to like that as much, but it was who I was. I'm still me, but... a different me.

I'm less creative, in some ways. I'm probably a better writer and actor now, but it isn't always quite as much fun. I heard somewhere that mental illness is far more common among artists... that close to half of all professional poets were somewhere on the bipolar spectrum.

I don't write much poetry any more.

Right now, psychiatry is kinda like taking a ball peen hammer to a malfunctioning Swiss watch -- it may very well get it to run better, but no matter how gently you hit it, your tool is less subtle than the internal mechanism by several orders of magnitude. Don't get me wrong, my meds work pretty damn well, and I'm glad I have them, but I do wonder what life will be like when we can medicate with greater precision. When we can change personalities on demand, and get exactly what we want. What if we could make people "artistic"? Or "nice"?

Who would you want to be?

Who would they want to be?

...

Next time, the Ugly Truth About Depression, Which Is Even Uglier Than You Thought, or "Why Sara Kane's Crave is the Worst Play in the Universe".

-- The Prolix Wag
I know more about it because I've lived it. I would know more about it anyway, but let's not quibble.

Me and My Mood Disorder Not Otherwise Specified, Part 2

Part 1 is here.

Let us begin Part 2 with Aristotle.

And what a huge dick he was.

Father of philosophy, great uncle of rhetoric, second cousin of math, huge dick. Huuuuuuuuge.

Why was Aristotle such a huge dick? Well, first and foremost, he was pretty much the inventor of dramatic criticism. Which subsequently led to the invention of drama critics. So, q.e.d.

It also led to the invention of the Neoclassical Unities, which is directly responsible for me having to read Racine's Phaedra in college. Which, as we all know, is The Worst Play Ever Written, Except For Sara Kane's Crave.

"Oh girl, hold on! Are those shoes on sale?"
"I have no idea, but thank god we're not doing Crave."

He also thought women were a lower form of life who could never be fully human, but some of our finest Supreme Court Justices believe the same thing, so let's just chalk that up as "controversial". No, the thing that made him a truly huge dick is the only thing I remember from my dabblings with philosophy in undergrad, which is drawing a big line from his name to "Mind/Body Dichotomy in Western Thought" in my notes.

See, we're stuck with this deep-seated belief that the mind, the Self, that-which-you-think-of-as-"me", is fundamentally separate from the body. Which, as anyone who's ever had to deal with any kind of neurochemical imbalance knows, is complete and utter bullshit.

The usual argument for their separation goes something like this: "You are yourself. Would you still be yourself if I cut off your arm? What about your leg? What about all your arms and legs? So, wouldn't you still be yourself without your body?"

Problem is, a brain is not a leg. Heck, a pancreas is not a leg. We cannot have a direct experience of what it is to be without a body, which is why the concept of life after death is exceedingly hard to debate... but we can have an experience of what it is to be without a self.

Let me turn that argument around: "You are yourself. Would you still be yourself if I cut out that part of you that feels happiness? What about the part of you that thinks? What about everything that you think of as consciousness? Would you still be yourself without a mind?"

And if you don't think we can do any of that, you've never met anyone that's had major depression. Much less a lobotomy.

"Oh, McMurphy! If your pneuma and your soma were not indissoluble, this would totally be a depressing ending!"

We don't like to think about this idea too much, because it has certain disturbing metaphysical implications (if "Self" is an expression of "Body", and "Body" can end... well, let's not go there), but it bears talking about because it has direct bearing on how we think about mental illness. Because "mental illness" is a panoply of diseases and injuries that attack the parts of our body (mainly the brain, but also the endocrine system) that create "self", and therefore are diseases and injuries that attack the "self".

Which is a bitch and a half, believe me.

One of the hardest things to wrap your head around as someone who has a mental illness is that there are thoughts and behaviors "you" are not responsible for... even though "you" are the one feeling and doing them. But it's vital that you do, because otherwise you spend all your time blaming yourself and feeling guilty for things you can't possibly control. I mean, if I break my leg, do I feel guilty about the fact that I suddenly can't walk without crutches? Heck, no. But I've had mornings when I could not -- and I mean could not -- get out of bed because of what was happening chemically in my brain. And blaming myself or feeling guilty about that wasn't just wrong-headed, it was incredibly counterproductive. It kept me from getting treatment for a long while.

The brain is an organ, like any other, and like all the other organs, it can break. When it breaks, it stops working... and that lack of function can make you sick, or even kill you. It's a very counterintuitive idea, but one that makes mental illness something you can treat just like any other injury or disease, instead of a fundamental fault in someone's being. And if you want to see the consequences of treating it one way instead of another, just look at the US Army. Treat PTSD like a brain injury? You get treatment for your soldiers. Treat it like a personality flaw? You get suicides, murders, and a generation of veterans that hate the service that betrayed them.

And if you've ever known anyone who's committed suicide due to a mental illness, it's a lot more comforting to think that they died of a disease, than that they chose to do it.

Next up, what "manic" means to me, or: "It's like there's a party in my pants... in my head!"

-- The Prolix Wag
The Gold Standard of Deviation.

Me and My Mood Disorder Not Otherwise Specified, Part 1

Several years ago, I was diagnosed with a Mood Disorder Not Otherwise Specified, which kind of surprised me at the time since the Moods in question were always Pretty Damn Specific, if not Predictable, Appropriate, or Pleasant.

What it basically means is that, if I'm unmedicated, my mood swings from depressed to manic to various places in between and back again completely detached from the actual circumstances of my life. My highs don't go quite as high as someone with full-blown Bipolar Disorder would (if it were up to me, I'd live my entire life in my manic zone, even though my wife would probably be forced to kill me after a couple days for the sake of her own sanity), and I have other moods that don't really fit on either end of a scale, like "agitated" (manic but irritable), "cranky" (depressed but energetic), and "WHARRGARBL".

Wharrgarbl.

You can think of me as Bipolar But With Longer, Gentler Swings, or as Depressive With Occasional Highs. Or, as most people thought of me before I was diagnosed, Weird.

One of the dirty little secrets of modern psychiatry is that they don't really make diagnoses the way other doctors can; they don't really have diagnoses. They have categories. When a doctor says "you have strep", there's a strep virus he can point on a big picture on a flipchart with one of those metal pointing things, and lo, that's what's wrong with you. The fever, sore throat, et. al. are symptoms. They can be markers of the underlying condition, they can help your doctor figure out what the underlying condition is, but they're the effect, not the cause. Although it annoyed my psychiatrist no end when I pointed this out, neuroscience is very much in it's infancy, and psychiatry is in many ways still a "Black Box" endeavor. In other words, they toss a few pills into the Black Box that is your neurological/system, shake it around a bit, see if it works or not, change up meds, and try again until they get a result they can live with. There's a reason I have a Mood Disorder instead of a Mood Disease; they don't quite know what my disease is, yet. There is no blood test for depression.

Oh, if only we knew. If only.

Mind you, they're working on it, which is great, but until they suss out the underlying causes, the way they figure out whether you've got a mental illness or not is in many ways subjective. The dividing line between a mental illness and what we call, oh, a "personality"?

Is it interfering with your life?

Or, as Peter D. Kramer noted about Sarah Palin's supposed "Narcissistic Personality Disorder", "If a personality style gets you a devoted husband, admiring children, a loyal circle of friends, a governorship, and a vice-presidential nomination, can we really call it a disorder?"

In any case, my Mood Disorder was definitely interfering with mine. Thankfully, they have a pill for that, now. But more of that anon.

Next time, I'll tackle the dualistic mind/body divide in Western thought and why my Mood Disorder has caused me to conclude that it's total bullshit. Or, "Why I Want to Cockpunch Aristotle for More Than Just Poetics."

-- The Prolix Wag
It's called erudition. Look it up.