Friday, February 6, 2009

In Defense of Prozac

A few days ago someone whose blog I respect and read almost daily Twittered a question: “Does anyone know how long it takes for SSRI’s to kick in?” SSRI, an acronym for Selective Seratonin Reuptake Inhibitors is a group of anti-depressants that includes Prozac.

A few years ago I had an experience that affected me profoundly, and I swore that if I ever had the opportunity to speak up for anti-depressants, I would. In my second summer here at Dancing Rabbit (2000) we had a spectacular group of interns. Ranging in age from 19 to about 26, they were enthusiastic, intelligent, and an inspiration. One of the brightest stars was Minna – with a dazzling smile, a zest for life and an infectious laugh, she was an absolute delight. When the summer ended the group of interns went their various ways; Minna went back to Stanford to complete her degree.

In July of 2001 Kurt and I were leading a hiking trip at the Sierra Club’s Clare Tappan Lodge in northern California. One afternoon we walked into the great room and there on table was the latest edition of the San Francisco Chronicle, with headlines screaming about a search for a missing Stanford coed. The accompanying photo showed an effervescent blond with a gorgeous smile – it was Minna. She was found three weeks later, hanging from a tree in a secluded wooded area. Like many of those who knew her, I felt like I had failed her. If I been more candid and honest about my own struggle with depression would she have been able to hear it? Would she have gotten the help that might have saved her life? I will never know, and carry the guilt and shame of that with me always.

My experience: In 1990 I found myself desperately searching for reasons to live. This sounds incredibly melodramatic; it felt incredibly awful. This feeling was particularly strong when driving. On the freeway (I was living in Berkeley and commuting to San Francisco and Hayward – I spent half of my time on one freeway or another) I would have to concentrate in order to not drive into the concrete abutments holding up the over passes; when taking the exit for highway 24, which rose high above the massive interchange and had a tight left curve, it was all I could do to turn the wheel instead of allowing myself and my white bug convertible to go sailing off the side. I could not think of reasons to get up in the morning, I couldn’t think of anyone who liked me. None of it made sense logically – messages from friends were piling up on my answering machine, I had a full social schedule and a job I enjoyed. It was very frightening, as my nature is naturally sunny and optimistic.

Depression wasn’t talked about much then. It was still discussed in whispers, with a kind of knowing look accompanied by eye-rolling; “too bad about XX’ and “why don’t they just snap out of it.”

About the same time my therapist put me on Prozac I found the book Darkness Visible, A Memoir of Madness by William Styron. The two of them saved my life.
"A meditation on Styron's ( Sophie's Choice ) serious depression at the age of 60, this essay evokes with detachment and dignity the months-long turmoil whose symptoms included the novelist's "dank joylessness," insomnia…and his persistent "fantasies of self-destruction" leading to psychiatric treatment and hospitalization. The book's virtues--considerable--are twofold. First, it is a pitiless and chastened record of a nearly fatal human trial far commoner than assumed--and then a literary discourse on the ways and means of our cultural discontents, observed in the figures of poet Randall Jarrell, activist Abbie Hoffman, writer Albert Camus and others. Written by one whose book-learning proves a match for his misery, the memoir travels fastidiously over perilous ground, receiving intimations of mortality and reckoning delicately with them. Always clarifying his demons, never succumbing to them in his prose, Styron's neat, tight narrative carries the bemusement of the worldly wise suddenly set off-course--and the hard-won wisdom therein. In abridged form, the essay first appeared in Vanity Fair." ~ The Publisher’s Weekly review on Amazon

One of the worst parts of depression, at least for me, is the sheer incomprehensibility of it for others. When I wasn’t actively wanting to die, I simply wanted to go away, to not exist. It was all too much work, and far too painful. Styron’s book helped me feel a bit more normal and less psychotic (although I hated the subtitle, A Memoir of Madness). It gave me reference points, a reality check, and let me know that things really would get better.

Therapy, a lot of work, kindness from friends and loved ones all contributed to my recovery. I have come to understand that life is a series of ups and downs, and I no longer fear the downs – I know that I will come through them just fine. And I continue to take Prozac.

I do not consider Prozac a crutch, a moral weakness or a sign of a lack of character. If my brain needs more seratonin then I am going to take it, much like I would take insulin if I were diabetic, or iron if I were deficient. I do not take Prozac to be “happy.” I take it so that I can be alive and function and so that I can work on what is causing me distress.

Also recommended: Unholy Ghost: Writers on Depression edited by Nell Casey. (Can you tell I'm a reader, and that I learn a lot about my world through the words of others?)

"A reader on melancholy," the editor calls this book: a collection of 22 modern essays about depression by writers (several well known) who know their subject intimately. Some face depression as a sudden interruption of a previously gratifying life; others have never known life without it. Their words wrestle to express their vision, their gloom, their attempts to cope, their interactions, their isolation, and, often, their reactions to medications. Some attempt to analyze their depression; others just want you to know what it's like. Besides the essays by writers who have experienced depression firsthand, editor Nell Casey (also a writer of one of the chapters) includes a few essays by their spouses and siblings about what it was like to live with a person suffering from depression. As a whole, the collection is a valuable contribution to the field of depression studies, and will lend some insight and cheer to those struggling with this little-understood condition." ~Review on Amazon

Friends, if you are depressed, go see a therapist, and inquire about anti-depressants. You are important, you matter, you have a whole life ahead of you in which to contribute, and we don’t want to do it without you. If I can help you in any way, please don’t hesitate to contact me.

Tuesday, February 3, 2009

I'll Have A Big Bowl of Sugar and Salt, Please!

NOTE: Great Granola recipe at the end of this post!

I subscribe to the Wall Street Journal (along with the weekly Memphis Democrat – what a contrast!). I get it mostly to keep up with the world; I will probably switch to the NY Times when this subscription runs out. Anyway, I usually skim the front section, skip over the investment section and read the “Personal Journal” front to back. Kind of my version of Wall Street Journal, Light. Which is just a long way of saying that while I read every single book review, author interview and play review, I miss a lot of other, more "serious" stuff.

On Sunday morning, taking a break from the nutritious, high-fiber oatmeal (organic thick rolled oats with apple chunks, sunflower seeds and raisins) I was frying up some bacon to go with our Sandhill eggs. I pulled a stack of newspaper from the recycling on which to drain the grease (no paper towels in this house) and had to find another page when, drippy bacon poised to land, I read the headline that I was about to obliterate: “Kids’ Cereals Saltier, Report Says.” I dumped the bacon on the Dow Jones report and read this:

“Cereal makers that reduce the amount of sugar in kids' cereals tend to ratchet up the salt content to improve flavor, says a report expected to be released Tuesday by Consumers International.

Cereal makers have been under pressure from consumer groups to reduce the sugar content of their kids' cereals, and Consumers International, in its report, "Cereal Offenses," says "manufacturers are likely to add salt to boost the flavor of the product, and may use salt to maintain customer appeal when sugar levels are reduced."

The London-based organization, an umbrella group representing 220 consumer groups globally, focused on products made by two of the world's largest makers of cereal for children, Nestlé SA of Vevey, Switzerland, and
Kellogg Co., Battle Creek, Mich. The group defined children's cereals as those that feature cartoon characters on the packaging, are endorsed by celebrities popular with kids and are advertised on kids' television programming.

A sampling of 100 grams of Kellogg's Frosties Reduced Sugar cereal sold in various countries contains, on average, 25% sugar and 1.5% salt -- more salt than is normally found in potato chips.

Last year, after two advocacy groups -- the Center for Science in the Public Interest and the Campaign for Commercial-Free Childhood -- threatened to sue Kellogg for marketing sugary products to young children, Kellogg said it would reformulate certain products. For those products that it couldn't get to taste as good through reformulation, Kellogg said it would simply stop advertising to kids under the age of 12 as of 2009.

Kellogg so far has reformulated its Froot Loops, Corn Pops, Rice Krispies, Cocoa Krispies and Apple Jacks cereals. The new formulas began hitting store shelves in June.

The report also takes aim at the overall sugar content of cereals, saying that in many cases, children's cereals contain more than twice the amount considered high by the U.K.'s Food Standards Agency. Nesquik cereal, for example, is made up of 36% sugar, on average -- a higher level than what is found in an equivalent amount of ice cream, Consumers International claims.”

So let's review. When pressured to lessen the sugar content of cereal aimed at children, manufacturers (i.e. Kellogg's, who I just praised here the other day) simply added more salt, sometimes the equivelent to that in potato chips. Additionally, some cereals are as much as 36% sugar, the same amount that is found in ice cream. Who ARE these people? And why are we buying food from them?

Except for a general sense of horror, there is not much for me to add here. However, I am closing with my favorite recipe for home made granola. It is absolutely astounding. The original recipe called for brown sugar but I found that by substituting brown rice syrup I could lower the glycemic index. It might take awhile for kids to get used to the “less sweet” taste, but with dried fruit (raisins, cherries, pears) they might never miss it. Is it as sweet as Froot Loops? Nope. But it won’t make your teeth fall out either. Enjoy!

The BEST Granola EVER
Yield: about 8 cups

3 cups quick oats
2 cups oat flour (if you can't find oat flour you can easily make it yourself by grinding oats in a food processor)
3 cups coarsely chopped raw nuts and/or seeds (I usually use a mixture of almonds, sunflower seeds, sesame seeds, pumpkin seeds and coconut, but use whatever tickles your fancy)
1 cup brown rice syrup or agave nectar (the original recipe called for packed brown sugar, which is delicious, but much higher on the glycemic index)
1/2 cup (1 stick) unsalted butter (for a vegan version, use Earth Balance Buttery Spread)
1/4 cup water
1/2 teaspoon salt
2 teaspoons vanilla extract
1 teaspoon ground cinnamon
1/2 teaspoon ground cardamom

Preheat the oven to 300F.
  • In a large bowl, combine the oats, oat flour, nuts and seeds.
  • In a microwave-safe bowl (or in a saucepan over medium heat), combine the brown rice syrup (or brown sugar), butter and water and heat just until the butter has melted and the mixture is bubbly.
  • Stir everything together until smooth, then stir in the salt, vanilla and spices.
  • Pour this mixture over the oats and nuts, stirring everything well to coat.
  • Let stand for about ten minutes.
  • Spread the mixture out on a large baking sheet, separating it into irregular clumps with your fingers, and allowing space between the clumps for the hot air to circulate.
  • Slide into the middle of the oven and bake for 25-30 minutes, or until the top is golden brown.
  • Remove from the oven and stir, gently breaking up the mixture into small-to-medium sized clumps.
  • Return to the oven and bake another 15 minutes or so before stirring again.
  • Repeat the bake-and-stir until the mixture is a uniform golden brown and completely dry; this usually takes 1-1 1/2 hours.
  • Cool completely, then stir in any dried dried fruit you want to use.
  • Store in a covered container at room temperature.

A few notes on this recipe: This recipe is a version of The Lip Lady's Granola, published on Melissa Kronenthal's marvelous blog The Traveler's Lunchbox. She had this to say about the ingredients: "Okay, so what exactly makes this granola different? I'm no kitchen scientist, but I can point out the things that seem to have the biggest impact. One thing is the addition of oat flour, which helps the grains and nuts stick together into those much-coveted clusters. Another is the use of sugar; as much I like liquid sweeteners like honey and maple syrup, they seem to produce a tougher, chewier granola. Finally, the right kind of oats are essential. For years I only baked with regular rolled ('old fashioned') oats because that's what recipes called for, but as soon as I switched to the smaller, thinner 'quick oats', the changes were remarkable - clusters formed, everything baked faster, and the texture became exquisitely light and crunchy. If you can't find quick oats where you live - and I have lived in a few places where oats come in one variety only - here's what I would do: pulse rolled oats in a food processor a few times to break them down to about half their original size. It won't be exactly the same but it will come close."