Thursday, January 22, 2009

Thought Acceleration and the Hypomanic Edge

Clinicians and patients have long observed a connection between "racing thoughts" and the experience of euphoria in mania. In some ways it "feels good" to be racing along, though in true bipolar affective disorder the experience often becomes overwhelming or distressing, and is almost always followed by a period of low energy or "crash."

In his book The Hypomanic Edge, John Gartner suggests there is something uniquely American about the hypomanic experience. He offers illustrative historical figures such as Christopher columbus, Alexander Hamilton, and Andrew Carnegie as evidence that hypomania may be related to success, or some component of potential success and that it can actually be rewarded in certain organizations or systems or cultures. He's referring here to the risk-taking, slightly grandiose, euphoric feelings associated with hypomania. Others, too (e.g., Dr. Ronald Fieve
and Tom Wootton) have pointed to the impact of manic experience on productivity and creativity.

Patients who suffer with bipolar disorder are unlikely to see the "advantage" or benefit of the condition, but are likely to report that when they are hypomanic they enjoy a sense of well-being and a capacity to get things done. And it may take several cycles or crashes to fully appreciate that the highs come at a real cost.

Still, many have mused that they wish there were some way to enjoy the productivity and pace of the "moderate" hypomanic experience - before the sleep deprivation and disorganization kick in.

As reported in the journal Emotion, Pronin, Jacobs, & Wegner found that test subjects who are instructed in thought acceleration (reading quickly or brainstorming or even narrating a silent video in fast forward) report positive affect. For these test subjects, it feels better to think faster. Here's a .pdf of the article, and here's a summer in Boston Globe article . No clinical application is described, but the obvious hypothesis emerges: could the mildly depressed individual experience a subjective mood with some of these practices, either as part of therapy or as self-administered mood management?

Saturday, January 10, 2009

The Big 5

I've been kicking around, for awhile now, this idea of the Big 5. That managing our health and happiness requires regular and dedicated attention to 5 key areas:



Awareness of key values and motivators,

Daily consideration of time stewardship, and


The Big 5 Self-Assessment, available for free download here , allows the user to consider one's awareness of these domains and commitment to taking good care of his or her physical and mental health. I'm hoping for feedback as I continue to sketch this out and consider clinical applications.

Tuesday, January 6, 2009

Schadenfreude and "Revolutionary Road"

In a recent New York Times editorial, Judith Warner suggests that our appetite for dour representations of 1950s and 1960s domestic life (e.g., the Sam Mendes adaptation of Richard Yates' Revolutionary Road) relates to a strange envy of that era. A doutbful and jealous curiosity about "how Dad managed to come home at 5 p.m. to read the paper or watch TV while Mom fixed dinner and bathed the kids. How Mom turned up at school, every day, unrumpled, coiffed, unflappable. And more to the point: how they managed to afford the lives that they led, on one salary, without hocking their homes to pay for college, without worrying about being bankrupted by medical bills."
Books and movies which portrays exemplars of this generations as "frivolous, almost simple-minded depressives" and "(assign) them drunken, cheating, no-good mates" give the viewer the satisfaction of come-uppance.
A strange type of happiness is schadenfreude - taking pleasure in others' misfortunes. Like a lot of not-so-nice human behavior, schadenfreude may be rooted in our genetic history.

A 2007 study by Shamay-Tsoory and colleagues, published in the journal Brain, suggests that the ventromedial prefrontal cortex may play an important role in the experience of gloating and envy. The ability to process these emotions may depend upon the cognitive ability to put oneself in another's shoes, to recognize that others have thoughts and feelings which differ from one's own. These are central aspects of the "theory of mind" , referring to a set of cognitive capacities which may be weaker among, for example, individuals with autistic spectrum disorders.

In a way, then, our capacity for schadenfreude is the "flip side" of our brains' capacity for empathy.

And we might not always be the one observing the suffering....recognizing that we may play a role in other people's experience of schadenfreude, the cast of Avenue Q remind us that "The world needs people like you and me who've been knocked around by fate. 'Cause when people see us, they don't want to be us, and that makes them feel great!"

Friday, January 2, 2009

Claiborne Pell and Happiness

Give someone a fish, and he or she will eat for a day....teach them to fish and they eat for a lifetime. One of the greatest leadership ideas to come out of Washington was the notion that getting students through college and graduate school creates leverage. Obviously you hope to create a tax payer at a higher level, but i'm also thinking here of Gross National Happiness
- the leverage associated with creating a society of happier, more engaged people.

Former U.S. Senator from Rhode Island Claiborne Pell passed away yesterday. Under his leadership, thousands of students were able to access higher education through the Pell Grant. In fact it's because of grant and student loan programs that I'm able to do what truly makes me happy now. if only they'd taught html classes when I was in school.....