In this case, though, form obviously trumps content. The beauty of this campaign is that it’s transformative. The literal message implies a static present, but the act of reaching out, of making these videos, itself shatters that illusion.

These videos prove that people have been moved already. They allow us to see a changing landscape in bloom. The point isn’t really that things will get better; it’s that – look! – they are getting better…

And that sharing our pain makes all the difference.

Bless you, Dan Savage.

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[This is a gorgeous essay. I hate to excerpt it at all. -Ed.]

More on Andrew Solomon

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[I have a friend in medical school – a psychiatrist in training – who tells me that AA gets tremendous credit for being the most effective addiction recovery program in existence. This surprised me, because a) I didn't know that AA's success rate is the gold standard, and b) I thought that many of AA's strategies were at odds with certain classic, psycho-therapuetic mores. The latter appears to be true, although this article suggests a welcome shift in attitude. If AA offers the best chance for recovery, than psychotherapy should follow its lead. Therapists, say the authors, should break out of their comfort zones when the failure of addiction looms; the successful treatment of alcoholism may require more communion with patients than is commonly advised.

This makes a lot of sense to me. In my own treatment (not for addiction, admittedly), my therapist never shared her own stories. I knew next to nothing about her life, and I assumed it would stay that way. But in one instance, she shattered this well-established practice – it was shocking to both of us – by sharing an incredibly intimate story about a death in her family. I could see this made her nervous. Clearly she was going out on a limb, defying her own notion of "best practices." Yet her intuition paid off. Her story changed my life, not because it made me feel any closer to her, but because it made me feel closer to others (certain others at first, and then more generally). I went from feeling confused and frustrated to feeling sympathetic and forgiving.

She told me her story, she said later, in an attempt to give me facts that she never thought I'd get, i.e. I wanted explanations from people who couldn't give them to me. The revelation of her family's secret became a stand-in for the experience I'd been missing, both literally – she told me something I never thought I'd hear – and figuratively – her story gave shape to the actions of people in my own life. She drew a parallel, but she also broke a boundary. Both helped my treatment; I can't say which helped more. This is the art of psychotherapy: the acknowledgment that, despite an appropriately clinical approach, any rules-based system is bound to fall short in the face of us. -Ed.]

This pending law in Nebraska correlates abortion with mental weakness; it suggests that women who are pressured to have an abortion should be handled with kid gloves. First of all, women face all kinds of pressure from all sides at this juncture: lovers, friends, family, and even circumstances themselves. Making a choice under pressure doesn’t mean that it’s a bad choice. Most important choices in life are made this way. Second of all, if we’re honest about these pressures, then we can see this law for what it is: an attempt to use the stigma of mental illness against women considering abortion.

As you probably know from reading this blog, I’m all about de-stigmatizing mental illness. This stigma leads to suicide all the time – every day. It killed my sister, who took her own life before she was willing to take an anti-depressant (even after she filled a prescription). So the thought of using this stigma, reinforcing it, for political victory makes my blood boil. Whatever your position on abortion, we must do better than this law.

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This remarkable result is not well known outside a small circle of sleep researchers for three good reasons. First, sleep deprivation is not as convenient as taking a pill. Second, prolonged sleep deprivation is not exactly a desirable state; it leads to cognitive defects, such as reduced working memory and impaired decision making. Finally, depression recurs after the mother, inevitably, succumbs to sleep, even for a short nap. Nonetheless this is an incredibly important observation; it shows that depression can be rapidly reversed and suggests that something is happening in the sleeping brain to bring on episodes of depression.”

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[Fascinating as a short-term means to dampening pain – but one still has to wait till nighttime to lose any sleep. -Ed.]

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[A wonderful follow-up to this post. Props to Cathy Horyn, who really hits all the bases in writing responsibly about a suicide.]

Several countries have trialled the prescription of heroin itself, with, it turns out, a great deal of success – including better health, a reduction in criminal activity and a higher chance of actually kicking the habit. This may seem counter-intuitive, but one of the advantages of these projects is that the user is constantly in contact with health professionals who can provide addiction treatment.

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Those patients with schizophrenia who are more intelligent and better educated, for example, who perform better on measures of abstract reasoning, and who demonstrate greater insight into the nature of their illness, are more likely to kill themselves [my emphasis]. Patients who do well socially and academically when young and who then are hit by devastating illnesses such as schizophrenia or manic-depression seem particularly vulnerable.

In other words: smart, sociable, over-achivers can be just as suicidal as withdrawn folks once illness hits – and often times illness isn’t given much expression. Jamison goes on to stress that many people fool their peers expertly, despite the darkest of feelings. Here she is again, in the book’s prologue, writing of her own ordeal:

Because the privacy of my nightmare had been of my own designing, no one close to me had any real idea of the psychological company I had been keeping. The gap between private experience and its public expression was absolute; my persuasiveness to others was unimaginably terrifying.

The point is, we are terrible at judging “the kind of person who would do such a thing” – especially parents when it comes to their own children (understandably so). We need to shed the mindset that we can grasp suicide, that we can see it coming. We need to open ourselves up to surprise. Suicide is not the province of the preternaturally depressed. It is, in a sense, all around us.

‘The idea that a drug designed to alleviate physical pain should reduce the pain of social rejection seemed simple and straightforward based on what we know about neural overlap between social and physical pain systems. To my surprise, I couldn’t find anyone who had ever tested this idea,’ DeWall said.

According to a study due to be published in the journal Psychological Science, DeWall and colleagues were correct. Physical and social pain appear to overlap in the brain, relying on some of the same behavioral and neural mechanisms…

Hurt feelings and social pain decreased over time in those taking acetaminophen, while no change was observed in subjects taking the placebo. Levels of positive emotions remained stable, with no significant changes observed in either group. These results indicate that acetaminophen use may decrease self-reported social pain over time, by impacting emotions linked to hurt feelings.

‘We were very excited about these initial findings,’ DeWall said.”

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[Because emotional pain feels less localized and more abstract, we're inclined to disregard it as something different from "real" pain. We take it less seriously as an injury – i.e., as a treatable medical condition. These findings are a nice counterpoint to that impulse. -Ed.]

I pride myself in keeping an open mind about mental illness, but I have to admit that it’s tough to watch this video without feeling a pang of conservative rage. Where are we going with all of this? Are we so desperate and starry-eyed that we’re willing to experiment on our own children?? Don’t they deserve a more cautious approach?!??!?!

I’m not quick to judge any of the parents. My heart goes out to them. I’ve never had a kid, let alone one with mental illness. But I do know something of the helplessness that surrounds families in the midst of these crises. It’s a God-awful experience – and a dangerous one, too. Feelings of abject helplessness lead to extreme vulnerability. And that’s exactly what you see in this video: vulnerable families being pressured into troubling treatment, all at the behest of powerful institutions with their own interests to weigh. I’m not skeptical of doctors or “experts” (that’s a strain of American fundamentalism I could live without), but at the same time we have to recognize our respective roles. A child’s care is the sole responsibility of his or her parents. The educational system and the health care industry, despite what they advertise, were not designed to care for any particular child. Those institutions have competing priorities (the profit initiative, organizational flow, etc.), including millions of other kids. What is good for a school or a doctor’s office might be at odds with what is good for a child. When it comes to medicating our youth, we should be especially vigilant about these conflicts of interest, and wise to how good people’s judgment can go bad.

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[Note the segment tiles above the video display; to watch the whole program, click on each segment.]