Posts Tagged ‘depression’

Book Review: Stuff: Compulsive Hoarding and the Meaning of Things by Randy O. Frost and Gail Steketee

February 24, 2016 2 comments

Book Review: Stuff: Compulsive Hoarding and the Meaning of Things by Randy O. Frost & Gail SteketeeSummary:
It may be difficult to describe a hoard, but you know one when you see one. Maybe you have a neighbor who keeps their shades drawn but when you enter their home you see piles and piles of stuff that either they keep for a project they’ll do one day or because every scrap of it contains important information (according to them). Maybe you’ve only encountered hoarding through reality tv shows focused around the forced clean-up of homes that immediately appear unlivable to you but yet that the person on the show insists is full of treasures. Or maybe you grew up in a home where the hoard slowly encroached on your own room

Between 2 and 5 percent of the population suffers from Hoarding Disorder. Frost and Steketee were the first to begin scientifically studying it. Here, couched in tales of real interactions with and homes of clients (who granted their permission to be featured in an anonymized fashion) Frost and Steketee present both what we know and what we don’t know about hoarding, as well as best practices for helping someone with the disorder.

As an outside observer of a hoard, it can often be difficult to imagine what leads a person to believe trash is treasure. But of course it’s more complicated than someone just being unable to recognize trash. After all…one man’s trash is another man’s treasure. The authors attack this head-on by first giving a true definition to what counts as hoarding and then talking about various causes and possible presentations of the disorder. So what counts as hoarding?

It hardly matters how much stuff anyone owns as long as it doesn’t interfere with his or her health or happiness or that of others….Hoarding is not defined by the number of possessions, but by how the acquisition and management of those possessions affects their owner. (page 58)

So basically, it counts as hoarding if the collection of items interferes with the person’s health or happiness or the health or happiness of others nearby. The complicated gray area of course is that the sufferer may not realize that the hoard is interfering with their happiness and health. That is the point of conflict for many loved ones of people who hoard.

After establishing and defining what hoarding disorder is and is not, the authors continue on to analyze the behavior and mind of someone suffering from hoarding. Fascinatingly, hoarding shares commonalities with many other mental illnesses, seeming to a certain extent to defy categorization, although the DSM 5 currently lists it among “Obsessive Compulsive and Related Disorders.” Are you shocked? Did you think that OCD always means cleanliness? The fact is that is often not what OCD means. It’s a misunderstanding spurred on by popular culture. OCD is an obsession. It can be with cleaning and germs but it can also be with anything. It also often features repetitive behaviors. If you think about it, you can see what hoarding has in common with this. People who hoard become obsessed with the idea of not losing something important, of collecting everything relevant to a certain idea, of not wasting things. They also can come to establish repetitive behaviors such as maybe always buying a newspaper from a certain store on the way home from work. Another similarity with OCD is that hoarders often are perfectionists. Part of why their homes become cluttered is they are obsessed with only doing a perfect job of cleaning up or of fixing something or using some item for a project, and they become paralyzed with the fear that they can’t do it good enough, so they never start.

The authors also talk about how hoarding has commonalities with Impulse-Control Disorders, such as gambling and compulsive buying. Many people who hoard also struggle with both of these ICDs, and it’s easy to see the relationship here. Similarly, many hoarders show symptoms of ADD. They often do much better cleaning up if there is simply someone there to help them maintain focus, rather than being easily distracted.

Hoarding is also often a result of trauma. People suffer a trauma and essentially attempt to build a protective space around themselves by hoarding.

Compared to people who do not suffer from hoarding problems, clutterers report a greater variety of traumatic events (an average of six versus three), as well as a greater frequency (an average of fourteen versus five) of such events. The type of trauma most often experienced by hoarders include having had something taken by threat or force, being forced into sexual activity, and being physically assaulted. (page 87)

Interestingly, there’s a comparatively low incidence of PTSD among hoarders, in spite of such a high incidence of trauma. (A 2006 study found only 6% of hoarders had PTSD, page 91). It is possible that hoarding prevents the development of PTSD. Many hoarders also report a childhood devoid of warmth and support, so even if they were not traumatized, it is still likely that they had a cold, distant childhood. In contrast to PTSD, the majority of hoarders (nearly 60%) meet the criteria for major depression, and it is posited that this depression could be in response to the hoarding itself.

People draw conclusions about their worth and competence based on their inability to control their living space, and not being able to entertain people in their homes isolates them and limits their social lives. (loc 532)

The authors then talk about what may be going on in the heads of people who hoard. People don’t do things completely irrationally. There are reasons for it. There are multiple possibilities for hoarding of what may be going on. No single aspect has been determined yet.  However, in general, hoarders suffer from a different type of threat signal. They fear something being removed, rather than the presence of something. It has also been posited that they have the opposite of claustrophobia. They feel safer in small, tight spaces, so they artificially create them. Hoarders also frequently struggle with identity. Rather than knowing who they are, they often are defined by the question “Who am I?” and collect items to try to show who they are. In addition to the aforementioned perfectionism, hoarders also seem to view items differently from the rest of us. They are generally very optimistic about future usefulness and can be quite creative as to reusing things. It has been posited that hoarding may be creativity run amok. However, many hoarders also gamble compulsively and the relationship between a hoarder’s positive thinking and a gambler’s is interesting.

“Seeing the scratch tickets over the counter at the convenience store leads me to think, One of those tickets is surely a winner, maybe a million-dollar winner. How can I walk away when the opportunity is there?” Our hoarders have said similar things about items they’ve wanted to acquire. (loc 202)

Distress avoidance is also often a common feature. Distress avoidance is when a person seeks to avoid a situation that they think will cause them distress. They then build up that situation in their heads to be more of a stressor than it actually would be. Continual avoidance of these types of situations also weakens a person’s ability to deal with them (due to lack of practice), so it’s a bit of a self-fulfilling prophecy.

Animal hoarding is its own special subcategory, and it seems that in addition to all of the other possible hoarding issues, animal hoarders may suffer from a form of an attachment disorder where their bonds with other humans are frayed and easily broken and replaced by bonds with animals.

So, essentially, hoarders are often people who are perfectionists who tend to perform rituals and struggle with impulse control. They may compulsively shop and/or gamble in addition to hoarding. They often had cold, distant childhoods and/or suffered a trauma (or traumas). They tend to come at life from a basis of fear and feel safer in tight, closed spaces, and their fear is heightened by removal of things, rather than appearance of new things. At some point, they started avoiding distress, and this distress avoidance became a self-fulfilling cycle. They also frequently struggle with knowing who they are internally, rather looking outward to possessions for identity signals.  In addition to these compulsions and fears, hoarders also often see things differently or in more detail than non-hoarders, and they also struggle to focus or concentrate, making cleaning up even more difficult for them.

The authors conclude by discussing both how to treat hoarding and effects on family members and loved ones (as well as on communities). The authors stress repeatedly that forced clean-ups are the absolute worst possible solution or treatment option. A forced clean-up just fulfills the person’s fear that people are out to get them, and simply makes them cling on to their possessions even more aggressively. It also can make them more depressed. Since their identity is wrapped up in their possessions, getting rid of them by force can cause emotional trauma akin to someone chopping off your hair by force. I was stunned to learn that there have been cases of people who hoard committing suicide after a forced clean-up. The authors strongly advocate for the much slower, but with more long-term positive results, method of going through the hoard with the person slowly and basically teaching them new ways to think about both their possessions and their identity. They also state that it’s easier to treat compulsive buying and gambling than hoarding, so when possible treat that first to prevent the arrival of new items into the hoard. It is a long, difficult treatment plan to go through a hoard slowly, and sometimes it may be necessary to remove the person from the home for safety but then to return with them repeatedly to work on cleaning out the hoard.

The fact that forced clean-ups are the worst possible solution for the sufferer and the fact that hoards get worse over time leads me to believe that early interventions are absolutely critical to render the most help to those suffering from hoarding. But this is a complex thing. Since many cases of hoarding start due to a cold home environment or from trauma, it may be difficult to get parents behind addressing the situation early. Many people who hoard interviewed in the book talk about their hoarding beginning to get out of control by late in their freshman year of college. Perhaps this is something colleges should be keeping an eye out and offering help for. Additionally, shame is often mentioned as a factor in keeping the problem hidden. Perhaps PSAs and other public service campaigns could both lessen the stigma and offer help to people early on in the development of a hoard.

So much of hoarding is stigmatized. To a certain extent this is understandable. It often isn’t seen by the public until it has reached a public health crisis level or in situations where animal hoarders are keeping their hoards in deplorable conditions. Often loved ones of those who hoard feel trapped and frustrated by the hoarding. They feel as if the loved one loves their stuff more than them. These are complex issues and professional help is required to address them. I honestly don’t think this is a situation that is easily handled one family at a time. A family member must be well-informed and patient and empathetic enough to wait through the long treatment process. Often that family member is the child of the hoarder and therefore a minor with no power, which makes the issue even more complex. This is definitely a situation in which public health education campaigns on things like early warning signs of hoarding tendencies and ways to seek help could be extremely helpful long-term. I do believe the authors could have taken things one step further at the end of the book to this connection to public health, rather than mostly focusing on individual therapy. They do mention less consumerism would be helpful, but that simply is not much of an observation. It is a small complaint, but I do feel that this interdisciplinary leap is important.

Overall, this was a fascinating, enlightening book. The authors have conducted extensive scientific research for years, and they do an awesome job of writing this information at the consumer level, as well as humanizing it by bringing in real cases with clients who they render in a three-dimensional fashion. I know I for one will never be able to stomach watching forced clean-ups on the tv show “Hoarders” again. Recommended to really everyone. Anyone could potentially know someone who struggles with hoarding, whether now or in the future, and the book is very readable.

4 out of 5 stars

Source: Library

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Illness(es) featured: Hoarding Disorder

May Updates and April Reflections

This daddy goose wasn't too pleased with us for walking so close to his lady and their nest.

This daddy goose wasn’t too pleased with us for walking so close to his lady and their nest.

Hello my lovely readers!

I don’t have any big blog updates this month, but I am happy to report that featuring a book of the month has been going well.  It’s been successfully generating new attention for books I reviewed years ago.  Yay!

The book of the month for May will be:

A Long Way Down by Nick Hornby
First reviewed in May 2012
“Highly recommended to the depressed and the sympathetic.  Both will be left feeling lighter and less alone.”

How was my reading, reviewing, and writing this month?

April books read: 6 (2 urban fantasy, 2 scifi, 1 erotica, 1 fantasy)

April reviews: 3

Other April posts: 1 giveaway and 1 giveaway winner announcement

Most popular post in April written in April: Book Review: Set Adrift by D. S. Kenn (Series, #1)

Most popular post in April written at any time: Book Review: Coming of Age in Mississippi by Anne Moody (The Real Help Reading Project)

April writing: I finally started using the Scrivener software I purchased last November.  I’m finding being able to set session word count goals and see a progress bar to be really helping my progress forward.  I’ve also started participating in the 1linewed hashtag on my twitter account.  This hashtag sets different rules every Wednesday for authors to share one line from their work (usually their work in progress).  I’ve been immensely enjoying getting bite-sized feedback on my writing on a weekly basis.  Definitely check it out if you are curious about my current work in progress.

Coming up in May: I have two fantasy reads for Once Upon a Time IX to post reviews for.  I also have a review of an erotica ARC I received back before I started limiting myself to only accepting review copies once a year.  Plus I’ll be reviewing an audiobook.  I also bought a Kindle Paperwhite, and I plan to do a post comparing it to my old Kindle Keyboard.

Happy May and happy reading!

Reading Challenge Wrap-up: Mental Illness Advocacy Reading Challenge 2012

December 24, 2012 2 comments

mia2012badgeAs you all know, the one reading challenge I host is the Mental Illlness Advocacy (MIA) Reading Challenge.  Since we’re into the last week of the year, I’d like to post the 2012 wrap-up.

This year, I read 8 books that count for the challenge, successfully achieving the Aware level.

The books I read and reviewed for the challenge, along with what mental illness they covered, in 2012 were:

  1. The Sparrow by Mary Doria Russell
    4 out of 5 stars
  2. The Story of Beautiful Girl by Rachel Simon
    Mental Retardation
    4 out of 5 stars
  3. Barefoot Season by Susan Mallery
    4 out of 5 stars
  4. Abject Relations: Everyday Worlds of Anorexia by Megan Warin
    4 out of 5 stars
  5. A Long Way Down by Nick Hornby
    4 out of 5 stars
  6. Haunted by Glen Cadigan
    3 out of 5 stars
  7. January First: A Child’s Descent into Madness and Her Father’s Struggle to Save Her by Michael Schofield
    4 out of 5 stars
  8. Germline by T. C. McCarthy
    Addictive Disorders
    4 out of 5 stars

The books I read covered genres from scifi to thriller to memoir to academic nonfiction to historic fiction.  I’m also a bit surprised to note in retrospect that all but one of these books received four stars from me.  Clearly the books I chose to read for the challenge were almost entirely a good match for me.  It’s no surprise to me that I enjoy running this challenge so much then.🙂

The most unique book for the challenge was The Sparrow.  The scifi plot of first contact with aliens was a very unique wrapping for a book dealing so strongly with mental illness.  Most challenging was Abject Relations: Everyday Worlds of Anorexia, which was my first foray into university-level Anthropology.  Something I’d like to see more of is more memoirs by parents of children with a mental illness, like January First: A Child’s Descent into Madness and Her Father’s Struggle to Save Her.  That was an interesting, new perspective for me.  I think I’d also like to read more schizophrenia books next year, as well as books that challenge the gender norms perceived of in certain mental illnesses, such as the idea that eating disorders are female or that alcoholism is male.

If you participated in the challenge this year, please feel free to either comment with your list of reads or a link to a wrap-up post.  I’d love to see what we all successfully read this year!

And if the MIA Reading Challenge sounds like a good match for you, head on over to the challenge’s main page to sign up for the 2013 iteration!

Book Review: A Long Way Down by Nick Hornby (Bottom of TBR Pile Challenge)

Four sets of feet in a circle with the sky in the background.Summary:
On New Year’s Eve, four incredibly different strangers accidentally meet on Topper’s House a popular local spot for suicides.  Somehow running into each other leads to them taking the long way down that night instead of the quick one.  What happens after is a continuance of their life stories that no one could have predicted.

I distinctly remember that this book made it into my tbr pile because of the suicide theme.  What makes these four different people want to kill themselves, and what makes them not do it.  Clearly this is a book about depression and suicidality.  But it is not a depressing book. Not by far.

Without revealing too much, since the revelations are part of the fun of the read, I will just say that the four suicidal people span different generations, reasons, and nations of origin.  Different levels of conservatism and liberalism.  But what makes them come to understand each other is their universal depression and suicidal thoughts.  This fact that someone out there gets them….well oftentimes that can help get a profoundly depressed or mentally unwell person over the hump.  Feeling less alone.

Her past was in the past, but our past, I don’t know…Our past was still all over the place. We could see it every day when we woke up.  (page 253)

In spite of this being a book about depressed people bonding over their depression, it doesn’t read as such.  I was reading it on an airplane and found myself literally laughing out loud at sections.  Because these people are brilliant.  They have a great understanding of the world. Of art. Of relationships.  Even of themselves.

I had that terrible feeling you get when you realize that you’re stuck with who you are, and there’s nothing you can do about it. (page 208)

That is, after all, frequently what depression can be all about. A profoundly clear understanding of how royally fucked up you are or your life is.  What’s hard is seeing past that moment.  The book is kind of a snapshot of the process of them learning to do that.  And that’s what makes it so eloquent and poignant.  Nothing is done melodramatically. Things are just presented as they are.  Even down to the four being able to laugh together periodically (and make you laugh in the process).  Depression isn’t just oh everything sucks nonstop.  There are moments of laughter.  It’s just that those moments are outweighed by the weight of the depression.  Getting rid of that weight is a cleansing, uplifting process, and that’s how it feels to read this book.  You bond and you laugh and you maybe even cry (if you have more susceptible tear ducts than this reader).  And in the end you come to an understanding of that suicidal dark place without being abandoned in it.

Overall this book manages to eloquently present depression without being a depressing book.  It is compelling to any reader who has ever struggled with a depressed period of life.  Highly recommended to the depressed and the sympathetic.  Both will be left feeling lighter and less alone.

4 out of 5 stars

Source: PaperBackSwap

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Friday Fun! (MIA Reading Challenge Update)

April 22, 2011 7 comments

Hello my lovely readers!  Since we have just one week left of April, I thought I’d provide an MIA Reading Challenge update!  I’m so pleased with the enthusiasm for the challenge shown by the participants, particularly since this is its first year existing.

By far our most prolific participant so far is Karen.  Her reads have covered everything from OCD to Antisocial Personality Disorder.  So far she has read and reviewed (links to her reviews): Saving CeeCee Honeycutt, Devil in the Details: Scenes from an Obsessive Girlhood, An Unquiet Mind, Cut, The Bell Jar, Darkly Dreaming Dexter, Dearly Devoted Dexter, Dexter in the Dark, Missing, House Rules, and I Don’t Want to Be Crazy.  She’s only one book away from completing the highest level of the challenge.  Go Karen!

Jules is keeping up a nice, steady pace so far, having read two books (links to her reviews): The Bell Jar (Depression) and Alias Grace (Dissociative Identity Disorder).  Keep it up, Jules!

Jessica also has finished two books (links to her reviews): The Silver Linings Play Book (recovery from mental break-down) and The Madonnas of Leningrad (Alzheimer’s).  Excellent pace for the level you signed up for, Jessica!

I’ve also completed two books that fit into the challenge description (links to my reviews): American Psycho (Antisocial Personality Disorder) and Hunger (Anorexia Nervosa).

Thank you everyone for your participation so far this year and for raising awareness on mental illnesses.  We may be a small group so far, but hopefully each year will grow!

If you’ve read books for the challenge and I did not list you, please comment and let us all know!  Unfortunately with the way my blog is, you commenting and telling me is the easiest way for me to keep up with what everyone has read.

It’s not too late to sign up for the challenge if you’re interested!  Check out the MIA Reading Challenge page to find out more.

Happy weekends all!

Book Review: Whitewash: The Disturbing Truth About Cow’s Milk and Your Health by Joseph Keon

March 31, 2011 4 comments

Cow relaxing on a glass of milk.Summary:
Joseph Keon seeks to combat the cultural myth of dairy being a necessary part of a healthy diet perpetuated by the milk moustache ads with his book citing multiple scientific studies that have been swept under the rug by those being paid by the dairy lobbyists.  Although Keon cares about animal welfare as well (and there is a chapter on the suffering of dairy cows), the book predominantly focuses on debunking multiple myths surrounding human consumption of dairy:  the overly-hyped “need” for calcium, that dairy is good for children, and the idea that dairy prevents disease.  Keon additionally alarmingly shows the various chemical, virus, and bacteria contaminants commonly found in dairy.  Citing multiple scientific studies, he unequivocally demonstrates that contrary to what the dairy industry and government want you to think, dairy is actually bad for your health.

I’ve been a vegetarian for five years as of January 2011 (working on my sixth year).  I’ve honestly stayed away from books on veganism, because I had a feeling vegans were right, and I could not see myself ever giving up cheese.  How odd that I could give up so many other things I was raised on like bacon, chicken nuggets, etc… but not cheese.  With my recent increased interest in my health, though, I had already decided to cut back on my cheese consumption, so I figured why not give a book on dairy a go.  The first few chapters were definitely pushing the buttons I already subconsciously knew–we don’t need dairy, it’s unnatural to consume the milk of another creature intended for their young, etc….  Where I suddenly found myself nodding along and saying yes, though, was when Keon got into the similarities between how adults and children act about cheese and addicts.  Keon starts the section by clearly defining addiction:

“Addictions are considered diseases because they are out of our control, often so much so that they lead us to behave in ways that are dangerous to our health.  In its most basic definition, an addiction occurs when we are physiologically or psychologically dependent upon a habit-forming substance or behavior, to the point where its elimination from our life may result in trauma or suffering.” Location 721

Keon then goes on to explain exactly what about cheese makes it so addicting when we know it’s bad for us.

“Research has shown detectable amounts of compounds identical to the narcotic opiate morphine in cow’s milk.  Study of the morphine found in milk has confirmed it has identical chemical and biological properties to the morphine used as an analgesic.  A plausible assumption is that all mammals produce this opiate compound to make sure their offspring return to the breast to acquire essential nutrients and to bond with the mother.”  Location 722

Whoa.  So cheese, basically, is morphine.  The chemical that is healthy for a calf to ingest as it causes her to return to the mother for food, comfort, and safety, when consumed by people causes us to return repeatedly in an addictive manner to a substance that is really, almost pure fat.  WOW.  You know those  life-changing moments?  I had one right there.

There are two other sections that are mind-blowing in Keon’s book.  The first deals with multiple first world “diseases” that are often actually allergic reactions caused by prolonged exposure to the allergen–cow’s milk.  When we take all races into consideration, most people are allergic to cow’s milk: 90% of Asian-Americans, 75% of African-Americans, 50% of Latino-Americans, and 25% of Caucasian-Americans (Location 900).  Yet despite these known statistics, the federal government continues to push dairy onto schools at the dairy lobbyists’ urgings.

“The policy of pushing milk upon children in inner-city schools is particularly problematic when we take race into account.  African-American children have a lactose intolerance rate of about 75 percent…..Worse, children who have made the healthful transition to beverages made from rice, soy, or almonds are out of luck when they get to school.  That’s because any public school in America that attempts to serve these beverages in place of cow’s milk will lose its federal support.” (Location 2163)

Being constantly exposed to an allergen in childhood can cause or exacerbate multiple issues such as colic, irritable bowel syndrome, eczema, acne, asthma, headaches, Crohn’s Disease, chronic nasal congestion, fatigue, depression, joint pain, and even autism.

Keon also addresses the issue of osteoporosis and breast cancer, two issues of utmost concern for women in particular.  Whereas women are told that drinking milk will help prevent the former and will not be a contributing factor in the latter, the science actually demonstrates both statements to be false.  If a woman follows a typical Western diet, the consumption of that much protein causes her body to become acidic and leech calcium.  Studies have shown that no amount of extra calcium consumed can keep up with the leeching.  This means that consuming three glasses of milk a day will do nothing for a woman following an omnivorous diet.  Add to this the fact that

“Milk has been associated with increased risk for breast cancer, and the combination of pesticides and radiation have been proposed as one possible explanation.” (Location 1816)

When the fact that dairy consumption does not prevent osteoporosis is combined with the association with breast cancer, one is left wondering why there aren’t government campaigns warning women to stay away from dairy to save their lives!  (Oh yeah.  The dairy lobbies.  Money.  It always comes down to money).  Further, studies have shown that

By age sixty-five, women who have followed a meat-centered diet have lost, on average, 35 percent of their bone mass, while women who have followed a plant-centered diet have lost only about half that amount: 18 percent.”  (Location 3195)

I’ve only touched on the surface of the shocking facts backed up by science contained in this book, focusing in on the ones that stuck out the most strongly to me.  If you have any interest at all in your health and/or the health of your children, I urge you to read this book.  Educate yourself on the facts instead of listening to government programs and advertising caused by dairy lobbyists who are only after your money.  Dig for the truth.  Read this book.

5 out of 5 stars

Source: Amazon

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