The Wisdom from an Editor

The Captivating Butterfly in Nature’s Beauty and Harmony — flying over a wooded landscape with spread wings about to land.

The perilous journey through core beliefs, entrapment, realization, and liberation.

Sometimes our life appears to be guided by a developed personal inner story — an inner voice thought narration that runs in the background and captivates our mental life. A very talented editor, Jacqui shares her personal story of getting entangled with some mental health issues on her path to realization, restoration, and change. Her story led me to explore our constant need to be self-aware and mindful of our influencing beliefs. Editing and modifying any self-defeating, inner stories or ideas is essential to maintain flow and healthy well-being.

Jacqui’s Mantra, “Anything other than first is a fail.”

This was my mantra from the time I was very young. Strangely enough, it wasn’t my parents that pushed me. Once my IQ was tested, teachers expected a lot from me. And thus, a cycle was born where I worked hard to be the best in what I was comfortable doing but didn’t try anything new for fear of failure.

However, being first in class certainly did not equate to emotional intelligence. When I look back now, it makes me sad to see how much I missed out on because everything in my life had to be planned from beginning to end. Being spontaneous and without a plan meant that something could go wrong. And being wrong was just not me. It created an intensefear that, in effect, handcuffed me. While others brushed mistakes off, I seemed to shrink more and more into myself.

I guess that’s why books drew me in. Not only did they have a beginning, middle, and end, and thus a plan, they took me to worlds where I could be anyone. I could fight dragons, solve mysteries, fall in love, and even try something new for the first time. Books stayed with me my whole life and were my constant companion.

My dream, when I left school, was to go into law, but with money being an issue, I decided to start working straight away. The bright lights of a casino beckoned, and the procedures that had to be followed daily on the tables appealed to my sense of planning. The rigidity damped down the fear that I had about starting something new and it turns out I was good at it, so being me, I threw everything into it.

Law was still at the back of my mind, so I started studying via correspondence. After working 16-hr shifts, the sheer amount of work became a burden, and I was no longer inspired, so stopped after four years. As my “summer job” in the casino turned into years, and I found myself losing interest, I turned once again to books. I changed my degree and majors, and focused instead on linguistics and psychology, with the ultimate goal being editing. Surely my love of reading could be combined with the rules of English?

But the fear was still there. What if I gave up my job and tried something new and failed? Would I be good enough? Would others see me as good enough? What if I couldn’t make any money? So, I carried on working while studying, and little by little I grew smaller and smaller inside until I hit a breaking point. I was so intent on pleasing others and “being the best I could be” that I felt no joy anymore. In fact, I felt nothing. I was permanently exhausted and lived on two hours’ sleep a night because I thought that was expected of me. I was angry and tearful for no reason, and felt dread each time I went into work. My brain was always foggy.

The pressure became too much, and I was admitted into a psychiatric hospital for two weeks. Being me, I took all my study material, as I wanted to be seen as the good girl. The two weeks were a revelation. Besides using medication, not only to calm my anxiety and depression but also to help me sleep, it was two weeks where I got to stop. To slow down. Not only my actions but also my thoughts. We learned about ourselves, about why this was happening, and about what we could do about it. We took part in arts and crafts, drumming lessons, and meditation. And yes, I still studied in my spare time.

After the two weeks, I went back to work. For two days. And in those two days, I suffered huge panic attacks. That was my sign. My sign to say enough. I quit my job after nineteen years of giving everything I had to it. It nearly broke me, but was what turned me on a completely different path.

My rock through this was my husband. My completely opposite in so many things, spontaneous husband. My bipolar husband. Oh, what a pair we made! But how perfectly we fit together.

Well, that was eight years ago. Since then, we have moved 650 kms away, live on the coast, and have a normal — where going to bed at 09h00 the day after your shift is a thing of the past — life. My husband writes books and by day I edit, and in the early morning I instruct fitness classes. The rules are still there, and working from home requires discipline, but I’m okay with me now. I realize how flawed I actually am and I’m fine with that. Turns out, that’s what being human is all about .

The Editor of Narratives

Jacqui¹ is a talented editor who has worked on some of my prior articles and is a significant help in writing the current one. Her account shared in the present writing reflects the opportunity we all have to learn and bring the skills of observation and the freedom to change our central narrative that guides actions and choices. An editor applies the same skill set to aid writers in making stories more readable and effective for the reader.

A picture of a writer and editor busy at work on a typewriter editing a draft with her note to one side

The inner story is an essential aspect of mental life and functioning.

The narrative in our mind is a product of our genes and learned survival strategies. It develops from socialization with our peers, growing up with parents or adult caregivers, and cultural influences — learning and programming from birth or earlier.² The innate tools with which we learn, process information, and do well or not, interact with our genetically influenced natural abilities or limitations and with our environment, peers, and family. The ongoing thought activity that runs as a composed story in our minds profoundly influences a person’s self-identity, behavior, beliefs, choices, and actions.

There is a bit of the survival of the fittest with our given assets and talents. Needs get met with rewards and gratification from successes. Learning and programming occur from our failures, punishments, and other childhood experiences. An associated fear of not succeeding and not getting the praise, rewards, or approval can dominate our ingrained guiding belief system. Suppose significant childhood adversity, disruption, or trauma have existed. In that case, survival and success can be even more of a desperate plight, where failure is not an option. The penalty and need for success can be a dread of severe unfathomable consequences.

Sometimes the internal program (narrative) can get set or fixed and become the core or dominator of our existence and remain for part or all of our lives. In Jacqui’s story, there was the restricting belief or core idea. The core idea often concentrates one aspect of the main governing narrative into a single idea or thought that has a commanding influence on us. Jacqui’s was: “Anything other than first is a fail.” A central or core idea, along with the overall inner narrative story, can not only influence but dominate a person’s life to the point of breakdown, exhaustion, emotion and mood disruption, and illness. Early recognition of difficulties allows an opening to get the help needed before significant worsening or decline occurs.

Natural breakthroughs, enlightenment, and transformation are always possible with some trigger or impactful event. Events such as loss, a painful experience, hitting bottom as an alcoholic, a breakdown from exhaustion, sleep deprivation, anxiety, and depression, or use of a psychedelic substance are examples. Other, more positive breakthroughs can occur instantaneously as in a profoundly spiritual experience, or through a period of psychotherapy work, working in a therapeutic group, with intentional study over time in yoga, meditation, mindfulness or spiritual studies, or as a part of western or eastern secular or religious tradition.

When an opening occurs for change or the modification of the inner story or mind’s operational guide, the opportunity is there to change course in your life’s direction. It could amount to significant change or just some needed adjustment to your internal compass or inner guide — what I most often refer to as the inner voice or narrator. The slight or significant shift in your choices and life activity can lead to a marked improvement in health, mood, wellbeing, and life functioning. Relationships and careers can also improve.

Sleep Disturbance, Exhaustion, Anxiety, Breakdown, and Depression

The development of one’s inner narrative and core beliefs occurs from the interactions of our unique genetic attributes with family, peers, cultural demands, adverse childhood experiences, and trauma. The evolution of an inner guiding mental activity is usually an educative process meant to protect and secure our basic survival, safety, relational, and mating abilities to preserve the species and social functioning in society.

An essential and needed part of our human development — the formation of a stable and functioning inner narrative with core ideas and beliefs — is necessary but can lead to an inflexible set of restraints or impediments to developing an adaptable and healthy existence. Suppose the thoughts or guiding narrative become too restrictive? In that case, it can lead to difficulties with learning and growing to meet the ever-changing life and environmental demands. If so, being stuck in the inner story or confining beliefs can lead to progressive exhaustion, breakdown, and depression.

Depression can be a life-threatening condition, with the loss of motivation, pleasure in doing things, and loss of will to live. The appearance of deepening depression needs early recognition and immediate steps when associated with physical exhaustion, deterioration from not eating or sleeping, and weight loss. If severe, the person might require a prompt psychiatric and mental health evaluation with the potential need for placement in a supervised setting with medical support, intensive therapy work, and the use of antidepressant medication if needed.

Depression and Other Illness

Depression often exists with other conditions, meaning recovery from illness is more difficult unless depression recognition and treatment occur. Major depression can be a severely disabling mental disorder with related physical impairments and loss of ability to function normally. Chronic diseases such as diabetes, pain, substance abuse, arthritis, hypertension, and heart disease worsen with depression.

Identification and treatment of depression may bring:

  1. Marked benefits such as mental and physical health improvements
  2. Enhanced quality of life
  3. Reduction in disability
  4. Progress in recovery and treatment compliance with the mood disturbance and other related health problems

Cost of Depression

Healthcare costs for depression and the value of lost work are enormous. Conversely, effective interventions for depression, including any coexisting substance abuse or medical problems, decrease health care costs. Depression can occur as a reactive response to other illnesses and related stress. Symptoms and presentation can relate to the type and intensity of the depression itself, or a co-occurring illness or surgery, treatment, or prescribed medications for the depression or other condition.

In neurological conditions such as Parkinson’s disease, multiple sclerosis, Alzheimer’s disease, and strokes, the lifetime prevalence of depression is thirty to sixty percent, compared to a much lower percentage in the general population. Similarly, in diabetes, the lifetime prevalence of depression is double or triple that of the general population. It can cause an increased insulin requirement and increase the risk of diabetic complications. In addition, people with coronary artery disease and depression have a forty percent higher risk of having a cardiac event.

Depression increases the risk of death from a heart attack fivefold and is a significant predictor of disability one month after a heart attack or one year after coronary bypass surgery. Finally, substance abuse can trigger depression. Estimates of depression and cocaine dependence range from thirty-three to fifty-three percent. Estimates of depression in alcoholics seeking treatment range from fifteen to sixty percent. Those who depend on opiates have rates of depression estimated as high as seventy-five percent.

Early diagnosis and treatment of depression are critical in preventing and easing sickness, suffering, and death. Some studies suggest that thirty to fifty percent of depressed patients go unrecognized in primary care settings — and only about twenty percent of those recognized receive adequate treatment. Health care providers, friends, family, and employers need to make a more significant effort. Community education about key signs of depression is essential.

Signs of Significant Depression

  • Feeling down, guilty, hopeless, helpless, sad, or irritable (“pushing people away” or not getting along with others)
  • Loss of one’s usual interests or pleasure in doing things (anhedonia)
  • Changes in sleep patterns, such as trouble falling asleep, not getting restful sleep, sleeping too much, not wanting to get up, or staying in bed much of the day
  • Feeling tired, a loss of vitality, or having little energy
  • Poor appetite, overeating, weight loss, or gain
  • Frequently feeling bad about oneself, such as feeling worthless or as a failure
  • Trouble concentrating or remembering things
  • Slowing down of speech or movements
  • Being more fidgety, nervous, or restless than usual with a marked increase in anxiety and worry
  • Difficulty functioning at home or work
  • Withdrawal and isolating self from others
  • Spending more time on TV, computers, tablets, or cell phones
  • Being preoccupied with watching movies or the news
  • Thoughts of dying, self-harm (suicidal thoughts), or harming others (homicidal thoughts) (put a link to my past article)

All the listed symptoms of depression, anxiety, or panic may be only slightly present, noticed at times, or pervasive in a severely affected person’s daily life and activity. Prolonged severe grief is also an indicator of major depression and the need for evaluation and treatment.

Be alert to a person who feels that life has lost its meaning and is not worth living and has suicidal thoughts or feelings about hurting oneself or others. When observed, it is time to act and seek outside help from a qualified mental healthcare professional or resource.³

For immediate or crisis help in the US, call your local suicide hotline or 1–800–273–8255 / 1–800–273-TALK for the National Suicide Prevention Lifeline.

Predisposing Factors for Mood Disorders

Identifying and treating contributing factors can be as crucial as getting help from a therapist, taking medication, or other beneficial treatments. Consultation to uncover risk factors or predisposition to significant emotional or depressive illness is a place to start, preferably by working with qualified mental health or medical healthcare provider. Some predisposing or vulnerability factors could include:

  1. Medical issues such as difficulties with nutritional deficiencies, hormone deficiencies, hypothyroidism, diabetes, heart disease, or obesity
  2. Family (genetic history) of depression, bipolar illness, or other mood conditions
  3. Adverse lifestyles such as inadequate nutrition, sedentary habits, and chaotic, stressful living, or working in adverse conditions
  4. Traumatic brain injury, chronic pain, multiple surgeries, loss of function or structural integrity of body secondary to accidents, injury, surgery, congenital disabilities, or paralytic illness
  5. Environmental exposure, disease, or sensitivity because of toxic metals, mold, or chemicals such as lead and mercury
  6. Presence of disabilities or poor social and adaptive skills that make one vulnerable to discrimination, rejection, bullying, and trauma
  7. Substance use problems with drugs of abuse such as opioids, alcohol, stimulants, sedatives, or hallucinogenic substances
  8. Social factors such as dysfunctional families, friends, or marriages; adverse, toxic, or abusive relationships; divorces; failures in school or work; loss of social support, a significant other, a job or career, a home, or financial security; or a recent move
  9. Personality issues or chronic adverse personality disorders such as narcissistic, antisocial, dependent, or paranoid personality disorders disrupt successful daily functioning and interfere with forming needed relationships

Trauma Effects

The effects of trauma and its aftermath can occur at any life stage — in childhood or adulthood. Different traumas can affect each person differently and underlie or contribute to trauma-related illness, depression, and post-traumatic stress disorder (PTSD). Adverse traumatic experiences may include:

  • Feeling helpless during trauma, as in childhood sexual abuse, rape, physical assault, auto accidents with the threat of injury, violence, or death
  • Occurrences of overwhelming, adverse, life-threatening events (early life or in adulthood) or compounded traumas (i.e., series of traumatic events: as a job loss, divorce, death of a significant other, financial loss, subjugation to violence, and imprisonment)
  • Being a healthcare worker, such as an EMT, nurse, or doctor in medical care work, or a soldier in combat overwhelmed by the witnessing of death and destruction⁴
  • Surviving a climatic or natural disaster, a war, a holocaust, a mass casualty event such as a terrorist attack, a pandemic, a mass shooting, or a bombing
  • Witnessing domestic violence, death, or injury to others (health care providers, law enforcement, and emergency workers experience much traumatic exposure regularly)

Secondary trauma also happens when witnessing despair and death, significantly when associated with the feeling of being overwhelmed by life, occupational, or work demands. Examples would be healthcare workers, those caring for a loved one, or soldiers in the military. Look for signs of depression and be ready to provide support and help with attention, support, and resources.⁵

Be aware of the signs and presentation of depression and severe grief states, especially where there is the progression to major debilitating and life-threatening illnesses. Reach out for help for yourself or someone else in need when a significant loss or the death of a significant other has occurred.

When depression occurs, beyond merely taking an antidepressant pill or a natural remedy, seek the benefits from social support, psychotherapy, and other complementary approaches. When needed, find help from qualified health professionals — preferably those with a more holistic orientation. Learn about depression from information, reading, attending educational programs, or support groups as much as possible.

TIPS

  1. As noted above, learn to recognize symptoms in yourself or other significant changes in mood or emotions or signs of depression.
  2. Learn what mental health resources are available in your community and how to access them in time of need.
  3. Read, attend courses, lectures, or public forums discussing mental health and prevention for yourself, your family, friends, community, and workplace for preparedness when needed.
  4. Study, seek help from a support person or group, or try counseling and possibly therapy to develop awareness about your personal story, narrative, and related core beliefs. When needed, reach out for help to prevent getting stuck in an inflexible mental and emotional state that can lead to progressive difficulties.
  5. Work on developing mindfulness and moment-to-moment awareness of your inner story and mental narrative. Be more the director and editor of your life and action — make conscious of what is often hidden or out of awareness, so you can adapt and change. Use any tools available to aid awareness of the vital narrative workings in the mind that one can harness for change, success, health, and wellbeing.
  6. Guide your life and those of your family and significant other with the holistic way of leading a healthy lifestyle for mental, physical, spiritual health, and wellbeing — find helpful, available, and trustworthy resources to begin your journey toward awareness and positive change.

I appreciate your interest. Be well and mindful on your journey of discovery and learning,

Ron Parks, MPH, MD

¹ https://finishingtouchesed.wixsite.com/editor

² There are interests and research into the prenatal (before birth) influences on a child’s postnatal development and behavior, as presented in some of Stanislav Grof’s writings.

Stanislav Grof, Beyond the Brain, State University of New York Press, 1985

³ Legg, T.J., PhD, CRNP (June 3, 2020). Depression: facts, statistics, and you, Healthline. healthline.com/health/depression/facts-statistics-infographic

Depression and Bipolar Support Alliance (2020). Depression statistics. dbsalliance.org/education/depression/statistics

⁴ Benabio, J., MD (April 22, 2020). Overcoming COVID-related stress, Medscape Psychiatry. medscape.com/viewarticle/929166

Brooks, M. (March 26, 2020), COVID-19: ‘striking’ rates of anxiety, depression in healthcare workers, Medscape Psychiatry, medscape.com/viewarticle/927581

Brooks, M. (September 21, 2020). Surge in opioid overdoses linked to COVID-19, Medscape Psychiatry. medscape.com/viewarticle/937770 Browser, D. (September 25, 2020).

Suicide, depression, anxiety: COVID-19’s heavy toll on youth, Medscape Psychiatry. medscape.com/viewarticle/938065 National Institute of Mental Health COVID-19 is an emerging, rapidly evolving situation. nimh.nih.gov/health/education-awareness/shareable-resources-on-coping-with-covid-19.shtml

⁵ Ostaseski, Frank. The Five Invitations: Discovering What Death Can Teach Us About Living Fully. Reprint edition. New York, NY: Flatiron Books, 2019.

Nisargadatta, Maharaj. I Am That. 2nd American edition. Durham, NC; The Acorn Press (revised), 2012.

Rinpoche, Sogyal. The Tibetan Book of Living and Dying: 25th Anniversary Edition Paperback. USA: HarperSanFrancisco, 2020.

Hawkins, David R. Letting Go: The Pathway of Surrender. Vol. 9. 9 vols. Power vs. Force. USA: Veritas, 2013.

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