The HSP - the Highly Sensitive/Perceptive Person

HSP stands for highly sensitive/perceptive person.  An HSP is someone whose brain and nervous system is 'wired' in a way that makes them more sensitive. This means that they are acutely aware of, attuned to, and affected by their environment, other people, and things going on within themselves. It can further be characterized as sensitivity to both internal and external stimuli, including social, emotional and physical cues: they are more emotionally and physically reactive.  Because they process cues, signals and other information more thoroughly than others, they become easily overwhelmed, experience more stress, startle easily, and are keenly aware of, and affected by, changes in their environment - even subtle ones - like energy, light, noise, smell, texture and temperature.

This sensory processing sensitivity is a basic, heritable, personality trait or temperament. It is not a pathology. It has evolved as a particular survival strategy for approximately 15 to 20 percent of individuals that differs from that of the majority of other people.  It is an inborn trait, noticeable at birth through observational studies of how infants respond to their environment and to other people. It has also been observed throughout the animal kingdom.

Approximately 30 percent of HSPs are extroverts; most, however, are introverts.  They all tend to be introspective, have rich inner lives, depth of thought, lean toward perfectionism, and require plenty of time alone in order to relax and replenish.  Social gatherings can leave them tense, exhausted, or highly aroused with difficulty falling asleep afterward.  They tend to not relax well in group activities such as a yoga class or other type of exercise class.  These types of classes which may promote relaxation and calmness in other people, can have the opposite effect on HSPs who relax better exercising alone. Even extroverted HSPs need time alone to replenish energy after periods of high intensity for them: after meetings, concerts, parties and social gatherings.

HSPs are easily disturbed, distressed or thrown into disarray by changes and don't enjoy living  situations which lack stability.  Constant upheaval (for instance, when a spouse travels frequently for business purposes) is overwhelming and upsetting.  And, because the nervous system of an HSP is so easily kicked into high gear, or affected profoundly, by things such as startling or loud sounds (like a firecracker going off or a rock concert), hormonal fluctuations, stimulating foods, spices and beverages, social interactions, strong scents or smells, bright lights, or temperature changes, they may often experience difficulty falling asleep or staying asleep.  They may also experience physical symptoms such as digestive disturbances, food allergies and intolerances, or nervous system effects such as tension, heart arrythmias or headaches more easily from foods/beverages/circumstances that others can easily tolerate. They may have trouble tolerating medications/alternative remedies that others easily tolerate. Violent or horrific images are extremely disturbing and these images can stay with the HSP for several days, if not longer.

Being an HSP is not a psychological disorder, but can certainly lead to one as a result of life experiences and ongoing stressors. All types of anxieties, neuroses, and depressions can develop as HSPs find it harder and harder to cope in an environment that doesn't suit their needs.  They may experience high levels of stress and find it hard to deal with, or cope with, situations that they find too stressful.  Generally speaking, they are misunderstood by others, seen as weak and vulnerable, and as children - even as adults - may be bullied, ridiculed or made fun of.  But, having a high-functioning, easily-aroused, sensitive nervous system is a physical trait which a person has no control over - and did not choose, but was born with - just like the colour of one's skin, hair or eyes.

Because of how their brains and nervous systems are wired, HSPs may experience life as fraught with types of difficulty and upset that other ‘average’ people have a hard time understanding or experiencing.  If expected to function in an environment  that doesn’t allow them to have what they need in order to grow and prosper, they will most likely deteriorate both physically and emotionally/mentally and conditions such as anxiety and depression may very well be the result.  If they are repeatedly told that they are too sensitive, that they shouldn’t feel the way they do, shouldn’t need what they do, shouldn’t ask for what they need in order to be successful individuals, and told that they should be different than they are and better able to cope with all that is thrown at them, then they will deteriorate.

Western societies/cultures do not value sensitive people. HSPs tend to be highly intelligent, talented, and gifted individuals. Telling an HSP to “just get over it” or exasperatedly asking them why they are so sensitive, or laughing at them while expecting them to develop a thicker skin is damaging and futile because they can’t change their wiring. Instead, imagine the courage/fortitude it takes for them to continue living, coping and thriving.  If they are treated with love and understanding as children (and also as adults) they will cope and thrive.  Otherwise, their sensitivity can take a more pathological turn towards neuroses and could develop into a psychological disorder such as generalized anxiety, social anxiety, or depression.   

HSPs are at higher risk of developing depression and anxiety than is the general population.  HSPs tend toward loneliness and social isolation if they feel unaccepted and misunderstood, and also because they become easily stressed and require more alone time (remember most have more traits of the introvert than of the extrovert).  It can be hard for them to arrange social engagements in order to maintain friendships. While they may strongly desire social interactions and relationships, they may have a hard time sustaining them as others fail to understand them and they suffer easily from fatigue, stress and exhaustion, especially as they get older.  If they do not live in a stable environment, it makes it even harder for them to plan social engagements and to maintain friendships.  And, if they start to lose confidence they will withdraw, becoming more isolated, lonely, depressed and anxious.

Having written all of the above, it is important to note that HSPs usually do make sensitive and caring friends - noticing the energy and emotions of others. They are conscientious, exhibit high levels of intelligence, talent, skill, focus, perception, passion, intensity, depth, compassion and empathy. They are highly creative and attuned to the environment, as well as being great lovers of the arts, often noticing subtleties and hues missed by others.  They are especially attracted to professions which require high levels of creativity. 

D.

Estrogen Dominance

In one of yesterday's blog posts, Women and Insomnia, I mentioned the term, "estrogen dominance". 

According to Michael Lam, MD, women from ages 35 to 50, experience a 75 percent reduction in the production of progesterone while estrogen declines by only about 35 percent.  By menopause, the total amount of progesterone made is extremely low, while estrogen is still present in the body at about one-half of its pre-menopause level.  With only a gradual drop in estrogen and a greater drop in progesterone, there is insufficient progesterone to counteract the amount of estrogen.  Estrogen dominance results.

Close to all women age 50 and older are overloaded with estrogen - even if they have not actually reached menopause yet - and at the same time are suffering from progesterone deficiency.  Excessive estrogen causes a whole host of conditions, including insomnia and anxiety, both of which stress the adrenal glands.  This then leads to a further reduction in progesterone output and ever more estrogen dominance.  After a few years, the adrenal glands may become exhausted.  This, in turn, may lead to chronic fatigue, hormonal imbalance and blood sugar imbalance.

D.

This information in this article may be found at www.drlam.com

The Tale of Epictetus

Epictetus was a Greek philosopher who began his life as a slave in the Greek-speaking Roman province of Phrygia, which is now a region in central Turkey.  After being too tightly shackled, despite his assurances to his master that he wouldn't run away, Epictetus' leg broke.  He had warned his master that if he kept tightening the shackles his leg would eventually break and loss of production would result.  When Epictetus' leg broke, as he predicted it would, instead of showing anger and pain, or any emotional reaction whatsoever, he was very calm and accepting of the situation.  His master became unnerved and asked his slave why he showed no reaction to what had happened.  Epictetus explained that as the leg was irreversibly broken and he could do nothing to change what had happened, there was really no point in getting upset about it.  The master was very impressed and released Epictetus, so that he could become a travelling student philosopher.  He even gave him money, goods and letters of introduction to facilitate his journey.  His famous idea - "it is not the things of this world that hurt us, but what we think about them" - is now widely accepted throughout mainstream psychology.  (His idea has been expressed a few different ways, but they all promote the same idea: that an individual is not disturbed by events, but rather by his or her interpretation of the events, or by the meaning he or she attaches to the events.)

This is the principle upon which modern day Cognitive Behavioural Therapy (CBT) is based. CBT works by focusing on the particular way in which an individual thinks and behaves in order to rectify behavioural, emotional and social problems, issues and challenges.  Clients learn to more clearly delineate their automatic thoughts, to see how these thoughts may be creating negative emotions and any resulting negative or unproductive behaviours.  They then work to quiet or change these negative thoughts in order to more positively view the world and their own issues, problems and challenges.

D.

Women and Insomnia

I have a very sensitive nervous system – like 15 to 20 percent of humans.  Supposedly, this highly-atttuned nervous system evolved as a survival mechanism.

During the first trimester of my one and only pregnancy, I had tremendous difficulty sleeping.  Many nights, I did not sleep at all.  It was a version of hell, trying to practise law, fend off anxiety, exercise, eat right, and stay healthy for myself and my child.  It was psychologically distressing.  I remember a friend telling me at the time that I will sleep when I’m tired enough.  I couldn’t believe it!  I was beyond tired!  She obviously couldn’t comprehend what I was going through.  The day I entered into the second trimester of pregnancy, it seemed like a switch suddenly went off and I was able to sleep normally again.  What a relief!

Now, I am experiencing what I term, “extreme perimenopause”.  Sleep has become elusive again.  Some nights I do not sleep at all, some I sleep only a few hours. Seldom do I get seven or eight hours, let alone the average 6 hours and 41 minutes that women aged 30 – 60 get on average, according to the U.S. National Sleep Foundation which also reports that women are more likely than men to have difficulty falling, or staying, asleep. (1)  In my household, this is definitely true where I am outnumbered by peacefully slumbering males, 2 to 1.  And, both of these males have lifestyles which throw my circadian rhythm off balance, and which negatively impact my ability to, and quality of, sleep.  (Yes, I am in a version of hell again: sleep deprivation has been used as a method of psychological torture for centuries.)

A woman’s biology can certainly affect how well she sleeps. The menstrual cycle and pregnancy, perimenopause, and menopause all can affect the quality and quantity of a woman's sleep.  Because fluctuating hormones affect the nervous system, the more sensitive the nervous system, the more likely a woman is to experience moderate to extreme difficulty sleeping.  It is well-documented that changing levels of hormones like estrogen and progesterone have an impact on sleep.  Estrogen dominance is a key component which impacts a women's sleep negatively.

Research relating to sleep deprivation has uncovered that too little sleep results in daytime sleepiness, moodiness including irritability, and an increase in mood disorders such as anxiety and depression, an increase in the number of accidents, including those caused by poor coordination/poor balance/poor attention, problems concentrating/focusing, poor memory, poor job performance, compromised immunity causing illness, weight gain due to cravings and disordered eating, feelings of dissatisfaction and boredom, isolation due to difficulty having the energy to maintain friendships or attend social functions, blurred vision, an increase in muscle tension and headaches, and an increased risk of dying early from causes such as heart attack.

When insomnia persists over a long period of time, secondary anxiety can develop in which a person becomes anxious about not sleeping well, and about all the increased risk factors for his or her health due to not sleeping well. (Just 'google' sleep deprivation if you want to really worry about not sleeping well, and you'll get an idea of all the nasty things that may befall you due to insomnia.  Just to mention a few:  at increased risk of heart attack, alzheimer's, depression.)  It can become a 'vicious circle'.

Insomnia is the most common sleep problem in the United States (and I suspect elsewhere, too). Women are more likely than men to report insomnia. In fact, according to the 2002 NSF "Sleep in America" poll, more women than men experience symptoms of insomnia at least a few nights a week (63% vs. 54%). Fortunately, there are a number of approaches to improve sleep, including those you can do yourself such as exercising, establishing regular bed and wake times, making dietary changes (consuming less or no caffeine, avoiding stimulating foods and beverages, and avoiding alcohol), and improving your sleep environment and sleep hygiene (before-bed habits). One recent study found that overweight, post-menopausal women who exercise in the morning experience less difficulty falling asleep and better quality sleep than evening exercisers. (2)  Some individuals have found relief through yoga, meditation, or other relaxation techniques/exercises. Medications, supplements, and alternative remedies that induce sleep or relaxation, as well as those that treat underlying disorders may be helpful.  What works for one person, may not work for another.

D.

(1) and (2) National Sleep Foundation, “Women and Sleep", www.sleepfoundation.org

Optimism vs. Pessimism

One defining feature of a person's general outlook or attitude is whether they see setbacks as temporary and limited, or as all-encompassing.  According to Martin Seligman, a professor of psychotherapy at the University of Pennsylvania, "pessimists tend to believe they're to blame when bad things happen and that these bad things will persist and ruin other events in their lives." (1)  Optimists, on the other hand, see setbacks as temporary.

Now, whether an individual's general disposition is primarily inherited, or whether it is primarily influenced by the attitude/outlook of their primary caregiver(s) throughout their formative years is still open for debate.  It's most likely a blend of both and inherited disposition can change under influence by others and can also repel influence by others.  It can be quite difficult to separate characteristics we inherit from those which are the result of environmental factors although this is an area under continued study.  Traumas and other life events can go a long way towards whether any one individual tends towards optimistic thinking or pessimistic thinking.  But, how that individual learned to deal with traumas and life events, or how they learned to view them, would have an influence on how their general outlook develops, perhaps as much as, or more than, living through the event or trauma itself.  I think that the people closest to a developing child teach the child how to interpret life's events - what spin to put on them.  Was your parent open and trusting towards other people, or suspicious and antagonistic?  Was your parent generally agreeable, or basically disagreeable and bitter?  Did he or she see the silver lining in clouds or just the darkness?  Did they use pessimism as an attention-seeking mechanism?

Throughout life, how traumas are dealt with, and how life's day to day events are interpreted, have a great influence on whether more positive interpretive neural pathways are laid down, or more negative ones.  Does life wear you down, or do you rise to most challenges?  Individuals continue to be affected by experiences during their adult years and new neural pathways, whether positive or negative, continued to be forged.  It is not uncommon for individuals to become more optimistic as they age, nor is it uncommon for them to become more pessimistic.  The experiences we have, no matter what our age, affect both the mechanism and chemistry of the brain.*  All sorts of subtle workings continue to be at play in the brain, two of which are neurotransmitters and neuromodulators, and these are influenced by a whole host of other factors such as sleep, stress, diet and illness.  (It's complicated.)

No matter the mechanism, study after study seems to prove better health outcomes as people age for those with optimistic outlooks.  (Whether they are more optimistic because they are healthier, or whether they are healthier because they are more optimistic requires further study.)  Slowly, but surely, however, it seems that scientific studies are showing that thinking optimistically can make you mentally and physically healthier.  (Perhaps being an optimist is, in itself, a sign of good mental health.  Perhaps optimists look after themselves better and avoid more self-destructive behaviours.)

In Holland, researchers discovered after studying approximately 1,000 seniors, that the most optimistic among them had a 55 percent lower chance of dying from all causes and a 23 percent lower risk of cardiovascular death.  A study of law students at the University of Kentucky found that students who were more optimistic than their counterparts had stronger immune systems.  And, a study at the University of Pennsylvania which involved incoming freshman who participated in a series of workshops aimed at helping them cultivate a positive attitude, lowered their risk of developing depression.  Other research indicates that high levels of optimism are linked to better recovery from heart transplants and heart bypass surgery, protection from stroke risk, and even delayed onset of frailty among the elderly. (2)  And, another study has shown that seniors who still think of themselves as healthy despite the fact that they may have some issues with their health, have better health outcomes and stay stronger and more vital longer.

Researchers don't know exactly how optimism is a protective factor.  Further study is required.  What they do seem to now know is that the evidence they do have strongly suggests that pessimism is detrimental when it comes to disease development and outcomes of disease whereas optimism points towards added protection.

A 2009 study by The Social Issues Research Centre in Oxford, UK came up with what they have termed, an "optimism spectrum", which I thought might be of  interest here.  Some of you may find that the categories overlap.  For what it's worth, here are the categories - which category describes you?:
Unabashed optimist:  I am always very optimistic, whatever the circumstances
Contagious optimist:  I am always optimistic, and my optimism spreads to those around me
Concrete optimist:  I am optimistic, but I am realistic about the possible outcomes of events
Cautious optimist:  I am optimistic, but I am careful not to be complacent about my good fortune
Situational optimist:  My levels of optimism/pessimism change from situation to situation
Realist:  I am neither optimistic nor pessimistic, but simply realistic about the good and bad things in my life
Fatalist:  I accept that essentially I can't change what's going to happen to me, whether it's good or bad
Individualist:  I believe that essentially I have control over what's going to happen to me, whether it's good or bad
Pessimist:  I am generally pessimistic, whatever the circumstances. (3)

D.
*the changing nature of the brain throughout life is called  'neuroplasticity'.  Up until a couple of decades ago, it was thought that the brain was incapable of changing during the adult years, apart from changes induced by injury or disease.  (Like the old adage that you can't teach an old dog new tricks.)  It has been well-documented over the last several years, however, that you CAN teach that old dog some new tricks, and that ongoing experiences and learning does, indeed, change the brain.  Much is being written on this 'plastic' nature of the brain - on the ability for it to continue changing as we age, to continue laying down neural pathways and making new synaptic connections, based on what we learn and experience.

(1)  and (2)  Health:  Total Wellness For A Better Life, October 19, 2011, Chris Wadsworth, www.newsmaxhealth.com.
(3)  Optimism:  A Report from the Social Issues Research Centre, February, 2009, p. 22.

Disorders of Personality

Familiar Personality Disorders (PDs) include narcissistic, antisocial, dependent, histrionic, borderline, and avoidant ones, although about 10 conditions are recognized by psychiatrists and psychologists as PDs.  Everyone knows that individuals with this type of disorder have a problem - except for them. They often seek professional treatment only after persuaded to do so by another person.

PDs are among the most difficult cases to successfully treat. They don't exist apart from an individual's core personality, like something like an anxiety disorder does; rather, they wind through a person's entire personality and, generally speaking, IS the personality, not just an adjunct to it.  It is estimated that about 40 percent of individuals suffering from a PD can find some improvement with a combination of medication and some form of 'talk' therapy. 

The cost to society resulting from PDs is great.  Individuals suffering from a PD are often perpetrators of spousal and child abuse and other forms of violence, creating unhealthy living conditions for others. Even if they are able to be persuaded to undergo therapy, they may continue to deny that they have a problem, preferring to list everything that is wrong with everyone else - blaming everyone else, or the situation, for their problems.  They seek therapy under duress, often using the sessions in order to bolster their claim that they don't have a problem;  that it is others - their spouse, their colleagues - who are to blame for the way they act and that their actions are completely justified.  They are usually self-absorbed, believing that they have every right to be because they're 'so hard done by' at home, or at work.  When the therapist doesn't provide them with the expected validation for their behaviour, they simply fire the therapist.

PDs are extremely complex and as noted above, difficult to treat.  They are often heritable conditions, but can also come about as a result of conditioning during a person's early years because of things like childhood abuse or some other trauma.  A PD doesn't usually manifest itself until the late teenage years;  however, earlier signs may simply have been missed by parents.  Alternatively, because a parent may have the disorder, they can't see that anything is wrong with the child.  Even when environmental factors such as child abuse take place, it is hard to determine whether the reason the child ended up with, for example, a narcissistic personality disorder, was simply because of the abuse which led to self-loathing and low self-esteem - to then be covered up by self-aggrandizement - or that the abuse ended up manifesting as it did because it triggered the heritable condition.  In other words, that is how the abuse manifested itself in that particular child due to genetic factors, whereas in another child it may have manifested itself in another type of PD, or in anxiety or depression.

According to Jeffrey Kluger's article "Pain, Rage and Blame" in a special edition of Time magazine, "personality disorders are ego syntonic:  individuals believe that the drama, self-absorption, and other traits that characterize their condition are reasonable responses to the way the world is treating them." (1)  As a result, because the patient doesn't accept that there is something wrong with them - as they do when they have something like panic disorder or a phobia - how can they accept the treatment required to give them any chance at all towards healing?

While antidepressant and anxiety medications do little to change something as fundamental as personality, they may help to smooth out the rough edges, to calm the stress that comes from living so disordered a life.  Once some patients feel less stressed, they may be motivated enough to take on the harder work of a therapy like cognitive behavioural therapy in which new ways of thinking and reacting about life situations are taught, and then utilized, in order to enable patients to repair what is not working in their lives.

D.

(1) "Pain, Rage and Blame", Jeffrey Kluger, Time magazine special edition: "Your Brain:  A User's Guide", p. 52.

On Stress and the Brain

Stress inhibits neurogenesis (the formation of new neurons) in the brain.  Help!!!

Aerobic exercise (which increases the availability of oxygen and nutrient-filled blood in the brain, nourishing the brain) increases neurogenesis.  Yeah!!!


D.