Children and Difficult Behaviour

From the Canadian Mental Health Association, an article about children and difficult behaviour, http://www.cmha.ca/bins/content_page.asp?cid=2-29-66&lang=1:

 Every child misbehaves from time to time. This is always distressing to us as parents because we would all like to be perfect parents of perfect children! There are many reasons for a child’s misbehaviour, and many ways for parents to help the child improve. Difficult behaviour includes:

• using bad language,
• behaving aggressively or violently,
• destroying property,
• lying,
• stealing,
• refusing to cooperate with necessary tasks, such as getting dressed in the morning, going to bed at night or doing school work.

Unintentional and intentional misbehaviour

Children can misbehave by accident or on purpose, and it is important to understand the difference, for example:

• Accidental misbehaviour – Your eight-year old throws a snowball in a friendly snowball fight and injures another child because a stone was accidentally packed into the snowball.
• Intentional misbehaviour – Your child steals candy from the corner store after you refused to give his/ her allowance two days early.

Why do children misbehave?

Sometimes, the causes of misbehaviour are easy to see; other times, they are hidden. The reasons may include:

• impulsiveness and inexperience – A lot of misbehaviour happens because the child does not know any better. For example, the eight-year old with the snowball was excited and having fun (impulsive) and may be too young to understand that even the simplest actions can be dangerous when done carelessly (inexperience).
• resentment and anger at rules - Nobody likes being told what to do, and that includes children. Yet, children get told what to do and how to do it all the time! So, it is not surprising that they misbehave out of resentment or anger. For example, your three-year old may hit a playmate after you insist that toys be shared, or your teenager may yell, swear and slam doors after being told repeatedly to clean up his/her room.
• resentment and anger at unfair treatment -Sometimes, we take out our own anger and frustrations on our children. We may yell at our children for being noisy when the real reason is we are angry about something that happened at work. We all do this kind of thing occasionally, but if we do it all the time, our children will respond with resentful and angry behaviour of their own.
• frustration from too much pressure to perform -Sometimes we push our children to achieve too much too soon. If a child is always being pressured to do things, like stand up on skates before he/she is physically ready or play games that are too difficult for his/her age, he/she may refuse to learn new things at home or slack off at school.
• fears: real or imaginary – If your child suddenly refuses to do things that he/she used to do, it may be because of a real or imagined fear. For example, your child may suddenly refuse to get on the school bus because he/she has been frightened by a larger, hostile child who has started taking the same bus (real), or it may be a case of resisting going to bed because “there’s a Tyrannosaurus Rex in the closet!” (imaginary).

What can you do to change difficult behaviour?

The most important things you can do are to be patient, avoid losing your temper and remember that love is more persuasive than punishment. Before you act, try to think a few things through – ask yourself questions. Then, act as calmly and as thoughtfully as you can.

• Does my child know that he/she is loved? Make sure your child knows that you love him/ her, and it does not hurt to tell them over and over again. Love brings love in return, and it is a lot harder for anyone, child or adult, to behave in ways that will hurt someone he / she loves.
• Is it necessary for my child to do this, or is it OK for him/her to choose? Obviously, there are times when you can give your children no choice. Unsafe, destructive, dishonest or rude behaviour has to be corrected, and children must learn what the limits are. However, leave some reasonable choices to your children – what to wear, what to eat for breakfast (as long as it is healthy!) and how to schedule time for homework and play.
• Did my child do this on purpose? Becoming angry at a child for misbehaving because he/she did not know any better will do more harm than good. In the case of the eight-year old with the snowball, you can deal with the problem by using the incident to teach some basic lessons in safety. However, you should remember that you will have to keep repeating that kind of lesson many times before your child automatically thinks in terms of safety without prompting from you.
• If I lose my temper, am I going to make matters worse? Suppose your three-year old goes to your bedroom and breaks a string of pearls after being reprimanded. Obviously, he/ she is enraged, and if you respond with rage, you will be continuing a cycle of anger from which it may be difficult to escape. Try to let your child know that you understand his/ her anger and the reason for it, and try to get your child to put his/her angry feelings into words. Try to help your child think about making amends for the damage done.
• Learn to use the “time out” method to help your child regain composure and self control. Give your child some time alone, not as a punishment, but as an opportunity to recover from a bout of misbehaviour. Send your child to his/her room and encourage him/her to read, colour or play with a favourite toy until he / she is calmed down. Then try to discuss the behaviour problem constructively with your child.
• Is the punishment I have given too harsh? If you punished your child when you were angry, you may later think that you were too harsh. Trust your feelings. Remember that changing your mind is not necessarily a sign of weakness. Children have a very keen sense of fair play and will respect an adult who changes his/her mind in favour of greater fairness.
• Try to put consistent routines in place for your children. Children need the security provided by regular routines and events in a stable environment. Security and stability make it easier for children to behave in a stable and cooperative manner.
• Allow for some breaks in routine to reduce boredom. Once routines are established, they can be broken from time to time for special reasons. This gives children a chance to experience fun and variety, and still lets them return to the security of familiar routines afterwards.
• Remember that every child needs to know there are limits. Setting limits and quietly but firmly insisting on certain standards of behaviour provides your child with a sense of security and help make him/her feel safe and secure.

Do you need more information?

If you are concerned about your child’s difficult behaviour and feel you need more help than family and friends can provide, there are useful books as well as courses and workshops on parenting.

If your child’s behaviour problems are persistent and serious, talk to your family doctor about therapists who work with children. You can also contact a community organization, such as the Canadian Mental Health Association, for more information about local resources and support. 

Post-Partum Depression

After having a baby, many women suffer from short-term baby blues, more serious, longer term depression and a small number suffer from post-partum psychosis. From the Canadian Mental Health Association website, http://www.cmha.ca/bins/index.asp?lang=1, an article about post-partum depression, http://www.cmha.ca/bins/content_page.asp?cid=3-86-87-88&lang=1.

POST-PARTUM DEPRESSION

For every woman, having a baby is a challenging time, both physically and emotionally. It is natural for many new mothers to have mood swings after delivery, feeling joyful one minute and depressed the next. These feelings are sometimes known as the “baby blues”, and often go away within 10 days of delivery. However, some women may experience a deep and ongoing depression which lasts much longer. This is called postpartum depression. References to postpartum depression date back as far as the 4th century BC. Despite this early awareness, it has not always been recognized as an illness. As a result, postpartum depression continues to be under-diagnosed. It is an illness that can be effectively treated. The sooner the condition is diagnosed, the more effective the treatment. It is important to recognize and acknowledge the symptoms of postpartum depression in yourself or another as soon as possible. This can be difficult, since the depressive feelings often involve intense and irrational feelings of fear. The mother may fear she is losing her mind or fear that others may feel she is unfit to be a mother. Women with postpartum depression may feel like they are bad mothers and be reluctant to seek help. It is important to remember that hope and treatment are available to women in need. Defining postpartum depression Researchers have identified three types of postpartum depression: baby blues; postpartum depression and postpartum psychosis. The “baby blues” is the most minor form of postpartum depression. It usually starts 1 to 3 days after delivery, and is characterized by weeping, irritability, lack of sleep, mood changes and a feeling of vulnerability. These “blues” can last several weeks. It’s estimated that between 50% and 80% of mothers experience them. Postpartum depression is more debilitating than the “blues.” Women with this condition suffer despondency, tearfulness, feelings of inadequacy, guilt, anxiety, irritability and fatigue. Physical symptoms include headaches, numbness, chest pain and hyperventilation. A woman with postpartum depression may regard her child with ambivalence, negativity or disinterest. An adverse effect on the bonding between mother and child may result. Because this syndrome is still poorly defined and under studied, it tends to be under reported. Estimates of its occurrence range from 3% to 20% of births. The depression can begin at any time between delivery and 6 months post-birth, and may last up to several months or even a year. Postpartum psychosis is a relatively rare disorder. The symptoms include extreme confusion, fatigue, agitation, alterations in mood, feelings of hopelessness and shame, hallucinations and rapid speech or mania. Studies indicate that it affects only one in 1000 births. Causes and risk factors The exact cause of postpartum depression is not known. One factor may be the changes in hormone levels that occur during pregnancy and immediately after childbirth. Also, when the experience of having a child does not match the mother’s expectations, the resultant stress can trigger depression. Studies have also considered the possible effects of maternal age, expectations of motherhood, birthing practices and the level of social support for the new mother. There is no one trigger; postpartum depression is believed to result from many complex factors. It is important, however, to communicate to women with postpartum depression that they did not bring it upon themselves. One certain fact is that women who have experienced depression before becoming pregnant are at higher risk for postpartum depression. Women in this situation should discuss it with their doctor so that they may receive appropriate treatment, if required. In addition, an estimated 10% to 35% of women will experience a recurrence of postpartum depression. The amount of sick leave taken during pregnancy and the frequency of medical consultation may also be warning signs. Women who have the most doctor visits during their pregnancy and who also took the most sick-leave days have been found to be most likely to develop postpartum depression. The risk increases in women who have experienced 2 or more abortions, or women who have a history of obstetric complications. Other factors which increase the risk of postpartum depression are severe premenstrual syndrome (PMS), a difficult relationship, lack of a support network, stressful events during the pregnancy or after delivery. How is postpartum depression treated? Therapy, support networks and medicines such as antidepressants are used to treat postpartum depression. Psychotherapy has been shown to be an effective treatment, and an acceptable choice for women who wish to avoid taking medications while breastfeeding. Coping with postpartum depression First, remember that you are not alone – up to 20% of new mothers experience postpartum depression. Equally important is remembering that you are not to blame. Here are some suggestions for coping: Focus on short-term, rather than long-term goals. Build something to look forward to into every day, such as a walk, a bath, a chat with a friend Look for free or inexpensive activities; check with your local library, community centre or place of worship Spend time with your partner and/or close friends Share your feelings and ask for help Consult your doctor and look for a local support group If you think a friend or family member is suffering from postpartum depression, offer your support and reassurance. You may be able to direct them towards useful sources of information about postpartum depression. Easing the isolation they feel is an important step. Where to go for more information For further information about postpartum depression, contact a community organization like the Canadian Mental Health Association to find out about support and resources in your community. On the internet, go to: www.cmha.ca.

Seasonal Affective Disorder

From the Mental Health America website, http://www.nmha.org/, information on seasonal affective disorder,  http://www.mentalhealthamerica.net/go/sad, affecting half a million people with depression during winter months:

SEASONAL AFFECTIVE DISORDER

Some people suffer from symptoms of depression during the winter months, with symptoms subsiding during the spring and summer months.  These symptoms may be a sign of seasonal affective disorder (SAD).  SAD is a mood disorder associated with depression and related to seasonal variations of light.  SAD affects half a million people every winter between September and April, peaking in December, January, and February.  The “Winter Blues,” a milder form of SAD, may affect even more people.

 Prevalence

• Three out of four SAD sufferers are women. 
• The main age of onset of SAD is between 18 and 30 years of age. 
• SAD occurs in both the northern and southern hemispheres, but is extremely rare in those living within 30 degrees latitude of the equator. 
• The severity of SAD depends both on a person’s vulnerability to the disorder and his or her geographical location.

Symptoms

A diagnosis of SAD can be made after three consecutive winters of the following symptoms if they are also followed by complete remission of symptoms in the spring and summer months:

• Depression: misery, guilt, loss of self-esteem, hopelessness, despair, and apathy
• Anxiety: tension and inability to tolerate stress
• Mood changes: extremes of mood and, in some, periods of mania in spring and summer
• Sleep problems: desire to oversleep and difficulty staying awake or, sometimes, disturbed sleep and early morning waking
• Lethargy: feeling of fatigue and inability to carry out normal routine
• Overeating: craving for starchy and sweet foods resulting in weight gain
• Social problems: irritability and desire to avoid social contact
• Sexual problems: loss of libido and decreased interest in physical contact

Causes

• As sunlight has affected the seasonal activities of animals (i.e., reproductive cycles and hibernation), SAD may be an effect of this seasonal light variation in humans.  As seasons change, there is a shift in our “biological internal clocks” or circadian rhythm, due partly to these changes in sunlight patterns.  This can cause our biological clocks to be out of “step” with our daily schedules.
• Melatonin, a sleep-related hormone secreted by the pineal gland in the brain, has been linked to SAD.  This hormone, which may cause symptoms of depression, is produced at increased levels in the dark.  Therefore, when the days are shorter and darker the production of this hormone increases.

Treatments for Seasonal Affective Disorder

• Phototherapy or bright light therapy has been shown to suppress the brain’s secretion of melatonin. Although, there have been no research findings to definitely link this therapy with an antidepressant effect, light therapy has been shown to be effective in up to 85 percent of diagnosed cases. Patients remain in light up to ten times the intensity of normal domestic lighting up to four hours a day, but may carry on normal activities such as eating or reading while undergoing treatment.  The device most often used today is a bank of white fluorescent lights on a metal reflector and shield with a plastic screen.
• For mild symptoms, spending time outdoors during the day or arranging homes and workplaces to receive more sunlight may be helpful. One study found that an hour’s walk in winter sunlight was as effective as two and a half hours under bright artificial light.
• If phototherapy does not work, an antidepressant drug may prove effective in reducing or eliminating SAD symptoms, but there may be unwanted side effects to consider.  Discuss your symptoms thoroughly with your family doctor and/or mental health professional.

Other Resources

Society for Light Treatment and Biological Rhythm
P.O. Box 591687
174 Cook Street
San Francisco, CA 94159-1687
www.websciences.org/sltbr

DISCLAIMER: Mental Health America does not endorse any specific mental health treatments or services.  In addition, it is not the intention of Mental Health America to provide specific medical advice but rather to provide readers with information to help them better understand their health and, when necessary, find the treatment that works best for them.

Sources:  The Harvard Mental Health Letter – February 1993.

The SAD Association Homepage. Accessed February 2002. Netscape:  http://www.sada.org.uk/symptoms.htm.

For More Information:

For more information, contact your local Mental Health America affiliate or the national Mental Health America office.

Page last updated: 03/09/2007

Kids and Self-Harm: Cutting

Although my own teenagers do not engage in self-harming behaviours like cutting themselves, the oldest does know kids at school who do.

This information on kids and self-harm, often in the form of cutting themselves, comes from the Canadian Mental Health Association website, http://www.cmha.ca/bins/content_page.asp?cid=3-1036&lang=1:

YOUTH AND SELF INJURY

Young people learn to cope with emotions in different ways. Tears, anger, depression and withdrawal are some of the ways of responding to – and finding relief from – overwhelming feelings. Some teens are troubled by frequent intense and painful emotions. While some are able to deal with these feelings, others react differently to their problems because they have not been taught ways to handle their emotions effectively. They are unable to find the words and the buildup of feelings makes it difficult for them to think clearly. Some teens release this bottleneck by cutting or burning or otherwise hurting themselves. Self injury provides immediate relief, but this is a short-term solution with serious consequences.

Self injury is not a new phenomenon, and it is becoming more common. In one survey, approximately 13% of adolescents who responded indicated that they engaged in self-injurious behaviours. Because this is a very secretive activity, it is difficult to determine exactly how many young people are affected.

The rate of self injury is growing. Gaining a deeper understanding of self harm is an essential first step to helping yourself or another. There is treatment, but as with all mental and physical conditions, early diagnosis is key to a successful outcome.

What is Self Injury?

Self injury, also called self harm and self abuse, refers to deliberate acts that cause harm to one’s body, mind and spirit. Examples include cutting the skin with razor blades or pieces of glass; burning and hitting oneself; scratching or picking scabs or preventing wounds from healing; hair pulling; and inserting objects into one’s body. Cutting is the most common form of self injury among today’s youth.

In a broader sense, behaviours such as smoking, alcohol and drug addiction, bingeing on food and staying in an abusive relationship can also be considered forms of self harming.

People who self injure may not be trying to kill themselves. Usually, they are not trying to end all feeling; they are trying to feel better.

Why do People Self Injure?

Experts describe deliberate self injury as ineffective problem-solving. People who self injure are often seeking relief from psychological pain, unbearable tension, loneliness, depression, anger or an absence of feeling or numbness. Some people self harm to feel emotions more intensely; others do it to punish themselves for being “bad.” They either cannot or have not learned how to express those feelings more effectively.

Self injury usually starts during puberty or adolescence. It can last for up to ten years, but if left untreated, it may persist. Episodes are usually responses to a “trigger,” such as a perceived rejection or other emotional pain. Cutting behaviour can spread, and there is a rising trend for teens to discuss cutting on the Internet and form cutting clubs at school.

There is no single pattern or profile for self injurers. According to research, most are from a middle to upper-class background, with average to high intelligence, and low self esteem. Some 40% have a history of eating disorders. Almost half report physical or sexual abuse during childhood. Almost all say that they were discouraged from expressing emotions, especially anger and sadness.

By physically harming themselves, self injurers often report feeling relief from the emotions that overwhelm them. They feel pain on the outside, not the inside.

Warning Signs

People who self injure go to great lengths to hide the behaviour. But there are warning signs, such as:

• unexplained frequent injuries, such as cuts and burns
• wearing long pants and long sleeved shirts in warm weather
• low self esteem
• problems handling emotions
• problems with relationships

What Can I Do?

If you are hurting yourself, it is important to begin talking to someone you trust – for instance, a friend, family member, a teacher, school nurse, guidance counsellor. Your doctor may be able to recommend a therapist or psychologist who can help you. There may be a support group in your area.

If you are concerned about a friend or family member, it’s okay to ask. Just talking about self injury won’t cause someone to begin hurting themselves. Before you ask, learn more about self injury. It can be shocking to find that someone you care about is deliberately harming themselves, and it can be difficult to hear what they have to say.

Offer support without judging or criticising. Try not to blame, or react as though their behaviour is impossible to understand.

The path to good mental health may be a long one. Having realistic expectations can help both you and your loved one manage what may be a slow pace of change.

Treatment for Self Injury

Treatment by a mental health professional is recommended. A specialist can help teens find alternatives and guide them toward substituting less harmful acts to express their feelings. Behavioural therapy can help to break the habit and maintain change.
 

Experts advise that early treatment is important. Some teens stop injuring themselves when their behaviour is found out. For others, being surrounded by a caring network of family, friends, teachers, counsellors and doctors reduces their need to cut or otherwise harm themselves. Assessment for depression or anxiety may reveal underlying issues that can be treated.

Where To Go For More Information

For further information, contact a community organization like the Canadian Mental Health Association (CMHA) to find out about support and resources in your community.

Do You Know The Warning Signs of Suicide?

Knowing these facts may help you to help yourself or family members or friends or coworkers to get help when needed in dealing with thoughts about suicide.

From the American Association of Suicidology, http://www.suicidology.org/displaycommon.cfm?an=2, here is an article about understanding the warning sides and what to do to help.

UNDERSTANDING AND HELPING THE SUICIDAL PERSON

Be Aware of the Warning Signs

Are you or someone you know at risk of suicide? Get the facts and take appropriate action.

Get help immediately by contacting a mental health professional or calling 1-800-273-TALK (8255) for a referral should you witness, hear, or see anyone exhibiting any one or more of the following:

Someone threatening to hurt or kill him/herself, or talking of wanting to hurt or kill him/herself.

Someone looking for ways to kill him/herself by seeking access to firearms, available pills, or other means.

Someone talking or writing about death, dying or suicide, when these actions are out of the ordinary for the person.

Seek help as soon as possible by contacting a mental health professional or calling 1-800-273-TALK (8255) for a referral should you witness, hear, or see someone you know exhibiting any one or more of the following:

Hopelessness
Rage, uncontrolled anger, seeking revenge
Acting reckless or engaging in risky activities, seemingly without
thinking
Feeling trapped – like there’s no way out
Increased alcohol or drug use
Withdrawing from friends, family and society
Anxiety, agitation, unable to sleep or sleeping all the time
Dramatic mood changes
No reason for living; no sense of purpose in life

Here is an easy mnemonic to remember these warning signs:
IS PATH WARM?

I Ideation
S Substance Abuse
P Purposelessness
A Anxiety
T Trapped
H Hopelessness
W Withdrawal
A Anger
R Recklessness
M Mood Changes

What To Do

Here are some ways to be helpful to someone who is threatening suicide:

Be direct. Talk openly and matter-of-factly about suicide.
Be willing to listen. Allow expressions of feelings. Accept the feelings.
Be non-judgmental. Don’t debate whether suicide is right or wrong, or whether feelings are good or bad. Don’t lecture on the value of life.
Get involved. Become available. Show interest and support.
Don’t dare him or her to do it.
Don’t act shocked. This will put distance between you.
Don’t be sworn to secrecy. Seek support.
Offer hope that alternatives are available but do not offer glib reassurance.
Take action. Remove means, such as guns or stockpiled pills.
Get help from persons or agencies specializing in crisis intervention and suicide prevention.

Be Aware of Feelings

Many people at some time in their lives think about completing suicide. Most decide to live because they eventually come to realize that the crisis is temporary and death is permanent. On other hand, people having a crisis sometimes perceive their dilemma as inescapable and feel an utter loss of control. These are some of the feelings and thoughts they experience:

Can’t stop the pain
Can’t think clearly
Can’t make decisions
Can’t see any way out
Can’t sleep, eat or work
Can’t get out of depression
Can’t make the sadness go away
Can’t see a future without pain
Can’t see themselves as worthwhile
Can’t get someone’s attention
Can’t seem to get control

If you experience these feelings, get help!

If someone you know exhibits these symptoms, offer help!

Contact:

A community mental health agency
A private therapist or counselor
A school counselor or psychologist
A family physician
A suicide prevention or crisis center

John Forbes Nash – “A Beautiful Mind” With Schizophrenia

John Forbes Nash is the fellow who was the subject of the book: A Beautiful Mind, which was also made into a movie.  His autobiography on the Nobel Prize website, http://nobelprize.org/nobel_prizes/economics/laureates/1994/nash-autobio.html, deals only briefly with his schizophrenia.  Although he deals in a matter of fact way about it, as a rational mathematician, economist and thinker, his fall into delusional thinking seems to be embarassing to him, which is sad and poignant.  As if it was of his choosing or fault.

John F. Nash Jr.

The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 1994

Autobiography

My beginning as a legally recognized individual occurred on June 13, 1928 in Bluefield, West Virginia, in the Bluefield Sanitarium, a hospital that no longer exists. Of course I can’t consciously remember anything from the first two or three years of my life after birth. (And, also, one suspects, psychologically, that the earliest memories have become “memories of memories” and are comparable to traditional folk tales passed on by tellers and listeners from generation to generation.) But facts are available when direct memory fails for many circumstances.

My father, for whom I was named, was an electrical engineer and had come to Bluefield to work for the electrical utility company there which was and is the Appalachian Electric Power Company. He was a veteran of WW1 and had served in France as a lieutenant in the supply services and consequently had not been in actual front lines combat in the war. He was originally from Texas and had obtained his B.S. degree in electrical engineering from Texas Agricultural and Mechanical (Texas A. and M.).

My mother, originally Margaret Virginia Martin, but called Virginia, was herself also born in Bluefield. She had studied at West Virginia University and was a school teacher before her marriage, teaching English and sometimes Latin. But my mother’s later life was considerably affected by a partial loss of hearing resulting from a scarlet fever infection that came at the time when she was a student at WVU.

Her parents had come as a couple to Bluefield from their original homes in western North Carolina. Her father, Dr. James Everett Martin, had prepared as a physician at the University of Maryland in Baltimore and came to Bluefield, which was then expanding rapidly in population, to start up his practice. But in his later years Dr. Martin became more of a real estate investor and left actual medical practice. I never saw my grandfather because he had died before I was born but I have good memories of my grandmother and of how she could play the piano at the old house which was located rather centrally in Bluefield.

A sister, Martha, was born about two and a half years later than me on November 16, 1930.

I went to the standard schools in Bluefield but also to a kindergarten before starting in the elementary school level. And my parents provided an encyclopedia, Compton’s Pictured Encyclopedia, that I learned a lot from by reading it as a child. And also there were other books available from either our house or the house of the grandparents that were of educational value.

Bluefield, a small city in a comparatively remote geographical location in the Appalachians, was not a community of scholars or of high technology. It was a center of businessmen, lawyers, etc. that owed its existence to the railroad and the rich nearby coal fields of West Virginia and western Virginia. So, from the intellectual viewpoint, it offered the sort of challenge that one had to learn from the world’s knowledge rather than from the knowledge of the immediate community.

By the time I was a student in high school I was reading the classic “Men of Mathematics” by E.T. Bell and I remember succeeding in proving the classic Fermat theorem about an integer multiplied by itself p times where p is a prime.

I also did electrical and chemistry experiments at that time. At first, when asked in school to prepare an essay about my career, I prepared one about a career as an electrical engineer like my father. Later, when I actually entered Carnegie Tech. in Pittsburgh I entered as a student with the major of chemical engineering.

Regarding the circumstances of my studies at Carnegie (now Carnegie Mellon U.), I was lucky to be there on a full scholarship, called the George Westinghouse Scholarship. But after one semester as a chem. eng. student I reacted negatively to the regimentation of courses such as mechanical drawing and shifted to chemistry instead. But again, after continuing in chemistry for a while I encountered difficulties with quantitative analysis where it was not a matter of how well one could think and understand or learn facts but of how well one could handle a pipette and perform a titration in the laboratory. Also the mathematics faculty were encouraging me to shift into mathematics as my major and explaining to me that it was not almost impossible to make a good career in America as a mathematician. So I shifted again and became officially a student of mathematics. And in the end I had learned and progressed so much in mathematics that they gave me an M. S. in addition to my B. S. when I graduated.

I should mention that during my last year in the Bluefield schools that my parents had arranged for me to take supplementary math. courses at Bluefield College, which was then a 2-year institution operated by Southern Baptists. I didn’t get official advanced standing at Carnegie because of my extra studies but I had advanced knowledge and ability and didn’t need to learn much from the first math. courses at Carnegie.

When I graduated I remember that I had been offered fellowships to enter as a graduate student at either Harvard or Princeton. But the Princeton fellowship was somewhat more generous since I had not actually won the Putnam competition and also Princeton seemed more interested in getting me to come there. Prof. A.W. Tucker wrote a letter to me encouraging me to come to Princeton and from the family point of view it seemed attractive that geographically Princeton was much nearer to Bluefield. Thus Princeton became the choice for my graduate study location.

But while I was still at Carnegie I took one elective course in “International Economics” and as a result of that exposure to economic ideas and problems, arrived at the idea that led to the paper “The Bargaining Problem” which was later published in Econometrical. And it was this idea which in turn, when I was a graduate student at Princeton, led to my interest in the game theory studies there which had been stimulated by the work of von Neumann and Morgenstern.

As a graduate student I studied mathematics fairly broadly and I was fortunate enough, besides developing the idea which led to “Non-Cooperative Games”, also to make a nice discovery relating to manifolds and real algebraic varieties. So I was prepared actually for the possibility that the game theory work would not be regarded as acceptable as a thesis in the mathematics department and then that I could realize the objective of a Ph.D. thesis with the other results.

But in the event the game theory ideas, which deviated somewhat from the “line” (as if of “political party lines”) of von Neumann and Morgenstern’s book, were accepted as a thesis for a mathematics Ph.D. and it was later, while I was an instructor at M.I.T., that I wrote up Real Algebraic Manifolds and sent it in for publication.

I went to M.I.T. in the summer of 1951 as a “C.L.E. Moore Instructor”. I had been an instructor at Princeton for one year after obtaining my degree in 1950. It seemed desirable more for personal and social reasons than academic ones to accept the higher-paying instructorship at M.I.T.

I was on the mathematics faculty at M.I.T. from 1951 through until I resigned in the spring of 1959. During academic 1956 – 1957 I had an Alfred P. Sloan grant and chose to spend the year as a (temporary) member of the Institute for Advanced Study in Princeton.

During this period of time I managed to solve a classical unsolved problem relating to differential geometry which was also of some interest in relation to the geometric questions arising in general relativity. This was the problem to prove the isometric embeddability of abstract Riemannian manifolds in flat (or “Euclidean”) spaces. But this problem, although classical, was not much talked about as an outstanding problem. It was not like, for example, the 4-color conjecture.

So as it happened, as soon as I heard in conversation at M.I.T. about the question of the embeddability being open I began to study it. The first break led to a curious result about the embeddability being realizable in surprisingly low-dimensional ambient spaces provided that one would accept that the embedding would have only limited smoothness. And later, with “heavy analysis”, the problem was solved in terms of embeddings with a more proper degree of smoothness.

While I was on my “Sloan sabbatical” at the IAS in Princeton I studied another problem involving partial differential equations which I had learned of as a problem that was unsolved beyond the case of 2 dimensions. Here, although I did succeed in solving the problem, I ran into some bad luck since, without my being sufficiently informed on what other people were doing in the area, it happened that I was working in parallel with Ennio de Giorgi of Pisa, Italy. And de Giorgi was first actually to achieve the ascent of the summit (of the figuratively described problem) at least for the particularly interesting case of “elliptic equations”.

It seems conceivable that if either de Giorgi or Nash had failed in the attack on this problem (of a priori estimates of Holder continuity) then that the lone climber reaching the peak would have been recognized with mathematics’ Fields medal (which has traditionally been restricted to persons less than 40 years old).

Now I must arrive at the time of my change from scientific rationality of thinking into the delusional thinking characteristic of persons who are psychiatrically diagnosed as “schizophrenic” or “paranoid schizophrenic”. But I will not really attempt to describe this long period of time but rather avoid embarrassment by simply omitting to give the details of truly personal type.

While I was on the academic sabbatical of 1956-1957 I also entered into marriage. Alicia had graduated as a physics major from M.I.T. where we had met and she had a job in the New York City area in 1956-1957. She had been born in El Salvador but came at an early age to the U.S. and she and her parents had long been U.S. citizens, her father being an M. D. and ultimately employed at a hospital operated by the federal government in Maryland.

The mental disturbances originated in the early months of 1959 at a time when Alicia happened to be pregnant. And as a consequence I resigned my position as a faculty member at M.I.T. and, ultimately, after spending 50 days under “observation” at the McLean Hospital, travelled to Europe and attempted to gain status there as a refugee.

I later spent times of the order of five to eight months in hospitals in New Jersey, always on an involuntary basis and always attempting a legal argument for release.

And it did happen that when I had been long enough hospitalized that I would finally renounce my delusional hypotheses and revert to thinking of myself as a human of more conventional circumstances and return to mathematical research. In these interludes of, as it were, enforced rationality, I did succeed in doing some respectable mathematical research. Thus there came about the research for “Le Probleme de Cauchy pour les E’quations Differentielles d’un Fluide Generale”; the idea that Prof. Hironaka called “the Nash blowing-up transformation”; and those of “Arc Structure of Singularities” and “Analyticity of Solutions of Implicit Function Problems with Analytic Data”.

But after my return to the dream-like delusional hypotheses in the later 60′s I became a person of delusionally influenced thinking but of relatively moderate behavior and thus tended to avoid hospitalization and the direct attention of psychiatrists.

Thus further time passed. Then gradually I began to intellectually reject some of the delusionally influenced lines of thinking which had been characteristic of my orientation. This began, most recognizably, with the rejection of politically-oriented thinking as essentially a hopeless waste of intellectual effort.

So at the present time I seem to be thinking rationally again in the style that is characteristic of scientists. However this is not entirely a matter of joy as if someone returned from physical disability to good physical health. One aspect of this is that rationality of thought imposes a limit on a person’s concept of his relation to the cosmos. For example, a non-Zoroastrian could think of Zarathustra as simply a madman who led millions of naive followers to adopt a cult of ritual fire worship. But without his “madness” Zarathustra would necessarily have been only another of the millions or billions of human individuals who have lived and then been forgotten.

Statistically, it would seem improbable that any mathematician or scientist, at the age of 66, would be able through continued research efforts, to add much to his or her previous achievements. However I am still making the effort and it is conceivable that with the gap period of about 25 years of partially deluded thinking providing a sort of vacation my situation may be atypical. Thus I have hopes of being able to achieve something of value through my current studies or with any new ideas that come in the future.

From Les Prix Nobel. The Nobel Prizes 1994, Editor Tore Frängsmyr, [Nobel Foundation], Stockholm, 1995

This autobiography/biography was written at the time of the award and later published in the book series Les Prix Nobel/Nobel Lectures. The information is sometimes updated with an addendum submitted by the Laureate. To cite this document, always state the source as shown above.

 

Aging and Mental Health

This article from the “Your Mental Health” section of the Canadian Mental Health Association website, http://www.cmha.ca/bins/content_page.asp?cid=2-74&lang=1, discusses normal changes that occur as you age and how to deal with them:

Growing older is an experience we all share and many of us worry about. As we age, we face many changes and many sources of stress -we are not as strong as we used to be, illness is more of a problem, children move away from home, people we love die, we may become lonely, and eventually we must give up our jobs and retire. Coping with all these changes is difficult, but it can be done. The keys to coping include your long-term lifestyle, your ability to expect and plan for change, the strength of your relationships with surviving family and friends, and your willingness to stay interested in and involved with life.

It is, therefore, very important to think carefully about what will happen to you as you age and how you are going to deal with the changes that will happen.

Dealing with physical changes

As you grow older, your body will naturally change. You may tire more easily than you used to. You may become ill more often. You may not see or hear as well as you did when you were younger.

Here are some things you can do to cope with these physical changes:

• Accept reality. Denying these changes will only make life less enjoyable for you and the people around you. Get the things that will help you – eyeglasses or hearing aids for example.
• Keep a positive attitude. Remember that slowing down does not mean you have to come to a complete stop. Chances are you will still be able to do almost all the things you used to; you may just need to take a little more time and learn to pace yourself.
• See your family doctor regularly. He/she can, then, deal with any changes or symptoms that require medical attention.
• Be careful about your medications. As you get older, they may begin to interact differently with other drugs and to affect you differently than before. Make sure your doctor knows about all your medications, even those prescribed by another doctor.
• Take responsibility for your own health. Do not hesitate to ask your doctor questions; some do not offer explanations unless asked.
• Change your eating habits. Adopt a balanced diet with fewer fatty foods, and try not to over-eat.
• Drink less alcohol. Your body will have more difficulty coping with it as you grow older.

Dealing with bereavement

As you get older, you will likely experience the loss of loved ones more often. It is important to remember the following ways of coping with your grief:

• Do not deny your feelings. Losing someone to death is like being wounded, and you need to heal. If you do not allow yourself to go through the grieving process, you are only storing up problems for a delayed reaction later on.
• Accept the range of emotions you will feel. Tears, anger and guilt are all normal reactions.
• Remember and talk about the deceased person. He/she was an important part of your life. Although your grief will pass, your memories will always stay with you.
• Look to your family and friends for support. They can help you through the grieving period and help you establish a new life afterwards.
• Be supportive of those you know who have suffered a loss. They need the warmth and caring that friendship can bring, just as you will when it happens to you.

Dealing with loneliness

Everyone needs some time alone, but being alone against your will is very painful. You risk losing your sense of purpose and self-worth, and becoming depressed. As family members and friends die and children become more involved in their own lives, it is important for you to find ways to cope with loneliness. You may want to consider some of the following suggestions:

• Stay active, and look for new social contacts. Most communities have a number of programs which can help replace the support that used to be provided by family and life-long friends. These programs provide older people with the chance to try new activities and make new friends.
• Very young children can brighten up your life. Try to make friends with people of different ages. You may be pleasantly surprised to find how much you have in common with someone 15 or 20 years younger than you.
• Spend time with grandchildren and great-nieces and nephews. Volunteer to help part-time in a local school or day-care centre. Very young children can brighten up your life with their enthusiasm and energy.
• Learn to recognize and deal with the signs of depression. Loss of appetite and weight, inability to sleep, loss of energy and motivation, and thoughts of suicide are all signs of depression. Your family doctor can refer you to a mental health professional for treatment.

Dealing with retirement

Your retirement can be a major source of stress because your job is usually a very important part of your life. This stress may be even greater if you have been forced to retire because of your employer’s retirement policies. You may lose your sense of identity and feel less worthwhile. You will probably miss the daily contact with friends from work.

However, retirement can be one of the best times of your life, and there are things you can do to meet the challenges facing you, such as:

• Make a list of your abilities and skills. The skills and experience you have gamed from a lifetime of work may help you succeed in a small business or do valuable volunteer work for a favourite charity.
• Enrich your life by renewing contacts with neglected family members and old friends. All too often, our work gets in the way of our relationships and those we care about.
• Renew your interest in the hobbies and activities you enjoy. You now have time to play – enjoy!
• If you can afford it, travel. There are probably places you have wanted to see all your life. The early years of your retirement can be the ideal time to become a nomad for a while.

Do you need more information?

If you or someone you know is concerned about growing older, check your local library or bookstores for some helpful books that can give you more information. There are also professional counsellors who specialize in the problems of aging. If you need more information about resources in your area, contact a community organization, such as the Canadian Mental Health Association, which can help you find additional support.

Seasonal Affective Disorder

From the Tuesday, November 13, 2007, Toronto Star, Living & Entertainment section, front page, an article Seasonal Affective Disorder (SAD) by Conrad McCallumo, Special to the Star:

Tale of Sad-Ness

Sometimes called “winter blues,” seasonal affective disorder is a mild depression believed to be triggered by reduced hours of daylight in late autumn.

• Two to 6 per cent of Canadians suffer from SAD.
• Women are eight times more likely to suffer from SAD. Average age of onset is 23 years old.
• Thirty minutes of light exposure (with 10,000-lux light-therapy box; sunlight measures at 32,000 lux), can lift mood and energy.
• Most patients respond to light therapy within two to four days.
• Treating SAD with fluorescent light boxes is effective in approximately 65 per cent of cases.
• Seasonal affective disorder was first noted in 1845.

Sources: Mood Disorders Society of Canada, Canadian Medical Association, Canadian Mental Health Association; compiled by Astrid Lange / Toronto Star Library