The fault’s not in the stars, but the brain chemistry

Born in 1957, he had no point of reference other than the “feedback” of his own culture. I say “feedback.” It’s more accurate to say collective prejudice.

He always ran anxious. Yes, there were times of ease, joy, flow and peace of mind. But, even in those times, just beneath the surface was his ever-present companion, anxiety.

Uncomfortable and even painful emotional surges, making it hard to objectify that which was objective. That is, not personal.

He was generally an affable, gregarious, fun-loving kid who made friends easily. Did well in school and extracurricular interests. People most often experienced him as uberconfident to the point of cocky. Devil-may-care. A personality often “bigger than life.” In cycles, regularly over the top.

These traits made him often popular. He was funny, warm, and could energize gatherings of peers with creative wit and playfulness. But those same traits made some folks tired. In some cases suspicious or put off. He could energize and inspire, but he could also suck the life out of a room with behavior that seemed to clamor for center stage.

Anything and everything could be too easily personalized. This made him often moody, which became just another way to burden and oppress those who loved him.

Privately, his view of himself was anything but confident. He felt painfully self-conscious. Too dramatic. Phony. Embarrassed by his helplessness to stop biting his fingernails and other fidgety habits. Into adulthood he swallowed — hook, line and sinker — the Freudian worldview that his personality was the consequence of the travails of childhood. At 33, he threw himself into depth psychotherapy. Three years and three months later, much was accomplished.

But he was still anxious. He saw this as either something weak and broken with himself, or some incurable psychic wound that would always make him weak and broken.

All told, he did the best he could with it, forging a good life despite his inner struggles.

At 57, he met a new colleague, a psychiatric nurse who had undertaken his life’s work in the study of the human brain. A new science had emerged. The nurse was deploying a simple test with patients, wherein a saliva swab was sent to a lab, returning a genetic level report about the brain. What was happening in that brain? What was not happening?

This new test radically cut down on the guesswork of prescribing medication. Where before a physician often had to try this drug or that drug over frustrating weeks and even months of trial and error before finding the right medication, now it was easier to pinpoint from the beginning what a patient likely needed. What type of medicine that particular brain needed, and what drugs would be less helpful.

On a complete whim, mostly driven by academic curiosity, the anxious man donated himself to this new test. He stuck a sponge into his mouth and sent his saliva to the lab.

The psychiatric nurse sat with him, holding the report, which said that the man’s brain underproduced an enzyme required to turn folic acid into serotonin. That, in the luck of the draw, this man’s brain was likely born this way, no different from the way a diabetic’s pancreas is born underproducing insulin.

The man is stunned. Seriously? This chronic, anxious moodiness driving all these troubling thoughts, feelings and behaviors has never been about moral weakness, unmanliness, or even having much to do with the travails of childhood?

All this time, I’ve just had an unhappy brain, doing its best to compensate for a lack of serotonin?

The man begins to take a low dose of serotonin, coupled with a prescription for the lacking enzyme. The latter is actually a food supplement but requires a prescription.

Six months later, the man could kiss the sky with gratitude. He moves more easily within himself. People who love him notice the ease and like it. He doesn’t even “feel” the medication. He merely notices that he is less often wrought. The lightness of his personality is more available as is his bent toward happiness.

Good Reader, the man in this story is me. See, even I, having given myself to the field of mental health, was not without vulnerability to society’s stigma about psychological symptoms. When we run a fever or bleed, we visit the doctor. But when we struggle with mental health, we decide we are some combination of weak or broken or bad.

When, all the time, the brunt of what’s going on might just be an unhappy brain.

Steven Kalas is a behavioral health consultant and counselor at Las Vegas Psychiatry and the author of “Human Matters: Wise and Witty Counsel on Relationships, Parenting, Grief and Doing the Right Thing” (Stephens Press). His columns appear on Sundays. Contact him at 702-227-4165 or skalas@reviewjournal.com.