Going Gluten-Free

Over the summer, a friend of mine recommended that I read the book "Wheat Belly" by William Davis MD. I lean towards skepticism when presented with literature that suggests dietary change, especially given the American penchant for obsessions with fad-diets and obsessive attention to eating that leans upon a lot of unfounded research and media fueled paranoia regarding weight and appearance. The book was a gift so I figured that nothing bad could come of it, perhaps a few wasted hours but nothing more. I was determined to tear it apart; a need to criticize scientific research seems to have been drilled into me throughout my college career. I received the book, and over the course of a week or two I finally got through it. The writing was clearly not targeted at the scientific community and a lot of it sounded cheesy and tacky. After reading it, I decided to experiment with eliminating gluten from my diet; I admit I was seduced by the potential for reducing the intensity of my depressive episodes and feeling better about my body. The challenge appealed to me, so I set out with the idea that removing gluten from my life would be a difficult, but temporary challenge.

I started over the summer by seeing if I could go an entire day gluten free. My family's dynamic is such that a random drastic dietary change would not go over very well, so I decided to play it safe. I felt hungry, grouchy, starved and peeved afterwards. My only solace was that I could eat as much fruit as I want, but I was left out of much of the family meals and snacking events. I realized how hard becoming gluten free would be, especially at school where the meal plan is included in tuition so impossible to opt out of if you live on campus. My job wouldn't supply me with enough money to support myself independently from the meal plan. Despite the initial terror of realizing that I may be in over my head, I decided to proceed as I originally intended.

My first week on campus was a week before all other students arrived; dining halls were opening and serving far better food than they do usually so there wasn't too much of a struggle to find food to eat. The first week and a half felt like a detox. I was perpetually hungry, I wanted to buy out Dunkin' Donuts and wallow in pounds and pounds of wheat products. My determination to control my cravings and my sheer sense of will power prevented me from caving and I managed to make it through the first few weeks with no purposeful infractions and perhaps one accidental wheat ingestion. The list of things a gluten-free diet precludes is extensive and something I imagine most college students would find impossible. You must say no to: (most) Chinese food, soy sauce, pizza, ramen, bread, cakes, cookies, crackers, cereals, hot dogs, many salad dressings, granola, (some) ice cream, home fried potatoes and many other foods.

At the beginning of the semester, around three weeks after eliminating gluten from my diet I found that I never experienced bloating after eating or the feeling of hating myself after eating a huge meal. I didn't feel cravings for different foods as much as I did before. If I ate enough at each meal I lacked the sense of perpetual hunger I previously had. More likely a sign that I was recovering from depression than a dietary change, I found myself better able to be motivated to do things and was less overtired for no particular reason. (Now my over tiredness is a result of an odd sleeping schedule and perpetually being woken up by my roommate in the middle of the night.) I spent money on some gluten free snacks to stave off the perpetual hunger I felt during the first week or two of changing my diet. I bought yogurt, cheese, gluten free ginger snaps, gluten-free Ben and Jerry's ice-cream, and strawberries to keep in my fridge (which is actually only mine for the semester). I found the changes in how I felt to be compelling enough for me to continue being gluten-free. I'd gotten used to most of the challenges and I felt like I could keep it up as long as I felt like it.

This was a good idea, but the dining halls seemed to have other plans for me. If serving "nutritional yeast sauce" wasn't bad enough all other foods served were contaminated with gluten most nights except for plain white rice. As much as rice stripped of all nutritional value holds great appeal to me, I quickly found myself frustrated with my "rice, beans and carrots" meals or "spinach, tomatoes and italian dressing" meals. I had occasionally given myself one or two "off days" and eaten foods with small amounts of gluten in them and I figured that everything would be okay if I simply stopped being gluten free and went back to continuous wheat consumption. I ate a huge sandwich at a local café filled with all kinds of yummy wheat-y ingredients convinced that I was done for good. It was just too difficult to find a consistent source of gluten-free food and I was spending what I felt was too much money on other foods.

That night and all of the next day, I knew the sandwich was a mistake. I felt ill all night and my stomach felt like I had been poisoned. I lay in my bed feeling the light tinge of a headache coming on, put my stomach pain out of my head and fell asleep. All of the next day I felt perpetually nauseous. I felt sick to the point of vomiting and couldn't focus or eat the next day. I tried sipping water and slowly drinking soup thinking my problem was related to stress or dehydration. I hadn't slept much the night before and got a migraine around halfway through the day that knocked me off my feet until the day after. Due to that experience, I don't think I will ever return again to eating foods with wheat in them 100% of the time. If I'm  a guest or in a desperate situation, I'm sure I will have no choice, but I honestly feel as if there is something incompatible with human digestion in modern wheat. I am not the type to hop onto fad diets, to claim that coffee causes cancer one week and prevents heart disease the next. I am a skeptic, a critic, broke and hungry, yet in my experience I can't deny the positive effects I've seen after removing gluten from my life. I can't deny that every time I've slipped up I have become at the very least moderately ill. I'm not trying to change people's minds or convert them into giving up every delicious food on the planet, merely sharing my experience with becoming gluten free this semester.

24.

So recently I've found that I haven't written in a while and it's not because my mind is void of thoughts, rather I am finding difficulty organizing many of these thoughts into something coherent. Feedback is something that I am willing to accept when it comes to my writing, but I want feedback to not be in the form of something that is a mistake I could have easily avoided.

Now I'm going to just use this space and this time before class to come up with a list of topics I think I'd be interested in writing in over the next few months. I don't think I'll be able to undertake a writing project as big as the one I undertook over the summer (that yielded vastly underwhelming feedback which I think was largely due to the controversial nature of critiquing religion). No matter what, I'd like to get my brain thinking like a writer a little bit more than I currently do. I have been thinking a lot like a scientist and although this is valuable, sometimes it's helpful to expand the ways in which I collect and organize my thoughts.

1. Negotiating the emotional aspects of long distance relationships
2. The Significance of "Brotherhood" - Expectations v. Reality
3. Self-care techniques for College Students (who don't have money)
4. Summary of Gluten-Free Adventures During the Fall
5. "Serious" Relationships
6. Positive Female Friendships 

Thoughts on Sex

Why are some people so obsessed with changing who they are because of sex? People feel the need to pretend that they are either okay with casual sex because they feel the need to fit in with college hook up culture or they feel the need to act like all sex is life changing because they worry about being judged by the people around them. It's hard to imagine a world where all my female friends and acquaintances are honest about their sexual selves. 

Something as simple as emotional honesty is totally ignored by most young people pursuing sexual relationships for the first time. Too much importance is attached to "virginity" and it's presence or absence when in reality the most important part of any sexual relationship is honesty. Many men are concerned that having sex with a virgin will make her attached to them to a point that they are not ready for. While this may be true for some women, it isn't true for all and virginity has nothing to do with levels of attachment after a sexual encounter. Many women are not honest with themselves about what they want from a "relationship" and this creates problems for them in the future. 

You cannot fuck a guy into loving you, you cannot fuck your emotional problems away and relationships are not a cure to your psychological ills. How can I pound this into the heads of the people I'm surrounded by?

I hate when people look to me and my relationship as an example of a "perfect" situation where someone you start off just sleeping with turns into a relationship. It's such an incomplete picture of what happened between Andrew and me. It's an attempt to turn an exception and a strange occurrence into a standardized experience in an effort to make this chance event something that could happen to anyone and likely will. 

How do I advise people without inserting my own experiences into my advice? This is difficult for me because many people I interact with tend not to comprehend the extent to which I am honest with myself and with others. It's not something "comfortable" or "easy" but it's necessary. Recently, I've been trying to just stay away from giving other's sexual advice. It seems to overwhelm many people when I suggest that you can be interested in both casual sex and emotional sex and having one type of sex doesn't mean you are giving up on the other for life. 

Endocrinology Paper

Something I wrote for a biology class I took last semester, Endocrinology. It's long and has a lot of jargon but I hope at least someone reads it.

Eriche S------

Endocrinology – Spritzer

Spring 2013

Neural-Diathesis Stress Model and Applications to Schizophrenia Vulnerability, Onset, Progression, and Treatment

Schizophrenia has piqued the interest of researchers for years. Recently, discovering more information about the mechanisms that cause schizophrenia as well as finding effective treatments has moved to the forefront of neuroscience research. Schizophrenia has been linked to an excess of dopamine or oversensitivity of dopamine receptors that result in positive symptoms of the disease (Birtwistle, 1998). Antipsychotics that reduce the effects of dopamine have effects on positive schizophrenia symptoms, demonstrating a correlation between schizophrenia symptoms and dopamine activation. In recent research, another axis is being explored, where cortisol release in conjunction with dopamine is highly correlated to schizophrenia onset. The neural-diathesis stress model combines the effects of stress and dopamine on schizophrenia onset, progression and treatment, and provides a more complete picture of the neuronal pathways involved, opening up avenues for more effective treatments.

Cortisol may increase susceptibility to schizophrenia acting via the hypothalamo-pituitary axis (HPA) (Walker, 1997). Anti-psychotics decreasing HPA activation demonstrate the possibility that the HPA axis and dopamine are connected in schizophrenia’s positive symptoms. HPA activation increases transmission of dopamine as well as releasing cortisol. This suggests a link between stress response and dopamine release. A dopaminergic response to stress provides evidence for a connection between dopamine and cortisol, suggesting that they do not act independently on schizophrenia’s onset and positive symptoms (Mizrahi, 2012). Stress also increases a schizophrenic patient’s susceptibility to psychotic experiences, which further suggests an interaction between stressors and a biological response.

The biological connection between stress response and dopamine on schizophrenia’s positive symptoms is neurochemical sensitization of the mesolimbic system (Mizrahi, 2012). The mechanism through which cortisol and dopamine interact is through the prefrontal cortical D₁ dopamine receptors and their regulation of D₂ dopamine receptors, connected to cortisol release. The secondary effects on D₂ are the effects that may stimulate positive schizophrenia symptomology (Scornaiencki, 2009). Scornaiencki (2009) used Sprague Dawley rats injected with D­₁ or D₂ dopamine receptor agonists forced to perform stressful swim tests in order to measure the interactions between stress and dopamine. Dopamine reactivity was greatly increased in rats after the stressful swim tests. Since D₁ receptor agonists decreased dopamine reactivity significantly in injected rats but D₂receptor agonists did not have the same effects. D₁ receptors in the prefrontal cortex regulated D₂ stress response, this pathway may be the one that is affected in schizophrenia patients and is one probable connection between the HPA and dopamine release.

Other researchers used different methodology to determine a connection between dopamine and stress response. Dexamethasone suppression tests were used to measure HPA activity in patients with schizophrenia (Hori, 2012). In this study, levels of cortisol after dexamethasone treatment were measured in controls and schizophrenic patients. Cortisol/DHEAS ratios demonstrated abnormal HPA axis function. Compared to healthy patients, schizophrenia patients showed higher cortisol levels after treatment with dexamethasone, which should have suppressed cortisol due to negative feedback. Patients were simultaneously undergoing anti-psychotic treatment, which may have confounded results, however increased cortisol activation was clear in patients with schizophrenia.

The neurological development of the prefrontal cortex is another viable connection between the HPA axis and dopamine on schizophrenia. Schizophrenia’s symptoms have often been related to prefrontal cortex dysfunction in the dopamine hypothesis as well as the neural-diathesis stress model. Dysfunction of the prefrontal cortex causes cognitive deficits, thought disorders, hallucinations and delusions in patients (Arnsten, 2011). Within the pre-frontal cortex, cell network connections are marked and altered via dynamic network connectivity. Networks between neurons are strengthened by cAMP-HCN inhibition and formed by D₁-cAMP-HCN channel weakening.

Exposure to chronic stress causes degradation of cAMP-HCN, collapsing the networks ability to fire signals appropriately (Arnsten, 2011). Chronic stress results in cortisol release as well as an increase in PKC signaling due to degradation of prefrontal cortex neuronal networks. In schizophrenia, patients have shown a lack of molecules that would normally reverse stress response as well as strengthen prefrontal cortex activity, suggesting that developing and strengthening these neuronal pathways is important. Exposure to stress ceases regulation of prefrontal cortex pathways that contain vulnerable circuitry; this is linked to the initial descent into illness – the first psychotic episode. Alterations in prefrontal cortex pathways show definitive links to positive schizophrenia symptomology.

Prefrontal cortex damage as a result of prenatal stress increases risk of schizophrenia development later in life; this model of prefrontal cortex damage integrates the HPA and dopaminergic systems as well (Martinez-Tellez, 2009). During the formation of the prefrontal cortex networks described above, some alterations take place that may directly impact the likelihood of patients developing schizophrenia. This could be important in development of prevention methods; decreasing prenatal stress levels may be easier than treating the disease directly. Inadequate stimulation of D₁ receptors that results in bad prefrontal cortex connections and loose associations between neurons is one effect of stress on prenatal prefrontal cortex damage. There is also the problem of too much D₁ stimulation which suppresses neuronal firing under mild stress conditions which increases dopamine release due to malfunctioning negative feedback loops (Arnsten, 2011).

This prenatal stress is often times due to bacterial infection; other researchers have used rat models to outline when this occurs prenatally and the role this may play in schizophrenia risk (Lin, 2012). Using lipopolysaccharide exposure, Lin (2012), examined the role of maternal bacterial infections on fetal brain development. Mothers who experienced bacterial infections produced offspring with reduced dopamine in the hippocampus and prefrontal cortex. There was a critical period for when prenatal stress would begin to have an effect on neuronal development. Martinez-Tellez (2009) determined that this critical period was around the middle of pregnancies. Infection and other prenatal stressors cause impairments in the HPA axis as well as in hippocampal dendrite morphology. These prenatal changes were shown to have post-natal effects in rat pups that were seen to have increased stress responses (Lin, 2012).  Given the link between stress and disease onset in humans, results from this study are applicable to human models.

Early exposures to stressors post-natally have also been connected to schizophrenia onset later in life. Benes (2004) suggests that mistakes in dopamine inputs to GABA pathways pre and post-natally may be responsible for schizophrenia onset in vulnerable patients. If pre-natally exposed to stressors, there are a number of post-natal factors that increase risk of schizophrenia development. Environmental triggers such as poverty, social marginalization and immigrant status have been stressors linked to increased risk in schizophrenia onset (Jones, 2006). Predispositions to schizophrenia are not the sole cause; cortisol release as a result of exposure to various environmental stressors must happen in conjunction with this predisposition (Benes, 2004). In the Benes (2004) study, rats injected with cortisol post-natally were also examined for dopaminergic responses. These rats possessed greater clusters of dopamine cells, signifying the connection between dopamine and stress within schizophrenia onset, as it relates to early stress.

One of the most highly correlated early traumas linked to schizophrenia is child abuse. A large percentage of schizophrenia patients have been abused throughout early childhood. At risk schizophrenia adolescents – who show schizotypal behaviors or schizotypal personality disorders - have higher baseline salivary cortisol levels than controls (Stilo, 2011). Consistently showing these higher cortisol levels is partially attributed to aging, but may also be attributed to early childhood trauma, described within the traumagenic neurodevelopmental model of schizophrenia (Read, 2001). Within this model, biological, psychological and social factors are combined to find more answers regarding schizophrenia onset. High levels of cortisol acting with dopamine may increase risk of disease onset, but the stressors of early childhood are very highly correlated to this excessive cortisol in the first place.

In adoption studies meant to assess the effects of child abuse on schizophrenia development, at risk children who lived with “healthy” adoptive families were compared to at risk children who lived with more abusive adoptive families. 3% of the children with health families developed schizophrenia, while 34% of at-risk patients raised by the abusive families developed schizophrenia later on (Read, 2011). Child abuse causes sensitization of stress axes to stressors, leading to minor threats being perceived as terrors, something that has relevance to schizophrenia’s positive symptoms like paranoia. Stress responses developed in childhood are long lasting; early childhood stress sensitization as the result of abuse may likely lead to baseline cortisol levels being higher throughout puberty and post-puberty during the ages where psychotic episode risk increases.

Another connection between dopamine and stress in the neural-diathesis stress model lies in the age of onset. Schizophrenia’s age of onset is roughly 19 years old, more generally described as “late adolescence” (Gogtay, 2011). Brain processes involved in puberty may play a role in schizophrenia onset due to positive feedback systems triggered by stress, which leads to a rapid increase in positive symptoms’ appearance (Thompson, 2004). In schizophrenia patients who had experienced positive symptoms triggered by an adolescent stress response, there were a higher number of dopamine (D2) receptors. Psychosocial stress worsens positive symptoms and triggers relapse (Walker, 1997).

Adolescence is a time when people are exposed to a large variety of psychosocial stressors, especially in high-pressure school systems that demand a lot academically and socially; this relationship to disease onset is not improbable. Sensitivity to these psychosocial stressors as well as a pre-existing vulnerability may trigger these initial pathways and activate positive symptoms. Since dopaminergic response to stress has been higher in patients vulnerable to schizophrenia, increased psychosocial stressors in adolescence specifically may act to trigger initial positive symptomology. However, the connection between cortisol and dopamine is not only found in early onset of the disease; there is something more than the stresses of adolescence at play in the development of schizophrenia’s symptomology.

Environmental triggers of stress response and stress sensitization in adolescents are similar to ones experienced in children; abuse seems to be more highly correlated in children. Use of cannabis and psychostimulants have been connected to increasing risk of schizophrenia; this is likely via dopamine pathway stimulation (Di Forti, 2011). These drugs have been linked to first episodes of psychosis. Adolescence is typically a time when experimentation with these drugs may come about; in conjunction with higher cortisol levels, over-activity of the two pathways may occur leading to onset of first psychotic symptoms.

Urban residence and migration have also been highly correlated to schizophrenia onset likely because of the intensity of these two stressors. Urban settings may, somewhat counterintuitively, increase feelings of social isolation; threats to the social self are seen as forming the sort of stress response that increases the risk of schizophrenia development (Jones, 2007). Di Forti (2011) shows that in urban areas with the least amounts of social cohesion, schizophrenia rates are the highest. Migrant and ethnic minority groups may also experience higher amounts of stress leading to psychotic episodes as a result of poverty, racial discrimination, unemployment and isolation from family members. Migrant and ethnic minorities are also more likely to reside in urban areas. Environmental stressors that control the release of cortisol should be avoided in high risk patients, however, in some of the cases above like migration or urban residence, this is not a realistic option; exposure to stressors and schizophrenia risk are increased among these groups.

If early childhood abuse and prenatal stressors have such a large effect on schizophrenia onset, there must be an explanation for why the average age of onset is not much earlier than “late adolescence”. Although these early responses show strong correlations to schizophrenia onset, the trigger for most psychotic episodes is thought to lie in post-pubertal maturation of neuronal pathways (Stilo, 2011). In longitudinal studies of healthy controls, age increases were positively correlated to increases in cortisol levels. Schizotypal “at-risk” patients presented with significantly higher baseline cortisol levels than controls; higher baseline cortisol levels combined with a natural increase in cortisol with age increase likelihood of psychotic episodes. Childhood, adolescent and prenatal stressors in typical schizophrenia cases may not be enough to solely cause psychotic episodes. Neuromaturation triggering latent vulnerability may explain why cortisol levels have effects on expression of schizotypal symptomology when they do. Schizotypal symptoms typically appear in adolescence with full-blown psychotic episodes as a result of increases in HPA axis activation occurring towards the end of adolescent neuromaturational processes. Cortisol effects are not only found in disease onset, but also in disease progression.

Schizophrenic patients have higher baseline cortisol levels than controls before the onset of psychotic episodes (Jones, 2007). Treatments for schizophrenia that concurrently raise cortisol levels cause positive symptoms of schizophrenia to worsen. Throughout schizophrenia’s development, continued exposure to stressors plays a role in symptom’s worsening. Hippocampal damage has been found in cohorts of schizophrenia patients; this directly affects the HPA axis and release of cortisol, leading to excess cortisol production and increases of positive symptomology, not just at the onset of schizophrenia. Sensitivity to dopamine stress responses has implications in relapse or conversion to psychosis, showing that stress response is connected to schizophrenia throughout disease progression (Mizrahi, 2012).

Raison (2003) found that the HPA axis released less cortisol over time in stress-disorders that began with high levels of cortisol; this is not in contradiction with Jones (2007), rather demonstrates the likely progression of HPA axis and hypothalamic degradation in schizophrenic patients. Prolonged stress, from continuously high levels of cortisol may eventually damage the HPA structures responsible for producing cortisol, down-regulating cortisol in the long run by either stopping the production of upstream hormones like CRH and ACTH or by alterations in enzymes that metabolize glucocorticoids.

Brenner (2009) focused longitudinal research specifically on schizophrenic patients stress response. After first psychotic episodes, patients were found to have less reactive stress responses to psychosocial stressors, which supported the Raison (2003) finding. Stress and coping mechanisms correlate to schizophrenia patients’ quality of life; high quality of life is significant to management of positive symptoms (Brenner, 2009). Schizophrenics typically report lower quality of life than healthy controls. Use of less effective coping strategies may be connected to cortisol reactivity. Emotionally focused coping and the blunted cortisol response are maladaptive for schizophrenia patients. HPA dysregulation that causes a weaker cortisol response could lead to neurological changes that debilitate cognition and lead to misjudgment of coping technique effectiveness in patients with low cortisol responses to psychosocial stress. Drug treatments are often not enough for disease management; using the neural-diathesis stress model may provide new insight in how stress responses can be used to determine more effective coping strategies for patients and improve quality of life.

Typical drug treatments for schizophrenia are dopamine partial agonists (Miyamoto, 2005). Drugs that target dopaminergic systems frequently come with a host of side effects – researchers seek out different treatments that do not act upon dopaminergic pathways. Cortisol response in different drug treatments is an area of interest for drug developers as well as researchers who seek to better understand schizophrenia causation and progression. Ritsner (2005) looked at changes in cortisol / DHEA ratios in schizophrenic patients treated with different antipsychotic drugs of the same class like haloperidol, clothiapine and risperidone in conjunction with anti-Parkinson’s drugs to control for side effects that mimic Parkinson’s disease symptoms. Higher baseline cortisol/DHEA ratios predicted that a patient would be more likely to respond to treatment.

Other research has been done looking at only plasma cortisol levels as opposed to cortisol/DHEA ratios (Meltzer, 2000 and Cohrs, 2006). Cohrs (2006) sought to clarify antipsychotic effects on schizophrenics, but rather than looking at cortisol/DHEA ratios, he looked at the upstream glucocorticoid hormone, ACTH, as well as cortisol levels in schizophrenic patients being treated with olanzapine, quetiapine and haloperidol. Olanzapine and quetiapine are atypical antipsychotics that have been shown to reduce positive symptoms as well as negative symptoms. These drugs have also been effective in treating comorbid disorders like PTSD. This study tests the hypothesis, mentioned briefly earlier, that antipsychotics will act on cortisol levels. Atypical antipsychotics are more likely to show changes, since they have been connected to reducing symptoms of comorbid depression, which is characterized by over-activation of HPA axis. Olanzapine and quetiapine decreased plasma cortisol levels as well as ACTH levels from the baseline, whereas haloperidol did not have the same effect (Cohrs, 2006). These atypical antipsychotics act both on dopaminergic systems as well as cortisol, which may make them more effective treatments than current typical dopaminergic antipsychotics.

Meltzer (2000) looked at the antipsychotic drug apomorphine and it’s effects on plasma cortisol levels in treated schizophrenic patients; unlike the Cohrs study (2006) Meltzer (2000) also looked at the effects on psychopathology to ensure effectiveness of the drug and to possibly find a correlation between drug effectiveness and plasma cortisol levels. Plasma cortisol response was significantly blunted in schizophrenic patients as opposed to controls. Patients who had previously responded to other antipsychotics showed more reactive cortisol response to apomorphine. Ritsner (2005) showed that higher levels of baseline cortisol/DHEA ratios predicted drug responsiveness; this finding could be related to Meltzer’s (2000) findings in that responders did not have higher cortisol levels as a result of previous treatment, but their higher cortisol levels allowed them to be more responsive to drugs in the first place. Cortisol response to apomorphine may also predict whether or not a patient will respond to future antipsychotic drugs.

Studies of different clinical drugs are inconclusive regarding cortisol’s role in antipsychotic drug treatment. Cortisol levels seem to result in different coping mechanisms and responsiveness to treatments; cortisol levels also change based on different treatments regimens. A lack of conclusive evidence on cortisol’s role in schizophrenia treatment means more research needs to be done to fully understand how the neural-diathesis stress model can be employed in developing schizophrenia treatments. Baseline cortisol is a good predictor for coping methods outside of antipsychotic treatment (Brenner, 2011). Cortisol response as well as cortisol levels seem to be related to antipsychotic drug treatment, but this appears to be dependent on the drug and whether or not baseline cortisol levels or cortisol/DHEA ratios will allow a patient to respond to drugs.

The neural-diathesis stress model provides some conclusive results with regards to the connection between cortisol and dopaminergic pathways. The HPA axis that regulates cortisol production is directly connected to dopaminergic pathways. These two pathways interact in schizophrenia patients; this has been demonstrated by showing that common antipsychotic drugs dull the cortisol response in patients treated. Stress via cortisol response has effects on schizophrenia risk and onset at different stages of development. Increased pre-natal stress can increase schizophrenia risk, as well as early childhood traumas like abuse. In adolescence, the cortisol increases associated with post-pubescence increase the risk of a first psychotic episode. Decreased cortisol response reduces the ability to cope well with symptoms and have a higher quality of life. Decreased cortisol response is also linked to being a non-responder with many anti-psychotic drugs.

A link is clearly present between stress and schizophrenia; the link between dopamine pathways and stress response is in the neurological development of the prefrontal cortex as well as the neurochemical sensitization of the mesolimbic system. The prefrontal cortex connection between stress and dopamine is found within the dopamine receptors; D₁ receptors in the prefrontal cortex regulate the D₂stress response. A cortisol-dopamine connection is demonstrated through cAMP-HCN, which strengthens prefrontal cortex neuronal networks; these neuronal networks are formed through D₁-cAMP-HCN channel weakening. Chronic stress damages cAMP-HCN, which in turn damages neuronal networks.

Future research should focus on solidifying the connection between cortisol and dopaminergic pathways in order to find more definitive results about the connections between the two in schizophrenic patients. Longitudinal studies looking at cortisol levels periodically throughout a schizophrenic’s life – before the first psychotic episode –throughout disease progression may provide data on when exactly cortisol levels are blunted and why this may occur. Understanding the connections between dopamine and cortisol more thoroughly could provide better information for drug developers looking to improve antipsychotics that act solely on dopamine pathways. Currently, conflicting information about cortisol response either being blunted or heightened makes this difficult.  Although more complex, large scale longitudinal research would provide the best data with regards to cortisol levels and dopamine activity’s connection throughout the progression of the disease, beginning with patients who are at risk – patients with schizotypal personalities for example – and following up with research on patients who eventually develop schizophrenia. Perhaps then we can develop better treatments of schizophrenia that manage symptoms more effectively with fewer side effects.

References

1.    
Ritsner M, Gibel A, Maayan R, et al. Cortisol Dehydroepiandrosterone Ratio and Responses to Antipsychotic Treatment in Schizophrenia. Neuropsychopharmacology. 2005;30:1913-1922.   

2.     Brenner K, Liu A, Laplante DP, et al. Cortisol response to a psychosocial stressor in schizophrenia: Blunted, delayed, or normal? Psychoneuroendocrinology. 2009;34:859-868.   

3.     Brenner K, St-Hilaire A, Liu A, Laplante DP, King S. Cortisol response and coping style predict quality of life in schizophrenia. Schizophrenia Research. 2011;128:23-29.  

4.     Cohrs S, Röher C, Jordan W, et al. The atypical antipsychotics olanzapine and quetiapine, but not haloperidol, reduce ACTH and cortisol secretion in healthy subjects. Psychopharmacology. 2006;185:11-18.   

5.     Meltzer HY, Lee MA, Jayathilake K. The blunted plasma cortisol response to apomorphine and its relationship to treatment response in patients with schizophrenia. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2001;24:278.   

6.     Lin Y, Lin S, Wang S. Prenatal lipopolysaccharide exposure increases anxiety-like behaviors and enhances stress-induced corticosterone responses in adult rats. Brain, behavior, and immunity. 2012;26:459-468.  

7.     Martínez-Téllez RI, Hernández-Torres E, Gamboa C, Flores G. Prenatal stress alters spine density and dendritic length of nucleus accumbens and hippocampus neurons in rat offspring. Synapse (New York, N.Y.). 2009;63:794-804.  

8.     Simona A Stilo, Marta Di Forti, Robin M Murray. Environmental risk factors for schizophrenia: implications for prevention. Neuropsychiatry. 2011;1:457.   Link

9.     Read J, Perry BD, Moskowitz A, Connolly J. The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry. 2001;64:319-345.  

10.  Walker EF, Walder DJ, Reynolds F. Developmental changes in cortisol secretion in normal and at-risk youth. Development and psychopathology. 2001;13:721-732.  

11.  Birtwistle J, Baldwin D. Role of dopamine in schizophrenia and Parkinson's disease. Br J Nurs.1998;7:832–841.

12.  Jones SR, Fernyhough C. A new look at the neural diathesis--stress model of schizophrenia: the primacy of social-evaluative and uncontrollable situations. Schizophrenia bulletin. 2007;33:1171-1177.  

13.  Walker EF, Diforio D. Schizophrenia: A Neural Diathesis-Stress Model. Psychological Review. 1997;104:667-685.

14.  Mizrahi R, Wilson AA, Addington J, et al. Increased stress-induced dopamine release in psychosis. Biological psychiatry. 2012;71:561-567.  

15.  Hori H, Kunugi H, Teraishi T, et al. Schizotypal Personality in Healthy Adults Is Related to Blunted Cortisol Responses to the Combined Dexamethasone/ Corticotropin-Releasing Hormone Test. Neuropsychobiology. 2011;63:232-241. 

16.  Simona A Stilo, Marta Di Forti, Robin M Murray. Environmental risk factors for schizophrenia: implications for prevention. Neuropsychiatry. 2011;1:457.  

17.  Thompson JL, Pogue-Geile MF, Grace AA. Developmental Pathology, Dopamine, and Stress: A Model for the Age of Onset of Schizophrenia Symptoms. Schizophrenia Bulletin. 2004;30:875-900.   

18.  Walker EF, Diforio D, Baum K. Developmental neuropathology and the precursors of schizophrenia. Acta Psychiatrica Scandinavica. 1999;99:12-19.  

19.  Walker E, Kestler L, Bollini A, Hochman KM. Schizophrenia: etiology and course. Annual review of psychology. 2004;55:401-430.   

20.  Scornaiencki R, Cantrup R, Rushlow WJ, Rajakumar N. Prefrontal cortical D1 dopamine receptors modulate subcortical D2 dopamine receptor-mediated stress responsiveness. The international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP). 2009;12:1195-1208.   

21.  Gogtay N, Vyas NS, Testa R, Wood SJ, Pantelis C. Age of onset of schizophrenia: perspectives from structural neuroimaging studies. Schizophrenia bulletin. 2011;37:504-513.   

22.  Arnsten AFT. Prefrontal cortical network connections: key site of vulnerability in stress and schizophrenia. International Journal of Developmental Neuroscience. 2011;29:215-223.   

23.  Benes FM. The role of stress and dopamine-GABA interactions in the vulnerability for schizophrenia. Journal of Psychiatric Research. 1997;31:257-275.   

23.

I feel a lot of things today but I don't feel much like going into details until I have a conversation with my boyfriend. I am making plans to start my four week gluten-free life and I'm not sure if I should post about it here or make a side blog. I think I will feel better if I can just post some things on here and remember to post daily even if I have a lot to do. I go back to school to start work on the third and I'll begin chronicling my new dietary changes then.

22.

Unpopular Opinion after the jump.



People are so unwilling to critique their religious beliefs. They are willing to accept that you can critique without mocking, yet they refuse to do it. No one questions the church and everyone constantly makes excuses for it. They mirror the very complaints they have about whites, homophobes, etc. saying things like "Well not all Christians are like that" to shut down valid critiques and questions. Our communities have a sickness, which isn't Christianity but a widely permeating fear of questioning it. I don't want to question something so fallible that a mere critique and questioning of the harmful parts of it will cause my belief system to crumble. I'm not sure how others do it. Yet we are supposed to believe that it's not brainwashing, but teaching. I've been taught many things that I continue to question and adapt my beliefs about. If you are truly "taught" and not brainwashed, shouldn't you be able to do the same? 

Christianity & The Church Within St. Lucia

Religious institutions in St. Lucia are a powerful political force that transcends personal beliefs and community organization. Within St. Lucia, Christianity was implemented by colonizers for specific reasons. Is it believable that people who raped, destroyed and enslaved really cared that their slaves were saved by God? Is it plausible that Christianity was spread throughout the Caribbean to "save" the very people that colonizers were attempting to control and enslave? It seems unlikely that Christian missionaries were interested in spreading goodness and truth and more interested in creating a system of power that would force subservience among specific groups of people, stamping out their traditions and cultures, convincing them of their evil and making them more pliable for the intentions of slave masters and colonizers.

Regardless of the malicious intent of our colonizers, they were successful in their spread of religion throughout the Caribbean. Although most countries in the Caribbean are sovereign nations, colonial mindsets remain prevalent. In St. Lucia, religion is greater than a set of personal beliefs and individual's practices. Religious beliefs are used through religious institutions in exacting social control and maintaining power over underprivileged groups of people (including women and the poor). From birth to death, religion is a controlling force in every day life and through this control which can range from the seemingly harmless to the openly violent, societal problems are obscured. Large scale religious institution as a replacement for smaller scale, community based religious gathering hinders progress.

In St. Lucia, a child's relationship with religion begins from the time they are born*. Baptism is seen as a requirement regardless of the level of parental devotion to a particular faith and only two generations ago, parents were forced to choose Catholic names for their children. For example, when my grandmother was born, her parents wanted to call her Morella, but were forced to put "Catherine" on her birth certificate by priests. These early influences in religious indoctrination may seem innocuous. It is possible to argue that things like baptism and name changes are not legally enforced, but it would be ignorant to disregard the powerful effects of societal pressure in St. Lucia, where our culture considers adhering to a particular standard and tradition to be valuable. This early induction into a church (predominantly the Catholic church) serves as an initiation into a system that flourishes on the oppression of others and on exercising social control for the benefit of those who support abusive patriarchal values and wish to continue a destructive status quo.

For young children, schools are one of the primary locations where religious control is ensured. Regardless of your parents' faith, you will be exposed to Christianity in schools and be forced to comply. Exposure to Christianity is not an exposure to the Christian ethics of kindness and love but rather an exposure to a system that values dominance and violence if specific behaviors are not performed. School becomes a Skinner box where performance of  learned behavior is emphasized and punishment is frequent and violent. Educating students about religion and Christian ethics is not the reality of early Christian education. Children who have only recently learned to talk are forced to pray words that they do not understand the depth of; prayers become mindless while performance is the focus.

During prayer, the punishment for non-compliance is a beating. The difference between beating and spanking is important. A spanking is supposed to cause enough pain to be a deterrent whereas beatings are excessive. Within public schools, students are beat with 1-2 inch thick wooden sticks between a foot or a foot and a half long. Often times, these sticks are broken in half or splintered on the backs of disobedient students, from as young as five years old. We have not moved forward from the same punishments West Indian slave masters used to force compliance from their slaves.

This sort of punishment can be "earned" from either perceives or actual non-compliance during prayer; it doesn't necessarily have to be disruptive. Students who were not totally silent, didn't clasp their hands properly or didn't close their eyes were often subject to this punishment. Sometimes, entire classes of students were subject to beatings if more than one student did not comply. Teachers often cited the popular phrase "Peter pays for Paul"; it is not coincidence that Peter and Paul are important figures within Christianity. By using violence not just in all facets of producing obedience, but in religious obedience, an association whether conscious or not is founded between violence and religion (specifically disobedience from a religious tradition will result in a violent reaction).

Prayer occurs at least three times a day. The recitation of prayers and prostration before God is seen as one of the most valuable aspects of a child's development within our school systems. It is unfair to deny the value of spirituality, but the public education system leaves no room for children of other faiths. Although these people are in the minority, should they be forced to abandon the traditions of their parents and families? Who does this benefit? The only Muslim child who I went to school with in primary school was forced to participate in Christian prayers, likely facing violent punishment or at the very least humiliation if he did not comply. This student left the school after only a year.

The use of religion and violence to exert control is reminiscent of what Caribbean colonizers did to the slaves and Amerindians under their control. In children however, the damage in reinforced throughout generations; no one seeks to modify our attitude with regards to children and we keep rehashing the same catchphrases regarding the discipline of our children. A common one is "Spare the rod and spoil the child".

Violence is effective at producing obedient behavior. Throughout early childhood and even afterwards, fear is a motivating factor in religious behavior and may eventually influence powerful religious beliefs. Children and eventually adults grow to believe that straying from what is perceived as "righteousness" is understandably met with violence. How can this message be true to a faith that (theoretically) preaches kindness and love above all else? Fear is a tool of control, not one that promotes love or positive growth.

Early in childhood, the importance of religious performance is extended from school to family life. In Catholic families, first communions are expected to take place when a child is between six and ten years old. Pressure to confirm your faith follows soon after; many confirmations take place when a child is between eleven and fourteen years old. Once a child is between eight and ten years old and older gender separation under the guise of "religious" ethics and proper behavior begins. There are different sets of behavior that are deemed correct according to religious leaders as well as other public figures who openly incorporate so-called Christian views into the ethics that they preach, but may not necessarily practice.

Girls are initiated into the role of sexual objects and boys are initiated into a cult of patriarchal masculinity where deference from female members of society is expected, respectable and in extreme cases justifiably punishable by violence. From a young age, women are told that dressing a certain way is inappropriate. People use words like "skettel" and "twi hal" to describe women who dress a particular way and female children internalize these concepts regarding what is respectable and what is not. Objectification is disguised as protection. By telling girls that dressing a certain way makes them either more or less sexually available for abuse, this reduces their clothing choices to choices rightfully subjected to the male gaze and to the behavior of rapists and other deviants. Predators have no responsibility here; blame is thrust upon girls who have either just entered puberty or are just about to. This is what we are taught is right.

This may not seem connected to religious institutions on the surface, but "respectability" is tied into Christian ethics. In a society with widespread Christian institutions, morality of any kind doesn't exist independently from the church.

Young boys have a different experience in their pre-pubescent and pubescent years. Instead of becoming sexual objects, their authority and superiority begin to be reaffirmed through religious patriarchal values and participation in patriarchal rituals. Families deeply involved in churches encourage involvement in the church through becoming altar boys or joining choirs. Church is a place where boys are expected to interact with the opposite gender, although girls interacting with boys is not encouraged. The ethics of respectability that are implemented on girls are non-existent for boys. Masculinity and patriarchal thinking is established via religion; the religious narrative is one where only the voices of men are significant.

Gender dominance is established through the structure of the church. Male priests and pastors are the dominant voices and control the behavior and beliefs of all their constituents. Even in churches with nuns, the nuns are clearly deferent to the male authority figures. Women are often supportive figures, working behind the scenes and sub-ordinate to male counterparts. This affects young, observant children who will then see the policing of women's behavior as natural and righteous. They begin to see a woman's unwavering obedience as expected and a lack of subservience is justifiably punishable by violence.

Women and men both serve to enforce "church patriarchy" within their homes; the practices become cultural and not just religious. We are falsely led to believe that this is all our culture entails. Girls are made to serve their male siblings and held to more rigid standards of behavior with emphasis on household duties, sociability with family members and child care. Boys may participate in household chores but are more often encouraged in activities aside from cooking and childcare such as yard work or household maintenance. It is foolish to think that this family structure is independent of religion as the values are clearly enforced by those who claim to preach the word of God and whose behavioral ethics are intertwined with Christianity.

If childhood experiences connecting to adulthood feels like a stretch because you somehow doubt young children to be absorptive or impressionable, rest assured that religious institutional practices are present and influential in the lives of teenagers. The two top performing secondary schools on the island are both Roman Catholic. Choosing Non-Catholic options doesn't eliminate the influence of religion - the influence is merely a non-specific Christian influence. To expand upon the educational options if you doubt the lack of separation between Christianity and education, I'll describe the best options for education if you place value on your child's secondary education.

Besides the two Catholic schools which are considered the best through reputation and CXC results, there is the International School, Leon Hess Secondary School and Castries Comprehensive Secondary School. The international school costs upwards of $13,000 per semester, and is known for housing spoiled children of expatriates and locals with excessive wealth. Leon Hess is co-educational and not preferred by most families who are interested in "protecting" their young girls from being around teenage boys; the educational standard is considered slightly lower than the Catholic secondary schools. Castries Comprehensive is also considered to have a slightly lower educational quality and is again co-educational.  These "reputations" may not be based in truth, but they still affect decision making processes of families making choices for where their children attend secondary school.

In secondary schools, regardless of denomination, prayer is constant and there is no opting out of it. There is a minimum of three prayers a day. A good education is incomplete without being forced into a religious practice which may not become genuine belief but conditions behavior that one believes to be "good". This is not questioned despite any apparent logical contradictions. With a so-called religious education, you would expect most, if not all students to emerge with a strong sense of ethics and critical thinking skills complementary to faith as opposed to contradictory. The reality is different from the theory because a commitment to Christian ethics is non-existent. There is a commitment to the institution of Christianity which has a destructive force because the power of spirituality is harnessed for social control.

Many of the school rules at the leading girls-only secondary school focus on appearance. The appearance of chastity and purity is the focus of the school's rules with a disproportionate number dedicated to policing appearance. Punishments are swift and frequent, disciplinary notes range in color and severity; although most punishments are not placed on the permanent record, the effects of receiving punishment are typically enough of a deterrent. Being punished frequently often means being labelled as a troublemaker by teachers; this may eventually lead to teachers being less willing to write recommendations for a student. Students at this school receive far more frequent punishments than students at the boys-only counterpart.

The focus on appearances is sadly, not unique to the secondary school experience. From childhood, the appearance of devotion has been valued more than actual devotion; this is extrapolated to a high school setting where the fixation on appearance becomes more literal. The policing of girls' appearances is an extension of Christian ethics. Being abstinent from sexual activity until marriage and ensuring that you don't tempt men before then are  both considered important within a Christian society; having a chaste appearance is a method that this abstinence is safe-guarded. Occasionally this commitment to chaste appearance is disguised (or maybe genuinely perceived) as an interest in protecting girls. How is suppression, blaming and shaming girls between the ages of eleven and sixteen also seen as ethical, necessary and even helpful? Within a patriarchal society reliant on Christian institution for validation, this attention to women's behavior is attributed to logic and men's behavior is attributed to "human nature".

In a boy's adolescent environment, the rules are a lot different. Boys are almost expected to come home with their collars off center and shirts untucked. Discipline in a male environment is an extension of the violence they experienced in primary school; boys who are too flagrant about their disobedience of school rules are caned by the headmaster. This experience, for boys who have grown up beaten their whole lives, is seen as a status symbol rather than a punishment by the time they are in secondary school. Defiance may appear to have been punished, but it is in fact rewarded by granting them status within their social groups. Boys are rarely punished for establishing dominance over female teachers who are often powerless to punish them or do not see the purpose in doing so. One girl recounted her brother's experience where students threw plastic bottles at a female teacher as she taught. There were no consequences, and she merely continued to teach until becoming overwhelmed and just exiting the class. If the leniency of an all boys school is contrasted to the constant vigilance teachers have in all girls school, we can easily see how this would create problems in the future for both genders. Both have different expectations of how the world works and these expectations are the result of patriarchal values being attributed to righteousness and using the institution of Christianity to peddle these differences as human nature.

In young adults, the detriments of religious institution are more obvious, as well as the hypocrisy behind the alleged commitment to Christianity that is fostered early in their lives. The marriage rates in St. Lucia are some of the lowest in the world, yet children populate our schools. It's absurd to believe that all these children come from the few church sanctified relationships on the island. In a religion that believes that pre-martial sex and divorce is against God's law, looking at birth rates and marriage rates is the only proof you need to show that genuine commitment to God's law is rare especially in regards to sexual behavior. The number of murders and other petty crimes support this as well. Religion is used when necessary for social control and genuine practice is uncommon. 0.06% of 15-19 year old St. Lucian men are married, 0.02% of 20-24 year olds and 0.25% of 25-29 year olds according to 2001 census data (the most recent available on line). The statistics for older men are not much more promising; 5.07% is the highest rate in the entire set of statistical data. (x)

I focused on these age ranges because teen pregnancy is a well known and well cited social problem facing St. Lucians; major news sources as well as international studies on St. Lucia focus on the "very high" teen pregnancy rates. Are all these pregnancies the result of church sanctified marriages? If we have to look at government statistics, this can't possibly be the case. St. Lucian newspapers, preachers and pastors will neglect looking at the United States models for public health especially regarding birth control because they believe it is against the Catholic church. Pastors and priests have openly claimed that birth control white supremacist invention to lower the birth rates of black people. They preach bold-faced lies to their congregations. People still believe that the church is the solution to the problem of teen pregnancy although it has shown no allegiance to any such movement and demeans practices that have been demonstrated through reliable scientific research to be helpful in reduction of teen pregnancy rates.

While women's sexualities are constantly policed, their position in society diminished. Being diminutive and always saying yes to people in power is valued for women. Is it such a shock then that they find themselves unable to say no to predatory men who only seek their company for sex? Is it any wonder that they continue to trust people who don't care about their agency when they have been repeatedly told that their agency is unimportant compared to the appearance of chastity? Women are blamed for the actions of rapists and abusers. Women are taught that their biological urges are impure unless they are married when they see children born out of wedlock constantly and can see that those who they look up to are immoral scum. The church denies them agency, yet blames them for societal problems.

We can also examine the fact that many teen pregnancies are the result of incest and rape. People will admit that these two things are huge problems here, yet no data currently exists with these statistics. Due to the taboo nature of these two, victims are left without recourse unless the rapes can be used to further the political (and sometimes personal) agenda of those in power. Rape cases are occasionally sensationalized to control women's behavior, reminding them that they are constantly in danger of an unknown rapist. I'm not suggesting that the danger isn't real, but there is a specific reason that these cases are the focus of the public eye as opposed to the frequently occurring rapes and incests that happen in secret.

No one tells their child to beware of their uncles or fathers or family friends who statistically would provide a greater danger, suggesting that the concern - consciously or unconsciously - is not about preserving safety but preserving a status quo. This regard to status quo is not independent of existing in a society where religion is the primary way social control is exerted. Regardless of personal beliefs, social and cultural mores that stem from religious institutions become internalized; the result is widespread denial of agency and misplaced blame.

With people who have moved out of "young adulthood" into "adulthood" and begin to have children, the emphasis on the value of men that has been bred into our culture early on in life is maintained. Parents are encouraged to have more children, and are seen as odd if they don't keep trying until they get a boy. Going around the island with my parents to visit different family members and family friends through out my life, my parents were asked on numerous occasions if the "didn't want a boy" or "didn't have a boy yet".

There is a huge emphasis on raising children within the church - baptism, first communions and confirmations are arranged without question because they are all seen as "something people do". Religion is indoctrinated since birth by those who are faithful and even those who can occasionally be forced to admit that they are not true believers. There is no way to question Christianity. There is no critical analysis, merely blind belief. Parents were once taught that "spar[ing] the rod will spoil the child" and perpetuate the violence they experienced as children. In fact, almost all that they were indoctrinated with as children continues into adulthood. It is anti-religious and satanic to question God; the ills of society are seen and taught as the will of God. We perpetuate our own colonization even without the presence of masters. There is no room for other religious beliefs which are mocked openly as well as subtly.

Criticism of Christianity in it's function as an institutional power within St. Lucia isn't inherently anti-Christian, atheistic or an imposition of imperialistic values. Social issues that all humans can agree are negative - teen pregnancy, rape and incest for example - are perpetrated in situations where men are given all power over human sexuality. Religious institution forces spirituality and religion to be associated with dominance, fear, threat and a method of having power over other human beings.

Humanity's drive to find peace with our place in the universe and with the possible existence of a greater power - God, science, a polytheistic pantheon - can hardly be accomplished under conditions where fear and power exist and are constantly perpetrated. Additionally, the belief in religious freedom is not an imposition of Western values as much as it is a belief in equality and a belief that people should be able to question God and choose whether or not to ally themselves with the practices of the church. It is evident that allegiance to the church is not allegiance to perfect or at times even remotely Christian behavior.

How is this all really negative, and can't these problems be critiqued and solved without questioning or counteracting the church (as an institution)? The church is inextricable from society and culture in St. Lucia. It is heavily involved with every aspect of life, as I hopefully have demonstrated above. Men are given all power over sexuality via church patriarchy and social issues like rape, incest, child abuse, domestic violence and teen pregnancy are all prevalent within the culture of church patriarchy. Religion is intertwined with dominance and violence and used as a way to exert power over people en masse; this of course was the intended use of religion in the West Indies by colonizers seeking to find ways to control their slaves.

A critique of religious institution in a country predominantly made up of people of color is also not a racist condemnation of their cultural practices, although it can easily be transformed into one without sound analysis. This is not an imposition of colonialist ideas of curing non-white savagery, but rather an attempt to assess how St. Lucia can begin to decolonize how we think about societal issues.

St. Lucia's population is 54% female according to most recently available census data. West Indian women have been historically anti-patriarchal. It is culturally embedded within West Indian women to fight against injustices thrust upon us; within the church this aspect of our nature is suppressed. In the past, St. Lucian women have consistently fought against gendered wage gaps, led marooned slave colonies and spoken out again sexism through Calypso music. It is clear that the roots of anti-patriarchal thinking are there, but church ideology and it's widespread social control prevent these instincts from actualization especially today when more and more people are retreating to the church for solutions to society's ills. Women are deprived of bodily autonomy, their basic rights and the awareness that something is wrong within our society that they have the power to fix.

Our culture is greater than Christianity. Our traditions and social beliefs do not need to be totally lost in an examination of what constitutes social power and how we can seek to improve our society post-independence from Great Britain. Recognizing the connection between the way religion is used by people in power so that issues like incest, rape, sexual assault and child abuse can be brushed under the rug for the sake of appearing moral or by using the justification of "God's will" is not a condemnation of our entire culture. Within St. Lucia, we need to examine the way religion is used to terrorize us through dominance and violence for us to have any real progress with eliminating our social ills. Thus far, the typical complacency with regards to social ills seems to be ineffective. Using God as an excuse for this complacency is not going to suffice if we truly desire change independent from major Western powers. Relying on Americans, the British or Asian powers will not work for us.

Condemning a belief in God and a removal of religion as many radical atheists would advocate is also not a practical solution to what is happening within St. Lucia. It is more important to differentiate between religious institutions - which to me represents the church as the primary method of social control and organization - and religion as a personal system of beliefs and a small scale method of community organization. Whereas religious institutions require turning towards a male leader (or a patriarchal minded female leader in rare occasions) for all understanding of Christian ethics and morals, churches should be a place where active engagement with scripture and a personal and individualized approach to God's teachings is encouraged.

There should not be only one way to follow God; in an ideal situation, Christianity would be tailored to the individual who would then share some of their beliefs, but maybe not all of them, with a larger congregation. Conformity to what a pastor or priest believes is the correct interpretation of the scripture means that no one asks questions. Parishioners are not encouraged to actively engage with what they believe but rather to accept whatever male leaders dictate is correct. How can you have true belief if you don't constantly grapple with what your belief means or actively engage with your spirituality? If you must suppress all other spiritual differences for yours to remain powerful, isn't that a demonstration of the weakness of your beliefs?

True resolution to our social problems can only come from decoupling politics - sexual politics, government etc. - from religious beliefs. This doesn't mean abandoning Christianity, but rather preventing a myopic view of morality from obscuring our vision of a better St. Lucia in the future. Christian morality  today cannot realistically reflect the same values it did at it's inception. Scholars and people in power in the church should be engaging with scriptures to provide a modern interpretation that fits within the context of our world today.

A place where the majority of child bearing citizens are not married cannot claim to have the same views on sexual morality as the Bible originally intended. The New Testament condemns divorce, yet we live in a nation not only of unmarried people, but in a nation filled with adulterers. Some of these adulterers sit in the front pews of the church.

Religious leaders need to take on a more positive role in communities. Instead of using their power to enact domination and violence, religious leaders or leaders who encompass religion as a huge part of their public personae should be encouraged to analyze scriptures with a critical mind and modify their understanding of the Bible to reflect an updated Christian morality that doesn't necessarily depart from the Bible, but certainly leaves behind the normalized violence that is rampant throughout our region.

Many religious leaders will likely argue that going back to church will solve the problems plaguing the youth. How can this be true when three generations of church goers (and likely more) continue to be plagued by ills that were around long before today's youth? We need to reflect on who carries the power in our society and what they intend to do with that power. Beliefs that are made "stronger" through violence and suppression of non-conformist thought should come into question. We will only see progress when we genuinely reflect on what controls our society and behavior instead of concocting new external evils or rehashing now irrelevant evils to place the blame on.

* A relationship with religion is not a relationship with God.

21.

Thinking about the future only stresses me out. I don't need that much time  alone. I don't need the much time to think. Loneliness can be good but I've had plenty. 

I'm picturing myself in a beautiful dress, alone in a beach house surrounded by things - loving nothing but memories. 

I picture myself traveling the world and always having to sit alone on airplanes, wondering if I will ever meet the love of my life. 

Word Vomit.

I always thought that I was the one who was going to falter and have the hardest time over the next six months. I am the one who cries too much, thinks too much and obsessed over insignificant details. I am the ill one with the misfiring neurons and the constant pain. But at the beginning of all of this I was reassured by someone I love(d). I can still think about him now but it seems like more of a distant memory because now no one loves me and instead of constant happiness there is a fresh wound in my heart each morning and my lungs never have enough oxygen and my chest cavity feels tight and too full. Maybe just a little cut will let some of the pressure spill out. Maybe if I hold my breath under water for almost too long when I break free of the ocean's surface I will inhale sharply enough to fill my lungs back up. There is a way to stop feeling. There is a way tto ensure my heart will never beat so fast and that my lungs will be empty. 

I am distraught because of how what I remember intersects with what I know to be true and what I know to be right. 

I remember the first time I whispered "I love you" before I meant to but not before I felt it. And I was perched on top of him looking down at his face and feeling how warm his skin was beneath my finger tips and listening to his heavy breathing - like every molecule that entered his lungs was praising God for getting the chance to touch him. And even when he said nothing back I felt safe. 

He always made me feel safe from the  first night I kissed him when I was shaking like a leaf because I had no clue what I was doing and I liked someone else. My heart was still reeling from the first person I had ever loved and I was a big old mess. A mess getting smaller and smaller. I didn't need help being messy. I didn't need help with anything except not being alone for one night. And I knew it was all bullshit because of how many times he told me I was beautiful and how many times he kept asking me why, pretending like he wanted to get to know me. 

Men are destructive but not in the same way a fire is because a fire will never let you think you are safe. A fire is blatant and honest and once you see it you know that it's intention is to burn. It wants to destroy. Men are more like rainstorms - comforting, peaceful until things get too heavy and flood waters begin to rise. Before you can get out safely you will drown and in your last moments of drowning you will still feel like you are safe. 

Despite my belief that it wasn't worth it and my disinterest in being in love, I feel as if it were inevitable. We tried being "just friends" a few times but it always went back to sex. As much as (now) you would like to pretend that I was the one who was interested in you I know you were interested in me too because some things are just too difficult to fake and falling in love has to be real. 

I remember before Christmas break I worried about us being apart from each other because it was too soon and I had only just gotten to know you. But the night before I left we spent the whole night together. I remember the candle light moving waves of color across your face, and occasionally illuminating how light your eyes were. I remember your chest beneath my head as piles of my hair invaded your faces orifices and your hands were wrapped around me, protecting me and keeping me warm. I remember the feeling of warm water flowing down my skin and your hands massaging shampoo in my hair with almost too much caution. I remember how you smelled like Old Spice right out of the shower and the way your hair felt soft and fuzzy when you were drying off. 

It feels like my memories are almost made up. Do you remember anything about me or why you love(d) me? Is anything about me interesting or appealing except for the fact that I do the right things? Am I hollow? Am I empty? What am I worth to anyone? 

A placeholder until someone better comes along. Someone who will never cry or get angry. Or someone pretty with lighter skin and hair down to their back that never gets in your mouth. Maybe someone with a little mermaid voice who never tells you to stop singing and won't want to hang out with you all weekend long and ruin whatever plans you may have had. 

It's hard to stop my mind from eating away at me. I feel as if I am constantly fighting. 

I am saying to myself "HE DOESN'T LOVE YOU ANYMORE" over and over almost taunting myself with it. He's still my phone background - a picture of us from a trip to NYC. The same picture is on my computer, but maybe that's denial more than anything else. I went through the hundreds of pictures I took of him in my iPhoto. I saw what being in love was like and I still see it. I'm holding pieces of my heart together waiting for him to say the right words or at least realize that he wants to say them. 

How can he forget. How can he not love me. We were what seemed like the perfect couple and although things moved quickly I thought that's ecause that was what happened when thugs were right. It's what happens when you meet someone who you are inexplicably drawn to. I believe in love and I believe in happy endings and I don't want that to change. I'm powerless - another one of my biggest fears that therapy has done nothing for. Maybe my mistake is always pursuing people who love God more than they could love a human being. 

Obsessed with the intangible. Escapists. Damaged men who keep running away from people who love them in hopes of finding something/someone more esoteric. I wonder if they will ever give up the hunt for what is not real in favor of something present and possible.