Wednesday, May 20, 2009

Utah Places: Bingham Canyon Mine

The largest artificial hole in the earth, Bingham Canyon Mine is one of the wonders of the world, and a monument to industry. There are tours conducted on a regular basis. Some of the mining machinery is very impressive, but all is dwarfed in scale by the huge open pit excavation.

Visitors Center

Utah Places: Butterfield Canyon

Another monument to mans insatiable appetite for metal ore, and an indomitable will to dominate the earth. This view is the Bingham Canyon overlook, reachable by traversing the Butterfield Canyon Road from Herriman up to the saddle, then turning north for a further short distance.

Butterfield Canyon is a lovely glen in the sprawl and squalor of cities that have sprung up across the west of the Salt Lake Valley in the last thirty years. After many years of decrepitude, the canyon was the recipient of extensive reclamation efforts by its principal property owner, the Kennecot Corporation. The area is now a show place and a delight to the eye year-round.

Bikers and peddlers love the harsh grades and switchbacks. It makes a nice picnic drive for a weekend afternoon too.



Utah Places: Fivemile Pass

BLM land is usually marginal as far as aesthetic value, but it is valuable for other intrinsics that are sometimes difficult to weight. The Pass area is one of those, unremarkable to the eye, but rich in history and culture.

Some links:
ATV Trails.
BLM Info- has link to a good map.

The BLM has given Fivemile Pass over to ATV use, and it shows. Prior to the ATV craze, the area was covered with mining claims, and that still is very much in evidence too. Someday, the whole mess will be cleaned up. Right now it looks like a ten thousand acre monument to wanton indulgence.

Trails crisscross the area indiscriminately leading everywhere and nowhere. Some leads can get you into trouble, like the one that looks like a thrilling leap over a deep ravine, but opens into a vertical mine shaft. Long ways down.

The steepest grade I ever drove the 4Runner on is to the north. A long hill that leads up to the ridge overlooking the Mercur Canyon mine and operations center. Climb it if you have the traction. I just made it. No problem for ATVs.

There are some spectacular high vistas, for those willing to climb. Snow lingers late this high -- don´t be surprised to find deeper drifts on the north shadowy spots into July.

Mineral mining was the big attraction in the Oquirrh Mountains to the north. For more than a hundred years copper has been mined and smelted. Plenty of other metals, like gold and silver, are also in rich supply. Try your luck high grading some rocks, you might strike the mother lode!

Rehab progress 33

Routine. That is what the workouts are approaching, much to my relief.

I have not experienced any untoward episodes in weeks. Settling down do a steady pace, I can easily crank out a half mile on the treadmill. I´m going to step things up a bit, increase the tempo and the length of my stride to cover more ground, because I think the treadmill is the best return for time spent.

I´m also covering more ground at home, walking around the yard. On Saturday, we travelled to a prospective contracting job site, South Willow Canyon, in the Stansbury Range. Part of the road was barricaded to vehicle traffic, so I hobbled on up the trail for about a mile or two. When I returned, my dad was just making motions to stir from a long nap and come to search for me. It was a long walk, but I did it - and without falling down. Not bad for a handicapped guy.

Tuesday, May 19, 2009

April 2009 General Conference: Faith in Adversity

Elder Rafael E.Pino of the Seventy testified of faith in adversity. He shared a number of heartbreaking incidents where faith in the Savior provided strength and comfort.

The Savior said:

"Therefore, whoso heareth these sayings of mine and doeth them, I will liken him unto a wise man, who built his house upon a rock—
"And the rain descended, and the floods came, and the winds blew, and beat upon that house; and it fell not, for it was founded upon a rock.
"And every one that heareth these sayings of mine and doeth them not shall be likened unto a foolish man, who built his house upon the sand—
"And the rain descended, and the floods came, and the winds blew, and beat upon that house; and it fell, and great was the fall of it" (3 Nephi 14: 24–27).

It is interesting to notice that the rain descended, the floods came, and the winds blew against both houses! Living the gospel does not mean that we will everlastingly escape adversity. Rather, it means that we will be prepared to face and endure adversity more confidently.

Monday, May 18, 2009

April 2009 General Conference: Faith in the Lord Jesus Christ

Elder Kevin W. Pearson of the Seventy bore testimony of his faith in Christ. He shared his witness of faith in the Savior that we can place our utmost assurance in, during these most difficult and trying times.

Elder Pearson stressed that we need to teach these principles to our children. True faith compels action and obedience to the Lord´s commandments.

Faith and fear cannot coexist. One gives way to the other. The simple fact is we all need to constantly build faith and overcome sources of destructive disbelief. Consider it this way: our net usable faith is what we have left to exercise after we subtract our sources of doubt and disbelief. You might ask yourself this question: “Is my own net faith positive or negative?” If your faith exceeds your doubt and disbelief, the answer is likely positive. If you allow doubt and disbelief to control you, the answer might be negative.
We do have a choice. We get what we focus on consistently. Because there is an opposition in all things, there are forces that erode our faith. Some are the result of Satan’s direct influence. But for others, we have no one but ourselves to blame. These stem from personal tendencies, attitudes, and habits we can learn to change. I will refer to these influences as the “Six Destructive Ds.” As I do, consider their influence on you or your children.
1. Doubt
  • not a principle of the gospel.
  • does not come from the Light of Christ
  • does not come from the influence of the Holy Ghost.
  • negative emotion related to fear.
  • comes from a lack of confidence in one’s self or abilities.
  • inconsistent with our divine identity as children of God.
2. Discouragement
  • comes from missed expectations.
  • leads to lower expectations.
  • decreased effort.
  • weakened desire.
  • greater difficulty feeling and following the Spirit.

3. Distraction
  • lack of focus.
  • eliminates the very focus the eye of faith requires.
  • Satan’s most effective tools.
  • bad habits.
4. Lack of diligence,
reduced commitment to remain true and faithful and to carry on through despite hardship and disappointment. Disappointment is an inevitable part of life, but it need not lead to doubt, discouragement, distraction, or lack of diligence.
If not reversed, this path ultimately leads to

5. Disobedience, which undermines the very basis of faith. So often the result is disbelief, the conscious or unconscious refusal to believe.
The scriptures describe
6. Disbelief as the state of having chosen to harden one’s heart. It is to be past feeling.
These Six Destructive Ds—doubt, discouragement, distraction, lack of diligence, disobedience, and disbelief—all erode and destroy our faith. We can choose to avoid and overcome them.

Friday, May 15, 2009

Utah Places: Squaw Peak to Hobble Creek

The vistas are as picturesque as the names. Squaw Peak trail starts up from Provo Canyon and winds along the mountainside, sometimes with breathtaking views of the valley below. It eventually ends up climbing over the shoulder of Hobble Creek Canyon, descending into the Hobble Creek area through muddy farm roads. Much of the road is suited for 4wd light, but if the weather is bad, there may be deep mud holes that can swallow a station wagon.

Makes for a delightful afternoon drive if the weather is good.

Lots of little informal camping-type spots, as well as some formally maintained campgrounds that never much interested me. There is rock that is good enough to challenge any climber around several of the precipitous canyon walls that slice thier way up from Utah Valley, if you are into that sort of thing. June and July wild flowers in great profusion. Every range of ecosystem from chaparal to alpine, and everything in between. Lots of wide-open meadow lands and green grasses in summer season.

Worth a trip.

Utah Places: Pittsburgh Lake

Why would you want any place else? There is serenity and freedom in this place -- no noisy neighbors to play their rock music too loud. Just fluffy white clouds drifting by, reflected in the untroubled placid waters collected so recently from fresh snowmelt.

Access to Pittsburgh Lake basin by crossing the American Fork above Tibble Fork Reservoir. There is an old mining trail that is fairly decent for 4wd or ATV, but don´t try this without serious consideration about getting back. Take along spares, ćuz you might use them.

The 4-Runner makes it easy, but I´m not sure about Jeep types. Might like lockers -- tends to be slippery muddy in spots. If you´re boots-on-the-ground, thats okay too. It is a nice hike. As you can see from the photo, typical Wasatch unspoiled beauty.

Don´t forget some DEET. Some things come at a price. Lots of mosquitos.

Utah Places: Timpanogos Cave

Timpanogos Cave is one place that everyone should visit, at least once. The hike to get there is a short but strenuous one. Almost anyone that can walk should be able to make the trek. It is worth the exertion.

There are a lot of good links for further info...

National Park Service

Utah Places: Timpanogos Front End

I´m sure most all resident of Utah have witnessed the awesome transformation. Mount Timpnogos is colored with the fiery blaze of sunset as the orange ball disappears behind the Oquirrh Mountains in the west. The backdrop of dramatic scenery is nearly wasted on hoardes of hurrying Wasatch Front residents, packed onto I-15, jamming up the freeway during rush hour. Instead of enjoying the beauty, too many are cultivating their hypertension and considering another road-rage incident on the public highway.

Up close and personal, the south and west slopes of Timp are not nearly as well developed as the traditional Mutual Dell or Timpanooke or Aspen Grove on the east or north. As it happens, there are roads, but they are not for the timid. Best suited for 4wd or ATV. Many trails lead out from the Pleasant Grove and Orem high bench areas. The lower down regions tend to be clogged with houses, but after you get by them, you´re on your own. If you venture out, you will discover there are many false leads, as well. Lots if rugged individualists have left their mark here. As a result, there are trails through the thick chapparal that lead everywhere and nowhere. Pick your course with some judicious care, and be prepared to backtrack.

Not that the lowland parks are bad. They serve their purpose well, and get lots of use. But to those few to whom the freedom of the hills beckons..

In several canyons on the west face of Timp, I have picked up many fossil specimens. Some of the canyons that run down the west face are apparently eroded through the layers of geological time, exposing the fossilized wonders of the past that were witnessed before the slopes were raised high. I won´t tell exactly where -- that would be giving away too much. But for the ambitious, they can be found, in great variety and profusion.

There is a mountain road that affords access to higher ground, accesible through Timpoonokie Campground. It is a long drive that wind around the shoulder of the mountain, eventually ending up in meadows above Pleasant Grove. A very nice place for a picnic, or just look at the wild flowers and enjoy the view. The view is unparalleled.

Thursday, May 14, 2009

April 2009 General Conference: Our Father’s Plan—Big Enough for All His Children

Elder Quentin L. Cook of the Quorum of the Twelve Apostles teaches in his conference address that even though our journey may be fraught with tribulation, the destination is truly glorious.
The doctrine of most churches is at odds with revealed truth, and this makes it difficult for some to accept. This should not come as a surprise.
My principal concern is for the honorable people on the earth who are open to religious faith but have been discouraged or confused by incorrect doctrine. For instance, with respect to the doctrine that revelation still exists, some very good people have been confident that the Church could not be true because they have been taught, and therefore believe, that the heavens are closed and there will be no additional revelation, no scripture, and no pronouncements from heaven. Let me emphasize that this widely held belief is not scriptural, but it is a stumbling block to some.
In Joseph Smith´s time, the vast majority of churches taught that the Savior’s Atonement would not bring about the salvation of most of mankind. The common precept was that a few would be saved and the overwhelming majority would be doomed to endless tortures of the most awful and unspeakable intensity. The doctrine revealed to the Prophet Joseph a plan of salvation that is applicable to all, including those who do not hear of Christ in this life, children who die before the age of accountability, and those who have no understanding.
At death, righteous spirits live in a temporary state called paradise. Alma the Younger teaches us that paradise is ¨a state of rest, a state of peace, where the righteous shall rest from all their troubles and from all care, and sorrow.”
The unrighteous spirits dwell in spirit prison. It is described as an awful place, a dark place where those fearful of the “indignation of the wrath of God” shall remain until the resurrection.
Because of the Atonement of Jesus Christ, all spirits blessed by birth will ultimately be resurrected, spirit and body reunited, and inherit kingdoms of glory that are superior to our existence here on earth.
At the resurrection, the spirit prison or hell will deliver up its captive spirits. Jesus came into the world “to be crucified for the world, and to bear the sins of the world, and to sanctify the world, and to cleanse it from all unrighteousness.”

The Savior said, “Let not your heart be troubled. . . . In my Father’s house are many mansions. . . . I go to prepare a place for you.” A succinct summary is provided in the book of Moses: “For behold, this is my work and my glory—to bring to pass the immortality and eternal life of man.”
A loving Father has provided a comprehensive and compassionate plan for His children “that saves the living, redeems the dead, rescues the damned, and glorifies all who repent¨. Even though our journey may be fraught with tribulation, the destination is truly glorious.

Wednesday, May 13, 2009

April 2009 General Conference: Learning the Lessons of the Past

Covering a topic that has been rehashed so many times before, Elder M. Russell Ballard of the Quorum of the Twelve Apostles makes the topic ring with new vitality as he reminds us in his conference address that we live in perilous times. He quotes the aphorism, ¨Those who do not remember the past are doomed to repeat it.”

He refers to a number of examples of cyclical behavior, from scriptural accounts in particular. There is a consistent theme of blessing and prosperity, then reoccurring periods of apostasy and spiritual darkness, followed by repentance and restoration of the Lord´s grace and blessings.

Our Heavenly Father loves all of His children, and He wants them all to have the blessings of the gospel in their lives. Spiritual light is not lost because God turns His back on His children. Rather, spiritual darkness results when His children turn their collective backs on Him. It is a natural consequence of bad choices made by individuals, communities, countries, and entire civilizations. This has been proven again and again throughout the course of time.

One of the most important lessons we learn from this is that actions do have consequences, for good or bad, individually and collectively. We learn to avoid the mistakes of the past by studying the lessons of history and culture. Herein lies the accumulated wisdom of past generations. Through their learning we can leverage and avoid some of the pitfalls of these perilous times.

We live in an era when the boundaries of good taste and public decency are being pushed to the point where there are no boundaries at all. The commandments of God have taken a beating in the vacillating marketplace of ideas that absolutely rejects the notion of right and wrong. Certain factions of society seem generally mistrustful of anyone who chooses to live according to religious belief. And when people of faith attempt to warn others of the possible consequences of their sinful choices, they are scoffed at and ridiculed, and their most sacred rites and cherished values are publicly mocked.

Elder Ballard counsels for each of us to strive to gain a faith and testimony of our own. His advice is that testimony is built the same way it has always been, and there are no technological shortcuts, despite all the gadgets that have proliferated these days.

And how do you get such a testimony? Well, there’s no new technology for that, nor will there ever be. You cannot do a Google search to gain a testimony. You can’t text message faith. You gain a vibrant, life-changing testimony today the same way it has always been done. The process hasn’t been changed. It comes through desire, study, prayer, obedience, and service. That is why the teachings of prophets and apostles, past and present, are as relevant to your life today as they ever have been.

Tuesday, May 12, 2009

Utah Places: South Slope of the Uinta

Everything unique and beautiful about Ashley National Forest is characterized by this blossom. Though Sego Lillies (Chalocortus nutallii) are found throughout the west, Utah claims this one as the state flower, and for good reason. A thing of beauty and the greatest practical utility, these flowers dot the ground in season in the middle elevations. I look for them to be heaviest in sparsely covered grasslands and sagebrush areas.

Where the Sego blooms in great profusion, there look for the freedom of the hills. That ever-elusive quality may be hard to find and difficult to keep, but it is always worth finding.

Million Dollar Baby

I watched this film today and it left disturbing questions unanswered.

The film is about the humane touch of boxing in the midst of blood and brutality. Morgan Freeman plays a part in the film, and sometimes narrates in the background, as if telling the story through recollections of the past. Ultimately, the plot comes down to euthanasia. Clint Eastwood finally decides that life on a respirator is not what his star boxer would want, and he pulls the plug on her, and she dies. End of story.

Very sad.

Very real scenario for me to face personally.

What is the worth of a life that is artificially supported? I have already asked myself that question, many times. What you decide is up to you. But it may be something any of us could face, any day. Impossible to predict.

What protection do we have against being held captive against our own wishes by medical technology?

On the one hand, there are artificial breathing apparatus, intubation devices, so-called heroic measures.

And on the other, there are living wills, DNR orders, and bureaucratic measures.

Nothing is certain...

Rehab progress 32

What is commonplace about establishing a routine when nothing is routine? I find myself struggling in another round of rehabilitation effort, which is discouraging. To keep starting over again at a point I have surpassed before makes it all seem somewhat futile. Imagine learning the alphabet again and again, only to forget and be forced to start training over again at some fundamental that you know very well was easily surpassed in previous performances.

But I can´t know that. If I had spent the time idly laying around, I have no idea what level of performance my mental or physical state would be, to say nothing of other considerations. Exertion is good for the soul, if no other benefits accrue. I suppose that must be as true in my case as it is for any other. I hold myself as unremarkable in every respect.

This week in PT sessions, I am working to maintain the half-mile in ten minute pace on the treadmill and 2 miles in ten minutes on the stationary bike. That is about the same level I could reach last March and September. Setbacks have pushed me back, but I am determined that keeping on is the only course for me. I will not quit. Ultimately I want to set the pace to cover 3 miles in 40 minutes on the treadmill, which is where I was last July and October. I´ll keep at it.

The norm for me seems to be to have another brain attack every six to twelve weeks. They vary in severity. Clearly, I will keep having them, unless something changes in the conditions that are causing them. And that is not likely. The real questions I am left with: Exactly when the next will occur, and how severe will it be? It seems only time -- and heaven -- can answer.

Toxic Shock?

Toxic Shock Syndrome.... as well as other kinds of horrific shock!

Darrin proceeded to collapse after the grad ceremony, and has been in the hospital since he had a black-out episode at home, shortly thereafter.

He has a skin rash and fever, but the doctors were not too certain what to make of it. The initial diagnosis was scarlatina, which generally responds pretty well to certain antibiotic treatments. Becky suggests that it sounds more like toxic shock symptoms. Apparently, either type more or less directly results from some kind of systemic strep or staph bacterial infection. The specific treatment may depend on how testing shows that cultures respond to specific anibiotoics. As the case may be, I´m certain his attending knows more than I do about what Darrin might be suffering from.

Anyway, after initial stabilization, they tranferred him from Castle Valley in Price to Utah Valley in Provo. He has a medical team of doctors and nurses in attendance, and if they should miss a beat, Ruth is there to catch them. Castle Valley is an adequate facility, but the resources are limited there. UVRMC is a better place for critical care, and the staff will be sure that Darrin gets the care he needs now.

Our most fervent prayers and best wishes to Darrin and family. I am sorrowful when I know that any suffer, and I know this is a trying time for them.


Please get well soon, and recover fully. Your family needs you, here and now, all of us.

Tuesday, May 05, 2009

Physiology 101

In physiology, medicine, and anatomy, muscle tone (aka residual muscle tension or tonus) is the continuous and passive partial contraction of the muscles. It helps maintain posture, and it declines during REM sleep. It is not to be confused with the concept of toning in physical exercise.
Unconscious nerve impulses maintain the muscles in a partially contracted state. If a sudden pull or stretch occurs, the body responds by automatically increasing the muscle's tension, a reflex which helps guard against danger as well as helping to maintain balance.
The presence of near-continuous innervation makes it clear that tonus describes a "default" or "steady state" condition. There is, for the most part, no actual "rest state" insofar as activation is concerned.
In terms of skeletal muscle, both the extensor and flexor muscles, under normal enervation maintain a constant tone while "at rest" that maintains a normal posture.
Cardiac muscle and smooth muscle, although not directly connected to the skeleton, also have tonus in the sense that although their contractions are not matched with those of antagonist muscles; their non-contractive state is characterized by (sometimes random) enervation.

Physical disorders can result in abnormally low (hypotonia) or high (hypertonia) muscle tone. Another form of hypertonia is Paratonia, which is associated with dementia.

Paratonia or gegenhalten is classified as a form of hypertonia with an involuntary variable resistance (i.e reduced ability of a muscle to stretch) during passive movement (i.e a movement without effort). The disease develops during a period of dementia and the degree of effect is dependent upon the disease's progress. Paratonia was classified very recently by experts, and is unrelated to the much more typical spasticity associated with spastic diplegia and simlilar forms of cerebral palsy.
Clasp-knife response refers to a stretch reflex with a rapid decrease in resistance when attempting to flex a joint, usually during a neurological examination. It is one of the characteristic responses of a upper motor neuron lesion.
It gets its name from the resemblance between the motion of the limb and the sudden closing of a claspknife after sufficient pressure is applied.

Although seemingly a stretch reflex when flexing a joint, force from the muscle during the attempt to flex a joint is actually thought to be caused by the tendon reflex of the antagonistic muscle of that joint, which is an extensor muscle that becomes stretched. In upper motor neuron lesions, muscle tonus may increase and resistance of muscle to stretch increases. However, if sufficient force is applied, limb resistance suddenly decreases.

Neurology 102

A somatic reflex arc is one in which there is the simplest possible arrangement of elements to permit a response to stimuli, and in which the final element in the chain is skeletal muscle. In the crude sketch given here, you see the basic elements of this system. 1 is some sensory transducer in the periphery, for example, a Pacinian corpuscle or other tactile sensor in the skin. Shown here in blue is 2, the pseudo-unipolar sensory neuron in the circuit. Its soma is physically located in a craniospinal ganglion (pictured here as a dorsal root ganglion, but it could also be on a cranial nerve). Drawn in black is 3, an interconnector neuron, whose soma is found in the CNS. Drawn in red, 4 is a motor neuron whose soma is in the ventral horn of the gray H of the spinal cord. The last element involved is 5, the effector organ, which in the case of this type of arc, will always be skeletal muscle.
Here's how the system works: something impinges on the transducer, which causes the afferent fiber of the pseudo-unipolar sensory neuron to fire. That signal is transmitted via its efferent fiber into the CNS, specifically into a synapse with an interconnector neuron in the dorsal horn of the gray H. That neuron then sends a signal to a synapse with the motor neuron in the ventral horn. The afferent motor fiber (axon) of the motor neuron—which may actually be several meters in length—leaves the CNS and terminates at a motor end plate on some myofiber. When it fires it initiates contraction of 5.
Notice that this loop is completely independent; it's not necessary to have CNS involvement beyond the "relay" at the interconnector neuron. Let's say you inadvertently put your hand on a hot stove burner. You will of course immediately remove it, and in doing so you are making use of this type of arc, bypassing conscious thought. In fact, the sensation of uncomfortable heat makes it to the CNS after the motor response to withdraw your hand is initiated. In other words, you move your hand away before you "know why" you're doing it. Of course, it's possible to override this loop with direct CNS input. As is always true, the Brain is The Boss. If you really, really want to, it's possible to hold your hand on that hot burner, ignoring the somatic reflex. Some people have done things like this, but most of us haven't got that level of willpower.
The doctor is testing your somatic reflex arc when he taps your knee with a rubber mallet and studies the knee-jerk reaction. The impulse of the hammer tap travels to the spinal cord and back to the effector muscle, in a reactive arc. Diagnostics can be derived from observing the speed and tone of the reaction.

Amateur Pshrink V

I am pretty partial to this disorder too. I feel just like this lady looks in the picture, much of the time. Only doing other things distracts me from sometimes tearing my hair out with tears of despair and hopelessness.
I like all of the DSM disorders, as a matter of fact. I am thinking of collecting them, like baseball cards...

Somatoform disorder (also known as Briquet's syndrome) is a psychological disorder characterized by physical symptoms that mimic disease or injury for which there is no identifiable physical cause or physical symptoms such as pain, nausea, depression, and dizziness. Somatoform disorder is a condition in which the physical pain and symptoms a person feels are related to psychological factors. These symptoms can not be traced to a specific physical cause. In people who have Somatoform disorder, medical test results are either normal or don't explain the person's symptoms. People who have this disorder may undergo several medical evaluations and tests to be sure that they do not have an illness related to a physical cause or central lesion. Patients with this disorder often become very worried about their health because the doctors are unable to find a cause for their health problems. Their symptoms are similar to the symptoms of other illnesses and may last for several years. People who have Somatoform disorder are not faking their symptoms. The pain that they feel is real, and they feel what they say they are feeling.

A person faking their symptoms may have factitious disorder (an unknown psychological cause for making oneself sick) or malingering (making oneself sick for personal or monetary gain; i.e. disability, insurance, etc). This is not at all related to the Somatoform Disorder, however.
A diagnosis of a Somatoform disorder implies that psychological factors are a large contributor to the symptoms' onset, severity and duration. It is important to note that Somatoform disorders are not the result of conscious malingering or factitious disorders.
The Somatoform disorders recognized by the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association are:
Included among these disorders are false pregnancy, psychogenic urinary retention, and mass psychogenic illness (so-called mass hysteria).
  • Somatoform disorder NOS
Additional proposed somatoform disorders are:
  • Abridged somatization disorder - at least 4 unexplained somatic complaints in men and 6 in women
  • Multisomatoform disorder - at least 3 unexplained somatic complaints from the PRIME-MD scale for at least 2 years of active symptoms
These disorders have been proposed because the recognized somatoform disorders are either too restrictive or too broad. In a study of 119 primary care patients, the following prevalences were found:
  • Somatization disorder - 1%
  • Abridged somatization disorder - 6%
  • Multisomatoform disorder - 24%
  • Undifferentiated somatoform disorder - 79%
In my case, I suspect false pregnancy would be tough to carry out, and right now I´d settle for a reasonable duration of urinary retention prior to wetting my diapers.

But in other words, we can´t explain what is wrong, but we gotta tell the insurance company something, so we made up this fancy title that means ¨we don´t know what is wrong, but this fella is REAALLY SICK!¨

Amateur Pshrink IV

Dr. Moench drew this cartoon on a napkin, when my parents came to get me from the nut hatch at LDS Hospital many years ago. This is one diagnosis from the DSM that is pretty straight-forward.

Major depressive disorder (also known as clinical depression, major depression, unipolar depression, or unipolar disorder) is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) classification, and has become widely used since. The general term depression is often used to describe the disorder, but as it is also used to describe a more temporarily depressed state of mind, more precise terminology is preferred for the disorder in clinical and research use. Major depression is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, approximately 3.4% of people with major depression commit suicide, and up to 60% of all people who commit suicide have depression or another mood disorder.
The diagnosis of major depressive disorder is based on the patient's self-reported experiences, behavior reported by relatives or friends, and a mental status exam. There is no laboratory test for major depression, although physicians generally request tests for physical conditions that may cause similar symptoms. The most common time of onset is between the ages of 30 and 40 years, with a later peak between 50 and 60 years. Major depression is reported about twice as frequently in women as in men, although men are at higher risk for suicide.
Most patients are treated in the community with antidepressant medication and some with psychotherapy or counseling. Hospitalization may be necessary in cases with associated self-neglect or a significant risk of harm to self or others. A minority are treated with electroconvulsive therapy (ECT), under a short-acting general anaesthetic. The course of the disorder varies widely, from one episode lasting months to a lifelong disorder with recurrent major depressive episodes. Depressed individuals have shorter life expectancies than those without depression, in part because of greater susceptibility to medical illnesses. Current and former patients may be stigmatized.
The understanding of the nature and causes of depression has evolved over the centuries, though many aspects of depression remain incompletely understood and are the subject of discussion and research. Psychological, psycho-social, evolutionary and biological causes have been proposed. Psychological treatments are based on theories of personality, interpersonal communication, and learning theory. Most biological theories focus on the monoamine chemicals serotonin, norepinephrine, and dopamine that are naturally present in the brain and assist communication between nerve cells. Monoamines have been implicated in depression, and most antidepressants work to increase the active levels of at least one.

Major depression is a serious illness that affects a person's family, work or school life, sleeping and eating habits, and general health. Its impact on functioning and well-being has been equated to that of chronic medical conditions such as diabetes.
A person suffering a major depressive episode usually exhibits a very low mood that pervades all aspects of life and an inability to experience pleasure in activities that formerly were enjoyed. Depressed people may be preoccupied with, or ruminate over, thoughts and feelings of worthlessness, inappropriate guilt or regret, helplessness, hopelessness, and self hatred. Other symptoms include poor concentration and memory, withdrawal from social situations and activities, reduced sex drive, and thoughts of death or suicide. Insomnia is common: in the typical pattern, a person wakes very early and is unable to get back to sleep. Hypersomnia, or oversleeping, is less common. Appetite often decreases, with resulting weight loss, although increased appetite and weight gain occasionally occur. The person may report multiple physical symptoms such as fatigue, headaches, or digestive problems; physical complaints are the most common presenting problem in developing countries according to the World Health Organization's criteria of depression. Family and friends may notice that the person's behavior is either agitated or lethargic. Older depressed persons may have cognitive symptoms of recent onset, such as forgetfulness, and a more noticeable slowing of movements. In severe cases, depressed people may have symptoms of psychosis such as delusions or, less commonly, hallucinations, usually of an unpleasant nature.

Depression is a major cause of morbidity worldwide. Lifetime prevalence varies widely, from 3% in Japan to 17% in the US. In most countries the number of people who would suffer from depression during their lives falls within an 8–12% range. In North America the probability of having a major depressive episode within a year-long period is 3–5% for males and 8–10% for females. Population studies have consistently shown major depression to be about twice as common in women as in men, although it is unclear why this is so, and whether factors unaccounted for are contributing to this. The relative increase in occurrence is related to pubertal development rather than chronological age, reaches adult ratios between the ages of 15 and 18, and appears associated with psychosocial more than hormonal factors.
People are most likely to suffer their first depressive episode between the ages of 30 and 40, and there is a second, smaller peak of incidence between ages 50 and 60.The risk of major depression is increased with neurological conditions such as stroke, Parkinson's disease, or multiple sclerosis and during the first year after childbirth. It is also more common after cardiovascular illnesses, and is related more to a poor outcome than to a better one. Studies conflict on the prevalence of depression in the elderly, but most data suggest there is a reduction in this age group.
Depression is often associated with unemployment and poverty. Major depression is currently the leading cause of disease burden in North America and other high-income countries, and the fourth-leading cause worldwide. In the year 2030, it is predicted to be the second-leading cause of disease burden worldwide after HIV, according to the World Health Organization. Delay or failure in seeking treatment after relapse, and the failure of health professionals to provide treatment, are two barriers to reducing disability.
The World Health Organization updated its report The global burden of disease in 2004. Their "Years Lost due to Disability", or YLD, is a measurement of the equivalent years of healthy life lost through time spent in states of less than full health, and they state that in all regions, "neuropsychiatric conditions are the most important causes of disability, accounting for around one third of YLD among adults aged 15 and over." Specifically, unipolar depressive disorders are the leading cause in both males and females, in high-income countries and in low- and middle-income countries.