A collection of some of the writing I’ve done.
EYETHU – STELLENBOSCH LIFE LESSONS – from a collection of 25 – 2017
Vusi was happy. He had been working for two months at his new job and his boss was very happy with him. ‘You’ve got a good attitude Vusi. Keep up the good work – I can see you are going to go far in life.’ That’s what he had said today. Vusi stopped in at The Department of Coffee on his way home to treat himself with his new favourite taste – a latte. It was coffee with lots of milk. He loved it! Much better than tea, but he would never tell his mom that. She thought tea was the best thing to drink for any reason.
It was a warm day and Vusi had taken his jacket off. He held it over his arm and sang to himself as he walked home. Suddenly a man staggered towards him, out of nowhere. It was his dad.
‘Vusi my boy. Vusi. My son. Look at you, so big and strong. Look at that uniform. You’re a big man now, neh.’
His dad’s breath almost knocked Vusi over – he smelt like methylated spirits. Maybe that’s what he had been drinking. Vusi’s dad put his arm around him and his stumbling knocked Vusi’s latte out of his hand. ‘My son. Vusi. Hello my son.’
His dad was completely drunk. He was mumbling and kept repeating, ‘Vusi, my boy, my son.’
Vusi stood still and gently pushed his dad away. ‘Hello dad. How are you?’ His dad just looked at him, a silly smile on his face. He was swaying a bit and put his arm out to hold on to Vusi again.
Look at him, thought Vusi. If mom was to be believed, this man used to be so clever. So strong. He had dreams. He was going to become a doctor one day. They had met at the hospital. Vusi’s mom was a nurse and Frank, his dad, a cleaner. But he always said he wouldn’t be a cleaner forever. He was going to study to be a doctor. Then, who knew why, he’d started drinking. And he didn’t stop drinking. Soon after Joe was born, their dad stopped coming home. They saw him sometimes on the streets, always drunk.
Vusi stared back at his dad. He felt angry, ashamed and sad all at the same time. Why had he left them? Why was beer so much more important than his own two sons? Vusi thought about all the times he had needed his dad and all the times his dad simply wasn’t there.
‘Dad’, Vusi said. ‘I have to go now. Mom is waiting for me. Keep well, dad. Look after yourself.’
His dad still just looked at him. He stumbled again and started to shuffle away, mumbling, ‘Vusi. My son.’
Vusi watched him walk away and felt pity. That wasn’t the same man who had married his mom. He wasn’t the same dad who had been so proud to have a son. He wasn’t the same man who wanted to be a doctor. That man was gone. Something else was in his place. Alcohol and broken dreams had taken his dad away. Vusi didn’t understand why. But he knew he couldn’t hold on to the anger and hurt like Joe did. He couldn’t let this man destroy his life the way he had destroyed his own life.
‘I forgive you dad’, Vusi whispered as he watched Frank move away. He felt lighter then. He felt as if a burden had lifted and even his lost latte was forgotten. He would be the man his father couldn’t be. He would rise above the damage and the hurt. He would not be held back by anger, hurt and hatred.
ARTICLE FOR WELLNESS MAGAZINE 2017
How much of the food on supermarket shelves actually goes to waste? Retailers around the world are finding ways to feed the world on what you don’t want.
PULL QUOTE: Across the world, restaurants are beginning to install fridges outside their eateries so they and patrons can place left-overs in an easy-to-access space for those in need.
We’re all used to seeing ‘best before’ and ‘sell by’ dates on food purchased at most supermarkets. A number of retailers have for years been giving their ‘sell by’ food that hasn’t yet reached its true ‘best before’ date to charities. It’s a great initiative that supports numerous people in need. But is it enough?
WASTE NOT WANT NOT
A 2013 CSIR study titled “The magnitude and cost of food waste in South Africa” found the costs [of food waste] to the economy were estimated at R61.5 billion a year or 2.1 percent of our GDP. “At the same time, 70 percent of poor urban households in South Africa live in conditions of food insecurity.”
Have a quick look in your fridge and count how many items are likely to get thrown away before they can be eaten or used. It’s generally quite shocking how much food is wasted on a daily basis. But, there’s not much you can do about it, or is there? Being consumer-aware is one way to stop food waste – buying only what you need for the day or week is something more and more people are doing. It does stop you from over-buying but it can be a slightly more expensive way to shop. Bulk items are usually advertised as being marginally cheaper and then there’s the convenience of doing one big shop as opposed to many little shops over the month.
Yet, even for the savviest shopper, there’s most likely going to be a few tired carrots or a couple of chops that need to be thrown away. Of course, you could ensure that food that’s not going to be eaten but will go off in a couple of days is given to someone in need – but how? Across the world, restaurants are beginning to install fridges outside their eateries so they and patrons can place left-overs in an easy-to-access space for those in need. We’re not talking half eaten chips and just a bite of a burger, but specially packaged food that’s already been paid for and would normally be thrown out.
One man in Saudi Arabia wanted to find a way to help the myriad homeless children in his area, so he installed a fridge in the street where he lived and asked neighbours to help in keeping the fridge stocked. Children were free to help themselves to whatever they needed – from water and fresh produce to nutritious meals. Another charitable organisation in Belgium did a similar thing – installing a fridge on the street that’s kept stocked by the kindness of strangers. The fridge is open 24/7 and is for anyone who is in need.
So, there are ways to ensure that food doesn’t go to waste. Sceptics in South Africa might feel a fridge wouldn’t last long unattended, so are there any other ways to ensure those in real need can benefit from consumer excess, without the admin? Maybe it’s time for some creative thinking. Although South Africa does have a food bank that sorts and distributes food to numerous charities, it must of course be strictly controlled in terms of food safety. There’s a time limit involved – giving away food isn’t quite as easy as donating a pair of shoes or some clothes. But communities can get together and create fresh produce growth areas, that can feed the community and those in need locally – no cold chain necessary.
The dramatic waste of food isn’t the only problem with throwing away foodstuff that’s past its use by date. The packaging your food comes in makes a major contribution to landfill, and this is a world-wide issue. By being mindful of what you are buying, as well as the packaging of your food products, will go a long way in helping you do your bit for reducing landfill issues. For example, instead of shopping for a bag of onions, rather buy one or two at a time – this way you won’t also be purchasing the plastic packaging that a whole bag is housed in. Most consumers are used to taking their own bags to the supermarket, to assist in reducing plastic bag waste. It’s now becoming possible to take your own containers as well. Dotted around South Africa are stores allowing you to bring your own containers – so you can fill up your own milk or olive oil bottle and the like.
While not every grocery store is geared up for this, we are now in ‘the age of the consumer’ and what consumers demand will begin to happen. The term ‘age of the consumer’ was coined by Forrester Research, referring primarily to how technology, social media and efficient information exchange will affect product development and marketing – but in short, how companies and businesses will transition to become more adaptable and consumer or customer-centric than ever before.
GIVE IT BACK
While the streets of SA aren’t dotted with charitable fridges at the moment, you can at least be part of reducing food waste by shopping mindfully (always shop with a recipe in mind); freezing food immediately that won’t be eaten straightaway (freeze half the loaf of bread); composting vegetables, tea, coffee grounds, egg shells and other compostable items to reduce landfill; use your own packaging in supermarkets and find a nearby charity or person you can offer food to on a regular basis; grow your own and make the excess available to those in need. The future is in your hands and it’s up to everyone to make a conscious stand against unnecessary waste.
DID YOU KNOW: In South Africa, 31,4% of all the food produced in the country annually goes to waste, a total of 9,04 million tons. Add imported food and South Africa wastes 10,2 million tons of food annually. The value of this is R61,5 billion, or 2,1% of the country’s GDP. Of this amount, 27% is wasted during processing and packaging, followed by agricultural production (26%), post-handling and storage (26%), distribution (17%) and consumers (4%). Reported in Farmers Weekly, 8 January 2016.
ARTICLE FOR BLAQUE MAGAZINE 2015
THE ECONOMY OF SEX
If you think that you’re not paying for sex, think again – the question is just how much
In 1960, the contraceptive pill was cleared by the American Food & Drug Administration for general use. While groundbreaking, nobody was really aware how much of an impact this would have on the world at large.
The Freakonomics team, journalist Stephen Dubner and award-winning economist Steven Levitt explain the economics of sex succinctly in an animated video produced by the Austin Institute for the Study of Family and Culture. The key concepts from this outline the far reaching effects the pill has had on how we deal with sex and relationships today.
It starts with the basic premise that sex is an exchange – each participant is giving something of themselves. Pre-pill, sex wasn’t taken lightly because the cost of sex could be parenting. So, while there might have been a lot of heavy petting in your grandparent’s time, sex simply wouldn’t have been on the cards unless a serious commitment had been made. In fact, marriage was the key to sex back then.
The invention of the pill not only saw women moving out of home and seriously getting into the workplace, it also brought about a sexual revolution. One wonders if the 60’s decade of free love would have happened without this miracle pill.
But, the other thing it did was change the supply and demand aspect of sex. Previously, there was a lot of demand but little supply, unless you were prepared to pay a premium for it (marriage). With the advent of the pill, the supply went up substantially – the fear of pregnancy was greatly reduced.
That’s not to say that women stopped wanting commitment and marriage; rather men were only too keen to make promises they were likely to break, without fear of parentage as a consequence. Women still had something men wanted, but now the cost was reduced from a lifetime to commitment to potentially a couple of drinks and maybe dinner.
WHAT MEN WANT
Online dating sites have revealed that men are mostly looking for fun, while women are still looking for commitment. Whereas before women had the advantage over men, by being able to withhold sex until they got the value exchange they wanted, the fact is that men are fertile for way longer than women, so they can afford to wait.
Men now have so many more choices regarding who to marry than they did before. Dubner and Levitt say that nowadays women can be picky about their casual sexual partners, but men can be picky about their marriage partners. This means that women are now competing with each other for the ‘ultimate price’. Before the advent of the pill, women were complicit with each other – they basically banded together and monopolised the value of sex. Now, it’s every woman for herself. The Freakonomics team contend that if women stopped competing and put their collective foot down, men would be in real trouble.
Sex has always been a women’s resource – collectively, she’s allowed it to become less valuable.
WHERE’S THE MONEY?
While economy is all about exchange, you might want to know where all the money is. Forgetting the cost of the pill and the possible cost of health implications, men and women spend an extraordinary amount of money on making themselves attractive. Just think of the fashion and beauty industry and you mind will boggle at what the world is spending on just looking good. Other than your immediate physical self, there are also the other assets that help make you more attractive – such as where you live, what car you drive, what your job title is.
As previously mentioned, women get to be picky about their casual partners – this means men have to really compete for those first dates or one-night stands. To compete in today’s world, you need to not only look good, you also have to be engaging and have a little cash in your pocket. Women on the other hand also need to bring a whole lot more to the table if they’re expecting a marriage proposal. So, just think about higher education, short courses and the like – there’s a whole lot of money tied up in that.
It does seem that almost everything is tied up in this economy of sex – from bed linen and gym contracts to the property market and higher education. So, what really is the cost of sex? Is it just a few drinks or is it a lifetime of education, grooming, character building and charm? Whatever the cost, it’s definitely not free; but paying the price may just make you a better person.
ARTICLE FOR LONGEVITY – 2017
Melatonin – sleep aid or hormonal nightmare?
Once touted as a perfect over-the-counter natural solution for sleep issues, melatonin is now a scheduled medicine; we look into the reasons why, and see what other uses melatonin may have.
PULL QUOTE: Currently the only legitimate use for melatonin is jet-lag, at a dose of 6mg daily
Dig deep into an air hostesses hand bag and in amongst the tissues and lipsticks, if she’s on the East to West route, you may find a bottle of Melatonin supplements. Having your day becoming night and your hours all mixed up messes with your sleep patterns.
If your body naturally produces melatonin, it stands to reason that taking it as a supplement could stimulate your body’s natural ability to produce it. Or does it? Your natural production of melatonin is directly related to light and the day’s cycle into night. But when you take a supplement, it kicks into action no matter the time of day. That’s why it’s the perfect solution to jet lag.
Largely unregulated for years, melatonin has also been the go-to natural solution for sleep onset insomnia (difficulty falling asleep). But, dosage is important – so without regulation, you could be taking too much or too little. The problem with taking too much is that it could cause your body to stop producing melatonin, which in turn could cause you to develop a sleep disorder.
The pineal gland, which regulates melatonin in your body, is triggered by the suprachiasmatic nucleus (SCN – a small region in your brain responsible for controlling circadian rhythms), which is in turn triggered by the light receptors in your eyes. Synthetic light has a major effect on our circadian rhythms, effectively disrupting sleep cycles. Taking too much melatonin will also have a negative effect on your natural sleep-wake cycle.
Dr. Graham Duncombe, the Health Renewal Functional Doctor at the Skin & Body Renewal Group says that “The duration of use is most important and I don’t recommend using melatonin continuously for longer than three months. During this time, it is still a good idea to have some breaks such as on a Saturday night, to avoid its suppressant effect.” Most health practitioners will agree, and integrated Medical Practitioner, Dr. Hema Kalan says it can be a short term solution but it’s much better to look for and treat the root cause of sleep issues; of which there are many, from obstructive sleep apnoea and musculoskeletal disorders to medication, vitamin deficiency and stress.
[IN BOX] WHAT IS MELATONIN Your body produces melatonin, which is a hormone regulated by your pineal gland and linked to your circadian rhythms. During the day, your pineal gland is inactive, but when the sun goes down, it begins to produce melatonin and this is released into your bloodstream. The levels of melatonin in your blood stay elevated for for around 12 hours and begin reducing as the sun begins its ascent. During the day, your melatonin levels are barely measureable. Natural melatonin levels peak at around midnight, so dosing should mimic this effect. Blue light causes a delay or inactivates melatonin, so phones and computers should have a red light filter after sunset (or even better, keep away from screens at night).
In March 2012, a number of changes were made to the schedules of the Medicines and Related Substances Act 101 of 1965 – one of those changes was that Melatonin was made a schedule 2 medicine, meaning it can only be obtained with a prescription. Currently, the only legitimate use for melatonin is jet-lag, at a dose of 6mg daily. One of the reasons that melatonin was regulated is because people were taking far too much of the supplement, according to Dr. Kalan.
But what has happened to the myriad supplements that were so readily available? It’s not that easy to get hold of melatonin anymore, other than through internet sites, which aren’t always the best option. Some anecdotal reports suggest that a pharmacist will give you a limited supply of melatonin if you say you need it for jetlag, without a prescription. This shouldn’t be the case, given that the supplement is now scheduled.
While you can get melatonin at your local pharmacy, on prescription, it’s recommended that you use a compounding pharmacy – Dr. Duncombe reiterates this, “The advantage of compounding pharmacies is that they can compound a patient-specific dose and provide bioidentical melatonin with the least chemical additives.” He doesn’t recommend a slow release formulation, however, as it won’t mimic your body’s natural biorhythms and can even suppress cortisol and testosterone.
DID YOU KNOW? Melatonin can interact negatively with certain medications, so tell your health practitioner if you are taking any of these: blood-thinning medications (anticoagulants), medications that suppress the immune system (immunosuppressant’s); diabetes medications; and birth control pills. This advice comes from Dr. Brent Bauer, a Director of the Department of Internal Medicine’s Complementary and Integrated Medicine Programme at Mayo Clinic.
THE CASE FOR BREAST CANCER
The Cancer Association of South Africa (CANSA) says that breast cancer is the most common cancer in women of all races, other than non-melanoma skin cancer. But, while melatonin is only allowed to be taken for jet-lag, and then only for a short period of time, researchers have found that supplementing with melatonin can actually reduce the growth of breast cancer tumours in some people. Breast cancer tumours grow in a certain way and through research, it’s been found that small doses of melatonin can actually assist in stopping tumours in their tracks.
According to the University of Maryland Medical Centre, studies have also shown that melatonin may strengthen the effects of some chemotherapy treatments used for breast cancer. In addition, a small study was done on women taking tamoxifen for breast cancer who weren’t getting any results – the addition of melatonin caused tumours to reduce slightly in 28% of the women in the study.
Further research is needed to establish if melatonin supplementation can be used as a viable option for treating breast cancer. But the research is looking positive and Dr. Duncombe says that melatonin has an indirect effect on hormones, and has an anti-inflammatory effect. He says that breast cancer has been linked to lower melatonin levels, which are usually caused by light pollution. It also promotes the growth hormone and DHEA levels, as well as lowering excessive estrogen levels.
Dr. Kalan says that interim results from studies on high doses of melatonin (50mg daily) are promising for people with stage 4 breast cancer, prostate cancer and gastrointestinal cancers.
SAFE FOR CHILDREN?
The ADHD Support Group of Southern Africa indicates that between 5-10% of people in South Africa have ADHD. One study has suggested the use of melatonin for children who experience insomnia as a result of ADHD. Child Psychiatrist Dr. Fiona Schulte says that “around 25% of children with ADHD report disturbed sleep patterns, particularly in the form of (chronic) sleep onset insomnia. Insomnia is in general a big problem in children with ADHD even without being on Methylphenidate (Ritalin), but often the medication makes it worse.” Parents who find that the hyperactivity, especially at night, difficult to deal with shouldn’t get too excited about a natural solution.
Dr. Schulte adds, “A bigger concern clinically is that Melatonin only promotes falling asleep, meaning you can address initial insomnia, but it has no effect on middle insomnia or early awakening and there seems to be reduced effectiveness with chronic use and you might need to increase the dose or have a ‘drug holiday’ and restart after a few weeks.”
During an interview with Science Daily, Director of the Circadian Physiology Lab at the University of Adelaide in Australia, Professor David Kennaway said that the “use of melatonin to treat children’s sleep disorders is ‘rather alarming’. He said there is ‘extensive evidence from laboratory studies that melatonin causes changes in multiple physiological systems, including cardiovascular, immune and metabolic systems, as well as reproduction in animals,’ and its effects on children’s developing bodies is yet unstudied.”
“Melatonin isn’t a safe option for children”, says Dr. Duncombe. He recommends rather looking for the cause of sleep difficulties, and looking to behavioural therapy. Dr. Schulte agrees, saying that “treatment with melatonin in children with ADHD is best reserved for children with persistent insomnia that is having a severe impact on daily functioning, particularly in cases where there is an obvious phase-shift of the endogenous circadian rhythm.”
While melatonin is useful as a sleep aid, and could possibly have positive effects on breast and other cancers, it does need to be used carefully and only on a short-term basis. If you’re having trouble falling or staying asleep, the first steps should always be lifestyle intervention as opposed to medication or even supplementation.
ARTICLE FOR BLAQUE MAGAZINE 2015
South Africa is rich with untold narratives. We spoke to David Forbes, a documentarian who risked so much to tell just one of those stories
‘There’s a huge gap in honouring our heroes. Why? Because nobody is telling the stories’, says David. Born in 1956, David skirted on the edges of activism in his youth; although he does say he’s not an activist, but rather ‘active’ – he’d never been part of any of the political structures in existence. He was briefly detained while studying at Rhodes University and remembers it as a terrifying experience. Like many of his contemporaries though, David fled to Australia for a time. But on hearing Nelson Mandela speak in Sydney, he returned to his home country, vowing to never be silent again.
LEST WE FORGET
Making The Cradock Four was part of this vow. So we never forget. Asked why he chose this particular story, David says it just gripped his imagination. He was the same age as Fort Calata, one of the four. The four were Matthew Goniwe, a school teacher; Fort Calata, also a school teacher; Sparrow Mkonto, a railway worker and unionist; and Sicelo Mhlauli, a headmaster from Outshoorn and an activist in his own right, was actually just along for the ride to catch up with his old friend Matthew.
David also says that when the four were found murdered, everybody knew it was ‘them’; the security police. It was touted as black on black violence, but that simply wasn’t the truth. In fact, their murders became a turning point in the struggle. On the day of the funeral, then President PW Botha declared a State of Emergency. Within five years, Nelson Mandela walked free.
Pull quote: ‘The death of these gallant freedom fighters marked a turning point in the history of our Struggle. No longer could the regime govern in the old way. They were the true heroes of the struggle.’ Nelson Mandela
When he first decided to make a film about this tragedy David tried to raise money, but it seems nobody was interested in telling the story. So, he resolved to do it on his own. It was a pioneering act of defiance against the SABC, which wanted to own everything it was involved in. The decision wasn’t easy of course and David could quite easily have given up on the whole idea.
But the story had really gripped him. He knew it was important to tell. He knew there would be great footage of the funeral in various media house archives – the funeral had been extensively covered by all major media; and with the state of emergency declared on the same day, most activists were arrested on their way home from it. So, David began gathering archived footage, as much as he could get from various sources – such as the SABC, the TRC and fellow documentarian, Mark Kaplan; although he wasn’t able to get the SABC archives as their price at the time was €7,000 per minute. The archived footage that David did manage to secure is now housed in the Mayibuye Archives at the UWC.
Gathering all the information took time and David was even forced to use the Promotion of Access to Information Act No 2 of 2000 to take the Department of Justice to court to gain access to archived footage [this is detailed in South African History Archive’s 2009 publication, Paper Wars: Access to Information in South Africa, edited by Kate Allan].
David also managed to gain access to Police archives, using his own equipment to read the files. However, those records were confiscated from him once he’d managed to extract what he needed. Needless to say, getting all the necessary information wasn’t an easy task by any means.
Before attempting to gain access to the various archives, David needed to be in contact with the grieving families. ‘Its’ very difficult making films like these’, he says. ‘You’re invading very private spaces of grief, and you’re asking these people to re-live the worst moments of their lives.’
He met with each widow individually to ask their permission to make the film. He also had to tell them it might be years in the making and there was no guarantee of any money. David did form a trust, however, for any profits from the film to be distributed to the families. The resulting interviews on the documentary are fascinating, albeit hard to watch as the grief is still very much there.
With the piles of research he’d gathered, David also had to simplify the story for the sake of the film. There were so many elements that could have been told, but in the end, he decided to tell the version that had been outlined during the TRC process, which was a largely unsatisfactory story, with no real hard and fast outcome and retribution.
THE BACK STORY
While telling the story was a process in itself, David’s journey to the end of the film has its own drama. In the midst of battling cancer, he thought he’d hit a huge break when he met a French documentarian, Michel Noll, in Cape Town who was looking into doing a story on political assassinations and was keen to partner with David on the Cradock Four.
David spent a number of months about 80 kilometres outside of Paris, working with his co-producer on the edits of the film. There did seem to be some difficulty in getting the agreements for co-production and distribution signed and sealed. However, David was just so pleased to have someone on his team, who also promised funding and assistance with distribution, that he put any doubts aside.
It was only when he’d returned to South Africa to film the dramatisations needed for the documentary that he really began to worry. On the day the shooting began, with a full film crew waiting, funds had still not arrived from France. Although some funds had been sent from France, it wasn’t nearly enough to cover all the essentials. David had no choice but to use his own money, borrowing from his house bond. He remembers arriving at the shoot with a serious amount of cash strapped under his shirt to pay everyone.
After that, it was back to France again for more editing, and to complete the 52 minute version for television broadcasters. The post-production process went completely awry due to Michel’s hollow promises, and David spent a number of frustrating months travelling between France and home to get the film finished.
It was in April that he returned to France, still without a finished product, to get the film to the MIP-TV market in Cannes. After finally getting an edited 52 minute product, David had a nightmare journey. He parked the car he’d borrowed from Michel at the editor’s house in Paris and in nightmare traffic made his way to the Metro. He ended up tripping in the Metro, sprawled on the train platform, and as every minute counted, he missed both the train and his flight. He eventually managed to get back to the editor’s house and Michel’s car, and began his journey to Cannes along roads he’d never before travelled. It was midnight by the time he got onto the road, however and David had to keep stopping to sleep along the journey, continuing whenever the extreme cold woke him up. He arrived at midday the next day.
Film delivered, David’s next leg of nightmare began with the 2010 Eyjafjallajökull volcano eruption in Iceland that grounded all air traffic for weeks, affecting over 10 million travellers. David’s wife Nadine was in England at the time and he booked himself onto the Chunnel to rescue her.
Sometime later, he arrived back at Michel’s house to try to salvage the editing process. To little avail. David says, ‘I was forced to leave France, having run out of money and Michel kicked me out of his house. Only after I came back to SA did I manage to persuade him to courier back the Master Tapes so I could complete the On-Line and Audio Mix here in SA and fix all the coding errors.’ David also served papers on him and laid charges with the French police, but so far, nothing has come of it.
His co-producer had failed on every count – from sales to funding. David was well and truly on his own again; and around half a million down on his bond.
Watching The Cradock Four, you’ll be grateful to David for all he went through to make the film – to tell the story. It’s certainly a tear-jerker and definitely honouring to the four men who were, let’s be honest here, murdered for their beliefs. The film was aired on the Day of Reconciliation in 2014, on DSTV through AfriDocs. The Cradock Four won Best SA documentary at Durban International Film Festival 2010 and nominated for Amnesty International (Durban) Human Rights Award 2010. The film has been screened in Berlin, Moscow, Cradock, Port Elizabeth, “The Bioscope”, Johannesburg, Cape Town, Ditswanelo Film Festival 2011 (Gaborone), Windhoek, Encounters Documentary Film Festival (2010) and at the TriContinental Film Festival (2010).
While David readily admits there is so much more to be told of the story, he’s proud of the film and is still doing what he can to get the story out there. There’s now a memorial to the four in Coega Vulindlela Village, near Port Elizabeth. If you’d like to find out more about the stories behind the story, go to David’s website dedicated to these men: www.thecradockfour.co.za
ARTICLE FOR HEALTH INTELLIGENCE 2012
Diagnosed or labelled?
The term bipolar is bandied about quite extensively – what does it really mean, how is it diagnosed and is it influenced by changing social norms?
Up until the 18th Century, unusual behaviour was viewed with suspicion and superstition, and so-called madness was linked to demonic forces and punishment from above. We all have opinions on what’s deemed normal
or abnormal behaviour and, to some extent, our current cultural and social environment dictates what that norm is. Doctors rely on certain criteria to make mental illness diagnoses and there are three basic measures that are the starting point:
- Deviance Does behaviour deviate from the norm, and is it deemed abnormal by society at present? For example in the 1500s, King Henry VIII had Mary Boleyn as a mistress and only married her sister Anne when she refused the same status. Prince Charles was heavily slated for his friendship with his current wife Camilla, while married to Princess Diana, indicating that behaviour accepted in King Henry’s time is no longer part of societal norms
- Maladaptive behaviour Enables a person to cope, but isn’t necessarily helpful in the long term. Avoidance of social settings due to anxiety is an example, specifically when this avoidance does nothing to cure or treat the anxiety in the first place
- Personal distress Everyone experiences times of distress, such as financial pressure or the ending of a relationship, for example. But when this state is prolonged, it’s often a precursor to anxiety or depression.
The Diagnostic and Statistical Manual of Mental Disorders
(DSM) is seen as the gold standard in diagnosing mental illness. It’s updated regularly and uses five axes to determine diagnoses. These include clinical syndromes; personality disorders or mental retardation; general medical conditions; psychosocial and environ- mental problems; and the global
assessment of functioning (GAF) scale. All this covers the basics of diagnoses for mental disorders. As more is learnt about human physiology, neurology and psychology, criteria are refined further. Hilgard’s Introduction to Psychology – twelfth edition, published in 1996, states that although depression is prevalent in American adults, bipolar occurs in less than 2% of the population. The National Institutes for Mental Health, US, now states the prevalence to be 2.6% of the population, with over 80% of those being severe cases.
ONE, TWO OR MORE
Characterised by dramatic shifts in mood, energy and activity, bipolar has far-reaching effects not only on the sufferer, but also the people who love and live with them. Manic episodes are one of the key characteristics in identifying bipolar disorder, coupled with periods of depression. There are two different types of bipolar: I or II.
Bipolar I is characterised by one or more manic episodes occurring in one’s lifetime. According to the DSM, a manic episode includes reduced sleep requirements, perceptions or feelings of grandeur, racing thoughts, preoccupation with an idea or thought and overindulgence in pleasurable behaviours which may have negative outcomes (such as sexual adventures, risky financial dealings or extravagant spending). To be diagnosed with bipolar I, you must have experienced both a manic and a major depressive episode. The time periods between the different episodes of mania and depression are often individualised and affect the treatment. It’s possible for a person to experience rapid cycling, where the periods of mania and depression occur four or more times throughout a year, as well as for both mood states to occur simultaneously. Ultra-rapid and ultra- ultra rapid (ultradian) cycles can also occur, where the mood shifts over a period of days or even within one day.
Bipolar II is seen as the less severe type and doesn’t have the accompanying dramatic manic episodes, but one or
more hypomanic as well as a depressive episode is required for diagnoses. Hypomania is a less severe form of mania, and can be likened to a heightened state of mind – where thoughts are clearer, the mind works faster and mood is elevated, but without the over-the-top riskiness of a manic phase. Sometimes mania is present, but is overlooked because depressive symptoms can overwhelm its effects.
Cyclothymia is similar to bipolar and diagnosed when mood swings are present, but not severe enough to be termed manic or major depressive. It’s perhaps this re ned diagnosis that blurs the line between what’s deemed normal or abnormal. If a mood isn’t high enough to be affirmed as manic, and in that case, not out of bounds enough to be damaging or dangerous, could it not just be called a good mood? So, too, if a down mood isn’t low enough to be clinically addressed as a major depressive episode, perhaps medication isn’t required, but can be dealt with through lifestyle changes. Is labelling necessary then, and is the medical profession possibly creating disorders to satisfy patients’ need for tangible answers, as highlighted in an article published by the Citizens Commission on Human Rights International?
With celebrities such as Catherine Zeta-Jones, Sinead O’Conner, Robert Downey Junior and Stephen Fry speaking out about their bipolar diagnoses, the stigma of the disorder is slowly being given a positive slant. However, research shows that self-stigma, as well as others’ perceptions, can have a damaging effect, worsening the consequences of the disorder. Even if negative stigma is merely perceived, the effect can be significantly dispiriting. A report in the Journal of Affective Disorders highlights the positive aspects of bipolar (spirituality, empathy, creativity, realism and resilience) and suggests that treatment would be more effective if these positive traits are encouraged. Creativity is an accepted characteristic of bipolar, although it isn’t a defining factor – in other words, a diagnosis of bipolar does not necessarily mean a person is creative. An article published in the Mental Health Review Journal discusses the effects of bipolar on author Herman Melville’s ability to write Moby Dick and concludes that the disorder has positive benefits to society. Johns Hopkins University Professor of Psychiatry, Kay Redfield Jameson, known for her poignant and honest biography An Unquiet Mind about the effects of bipolar, encourages doctors to minimise medication as much as feasible to ensure that the inherent creativity of bipolar isn’t dampened.
Currently there’s no cure for bipolar, and sufferers are doomed to a life on medication, such as antidepressants, mood stabilisers or antipsychotics, or a combination – all of which come with their own side effects, from lowered libido to weight gain. In addition to medication, psychotherapy is recommended for the bipolar person as well as their family. However, as science delves deeper into the brain and learns more about the processes of neurons, alternative treatments are beginning to come to the fore. One such treatment is deep brain stimulation (where a device called a brain pacemaker is implanted in the brain, and gives o electrical impulses that are targeted to specific parts of the brain), although it’s only been tested in terms of treating depression in bipolar, not mania.
QEEG (Quantitative Electro-encephalogram), or brain mapping, coupled with neurofeedback is showing promise as a treatment for mood disorders. It’s already shown
good results for other brain-related disorders, such as ADHD. Basically, QEEG assesses areas of the brain that aren’t functioning normally, in terms of neuron ring, and neurofeedback offers the opportunity to train neurons to work more cohesively.
Highlighting the positive aspects of the disorder will certainly go a long way in changing public perception of bipolar and patient treatment, and new science could pave the way for less erratic treatment outcomes.