Sleep versus Exercise

Long-term, severe sleep deprivation can result in severe illness, hallucinations and death.  That doesn’t mean that short-term lack of sleep has no adverse consequences.  Recent studies have found that even  several  days of  reduced or shallow sleep can accumulate and resemble the effects of several dozen hours of acute sleep deprivation. 

Sleep deprivation increases the risk of obesity, diabetes, and cardiovascular disease, which are among the medical conditions that we try to prevent via regular exercise.  Thus, even looking at the short-term, sleep deprivation has significant adverse effects that almost certainly outweigh the benefits of exercise.

The sleep versus exercise question has no black and white answer, since exercise is often beneficial to sleep.  Recent findings suggest that, contrary to popular belief, exercising vigorously close to bedtime does not cause insomnia. So my overall feeling is that, given a choice between sleep and exercise, sleep should be given priority.

Thoughts on “The Leap”: New York Magazine’s cover story, June 7, 2010

The magazine cover shows a photograph of a young Dalton School football player,  Teddy Graubard.  The expression on his face is indecipherable, as appear to be the reasons for his suicide on  February 18, 2009.  The story of this tragic event appeared the next day in the New York Daily News but received little overall media coverage.  The News followed up with an article on depression among teens.  Teddy, 17, had jumped out of a partially-open 11th floor window at Dalton, the prestigious and academically challenging Manhattan independent school, and landed on the sidewalk near a group of children.   

The New York Magazine article was written by Jesse Green, a well-respected contributor to New York,  The New York Times, and other publications.   Teddy is described in the article as having been generally happy and brilliant,  a successful athlete who overcame his natural awkwardness. He was, “Intense… spontaneous with both affection and self-reproach. (He gave bone-crushing hugs to almost anyone, and banged tables so hard when frustrated that classmates flinched.)”

A precocious and happy child,  Teddy grew into adolescence,  and people began to notice a change. He would stay up late reading arcane materials such as almanacs,  and developed increasingly concrete thinking. One day he asked his mother if she thought he was autistic.

Teddy was tested, and found to have a mild form of Asperger syndrome,  a condition on the autism spectrum, first described by Austrian pediatrician Hans Asperger in 1944.  Asperger noted characteristics such as lack of empathy, little ability to form friendships, intense absorption in a special interest, and “clumsy movements”.  He called children with Asperger  syndrome “little professors” because of their ability to talk about their favorite subject in great detail.

Whether the diagnosis was the correct one for Teddy is beyond the scope of this blog.  The article states that he was seeing a psychopharmacologist  and was taking  Risperidone, an antipsychotic agent sometimes used “off-label”, in other words not according to official FDA  guidelines, for autism, obsessive-compulsive disorder, and other conditions.  Teddy was also taking an antidepressant. 

Mr. Green explores the issue of whether Teddy’s suicide was impulsive, as opposed to planned.  Teddy had been found, via monitoring of his laptop by school officials, to have cheated on an exam the morning of his suicide, was aware of this, and had gone up to an empty dance studio on the 11th floor.  A teacher found him there, inquired about his presence, and was told that he wanted to “look around”. 

Mr. Green describes the concept of impulsive suicide as controversial.  “As much comfort as it may provide survivors… ‘Mental-health types’ , (quotes are mine) , including many youth-suicide experts, prefer to de-emphasize the concept, insisting that almost no one kills himself without a history of mental-health issues…” That is certainly debatable, particularly when one is dealing with adolescents, whose moods and self-concept can turn on a dime. 

What disturbs me most about Mr. Green’s article is the following statement: “But Teddy gets lost in this debate. He’s neither a romantic hero nor a public-health trend. Nor did he jump because of a mental illness, even if a “mental-health issue” contributed.  He jumped because his foolish solution to a passing academic problem reacted with the peculiar ideational rigidity of his condition – and, who knows, perhaps with the ‘suicidality’ that is a potential side-effect of most psychotropic medications – in a way even he, with his complicated brain, could not have predicted”.

Here, Mr. Green, with extraordinary hubris, and apparently armed with a “retrospectroscope” of Hubble-like proportions,  rushes in where not only angels, but ”mental-health types”, fear to tread, and gives us the explanation we’ve all been waiting for. 

Thank you, Mr. Green, for turning an otherwise interesting and informative article into a ”psychological autopsy” that, I would venture to say, you are completely unqualified to perform, let alone draw your “ex cathedra” conclusions from.

No, not your nineteenth…

There’s an interesting article in today’s New York Times Health section about the reemergence, of sorts, of the old concept of  “nervous breakdown”.  This term has long been criticized as vague and unscientific by mental health professionals, yet in many ways, quite effectively describes what occurs.  The term  ”burnout syndrome”, conceived and diagnosed in Europe,  has appeared in scientific articles, with “vital exhaustion” as a symptom.  Is the reincarnation of “neurasthenia” coming next?  Link: http://www.nytimes.com/2010/06/01/health/01mind.html