The Women’s Brain Book by Dr. Sarah McKay

Reading Time: 7 minutes

As a scientist with two years after her PhD training complete, I’ve realized time and time again the importance of effective scientific communication. I find value in reviewing the work of fellow colleagues and presenting it to an audience who has yet to be introduced to new findings.

I’ve mentioned before in previous “science-based” posts on this blog that science shouldn’t be intimidating, but oftentimes it comes across that way because many scientists are used to speaking with their peers. After years and years of school, training, and specialized research, technical terms become a part of one’s everyday jargon in the scientific research field.

So when I see scientific communicators like Bill Bryson—or in this post’s case, Dr. Sarah McKay—publish works meant for a general audience, I’m enthusiastic about reading them from a critical scientist’s point of view, and featuring them on this blog to pique your interest.

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The reason McKay’s book, The Women’s Brain Book, came across my (virtual) desk was because a fellow woman in STEM, Dr. Anjali Kasunich, and I connected on Instagram to form a “nerdy science girls” book club of sorts, because of our shared passion for disseminating topics in science for the general public. Anjali and I both thought TWBB would be a fascinating read for our inaugural IG Live book club series since it was expected to contain a hefty collection of peer-reviewed studies, simmered down to simplicity, in relation to a woman’s hormonal health and her brain.

TWBB has a chronological order to its chapters, with the book spanning over how a woman’s brain is formed, conditioned, influenced, and changed throughout all of life’s stages. Major external factors like the environment in which we grow up in, and the social connections we make, have a crucial impact on our general brain health as well.

Depending on your level of interest in a specific life stage and how it affects the woman’s brain, it’s easy to jump from one section to the other in the book without feeling incredibly lost. I decided to read the book in the “traditional” way, and while my background as a scientist made me familiar with some of the studies and concepts Dr. McKay mentions throughout the book, I found at least four key takeaways from the book that I thought were worth mentioning:

1. We are to be female, unless SRY has its way

My sub-heading title is not to be taken literally, but it refers to some interesting observations…

In the very first chapter of TWBB, McKay addresses an important detail – female brain development technically doesn’t take place right at conception, and its progression is based on whether or not the Y chromosome is present. If we define (in this context) a biological female as having two X chromosomes, and a biological male as having one X and Y chromosome, we can then understand why the presence of these chromosomes is life-changing.

McKay notes that when XY embryos are 6-8 weeks old, a gene known as the “sex-determining region of the Y chromosome” (SRY) is turned on. SRY allows for the development of the testes, as well as turns on several more genes that guide in other “male-associated” biological processes. Without the Y chromosome however, SRY and it’s associated genes remain off, and we become female!

I would have thought that if SRY has such a powerful role in male development, a similar gene would have a role in females, but that is not the case. I also found it interesting that while the presence of androgens (the family of male hormones that includes testosterone) turns on genes that involve the development of male organs and physical characteristics, the female hormone estrogen doesn’t have such a role in “feminization”. In fact, ovaries develop in the absence of testosterone.

We are conditioned to think that if A=Male, then B=Female, but perhaps we should think of it more like 0+A=Male and 0=Female. Nature prefers us to be female unless otherwise noted 😜.

Just a thought 🤔

2. Nature and nurture are equally important in brain development

Growing up in California, I remember seeing ads on TV—and later billboards, buses, and the metro when I moved to Los Angeles for grad school—for the First 5 California campaign, which emphasizes the importance of the first five years in a child’s life in regards to cognitive, physical, and emotional development.

In TWBB, McKay provides examples for which natural disasters could impact this development. One such example was an event that took place in Montreal in the late 90s. An ice storm left the city without power for 45 days, and researchers took it upon themselves to monitor women who were pregnant at that time to see how the development of their children was affected for years to come.

Understandably, the “Project Ice Storm” babies were born prematurely, and this also correlated to timing of a woman’s pregnancy (very early and very late stage pregnant women tended to have premature births). When the babies became toddlers, they not only had cognitive and language developmental delays, but attention deficits and behavioral problems as well. “Ice Storm Girls” had increased risk of puberty, obesity, and asthma, but interestingly, “Ice Storm Boys” tended to have more serious problems compared to the girls, and researchers hypothesize that this may be due to the fact that the female placenta is a more protective barrier against maternal stress hormones. While we can’t control the presence and timing of natural disasters, this study seems to demonstrate that external factors that impact a pregnant woman’s well-being can lead to striking outcomes in the development of her unborn children…

3. Hormone sensitivity and depression

I have struggled with depression as early as 18, but over the years, I have noticed that while it may be underlyingly chronic, there are certain periods in my life when the condition feels “stronger” than others. If I am to line up all the variables that could be involved, I automatically consider external factors contributing to stress, hormone fluctuations, and diet (quality and quantity of food, in addition to vitamin supplementation).

So I was certainly interested to see what sources McKay collected in regards to premenstural syndrome/ premenstrual dysphoric disorder, or PMS/PMDD. I am highly convinced that during a very stressful period of my life in late 2018 (the fourth year of my PhD, prior to the publication of my first paper…you can imagine), I was suffering from all symptoms associated with PMDD.

Some researchers have suggested that PMS is something that has developed out of social context, meant to “put down the woman” as a reason for her “inability” to perform activities. At first, I wasn’t sure how I felt about this because the way I see it, it is good to have a medical reason to explain why you feel certain symptoms at certain times of the month. Of course, each woman has a unique experience—unique symptoms, unique timings, you name it. I often found that in my situation, I had non-stop irritability, mood swings, intense bouts of crying, and physical issues like fatigue, sleepiness, and bloating that went on for half the month, only to quiet down around my period, but rise back up again within a few days after my period ended.

So, I did have these crazy symptoms, but sometimes it felt like I was under nature’s wrath for almost the entire month, or sometimes only in the two weeks before and after my period. Confusing in an understatement 🤷🏽‍♀️.

McKay’s note about a 2013 Canadian study titled “Mood in Daily Life (MiDL)” was able to find that in a cohort of women who were asked about their PMS-associated symptoms—without knowing they were being asked about PMS—there was no significant correlation that PMS phase influenced mood. The researchers suggested that the symptoms were more influenced by factors in a woman’s life that were external, like lack of social support, environmental stress, or poor health.

While this could be, I was relieved to see McKay included a note by Jayashri Kulkarni, a researcher who supports the study of endocrinology to understand what causes PMS. And when she said that “women may differ in their sensitivity to hormones, perhaps via genetic variations in receptor structure or number”, I wanted to stand up and scream RIGHT???? THANK YOU 😂! I’m sure some kind of specialized hormone profiling for women at different phases of their menstural cycle could bring SO much more insight into caring for unique sets of symptoms. And given that my family does have a (maternal) history of mental illness, I can’t help but hypothesize that my genetic make-up influences how reactive I am to the hormones in my body, and how that in turn can influence how I feel.

One of my fave quotes from the book

4. Estrogen’s importance in late life

Even though estrogen doesn’t seem to be “so important” in utero, we can see it has tremendous effects on our well-being as we get older. McKay noted several points about estrogen throughout the book, including the point that high levels of the hormone in young, fertile women are thought to lower schizophrenia risk (although, context is needed to clarify what is considered “high”), and that low levels of estrogen could exacerbate PMDD.

In the latter half of the book, McKay touches upon menopause, and how estrogen and glucose are essential players in menopausal outcomes. The brain’s main fuel source is glucose, and it is a greedy little organ consuming 20% of our resting metabolic rate (RMR). McKay mentions an interesting observation that women who’ve had their ovaries removed before menopause experience a critical drop in estrogen, and that this drop is associated with increased type 2 diabetes risk. This risk is similar in women after they experience menopause naturally, suggesting that estrogen may have an essential role in regulating glucose metabolism and lowering diabetes risk.

While we can’t fight nature on certain processes like menopause (although solutions like hormone replacement therapy are available, with McKay going into detail on that in the book as well), it’s eye-opening to see how such tiny molecules have an incredible impact on our metabolic processes and in turn, our physical outcomes and well-being. All the more reason to take care of ourselves as much as possible!

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McKay has done an incredible job compiling what is known about the field in regards to women’s health and the brain, but as she points out time and time again, there is still so much more that can be done to understand a woman’s biology and its impacts on her brain health.

Recently, the NIH and other research funding bodies have stressed the importance of including male and female subjects in future research projects—especially if you have any hope of wanting to have your research funded in the future. This is a great step in the right direction, but there is no doubt we have a lot of catching up to do, as well as needing to put in energy to shift the current social construct of how women’s health is perceived.

If you’ve ever been curious about what we know so far about women’s health and the brain, TWBB is certainly a resource for anyone in this regard, whether you have an extensive science background or not!

Appreciating America

Reading Time: 8 minutes

It has been almost one year since I left for Italy—a year that oftentimes feels like ten.

In pre-pandemic times, my excitement for a new life experience in Italy was based on what I had read in travel memoirs, heard from Italian post-docs in my lab, and honestly, a number of baseless fantasies thought up by moi.

I had made trips to Europe before with family and by myself, and I was expecting Italy to match the classic, European allure of the other countries I had visited. Unfortunately, my expectations didn’t exactly match my imagination, and a lot of that was due to the pandemic. I’m still holding out on Rome though—I’m dying to know if the Eternal City matches up to all the pre-teen dreamy scenes of the Lizzie McGuire Movie…

When I see pastel-colored Vespas, I immediately think Lizzie McGuire Movie

This, and many other observations and experiences over the past year have led me to actually feel something I never thought I would, to the extent that I feel it now.

I am very, very proud to be an American.

Part of being a good American is complaining about America. We are enlightened about our right to free speech from a very young age, and it’s something we shamelessly take for granted. And of course, I was one of those complaining folks. I would shake my head with embarrassment every time America ended up on the news for a radical remark a president had said, or for decisions the American government had made that other countries had the right to tease us about.

I once thought I was one of a country of uncultured swine, but that is too cruel of me to say. Especially since I now realize no country is perfect, including Italy. I’m not saying America is without its faults, in fact, incessant gun violence and a money-guzzling healthcare system are not things to brag about. But as an American citizen, I’ve come to realize that there are plenty of things I have taken for granted that living abroad has made me reflect on and “re-appreciate”.

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1) Financial security…

Before coming to Italy and taking on a post-doctoral scientist appointment, I was given an award letter for my fellowship. At first glance, I thought WOW, they are paying me double what I’m getting now as a first-year post-doc/recent PhD grad!

Haha, there was a catch.

The full amount of the fellowship covered my employer’s expenses for having me on as an employee, taxes, and then finally my actual salary—which ended up being equivalent to a little bit more than what I was getting as a PhD student 😶😶😶.

I definitely was in shock upon realizing this, and before confirming my decision to take on the role, there was at least two weeks of back-and-forth with HR trying to understand where my fellowship money going. I was told by some Italian acquaintances that my net earnings were very good for Italy, which horrified me.

Good for Italy? Like, people are OK with this? I can’t imagine what someone working a “minimum wage” job takes home

And perhaps the general population is “vabbe” about this because of communal, multi-generational living arrangements (i.e. NO RENT) and paying things “on the down-low with ca$h money” (i.e. what taxes?), but even so, I can’t see how this can be good economically in the long run…

This is not to say America is handing fistfuls of dollar bills to every person aged 0-99 (although 3 COVID-19 stimulus packages argue against this…), but there is definitely room to negotiate luxurious salaries with the right degree and industry. For example, an entry level medical science liaison, a high-profile position in the pharmaceutical industry that is often sought after by terminal degree holders, can earn on average $80-100k a year. In Italy, it’s around €55,000 a year, on average. Approximately $67,000 a year.

Personally speaking, I would jump on this amount given that my current job pays less, but it surprises me that there is such a striking difference in the starting salary of a highly-qualified position between two countries…

This discrepancy is also quite confusing to my cute neighbor.

2) Fashion freedom

Before moving to Italy (specifically Milan), I did give a good thought to reshuffling my wardrobe so that I fit the “bella figura” stereotype that is often associated with the culture.

But, I am a girl who lived in pajamas and running clothes for 3 months during the pandemic—what can I say? I’m very low maintenance!

I didn’t think twice about walking into a Whole Foods or Trader Joe’s after a long run when I was in the US. I’d be a sweaty mess, but I didn’t let that stop me from getting an ice cold kombucha and a vegan treat to-go. I suppose I didn’t have to be self-conscious about walking around town in workout gear if every other person was doing it too.

But Italy doesn’t seem to offer that “chill” attitude, not even if I’m actually working out! During a particularly hot workout one Sunday afternoon, I remember an elderly couple giving me side-eye because of my short running shorts and tank top. It reminded me of the many judgmental desi aunties I’ve come across over the years, but I was honestly surprised to come across this in a “Western” country like Italy.

Judgy people exist everywhere, but I can’t exactly say I feel comfortable wearing sweaty running clothes to take care of errands in Milan’s city center vs. somewhere in SoCal. I suppose it serves as an excuse to freshen and dress up for an otherwise mundane occasion, but there is something about convenience and a relaxed attitude when it comes to “American fashion” that I do kinda miss…

Actually running 🏃🏾‍♀️ around the Duomo in workout clothes is one thing, but stares are guaranteed if you stay in said clothes after working out and continue on with errands 🤷🏽‍♀️

3) Vegan options and freedom to be a foodie!

Southern California spoiled me when it came to vegan food options—as long as I frequented Whole Foods and Sprouts, as well as bookmarked up-and-coming vegan cafes and restaurants spanning the Los Angeles and Orange County areas, I was all set. I have always been a vegetarian, but picking the vegan option whenever possible has always been my prerogative. And without a doubt, this was so much easier to do in the USA…even when I spent 3 months in Oklahoma!

Milan does have a few vegan outlets, but the quirky idea of “vegan-izing” everyday meals just hasn’t caught on in Italy as it has in the US. I will admit however that when it does come to proper labeling of supermarket items, Italy does a good job of saying “adatto ai vegetariani” or “vegano” on the label. As a strict vegetarian, it can be troublesome when simply “caglio” (rennet) is listed on an ingredient label, but I have found many brands that list “caglio microbio” which makes things less complicated.

And yes, I’m all for the nut-based crema spalmabile (especially pistacchio!!), rich scoops of neighborhood gelati, and Sicilian cannoli, but the incomprehensible food “rules” like “cappuccinos after noon are sin” or “pineapple on pizza deserves jail time” will never, ever make sense to me.

Even though I personally believe everyone has the right to have a cappuccino at any time of day, this is one “rule” I have ended up following due to daily routine. Sometimes the timing works out and a pistacchio latte is able to work it’s way into your day 😊

I just know that if a country is vehemently unaccepting of pineapple on pizza and BBQ sauce, I really do have to applaud America as being the land of the free (for foodies!). 😅

4) Feeling myself

I think the realization that I would always be innately me, wherever in the world I went, has hit me the hardest from all of these items listed.

In the US, I tended to lean towards the introverted side of the spectrum, but around friends and people I trusted, I was a chatty, witty, and incredibly fun person to be around. In professional settings, I felt absolutely comfortable speaking to colleagues, giving presentations, and mentoring my juniors.

And I believe part of this is because of my strong command of English. It is right now the only language I speak fluently, and it is the only way for me to express myself. My forays in writing have only enhanced my exposure to the language, and the fact that the US adamantly proclaims English as the one and only official language of the land makes things easier when it comes to communication and expression.

In Italy however, I feel like this identity is not quite the same. Opportunities to improve my Italian have been minimal, and the interactions I do have with people I come across on a daily basis have been restricted to English. Despite this, I oftentimes feel like I have to hold back when it comes to my true self. American slang and references can leave people lost, and so I’m not left with much to hold an “engaging” conversation. When I do attempt Italian, I am shut down when the person on the other end switches to English without giving me a chance. Just like in America, patience can be a hard thing to find in Italy.

I believe if I am given the opportunity to express myself in the truest sense, it will be possible to find and enjoy the person I am here, but it also depends on if I will ever find my people here. Friends who understand my humor, share similar interests, like the same TV shows (it doesn’t help that I like the American shows that have yet to cross the Atlantic on Netflix…). Social media and women’s’ networking circles can only do so much—at the end of the day, new, trusting relationships* require work which can be utterly exhausting.

Milano Navigli on a very hot June day…

*I should add that there is one relationship in my life that has blossomed since my stay in Italy, and it has allowed me to be myself to the fullest☺

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Maybe a lot of this reflection is fueled by homesickness, and the fact that I haven’t seen my family in almost a year. Even though I’ve lived on my own since 2014, this is the first time I’ve been oceans apart from the people I feel most comfortable around.

Maybe a visit home would help give me a much-needed reset to tackle Italy again under new and improved, recovery-from-COVID-19 circumstances. This past year has been a rough ride emotionally, and I’m sure this has also influenced a lot of the opinions detailed in this post.

Still, I won’t deny the fact that living abroad—living in Italy—has given me a new-found appreciation for the country of my birth: something I have struggled with for years, but now I find easy to accept, with open arms.

Bellagio (Not the One in Vegas)

Reading Time: 6 minutes

Since my excursion to somewhere in Switzerland in late August of last year, no other opportunities made themselves available in regards to day trips in Italy or beyond.

Nope, the second wave of ‘rona got in the way of that.

I even went so far as to daydream about Christmas break trips to Venice or Rome, but after summer ended, the way reality was shaping up crushed those plans to smithereens.

That, plus work stress and life stress—it was all piling up, and putting in the time and energy to plan out trips “for the future” seemed like a lost cause.

And it was, until April 26th, 2021 brought signs of hope. The following weekend—with the weather being a foreshadowing of a summer yet to come—was the first opportunity in months for lost souls to venture out once again.

I was itching to travel somewhere, anywhere, and I even thought about some “nearby” major cities I could try to visit from Milan.

Turin? Genova? Bergamo?

But, I ended up going somewhere not too far from my (weekend) homebase of Como—a special place at the center of Lago di Como, hand-in-hand with a special person—Bellagio.

Lago di Como is HUGE. From Como City, Bellagio is an HOUR away by car!!

Since moving to Italy, I have lost the urge to keep up with my early bird tendencies on weekends. With weekdays being harrowing at times, I decided that my time, on the weekend, should be spent in whichever way maximizes relaxation and recovery. And, whadya know, sleeping in till 11am or 12pm on Saturdays sometimes does the trick!

The good thing about Bellagio is that it’s small enough to explore within 2-3 hours. So even if you have errands to run on a Saturday morning but you’re somewhere in the Lago di Como region, it’s not too silly of an idea to drive up for a few hours of some nature eye-candy.

I. Mean. Eye. Candy.

The classic Bellagio pic

At first, I wasn’t sure if I would end up going solo, but my companion offered to drive both of us in his car—on a winding, solitary road that overlooked the lake many times along the journey. It didn’t help that we were slowed down by a group of four girls who were also on their way to Bellagio, taking their share of pics for the ‘gram with their phones precariously held out the car windows.

When we did arrive close to 3pm, parking was a minor issue. We found a spot eventually, and shockingly had to pay by the hour. I guess it wasn’t too much of a surprise given that it’s a ploy to get every last bit of a tourist’s pocket change, but at least the rate wasn’t Los Angeles-crazy 😂.

City center is about a 15 min walk from the parking lot we used.

Since I’ve seen Lake Como from Como city many times, it seemed redundant to find a viewpoint to look out at the water in Bellagio, but that’s the main attraction 😂. Technically, there are some differences in the landscape…

Rockier mountains to the east

It was interesting to see how the mountain “terrain” changed across a panoramic-like view.

Smoother textured mountains on the left, snow-capped mountains in the center…

But the best part of going out to see the water at this time and location, was the wildlife of course.

Momma and her babies

I had front-row seats for the Momma & Babes show 🥺!!!

We weren’t the only ones enamored by their cuteness. Other people surrounding the dock seemed to notice my excitement (I was literally pointing and waving my arms at the ducks!) and shifted the focus of their phone cameras from the landscape to a few baby birds.

These docked boats scream I AM ITALY.

After enough time was spent at the water, we decided to walk back towards the city center. My eyes fell upon the buildings that faced a central dining area of sorts, and I could not look away. The architecture was so fitting for Northern Italy.

Bellagio center

A work colleague of my companion also happened to be in Bellagio at the same time and we ran into him. He was one of those guys who dresses up in a suit to eat pasta 😅.

South of the shops and eateries, there was a picturesque walking path with tall trees and perfectly-cut shrubbery all on the side.

Too pretty for a long run. Walking will have to suffice.

Once again, it was another ideal location to stop and look out at the water. And sneakily people watch.

Two hours had passed by this point, and so my companion and I decided to take “the long way” back to the car. We passed the I Giardini di Villa Melzi, but it was another tourist trap that we ran from. They couldn’t stop me from taking pictures through the gates!!

Peepin’

To be fair, there weren’t that many people walking around that day, but I secretly appreciated that we were walking away from the crowds.

Classic Italy

I started to figure out why we weren’t seeing many people at the point…the roads were increasing in elevation and our casual stroll was becoming a stairclimber session.

The biggest perk of this surprise workout was “accidentally” falling upon the Church of Goats*.

*that is not the real name lol

When special guests donkey and black baby goat made their appearances, I literally died 😂. My name is Pree and I like animals.

Ducks, goats, donkeys, dogs, and cats. Bellagio has everything.

There was no issue with finding the parking lot since we pinned our location with Google Maps. We did however still have some more time left on the meter, so it was an excuse to walk through some alleyways for that authentic Italian “village” feel.

All cobbly and stuff

When we entered this path, I looked down at my sneakers and wished they had more padding at the bottom (can’t expect much from a cheap pair from Primark though…), but I was grateful that I wasn’t in a pair of high heels trying to navigate this pretty chaos!

As time started to inch closer to 6pm (or 18:00, military time for Europeans 😂), we called it a “day” and got back in the car. As I expected, I drifted in-and-out of sleep on the drive back: a genuine indication that I had a pleasantly exhausting time.

Wanna know one of the best things about travel, even if it’s just a short daytrip? Coming back home so exhausted and instantly falling into a deep sleep.

Another cute view

So, Bellagio. My few hours here were enjoyable and well-spent. And while the scenery was nice, the experience was much more memorable because I had someone special by my side. I could have gone on my own, but sometimes it’s nice to walk around with someone’s hand in yours.

And if they have a car, it saves you a bumpy bus ride 😂.

International PB Craving

Reading Time: 6 minutes

Peanut butter was never a favorite of mine growing up, yet as I got older, it became an essential staple. But before that realization, I had a looooooong period of infatuation with other food spreads.

When I first tried Nutella as a kid, I was enamored. And when I learned that people on the other side of the globe—in fancy Europe—had Nutella on flaky croissants or on toasted bread for breakfast, I was convinced I was born on the wrong continent!

Peanut butter just seemed boring in comparison…it wasn’t even that sweet, so what was the point? I was the crazy child that would have rather had a jam-filled sandwich than the American PB&J classic. I know, crazy.

So when did things change?

When I got to college, and fell into the world of food blogging and food reviews, while also being restricted by an eating disorder. All of this led me to become obsessed with “protein-fortified” snacks that were marketed as healthy and for fitness enthusiasts—including peanut butter.

Nuts ‘N More was (and I believe still is) a popular brand specializing in “protein-packed” peanut butter, but stood out from the likes of Skippy and Jif with their collection of unique flavors—like Maple Pretzel, Birthday Cake, and Salted Caramel! Brands that struck gold in the protein bar and protein cookie industries weren’t the only ones dipping their toes into the pool of creativity—peanut butter was also becoming a canvas, and I was all for it!

After moving to Italy, I realized very quickly that Italians didn’t see peanut butter as a kitchen staple. When I paid my first visit to an Esselunga (the Italian equivalent of a Kroger I suppose), only two brands of peanut butter were on display.

One of two brands of peanut butter I’ve seen stocked on grocery shelves in Italy.

But there were tons of nocciole and pistacchi spreads—my dream was being overcompensated on one hand, while something too familiar to me was fading away in the aisles of an Italian supermarket.

If you ask Google about peanut butter in Italy, you get redirected to another blogger’s experience—and how you’re better off bringing it from outside the country!

It took me about six months of scooping through hazelnut spread jars for me to realize that my heart does have a soft spot for peanut butter, and that I missed the crazy flavors that I could find with ease back in the US.

And it’s as if Instagram read my mind, because the next thing I knew, I “found” Joey’s Spreads on my discover page, a small business churning out peanut butter from the UK. A single, top-view pic of their birthday cake flavor was enough for me to log onto their site and order myself a 4-pack of their offerings.

Ya know, treat yo’ self or something like that?

Yes, I paid almost 60 euros for peanut butter. But it was “fancy” peanut butter. And I saved 4.19…

Seeing as I used their “JAN” coupon, you can guess I made this order early this year. As with any company using shipping services in 2020 onwards, Joey’s gave me a heads up that delays due to COVID could impact the shipment and delivery of my order, but I didn’t think it would take almost two months.

Sliding into the DMs

I got in touch with them via email a month later, and then IG because I was impatient 😅. At least Joey’s was considerate about it, and replied straightaway. We kept in touch via Instagram DMs, and even though weeks were continuing to pass by, it seemed as though they were on top of checking in with the postal service they used.

Then, on fateful March 11th, my jars arrived.

(L to R -> Blueberry Muffin, Birthday Cake, Cookie Crumble & Carrot Cake)

Seeing their presence on my kitchen counter was a huge thrill after a particularly tiring and long day at work. I couldn’t hold back my excitement and had no issues deciding which flavor I’d try first.

I received the box in the morning, but didn’t have time to drop it off at home before leaving for work. So all four jars were taunting me for the entire work day until I could get home and consume them in peace 😆!

Of course, without a doubt, I decided that I would try Birthday Cake first.

I’m the kind of person who prefers a frosting-to-cake ratio of 75-to-25…if not more on the frosting side! And the more brightly-colored and sprinkled a frosting is, oh how better it is.

This jar had a generous layer of creamy pink frosting at the top with colorful bead-like sprinkles. If they want my opinion, I wouldn’t argue if they decided to change up the frosting-to-peanut butter ratio so that half the jar was frosting 😋. I think the point was to mix the frosting with the PB, but are you kidding? I think fellow frosting-lovers would agree—who in their right mind would do that?

The peanut butter itself had a nice crunch, but was still soft and chewy. So even though I inhaled all of the frosting, the PB itself was decent on its own.

Next was 🥕 Carrot Cake 🥕, because it had a frosting-like addition to it as well 😛.

Oh boy was the frosting delicious…it was actually so smooth and mixed with the PB almost to the bottom of the jar. To be honest, it was probably more like icing in consistency! The first flavor note I detected with my first spoonful (PB+icing together this time!) was that of orange. When I flipped the jar around, ‘orange’ was literally listed as one of the ingredients 😂. The next thing I knew, I struck an orange rind and a clump of raisins. Classic carrot cake things I guess?

With Blueberry Muffin, I was given a heads up:

And Joey’s was right, the jar had indeed “firmed up” thanks to a long trek across the pond and over to mainland Europe, but this did not impact the flavor.

I actually didn’t mind the crumbly texture, sharply-defined mini peanut chunks, and juicy blueberries (despite the fact they were dried, lol). The blue color reminded me of Sesame Street’s forever-hungry character Cookie Monster 😂.

And finally, there was Cookie Crumble:

This was a fun flavor to “go archaeologist” on. I was on a mission to dig up chunks of cookies, but I found mini chocolate pieces instead. Eventually I did find what I *thought* were cookie pieces—they at least had a crunch to them, so I assumed them to be so. Overall, the jar tasted and smelled like a giant, crushed chocolate chip cookie mixed with smooth peanut butter. Mission accomplished.

Overall, each jar of Joey’s Spread is a whopping 500g, so the amount you receive justifies the price. If I was living in the UK, I wouldn’t mind ordering from them more often. Their flavor offerings make up for what I’m missing out on back in the good ol’ US of A.

But realistically speaking, as much as I do miss peanut butter, I’ve gotten used to just seeing hazelnut and pistachio-based spreads in the grocery store, and being content with it. I mean, that’s what lil Pree used to dream of, so the least big Pree can do is buy a couple jars and indulge 😉.

Moral of the story is, Italy doesn’t offer anything spectacular in regards to peanut butter.

Shipping finely-ground peanuts from the US (yes, even with frosting mixed in) is not worth it, in my opinion.

So next best thing? Ordering from Joey’s Spread when that international PB craving hits.

Day by Day

Reading Time: 10 minutes

Before that night in late spring of my junior year of high school, I could not comprehend how painful a mental breakdown truly was. 

I played singles varsity tennis that fall. I had been awarded the position of first chair flute in county honor band that winter. And that night, I had completed two regional competitions for Robotics as president of my high school team, bringing home an award for our website as well—-something that had been a personal project of mine finally received validation, yet it triggered my anger. 

Logically, I had nothing to “cry over”, yet the dark idea that it would all come crashing down triggered the tears, guttural yelling, and body slams against the floor of my parents’ bedroom. 

My mom with her own mental illness, fueled the fire with her share of yelling and ridicule that I was the one that needed help. My dad, shocked at the scene going on before him and unable to stop my incessant crying and self-harm, threatened to call the police. 

But this only pushed out more tears, and at one point, my body couldn’t take it anymore. I continued to lay on the floor listlessly while my parents calmed down as well. 

The police never came, but Dad thought I should see a therapist. I was resentful, given the fact that my mother had not seen a doctor in years, but part of me felt the urge to see someone, with a sprinkling of curiosity.

————————————————– 𝕊𝔾𝔻 ————————————————-

I have lived with depression since then, with it popping in and out of my life at varying intensities, depending on how kind my environment was to me.

An eating disorder was mixed in as well, sometimes making it unclear what was first to influence what.

The depression, along with OCD tendencies, popped up along my PhD journey as well, with one of my darker episodes occurring at a time when so many unknowns were at play… the biggest of which was the worry of how soon my first, first-author paper would be published, if I would be able to graduate, and if it was even worth all of the anxiety and emotional breakdowns I was going through.

It was around this time I decided to see my third therapist, but also consider taking medication for the first time. When I received the news that my paper had been accepted, that itself lifted away the weight of the world that was pressed so firmly at my shoulders for the past six months, but I still felt it necessary to seek out professional help.

Dr. S was an immense help through the first half of 2019. It may have helped that my environment suddenly turned friendly, but she helped me battle the ennui I was now experiencing as I inched towards a summer graduation.

At first I saw her once a week so she could get to know me better and monitor me as I started taking Lexapro for the first time. I was on 5mg initially, but was bumped up to 10mg. Beyond a few headaches and fatigue, the pill got acquainted with my body and lifestyle, although I personally didn’t feel any changes.

Especially since I still felt cyclical anger and irritability.

Dr. S was a trained psychiatrist, but would not continue writing prescriptions for patients unless paired with counseling sessions. I enjoyed our sessions in the beginning, since I was able to vent to her about my desire to start anew outside of SoCal. She knew about my plans to apply for a fellowship in Italy, and how I yearned to have the opportunity to meet new people and travel all over.

When my plans were starting to gel by November 2019, I began to grow tired of my sessions with Dr. S. Like with the therapists of my past, I had hit a plateau with her. I felt like I didn’t need her anymore, and that my depression had retreated once I received confirmation about Italy.

Of course with COVID in early 2020, my plans changed dramatically. I was “stuck” in Tulsa (although now I see it as a blessing I wish I could relive again). Being with my family definitely played a key role in mitigating stress. I was still taking my Lexapro, but popping a pill each day without knowing if it was truly serving its purpose was beginning to irritate me, to say the least.

Dr. S wrote me a prescription for 90 days to take with me as I settled down in Milan, but who’s to say if it got me through my two weeks of isolating self-quarantine?

Because my mind was already set on starting fresh and throwing myself into a different world, I felt ready to stop the Lexapro. I didn’t want to rely on medication to modulate my mood for the rest of my life, especially if it wasn’t doing its purported action in the first place.

Things seemed to be going wonderfully at work.

I was finally opening up and starting to date for the very first time in my life.

In fact, I was lucky to meet someone so early in the “game” who I clicked with instantly.

And with all of this new-found happiness, I wanted to see what my body could do on its own…in an environment where I felt in control and eager about navigating through.

So I stopped taking Lexapro in mid-August 2020. I informed my Dad and a close friend of my decision, both of whom knew of my recent depression history. My Dad, knowing the obstacles I have faced when it comes to doctors and their diagnoses understood why I chose not to wait until I found a doctor, but my close friend was more concerned. While I acknowledge it would have been helpful to see someone within weeks of arriving in Italy, I knew that with the painfully frustrating administrative system in place—especially in regards to healthcare—it would have been a nightmare to wait for a second opinion.

In my battle with depression over the years, I quickly realized that when it came to my body and mind, only I could be the one to decide what felt right for me.

I felt “normal” for about a week, after which painful, throbbing headaches began to make an appearance on a daily basis. I was starting to feel easily triggered by what I would normally see as minor inconveniences. On my early morning runs, I would have to stop mid-run because I would be on the verge of tears…

Things started to feel uneasy at work. I found myself silently hyperventilating at times, and I often had to duck into the bathroom to let myself had a good cry.

I knew fully well I had nothing to be upset about. I stopped taking the medication because things were going well. I wasn’t too concerned about these symptoms arising because I was expecting them as part of the withdrawal process.

Everything would be better in a few weeks…

But it seemed as though things were slowly retreating and heading in the opposite direction. The throbbing headaches did stop after three weeks. I wasn’t crying uncontrollably everyday either, but my mood was no longer at the same elevated level that it has been in mid-summer.

And perhaps it was because my environment, the one I thought I had control over, was starting to become more overwhelming than I ever imagined it would be.

Having the patience to learn and speak Italian was becoming a stressful chore.

Work was becoming something I was slowly starting to dislike. I resented the idea that my position wasn’t as flexible as I thought it would have been. I felt like my skills weren’t being appreciated. And having these feelings woven through a five-day work week was an feeling that grew unbearable by the minute.

As fall turned into winter, I thought time would make things better, but with the rise of COVID infections, we were back in a lockdown in late October. I was resenting the fact that I had yet to travel outside of Milan or Como, and I was counting on the winter holidays to make my Rome trip a reality.

But that of course didn’t happen.

At least I wasn’t alone during the holidays, but my anxious thoughts and depression still would not leave me, even though I knew I had a full week off from work to take in the last of 2020 (although, what was really there to take in?).

I kept thinking about how I was “wasting” my time off because I wasn’t able to travel. Or ruminating over what experiments I should be planning my first week back at work, even though that was the last thing I wanted my thoughts to dwell on…

Castel Baradello hike the day after Christmas. It was a beautiful sight, but my mind was gripped with anxiety about my week off ending soon…

And with the arrival of 2021, things still seemed to not “feel” any better. Yes, I was finally able to move into apartment that wasn’t the size of a claustrophobic closet, and with a balcony (something that was a top priority), but I still felt unsettled 😔

I thought I would appreciate a long, cold winter after months of painful humidity and encapsulated heat, but I guess I didn’t know what I was asking for when it came to an Italian winter. The weather became piercingly cold, and the sky always seemed to match my mood—gray, dreary, tired, depressing…

I tried to keep my mind away from the gray by appreciating things I knew would bring me joy.

Like, (finally) buying a Nespresso machine so I could have coffee on my terms.

Or stopping for adorable cats that ‘meow’ back and don’t mind being coddled.

And even trying to shift back to daylight runs vs. the nighttime runs I had a habit of partaking in during the summer. Because every ounce of sunlight helps.

Work continued to aggravate me. I still felt like I was doing tasks that weren’t adding to my skill set, and that what I was doing had no relation to what I thought I had signed up for.

Looking back, I find it ironic that in the phone calls I had with my Dad during this time, I’d semi-joke about having a breakdown at work given all the emotional turmoil that had been building up for the past several months.

And, then it happened right on cue 🙃. Before I broke down into a solid cry that drenched even my blue disposable mask, I was having a meeting with my boss, during which she expressed her disappointment with how things were going (I would later learn that she had been described by others to push people to their breaking point in an effort to get the most work out of them). I didn’t have the energy to explain my situation, so I let my emotions do the talking.

She seemed to understand immediately, and offered help where she could. At least that situation got me into a doctor’s office for the first time in Italy 🙄. I knew counseling had helped me in the past, but this time, I already knew what my trigger was.

A stressful, overwhelming environment.

————————————————– 𝕊𝔾𝔻 ————————————————-

Since my breakdown as a junior in high school, I have accepted that depression will always be a condition in my life, and that it may need managing from time-to-time.

When I felt out of control with where I would be going to college and troubles at home with mom, diving into an eating disorder was my solution.

When I felt deep anxiety about the fate of my PhD, and the paper I was anxiously trying to publish for a timely graduation, Dr. S and my willingness to try medication for the first time was my solution.

And I thought Italy would be a long-term solution. Especially for the irritability and ennui that popped up in recent years, but it turned out that Italy was an issue of her own.

COVID has been an obvious key player in this, and it’s hard to say how things would have turned out if I had arrived in Italy back in early 2020 as originally planned, and if the world had not been shaken by COVID.

But ongoing events have made me realize that the biggest trigger of my current depression “flare” is directly associated with the very reason I came to Italy in the first place. And how do you manage and cope when the very thing that is your livelihood causes so much distress?

Recently, I’ve been fortunate to have possibilities open up. Knowing that there may be a way out has put my mind at ease, but at the same time, there’s no guarantee that the solution to cutting myself off from the triggers here will help me somewhere out there.

That’s why I’m trying my best—with whatever ounce of energy I do have—to take things day by day. Making sure to sip my coffee, savor a relaxing dinner at home, and pet that furry cutie before each run…

When it comes to using medication to manage my mental health, I personally do not want to get near it ever again. I’m sure it works wonders for some, but that doesn’t mean it works favorably for everyone.

Managing my depression has led me to prioritize my happiness no matter what. I acknowledge that what I may constitute as happiness right now in life could change over time, but even so, I believe that if we make it a priority to live in ways that ensure balanced levels of happiness, we can encourage the same from those we interact with on a daily basis.

An infinite loop of happiness, wouldn’t that be nice?

Looking down on Como from Castel Baradello, two months after Christmas ❤

Icons made by Good Ware from www.flaticon.com