Thoughts on mental health, physicalism and our narratives of our lives

For those of you who are relatively new to following me: I have long term issues with depression and anxiety which I occasionally post about, partially for my own catharsis and partially as part of an effort to tackle the stigma around mental health issues. Stuff below may trigger feelings of depression, anxiety, etc. if you have them, so trigger warnings, caveat emptor, and so on apply.

For the latter half of 2016 my anxiety was worse than it had been in a long time, I was having trouble sleeping, and most of all I was having trouble getting up in the morning. I was often sitting paralysed with anxiety and unable to move, when I wanted to get up and leave the house. Since the beginning of this year my anxiety has been much better, probably better than it was before. So what happened? Did I come to some personal revelation? Understand the source of my fears? Master some advanced meditation technique? Not really. I changed the pills I take. In June I switched to a new medication recommended by my doctor in Beijing, hoping to reduce my anxiety and my daytime tiredness. In December I spoke to my old doctor in the UK, and switched back to my old medicine plus another one. In between I took various medicines to help with concentration and anxiety in acute times, none of which seemed to help.*

So far so obvious right? Medication designed to change how your brain works changes how your brain works. But in some way I find it very difficult to internalise that that is what happened. Hell maybe it wasn’t, it took me so long to notice it because there were so many other variables in terms of lifestyle and stuff that the change of medication was lost in the noise. It was only when I talked to my UK doctor, who was not a fan of the medication I had been given, that I made the change back.

If you will forgive my jargon, I think the reason this feels like such a narratively unsatisfying explanation to me is implicit dualism. We (by which I mean the vague set of modern western intellectuals) are intellectually aware that we are physical beings in a physical world, which to a large extent has predictable rules. Hardcore dualism, that posits the existence of a separate soul, consciousness or whatever, has rather gone out of fashion among philosophers. The closest you will get these days is mealy mouthed talk about qualia and “irreducible mental phenomena”. No-one seriously denies that neurochemistry is what determines us, to a large, if not necessarily complete, degree.

But that doesn’t satisfy us emotionally, and doesn’t fit with how we think day to day. Have you ever had the experience of being incredibly angry or upset about something, and knowing in the moment exactly why, and that it makes perfect sense. But later finding that once you have eaten, or slept, or recovered from an illness, you feel completely differently? Even knowing that happens, it still doesn’t feel like a real explanation. Yes, I was tired, but he was still being an asshole, right? Our internal introspective sense of why we think and feel the things we do always takes priority in our minds. Even if, in some abstract way, we might agree it was influenced by other more pragmatic factors.

There’s also a sense in which we want the narrative of our lives to make sense. We think in terms of stories, not detached cause and effect. Protagonist overcomes fears by soul searching and introspection is a compelling story. Protagonist changes their diet, isn’t.**

One of the fundamental lessons I’ve learned from dealing with and reading about mental health is that our instincts are not always to be trusted. Our brains lie to us all the time, about little things like optical illusions, as well as big things about how we relate to the world, and why we do the things we do. But that’s a hard and (if you’ll forgive the pun) depressing thing to learn. Knowing that your brain misleads you can leave you in a state of perennial uncertainty, never quite trusting yourself to judge situations. External validation helps a little, I’m sure even people who have no known mental health issues frequently ask their friends “I’m I being oversensitive or ….” But that doesn’t change the underlying disconnect between how we feel we are and what we really are. Maybe this is one of those things you have to slowly internalise over time, I don’t know yet.

*If anyone wants to chat to me about my experiences with different medications let me know. I left out the names because I didn’t want to distract from the larger point of the story.

** I wonder if this is also true at a social level. If some group of university researchers showed we could make violent criminals into safe law abiding members of the public by increasing the amount of iron in their diet, I doubt our society and legislators would accept that as a policy response. It just fundamentally doesn’t fit with our view of how human beings work.

Post election thoughts: Things I'm surprised we're not talking about

[Epistemic status: mostly contrarian listing or ideas I don't consider myself to have any particular expertise in determining the real answers. Came out a bit more sarcastic than I had intended. But seriously what else can you do.]

I started writing a post called something like “5 narratives you will see about this election” last week, but didn’t have the energy for snark so gave up half way through. It seems that since then the media has settled on the narrative that they/the democrats/the general “liberal elite” didn’t listen enough to white working class Trump voter’s concerns.   No-one seems very clear exactly what those were, but they are definitely very important and legitimate. And definitely not racist.  

We should be a teeny bit sceptical of the self diagnosis of a commentary system that until last week was absolutely certain of the opposite of what happened. Particularly when it ties into the existing “globalisation bad” contrarian narrative the media has been tossing around for a while, conveniently meshes with the popular Bernie remnants belief that he would have done better, and conveniently refocuses the narrative on white people, or “real Americans”. (Weird how often the American media talks about “the working class” as if the non-white people don’t count).

None of us know the actual reasons Trump won. Some political scientist will probably get their PHD explaining it in a few years time. But by then the narrative will have been long settled anyway. So for the sake of ideological diversity/contrarianism heres a few things that I’m surprised more people aren’t talking about. 

Emails emails emails, or the FBI/Russia/Wikileaks

Knowing nothing else, it seems like a presidential candidate who had the FBI announce an investigation into their emails 5 minutes before an election would be in trouble. Nevermind that the new set of emails discovered from Anthony Weiner’s laptop turned out to be unimportant, facts have always been an afterthought in the crooked Hillary narrative. I’m genuinely surprised that the American left hasn’t torn into the FBI director in the aftermath of the election for going against long standing FBI protocol, and the advice of the attorney general, to announce a reopening of the emails investigation long after it was finished. Keep in mind the FBI doesn’t normally make anouncements about prosecutions where they have actual evidence, even at the lowest level of elected office, in the run up to elections, for fear of seeming biased. There have been some unsourced reports of strong anti-Clinton feeling in the FBI, I’m not sure how seriously to take those, but the overall impression is a little troubling. 

A technically separate, but narratively related issue, is the massive leak of Clinton campaign emails. Depending whether you believe the claims that wikileaks has been subverted by Russian security agencies this is, at best, a non-state actor actively intervening in an election via illegal means, or a foreign state intervening in an election at a scale not seem since the cold war. Nevermind that despite concerted digging through the emails Trump supporters have failed to find anything of note, other than weird pizza and child molestation conspiracy theories, (that’s sadly not a joke), it continued to reinforce the “Crooked Hillary” narrative. A potential foreign hijacking of a presidential election seems like kind of a big deal.

The disappearance of the “Obama coalition”, or where did the minority voters go.

The overall number of voters in this election as significantly lower than in 2008 or 2012, and it seems like  lot of that came from a reduced turnout in the democrats who had voted for Obama, predominantly the young and minorities. 

Two possible explanations: 

Since the last election the Supreme Court overturned part of the Voting Rights Act, and many states have put into effect strict voter ID laws, to combat the scourge of voter fraud. Which, by utter coincidence, seem to make it more difficult for ethnic minorities, and other traditional democratic voters, to vote. Also the number of available polling places in certain areas has mysteriously decreased.  

Other explanation, Obama was uniquely charismatic or Hillary was uniquely uncharismatic. 

A large part of the electorate never votes, for lots of legitimate and sensible reasons, since it is a very inefficient use of your time as an individual, but something something collective action problems, and when you don’t vote you get screwed. 

Short of compulsory voting, making election day a national holiday, or making voting less of an unnecessarily complex pain in the ass, none of which are particularly likely in the American status quo, you need an exceptionally charismatic individual or narrative to overcome that collective action problem and make people turn out. For whatever reason Barack Obama was that in spades, Hillary Clinton wasn’t. Personally I like pragmatists who know huge amount of policy minutiae, but the electorate seems to disagree. Obama is an extremely charismatic speaker, and his message seemed to work a lot better than Hillary’s. 

[There’s probably a useful discussion to be had here about the gendered nature of our expectations of ‘charisma’, but other people have done that better than me.] 

Possible takeaway for democrats: Individual charisma matters a million times more than any other factor, including competence, select future candidates accordingly. 

Systemic factors meant no democrat could win.

It’s incredibly rare for a party to get 3 presidential terms in a row, so the democrats were fighting an uphill battle to begin with in this election. The public always wants a change from the status quo, so any democratic candidate would have been in trouble. Hillary particularly was seen as a continuation of the status quo, and didn’t particularly differentiate herself from Obama. 

The electoral college map is skewed against democrats, so you need a large najority to win. It’s a stupid system but its not going away any time soon. 

There’s probably also a narrative to be had in the economy, job growth, unemployment, inflation, etc. Things are better than they were at the end of GW’s term, but they are still not great. Campaigning for slow gradual improvement is never easy. 

Trump is literally a wizard.

Or more boringly: Trump’s candidacy was a weird anomaly that no one could have predicted or countered. Even with perfect play you sometimes lose by sheer dumb luck. We should continue as normal and not rip up all accumulated experience over this one case.

Gif unrelated, but cathartic.

Scattered thoughts on empathy, responsibility and living abroad.

Earlier today on a crowded street in the mid-afternoon a small Filipino child, he can’t have been older than twelve, shoved his hand in my pocket in and grabbed my phone. Fortunately for me I noticed and managed to hold on to it, and told him to fuck off with as much anger as I could muster. Nothing has given me as much of a sense of combined irrational fear, anger and guilty self-hatred. I’m one of the richest and most privileged people in the world, and he was likely among the least. What sort of monster would I be to blame him?

Say what you like about the Chinese government (well, at least if you are on the right side of the Great firewall) but I’ve never experienced anything like that in  my last few months of living in China, even in the poorest cities. Due to  a combination of the One Child Policy and aggressive controls on  internal migration you never see children on the streets, and adult beggars are also rare. Of course that isn’t anywhere near the whole story, outside the cities there is rural poverty that would shame anywhere in the third world, with children scraping a living on farms. But the Government has made sure that there are nice safe walled enclaves for the middle class and us expats.

Chinese people are often accused of being cold and unfriendly, though I think that impression is more due to different norms about body language and manners than anything. But there is definitely an element to living in any large city, and even the smallest in China are large by Western standards, of having to train yourself to filter out other people their lives, or else be overwhelmed by a continuous barrage of emotion. It’s worryingly easy to train out your empathy

The Philippines is on the surface much friendlier, everyone you pass will say hello and wish you a good day in English. But they’ll be persistent to the point of harassment in getting you to buy whatever they’re selling, whether it’s the ubiquitous tricycles and taxis, or massages and illicit pharmaceuticals. My ingrained British politeness is at war with the necessity of repelling people in order to reach the other end of the street.

The Western middle class prides ourselves on our empathy. The mark of a good person is giving generously, helping friends, and treating everyone you encounter as equals. With caveats. Its easy to be kind and generous with other people of a roughly similar economic class, you give to your friends and others of your tribe with the implicit knowledge they will return the favour. And on a global scale even the poorest person in Britain is not that far away from you.  But how does this vaunted empathy deal with people so much poorer they could never give anything in return? When your slightest whim can mean a massive difference to their lives. And, worst of all, there are so so many of them that if you were to try and feel their suffering it would overwhelm you.

Faced with that, isn’t it so very tempting to wall them off in your mind, decide that they’re not your responsibility, or they’re not really people in the same way as nice middle class British people. If your lucky they’ll make it easier by looking or sounding different from you, making it easy for you to determine whether you have to empathise with them, with no niggling reminders of people you care about.

I haven’t fallen quite that far, but the temptation is always there.

A quick photo I took here, yes to pretty waitresses, no to firearms in the restaurant. 

When I was 17 I visited Malawi, a poor central African country, with a group from my School. Part of the implicit aim of this was to expose us privileged private school boys to what poverty was like and wat it was like to be a visible minority in another country. It’s cliché to say that a trip abroad changed your life, but this probably did.

Among other things this instilled in me a sense of overwhelming responsibility. People would continuously ask us for money of course. But even worse than that, Malawi like many countries has a system where glass bottles, for coke or Fanta or whatever, are returned for a deposit. Except here that sum was as much as a day’s work for a farmer. So our trash was another’s livelihood. Some of us thought we were doing good by giving them to kids. I was terrified of the randomness of it, how could we ever know who to give to, or know the impact of our actions. So I kept my distance.

The year before us the teachers of the group had given a local teenager some money to pay for schooling, only for him to be beaten and robbed for it in minutes. That’s a particularly shocking example, but there’s a thousand examples of the arbitrariness of western giving resulting in more subtle problems of perverse incentives, imbalances and so on.  How on earth can a pampered western child know how to make those choices? What sort of mad world is it that magnifies the effects of our actions to such an absurd degree?

Of course that terrifying responsibility always exists, not just when you happen to be near enough to the poor people you can affect that you notice the consequences of your actions, or the suffering you fail to prevent. Like the Chinese government keeping the poor away from the pretty western style streets of Beijing, we in the west have built our own comfortable walled cities where we don’t have to see the suffering of the poor.  

Looking at the upper middle class private school kids I grew up with, it seems that the response to privilege is either a sense of entitlement, of believing you deserve everything you got, or a sense of near pathological responsibility, a need to do good to justify all that you have. On the global scale all of us in the west are the entitled posh kids, who by accident of birth have incredible power and privilege.

Back to empathy. Given we can never really know the consequences of our actions when we are in a situation of such ridiculous power and minimal knowledge perhaps its best to separate out our empathy from the actual act of doing good.

I maintain a consistent policy of not giving to people I see in real life, no matter how much my heartstrings are pulled. But I also give a tenth of my income to effective charities like the Against Malaria Foundation (via Givewell), on the basis that they have been assessed as one of the most cost-effective charities in the world at saving lives.

An impersonal donation doesn’t have the same emotional resonance as helping a person in need face to face, but I think that I would rather be as certain as possible that I’m doing good than do just what makes me immediately happy.

This may seem like a slightly soulless way of thinking, treating human lives on a mass scale not as individuals. But I’m not sure what else we can realistically do given the scale and complexities of the world, the alternative is normally that people draw up mental barriers about who they should care about. And I cannot let myself do that.

So that puts me in credit on the utilitarian scales, but I’m still a human being and want to still treat the people I deal with face to face well. That’s harder, the best I can do is just remind myself that everyone has their own inner life as a ward against the temptation to narrow the field.

I suspect having a pathological sense of responsibility is part of my character, it affects the way I deal with people in general and probably ties into the mental health stuff I've written about before. As such I'll never be wholly comfortable being a wealthy person encountering visible poverty. But I think I can live with that provided I can contain it enough that I'm not overwhelmed. On a day to day basis tht means trying not to be a pushover, being kind not beig taken advantage of. Setting an arbitrary level of donation of at 10% of income at which I am doing good but not overwhelming myself helps.

There isn't an easy line to draw between not being overwhelmed with moral responsibility, and still being the sort of person I want to be, someone who does good as much as he can and still feels empathy for others as individuals. Its a bit of a messy compromise but, thats life.




This was originally just going to be about observations of the Philippines and China, but triggered some self reflection so evolved a bit. Please caveat all my comments about other countries with the obvious silliness of making generalisations about large groups of people, and the distorted perspective I have as a foreigner visiting. 

Some uninformed commentary on the UK general election debate specifically Nicola Sturgeon's performance

I'll confess now I haven't watched the whole thing because a) its long and dull b) Youtube is verboten in China, and watching video through a VPN is a pain in the ass. But here's some semi-informed commentary anyway. 

For the most part the debate wasn't that interesting, soundbites were exchanged and afterwards everyone agreed that [their side] was absolutely excellent, persuasive and prime ministerial and [the other side] were lame, out of touch and irrelevant [and Farage is an asshole].

The most interesting part was the general agreement that Nicola Sturgeon came out ahead, leading English tweeters to lament that they didn't have a chance to vote for her. 

So let me share a few thoughts on why that might be the case and the consequences: 

As Scotland has historically been more left wing/liberal intellectual than England it shouldn't actually be that surprising that a politician who is appealing to that electorate would resonate with urban liberals. [If you read politics blogs, tweeted about the debate, etc this probably includes you. Its a position that's probably over-represented online and in the press. So its easy to forget large amounts of the population are anti-immigration, pro-death penalty etc.]

Whereas the Westminster parties have to appeal to stereotypical little Englanders if they want any chance of success. Labour at least has never been totally comfortable with this (see Brown's attempt to sell "British jobs for British workers" with all the enthusiasm of a man self administering surgery). But that doesn't mean it is any less necessary to win, the electoral math leans that way whether we like it or not. This also means they can't do cathartic things like call Farage a racist asshole, since they need to court some of his voters who probably believe the same things. 

This confirms the SNP's shift to the left. 

Not too long ago the SNP could be fairly described as loose coalition of people with little in common other than Scottish nationalism, (including everyone from people who would be Tories were it not for the toxic legacy of Thatcher , old Labour union hacks to ideologically apathetic pro-business technocrats). Now the SNP under Sturgeon is unambiguously a party of the populist Left.

As a left leaning Scot who felt nothing but annoyance and bafflement at Scottish nationalism I'm vaguely in favour of this, but it will be interesting to see the effects on day to day government. One of the reasons of the success of the early SNP years was that, lacking a strong ideology about the shape of the state, they did a lot of sensible pragmatic things, listened to civil servants, followed public opinion and generally didn't fiddle too much. Contrast this to the several thousand reorganisations the NHS in England has gone through in recent years.          

Was this an audition for coalition government? 

The vast majority of people watching the debate can't vote for Sturgeon's party, so why should she bother appealing to them? In the (inevitable) event of a hung parliament the SNP will be obvious kingmakers. Knowing this the conservative press office and their friends in the press have been banging on about how in a potential Labour-SNP coalition Milliband would be in the SNPs pocket (complete with terrible photoshop) and that this would spell doom for English voters (presumably the nationalists will send all your hard earned tax money to my Brethren in the northern tribes, or force you all to deep fry your dinners). 

Truly the pinnacle of
political discourse

That's a much harder message to sell now when Sturgeon has been massively exposed to a national public and received a positive response, making the prospect of a coalition with them more palatable, and hell it perhaps even a selling point in Millibands otherwise dry package. 

[I wonder if Cameron is regretting the single 7 person debate? Having multiple debates, only one of which would have included her, would have split voters interest. Though they probably figure the risk of a Milli-Bounce was worse.]

A slight note of criticism, its probably easier to sell your package when you don't have to answer some of  the more awkward questions. 

The SNP are under less pressure to talk about the national deficit, since its not ever going to be their problem or responsibility. As such they can say popular things about ending austerity, increasing welfare, etc. without the awkward questions on the costs the other parties have to contend with. (They still need some answers for those questions, but its not the make or break issue it is for Labour).

Pop culture analysis - Why The Doctor is a terrible person and moral cop outs in general

[Spoilers ahead for Doctor Who and the Legend of Korra, but will try to minimise them.]

In the finale episode of the first season of the revived Doctor Who the doctor is faced with a dramatic moral dilemma. A vast unstoppable army of Daleks is attacking the earth, once they have conquered the earth they will spread out in an unstoppable horde and conquer the whole universe, resulting in untold death and destruction. The Doctor has a way to stop this with a magic technological gadget thingy, it will destroy all of the Daleks, but at the cost of killing everyone on the planet earth. So a standard trolley problem basically, should the doctor sacrifice the population of earth to save innumerable other worlds (including human colonies, in case you think there’s a moral distinction between sentient species).

The antagonist (the Dalek Emperor) dares him to do so saying he would therefore become like it, and show he’s not as moral as he thinks he is. He has to make the choice between “coward and killer.” The Doctor hesitates, and then says he would “be a coward any day.”

So the doctor refuses. Dies instantly. Humanity is exterminated, followed by the rest of the universe. But at least the doctor kept his hands clean.

My glowing eyes will resolve this plot!

Nah, not really. The Doctor’s companion saves him with a deus ex machina, destroys all the daleks, humanity and the rest of the universe are saved. Yay.

So the Doctor’s choice is made the right one retrospectively, because for reasons he couldn’t have predicted something else fixed the problem.

I don’t want to spoil any other episodes, but this basic pattern happens a lot (there’s a whole section in the relevant tvtropes page if you are interested). The Doctor is faced with a moral dilemma, stands by his principles in making the non-utilitarian choice, but then the bad consequences are averted by the magic deus ex machina/the writers. To be fair Doctor Who isn’t the only series that does this, but they are a particularly popular and prolific example so I have singled them out.

A variation of this that is particularly common is for the antagonist characters to have a serious point that the story shows to be legitimate. Its set up so the protagonist has to make a moral judgement, but then they do something unambiguously evil for no good reason, or are exposed as hypocrites, so its all fine and the protagonist can just beat them up and happily restore the status quo.

I’ll avoid spoilers, but the first season of the otherwise excellent Legend of Korra is bad for this. The main antagonist is shown to be an evil hypocrite, so the underlying moral issue (a thinly veiled allegory for real world oppression of the poor) is glossed over and resolved off screen without the protagonist having to make any difficult choices or come to terms with their own privileged position or the institutional problems that led to the problem. I can’t be alone in thinking that a version where both sides were consistent and well meaning, so a compromise had to be reached, would have been far more interesting.

This trope really annoys me and I’m going to try to articulate why

Firstly there’s the general reasons that deus ex machina plots are bad writing. Especially when you use them regularly, and the audience are robbed of any sense of suspense of consequences for the characters actions.

But they specifically annoy me when they are used to resolve moral dilemmas.

They allow the writers and characters to have their cake and eat it. You set up a big serious moral question, and score points with the audience and critics by doing so, but don’t have to pay the cost of having the character either take the family unfriendly option of sacrificing the few for the sake of the many, or have them suffer the consequences of their principles in the real world, where a lot of innocents die for no good reason.

Bentham's views on
Doctor Who are
sadly lost to history

Putting my cards on the table, philosophically I’m a fairly hardcore utilitarian, so I think the obvious moral answer in these cases is to sacrifice the few for the greater good. But I accept that there are good criticisms of utilitarianism and serious arguments for other moral positions.

However these only work if you are willing to accept the negative consequences. If you believe that murder is always wrong, even when it results in less overall death and suffering, that's fine, but you have to bear the costs. [Kant was willing to bite the bullet and say lying to a murderer to save a life was immoral, which is remarkably consistent, if bizarre.]

However in these cases the non-utilitarian option is right because when you choose it you always get the best outcome due to circumstances outside your control. The message being that you should always stand by your principles, even when its a terrible idea, because there are no consequences.

This is harmful internal to the work of fiction because you lose any opportunities for meaningful character development and angst from them living with their choices and consequences.

But I also think it has a real world harm.

For better or worse we absorb moral messages from our entertainment (indeed many people have argued this is the point of fiction), and this is especially true for children, who are the intended audiences for most of these shows. (I hate doing a “think of the children” argument but for once it’s true).

The problem is that if we are absorbing our moral intuitions from shows where there are literally no consequences for standing by abstract principles and making moral choices this leads to terrible real life decision making. The real world isn’t fair, there are no magic plot devices that save the day or writers to reward you for making the “right” moral choice. If you choose not to sacrifice the few for the needs of the many, the many die.

A huge number of real world political and moral issues take this form. Governments have to make difficult tradeoffs about how they spend money and who they save. E.g. doing everything you can to save a single human life is a very moral principle in the abstract, but applied in reality it means spending huge amounts of money on rare cancer treatments for charismatic middle class white people, when that same money could have saved far more lives spent on boring things like more nurses and hygiene, and not even counting the costs of spending the money on the well being of people in our own country, or the society for the treatment of cute puppies, rather than donating it to treat malaria in the third world.

My hypothetical interlocutor might say: “Well that's true for the decisions of government’s, but most people aren’t governments, their moral choices just impact them and people they know personally. So they should just stick to principles in most cases and not do bad things even when they want to.” There’s a kernel of truth to this, most of the time killing is bad, and you can maybe make an epistemic argument that you need very good proof of good long term consequences before you do a bad thing for the greater good. But people do make real choices where this applies, they choose who to vote for, they choose what charities to donate to, they make tradeoffs between their personal desires, or the good of those close to them, and the greater good every day. When people have been taught all their lives that standing by your principles is always the right thing to do regardless of the consequences, because things will somehow always work out, they will consistently make bad choices.

I understand this seems mean of me. The idea that the good empathic people are rewarded and the cold calculators punished is very intuitively appealing. Our brains literally give us happy chemicals when we see people happy, and sad chemicals when we see people sad, and nothing when we give money to save the lives of far away people we've never met. but we should be trying to counter this tendency not indulging it, and pretending the world is just.

Screw moral complexity,
I'm a giant glowing eye! 

I’m not saying every piece of fiction has to be a deep examination of ethics (I’d like that because I’m a massive philosophy nerd, but I know I’m in a minority there). There are extremely good works of fiction where the bad guys are unambiguously evil (e.g. in the Lord of the rings trilogy, Sauron is literally the personification of evil). But in those cases the central driving conflicts and plots come from different areas, Tolkein never pretends there is a ‘deep ethical question’ about whether we should let Sauron win, the plot is about how the protagonists beat him.

The problem is that writers try to have the benefits of moral complexity and drive a plot based on the dilemmas, but then cop out at the last minute. We get better fiction, and a better society when we are willing to live with the consequences of our moral choices.

This post was written in one go, then posted as part of my attempt at NaNoWriMo, where I’ve set myself a target of doing a certain number of words a day. So may not be as dazzlingly perfect as it would be if I spent longer on it. Its also in a more informal and conversational style than I normally use when I’m writing about debating or whatever. Thanks to everyone who commented on the drafts.

Comments on the content or style are very welcome. Feel free to be critical, I'm trying to get better at this whole writing thing.

Mental Health - Ways I've gotten better

Every once in a while its useful to pause and take a look back. It's been about 5 years since I was officially diagnosed, though an objective observer would probably have noticed before then I was for a long time in a state of terrified denial and not wanting to ask for help. I'm still not doing as well as I'd like to be but in many was things are a hell of a lot better than they were.

I can sleep normally 

For a long time I could only fall asleep at night by hours of conscious effort. By which I mean I would lie awake in bed in the dark for hours desperately trying to sleep but being unable to. Then I would sleep in until mid afternoon. This obviously wasn't good, as I'd often sleep through lectures, and living in the frozen north of Scotland I'd often sleep through most of the sunlight in the winter, which really didn't help. I also was able to get p and turn off multiple alarms entirely without engaging my higher brain functions.

The problem with bad sleep patterns is they're self perpetuating. If you wake up at 3pm you aren't going to be able to go to sleep at a decent time however hard you try (and my occasional attempts to 'reset' by staying up all night didn't help).

These days I can fall asleep fairly easily within 15 minutes of going to bed, and I seem to get sleepy naturally at the appropriate times without much effort. I still sleep in more than I'd like to, but if I have a specific reason to wake up and do something I can. The problem is more when I have nothing scheduled goign back to bed to 'use my laptop' then falling asleep again.

Less anxiety 

I still have fairly bad anxiety, my left leg is twitching compulsively as I write this, and I get a tension in my chest when I try to do something stressful, but its nowhere near as bad as it used to be. There have been times when the mere thought of leaving my room would paralyse me, the little choices of whether to shower, or what to wear, suddenly become terrifying. Its hard to explain to someone who doesn't have it, but imagine the fight/flight response you get at really really scary situations (being attacked by a tiger say) at moments that really don't deserve it. Its still an issue, and it tends to vary day to day, but I can normally consciously work myself through the stress and do the things I need to do.

No suicidal thoughts 

This is not a very cheerful one. Psychologists make a distinction between "active" and "passive" suicidal thoughts. An active thought is when you consciously plan or daydream about a way to kill yourself, luckily I've never done that. But I have had "passive" suicidal thoughts. That's when you don't really care if you live or die, and you think that if you just died in your sleep, or a bus hit you, you wouldn't really care. I have had those times, where being alive and suffering seems a bit pointless. [Here's a good podcast on the subject.]

But these days I really really don't want to die, which is definitely an improvement.

Generally less deep depression. 

Still have occasional days of complete apathy and lack of energy, but I don't hate myself when I'm in those states and spiral deeper. I think this is linked to training myself out of compulsive negative thinking, when you're depressed you automatically generate negative thoughts (Oh I did this terrible thing...)  and  think circularly on that. I've learned some good CBT techniques for stopping myself when I realise I'm doing that, and stop it.

How? 

The problem is I don't really know why and how these things improved, I never had any big moments of revelation but I've done a bunch of things which seem to have slowly accumulated:

• I'm on medication which has definitely helped, though more at removing the deep dark bits and cutting background anxiety and increasing energy than making me feel actively happy. (For the record I'm taking 75mg of Venlafaxine, an SNRI, twice a day); 
• I've also had therapy of different types, general counselling and also Cognitive Behavioral Therapy focused on learning helpful ways of thinking and unlearning bad ones; 
• A nice thing about CBT is you can do some of it on your own from books (I recommend Introducing Cognitive Behavioural Therapy (CBT): A Practical Guide and Feeling Good: The New Mood Therapy); 
• Lifestyle is also a factor, I exercise far more regularly now, it doesn't make me immediately happy afterwards, though some people say they get an endorphin rush, but it seems to impact my general mood and lower anxiety, and I definitely notice when I haven't done it for a while I get stir crazy (I'm doing a mix of weightlifting and low level cardio);
• Other lifestyle factors might include getting out of some of the negative things of student life, e.g. variable hours and big deadlines that stressed me out, but I've also been depressed when I've been working normal 9-5 days so its hard to tell. 

The takeaway for anyone with similar issues is, to paraphrase Dan Savage, it gets better, it really does. Often when you're depressed it feels hopeless and like you can never get out of it into the sunlight and feel normal again, but you can. Its not sudden, and its not easy but you can get there.

The things they don't tell you about death

You've seen death a thousand times on television, they can't  get enough of it. They show you the screams, a frozen moment of blinding grief and pain. Then it fades to black.

They don't show you the waiting. Waiting in the hospital to know if this is the time it ends. Long moments of tense boredom, unable to help, watching someone suffer.

Waiting for a piece of paper to certify it happened. Why does it take them days? What fact could be more simple to prove than death.

They don't show you sifting through paperwork. Banks and charities and bills and all these supposedly vital elements of life. Finding ways to discover passwords for websites, wondering what will happen to your shadow on the internet when your time comes.

They don't show you smiling politely and saying thank you, when people say they're sorry, again and again. The awkward pause and lying and saying its all okay.

Funerals should be moments of high drama, they don't tell you about the logistics, the tiresome exercise of planning, standing waiting for it to start so it can be over.

The don't tell you how tired you will be.

They don't tell you about the strange little pangs you get when you find a half finished book.

Throwing out or donating the possessions accumulated over a lifetime. Bagging and sorting and lifting and trips to the dump.

The don't tell you how the great truth of human life is made neither sacred or horrible, but crushingly mundane.