Archive for the ‘stress’ Category
discussing mental health and illness
Canto: I’ve been told I’m on the autism spectrum, by someone who’s not on it, presumably, but who’s also not an expert on such things, but I’m not sure who is.
Jacinta: Well of course we’re all on the autism spectrum, it depends on your location on it, I suppose, if you need to worry. ‘You’re sick’ is one of the oldest lines of abuse, but I’m reminded of a passage in The moral landscape, which I’m currently rereading. He describes a funny-but-not-so-funny piece of research by one D L Rosenhan:
… in which he and seven confederates had themselves committed to psychiatric hospitals in five different states in an effort to determine whether mental health professionals could detect the presence of the sane among the mentally ill. In order to get committed, each researcher complained of hearing a voice repeating the words ’empty’, ‘hollow and ‘thud’. Beyond that, each behaved perfectly normally. Upon winning admission to the psychiatric ward, the pseudo-patients stopped complaining of their symptoms and immediately sought to convince the doctors, nurses and staff that they felt fine and were fit to be released. This proved surprisingly difficult. While these genuinely sane patients wanted to leave the hospital, repeatedly declared that they experienced no symptoms, and became ‘paragons of cooperation’, their average length of hospitalisation was 19 days (ranging from 7 to 52 days), during which they were bombarded with an astounding range of powerful drugs (which they discreetly deposited in the toilet. None were pronounced healthy. Each was ultimately discharged with a diagnosis of schizophrenia ‘in remission’ (with the exception of one who received a diagnosis of bipolar disorder). Interestingly, while the doctors, nurses and staff were apparently blind to the presence of normal people on the ward, actual mental patients frequently remarked on the obvious sanity of the researchers, saying things like ‘You’re not crazy – you’re a journalist’.
S. Harris, The moral landscape, p142
Canto: Well, that’s a fascinating story, but let’s get skeptical. Has that study been replicated? We know how rarely that happens. And there are quite a few other questions worth asking. Wouldn’t most of the staff etc have been primed to assume these patients had a genuine mental illness? And surely only a small percentage would have had the authority to make a decision either way. Who exactly had them committed, what was the process, and what was the relationship between those doing the diagnosis and those engaging in treatment and daily care? Was there any fudging on the part of the pseudo-patients (who were apparently also the researchers) in order to prove their point (which presumably was that mental illness can be easily shammed)? And wouldn’t you expect other patients, many of whom wouldn’t believe in their own mental problems, to be supportive of the sanity of those around them?
Jacinta: Okay, those are some valid points, but are you prepared to accept that a lot of these mental conditions, such as bipolar disorder, borderline personality disorder (the name speaks volumes), attention deficit disorder, narcissistic whatever disorder and so on, are a little flakey around the edges?
Canto: Maybe, but with solid centres I’m sure. Depression is probably the most common of those mental conditions, and too much skepticism on that count could obviously lead to disaster. Take the case of South Korea, which has one of the highest suicide rates in the world. There appears to be a nationwide skepticism about mental health issues there, which clashes with high stress levels to create a crisis of care. Professional help is rarely sought and isn’t widely available. It raises the question of the value of skepticism in some areas.
Jacinta: I wonder if the rapid advances in neurophysiology can help us here. Mental health is all about the brain. In the above quote, the pseudo-patients were mostly diagnosed with schizophrenia. That’s surprising. In my naïveté I would’ve thought there was a neurological test for schizophrenia by now.
Canto: Well, the experiment described in The moral landscape dates from the early seventies, but currently there’s still no diagnostic test for schizophrenia based on the brain itself, it’s all about such symptoms as specific delusions and hallucinations, which could still be shammed I suppose, if anyone wanted to. But what about borderline personality disorder – I was told recently that it’s very real, in spite of the name.
Jacinta: Well, there appears to be a mystery about the causes, and a general confusion about the symptoms, which seem to be rather wide-ranging – though I suppose if a patient displays several of them you can safely conclude that she’s stark staring bonkers.
Canto: Yes that’s a thing about mental illness, quite seriously. You don’t need to be an expert to notice when people are behaving in a way that’s detrimental to themselves and others, especially if it’s a sharp deviation from previous behaviour. And if it’s a slow descent, as quite often depression can be, it’s harder to pick from that person’s standard lugubrious personality, so to speak. And in the end, maybe the labelling isn’t so important as the help and the treatment. But then, people love a label – they want to know precisely what’s wrong with them.
Jacinta: I suppose the difficulty with mental illness and labelling, as opposed to labelling other more ‘physical’ illnesses or injuries, is the near-ineffable complexity of the brain. For example, I notice that among the symptoms of borderline personality disorder are apparent behaviours that don’t really cohere in any way. This site places the symptom of uncertainty and indecisiveness along with extreme risk-taking and impulsiveness, and then there is fear of abandonment, and other odd behaviours which seem to head in different directions, seeming to have one thing alone in common – being extreme or abnormal.
Canto: Yes, again, behaviour that tends to harm the self or others.
Jacinta: At the moment, I think there are still too few connections between neurology and psychiatry and the treatment of mental illness, though it’s a matter of enormous complexity. I had thought, for example, that the role of the neurotransmitter dopamine was essential to our understanding of schizophrenia, but more recent research has found that the neurochemistry of the condition involves many other factors, including glutamate, GABA, acetylcholine and serotonin. There’s so much more work to be done. But we also need to be very aware of the social and cultural conditions that tip people over the edge into mental illness. Changes in the way our brain is functioning might be seen as proximal causes of an increase in depression and suicide, but it’s more likely that the ultimate causes have to do with the stresses that particular organisations, societies and cultures impose upon us.
The over-population clock
a pro-democracy demo in Egypt, 2011
Canto: From time to time I’ve shown my students the world population clock (WPC), because I’ve brought my discourse round to it for some reason, and they’ve been mostly fascinated. And I’ve usually told them that the world’s population will level out at about 9.5 billion by mid-century, because I’ve read or heard that somewhere, or in a few places, but is that really true?
Jacinta: So you’re wanting to investigate some modelling?
Canto: Well yes maybe. I was looking at the WPC the other day, and was shocked at how births are outnumbering deaths currently. What’s actually being done to stem this tide?
Jacinta: Looking at the WPC website, there’s a lot more data there that might enlighten you and calm your fears a bit – if it can be trusted. Ok we went past 7.4 billion this year and you can see that so far there’s 70 milliom births compared to around 29 million deaths, and that looks worrying, but you need to look at long-term trends. The fact is that we’ve added a little over 40 million so far this year, with a current growth rate of about 1.13%. That figure means little by itself, but it’s important to note that it’s less than half of what the growth rate was at its peak, at 2.19% in 1963. The rate has been decelerating ever since. Of course the worry is that this deceleration may slow or stop, but there’s not much sign of that if we look at more recent trends.
Canto: Okay I’m looking at the figures now, and at current trends the projection is 10 billion by 2056, by which time the growth rate is projected to be less than 0.5%, but still a fair way from ZPG. The population, by the way, was two point something billion when I was born. That’s a mind-boggling change.
Jacinta: And yet, leaving aside the damage we’ve done and are doing to other species, we’re doing all right for ourselves, with humanity’s average calorie intake actually increasing over that time, if that indicates anything.
Canto: Averages can carpet over a multitude of sins.
Jacinta: Very quotable. But the most interesting factoid I’ve found here is that the current growth rate of 1.13% is well down on last year’s 1.18%, and the biggest drop in one year ever recorded. In 2010 the growth rate was 2.23%, so the deceleration is accelerating, so to speak. It’s also interesting that this deceleration correlates with increasing urbanisation. We’re now at 54.3% and rising. I know correlation isn’t causation, but it stands to reason that with movement to the city, with higher overheads in terms of housing, and with space being at a premium, but greater individual opportunities, smaller families are a better bet.
Canto: You bet, cities are homogenously heterogenous, all tending to favour smaller but more diverse families it seems to me. That’s why I’m not so concerned about the Brexit phenomenon, from a long-term perspective, though we shouldn’t be complacent about it. We need to maintain opportunities for trade and exchange, co-operative innovation, so that cities don’t evolve into pockets of isolation. Ghettoisation. Younger people get that, but the worry is that they won’t stay young, they won’t maintain that openness to a broader experience.
Jacinta: Well the whole EU thing is another can of worms, and I wonder why it is that so many Brits were so pissed off with it, or were they duped by populist nationalists, or are they genuinely suffering under European tyranny, I’m too far removed to judge.
Canto: Well, if there were too many alienating regulations, as some were suggesting, this should have and surely could have been subject to negotiation. Maybe it’s a lesson for the EU, but you’re right, we’re too far removed to sensibly comment. Just looking at the WPC now – and it’s changing all the time – it has daily birth/death rates which shows that the birth rate today far exceeds the death rate – by more than two to one. How can you possibly extrapolate that to a growth rate of only 1.13%?
Jacinta: Ah well that’s a mathematical question, and I’m no mathematician but obviously if you have a birth rate the same as the death rate you’ll have ZPG, no matter what the current population, where as if you have a disparity between births and deaths, the percentage of population increase (or decrease) will depend on the starting population and the end-population, as a factor of time – whether you measure is annually or daily or whatever.
Canto: Right so let’s practice our mathematics with a simple example and then work out a formula. Say you start with 10, that’s your start population at the beginning of the day. And 24 hours later you end up with 20. That’s a 100% growth rate? But of course that could be with 1000 additional births over the day, and 990 deaths. Or 10 more births and no deaths.
Jacinta: Right, which indicates that the total number of births and deaths is irrelevant, it’s the difference between them that counts, so to speak. So let’s call this difference d, which could be positive or negative.
Canto: But to determine whether this value is positive or negative, or what the figure is, you need to know the value of births (B) and deaths (D).
Jacinta: Right, so d = B – D. And let’s set aside for now whether it’s per diem or per annum or whatever. What we’re wanting to find out is the rate of increase, which we’ll call r. If you have a start population (S) of 10 and d is 10, then the end population (E) will be 20, giving a birth rate r of 100%, which is a doubling. I think that’s right.
Canto: So the formula will be: r = S – E… Fuck it, I don’t get formulae very well, let’s work from actual figures to get the formula. It’s actually useful that we’re almost exactly mid-year, and the figure for d (population growth) is currently a little under 42 million. That’s for a half-year, so I’ll project out to 83 million for 2016.
Jacinta: So d now means annual population growth.
Canto: right. Now if we remove this year’s growth figure from the current overall population we get as our figure for S = 7,391,500,000 and that’s an approximation, not too far off. And we can calculate E as 7,474,500, approximately.
Jacinta: But I don’t think we need to know E, we just need S and d in order to calculate r. r is given as a percentage, but as a fraction it must be d/S. And this can be worked out with any handy calculator. My calculation comes out at 6.6% growth rate.
Canto: Wrong.
Jacinta: Yes, wrong, ok, a quick confab with Dr Google provides this formula. d = ((E – S)/S).100. But we already have that? E-S is 83 million. Divided by S (7,391,500,000), and then multiplying by 100 gives a growth rate annually of 1.1229%, or 1.12% to two decimal places, which is not far off, but significantly less than, the WPC figure of 1.3%. I must have stuffed up the earlier calculation, because I think I used the same basic formula.
Canto: Excellent, so you’re right, my fears are allayed somewhat. Recent figures seem to be showing the growth rate declining faster than expected, but let’s have another look at the end of the year. Could it be that the growth figures are higher in the second half of the year, and the pundits are aware of this and make allowances for it, or are we actually ahead of the game?
Jacinta: We’ll have a look at it again at the end of the year. Remember we did a bit of rounding, but I doubt that it would’ve made that much difference.
Some current national annual population growth rates (approx):
Afghanistan 3.02%
Australia 1.57%
Bangladesh 1.20%
Brazil 0.91%
Canada 1.04%
China 0.52%
India 1.26%
Iran 1.27%
Germany 0.06%
Morocco 1.37%
Nigeria 2.67%
Pakistan 2.11%
South Africa 1.08%
United Kingdom 0.63%
(These are not, of course, calculated solely by births minus deaths, as migration plays a substantial role – certainly in Australia. Some surprises here. The highest growth rate on the full list of countries: Oman, 8.45%. The lowest is Andorra with -3.61%, though Syria, with -2.27% on these figures, has probably surged ahead by now).
More impressions of Budapest, mainly
Matthius church, Buda. Supposedly first associated with ‘Saint Stephen’, Hungary’s first Christian king, in the early 11th century, it was largely built in the late 14th century and much-restored in the 19th. Its style is over-the-top late gothic – sort of steampunk sans irony
Once we’d checked in, we didn’t much want to leave the air-conditioned comfort for the cold and damp, so we settled in at the hotel bar for a bit. I’d decided to over-dress to cheer myself up – fancy tie and colourful waistcoat, etc – so this elicited discomforting looks from the definitely not over-dressed bar people, and even smirks and laughter from passers-by when we decided to brave the weather and try out an ATM down the road. When a particularly attractive damosel made some obviously mocking remark about me to her beau I was stung into trying out a charming French greeting, but she ignored me. Our ATM venture was also unsuccesful, it would only spit out Magyar currency, aka forints. Still I was beginning to warm to the city, as I noticed a lot of attractive, interesting-looking young people on the streets, all dressed mostly in black. This was probably because, as I discovered next day, the city’s principal university was very close by.
The next day was slightly warmer and drier, and we went for a walk to the nearby museum, an absolutely massive building which was closed, and only open a few days a week – a bad sign I thought. The university precinct, though, gave me the sense of lively Enlightenment that all such areas do. We took some lunch in a pub across from the hotel, after which I took a stroll down to the nearby Danube, where I discovered a lively cafe hub, just one street back from the river, jammed between the usual tall, tightly-packed examples of Euro-impressive architecture. By which time I’d decided I really liked Budapest, but I’m probably more easily pleased than most.
There were a few touristy/traveller problems though. The flight had affected my normally regular sleep pattern, and two weeks into the holiday I still haven’t regained any sleep normalcy (I’m writing this at 3am in Amsterdam), and my cash-flow concerns weren’t alleviated by another ATM failure. This time I’d pre-located nearby a so-called ‘Euro-ATM’ via GPS on my phone but when I got there I couldn’t make any sense whatsoever of its instructions, and I ended up withdrawing a massive number of forints – something like 400,000 of the buggers – thinking I’d receive euros. This is no doubt the closest I’ve come to being a demi-millionaire in my life, but I felt more like a bloody idiot, with a pocket stuffed with a wad of currency that would be practically useless to me within 24 hours. My stress about this caused my first contretemps with my TC, who decided to shop for something warm to wear, in consideration of the somewhat unexpected chilliness, and so left me waiting longtemps outside stanping my feet and sensing the beginnings of a cough and a ‘bubbly dose’, when all I wanted to do was get to a bank that would turn my unearned forints into a maximum of euros. So after an all-too-familiar nasty spit-spat I stamped off to a bank. I’d been warned off having dealings with money exchangers, whose shingles were all over the place, because they apparently charge extortionate commissions, but in the bank I was advised by a friendly young teller in perfect English to use a money-changer down the road who charged no commission and whose rates were much better than the bank’s. This sounded all very helpful and civilised and I followed the young man’s directions precisely and with alacrity until I came to a kind of hole-in-the-wall booth advertising no commission and told my tale to a solemn-looking university type who very carefully counted out my great bundle of forints, typed a formula into a calculator and asked me silently to approve the result, some 800-odd euros, which I could only pretend to know was correct. But I really did feel enormous gratitude that these people seemed to be on my side, if that’s not too self-indulgent a term. Shortly after leaving the hole-in-the-wall with great relief, I stopped as my heart skipped a beat – should I have ‘tipped’ the fellow for his good sevices? I must say I can’t stand the stress and strain that tipping and haggling and such things causes. I’m no good at either, and I’m sure it’s not just a matter of inexperience. It’s just not a fair system – I would rather that people charged plainly and were paid appropriately, so I don’t have to fret about it…
Anyhow, I was happily cashed-up and ready to start the cruise….
bumping into Budapest
view from the hotel window, Mercure-Korona, Pest
Dubai aiport is, of course, multicultural, and you can see that’s very good for business there. It was busy when we disembarked, and busy busy when we embarked for Budapest. My TC, so much more patient than me, queued longtemps to secure a table and brekky at a patisserie française while I mooched around in a Dubai-promoting bookshop and took pics of random distant buildings. So then we spent a pleasant hour or so watching the colourful crowd – Africans, Asians, Europeans, Unidentifiables. The United Arab Emirates is just what you mitght guess it to be, a union of absolute monarchies – seven in all. The Emirati citizenry make up not much more than 10% of the pooulation, the rest are expatriates, with Indians and Pakistanis predominating. Its wealth is based pretty much entirely on oil, and I picture a thoroughgoing stratification of the population. It’s described as more diversified than other Arab states, but that’s not saying much, it’s mostly the same old shite; no elections, no press freedom, abysmal treatment of half the citizenry, not to mention the non-native semi-slaves. I was as happy to remain in the airport as they would’ve been happy to keep me there, all nuances aside.
The flight to Budapest was easier, at least most of it; I definitely fell asleep as I don’t recall much of it. The pilot spoke of turbulence, and the weather at Budapest would be storm-cloudy and cold, but I was feeling blasé and I had more leg-room in this slightly differently configured craft, and again no window seat to distract me, so all was floaty until we started in on the landing, and I noticed the viewing screen was all grey with what looked like slabs of slush hitting and slip-sliding off it. Hoping this wasn’t the view from the cock-pit, I couldn’t help but peek around a bit desperately, but couldn’t spot anything to reassure or concern me. This situation pertained for quite a while, maybe they were hovering about for conditions to clear. The aircraft was being distinctly buffeted. Finally I could feel us descend, and a lonely-looking airstrip came into view. Nothing like the bright criss-crossing lines of light in midnight Dubai, this was midday dark, divided by a solitary road. It looked more like a road than a runway; too narrow, too rough and uneven, too meagre. As the plane approached it, the noise, presumably of air brakes but imagination played it into a drum roll or mad piano music, got pretty intense and the plane was shaking. My eyes were absolutely glued to the screen and I felt completely alone in there. The touch-down wasn’t good, I could feel it. The plane veered sharply left, off, then corrected, finding and sticking to the centre line, rushing over every hump and bump, and when it had sufficiently slowed and quietened there was a smattering of clapping from the passengers. So it wasn’t just me.
So, Budapest airport, foggy, drizzly, outside temp 7 degrees. My first impression: the bleakness wasn’t just a weather thing. Sure once we got inside the ambience was that of universal airportland – big off-white tiles, discreet neon with blue signs in native and English – but when we lined up to leave that land for Hungary, the atmosphere got chillier…
final remarks preliminary to a voyage, part 2
This photo anticipates, but it intoduces my illustrious Travelling Companion, who hardly needs any introduction, here at Dubai Airport
We arrived at the airport unfashionably but sensibly early, driven by a kindly friend of my TC, who has many kind friends quite prepared to let me tag along as my TC’s friend.
It wasn’t busy. En fait, as airports go, plus ou moins vide. Which was nice, frankly. We could check in our baggage before time came when we’d actually have to queue.
As mentioned our flight was with Emirates, in association with Qantas. I feel unnerved by these Middle-Eastern-Arabic cultures with their male superiority BS and their nonalcoholic antifun holier-than-thouness, and I had imaginings of semi-veiled, infantilised, under-the-pump air stewards failing to perform their modest duties, all of which I knew was molto-ridiculous, having taught a few feisty Iraqi and Arabic mothers in my time. I also had visions of Dubai airport, our stopover, as awash with tall white-robed mullahs disdainfully observing our decadence from under their sanctified headgear. Strange, smug, scared phantasies….
Baggage processing was a breeze. Of the Emirates-uniformed staff that ushered and dealt with us there was a dark-skinned male, probably Indian, and two females, one probably Chinese, the other possibly Scandinavian, and I saw that it was good. The women wore vestigial hijabs, bits of white cloth dangling from the backs of their Emirates caps (and later, in flight, I noticed that many of them had shed even this vestige). I look forward to many correctives over this trip, experiential reshapings of vague fantastical ideas.
So the big luggage had scarily disappeared and we rambled on with our carry-ons, browsing and buying in the airport shops and looking out for eateries. Typically, we chose to calm our (or at least my) silently screaming nerves with doses of champagne. Then, to absorb the alcohol (we argued), we ordered a bowl of ‘phat chips’. They turned out to be reasonably fat, but were they in fact phat? I went into a little language dive; maybe phat is related to fat as phantasy is to fantasy? Or phact to fact? Ph words generally do have a cachet, as in physics, phenomena and pharmacology, unlike farmer, fart and fool….
My TC pulled me out of this phrolic by adverting to the tastiness of our phrites. ‘Have you noticed how soft they are to the tooth?’ In truth, I hadn’t. ‘I think they’re made from mashed potato!’ Sure enough, they seemed so to be… unless of course it was the more cacheted smashed potato…..
I lost myself in further labyrinths of language and style, luckily enough, until it was near time to bustle aboard with the finally sizeable crowd. Not a busy busy crowd though by any means. We were of the economy class, bien entendu, and had to wait until the best and second-best classes were settled in. I noticed too, with a kind of peculiar relish, that we were herded through the established better classes to the back of the bus, like ‘people of colour’ in former times and places. We were treated very nicely though.
More subsequent remarks preliminary to a voyage
my officially incipient tache – a supposedly fun thing I’ll never grow again
So as flight-time draws nigh, it’s hard to describe my tangle of emotions. The first is dread that this is the end [litt ref 3.5, with apologies to the Doors]. I have a micro-fear of flying, and this’ll be the first long haul. I love embracing travellers’ lingo. We’re flying Emirates, stopping over at Dubai, but the thing is, we’re flying all night. I mean, how do the pilots see anything?
OK, I know it’s all ineffably hi-tech and the safest form of transport ever invented and night flights are pushbuttoningly routine, and Mick Jagger’s still alive and dancin after 10 zillion flights, but there have to be exceptions to prove rules perhaps, and when disasters do happen they’re always spectacular. I mean, you don’t get a dose of whiplash from a plane crash. They’re not called prangs. It’s, like, 279 dead, body parts spread over an xx-kilometre zone, so much for safety in numbers, and I’m wondering, as strangely-pathetically I often do, what will be the reaction to my passing…
But enough self-indulgence, I’ll be right on the night. Still the other emotions and stressors are pastel in comparison. In fact, actually, truthfully, the flight’s the only real issue. Money, la langue francaise, communications home, possible tensions with my TC, health concerns (not flu jabbed, tsk tsk), all mere nanothemes. I’m collecting gratis advice – take a KO dose of valium, get drunk, use nasal spray (done), chew gum (will do), sleep, get over it, enough self-indulgence.
The home I leave behind will be tenanted by a sweet young miss of whom I will say no more in the unlikely event that she reads this blog, and I must say I’ll miss the daily watched-kettle-not-boiling progress of the various building sites in my neighbourhood, with, as a neighbour pointed out, possibly lethally ambitious NYC names like the Bowery, the Beeline (or is it the Beehive?) and Park Central. Really. Cafés and R & R areas are proliferating and jackhammers and earth-pounding noise-makers are just starting to shape the projected City Square a few blocks away. How thrilling it’ll be to actually notice a difference come the end of May. I don’t feel at all cynical about it, as a relative newcomer to regular acceptable employment, a parvenu, a bourgeois – but not assez plat, to recall the slicing words of Stendhal [litt ref 4.5]. Besides, I’ve encountered a few of the occupants of the new medium density constructs sprouting around me (I mean sighted them, not met them) and mostly they look just as spivvy as myself. And the enviro-ideas shaping those buildings really are exciting, but I’m too excited – just about to be picked up and driven to the airport – to detail them now. I will survive [musical reference 1 – but then the Doors reference should really be a musical reference not a half-litt reference – ok no more ref-mentions].