Later On

A blog written for those whose interests more or less match mine.

Archive for January 13th, 2018

Is everything you think you know about depression wrong?

leave a comment »

Johann Hari writes in the Guardian:

In the 1970s, a truth was accidentally discovered about depression – one that was quickly swept aside, because its implications were too inconvenient, and too explosive. American psychiatrists had produced a book that would lay out, in detail, all the symptoms of different mental illnesses, so they could be identified and treated in the same way across the United States. It was called the Diagnostic and Statistical Manual. In the latest edition, they laid out nine symptoms that a patient has to show to be diagnosed with depression – like, for example, decreased interest in pleasure or persistent low mood. For a doctor to conclude you were depressed, you had to show five of these symptoms over several weeks.

The manual was sent out to doctors across the US and they began to use it to diagnose people. However, after a while they came back to the authors and pointed out something that was bothering them. If they followed this guide, they had to diagnose every grieving person who came to them as depressed and start giving them medical treatment. If you lose someone, it turns out that these symptoms will come to you automatically. So, the doctors wanted to know, are we supposed to start drugging all the bereaved people in America?

The authors conferred, and they decided that there would be a special clause added to the list of symptoms of depression. None of this applies, they said, if you have lost somebody you love in the past year. In that situation, all these symptoms are natural, and not a disorder. It was called “the grief exception”, and it seemed to resolve the problem.

Then, as the years and decades passed, doctors on the frontline started to come back with another question. All over the world, they were being encouraged to tell patients that depression is, in fact, just the result of a spontaneous chemical imbalance in your brain – it is produced by low serotonin, or a natural lack of some other chemical. It’s not caused by your life – it’s caused by your broken brain. Some of the doctors began to ask how this fitted with the grief exception. If you agree that the symptoms of depression are a logical and understandable response to one set of life circumstances – losing a loved one – might they not be an understandable response to other situations? What about if you lose your job? What if you are stuck in a job that you hate for the next 40 years? What about if you are alone and friendless?

The grief exception seemed to have blasted a hole in the claim that the causes of depression are sealed away in your skull. It suggested that there are causes out here, in the world, and they needed to be investigated and solved there. This was a debate that mainstream psychiatry (with some exceptions) did not want to have. So, they responded in a simple way – by whittling away the grief exception. With each new edition of the manual they reduced the period of grief that you were allowed before being labelled mentally ill – down to a few months and then, finally, to nothing at all. Now, if your baby dies at 10am, your doctor can diagnose you with a mental illness at 10.01am and start drugging you straight away.

Dr Joanne Cacciatore, of Arizona State University, became a leading expert on the grief exception after her own baby, Cheyenne, died during childbirth. She had seen many grieving people being told that they were mentally ill for showing distress. She told me this debate reveals a key problem with how we talk about depression, anxiety and other forms of suffering: we don’t, she said, “consider context”. We act like human distress can be assessed solely on a checklist that can be separated out from our lives, and labelled as brain diseases. If we started to take people’s actual lives into account when we treat depression and anxiety, Joanne explained, it would require “an entire system overhaul”. She told me that when “you have a person with extreme human distress, [we need to] stop treating the symptoms. The symptoms are a messenger of a deeper problem. Let’s get to the deeper problem.”

*****

I was a teenager when I swallowed my first antidepressant. I was standing in the weak English sunshine, outside a pharmacy in a shopping centre in London. The tablet was white and small, and as I swallowed, it felt like a chemical kiss. That morning I had gone to see my doctor and I had told him – crouched, embarrassed – that pain was leaking out of me uncontrollably, like a bad smell, and I had felt this way for several years. In reply, he told me a story. There is a chemical called serotonin that makes people feel good, he said, and some people are naturally lacking it in their brains. You are clearly one of those people. There are now, thankfully, new drugs that will restore your serotonin level to that of a normal person. Take them, and you will be well. At last, I understood what had been happening to me, and why.

However, a few months into my drugging, something odd happened. The pain started to seep through again. Before long, I felt as bad as I had at the start. I went back to my doctor, and he told me that I was clearly on too low a dose. And so, 20 milligrams became 30 milligrams; the white pill became blue. I felt better for several months. And then the pain came back through once more. My dose kept being jacked up, until I was on 80mg, where it stayed for many years, with only a few short breaks. And still the pain broke back through.

I started to research my book, Lost Connections: Uncovering The Real Causes of Depression – and the Unexpected Solutions, because I was puzzled by two mysteries. Why was I still depressed when I was doing everything I had been told to do? I had identified the low serotonin in my brain, and I was boosting my serotonin levels – yet I still felt awful. But there was a deeper mystery still. Why were so many other people across the western world feeling like me? Around one in five US adults are taking at least one drug for a psychiatric problem. In Britain, antidepressant prescriptions have doubled in a decade, to the point where now one in 11 of us drug ourselves to deal with these feelings. What has been causing depression and its twin, anxiety, to spiral in this way? I began to ask myself: could it really be that in our separate heads, all of us had brain chemistries that were spontaneously malfunctioning at the same time?

To find the answers, I ended up going on a 40,000-mile journey across the world and back. I talked to the leading social scientists investigating these questions, and to people who have been overcoming depression in unexpected ways – from an Amish village in Indiana, to a Brazilian city that banned advertising and a laboratory in Baltimore conducting a startling wave of experiments. From these people, I learned the best scientific evidence about what really causes depression and anxiety. They taught me that it is not what we have been told it is up to now. I found there is evidence that seven specific factors in the way we are living today are causing depression and anxiety to rise – alongside two real biological factors (such as your genes) that can combine with these forces to make it worse.

Once I learned this, I was able to see that a very different set of solutions to my depression – and to our depression – had been waiting for me all along.

To understand this different way of thinking, though, I had to first investigate the old story, the one that had given me so much relief at first. . .

Continue reading.

Written by LeisureGuy

13 January 2018 at 4:10 pm

World Bank Gamed Data to Make Chile’s Socialist Party Look Bad

leave a comment »

Astonishing story. Read this Kevin Drum post.

Given the direction the Trump Administration is going, and Trump’s explicitly stated belief that government statistics are slanted, I expect we’re going to see much the same in the US. Or, as seems to be frequently the case, the whole report/database/whatever is just scrapped or made inaccessible to the public.

Written by LeisureGuy

13 January 2018 at 2:04 pm

Posted in Business, Politics

Have They No Sense of Decency?

leave a comment »

James Fallows has a powerful column in the Atlantic:

“Have you no sense of decency?” It’s the question that the members of the Republican majority in the Congress—51 senators, 239 representatives—might bear in mind, in the “shithole” era.

If only two of those senators would stand up against Donald Trump, with their votes rather than just their tweets or concerned statements, they would constitute an effective majority.

With the 49 Democratic and independent senators, these two would make 51 votes, which in turn would be enough to authorize real investigations. They could pass a formal resolution of censure. They could call for tax returns and financial disclosure. They could begin hearings, on the model of the nationally televised Watergate hearings of 45 years ago.

They could behave as if they took seriously their duties to hold the executive branch accountable. They could make a choice they know will be to their credit when this era enters history — as did the Republicans who finally turned against their own party’s President Nixon during the Watergate drama, as did the Democrats who finally turned against their own party’s President Johnson over the Vietnam war, as did the Republicans who finally turned against their own poisonous Senator McCarthy in the episode that gave rise to “Have you no sense of decency?” more than 60 years ago. They could spare themselves the shame that history attaches to people who did the wrong thing, or nothing, or kept looking the other way during those decisive periods.

(I’m not even talking about the House, where the GOP has a larger majority, where there’s never been as much talk about “world’s greatest deliberative body,” and where the main outlet for Republican concerns about this era in politics has been the rapidly growing list of incumbents deciding to retire rather than run again.)

Even without the House, just two senators could make an enormous difference.

  • Two like Jeff Flake and Bob Corker who are not running for re-election and have no primary-challenge consequences to fear;
  • Two like Orrin Hatch and John McCain who mainly have their places in history to think about;
  • Two like the young Ben Sasse and the veteran Lamar Alexander who pride themselves on being “thoughtful”;
  • Two like Susan Collins and Lisa Murkowski who pride themselves on being “independent”;
  • Two like Rand Paul and Mike Lee who pride themselves on their own kind of independence;
  • Two like Rob Portman and John Barrasso who pride themselves on being decent;
  • Two like Marco Rubio and Tom Cotton with conceivable long-term higher-office hopes;
  • Two like Tim Scott and James Lankford who jointly wrote a statement on the need for broad-minded inclusion;
  • Two like Chuck Grassley and Richard Shelby, who like Hatch and McCain are in their 80s and conceivably have “legacy” on their minds (remember that in the Alabama Senate race Shelby took a stand against his party’s odious nominee, Roy Moore);
  • One like Dean Heller, facing a tough re-election race, plus maybe Lindsey Graham, who used to be among the leaders in blunt talk about Trump’s excesses;

If any of these two, or some other pair from the thirty-plus remaining Republicans, decided to take a stand, they would not change everything about  this perilous moment in politics. But they would do something, about the open secret of a destructive presidency that nearly all of their colleagues are aware of and virtually none is doing anything about.

They could remind their colleagues of the Senate’s appropriate check-and-balance function.

And they could spare themselves, in history’s perspective, the question Joseph Welch so memorably asked the rampaging Senator Joe McCarthy, during the Army-McCarthy hearings of 1954.

From the Senate’s own historical  site: . . .

Continue reading.

Written by LeisureGuy

13 January 2018 at 1:56 pm

Johnny Cash Takes A Stand: Looking Back On His Folsom Prison Performance

leave a comment »

NPR has an interesting article giving the backstory on the Folsom Prison concert.

Not in Folsom Prison, but Johnnie Cash singing it:

Written by LeisureGuy

13 January 2018 at 1:53 pm

Posted in Business, Daily life, Music

The GOP Only Selectively Cares About States’ Rights

leave a comment »

John Stoehr writes in the Washington Monthly:

You may have noticed something peculiar going on since Donald Trump’s election. The party of federalism and states’ rights has changed. In important ways, the GOP is now the party of big government.

“Has changed” isn’t quite right. “Is changing” is more accurate. We have not yet arrived at a moment when the party’s leadership is saying what Trump surrogate Gina Loudon said on Fox News last week: “States rights don’t override federal rights.” But we are getting there. Loudon was referring to Attorney General Jeff Sessions’s decision to cancel an Obama-era policy of a more hands-off approach to drug enforcement, which allowed states to decriminalize pot before legalizing it. His decision has states like Colorado and California, where it is legal to buy and sell, waiting with bated breath. Others, like Connecticut, are unsure whether they should move forward with ending prohibition.

Sessions’s decision is only one of a handful of serious policy shifts indicating the Republican Party is no longer squeamish about flexing federal muscle to advance its agenda. ICE Acting Director Thomas Homan said on Fox News: “We’ve got to take [sanctuary cities] to court, and we’ve got to start charging some of these politicians with crimes.” He added Sessions should “file charges.”

I’m not willing to call this authoritarianism, at least not yet, but I am willing to call it big government, because that’s what the Republicans have been calling it since the New Deal and Great Society. I’m interested in holding those in power to their own standards, and this standard of railing against big government was partially the reason the Republican Party is now in power. For conservative voters, Obamacare was big government par excellence.

Sessions has a snowball’s chance of success in prosecuting sanctuary cities, but that’s not my point. GOP’s other big government objectives include opening up virtually all coastal waters to drilling, despite vehement objections by states; pushing for so-called “reciprocity laws,” overriding local bans on the open carry of firearms; and, perhaps most importantly, extracting hundreds of millions from red and blue states to pay for tax cuts for the rich with the elimination of deductions for state and local taxes.

New York Governor Andrew Cuomo last week called this “economic civil war,” and he’s close to being right.

Sure, the Republicans still favor privatizing Social Security and Medicare, as well as nixing business regulations from here to Alaska. But does this mean Republicans stand for federalism and states’ rights? I don’t think so, not when you consider efforts to challenge or undermine the gist of the Tenth Amendment. It’s more accurate to say the Republican Party stands for states’ rights when the states in question voted for President Donald Trump.

Some will say, yeah, duh. The Republicans are hypocrites. They’ve been playing both side of the states’ rights principle for years. I don’t disagree, but I suspect something deeper is going on. It feels like we are approaching a tipping point impacting both parties. Republicans may have won the White House in the past in spite of favoring big government policies, but never in my lifetime has a Republican won because he favored them. And just as the Republicans are becoming the party of big government, the Democrats—and I’m serious—are becoming the party of federalism and states’ rights.

I say I’m serious, because the Republicans have been so successful in branding the Democrats as the party of big government that to suggest they are becoming the party of federalism and states’ right sounds crazy. But how else can explain the success of gay marriage, battles over the minimum wage, pot legalization, and gun control? They didn’t win in Washington. They won in the states.

And it’s not just me saying the Democrats are becoming the party of states’ rights. According to a new book by a couple of political scientists, the era in which progressives used the federal government to advance progressive goals was, from the 1930s to the 1970s, something extraordinary. Here’s what I would add: short of an international calamity, like the Great Depression and World War II, we may never return. . .

Continue reading.

Written by LeisureGuy

13 January 2018 at 1:02 pm

When Congress Paid Its Interns

leave a comment »

Saahil Desai points out in the Washington Monthly the actual effects of continual tax cuts: the government then simply does not have enough money to do the job well, if at all. Whole sections of regulations have been turned into de facto or even de jure “voluntary observance,” which means, of course, that most companies don’t volunteer to observe the regulations because flouting them increase profit, with the costs (public health, for example) totally externalized: the companies don’t pay those costs, so they do not care.

The people should want an effective government that works to keep them safe, healthy, educated, housed, and so on. And you get what you pay for. I truly do not think that is hard to grasp.

Her article begins:

When I met Kendall on a November Sunday afternoon in a downtown D.C. bar, she had just finished her shift serving appetizers and drinks for a catering company. An energetic Southern California native, Kendall splits her time between the serving job and the one she actually came to D.C. to pursue: an internship on Capitol Hill.

Kendall, who is being identified by her middle name so she can speak openly about her internship, is just the type of young person any congressional office should be eager to employ. She’s articulate, shrewd, and a voracious reader (when we first met, she was paging through a tattered copy of The Culture of Narcissism, by the late political theorist Christopher Lasch). Kendall—whose father sells orthopedic implants and whose mother is a babysitter—grew up in  La Verne, in far east Los Angeles County, excelled at school, and attended Pomona College with significant financial aid, graduating last May. The work she’s doing in Congress, for two California Democratic House members, is mostly clerical—compiling news clips, sorting mail, answering calls from constituents. But she has also been given some higher-order tasks that put her closer to the action. “It was really cool to see a press release go out with what I had written,” she said.

The internship, however, is unpaid, and because her parents can’t afford to bankroll her, she has had to make sacrifices to make her stint on the Hill viable. To cut down on expenses, Kendall takes a grinding hour-and-a-half commute, on two separate buses, from the Arlington, Virginia, apartment she shares with two roommates to the Rayburn House Office Building, where she works. She could take the Metro and zip to work in thirty minutes, but during rush hour that would cost $3.25 each way, while a weekly bus pass costs her just $17.50. On days when she works her second job, she might not get home before 11 p.m.

Her parents try to help out when they can, but still Kendall says that she spends just $25 per week on groceries—“I eat lots of pasta,” she said. And the requirement that she wear business attire every day has strained her thin budget even more. “For me, it was hard because I didn’t have much of a business wardrobe,” she said. “So I went to the thrift store and bought a blazer for $8. It didn’t fit me right, but it was the best I could find.”

Up to 40,000 interns flock to the nation’s capital annually, working temporary stints in government, journalism, think tanks, and lobbying. By far the highest concentration of interns is on Capitol Hill. Visit on a muggy summer day, and you’re sure to see “Hillterns” in their recognizable ill-fitting suits, struggling to find the nearest Metro station.

Nationwide, about half of all internships are unpaid, even as they are now a nearly mandatory credential for gaining an entry-level job in many white-collar professions. Congress is especially bad: in the House, only 8 percent of Republicans and 4 percent of Democrats compensate even one of their many interns, according to Pay Our Interns, an advocacy organization that tracks payment for interns on the Hill. The partisan difference is partly due to the fact that the GOP is in the majority and can allocate more funds to its members, but it’s still a bad look for liberal politicians who claim to stand for fair pay and higher wages. The situation is better in the Senate, though the disparity isn’t, at least not by much: fifty-one Republicans and thirty-one Democrats offer at least a stipend for at least one intern each year. Still, the great majority of Senate interns are unpaid, and among the minority who are paid, the level of compensation varies widely by office. Bernie Sanders admirably pays all his interns $15 an hour, while Republican Orrin Hatch pays half that, just $7.50 an hour.

Unpaid internships are burdensome anywhere, but especially so in Washington, D.C. For renters, D.C. ranks as the seventh most expensive city in the world. The total cost of a three-month unpaid internship in cities like D.C. and New York can inch toward $6,000 once you factor in such variables as rent, food, and transportation.

As a result, Capitol Hill internships are increasingly opportunities that only young people from affluent families can afford to take. This fact has not escaped Kendall’s notice; she talks about a fellow intern who goes out for lunch on his parents’ credit card while she eats a peanut butter and jelly sandwich at her desk. . .

Continue reading.

Written by LeisureGuy

13 January 2018 at 12:58 pm

Two delicious Canadian specialties: The Caesar and the Butter Tart

leave a comment »

Written by LeisureGuy

13 January 2018 at 12:24 pm

Posted in Daily life, Food, Recipes

%d bloggers like this: