Monday, March 30, 2015

Depression is *not* Psychosis

After the horrible #Germanwings tragedy, the media is aggressively pushing depression as the cause, and the word "suicide" appears in almost all related headlines. A few quick points:

(1) One of the very first things that mental health professionals ascertain, when confronted with a troubled person, is whether that person is (a) a potential harm to themselves, or (b) a potential harm to others. That's one of the first steps in assessment because those are two very different branches of behavior, requiring very different treatments;

(2) Depression and suicide are very different from the kind of psychotic behavior apparently exhibited by this pilot. It is wildly unfair to the many people who occasionally struggle with anxiety / depression to confuse them with psychosis;

(3) Partly because of (2), many who could/should get treatment for depression will be disinclined to do so, and that is a real shame. Stigma kills. It really does;

(4) Depression is treated in very different ways than psychosis and other issues tending to lead to harm of others. In fact, medications used for one may even worsen the presentation of the other, in some cases;

(5) Some of the SSRI medications widely used to treat depression can [rarely] induce psychosis, and for that reason, the SSRI industry (yes it has become an industry) really needs to insist that these are used in combination with person-to-person therapy;

(5b) I find it outrageous how casually certain medications are prescribed, typically by doctors with little mental health experience and usually without any regard to patients' access to supportive counseling, socialization and exercise habits;

(6) Many, many young people have depressive or even suicidal thoughts from time to time. It's really not that uncommon in our hyper-anxious, fast-paced world... and we shouldn't treat anxiety / depression like some taboo topic. My experience is that those young people who disclose and verbalize their thoughts and anxieties are far more likely to recover (although this is, to some extent, a tautology);

(7) In this case, it seems that this pilot faced the loss of his job if his condition(s) were revealed to his employer. Cosistent with (6), this tends to correlate with a poor outcome. Also, if he were perchance experiencing depersonalization as a [fairly common] side effect of his treatment, this might well have exacerbated or promoted the behavior. I.e. incomplete treatment might even be the cause of the tragic behavior. That is scary to me, given how widely and casually these medications are now prescribed.

Thursday, March 26, 2015

Advice to Young Bigots

Having the freedom to say what you mean and mean what you say, without having to hide anything of shade the meaning, is very liberating. I suspect that a lot of people with hidden biases feel those issues eating away at them, all the time. Everyone is at their best when they are their whole self, openly being whoever they are; becoming who they want to be.

One of the common things that young people experience on their way to adulthood is a "club" or "tribe" or "frat" effect in which they are expected to adapt their behavior, appearance, words, and even thinking just to fit in.

I suppose everybody tries this at some point in their lives. It's a natural and powerful feeling to want to be part of a tribe. But if that tribe causes them to say or do things in order to belong, and those things feel uncomfortable at an unconscious level, then it will progress like a cancer to their conscience. They can deny it, they can hide it... but it's still there and it wants to spread and consume the whole self.

Based on this observation, my advice to the chanting Ohio State SAE boys, Levi Pettit and Parker Rice, and their colleagues, is as follows:

Find how to be thankful that your behavior was caught on video. Only when you are able to do that, only then will you know why it caused so much hurt.

"Then you will know the truth, and the truth will set you free."

Friday, March 6, 2015

Federal Spending vs. Federal Investing, and the #DebtCeiling Debate

Treasury Secretary Jack Lew just announced that the Federal Government will again reach its debt ceiling around 3/18.

There will be predictable nonsense about how much debt we have taken on as a nation, and how this is around 100% of GDP, and how the Chinese can manipulate us, if they want. I'll attempt a few words of clarity....

* The Chinese can't manipulate us. We could, in fact, unilaterally cancel all debt payment obligations, which would simply whack our credit ratings for a while. This really isn't about China or any foreign debt holders; this is about the status of our national debt as the absolute safest security, the so-called zero-risk asset.

* That US debt is in such high demand is a good thing and a bad thing. It allows us to, in essence, spend more in the near term, but....

* ...There is Federal spending and then there is Federal investing. Which are we doing? I am not convinced that the current leadership in either major party knows the difference. We need clarity, more than ever before.

* The Tea Party fringe that adamantly opposes any debt ceiling increases is not proposing any workable solutions. They really do believe that shutting the machine down is a solution- it's not.

* Shutting down the government or forcing 'extraordinary measures' is expensive. It does not save money, in fact it costs us a lot more. A protracted shutdown would do a lot more damage than just the direct costs, it'd raise the long-term cost of our debt payments. Imagine you tell your bank you're just join to skip some payments... what happens to your interest rate? Any sensible person knows that you have much more bargaining leverage after you rein in your debt!

* In a functional government, the debate would be about how to bend down spending and increase investing. The US is in a fantastic position to invest very strategically, in ways that would put our kids and grandkids in a position of leadership for the next century. Will we do it? Well...

* ...the big problem here is that our leaders think in terms of short-term election cycles, not longer term investment. It's all about attempting to whack the other side right before the election, and playing to the base before the primaries. This mentality is the polar(ized) opposite of what we need to set up long-term investments.

I could go on and on but will refrain. Just... please don't vote for someone whose entire political vision is to shut the thing down. It benefits no one but a few politicians in districts where financial education is lacking. (Politically incorrect, but sorry, it's true)

Why we don't bring back "civics" and infuse real financial education? It's urgent that our kids understand the basics, because clearly a lot of adults do not. On both sides.