ImaginEndless: January 2011

Monday, 31 January 2011

There's no punchline. It's one of the saddest things I know.

It's an expression of the pain of mental illness. The isolation which comes from automotons' lack of understanding and compassion. It takes every automoton a mad person meets or has met to create the isolation which is so common for people with severe mental illness and redoubled by a system which seeks to outcast them into the benefits system hidden from mainstream society by the prison of poverty.

The automotons greatest trick was to make the mentally ill desire this. They fight not to work but they foster the exclusion of their kind from mainstream society. They continue the "great confinement" where the mad disappeared into the asylum system. Now they disappear into the benefits system.

Great talents are wasted. Whole lives are lost to the life lived outside the mainstream of society. A life trapped in the prison of poverty and the mad are persuaded that this is what they want.

How many automotons does it take? It takes one person to reach out and make contact, real contact as equals, to stop the continued exclusion. It also takes changing every single automoton.

Sunday, 30 January 2011

A unique placebo trial which could only be done at Dignitas

There's a bit in the film Nikita (the original) where she's killed by
lethal injection. It's a fake injection and from that point she's
recruited into the secret military.

It makes me think of an experiment. It could either be something to
trial the nocebo effect, i.e. the negative placebo effect, so patients
would initially be given an anaesthetic which renders them unconscious
rather than kills them. The experiment would seek to find out how
powerful the nocebo effect was. It's not an unethical study except for
the problem of people walking up and feeling that they've been betrayed.
They'd gone through the process it takes to come to the decision to end
their life and had gone through the 'death' process only to find it
wasn't real (unless the nocebo effect kills them). A second, lethal
injection would be offered at this point.

In fact I wonder if that's what happens anyway. It gives a person that
last chance to change their mind but if they're set on it they can still
get the lethal injection. It's a betrayal of course and I suppose it's
not very good of me to think about this betrayal of trust at such an
important part in a person's life: their last contact with society.

I'd be fascinated to know if the nocebo effect is true. There's a single
case study often cited to show the nocebo effect. It broadly goes a
doctor diagnosed a patient with (stomach?) cancer and gave them 3 months
to live. In 3 months they died but when they autopsied the patient they
found no traces of cancer and were unable to determine cause of death.
It was assumed that this patient was killed by the nocebo effect. Like a
swallow in summer, a single case doesn't indicate fuck all but a
possibility.

The Dignitas clinic presents a unique opportunity. It presents the
opportunity to experiment on people who are just about to die. The
experiment is to see if the nocebo effect can really kill someone.
Honestly I doubt it can but if this became standard practice at Dignitas
(a single injection to knock the person unconscious which they're told
is a lethal injection then the second true lethal injection) it would be
an opportunity to prove me right or wrong. Their could be two groups: a
placebo and an active group. I'm just not sure what the point would be.
I'd expect placebo comparisons in any good experiment except one
investigating the nocebo effect in this way but I'm assuming that
everyone who gets helped to die at Dignitas is killed successfully first
time using the lethal injection.

The value of this experiment is higher than one might think. In the
hypothetical situation that people can die from the nocebo effect there
are signifcant things which doctors and other professionals need to
consider when interacting with patients/clients/etc. A misdiagnosis
could kill quicker than a germ.

How mobile phones might be helping to do something wortwhile

UN trialling mobile payments to help the poor
http://www.gomonews.com/un-trialling-mobile-payments-to-help-the-poor/

I've read a fair few articles and written a few on how the mobile phone
is going to revolutionise everything from shopping to gaming. Frankly I
don't give a flying fuck except when it comes to good ideas this this.
Mobile phones are to become the new wallet amongst other things. Again,
don't give a shit. But when local economies collapse and there's no one
or way to pay people but through mobile systems like GCASH then I'm
interested.

What's happened is the mobile phone has become something poorer people
in developing world countries can afford. Within a few years feature
phones will be even cheaper and I wonder if the developing world is
where a lot of recycled handsets end up too. Again, don't give a shit.

Except when I read an article like this. It gives me hope that the
progress of technology isn't there just to make the technorati and
investment bankers rich. It actually makes a difference to those worst
off. Fucking great work by the UN!

Saturday, 29 January 2011

No title

I wish I was dead. There's just no end to the misery of this life. Cause
and without cause the misery is unending. But it's not. There's a way out.

Day after day dragging myself through this shit of a life. The only
point is that I have a purpose to serve but I feel so far from it it may
as well not exist. There will be moments of vacuous pleasure to lift me
about the ennui and endless black. And then the black returns.

I want this piece to have purpose but there's none. Just an expression
of the inner bleakness which I carry inside me, hidden under the veneer
of whatever I project or whatever people see in me.

I've been self-medicating for years and I haven't been able to get
medication recently. It's when I come off it that the reality of life
becomes so present.

Having a plan to end my life and be assisted in was meant to make this
all easier but this morning it feels like it's not enough.

So I do what everyone does. Suck it up. Engage the mask. Live the life
that my life is worth living.

Friday, 28 January 2011

Loser

I writw this on a Friday night in a wetherspoons pub.

I sit here on the 13th page of a literature review I started reading when I got in here.

People don't get what severe mental illnesses is like

I can only guess people think that schizophrenia is delusions and
bipolar is mood swings. That's all the know and understand. They have a
bit of fear put into them by the media but they never get to know
anything about severe mental illness.

A good friend of mine asked me to pass her some information on assisted
suicide. She knows I'm planning to kill myself and how I hope to do it.
She was hoping I could offer her some light too.

I said I wouldn't give her the information. I'd give her something else:
someone to talk to. If she wants to get the information she can find it
easily on the internet and her need to die probably wouldn't have been
accepted as suitable by the service I'm hoping to use.

People have all sorts of assumptions about what it's like to have
delusions but they have no idea. They can assume that it's just feeling
like their thoughts are being monitored. It can feel like they're
thoughts are being broadcast or that there are unusual thoughts being
put into their own stream of consciousness.

I fear this is all health services see as well. The see the delusions,
they see major tranquillisers as the solution and that's it. NICE's
guidelines for schizophrenia can suck on my chocolate salty balls for
this reason.

There is a huge amount of suffering which comes with delusions a person
doesn't want. Depression is a fucking walk in the park in comparison as
are other common mental disorders on their own. When the cause of common
mental disorder is the torturous experience of delusions in a world
which knows nothing else to do but label the person and tranquiise them
it is hell on earth.

I do not use the word torture lightly. It is apt for the experience. The
suffering is intense, there's no one to help a person understand it or
come to terms with it, there's no fucking support for them, there's just
medication. The internal consciousness shatters. The daily experience of
walking around outside one's home is a mishmash of strong perceptions
and emotions. Containing it all and presenting a semblance of sanity is
a tiring process which burns out people emotionally and physically. A
person's very reality shakes under the onslaught of the unusual
percpetions which aren't understandable.

She wanted to die because she couldn't take it any more. She has to live
with this wrecking her life. This effect is why the social disability of
schizophrenia and other severe mental illnesses is compared to cancer.

So having a common mental disorder and a severe mental illness is a hell
no one could even describe in words but no one would wish on their worst
enemy, not if they knew what it was actually like. I wish I could take
people into this world of pain. If they entered it just for a day then
they'd begin to understand what a lifetime of this experience is like
and why 10% of people with schizophrenia successfully take their life.
(The 5.6% estimate is a load of arse to me. The suicides in the early
stages still count for what is the pain of schizophrenia).

I doubt many mental health services are even equipped to treat this.
They're well equipped for standard depression and now they're very well
funded. This is nucking futs. Thankfully on the grapevine I hear that
the £173 million a year IAPT scheme might start opening up to help those
with the severest conditions. At the moment the We Need to Talk
coalition of organisations seemed happy enough to allow the scheme to
exclude those with the most severe conditions. So while cancer patients
get treatments which costs millions for a small number of people and
people with depression get treatment quickly my mate can't get the
fucking help she needs.

The reason? Because no one gives a shit about another dead schizophrenic
because none of the fuckers in commissioning or leading the UK's mental
health movement have any fucking idea of what it's really fucking like.

And that Layard prick can go fuck himself too. Fucking health economics.
"Keep the meat working" more like. Help those who are suffering. That's
what healthcare is meant to be about. Cunt.

Agateophilia

Love of madness.

It's not a real word. Not yet. Agateophobia is. It's fear of insanity.
There seems to be no word for love of insanity.

Go figure.

Gartner Says Worldwide Mobile Gaming Revenue to Grow 19 Percent in 2010

http://www.fiercemobilecontent.com/press-releases/gartner-says-worldwide-mobile-gaming-revenue-grow-19-percent-2010

"

Worldwide mobile gaming end-user revenue is forecast to surpass $5.6 billion in 2010, a 19 percent increase from 2009 revenue of $4.7 billion, according to Gartner, Inc. The market will continue to see steady growth through 2014, when the market is projected to reach $11.4 billion.

"The hype around mobile application stores has opened this market up to numerous publishers and developers - further expanding revenue potential and competition in this industry," said Tuong Nguyen, principal research analyst at Gartner. "Although we expect most mobile gamers to continue to gravitate toward 'free' games, we do not expect the ad-supported model to take off within the next three years - despite the success we have seen with this approach in the Japanese market."

Gartner estimates 70 percent to 80 percent of all mobile consumer applications downloaded are mobile games. Moreover, 60 percent to 70 percent of these downloaded games are "free." This trend is expected to continue for the next two to three years.

Other factors that are boosting the global popularity of mobile gaming include the increasing accessibility of mobile games in emerging markets, where alternative gaming media are limited. The growing availability of micropayments for mobile gamers attracts users previously wary of investing larger amounts of money upfront to try out a game and also attracts groups whose disposable income is limited.

Improved user interfaces are a top priority for handset vendors as a competitive differentiator. A growing number of devices are implementing touchscreens and gesture, and enhanced qwerty keyboards will also improve the end-user experience. Furthermore, an increasing number of games are taking advantage of existing device features, such as camera, GPS and accelerometers, to enhance game play.

Communications service providers (CSPs) are also facilitating mobile gaming growth by improving ease of use and access for consumers. Direct billing is one of the most significant value-adds that CSPs can provide their partners - allowing consumers to charge purchases directly to their wireless bills. Improvements to boost access to mobile games via search and recommendation engines will also improve take rates for mobile gaming, while more-competitive data pricing will lower barriers to adoption.

"Mobile gaming will remain an important component of consumers' value-added service offerings, as well as a revenue driver for CSPs," Mr. Nguyen said. "On the high end, consumers will benefit from more-robust devices, such as smartphones, better cameras, more brilliant displays and increased processing power, to improve the gaming experience. Users from developing markets will also benefit as more-capable phones move down-market. Moreover, as more devices become connected, consumer electronic devices, such as tablets and portable gaming consoles, will join this space, adding another aspect to the market."

The popularity of application stores has also increased competition for market share in the developer space by lowering the barriers of entry for developers. Mobile carriers and application store owners both have the opportunity to take advantage of this enthusiasm to expand their mobile gaming offerings to their customers. Developers themselves can also take advantage of this to increase their negotiation power, as well as their channel options.

Additional information is available in the report "Market Insight: Mobile Gaming Expectations Boosted on Application Store and Smartphone Popularity" which is available on the Gartner website at http://www.gartner.com/resId=1330237.

U.S. Smartphone Battle Heats Up: Which is the “Most Desired” Operating System? | Nielsen Wire

The full report is linked to but there's some good coverage on this article.

http://www.fiercemobilecontent.com/story/nielsen-men-want-android-devices-women-favor-iphone/2010-12-02

Smartphones running Apple's (NASDAQ:AAPL) iOS and Google's (NASDAQ:GOOG) Android are the most desired among U.S. consumers likely to upgrade their current mobile handset according to a new survey published by The Nielsen Company--while women planning to upgrade lean toward the iPhone, men are targeting Android devices. Smartphones presently make up 29.7 percent of the U.S. mobile device market, Nielsen reports--iOS leads with 27.9 percent of the market, followed by Research In Motion's (NASDAQ:RIMM) BlackBerry at 27.4 percent and Android at 22.7 percent. Among all U.S. smartphone users planning to upgrade their current phone, iOS is the likely destination for 35 percent of respondents, with Android at 28 percent and BlackBerry at 15 percent--however, among feature phone owners looking to upgrade, Android is targeted by 28 percent, edging past iOS at 25 percent and well ahead of BlackBerry at 11 percent.

Among female respondents, 30.9 percent are planning to purchase an iPhone--22.8 percent want an Android smartphone, followed by BlackBerry at 12.5 percent. In addition, 23.8 percent of women say they haven't yet decided which platform they'll select. As for men, 32.6 percent plan to go Android, with iOS at 28.6 percent and BlackBerry at 12.8 percent--14.9 percent of males are still weighing their options.

iOS remains the smartphone platform of choice among younger subscribers, with 35.9 percent of respondents ages 18 to 24 desiring the iPhone, compared to 32.0 percent favoring Android; the gap narrows among users 25 to 34, with 31.9 percent citing iOS and 29.8 percent targeting Android. Among respondents ages 35 to 54, Android is favored by 27.4 percent, with iOS at 26.3 percent.

Most smartphone owners exhibit little loyalty to their current mobile operating system, with just 25 percent of consumers planning to stick with their current platform when they next upgrade their phone, according to a global survey published earlier this week by market research firm GfK. iOS fared best, with 59 percent of respondents planning to remain loyal, followed in descending order by BlackBerry (35 percent), Android (28 percent), Symbian (24 percent) and Microsoft's (NASDAQ:MSFT) Windows Phone (21 percent).

Read more: Nielsen: Men want Android devices, women favor iPhone - FierceMobileContent http://www.fiercemobilecontent.com/story/nielsen-men-want-android-devices-women-favor-iphone/2010-12-02#ixzz1CKPDMLlY
Subscribe: http://www.fiercemobilecontent.com/signup?sourceform=Viral-Tynt-FierceMobileContent-FierceMobileContent

Technology reduces disability: the spell checker

My psleling can be really applaulling at times. I can type really fast
but my fingers don't awlays sync up to type the letters of the word
correctly.

There's a condition where people have this problem where thney find it
hard to spell words correctly. They'll often spelll them right
fonetically but because we're taught that words must be spelt as they
are this can still mean a person is considered less clever or whatever
because they don't spell the words perfectly.

The psell check is a life saver for many people. I assume it's brought
benefits to people with dyslexia. It has reduced one small aspect of the
disability by allowing computers to do the irrelevant stuff like getting
words spelt right. Leaves people to get on with important stuff, like
concepts.

Monday, 24 January 2011

This annoys me: technology and intellectual property

Apple hare patenting important ideas in augmented reality.
http://gpsobsessed.com/apple-patent-points-to-an-augmented-reality-future-for-the-iphone/

They have the money to spend on patent applications but what they're doing isn't rocket science. The patent system means stuff which isn't really that hard to work out can become owned by someone. People using the idea or technology in the future have to pay them otherwise they can't use it.

Patents are a big reason behind the expense of digital technology. It drives the costs up so only those in developed world countries can afford them and only the wealthy minority too.

Of course the patent helps fund the research which goes into these technologies which is billions of pounds. The problem is the value of the patent - i.e. the amount of work done - isn't worth what the law suits cost companies who infringe on them even though they may have come up with the idea first or independently. It's just those who can afford a patent that can apply. Apple can knock out thousands of patent applications to cover technology in all sorts of industries and they're not the only big business doing this. It's worse in genetics where companies try to patent genetic code discoveries. That's our shared code. It's owned by humanity.

Idealists give their ideas away free and they work for sod all. They rarely get rewarded for their labour. The scientists who come up with the ideas which get patented don't see much of the rewards which are reaped by the corporations and lawyers in intelletual property/patent cases.

Worst of all, the system doesn't really serve humanity. It creates wealth for those who can afford to hire scienty people to come up with lots of ideas which they'll patent and hope that one or two are successful. But those ideas would happen anyway. Someone else can think of them independently. It just takes sufficient research.

It holds back progress and utility of technology. It also ensures technology filters down to the poorest slowly.

Sunday, 23 January 2011

"But I've committed no crime"

These were my first words upon being told I was under section for the
first time. They took my liberty away but I'd committed no serious
crime. I'd not killed anyone. Why did you take my liberty away and stick
me in a cell with a bunch of other people who'd committed no serious crime?

Thoughts on depression

Depression is a word with a wide variety of meanings. People use it to
mean they feel low. People use it to mean they've feel crap and unwell
in their life or head. Doctors use it to describe a syndrome which may
or may not be the medicalisation of misery. Some professionals see it only as a syndrome while others see it as the medicalisation of misery. The biomedical model supposes it is a biologically caused syndrome but this view has changed. Earlier versions of the diagnosis itself used to attempt to differentiate between exogenous and endogenous depression but I don't know much about those. Now the modern cluster of symptoms approach lumps together a lot of different experiences some of which may have biological cause but also involve other factors. There's always the interesting exclusion of grief from depression though grief can become depression after 6 months of grieving, so here a biological syndrome is possibly excluded because of life circumstances. There's also adjustment disorders which I don't quite understand either. These are about not behaving correctly or recovering from after or from a life event.

The psychiatric paradigm is interesting to me. I recalled a study on the
diagnostic criteria for depression. Here's the ICD critieria.

http://www.mentalhealth.com/icd/p22-md01.html

Here's the American one.

http://www.mental-health-today.com/dep/dsm.htm

I'll snip from the American one because I know a little bit more about
it and the study I'm thinking of was an American one.

"
A. Five (or more) of the following symptoms have been present during the
same 2-week period and represent a change from previous functioning; at
least one of the symptoms is either (1) depressed mood or (2) loss of
interest or pleasure.

Note: Do note include symptoms that are clearly due to a general
medical condition, or mood-incongruent delusions or hallucinations.

(1) depressed mood most of the day, nearly every day, as indicated by
either subjective report (e.g., feels sad or empty) or observation made
by others (e.g., appears tearful). Note: In children and adolescents,
can be irritable mood.

(2) markedly diminished interest or pleasure in all, or almost all,
activities most of the day, nearly every day (as indicated by either
subjective account or observation made by others)

(3) significant weight loss when not dieting or weight gain (e.g., a
change of more than 5% of body weight in a month), or decrease or
increase in appetite nearly every day. Note: In children, consider
failure to make expected weight gains.

(4) insomnia or hypersomnia nearly every day

(5) psychomotor agitation or retardation nearly every day (observable by
others, not merely subjective feelings of restlessness or being slowed down)

(6) fatigue or loss of energy nearly every day

(7) feelings of worthlessness or excessive or inappropriate guilt (which
may be delusional) nearly every day (not merely self-reproach or guilt
about being sick)

(8) diminished ability to think or concentrate, or indecisiveness,
nearly every day (either by subjective account or as observed by others)

(9) recurrent thoughts of death (not just fear of dying), recurrent
suicidal ideation without a specific plan, or a suicide attempt or a
specific plan for committing suicide
"

In the study I'm thinking of the researchers asked whether people had a
2 week period of feeling mentally unwell in some way. Then they counted
the symptoms. The results were people had a reasonably high level of
reporting a period of feeling mentally unwell for two weeks. As the
number of symptoms in the diagnostic criteria increased fewer people
were counted. When it reached 5 symptoms - enough for a clinical
diagnosis - there were a lot loss people than those who'd answered that
they felt subjectively unwell for a 2 week period. (The authors didn't
note that the rate of decrease was higher in men, a failing of the
diagnostic criteria in America which often underdiagnoses depression in
people who have 'acting out' symptoms, usually men.

And so there's a clinical question about the syndrome versus the
subjective report of unwellenss. Unwellness isn't the same as
psychological distress in a strict sense but they're inter-related
concepts.

The dual continua model of mental health is something which is not know
about enough. One continuum, the historical psychiatric continuum, is
mental disorder. This is synonymous with psychopathology and the
syndrome which is depression, i.e. the one where 5 symptoms out of 9
make a diagnosis. The other is psychological distress which is akin to
subjective report of unwellness. Importantly there are two paradigms
measures on two scales. It has been a century's work to get the dual
continua model recognised in mental healthcare policy. The recent New
Horizons mental health strategy proposed a new measure, flourishing,
while forgeting about the dual continua model. This represents yet a new
paradigm though it may be a while before it becomes accepoted. In a
sense it's a bit like the social model of disability at the negative
end. People should be able to flourish and reach their true potential.
Depression can get in the way of that however flourishing means that
social and cultural systems must also change because these are also the
reasons why people don't do as well in life as they should. The latter
wasn't mentioned in the concept of flourishing so there's clearly a lot
more thought which needs to go into it.

The relevance of the usual dual continua model, as it was taught to me,
was the recognition that a person can have high levels of
psychopathology yet be doing ok, i.e. they can be mad as a hatter but
happy. Alternative a person with low psychopathology, a 'normal' person,
can be very unhappy.

It also means a person with clinical depression can report high levels
of subjective well being. Without the clinical definitions there would
only be the report of unwellness used to define depression but
depression without low mood still comes with the cognitive, social and
other impairments.

So it's fucking complicated. I've barely managed to scribble down my
thoughts this morning in this short blog post.

The relevance of all this abstract thinking is a bit of a leap. It's
about recognising and dealing with depression in practice.

A middle step is recognising that depression may not need to be treated
how the modern psychiatric system treats it, i.e. by trying to take it
away by drugs, activity or talking therapies. These are all choices made
by society, not absolutes. Depression may have negative social outcomes
but this is because of society's malformation. Psychiatry choses to tell
individual's that the problem is rooted in them and therefore they need
to be changed so they're not like that anymore.

Depression may have a purpose and value. For example depressed people,
in general, may be more critical. They may be 'deeper' too. They may be
funnier, more compassionate, smarter, more creative and perhaps even
wiser than those who don't get this valuable experience in their life.
These ideas of psychosanology - a word I'm using to mean the study of
wellness and the interplay between psychopathology and wellness - are
little studied but observed in pre-mental health systems which did
pretty much the same thing - sprirituality, religion and sage
healing-people.

""The soul would have no rainbow unless the eyes had tears." This is a
piece of native American wisdom which expresses this concept better than
I can.

So really there's not certainty in what the diagnosis of depression is
nor what to do with it in any sense.

My conclusion through all this thinking is the same as I've ranted on
about before. Give people the expertise to make the decisions. Expert
patients enabled and empowered to self-manage is much better than
leaving this to doctors who know nothing about the patient compared to
what the patient can know about the patient, don't have time to keep up
with the latest developments nor to fully interview the patient to get a
proper history and sense of the individual, need to work with guesses
based on what works for most people rather than works for the individual
(and it turns out a lot of treatments don't really work for most people
compared to the placebo effect of the treatment) and may fundamentally
offer the wrong 'treatment' because the 'disease' may not be needed to
be treated in the individual but society needs to change.

Empowering people and giving them the information which doctors have
will give them the capability to recognise and treat their own
coniditons how they want to. A doctor might suggest that they're
clinical experience is impossible for a patient to get. This is true.
The knowledge of the individual patient is as impossible for the doctor
to understand and comprehend. Clinical experience has a value but
complete knowledge of the patient themselves, what they're going
through, how it relates to them, how they express their unwellness and
all manner of other aspects of what's important in mental health is not
available to a doctor or any other person but the individual themselves.

Leave doctors, or whoever, to change society. Society works on averages
and that's what they're experts in. People work on an individual level.

Another counter argument might be insight. This is a word that may be
considered a trick by some patients. It's about awareness of
psychopathology. It's also about awareness of being in a severely unwell
or mentally ill state, for example being in hypermania. There's part of
me that wants to strip the element of psychopathology away per se.
That's just the construct of psychiatry. It's sort of like saying you
don't agree with the dogma of the Church therefore there's something
wrong with you. I prefer the understanding that there are states of
awareness that can be diminished when a person is experiencing certain
mental states. For example someone who's getting high for the first time
on cannabis may not realise they're stoned. They don't know how to
recognise the state. It takes experience to recognise the feelings of
being stoned. People when they experience mania for the first time may
not recognise it and the detrimental effects it can have on a person's
life. This happened in my life. It was assumed I could never learn to
control these moments or manage myself so I'd not get into the sort of
states where I'd end up in a psychiatric ward or doing something worse
outside a psychiatric ward.

I may not be perfect at this but I've learned to self-manage. It's a
hard process. It takes time and I fall often. I've lost a lot in my life
because of my psychiatric mistakes but I'm getting better at fucking up
less. Sadly other people are still a problem. They don't understand my
difference because everyone else who's like me either doesn't talk about
it or no longer experiences it because they take medication. I don't and
I get all the value of life back which medication and psychiatric
treatment takes away. It's fucking hard on me and it's made my life a
total wreck such that I really can't be arsed with all this shit. But I
keep plugging on because I'm resilient (at the moment), which is another
important concept in mental health but one I'll ramble on about at
another point.

And so I don't tell people not to take medication. It is a personal
choice just as not taking medication is a personal choice. Recently I've
begun to take medication - St John's Wort - because I've been
mild-to-moderate depressed (excluding the suicidal feelings but those
are pretty permanent). A few months ago I was a lot worse and didn't
take any SJW but I had the luxury of very little work to do. I was very
isolated, alone and suffering inside. It was torment but I knew I could
always reach for the SJW. I didn't and I got through it. Sure, I now
have a plan to kill myself but it's been one of the positive things and,
perhaps, part of how I recovered. I'm talking SJW while I'm in a much
better place because I have to work and keep up my productivity. I
simply can't do that when I'm tired, sleeping lots, not motivated,
crying and in mental pain. This is where I see depression as a problem
in society. Sick leave is the only system available and that would mean
seeing a doctor and getting them to give me treatment. Sadly my previous
experiences make me think this isn't worth the effort for a number of
reasons. I'm self-employed too and have been for over a year so people
like us just don't get to take sick leave. So I took the drugs and I
feel better. I made all the choices and I've got lots of shit from my
'real' life to sort out. Debts. Taxes. Broken friendships (which weren't
really friendships I think...). Paying for an assisted suicide.

The complexities of depression conceptually and in treatment are all
solved by educating and empowering people. Instead there's a huge debate
where the powerholders, the doctors, have a system which patients don't
believe in and offer treatment which patients may not want. The system
treatments the mentally ill as without capacity by default. It doesn't
actually medical all misery, only what doctors and their doctorine
consider misery. They hand out salvation to those who they judge worthy
like priests at confession. They use the principle of science rather
than religion to justify their dogma.

Saturday, 22 January 2011

A Brighter Future for Retinal Implants - Technology Review

<http://www.technologyreview.com/biomedicine/23539/?mod=related>

Retinal implant technology is surprisingly advanced. It's at the level
where it's possible to offer people who are blind very basic levels of
sight.

Retinal implants are a step in transhumanism. I'm quite positive about the possibilities for removing the value of physicality. For example this could end a lot of image-based mental disorders. It could free people to be who they want to be. Retial implants allow full, permanent and ubiquitous overlay of digital information on the real world. People can wear who they want to be.

Research project on retinal implants

Universitäts-Augenklinik der RWTH Aachen - Prof. Dr. Peter Walter
<http://www.eyenet-aachen.de/05-07-1-implants.html#retina>

Thursday, 20 January 2011

Why murder has a profession

The history of different ideas about what is mental illness is like the history of alchemy. One day mental health will have the true science of chemistry rather than the alchemy of psychiatry.

What stands in the way is human factors - the very things which mental health attempts to apply science to. It's not just the various forms of bias. It's the dogma, the same quality which religion has, where people's prejudices make things hard to change.

Mental illness is a biological illness, for example, is a dogma like mental illness is a punishment from god. I'd be considered a heretic if I questioned either. Psychiatry has something to replace god: the apparent use of science. This is false rather than poor science.

True scientific methods are hard to apply in any new field of science but there's nothing harder than the science of the human condition.

What's different though are the judgements. A bottom quark is not better or worse than a top quark. They just exist. The labels have a value to describe extremes of difference but not extremes of value.

In mental health it is different. A difference has a value judgement. Difference can be measured negatively. It can be perjoratised. That's ok in a sense of human judgement and the lack of validity of human judgement in anything we consider true science.

It's not ok when science is used to justify and enforce human judgements, i.e. when different behaviours, emotions and experiences of consciousness are judged abnormal then science is applied.

This false science is common in mental health. A good example is psychiatry. About a century of research has shown seizures to be a good thing for treatment resistant behavioural and emotional disorders. Psychiatry values the electrically induced seizure more than real doctors value the operation which removes half a child's brain to treat seizures.

Ect was invented without true evidence. It was used without consent on people the medical profession considers sub-human. It kills people with different emotions and behaviours. But, thankfully, it helps those that aren't killed. At least as well as sham ect.

Those deaths were because medicine didn't know what else to do. Except the results of the placebo controlled trials say it all:

Do more, you lazy fucking cunts. Be good doctors. Do no harm. Don't electrocute when you can give time and energy, the sort of time and energy you'd give if the patient was in a trial.

Stop creating illness if you've taken an oath which says do no fucking harm. You have no right to be doctors if you do.

You're just murders with a profession, a degree and without any recourse. After all (non) doctors have already killed without recourse when they treated behaviour. 1,800 people a year were killed by them. It's higher than the murder rate.

Wednesday, 19 January 2011

Mobile Marketing In 2011 – Are You Ready? | B2C Marketing Insider

<http://www.b2cmarketinginsider.com/mobile-apps/mobile-marketing-in-2011-%E2%80%93-are-you-ready-09551>

Some guesses at what's going to be the mobile business trends this year.

"
1. Personalization and privacy will drive effectiveness. The association
is predicting that we will see the widespread adoption of
permission-based activity as well as the introduction of both policy and
apps to bloc unwanted messages.

2. It's all about Apps – whether it's a tablet or a 4G phone, apps will
drive advertising revenue.

3. Free texting, calls and video chat – Skype on the iPad is already
accomplishing this but more and more applications will surface to allow
more "free" services like texting and video chat.

4. Windows 7 mobile is not dead – I'm not sure I see this one coming
with the emergence of the Android platform, but hey, these guys are the
experts.

5. HTML5 vs Apps war – Apps will continue their dominance in the
development circle through 2013 with HTML5 driving the next wave of
development. It's a good time to be a mobile developer.

6. Location-Based Services and Augmented Reality Development Matures –
The combination of these 2 services will drive consumer interest and
excitement as new applications and advertising opportunities are developed.

7. Mobile payment replaces the ATM card? Will the dream of the
electronic wallet finally become a reality in 2011? I sure hope so (and
so do advertisers!)

8. Mobile blogging - (M0-blogs?) I think the larger trend here is that
mobile devices like tablets will continue to bite into PC time as more
power and usability is built into phones and tablets.

9. Say Goodbye to the "Feature Phone" -While my Mom will still use a
feature phone, the Mobile Marketing Association predicts over 85% of all
phones shipped in 2011 will be smart phones. What this really means:
search! More and more users will be browsing the internet from their
mobile phones and this is where the advertising opportunity becomes
clear. Easy-to-read landing pages, multi-platform compatibility and
intuitive interfaces will be required for all search engine marketers.

10. Mobile jumps on the 3D bandwagon – According to the association, an
Indian mobile manufacturer called Spice Mobility has already introduced
a phone with 3D capabilities. This will lead to new apps, content and
plenty of opportunity for advertisers.
"

Autostereoscopy - Wikipedia, the free encyclopedia

<http://en.wikipedia.org/wiki/Autostereoscopy>

This is a powerful enabling technology which means 3D vision will be
accepted by the consumer quicker. This is 3D without glasses. For the
life of me I can't think how this works but it's sort of like
holographic images I think.

Gamasutra - News - Kinect Contributor, Accomplished Researcher Leaves Microsoft For Google

<http://www.gamasutra.com/view/news/32498/Kinect_Contributor_Accomplished_Researcher_Leaves_Microsoft_For_Google.php>

Looks like any company with the money is buying up anyone who has
anything to do with augmented reality and Articulated Naturality. Google
have poached a top researcher from Microsoft and from an important team
who are bringing augmented reality to the consumer. Google Goggles,
though not a fantastic product, was way ahead of the market. The next
Google trick which sounds like a Universal Translator from Star Trek may
be the next big augmented reality success. Who knows what they have in
store.

Museum Virtual Worlds | Augmented Reality — A Looking Glass into Other Worlds: AR Artist and Researcher Helen Papagiannis Explores Wonderment and Play in Exhibit Design

<http://museumvirtualworlds.org/?p=258>

This is a great blog on how augmented reality is being used in the art
world. There's been a lot of work in the area way ahead of the marketing
industry who have been the early adopters of the technoology as it
reaches the public who use smartphones.

Tuesday, 18 January 2011

Mcommerce to generate $50B in sales by 2014: study - Luxury Daily - Research

<http://www.luxurydaily.com/mcommerce-to-generate-50b-in-sales-by-2014/>

Games as advertising

TREBAX INNOVATIONS
<http://trebaxinnovations.com/platform.php>

This is a new and sort of predictable avenue for marketing. Games.
They're cheap and simple ways to engage people. Social network games
make a lot through advertising revenue as more people of a wide
demographic login to play games like Farmville and Mafia Wars.

HTC - Developer Center

<http://developer.htc.com/google-io-device.html#s1>

software and instructions for factory reset t mobile g1

More examples of AR used for marketing

Augmented Reality Marketing In 2010 And Beyond

<http://thenextweb.com/socialmedia/2010/12/13/augmented-reality-marketing-in-2010-and-beyond/>

Stalking, psychosis and detention: Habeas Corpus under the Human Rights Act « UK Human Rights Blog

<http://ukhumanrightsblog.com/2010/06/17/stalking-psychosis-and-detention-habeas-corpus-under-the-human-rights-act/>

Deprivation of liberty best interests test compatible with human rights law [updated] « UK Human Rights Blog

<http://ukhumanrightsblog.com/2010/07/23/deprivation-of-liberty-best-interests-test-compatible-with-human-rights-law/>

Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion - Psychiatric Times

<http://www.psychiatrictimes.com/dsm-iv/content/article/10168/54831>

More notes on the placebo effect

I can't find a damn article about the possibilities the placebo effect is caused by body systems which respond to talking and healer behaviour.

So I'm wandering around the web looking for more information and not getting far. My head's really starting to hurt to understand the following paper.

Evidence for placebo effects on physical but not on biochemical outcome parameters: a review of clinical trials
Karin Meissner , Hans Distel and Ulla Mitzdorf
BMC Medicine 2007, 5:3doi:10.1186/1741-7015-5-3
http://www.biomedcentral.com/1741-7015/5/3

So after filtering out a low of studies the authors found a few select ones which allowed them to compare placebo control group effect sizes with those who got no treatment at all. The results are that certain types of research measures, "physical parameters", have a significant placebo effect where as body systems, "biochemical processes", don't. The review excluded all psychological, neurological and psychiatric papers. It purely looked at physical medicine.

""

The explorative analysis revealed that significant placebo effects were predominantly found for parameters measuring physical processes, e.g., blood pressure, or forced expiratory volume in 1 second (FEV₁). Therefore, all types of physical outcome parameters were collected in one class, which was named "physical parameters". The remaining parameters, less frequently responding to placebo treatments, appeared to represent biochemical processes measured in peripheral body fluids and tissues, e.g., cholesterol and cortisol. Therefore, they were all taken together in one alternative class, which was named "biochemical parameters". To be more precise, 8 of 16 trials (50%) using physical parameters as outcomes reported significant placebo effects compared with only 1 of 18 trials (6%) using biochemical parameters. This difference was statistically significant (Fisher's exact probability test, P < 0.01).

To further substantiate this classification, we performed subanalyses for both groups of parameters. This revealed a significant placebo effect for physical parameters with a pooled effect size of g = 0.34 (95% CI 0.22 to 0.46, P < 0.0001), but an effect size close to zero for biochemical parameters (g = 0.03, 95% CI -0.04 to 0.10, P = 0.41) (see Figure 1). The differentiation between physical and biochemical parameters reduced heterogeneity (χ²= 24.63, P = 0.03, I²= 47.2%; and χ²= 6.39, P = 0.96, I²= 0%, respectively). Sensitivity analyses revealed that heterogeneity within the group of physical parameters was due to one outlier [20], and the exclusion of this study substantially reduced heterogeneity (I²= 0%).

"

Here's a useful bit of the discussion.
"

Our results indicate that placebo interventions can improve objective measures of peripheral disease processes. They furthermore suggest that placebo interventions do not improve all kinds of peripheral outcome parameters equally, but primarily those reflecting physical disease processes.

The meta-analysis of placebo effects in the first dataset (collected from a MEDLINE search for placebo-controlled clinical trials) revealed a significant overall improvement of peripheral outcome parameters by placebo treatments. The explorative analysis indicated that significant effects occurred more frequently on physical than on biochemical parameters. Accordingly, an overall placebo effect across trials was only found within the subgroup of physical parameters. In comparison to the pharmacological medication, the administration of placebos improved physical parameters on average by one-third – a remarkable efficacy, not found for biochemical parameters. These results already suggest that placebo interventions affect physical parameters more frequently and strongly than biochemical parameters.

However, our classification was derived from clinical placebo-controlled trials without a no-treatment arm. These trials had not been designed to analyze placebo effects but to estimate the effect of the active medication against placebo control groups. Therefore, factors not due to placebo treatment may have contributed to the changes in the placebo groups in such trials, e.g., the natural course of the disease, and regression to the mean. We attempted to control for these factors by focusing on trials with otherwise stable disease conditions and tried to minimize the risk of regression to the mean by excluding trials on non-random samples selected by screening from a healthy population [68]. However, even in stable chronic conditions, symptoms may vary over time, and the possibility that some of the improvement on physical parameters may be due to regression cannot be fully excluded by the present data.

Therefore, to further substantiate our classification, we made use of the database of Hróbjartsson and Gøtzsche, which contains a complete collection of trials including both a placebo and a no-treatment control group [5,6]. Again, the subanalysis of trials with peripheral outcome parameters revealed a significant improvement from placebos compared with no treatment for the subgroup of physical parameters only. In fact, the analysis even showed a significant negative effect of placebos on biochemical parameters. However, as the number of trials reporting on biochemical parameters was small, this finding should be treated with caution.
"

And here's the sort of gold I was looking for. This is what I find interesting about the placebo effect and the possibilities for healthcare and other areas of life.
"
One frequently discussed mediating mechanism of placebo effects is the patient's expectation of clinical improvement, which can be raised, for example, by verbal suggestions accompanying placebo treatment [79,80]. Expectation and operant conditioning may complement each other. Learning theory emphasizes the importance of response-specific expectations for the performance of operant conditioning tasks [81]. Thus, the patient may direct his/her attention to symptom improvement because he/she is expecting a clinical benefit. In this sense, expectation may be necessary to both initiate and maintain the process of operant conditioning. It has recently been demonstrated that in patients with parkinsonian disease, both the expectation and the actual experience of a clinical benefit during placebo treatment activates the inner-brain reward circuitry [74,82]. This experimental result fits well with the hypothesis that both mechanisms (expectation and operant conditioning) are involved in the mediation of placebo effects.
"

The conclusions are interesting.
"

Our results indicate that placebo treatments of peripheral disease processes can affect physical parameters more easily and strongly than biochemical parameters. This differentiation holds true for both datasets we tested, i.e., conventional placebo-controlled clinical trials, and clinical trials that included a no-treatment arm. As a corollary, it follows that placebo-responsive subgroups may also be identified in datasets in which global averages conceal such specific responses.

Although much progress has been made in the past decade in understanding the biological basis of placebo effects in neurological conditions, e.g., pain and parkinsonian disease, the mechanisms that mediate placebo effects on peripheral organ systems still await to be further elucidated. The differential placebo responsiveness of physical versus biochemical parameters, as disclosed in the present study, offers a good starting point for theoretical considerations on possible mediating mechanisms, as well as for future investigations in this field.
"

The Biochemical Bases for Reward,Implications for the Placebo Effect

The Biochemical Bases for Reward
Implications for the Placebo Effect
Raúl de la Fuentefernández
A. Jon Stoessl

http://ehp.sagepub.com/content/25/4/387

"
The authors propose that the placebo effect is mediated by reward-related mechanisms. Recent evidence suggests that it is the expectation of reward (in this case, the expectation of clinical benefit) that triggers the placebo response. In Parkinson’s disease, the placebo effect is mediated by the release of dopamine in the striatum. The authors argue that placebo-induced dopamine release in limbic structures, particularly in the nucleus accumbens, could also be a major biochemical substrate for the placebo effect encountered in other medical disorders. Other neuroactive substances involved in the reward circuitry (e.g., opioids) are also likely to contribute to the placebo response, and such contribution may be disorder specific (e.g., opioid release in placebo analgesia; serotonin regulation in response to placebo antidepressants). In addition, placebos may have a role in substitution programs for the treatment of drug addiction.
"

Ah yes. Isn't everything in mental health about behavioural judgements and modification.

The Biological Basis of the Placebo Effect

by Eugene Russo
The Scientist 2002, 16(24):30
http://www.the-scientist.com/article/display/13424/

This is the article I've been looking for. Makes for interesting reading
about the placebo effect. There's a biological basis for the existence of the placebo effect. How amazing is that? Influences outside biology create a neurobiological reaction which is as capable of treating depression as antidepressants. It doesn't work on all the areas of the brain which antidepressants work on but still has an effect which is as potent as an SSRI for many reasons. Remember that bigger pills, bright and better packaged pills have a better effect. This is how complex and how powerful the placebo effect is. It's not just physician-client relationships alone.

A study on suicide which probably doesn't exist yet

I've been chewing over a conversation about suicide as help-seeking
behaviour. I think this is, in general, a total load of bollocks. It's
the sort of thing someone who's not attempted suicide would foist on
someone who had so they'd think that they were trying to get help rather
than wanting to die when they attempted to take their own life.

I really wanted this person to suck on my chocolate salty balls. Suicide
is something you read about and understand.

I am 99% sure he wouldn't have any good evidence to bring to bear. There
might be research into why people kill themselves. Certainly one of the
most significant suicidologists in the 20th century, Edwin Schniedman,
dedicated much of his life to understanding it. I'm not sure if he ever
attempted suicide. His interest stemmed from other reasons, at least
publically. His research used suicide notes. He considered these a very
significant source of information and brought a science to the
understanding of these significant documents. They're the last thing a
person writes before they kill themselves.

You know what he thought the reason was? He called is psychache. I
interpret is a deep soul pain, something which may not express itself in
psychiatric measures like GAD or PHQ. Whether or not he attempted
suicide he did the best research into it. None of that arsing about with
epidemiological research. He bothered to find out something useful using
techniques which are akin with qualitative research though he appleid
positivistic principles.

While people perhaps should have sought help before they tried to kill
themselves and while the help they seek after an attempt may help them
with the problems they were having before the attempt what's going
through a person's head when they're thinking of killing themselves is
not "I need mental healthcare and this is how I'm going to get it. I
think everyone is the UK is aware of the Samaritans and anyone who puts
suicide into Google will come across many links to support services. I'm
unaware if this has had a significant impact on the number of attempted
suicides.

The conversation which I'm speaking about centred around the male
suicide rate. He was dismissing the high female attempted suicide rate
as largely due to help-seeking, i.e. the women who attempted suicide, in
the main, were trying to do it because they were trying to get help or
attention. It was at this point I wanted to get my chocolate salty balls
out for him to taste.

The problem is before I let him taste my chocolate globules I need to be
sure that I'm right. The value of my personal experience versus his book
reading (and I've read a few books too) is another debate. I think we
could both agree that a decent study into the issue, one that used
evidence rather than supposition, would be the deciding factor on who
gets to eat what of whoms.

My guess is doctors would make a good group. They have a statistically
significant higher suicide rate than the general population. They have
one of the highest levels of knowledge of how to take their own life as
well as having access to the means to do it peacefully. Doctors are also
meant to know a fair amount about mental illness however they're also a
highly self-stigmatic group. They understand the notion of seeking help
for mental ill health. There's a case of a UK doctor being suspended for
self-prescribing antidepressants. He could have asked another foctor to
prescribe him antidepressants but felt unable for reasons which I
attribute to stigma. Doctors and other mental health professional are
also usually put in psychiatric wards away from where they usually practice.

The potential to compare the completed versus attempted suicide rate in
doctors is an opportunity to understand this idea of help seeking
behaviour. I expect it will show that not every doctor who attempts it
is successfuly but the rate is considerably higher. The doctors who
survive (or fail) could be be asked about whether they thought they
should have sought help before their attempt and how help afterwards
helped them.

Or perhaps there's a better study into what's behind a suicide attempt.
I think most of all it's about a person wanting to die. I think one of
the world's top suicidologists of the 20th century would agree with me.
He would give the reason of psychache. I would say it's because the
person wants to die. We'd both agree the idea of suicide as a form of
attention seeking or help seeking was something which needed to be
dispelled with expediency with methods that may, perhaps, involve
sampling the delights of my chocolate salty balls.

It's the same with the whole gender help seeking before attempting
suicide prejudice. It's all stuff whose proponents can suck on my
chocolate salty balls.

But you don't looked depressed

If anyone met me they'd be very unlikely to be able to tell I was pretty
fucking depressed at the moment. They might judge me as strange,
eccentric or weird. They wouldn't be able to tell that I'd woken up with
a desire to die every day this week, and for weeks before that, and
months and years where many days have been like that. They wouldn't know
just how tired I am mentally, physically and on a deeper plane. They
wouldn't know just how much I've been struggling to eat enough to
survive. They wouldn't know how low I can feel nor the depths to which
my soul pain can sink. They wouldn't know that I can barely be arsed to
change clothes, shower and stay clean.

Whenever I see people I don my mask. I clean up. I don my mask - with
clothing and with an external character I don like an actor on stage. I
do everything possible to hide what I'm like in truth.

I'm sure it must show to sensitive people. I think a lot of the
weirdness may come from the conflicted personality which hides the inner
pain but overcompensates in their creation of the mask of normality.

This is the thing with mental illness. It is unseen. It means it is hard
to recognise for the observer and for the person experiencing it. Had I
not become educated to recognise this is a state that other people call
mental illness and understand the reasons why they have that construct
I'd deal with this problem a lot differently. Now I've had time to
understand that it's not really an illness but there's still a relevance
for my life I'm able to recognise this state as severe misery but
something I function through.

The mask is not just to avoid sympathy or being treated differently.
People don't like spending prolonged periods with depressed people. Many
people don't want to spend short periods with miserable people. My
miserable state is far from the genuinely happy and fun person I am in
other periods in my life. That person is the person people like to spend
time with. The person I am behind the mask is very different and someone
people wouldn't want to spend time with, simply because the levels of
intensity and misery may be too much for them to handle. It may be
infectious too.

There is a large part of me that doesn't want what I'm going through to
be thought of using the paradigm of mental illness. The paradigm
simplifies it too much then shifts it to something a doctor is meant to
be capable of fixing. It devalues what I'm going through. It gives it a
lack of import and, most significantly perhaps, pathologises it so it is
something people shouldn't experience.

It's gotten really hard to keep the mask up. That's when it's most
difficult for me. I have to function in the real world and when I'm not
capable it takes a lot of energy and time to maintain the facade that I
am functioning ok. I've had to learn this while dealing with this
experience of being before I was medicated and now I've relearned it
since coming off medication. I'm still not finished on that path.

Part of my recovery has been about developing the mask so if I mention
I'm depressed people might think "but you don't look (or sound)
depressed." In a way that's an achievement I guess. Something out of
nothing. At least I achieve what I'm trying to do.

A sort letter/article on genes and behaviour

Molecular Psychiatry - Dopaminergic polymorphisms associated with
self-report measures of human altruism: a fresh phenotype for the
dopamine D4 receptor
<http://www.nature.com/mp/journal/v10/n4/full/4001635a.html>

Is the possibility that our personal traits may be genetic a strange
one. Or perhaps it's obvious. I'm not sure. It sort of means we're like
our parents.

A note on genetics and schziophrenia and the extinction of a type of human

Understanding What Causes Schizophrenia: A Developmental Perspective --
Gilmore 167 (1): 8 -- Am J Psychiatry
<http://ajp.psychiatryonline.org/cgi/content/full/167/1/8>

A snip of one person's perspective on genetics and schizophrenia
"
Currently, it is thought that genetic risk for schizophrenia emerges in
two basic ways—the first being the polygenic interaction of multiple
common variants of probably thousands of genes, each with very small
individual effects (8). The second are rare but highly penetrant genetic
events such as deletions or duplications—copy number variations (9). Of
the environmental causes of schizophrenia, most studies have focused on
pre- and perinatal environmental risk factors; three of the
gene-environment studies relevant to schizophrenia focus on
these—infection, depression/stress, and urban birth.
"

Another snip
"
In this issue, Mäki and colleagues (2) studied the interaction of
genetic risk (having a parent with schizophrenia) with an environmental
risk—that of maternal depression during pregnancy. They found that
maternal depression during pregnancy significantly increases the risk of
schizophrenia in offspring if one of the parents has a psychotic
disorder. If a child had one parent with psychosis, their risk of
schizophrenia increased 2.6 times. Maternal depression by itself did not
increase rates of schizophrenia. However, if the genetic risk of having
a parent with schizophrenia was combined with the environmental risk of
maternal depression, schizophrenia was more than 9 times more likely.
The combination of genetic risk with an environmental exposure
interacted to increase rates of schizophrenia more than that would be
expected by simply adding risk from each.
"

It's this paragraph which is most telling
"What causes schizophrenia? The short answer may be "nothing" or more
precisely "no one thing." In most cases, schizophrenia is an end result
of a complex interaction between thousands of genes and multiple
environmental risk factors—none of which on their own causes
schizophrenia. Daniel Weinberger, in his classic paper on brain
development and schizophrenia (10), entertained the "unlikely"
possibility that schizophrenia is "not the result of a discrete event or
illness process at all, but rather one end of the developmental spectrum
that for genetic and/or other reasons 0.5% of the population will fall
into." Over 20 years later, this unlikely scenario is looking more
realistic. Schizophrenia is increasingly considered a subtle
neurodevelopmental disorder of brain connectivity, of how the functional
circuits in our brains are wired. Schizophrenia may in fact be the tail
end of a distribution of how the estimated 20 billion neurons and their
trillions of synaptic connections in our brains are generated,
eliminated, and maintained. Schizophrenia may be the uniquely human
price we pay as a species for the complexity of our brain; in the end,
more or less by genetic and environmental chance, some of us get wired
for psychosis."

This means that genetic assay to remove the possibility of stopping a
baby developing schizophrenia in later life may not be possible unless
Meehl's hypothesis of schizophrenia is true, that there's a genetic
prestate necessary. Certainly one of the new emergent theories, that
schizophrenia can be caused by an HVN virus which is a very rare type of
virus encoded into the human genome, would lead credence to this
possibility however it has not been proven yet.

The problem is still the problem of pathologisation, the value of
schizophrenia, human value and the prevention of an important phenotype
being attempted to be wiped out because society pathologises it in 2011.
What I mean is these new research studies into genetics and embryo
screening make it every more possible to make Hitler's objectives
possible: the creation of a super race by extermination of those
considered to be undesirable. This may seem like an ad hominem argument
against genetic screening for behavioural and emotional disorders
however I use it to convey the magnitude of immorality of stopping
certain types of people being born. Hitler wanted to castrate the
schizophrenics. He wanted them exterminated from the gene pool. He
probably would have wanted the Jews, homosexuals and other types he
didn't like exterminated so the human gene pool could be pure, white and
Aryan. He wanted Aryans the same way the world through psychiatry wants
automotions - machine-like, ideal human beings - and so will parents who
want their offspring to have the best opportunities in a world where
inequality is increasing all the time.

Emotional and behavioural disorders (as they're know in psychiatric text
books, probably because psychiatrist know mental illnesses aren't real
illnesses) have included many 'conditions' which are no longer
conditions but not through any change in biological processes. They
stopped being illnesses because society advanced, for example by
becoming more sexually liberated (hysteria) or by considering black men
who were slaves and kept running away were in fact very sane (drapetomania).

The psychiatric paradigm, i.e. the formalisation of prejudice using
'science' (a bastardisation of science with social norms and cultural
morality), carries risks because it can be used to suppress and
subjugate normal human behaviours based on the temporary and local
values of the largest consensus group of psychiatrists. But they're not
really treating real illnesses. And so exterminating schizophrenics by
removing them from the gene pool - even if it's at the behest of parents
- is a fucking bad thing.

I know the horrors of severe mental illness first hand so I can
understand why a parent may not want their child to be a schizophrneoic,
just like a parent might want their child not to be gay a century ago.
Psychiatry has got lots of evidence that they're do worse in life.
There's also a significant evidence base to show the problem is a large
part to do with the effect of societies and local cultures.

There's a humane reason for the extinguishing of certain phenotypes
however there are strong ethical and moral reasons why types of human
beings should be made extinct. There's also the value to society. The
severely mentally ill have contributed to human civilisation in an
inordinate number of ways. They contribute across the world in different
areas just like automotons too. There's a value to their experiences and
the diversity they bring to the human race. They may be disadvantaged by
post-Industrial Age 'developed' (are developed nations really
developed?) post-capitalism societies. I a hundred years the severely
mentally ill may be valued above automotons because of society changes
to see their value and give them back their rightful place in society.
In the UK the diagnosis of bipolar has gone through a change where
people think it may be a desirable attribute (little do they know of the
hell).

So any parents who wish to condemn my opinion that no types of people
should be allowed to be made extinct ever can, frankly, taste my
chocolate salty balls. They are my adversaries but I'd still like to let
them chomp on my chocolate salty balls.

Understanding sham-ECT and the bullshit that's untreatable conditions

About a million people a year worldwide are electrocuted because they've
not responded to other treatments. Seizures are induced to treat
behaviour as a last resort. This can still be done without consent as it
has been done since the first person screamed for the doctor not to
shock them again. When it was first tried they didn't even bother with
anaesthetic.

In a recent high quality review of scientific trials, i.e. ones which
use a true placebo comparison, the placebo was shown to be very
effective. So effective that during treatment real ECT was only
marginally better and just as good after treatment.

I wonder if anyone else is sitting here thinking this is fucking nuts?
When modern mental healthcare is inept it uses treatments of last
resort. These are dangerous, inhumane treatments only made possible
because of the privilege of medicine, i.e. it's because they're trying
to do a a good thing that ECT is allowed to be used without due process
or forethought. It's just the choice of a psychiatrist to electrocute
their patient. It's the same profession that might have considered
waterboarding, the torture which is now outlawed in civilised society,
as a suitable treatment two centuries ago.

Whenever the placebo effect is explored there are many factors found
other than what's true placebo. In trials it's different from clinical
practice because during a trial staff treat patients differently,
patients get more time spent on them and more attention. The patients
may also get hope from this extreme treatment being used. Specifically
it's not sham-ECT which is as good as ECT. It's sham-ECT in a research
trial setting which is as good as real ECT in a research trial setting.

So what that means to me is there are many other things which could done
before the psychiatrists should think about electrocuting their patient
to change their behaviour. They're all the things that happen during a
research trial. They should do their job properly, offer support and
contact to patients and lots of others things which make research trials
different from clinical practice.

Then perhaps they might not have to ECT patients. Then when they fail
and it is time to ECT them they should only use sham-ECT because the
evidence shows the risks of real ECT compared to the benefits means they
don't have a fucking leg to stand on just like when they used insulin
induced shock until an early RCT showed it to be ineffective.

The key point which I'm probably making pretty badly is that there are a
bunch of things that can be done instead of resorting to treatments of
last resort which don't work. They're they things which are part of the
placebo effect of sham ECT. They're the sort of things that should be
done for all patients so perhaps they won't end up having to be
electrocuted until their memory and cognitive functions are so fucked
that they don't remember why they're unhappy, or till they die.

Many have died because of ECT. Many f those lives could have been saved
with sham-ECT instead, even with the risks of the nocebo effect. Many
people could be helped to recover using the non-electric parts of ECT
trials taken to be used in clinical practice. For example the changes in
clinician behaviour. Clearly ECT is considered a hope by the Royal
College of Psychiatry. Not a treatment which can't be done by any
physician who's taken the Hippocratic Oath.

"First, do no harm."

It's funny but not in a good way. The motto of the Royal College of
Psychiatry is "Let wisdom guide." What wisdom is there in using at
treatment which kills yet is only as effective as a sham treatment on
measures which are valuable to the patient?

Let wisdom guide? Let them suck on my chocolate salty balls.

How many dead people does it take to make change?

Clozapine. ECT. Seroxat. Antipsychotics in dementia. Just a few of the
killer treatments used in modern times to treat behaviour, emotions and
experiences of consciousness.

The psychiatric profession can murder without recourse. A Homer
Simpsonesque "Doh!" after they and GPs killed 1,800 old people a year
was enough. It was enough for them to limit the murder of the elderly
rather than ban the use of antipsychotics for demenita in the community.
Now they know they're killing their patients it's no longer
manslaughter. Doctors are murdering the elderly because of their behaviour.

Psychiatrists put people with severe mental illnesses on these drugs for
life. They never tell them of the risk they pose. They don't offer them
help. They just leave them to rot on benefits or in a psychiatric ward.

Anyone who's bothered to read the smallest amount of history about
psychiatry will know it's an industry of death and inhumanity. There are
so many instances of this across the centuries. In each century the
doctors said the deaths were unavoidable and they were genuinely doing
medical treatment. People with hindsight can see this is not true. Today
psychiatry makes these same excuses. I don't live in the future but I
can see the deaths and inhumanity are the same as in the last century
when people were lobotomised or pathologised for their sexuality.

And they can get away with it. What's done to psychiatric patients can't
be done to prisoners of war or criminals. Because they're the mentally
ill and because they're treated by 'doctors' (and I use the phrase in
the loosest sense of the term since being a doctor fundamentally means
someone who's taken and adheres to the Hippocratic Oath but this isn't
true of psychiatrists and many GPs in their mental health treatment).

The medico-legal framework seeks to strip rights. Even the Human Rights
Act does so. There is not right to live, liberty or choice for the
severely mentally ill. There are no protections against harmful
treatments which kill them. There is no punishment for a profession
which kills them. A psychaitrist who has sex with his patients would be
struck off but one who murders in the name of treatment of dementia
symptoms (a behavioural problem treated using a chemical straitjacket)
just scores poorly on their Key Performance Indicators.

So how many dead schizophrenics, elderly people with dementia, manic
depressives and other loonies does it take before society wakes up and
does something?

Brainwashing and behavioural modification available free on the NHS

It's funny because this is something I'm sort of in favour of. It's
called psychological therapies but if you don't call them the right
thing the people don't know what they're getting.

Concepts are so much more important than words but the mental health
fraternity/sonority usually spend their time fucking about with the
words instead trying to understand the concepts. I've chosen a
fundamentalist paradigm to change the way people see the consensus one.
Our minds must be open to what psychiatry and mental healthcare
represent, have represented and will represent. It is only history or
bloody clever anthropologists like Foucault who can see past the smoke
screen created by language to the concepts underlying.

Behavioural modification is better than being dead though. That's sort
of the thing really. It's why I'm in favour of talking over electricity.

I think there's another solution though. A better one. I just font know
what it is, yet.

Monday, 17 January 2011

FMRI studies of ECT

I'm writing this while walking.

I assume these haven't been attempted. It's a guess based on my dislike of tendencies in psychiatric practice. They'd rather just keep shocking people rather than attempt to work out why ECT works (or doesn't). Perhaps this could lead to the use of treatments which don't cause a full on seizure.

The obvious complication is the strong magnets used in fMRI scans. There's not standard non-ferrous ECT eqio

Saturday, 8 January 2011

Geotagged blogging for campaign

People do a lot of waiting in hospitals and wherever else they access government services. When people start using their phones more often as entertainment items to allieviate boredom the opportunity for electronic content written by citizen journalists, and the odd professional blogger, to get disseminated to a wide audience is higher if the tagging is in a place where people have to wait.

Leaflets, magazines and books litter a typical clinic waitig room. Soon people will be able to search for local blogs from the proctologist or gynaecologicalist. Or they might want to read what services are being cut.

As GPs have more power in commissioning campaigns leafleting local practice waitng rooms makes a lot of sense. It may be even easier in the future to geotag either by a centralised effort using a location database 'mail merge' or by local activists rather than writing to their MP writing a geotagged post at the affected service - the service rather than the adminsatition builiding or the offices of people high in the hierachy - utilising citizen journalists.

Written at the Netroots conference 2010.

Useful fundraising and campaigning tips

http://bluestatedigital.com/blog/entry/last-minute-tips-for-end-of-year-fundraising/

Friday, 7 January 2011

3D | Impact Lab

<http://www.impactlab.net/?tag=3d>

Another useful tech blog

Happiness and Health - Chronic Disease Prevention - Harvard Public Health Review - Harvard School of Public Health

<http://www.hsph.harvard.edu/news/hphr/chronic-disease-prevention/happiness-stress-heart-disease/index.html>

A good piece and some interesting results for mental health

"
A vast scientific literature has detailed how negative emotions harm the
body. Serious, sustained stress or fear can alter biological systems in
a way that, over time, adds up to "wear and tear" and, eventually,
illnesses such as heart disease, stroke, and diabetes. Chronic anger and
anxiety can disrupt cardiac function by changing the heart's electrical
stability, hastening atherosclerosis, and increasing systemic inflammation.

Jack P. Shonkoff, Julius B. Richmond FAMRI Professor of Child Health and
Development at HSPH and at the Harvard Graduate School of Education, and
Professor of Pediatrics at Harvard Medical School, explains that early
childhood "toxic stress"—the sustained activation of the body's stress
response system resulting from such early life experiences as chronic
neglect, exposure to violence, or living alone with a parent suffering
severe mental illness—has harmful effects on the brain and other organ
systems. Among these effects is a hair-trigger physiological response to
stress, which can lead to a faster heart rate, higher blood pressure,
and a jump in stress hormones.

FOCUSING ON THE POSITIVE
"But negative emotions are only one-half of the equation," says Laura
Kubzansky, HSPH associate professor of society, human development, and
health. "It looks like there is a benefit of positive mental health that
goes beyond the fact that you're not depressed. What that is is still a
mystery. But when we understand the set of processes involved, we will
have much more insight into how health works."

Kubzansky is at the forefront of such research. In a 2007 study that
followed more than 6,000 men and women aged 25 to 74 for 20 years, for
example, she found that emotional vitality—a sense of enthusiasm, of
hopefulness, of engagement in life, and the ability to face life's
stresses with emotional balance—appears to reduce the risk of coronary
heart disease. The protective effect was distinct and measurable, even
when taking into account such wholesome behaviors as not smoking and
regular exercise.

Among dozens of published papers, Kubzansky has shown that children who
are able to stay focused on a task and have a more positive outlook at
age 7 report better general health and fewer illnesses 30 years later.
She has found that optimism cuts the risk of coronary heart disease by half.

Kubzansky's methods illustrate the creativity needed to do research at
the novel intersection of experimental psychology and public health. In
the emotional vitality study, for example, she used information that had
originally been collected in the massive National Health and Nutrition
Examination Survey, or NHANES, an ongoing program that assesses the
health and nutritional status of adults and children in the United
States. Starting with the NHANES measure known as the "General
Well-Being Schedule," Kubzansky crafted an adaptation that instead
reflected emotional vitality, and then scientifically validated her new
measure. Her research has also drawn on preexisting data from the
Veterans Administration Normative Aging Study, the National
Collaborative Perinatal Project, and other decades-long prospective studies.

In essence, Kubzansky is leveraging gold-standard epidemiological
methods to ask new public health questions. "I'm being opportunistic,"
she says. "I don't want to wait 30 years for an answer."

STATE OF MIND=STATE OF BODY
Some public health professionals contend that the apparent beneficial
effects of positive emotions do not stem from anything intrinsically
protective in upbeat mind states, but rather from the fact that positive
emotions mark the absence of negative moods and self-destructive habits.
Kubzansky and others disagree. They believe that there is more to the
phenomenon—and that scientists are only beginning to glean the possible
biological, behavioral, and cognitive mechanisms.

Previous work supports this contention. In 1979, Lisa Berkman, director
of the Harvard Center for Population and Development Studies,
co-authored a seminal study of nearly 7,000 adults in Alameda County,
California. Participants who reported fewer social ties at the beginning
of the survey were more than twice as likely to die over the nine-year
follow-up period, an effect unrelated to behaviors such as smoking,
drinking, and physical activity. Social ties included marriage, contact
with friends and relatives, organizational and church membership.

A HAPPINESS POLICY?
If scientists proved unequivocally that positive moods improve health,
would policymakers act? Some observe that, in the U.S., we define
"happiness" in economic terms—the pursuit of material goods. They
contend that even an avalanche of research showing that emotional
well-being protected health would have no traction in the policy world.
Many Americans believe, after all, that people are responsible for their
own lives.

But others see direct policy implications. "In public health, it's
important to understand how we can translate guidelines into behavior,"
notes Eric Rimm, HSPH associate professor in the Departments of
Epidemiology and Nutrition and director of the program in cardiovascular
epidemiology. "Seventy to 80 percent of heart attacks in this country
occur not because of genetics nor through some mysterious causative
factors. It's through lifestyle choices people make: diet, smoking,
exercise. Why are people choosing to do these things? Does mood come
into play?"

The toll of toxic stress goes far beyond poorer health for
individuals—population-wide, the cost of chronic diseases related to
these conditions is enormous. "Imagine if we could enact a policy that
would reduce heart disease by just 1 percent," suggests Shonkoff. "How
many billions of dollars and how many lives would that save? Now what if
we could also reduce diabetes—which is growing in epidemic
proportions—and even stroke?" The point, Shonkoff says, is that society
pays a considerable cost for treating chronic diseases in adulthood, and
reducing toxic stress early in life may actually get out in front of
these diseases to prevent them.

Kubzansky concedes that psychological states such as anxiety or
depression—or happiness and optimism—are forged by both nature and
nurture. "They are 40–50 percent heritable, which means you may be born
with the genetic predisposition. But this also suggests there is a lot
of room to maneuver." Her "dream prevention": instill emotional and
social competence in children—with the help of parents, teachers,
pediatricians, sports coaches, school counselors, mental health
professionals, and policy makers—that would help confer not only good
mental health but also physical resilience for a lifetime.

Even in adulthood, it's not too late to cultivate these qualities, she
says. While psychotherapy or meditation may work for one person, someone
else may prefer faith-based activities, sports, or simply spending time
with friends. "My guess is that many of the people who are chronically
distressed never figured out how to come back from a bad experience,
focus on something different, or change their perspective."

MAPPING HAPPINESS
Drawing on recently compiled data from a nationally representative study
of older adults, Kubzansky is beginning to map what she calls "the
social distribution of well-being." She is working with information
collected on participants' sense of meaning and purpose, life
satisfaction, and positive mood. By tracking how these measures and
health fall out across traditional demographic categories such as race
and ethnicity, education, income, gender, and other categories, she
hopes to understand in a fine-grained way what it is about certain
social environments that confers better frame of mind and better
physical health.

The last thing she wants, Kubzansky says, is for her research to be used
to blame people for not simply being happier—and therefore healthier.
Referring to one of her first major studies, which found a link between
worry and heart disease, she said: "My biggest fear was that journalists
would pick it up and the headlines would be, 'Don't worry, be happy.'
That's useless. Not everyone lives in an environment where you can turn
off worry. When you take this research out of the social context, it has
the potential to be a slippery slope for victim blaming."

BEING IN THE MOMENT
Kubzansky, who is married and has two young children, says her work has
made her think a lot more about finding balance in her own life. To that
end, she says, she recently signed up for a yoga class. She also plays
classical piano—both chamber music with friends and solo hours at the
keyboard for her own enjoyment.

"When I'm playing piano," she explains, "I'm in the moment. I'm not
worrying or thinking or trying to work out a problem. I'm just doing
this thing that takes all my attention."

That insight is also at the center of her research. "Everyone needs to
find a way to be in the moment," she says, "to find a restorative state
that allows them to put down their burdens."