Thoughts on the pursuit of happiness

I was speaking to someone last week and stumbled across something that I hadn't thought of in a while: the hedonic treadmill. The model says that good and bad events temporarily affect happiness but a person usually quickly returns to a neutral state.

People fill their lives with the acquisition of things that have meaning to them. Often it's money, status, possessions or people (e.g. having a more beautiful girlfriend). Once these goals are achieved happiness results. That's the assumption. In fact what often happens is the happiness is short lived and the next goal comes up. This is the treadmill.

In my mind it is represented by a hamster in a wheel. It's the futility of desire. The satisfaction of achieving a target quickly fades and the next rung in the hamster's wheel becomes the new goal.

One aspect of the psychology behind this effect was explained to me by a drugs and alcohol counsellor. He spoke of the work of Jorge Luis Borges who wrote about labyrinths and mazes of life. Life itself is a corridor. The maze is a construct of the mind, the winding paths and twists and turns of the hedonic treadmill. Maze-dwellers travel through the maze seeking the end - the completion of their goals - but in the end they return to the corridor upon achieving success and the mind creates another maze with new twists and turns. This is a human trait.

Awareness of this effect is useful but troubling to me. This paper makes an important point.
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The theory, which has gained widespread acceptance in recent years, implies that individual and societal efforts to increase happiness are doomed to failure
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It's as though there is no hope for human happiness.

I've tried to live with a new understanding over the past few months. I don't remember who said it but
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The secret to happiness is realising you don't have to be happy.
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It's not a positive message nor one that's given me much happiness, but then I wasn't looking for it.

Reflecting on my conversation with the Rastafarians last night makes me think this quote is a more important idea. It's a quote from Bertrand Russell.
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I've made an odd discovery. Every time I talk to a savant I feel quite sure that happiness is no longer a possibility. Yet when I talk with my gardener, I'm convinced of the opposite.
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Most other people are more optimistic about the potential for people's happiness. There's a wonderful piece by Polly Toynbee published in The Guardian and reposted on this site where she speaks of her hopes that society will shift from a Gross Domestic Product-orientated measure of success to Gross Domestic Happiness. It was hoped to become a reality in the UK before the financial crisis and change in government.

In my own life I've eschewed the hedonic treadmill as much as possible. I've forsaken the wealth of my parents and the opportunities of wealth my education gives me. I've battled the internal desires to have more and want what other people have though it was yet another thing I failed at. It gave me access to valuing the small pleasures as much as someone else might enjoy a fine wine or dream holiday. Cheap wines taste like Chateauneuf du pape and discovering my local area is a substitute for the holidays I used to have.  Accepting my desire to have more was the same desire that millionaires feel when comparing themselves to billionaires helped me understand a little bit more about what was valuable.

My home is where I rest my head. My kingdom is where my feet touch the ground. My wealth is my brain, my heart, my soul and what I do with them.

Misery will come and go but it's the same for everyone.

Notes mental illness and disability

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(the use of the word disability is in the consensus sense. I'm not ranting about how no one is disabled and it's the construct of society at the time which is where the disability exists. We're all equal and capable, etc, etc, etc.).

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A person who's a thalidomide baby would be undoubtably be considered disabled if they lived to adulthood. These children were born with missing limbs and internal deformities after their mothers were prescribed thalidomide. Earlier this year the UK government apologised for licensing the drug. (http://www.thalidomideuk.com)

It is a clear physical illness. The detriment is physical. Even a Daily Mail reader can understand that the loss of limbs reduces a person's capability and causes suffering.

Many may not see mental illnesses as disabilities. Few would understand why schizophrenia is considered a serious disability. I'm not sure how many members of the unaware (mental health or social model of disability) accept mental illness as a disability.

Caelic's disease which is a gluten allergy is also conisdered a disability.

There is a hierachy of disability and "hierachy of disability" is an established term.

When considering the impact of the disability it is easy to see how Helen Keller is disabled. People may not be able to see that John Nash or Sylvia Platt's state of mind may be of a a comparable level of disability. Chronic severe depression and other severe illnesses make people want to kill themselves. This happens far less often that with cancer.

The the internal experiences which make severe mental illness just like any other disability are unseen. A person can suffer inside and not show on the outside, just like a person can cover their self-harm scars with clothing. The intense experiences that happen during periods of isolation are like a suffering that words have yet to be made for. For many it is an experience that can only be understood by going through it.

The mentally ill and malingers are the government's target for moving people off sickness benefit. I feel this decision would polarise people: those who understand and agree with the social model of disability and those who don't really understand how mental illness affects an individual's life.

In general people have sympathy for cancer patients, Thalidomide babies and people in wheelchairs. Few have sympathy for the lonely man sitting in the corner talking to himself. Few understand the internal torture. Fewer have compassion. The lack of compassion for severe mental illness is part of the disability. Even the medical profession give lower quality treatment to patients with a diagnosis of severe mental illness (a result from a review (or meta-analysis) published in the last year or so in the British Journal of Psychiatry).

I heard about a psychiatrist who'd tell carers of people with a diagnosis of schizophrenia that they'd have been better off if they had cancer. I thought that was a riduclous thing to say and I thought it was another example of stupid psychiatrists. As I think about the hierachy of disability, the difference between physical and mental illness, stigma and the effects of the absence of compassion/understanding and the idea of disability I consider that he may have been correct.

The social detriment, disadvantage, exclusion. The broken dreams. Severe mental and physical illness share this.

A surprising result on love

I'd expected a search of articles in Google Scholar with "love" in the title to give a tiny number of studies compared to the number with "depression" in. In fact there are barely twice as many academic sources on depression as there are on love.

http://scholar.google.co.uk/scholar?as_q=love&num=100&btnG=Search+Scholar&as_epq=&as_oq=&as_eq=&as_occt=title&as_sauthors=&as_publication=&as_ylo=&as_yhi=&as_sdt=1.&as_sdtp=on&as_sdts=5&hl=en

http://scholar.google.co.uk/scholar?sourceid=chrome&q=allintitle:%20depression&um=1&ie=UTF-8&sa=N&hl=en&tab=ws

However since 2000 there are just over three times as many on depression as on love.

http://scholar.google.co.uk/scholar?hl=en&q=allintitle:+love&as_sdt=2000&as_ylo=2000&as_vis=0

http://scholar.google.co.uk/scholar?hl=en&q=allintitle:+depression&as_sdt=2000&as_ylo=2000&as_vis=0

And drops back to around 2 times looking at sources from 2009.

There still significant. If I included "depressive", "melancholia" and other broad synonyms for intense unhappiness there may be a bigger effect.

The point I was going to make is that unhappiness is thoroughly medicalised however love doesn't seem to be. There'd be an interesting pub debate on whether is should be medicalised. In a way excessive love is - stalking may be considered a form of mental illness though I'm not sure under what diagnosis. I think there's a diagnosis in DSM-IV related to women who can't achieve orgasm. Liking sex too much is also in the American diagnostic criteria.

There certainly isn't a diagnosis for lack of love or avoidance of falling in love as far as I am aware. Living without that essential part of human life is something that many people live with, even people in relationships. The sadness of that makes me want to medicalise their sorrow, even if they don't recognise that they're missing out on a beautiful part of life.

The point I was hoping to make but I don't have the evidence to support it is that depression is medicalised because it affects people's work capability. A lack of love may cause depression but that is of little concern to medicine. It certainly offers no treatments. There are therapists who might advocate love as a treatment however they get struck off.

Would there ever be a society that could have "love leave" where a person needs to take time off because they've fallen in love and they want to enjoy that feeling and for it to blossom. I doubt I'd see that in my lifetime. It will be many decades before the shackles of Victorian conservatism and prudishness are overcome by progress towards the truer nature of humankind. The pub banter of "bet that person would chill out if they just had a shag" is where the wisdom remains.

I'm not sure if the barrier to a prescription of love (or sex in the jokey pub quote) becoming a regular treatment option is the prudish morality or the fact that the mental health care is becoming a system to keep people employed rather than anything to do with genuinely making life better for anyone. Certainly in the UK the people are seen as meat for the machine of society and improvements in mental healthcare are mainly in behavioural modification to get them back into whatever mindnumbing, soul crushing drivel that most people have to spend most of their adult lives doing.

Another post I have yet to write or perhaps I've written already is what I consider the next mental health system to be: unending, unconditional love for everyone by everyone. Its an insane idea but it comes from an understanding of why the second major mental health system (psychiatry) developed. Unconditional love for all means there would never have been the outcasts that were created as society changed during the Industrial Revolution/Age of reason. Homosexuality wouldn't have been treated as an illness. Psychosis would be an experience manageable in the community. Schizophrenia wouldn't exist.

I might as well as for heaven on earth....

Will assisted suicide laws ever allow for mental illness

This is a very cold piece devoid of consideration of the arguments against suicide or compassion for the loved ones left behind. It is primarily a piece of free thinking rather than an argument for or against assisted suicide.

In a handful of countries and states there is legislation that allows for assisted suicide if a person has a terminal physical illness and are in extreme pain. It is seen as both compassionate to let the person die though many opponents argue that it assisted suicide should remain criminalised for a variety of reasons.

Reading Derek Humphry's assisted suicide blog (http://assistedsuicide.org/blog/) has an interesting post that describes what the mainstream assisted suicide movement is campaigning for.

"Only subscribe if you in principle support the right of a competent adult to choose to die when physical suffering is unbearable."

Reading other posts on the blog is elucidating on the shift in euthanasia laws worldwide. A recent post about assisted suicide in the Netherlands is related to mental health. I was quite surprised to see that a group of people were trying to change the already progressive euthanasia laws si that people over the age of 70 who are "tired of life" should be allowed professional help to end their lives.

I assume the phrase "tired of life" has lost something in translation but I think it may be possible to understand the concept better than the words express. 7o years of living may be enough for some people.

There may be reasons why elderly people may want to end their life early, not least because of the problems caused by the proliferation of the 'nuclear family' unit that removed the value of the third generation from most households and left them to spend their last years in homes or looking after themselves.

Those people aren't dying from a physical illness nor is there extreme or untreatable physical pain. I think many a reader may jump to the conclusion that they are depressed and that's not true in my opinion. Their state of mind, their rational decision, their choice is, perhaps, sane.

This would be a challenge for the best psychiatrist to judge what may be rational suicide and what is a mental illness. Assisted suicide for an untreatable, terminal and painful physical illness is not considered a mental illness. I'm sure in practice equivalents of diagnostic tools like the mini-mental state examination are used to weed out signs of depression or other psychiatric illness.

I suppose what I'm perhaps poorly trying to ask is is there such a thing as a rational suicide for mental illness, or could it be possible that in the future a person defined as having an untreatable and deeply painful mental experience could be assisted to take their own life?

I'll end up ruminating over that because I feel it is a complex question that quick judgements would do no justice to. It is a question that needs a precise definition of what is mental illness outside (though not necessarily above) the lay opinion.

Wanting to die clearly isn't a mental illness in itself. Its ok in some countries if physical pain is unbearable. It can be a sign of a mental illness as can many things. I suppose that the arguments that it will never be legal for mental illness is that there are treatments available that can take away the pain. For example a seizure can be induced electrically and this has been found to work for some people with chronic depression. Personally I see ECT as a form of physical reset of personality or emotional state and as a form of death in itself though a death of a state of consciousness rather than physical. Neurosurgery for mental disorder is another option though comes with a higher risk to life.

For some though all the antidepressants, electric shocks and attempts at fixing the problem neurologically don't work. Would society ever evolve to the point where a person with a persistent desire to die that isn't irrational could be assisted in dying with dignity? I doubt I'll see it in my lifetime. My heart says that its not something I'd want to see either but my head says that people have free will.

I thought I'd end it there but there's one more consideration. Personality disorders are very complex and are often defined as difficult to treat, i.e. the people are difficult to change. This may simply be because of lack of research or perhaps lack of resources to pay for long treatment programs. Imagine the scenario where an individual has accepted they have a personality disorder and they want to change because they see their behaviour as destructive to their life but no treatment works. Imagine that this drives them to despair as months and years and decades of treatment are to no avail and their, their life is in tatters and the doctors have given up. They are not depressed per se but decide after deliberation and consultation that it would be better to "catch the bus" (to borrow a term from the suicide underground) but they've never attempted it before (if that's possible with personality disorders. I'm afraid I don't know a huge amount about them but I think that some, e.g. schizotypal, may not have suicide as one of the symptoms.)

In this example there is the possibility of a non-mentally ill suicidal wish but unrelated to the diagnosis. It is possible to see parallels with the reasoning of assisted suicide for mental illness. There is a difference in that the condition is not terminal per se. The pain and the lack of hope are what is in common with the physical illness argument. Compassion for the life of someone who wants to change but can't and can't be helped to change would make me think that assisted suicide for intractable mental health conditions could be a moral thing however the above example is a philosophical or thinking example. I'm not aware if that's based on reality, i.e. I don't know if there people with intractable personality disorders who want to change but can't and whose suffering is so great that suicide is rational.

A bit on stigma and exclusion and my life

Many would consider it appropriate to hide my unusualness and make sure I fit in with normal behaviour. That's something I do and have to do and its something I like to do because being different can be very lonely. There have been times when my madness was beyond my control such that unintended consequences made me something of a social pariah.

I think many people hide their madness, from hiding their inner child's inappropriate playfulness to keeping silent feelings of attraction to never speaking about unusual experiences or thoughts. Its something we all have to do to fit in and perhaps there is a need for this because without it could be a social anarchy where social taboos no longer exist. (Frankly my opinion is that this would be an ideal society but that's probably why I'd be considered a libertine.)

I think its wrong that we have to hide the truth about ourselves because to me that is a real truth, or moreso than the truth that openness and honesty leaves an individual open to ridicule, scorn, social disgrace, discreditation and perhaps, counterintutively, mistrust. Its fear of that latter that makes people do it.

Its a fear that feels like a leftover from the playground: the fear of being a weirdo. "Weirdo" was one of the earliest mental health diagnoses I came across. Its a diagnosis without sophisticated epidemiological studies but it has an estimatable prognosis. There's usually a degree of social isolation and in childhood this can be a direct cause of depression. Some children rise to the name of "weirdo" but for others it can be a shattering experience. Breaching the unwritten social laws of behaviour at school can bring harsh punishments to young minds. Exclusion, ridicule and devaluation are hard to take as an adult but for a child the impact is far worse and I wonder if it could cause future psychiatric symptoms.

Some children are different and grow from their difference rather than hide it for fear of the consequences. I can reflect somewhat on my miserable childhood and see that it helped make me whatever I am. I was weird then but didn't really realise that it was important not to be weird. I just bumbled along regardless.

This isn't the post where I retell my childhood but I can describe some of the impact. I'm reflective and perhaps somewhat intense person now underneath my mask of vacuous cheer. The me underneath the mask came from long periods of loneliness, solitude and time spent with my own thoughts. My friends were often my books and I read prolifically. They took me away to fantasy worlds away from the terrible present like the joints I smoke today. I would make dreams and stories for myself to escape the present and entertain my bored mind. Some children have imaginary friends but for me science and science fiction were enough.

From an early age I remember experiencing lows but not really knowing that they were bad. They felt bad but I didn't know that that it was something that could have been stopped. I got on with things and day after day would continue to function to the necessary measures, i.e. turn up to school, do the minimum amount of homework, eat, sleep and make sufficient social contact to get through my life. On the inside I'd be carrying the weight of depression and I just stumbled on through.

Loneliness became solitude as I grew used to it and learnt to appreciate it. I relied on myself as much as I could, hiding away my problems and developing the mask. I never stopped being weird but I managed to find groups of people that accepted me and disregarded or even enjoyed my uniqueness. I became able to find friends like that whenever, wherever and that's something that I'm thankful for because adult life has seen many crises where I've lost lots of friends.

There's a point to all this. Its that there can be a positive to the loneliness and solitude that comes with exclusion. Its not all good. Conquering the overbearing sense of self-reliance that came from having to rely on myself has been a struggle in adult life. Its made my recovery considerably longer and more arduous, but there is still a sense of pride derived from the challenge. I was a weird child and now I'm a very weird, mad, mentally ill adult and that comes with all sorts of scientific evidence that my life is disadvantaged because of my unusualness and I will die sooner. (The former is bareable because the lesson I've learnt is that sometimes its better to be different and true than happier and false and the latter is a pleasant thought.)

I'd originally started this piece with the line "I've committed the sin of hiding my madness". The information above is in my usual vein of attempting to see positivity in negative experiences. But the point I originally started to make was about changing stigma, openness and individual responsbility. I've clearly gone off on a tangent but its a worthwhile one.