Eccentric Flower talk:201103/Small Conclusions

Ysabel:

Disclaimer: I am not in any way telling you what you should do with your own body.

However, you don't understand how antidepressants work (there are a variety of mechanisms, none of which work like you describe). Don't pretend that you know something when you are full of shit. It looks petty.

-- 20:20, 15 March 2011 (GMT)

Columbina:

Fine. How about if I say I am extremely uncomfortable with the idea of ingesting any substance which alters my brain chemistry in any significant way? Will that pass muster with you?

(Yes, yes, caffeine and alcohol, yada yada, we can just take that part as read.)

-- 20:32, 15 March 2011 (GMT)

Ysabel:

That depends. Can you manage that without insulting pretty much everyone who is willing to try them (or, for that matter, who feels it appropriate to use any sort of pain med)? Because you failed pretty spectacularly at that the last time.

Are you similarly dismissive to anyone who uses glasses or other assistive devices? How about drugs for issues unrelated to brain chemistry?

-- 20:43, 15 March 2011 (GMT)

Mel:

like when I read a tweet from one of my friends, whom I will not name to avoid trouble

You realize, don't you, that this is not avoiding trouble at all - this is making everybody wonder if it's them you're talking about. Including, of course, me.

(I probably have other things to say about Japan, etc, but my brain chemistry is not letting me think right now. Or something.)

-- 20:51, 15 March 2011 (GMT)

Columbina:

I have never quite understood how the part where I say that *I* am uncomfortable with such things gets interpreted as saying that I'm uncomfortable with *anyone else* using such things.

I think I've stated many times that some people consider anti-depressants a lifesaver, and more power to them. If you are comfortable with that, and you find it good and useful, then great! More power to you. I don't know how to make that clearer.

Corrective lenses (as they say on the driver's licenses) and other assistive devices, wheelchairs, etc, are generally the only workarounds to the problem. I suppose with some kinds of eye conditions you could go for laser surgery, but that's a very specific and rare case where there's a physical correction that can be done. If you are missing both legs, we don't yet have the technology to do the most correct, best thing - grow you new legs.

The problem I have with any sort of fix to brain chemistry is that it feels like the wrong fix; that the solution is to get to what is causing the depression. Now, if your depression is purely chemical and has no situational causes, well, then, there's no "real fix" for you because we don't have the science to permanently alter your chemistry; better go ahead and go for the drugs.

However, I don't think that my depression, to the extent that I admit I have it, is chemical; I believe it is situational and DOES have specific causes - causes I would rather work on fixing.

Unfortunately, I feel that many of them have to do with the larger state of the world, and therefore are beyond my control; a hopeless, frustrating situation. But I am not comfortable with masking that situation; if the choice is "hopeless about things beyond my control" or "taking drugs to feel less hopeless about those things," I have to pick the former every time.

-- 20:58, 15 March 2011 (GMT)

Columbina:

Mel: I'm sorry, but I'd rather have several people wonder and be mildly annoyed than definitely piss off the person in question.

(P.S. It's not you.)

-- 21:00, 15 March 2011 (GMT)

Jette:

My husband has strikingly similar sleep issues. He's seeing a doctor and another medical professional and no one is suggesting antidepressants. Instead they are suggesting things like a morning walk in the sun, computer-free downtime before bed, and more "fun" downtime generally. (Turns out he has both sleep apnea and insomnia, and they are finally being addressed and treated separately.)

-- 21:02, 15 March 2011 (GMT)

Columbina:

Jette, sorry, I was actually thinking of the sleep issues as a separate issue and had nothing to do with depression, apart from possibly acting as a contributor. That is, my distaste for sleep drugs is a separate case from my distaste for depression drugs!

-- 21:05, 15 March 2011 (GMT)

Ysabel:

I state again: I have no problem with any decision you make about your own body.

However, if you plaster a wide swath of people with the sort of dismissive language, based on erroneous assumptions, that you did up above, I'm going to call you on it.

The thing about anti-depressants is, they don't make the sucky state of the world go away, and they don't actually make you happier, in the same way that morphine does not actually reduce your pain.

I think anti-depressants are a lie; they make you better able to function, but they plaster over symptoms; they don't actually solve the problem.

And even better:

"Gee, if I took brain drugs, I too could be that blithely, obliviously cheery most of the time."

I say again: you do not appear to understand how any of the classes of antidepressants actually work, and your words display a remarkable level of contempt for anyone who would choose to use them, based entirely (I suspect) on your misunderstandings of how they work. Your own words are not just about you not wanting to take them.

If you needed glasses and chose not to use them because "they don't actually solve the problem", that's just fine, even if your understanding of the situation is incomplete at best. If you, however, go further to characterize people who choose to use glasses with a series of negative adjectives, that's not so fine.

Your response to me continues to miss the point, and imply that depression is largely situational and that the idea that depression could be purely chemical is somehow rare or exceptional, and that's just not at all what the current state of medicine's understanding of depression tells us.

If your depression is purely situational, treat it however you like. Hell, even if it's not, treat it however you like, it's your life and your body. But belittling folks who're already coping with difficulties by shoring up every social stigma on the subject is not something I think of as cool.

-- 21:11, 15 March 2011 (GMT)

Ysabel:

(Also, frankly, I thought that if you'd bother to insult a whole class of someones you'd use something creative, rather than the same insult everyone else uses. That seems unlike you.)

-- 21:13, 15 March 2011 (GMT)

Ysabel:

As far as the medicine, there is a lot of evidence that being in depressing situations actually affects the brain's chemistry -- situational depression can turn into chemical depression very easily, and there seems to be some evidence that treating the chemistry can then help someone deal with the situational stuff using a wide variety of coping mechanisms by making those coping mechanisms more effective.

So the dichotomy you're using does not appear to be a real one. Real-world depression appears to be a good deal more complicated.

Again: I'm not telling you what to do, I'm just pointing out that you went a lot farther than talking about yourself, and you appear to be basing your negative words on incorrect assumptions.

-- 21:17, 15 March 2011 (GMT)

Columbina:

Because this is actually NOT an entry about depression or anti-depression or any aspects of the same, I don't think I should carry this discussion any further here. I still think you think I'm impugning other people when I'm not, but have it your way. I really shouldn't have put the item in at all, and I only did because I know that whenever I talk about what depresses me about the world, five people think, "Why doesn't C. just get drugs/psychotherapy already?" and I hate people thinking that, so sometimes I feel obliged to reexplain why. That is all.

-- 21:17, 15 March 2011 (GMT)

Columbina:

Also, where the hell is the argument about nuclear power that I was *expecting* to have to deal with?

-- 21:19, 15 March 2011 (GMT)

Ysabel:

Naw, I agree with you on nuclear.

-- 21:37, 15 March 2011 (GMT)

Mel:

The nuclear power piece is the part my brain wouldn't wrap itself around earlier. I guess the gist of it is that yes, this is going to make people rethink nuclear power again, and I'm honestly not sure if that's a good thing or a bad thing. Tangentially related to that is the conversation Anthea and I had this weekend about (among other things) the issues this has caused with Japan's petroleum refineries, which hasn't gotten discussed much, that I've heard. I guess what I'm really wanting to say is that what we all *should* be thinking about is all of our sources of energy and the various problems they cause, rather than just nuclear and its (very obvious) ones.

-- 21:37, 15 March 2011 (GMT)

Mrissa:

I think it's confusing many of us how you can *not* feel you're impugning others and are only talking about yourself when you use the terms you have above to discuss the effects of anti-depressants. Seriously. You phrase it in terms of the effects they have, and you are not currently taking them, so...the effects on whom? Have you advanced an argument for why your brain is fundamentally different from any other human brain?

Also, the Advil seems emblematic. You're feeling guilty about using it; fine, not my call. But if you think that you should be fixing it rather than patching over, well, aren't you...supposed to be...fixing...it? Yes? I have perhaps missed something here?

Or is it that you are dealing with all of these cases as though fixing exists in an ideal world situation, while you continue to function in the real world where your money for ergonomic improvements and your time for various exercises and massage/physical therapy are limited? As long as an ideal fix exists somewhere, that's the only okay one? Or am I missing something.

Also, I am disappointingly with you on nuclear power, nearly, so not the source of arguments. I object to the suffix -proof, because the world does not contain perfection. Leak-resistant is a lot more accurate than leakproof. But we are already doing much better than we could have been with things like the disasters in Japan because of very specific plant design improvements over a plant like Chernobyl, and we can do better yet.

-- 22:11, 15 March 2011 (GMT)

Medley:

"This is going to once again kill nuclear power in America"

I don't buy it. Poisoning the gulf this past summer didn't kill offshore drilling. Why do you think this is going to be any different. Oh, the *people* might complain (however informed or informed you think they are), but both the politicians who are bought by the energy industry and those (much fewer) who understand the energy supply/demand projections for the next 50 years have no incentive to kill nuclear and won't actually pay a political price for it (justified or not). So why?

Just today, Stephen Chu: "To meet our energy needs, the Administration believes we must rely on a diverse set of energy sources including renewables like wind and solar, natural gas, clean coal and nuclear power."

-- 22:55, 15 March 2011 (GMT)

Columbina:

Elsewhere, in direct chat, Ysabel, in her usual calm and gentle way, knocked me around with a 4x4 joist until I saw the error of my ways.

I know you're not going to believe this, but the scorn was inadvertent, and while I don't think I should go back and edit it now that it's out there, I do apologize.

(There was always going to be some dubiousness, because of my very muddled feelings on this ... but to use Ysabel's phrase, I was dispensing it with a backhoe while thinking I was using a teaspoon.)

My feelings on the whole depression matter are very, very tangled. I'm going to go a little further, because you asked me a question ... but I really do not blame anyone for not wanting to jump into this maze any further, and if you choose not to, that's fine.

First, the ibuprofen (we use generic in this house): the point was that I feel guilty because I should be fixing the problem, but am choosing to take the painkiller instead because it is an easier/faster fix. It is, as you say, emblematic, which is why I dragged it in (and why I'm mentioning it first here).

The problem with finding the "real fix" for whatever levels of depression I may have is twofold. First, I'm pretty convinced that depression is a normal reaction to the world. This is the part I thought I was discussing in the entry. Thus, fixing depression is imposing an abnormal state.

I realize that even that statement, which is much milder, may not strike you as scorn-free, because it is judging everyone else who has chosen that solution. Well, I can't help that. I figure that depression is really the only sane reaction to the state of the world, so if the world depresses me, I am acting sanely. Ergo ....

On the other hand, this may be a lie, because frankly, when I look at all my friends whose lives have improved because of anti-depressants, "scorn" or "condemnation" is definitely NOT what I feel. My actual feeling would be closer to "envy." It's not YOUR fault that choosing that path seems fundamentally dishonest to me. Maybe my reaction is pathological. You can think that if you like.

My point is that looking at the world and getting depressed does not strike me as a case for saying, "Wow, that person needs treatment," but because I am paranoid, every time I write about how much the world depresses me, I assume my friends are saying that where I can't hear them. And that disturbs me greatly.

But let's assume for a moment, just for the sake of argument, that 1) I am chronically depressed and 2) this is not a normal reaction to the world and 3) it is worth fixing. (We will leave aside the question of whether I would become a less interesting person on anti-depressants for now, but suffice to say it's a real fear.)

The second half of the problem is that there is a part of me that is severely, tremendously, go-throw-up-from-anxiety opposed to two of the main treatments involved: Psychotherapy and/or drugs. Drugs we have discussed, and as I've already said to two people this afternoon, a person who takes six months to work up the courage to schedule a routine doctor's annual visit is not likely to be able to sit down with a therapist anytime soon.

So, even if we stipulate need and desire to fix a problem here, I'm really not sure what sort of fixes for the problem I would find palatable.

But, eh, none of this is your problem.

Do take this away: If anti-depressants have improved your life, I really, truly bear you absolutely no ill will of any kind because of that. My dubiousness is entirely about my own self and the conditions inside my head.

-- 23:14, 15 March 2011 (GMT)

Columbina:

Medley: It is possible I am being overly pessimistic here (imagine!) but it seems to me that nuclear power has become such a Not In My Backyard thing in America that no politician is going to risk being a cheerleader for it.

-- 23:15, 15 March 2011 (GMT)

Ysabel:

FWIW, I would assert that indeed the sane reaction to the world as it is includes some measure of frustration, anger, sadness, and a host of other negative emotions. (And, incidentally, antidepressants don't usually change that.)

That said, I do not believe it should include depression. Depression is more than just that.

Yes, some of your behaviour is sometimes consistent with actual depression, but I so do not have enough information to make that diagnosis.

However, like I said in chat, I don't think denial is the right answer in any case. I can help you find information if you like, but I think information is the right answer, and at least initially doesn't require psychotherapy or drugs (though the information may well lead you to either or both of those, particularly since good psychotherapy is all about information). But you can't make an informed decision without information, and your fear is keeping you from looking (and incidentally allowing you to accidentally lash out like this).

All that said, all the information in the world won't do anything unless you really want to know, and there's a big chunk of you that still desperately wants denial to be the right answer. All I can say to that is that I empathize more than I can describe.

And thank you for the apology. I appreciate it.

-- 23:25, 15 March 2011 (GMT)

Bunny42:

I would like to suggest, Columbina, that you are calling innate pessimism "situational depression." As a pessimist, you make certain subjective generalizations which you consider to be facts, such as: there is something wrong in the fundamental American character. If you consider us fundamentally broken and are convinced nothing can be done about it, then I suppose you can be depressed. I just think you're a pessimist, and I don't see the terms as interchangeable. Chemical depression I can comprehend, but situational depression eludes me.

And, of course, I find your aversion to taking palliative drugs unfathomable. I believe firmly in better living through chemistry (legal chemistry, that is...) I can't understand having a pulled muscle and not wanting to take Advil. It's such a divergence in approach, I have to assume we're just wired differently and leave it at that. To each his own.

(FWIW, I took Zoloft for a time, after my late husband died. It did what I needed, which was to help me regain some emotional control, and then I didn't need it anymore. I didn't see it as a weakness; on the contrary, I found it to be a useful tool. To each her own.)

-- 00:14, 16 March 2011 (GMT)

Iain:

they knock out the body and not the brain.

So does that mean you stay awake but feel all logy and bleah? That would be unbearable, yes.

And no, I'm not going to comment on the entire depression/drugs/etc. thing, since people better equipped are doing it here.

I am shocked! Shocked, I tell you! Aren't you shocked? Of course you are.

Yes, I am shocked. So very shocked. Oh so shocked. There was never anyone as shocked as I am at this very moment. (I would say you should hear the previous statement as read by Ben Stein, but he's kind of a dick and you've probably heard my actual voice enough to figure out how I might actually say that.)

You would never in a million years guess all three, and I'm not going to tell you, not even Iain if he begs

You are evil and must be destroyed. (I will just assume that one of the types is the Bieberized Tom Brady and run from there.)

I'm just going to remind you that we are going to run out of oil and a lot sooner than any government in the world seems willing to admit. No one wants to be the first to take their kids off the tit. No politician has the will to be the first to deal with the screaming. But we're going to run out of oil, sooner than you want, sooner than you think, no matter how many cowards you pile up.

...You realize the oil issue isn't actually relevant to the nuclear power issue, right? Nuclear power is used to generate electricity, not drive cars. Most electricity in this country isn't generated by oil. The bulk of it is generated by coal (and yes, that will run out, too, but not as soon, and most of it isn't imported -- and those aren't the main problems with coal right now anyway) and natural gas (ditto), followed by nuclear. (More ditto, but irrelevant to my argument.)

I don't believe it's possible to design a disaster-proof, leak-proof, everything-proof nuclear reactor, but I'm also not willing to say that we should stop deploying nuclear reactors until we get that solved. Our demand/need for electricity isn't likely to drop significantly any time soon.

-- 00:59, 16 March 2011 (GMT)

ProfRobert:

I find it interesting that your complaints about the American Identity on a national level would appear to apply to you on a personal level: "The drugs and therapies are fine for others, but I am such a special flower that I can abjure them as a Big Lie and face reality without assistance. The experiences of others are irrelevant to me because they are Too Foreign for them to be applicable to me."

That probably came across as harsher than I intend, but I do want to give you a good, well-intentioned shake.

To add to what Ysabel said, I can't imagine any reputable psychiatrist prescribing drugs in the absence of some kind of psychotherapy. I can't speak to whether drugs would or wouldn't help you; I do think psychotherapy would, based on this phrase, "I don't like the other me's." That's not an acceptable way of living one's life. You either need to change what you don't like, or your need to accept and like what you retain. You need to have that Good Will Hunting moment, where you realize It's Not Your Fault -- a moment that I thought was ridiculous and contrived when I saw the movie, up to the point where I experienced it myself. In other words, it's not your view of the world that is problematic (except to the extent that you use it as an excuse not to address your own issues); it's your view of yourself.

As for ibuprofen and "fixing" your physical issues -- you're over 40. There is no "fixing" it anymore. It's only going to get worse as you get older. Ibuprofen (and I'd suggested naproxen if your discomfort is chronic) is not a pain-killer; it's an anti-inflammatory. Inflammation is the problem, and anti-inflammatories do not mask pain; they actually do fix the problem by reducing the inflammation.

-- 01:28, 16 March 2011 (GMT)

Medley:

ProfRobert said what I was going to say about ibuprofen. Getting old sucks - but bodies were not really designed to last this long!

And I say this as someone who also resists taking drugs, took my first antibiotic at age *32* (and promptly discovered I'm allergic to penicillin - oh! so that's what 'hives' are!) and also refused the codeine-laced tylenol after a c-section.

There are a lot of things I should be doing to reduce inflammation "naturally" but I have not yet managed to succeed at those and ibuprofen helps. Suffering to avoid an occasional anti-inflammatory is not something I have the time for. It feels like an indulgence.

(I have more on the larger point re the reality of the world and reactions to it... but that may be worth a post of its own....)

Oh, and re nuclear energy. On reflection I think I'm wrong - we'll get the worst of all possible worlds. NIMBY will mean no new plants, and the need for energy will mean we keep operating older and older plants/designs increasingly outside of their safety margins.

I do not consider those crying NIMBY to the be the problem. As in so many other things, what we have here is a failure of leadership. Over decades.

-- 02:18, 16 March 2011 (GMT)

Columbina:

Iain, while I agree I didn't fully fill in the links between nuclear power generation and the demise of oil, I stand by my statement. Although petroleum only is used to generate a fraction of the mains-service electricity in this country, what happens when the cars (and the jets and the trucks) run out of fuel? We are forced to find alternate sources for them. Put natural gas tanks on them? That cuts back the supply of natural gas for power generation. Give them batteries? Those batteries must be charged from mains power - more generation demand. Even if you decide to revert to the days of the steam engine - gotta burn something.

Put another way, power needs are power needs, and more or less fungible, and taking the oil out of the equation - no matter what is drinking most of it right now - creates a gap one way or another.

-- 03:20, 16 March 2011 (GMT)

Joy:

I'm just glad I have a big enough yard to stable horses. At some point I predict a resurgence of more-than-century-old means of transportation (along with a revival of subsistence living among the former middle class) as the fuel and equipment costs skyrocket, and supply goes down.

I'm actually profoundly uncomfortable with nuclear power plants, but I don't have an argument in me to express, really.

I did feel similarly as Ysabel about your original comments on anti-depressants, btw.

-- 15:47, 16 March 2011 (GMT)

Peebles:

I'm not uncomfortable with nuclear power. But (1) it's necessary but not sufficient to increase our use of nuclear energy, and (2) your belief notwithstanding, there's no design of a power plant that's disaster-proof.

The second point is easier to dispense with. You can't design a disaster-proof nuclear power plant. You can't even design a a disaster-proof combustion engine, and we've been working on that for a lot longer. Remember, the safety systems at the nuclear power plants in Japan responded the way they were supposed to when the earthquake hit. What we're dealing with now is the failure of the external power grid that run the backup system, and the destruction of the diesel generators that were the backups of the backups. There just isn't a way for limited human imagination to account for and prepare for every possible contingency.

There's also the slow, inevitable disaster inherent to the use of nuclear power. The spent nuclear fuel remains radioactive, but not radioactive enough to be useful for energy production. We still don't know how to process nuclear waste (although, of course, there's a lot of research towards that end). Right now, our solution is literally to stick it in the ground and hope nothing bad happens. (Like, OH AN EARTHQUAKE or something.)

So. Let me put on my scientist hat and address point 1. The current annual global rate of energy consumption is about 14 TW; about 80% of that comes from fossil fuels. If coal/natural gas/petroleum were to become unavailable tomorrow, we would have to make up more than 11 TW of power through other sources. The output of a nuclear power plant is roughly 500 MW; we would need to build over 22,000 new nuclear power plants to make up the difference. And that doesn't account for population growth, or for the projected increase in energy needs as the developing countries continue to industrialize.

It also doesn't take into account the fact that nuclear fuel is also a finite resource. So, any way you look at it, nuclear power is, at best, a stop-gap solution. We need to learn to use solar, which means developing inexpensive technologies that have better than the current 11% efficiency maxima and developing battery technologies capable of storing orders of magnitude more efficiently than anything we have now.

Either that, or we can just throw up our hands in despair, which is kind of what I feel like doing most of the time.

-- 12:57, 17 March 2011 (GMT)

Jweader:

Two things:

1. I recently learned that, in the US, it's the Republicans who are in favor of building more nuclear plants. I had always assumed the Democrats were in favor, from their "eliminate the oil dependency" plank. I guess the "think of the environment" plank took precedence. I don't know why this surprised me so much, but it did.

2. I think Japan is getting close to a Spock moment in dealing with their reactor crisis. The problem is, Spock was able to both make the decision and take the corrective actions necessary. In Japan's case, the decision-makers wouldn't be the ones who are actually sent in. Militaries send people off to war all the time, with no expectation that they'll come back. Civilian governments and the private sector don't usually have to deal with decisions like that. Would the Japanese government, or the Electric Company, be able to make the decision to send in a team in order to avert a larger catastrophe?

-- 16:58, 17 March 2011 (GMT)

Iain:

Civilian governments and the private sector don't usually have to deal with decisions like that. Would the Japanese government, or the Electric Company, be able to make the decision to send in a team in order to avert a larger catastrophe?

Well, technically speaking, civilian governments make those decisions all the time, if at a bit of a remove. After all, the military doesn't order itself into war. But the civilians who order the military into action do it knowing full well that many of them won't come back.

However, in the instant crisis, the decision for self-sacrifice seems to be getting made by the "Faceless 50" themselves. Possibly with the encouragement of TEPCo, but themselves nonetheless.

-- 05:48, 18 March 2011 (GMT)

Columbina:

Steven Syre in the Globe says today I am wrong and nuclear power was not actually on the verge of a rebirth in the US, but the problem isn't safety, it's cost:

Which is fine - until we run out of natural gas.

-- 13:16, 18 March 2011 (GMT)