Why a Covid-19 vaccine is probably closer than you think

Since the pandemic started, I’ve spent way more time than is healthy reading about it on the internet. I’ve read numerous news articles and discussion threads on all aspects of the Covid situation, and to be honest most of it has been pretty depressing. Everyone wants things to get back to normal in a safe way, but even now that we’re out of the full lockdown, the prospect of that happening still seems quite remote.

A vaccine would obviously be a huge step towards that (maybe even the only realistic way of achieving it), but most of what I read let me feeling despondent about the chances of it happening any time soon. After all, vaccines always take years to develop, don’t they? And even if they manage to do it quicker than that, it’ll mean they’ve cut corners on the safety testing. Anyway, we don’t even know if a vaccine for Covid-19 is possible – there’s no vaccine for any other coronavirus, no vaccine for HIV or for the common cold, and they’ve been around a lot longer. And wasn’t there that story about the guy who got Covid twice? Surely that means it doesn’t induce immunity, in which case how’s a vaccine going to work? Even if we do get one, we probably won’t be able to wipe out Covid – after all, the only virus ever to be fully eradicated was Smallpox and that took decades.

But then, during one of my information-guzzling sessions online, I stumbled across some communities that were very different from what I’d seen before. Communities that were largely made up of medical experts and where posts were strictly moderated to prevent people posting claims that can’t be verified from reputable sources such as academic journals. What immediately jumped out at me was how much more positive they seemed about the chances of a vaccine than most of the general public seem to be. Interested, I kept on reading, and soon discovered that all the pessimistic claims I made in my second paragraph, claims that I’ve seen repeated ad nauseum for months now, are actually untrue (or at least not particularly relevant).

(Or at the very least, the scientists who know most about vaccine development regard them as untrue, which right now is good enough for me).

I thought I would write this post to discuss some of the main Covid-19 vaccine myths and, hopefully, convince you that the picture isn’t nearly as bleak as we’ve been led to believe by ill-informed journalists and commentators. I’m not by any means an expert on this, just an intelligent and interested person who’s done some research and listened to the real experts. As such, if you are an expert on this and I’ve said anything untrue or nonsensical, please get in touch to correct me. If you are interested in doing further, more in-depth reading on this subject, the r/COVID19 sub-reddit is a good place to start.

On with the myths…

Doesn’t it take years to develop a vaccine? And wouldn’t it be unsafe to try and do it in less time than that?

It often takes a long time to develop a vaccine, yes. But this is actually less to do with safety than people think, and more to do with two other factors:

  1. Most of the “easy” diseases have already had vaccines for decades now, so what’s left is the ones that are harder to vaccinate against, and those inevitably take longer.
  2. For the Phase III trials, you have to wait for enough people in your test group to be exposed to the virus you’re trying to vaccinate against, so that you can see whether the vaccine protects them or not. For a rare virus, it can take a very long time for this to happen.

Neither of these reasons applies to SARS-CoV-2 (the virus that causes Covid-19). The reason we didn’t already have a vaccine for it is because it’s new, not because it’s particularly difficult to protect against (based on our current knowledge it seems that it should, in fact, be reasonably easy to produce a vaccine for). And waiting for people to be exposed to the disease won’t take too long in the middle of a pandemic either, because there’s plenty of it going around (at least in some places).

It’s a common misconception that Phase III trials take a long time because scientists are waiting to see if their vaccine causes weird, unexpected side effects years after it’s been administered. In fact, this sort of effect is extremely rare – vaccines do cause side effects, but they typically happen on a timescale of days or weeks. There is not really a plausible biological mechanism for a seemingly safe vaccine to suddenly start causing problems years down the line.

It’s true that certain changes have been made to speed up the vaccine development process, but (at least in the west) these are not things that affect the safety. For example, starting to manufacture millions of doses of a vaccine before it’s been fully tested is obviously a big financial risk that’s only worthwhile because the financial impact of Covid-19 itself is so enormous, but it’s not a health risk at all.

It’s also worth remembering that developing a vaccine in a period of months isn’t actually completely unprecedented – a new flu vaccine is developed every year to target whichever strains seem likely to cause the most problems this season.

We still don’t have vaccines for HIV, the common cold or any other coronavirus. Doesn’t that mean we’re unlikely to find one for SARS-CoV-2 any time soon?

HIV is a particularly nasty virus. It does all sorts of tricks like mutating frequently, hiding within a patient’s own immune cells, and so on, and it can’t naturally be fought off by the immune system. A vaccine is therefore likely to be extremely difficult. SARS-CoV-2, on the other hand, doesn’t do any of that stuff. It’s just a bog standard ordinary virus and there’s no reason to think it’s particularly difficult to vaccinate against.

It’s not completely true to say that we don’t have a vaccine for any other coronavirus – we actually do have vaccines already for some animal coronaviruses. The reason we don’t have any for the other human coronaviruses is less to do with it being particularly difficult and more that it just hasn’t been necessary. The original SARS and MERS were both brought under control through other means before vaccines could be developed, and the common cold coronaviruses are not really dangerous enough to be worth putting in the effort to make vaccines.

Most vaccine candidates fail, so we shouldn’t get our hopes up over the Covid-19 vaccine research.

Most vaccine candidates (about two thirds) do indeed fail… but they mostly fail quite early on in the testing process. Several of the Covid-19 vaccines have already reached Phase III trials, and historically the eventual success rate for vaccines that make it this far is about 85%.

Of course, we can’t take anything for granted yet. It’s still possible that all those vaccines could fall at the final hurdle. But at this point it’s really quite unlikely, especially since they’re based on various different technologies, so a problem that trips up one of them may not affect the others at all.

But do we even know if it’s possible to develop immunity to Covid-19? There were a few people who tested positive twice…

Some people have indeed tested positive twice, but this doesn’t mean that catching Covid doesn’t give you any immunity, or that it’s not possible to induce immunity via a vaccine. Everyone’s immune system is a little different and it’s normal for there to be outliers – for example, most people are immune to chicken pox after they’ve had it, but a few can catch it again. It’s not at all surprising that it’s the same with Covid.

More to the point, although some people are confirmed to have tested positive with Covid twice, I’m not aware of anyone actually having got ill with it twice. This suggests that although the virus was detected in their system a second time, they had enough immunity to prevent it from causing symptoms the second time.

I think a lot of the hysteria about whether immunity is possible or not is due to people not understanding how scientists communicate (and conversely, scientists not understanding how they come across to the general public). We’ve had instances of high profile scientists saying things like “There is no evidence that people develop immunity after having this virus”, and a lot of people freaking out and interpreting this as meaning “People probably don’t become immune after having this virus”. In actual fact, it’s likely the scientists meant something more like “People probably DO become immune after having this virus, because that’s what happens with most diseases and there’s no particular reason to think this one is any different, we just haven’t directly observed it happening yet”. There’s also probably been an (understandable) element of wanting to discourage people who’ve had the virus from disregarding the social distancing restrictions in case it turns out that they (or at least some of them) can still spread the virus even after recovering from it.

Even if we get a vaccine soon, it’s likely to be imperfect, and we’ll still have to live with Covid-19.

Whilst this is true, even an imperfect vaccine could be a total game changer. Even if a vaccine only prevented 50% of infections that would otherwise have happened (either because it was relatively weak in its effects or because not everyone was able to receive it), that would immediately cut the infamous R number in half, making it far easier to control the virus without needing the kind of draconian measures we’ve seen over the past few months.

There’s been a lot of talk about how the Oxford vaccine (one of the current front runners, which could be approved within two or three months if all goes well) didn’t prevent monkeys from contracting the virus, it only stopped them from getting seriously ill with it. Whilst it would obviously be preferable to get complete “sterilising” immunity from a vaccine (i.e. completely preventing people both from getting infected by the virus and from passing it onto others), it’s worth bearing in mind that:

  1. Even a vaccine that “only” prevented people from getting seriously ill would put us in a much better position than we’re in now. It would prevent numerous deaths and hospitalisations and relieve a lot of the pressure the virus has put us under.
  2. It’s fairly likely that people with less severe symptoms would also be less infectious, so they might still spread the virus less than they would have without the vaccine.
  3. The monkeys in the trial were exposed to extremely high levels of the virus, far higher than any person could ever be expected to come into contact with in normal circumstances. It’s entirely possible that, given a more realistic level of exposure, this vaccine might prevent people from catching the virus at all. We just won’t know until the trials progress further.

Lockdown Blog 1

I haven’t posted on here in a while… I think it’s fair to say that, back in the now very innocent seeming days of mid-2019, I did not expect my next post to be written from a country in full lockdown, forbidden from leaving our homes except for a few very specific reasons. I don’t think anyone else saw it coming either.

As I write this, we’ve been in lockdown for just over a week, and I personally have been working from home for just over two weeks. I should acknowledge right from the start that I’m in a pretty fortunate position compared to a lot of people: no-one close to me seems to have got the virus yet, I have a pleasant and secure place to spend lockdown with people I love, and I’m relatively safe from the financial effects of all this as well. I fully support the lockdown and I know that people suffering from the virus and those on the front line of treating it are much worse off than I am.

That said, I also think it’s important to acknowledge that this is an unprecedented upheaval for almost all of us, and that it’s clearly going to affect everyone one way or another. So I think it’s completely legitimate to talk about how it might affect our mental health and what might be good coping strategies, even for those of us not on the front line.

Speaking for myself, a few weeks ago when it started to become clear what was about to happen, I was utterly dreading it. Probably not an uncommon reaction, but I had particular reason to be worried. As I’ve mentioned in previous posts, I’ve spent a lot of my life (almost the whole of the first 15 years of adulthood, in fact) living with clinical depression and anxiety. Eventually I managed to get this mostly under control, but the only way I ever found to keep the depression at bay was to keep doing lots of exciting things to keep my mood up: folk dancing, solo foreign travel, urban exploration, taking part in the Beltane Fire Festival, and so on.

I’ve pretty much spent the last several years making sure I always had a few of those things lined up to look forward to within the next few months, and it has made a massive difference: to put it bluntly, the difference between life feeling worth living, and… well… not worth living. So hearing the news that none of these activities were going to be possible for several months, quite likely not for the whole of this year, I didn’t know what I was going to do. I felt as if, after years of thinking I’d never be able to walk again, I’d finally learned to hobble around with the aid of crutches, only to now be told I wasn’t allowed to use the crutches for the next several months. And I really, REALLY didn’t want to go back to the way I used to live my life before I found the crutches.

After that initial panic was over with, though, I feel like I’ve settled into a new routine a bit better than expected. It actually reminds me a bit of two previous periods of my life, in some ways at least. One is the time 18 months ago when my son had just been born and I was off work on paternity leave. All the usual rules and day-to-day routine just went out the window and suddenly there was only one objective: to survive each new day as it came. I don’t mind admitting that I had some pretty dark thoughts at times during those early weeks, wondering whether I’d ever get a decent (or even adequate) night’s sleep again, wondering whether I’d ever get my life back, whether I’d ever be able to do the adult things I’d once so enjoyed again or whether I was destined to sacrifice everything for this tiny little new person for evermore. (In the end it was nowhere near as bad as I feared and, while some stuff obviously has changed, I was back to sleeping OK and back to doing most of my activities within a few months).

The other period this reminds me of is when I was a child myself, in the sense that my horizons seem to have suddenly and drastically shrunk back to nearly where they were back then. As a child, almost my whole life revolved around my home, my school a short walk away, and nearby places like the shops and the green spaces where we would walk our dog. Going anywhere further afield, like to visit extended family, go on holiday, go for a walk in the countryside or even go into the city centre felt like a rare special treat in comparison. As for going abroad, I’d never been at all.

After I became an adult, the world seemed to open up: the city centre became somewhere I would go every day for work and often for multiple nights out per week; I would go for frequent weekends away, sometimes as many as two or three in the same month; everywhere within an hour or two’s drive could be visited on a whim just by jumping in the car on a day off; and I would go abroad, either for work or pleasure, anything up to four or five times a year. That became the new normal for me. Now it’s abruptly reversed and I’m suddenly back in that closed, parochial world of childhood again, only even more so this time.

Whilst neither of those past experiences were quite like what’s happening now, I feel I did learn some stuff from them that might help in the present. I’m trying to view the current situation very much like I viewed the early days of fatherhood: focussing on surviving one day at a time, not worrying about anything bar the essentials, and trying to keep the faith that things will go back to normal eventually. I’m also trying to remember the habits that got me through spending so much time in or near the house back in my teens: enjoying music, TV, movies and video games, being creative, and looking forward to the fun stuff I can do in future when the opportunities arise. I’ll probably write some more entries about specific things I’m doing (I’ve already got a few ideas) over the coming days and weeks.

Of course, it’s a bit hard to look forward to fun stuff in the future when we have absolutely no idea how long this is all going to go on for. I find myself really hoping that the government are going to follow the “hammer and dance” strategy set out in this very informative article, because that would mean only a few weeks of strict lockdown, followed by relaxing some restrictions and applying some more targetted and intelligent measures instead. But it’s hard to tell from the briefings whether this is their intention, and I’m not qualified to judge whether it’s even a viable plan at all. So I’m trying to prepare myself for the possibility that we might be locked in for much longer than that.

I’m struggling this year

In my last post I talked about how I thought it should be OK to share more about your mental health issues on social media and that there should be less stigma attached to it. I’m starting to realise, though, that I haven’t really been practising what I preached, and maybe it would help if I did.

The truth is that so far, I’m not doing so well this year. Over the course of my adult life I’ve had a lot of years (the large majority in fact) in which I haven’t done well in this respect, but 2018 is a bit different in that it’s come after a run of comparatively good years. Up until about Christmas last year I really thought I was starting to get this under control, but now I don’t know anymore.

(I should preface this entry by saying that I’m not about to do anything daft and irreversible, so please don’t worry about that. I’ve been through far worse than this for far longer in the past and I’m still here, so I doubt this latest down period is going to finish me off).

I’m not entirely sure what has made the depression start to come back, though I have a few ideas of what might have contributed. Being ill three times already this year certainly hasn’t helped; I feel like I’ve spent half of January and February either suffering from the cold or flu, or trying to recover and catch up on everything, and by the time the third virus hit I was getting seriously fed up with living that way. I also feel I haven’t been doing enough in the way of socialising or fun stuff lately, which usually doesn’t help either.

But in truth, while those things obviously haven’t helped, I think the problems run much deeper. I’m starting to question whether the progress I thought I’d made since about 2012 is really progress, or at the very least whether it might be built on much shakier foundations than I thought.

You see, the only thing that was ever really effective in making my depression go away was to find activities that excited me and do as much of them as possible. These included taking up Scottish Country Dancing, going hostelling in Europe and, probably most of all, urban exploration (which for a time was such a large part of my life that I made a second blog completely dedicated to it). At the time, doing all this stuff felt amazing and I didn’t waste much time worrying that it might not be the right approach to solving my psychological problems. For the first time since 1997 I wasn’t feeling dragged down by depression at every turn, and that was more than good enough.

The best antidepressant I’ve found so far

The trouble with using excitement to combat depression, though, is that for it to keep working, you need to keep on doing exciting things, and that’s not always easy. Life intervenes and the time, energy and money required are not always plentiful. More than that, no matter how amazing any activity seems at first, the novelty just tends to wear off a bit after a while. Take the urban exploration, for example. The places I loved exploring the most were the disused urban tunnels… but there really aren’t that many of them in Scotland. Once you’ve explored Scotland Street, Botanic Gardens and a handful of others, you’re left with ones that are either far too difficult or risky to get into, are a huge anti-climax compared to what you’ve already explored, or both.

I’m now wondering whether all I really did for the last few years was try to outrun my real problems, but now they’re catching up with me and I don’t think I’ve got the strength to run any further. “What real problems?” you might ask, and that’s understandable. After all, I’ve got a good job, a happy marriage and a nice house, and I haven’t suffered horrific abuse on a par with what some people go through. What right do I have to feel so depressed?

Well, the biggest problem is a constant feeling of being out of place, disconnected, and different from other people. It’s bothered me pretty much my whole adult life, other than fading into the background a bit during the last few good years. I experience it with almost everyone (I think I can literally count the exceptions on one hand), almost all the time, and it can get intense enough to make me just not want to be around people anymore. And I really don’t have a clue what to do about it 🙁 .

Over the years I’ve already exhausted the obvious potential solutions. Most people seem to think (and I used to as well) that if I just pushed myself to be sociable despite my discomfort, I would then realise that actually there’s no reason for me to feel out of place and the feeling would go away. But unfortunately it doesn’t, not even when I spend quite a lot of time around people and get used to them.

The worst thing about this is that it becomes a sort of vicious circle. The more I keep myself apart from other people, the more I don’t just feel different from them, but actually am different. For example, whenever any group of people around my age socialise together, it seems to be only a matter of time before the conversation turns to reminiscing about the great times they had at uni or in their teens. I don’t have any great times from that part of my life to reminisce about (the depression and social awkwardness was at its worst back then) so it makes me feel utterly alienated and depressed. So then I avoid that group, I miss out on yet more life experiences, and I feel even more out of place in the next group.

(Don’t get me wrong. I’m not saying there’s anything wrong with them reminiscing about that stuff. It’s obviously enjoyable for them and I’m certainly not going to ask anyone to stop it for my benefit. I’m just observing that it inevitably puts up a barrier between me and everyone else, one that I haven’t yet found a way to get past).

I suppose, since the simple and practical solution failed, all that’s left is to dive into the murky waters of my emotional mind and try to work out what the hell’s gone wrong down there. I have tried this in the past (in fact I once calculated roughly how much I must have spent on private therapy sessions over the course of my life, and it was quite jaw-dropping), but I think for various reasons I shied away from doing it properly. There are certain upsetting facts about my life, and more generally about how the world works, that I didn’t feel ready to fully accept, but I probably need to accept them if I’m ever going to conquer this.

Do I feel ready now? Frankly, no, and I strongly doubt I ever will. But maybe realising that’s what I need to do is the first step.

Thanks for reading.

Hostility to emotions, and the consequences

This post probably falls into the category of “cans of worms I probably shouldn’t open, but need to in order to stop them running round inside my head forever”. (Apologies for the horribly mixed metaphor there).

Not long ago I read an article about the shameful male suicide rate in the UK. I think the article was in the Guardian and I can’t find it now, but there are plenty of similar ones from the last couple of years, and they all make pretty grim reading: suicide is now the biggest killer of men under 45 in Britain, and the rate has been increasing. I don’t think it would be unreasonable to call this a crisis.

It’s not just a male problem, of course, but the suicide rate for men is around 3 times higher than it is for women. Intriguingly there doesn’t seem to be a correspondingly higher rate of mental illness in general in men, so naturally there’s been a lot of speculation about why that might be. Whilst I’m not of course claiming to speak for all men or to understand what all of them might be going through, I do feel that as a man who’s struggled with suicidal feelings quite a lot in the past, as well as spending a lot of time learning about mental health, I may at least be more qualified than most to stick my oar in.

The first thing that strikes me (and I’m aware I’m probably stating the obvious here) is that we have real problems with emotions in our culture. People aren’t just made to feel like they can’t express their emotions, which in itself would be bad enough; they’re often made to feel like they shouldn’t even have them at all.

You can see this attitude in almost any online debate, for example. Those raising concerns about how something might affect people’s emotional wellbeing are routinely ridiculed, dismissed as oversensitive snowflakes. Anyone who admits to experiencing negative emotions, no matter what their circumstances, is seen as weak and is brusquely informed that they just need to “grow up”, “man up”, “get over it”, “deal with it”, etc. (or worse), and that under no circumstances should they expect any help or support from others.

I can sort of see where this comes from, but for reasons I’ll go into shortly I think it’s a very flawed, irrational and destructive way of looking at the world. People defending this position are quick to point out that it wouldn’t be possible to have a world where no-one is ever upset by anything. Since everyone reacts differently to the world around them, we can only be directly responsible for our own words and actions, not for how other people might respond to them.

In this at least they are correct. It isn’t possible to engineer a society where no-one ever upsets anyone else, and attempting to do so would lead to serious problems, such as severe restrictions on freedom of expression. I also agree that it’s better if people have some measure of control over their emotions so that they don’t experience wild mood swings due to external factors they can’t control. But many commentators go much further than this, making various other assertions that don’t actually follow from that first one, and are in fact highly debatable. For example:

  1. That there is no downside whatsoever to upsetting people, so we don’t need to bother considering other people’s feelings before deciding to speak or act.
  2. That it’s possible and desirable for human beings to reach a state where they are no longer emotionally affected by other people’s words or actions.
  3. That when someone claims something has had a negative effect on them emotionally, they’re not genuinely hurt, they’re just being a crybaby and seeking attention, or trying to manipulate others.
  4. That people who are emotionally sensitive could quickly and easily become less sensitive any time they wanted, they just choose not to.
  5. That people who are emotionally sensitive just don’t have enough life experience, and a good dose of cold, hard reality will make them toughen up.
  6. That mental illness is some distant, mysterious, tragic thing that can’t be helped (or can only be helped by specialist treatment), and is not influenced at all by the way people treat each other in normal, day-to-day situations.

All six of these statements appear to be widely held beliefs, but I would dispute all of them. I suspect that many of the people espousing these beliefs are doing it because they want the world to work that way rather than because it actually does. I used to believe a lot of that stuff myself, back when I was badly depressed, and I used to think that attitude would help me get better, but as I described in my Safe Spaces post last year, it didn’t. It was a disaster. I think that’s why I feel so strongly about this… I hate to see vulnerable people being led down a path that might result in them experiencing years of needless misery, like I did.

“But”, I hear you say. “Isn’t your way just as bad, if not worse? Aren’t you just encouraging people to be self-indulgent, to wallow in self pity and demand that others walk on eggshells around them, instead of taking responsibility for their own lives?”.

No, I’m not. I’m encouraging people to face reality instead of denying it. In this case, the reality that human beings have emotions, that they’re an essential part of our existence, that we cannot live life to the full without them and that the things we do and say affect others whether we want them to or not. I know a lot of people are uncomfortable with emotions; they see them as troublesome, or childish, or mushy, or irrelevant, or effeminate, or whatever; but pretending they’re not there or pretending we don’t need them simply doesn’t work.

Whenever I think of someone trying to deny their emotions or bottle them up, I’m reminded of my old next door neighbour, whose solution to his water tank overflowing was to stuff plastic bags into the overflow pipe until the water stopped coming out. I never actually saw the end result of his endeavour since it would have played out inside his house, but I can’t imagine it ended well. Bottling up emotions tends to result in similarly bad consequences.

I think this is what a lot of people fail to understand. They present a false dichotomy between thoughts and feelings, with logical, rational, sensible thoughts on one side and hysterical, irrational, sentimental feelings on the other. They talk disparagingly about emotional people while seeing themselves as superior, rational beings driven by logical thoughts alone. But in reality, as Dr Jonice Webb puts it in Running on Empty (a brilliant book which I would totally recommend to anyone who’s struggling with their emotions, or even just finds this stuff interesting), the happiest and most successful people tend to be the ones who are comfortable with both their thoughts and their feelings, who have found a way to make both work in harmony, helping them towards achieving their goals rather than getting in the way.

I have read a lot of self help and psychology books over the years, some good and some bad, but Running on Empty puts forward one of the most helpful models for how emotions work and how to solve emotional problems that I have ever seen, and does it in a very clear and readable way. Here are some of the main points that I took away from it:

  1. Human beings evolved as emotional creatures, and there’s no getting away from that. Our emotions will always be there and trying to get rid of them isn’t a healthy or useful goal.
  2. Emotions are incredibly useful, indeed essential, for navigating the world. Every emotion is actually a signal trying to tell you something. Life works much better when you are able to listen to those signals and respond appropriately.
  3. Emotions are important and every emotion you feel is valid and acceptable. There are no “bad” emotions, only bad actions.
  4. Emotions that are expressed and out in the open are far less likely to cause problems, both for you and for those around you, than ones that are bottled up and denied.
  5. Many people do not learn good strategies for dealing with their emotions during childhood, for various reasons. This can lead to a range of problems later on in life: depression, anxiety, feelings of emptiness or not fitting in, even suicidal feelings in some cases.
  6. Being made to feel that your emotions don’t matter or that you somehow shouldn’t be feeling them can be particularly destructive.
  7. These problems can be overcome in adulthood by learning how to deal with emotions effectively, as well as other related life skills. Contrary to popular belief it is not “too late” if you didn’t learn this as a child. However, it can be difficult and time consuming, and some people may need external help to be able to do it.

This, to me, is a far healthier, more constructive and balanced set of beliefs than the ones I listed several paragraphs back.

This post is getting much longer than I intended, so I’ll try and wrap it up now. Getting back to my original point, I believe that at least one reason for the high suicide rate is the hostility towards emotions that’s unfortunately often displayed in our culture – especially if you’ve had bad experiences in the past, it’s difficult to cling to the belief that your feelings are important and that you’re entitled to feel the way you do when you’re bombarded with the opposite message several times a day. And I think the reason males seem to be more at risk is the old macho stereotype that men are supposed to be strong and stoic and not show emotion (and especially not “negative” emotions like sadness and fear).

If I’m right, though, what’s the answer? I don’t know. But I do think it would be a good start to at least acknowledge that emotions are, and always will be, central to our lives, and that living in a culture that’s hostile to them does have adverse consequences.

And we need to stop letting those who would have us do the psychological equivalent of sealing a dripping overflow pipe with plastic bags get away with claiming they’re the sensible, rational ones.

Casual ageism… and why it’s bad

This is another thing I’ve been meaning to write about for a while, and something I saw posted by a couple of friends on Facebook has spurred me on to finally do it.

I’ve always found it slightly curious that ageism often doesn’t seem to be taken very seriously compared to the other -isms. There are countless articles online about things you shouldn’t do once you’re over 30*, for example, and although many people do find them annoying, they rarely provoke more of a reaction than that. Yet just imagine the uproar if there were breezy lifestyle articles on popular sites entitled “20 Things Black People Shouldn’t Do”, or “10 Things Gay People Need To Stop Wearing”.

The difference in response just seems odd to me… after all, you can’t choose your age any more than you can choose your skin colour or your sexuality, so why should it be considered more acceptable to judge and pigeonhole people according to age?

(* Full disclosure: the specific article that got me thinking about all this again was actually entitled something like “30 Things Women Over 30 Should Stop Wearing”. Now, I’m not a woman so I don’t really feel qualified to talk about the sexist aspect of the article – why “women over 30” and not just “people over 30”? – but I still feel entitled to stick my oar in when it comes to the ageism. In any case, I’m not really going to focus on that particular article much, it was more just a catalyst that got me back to thinking about the whole issue).

The underlying message of that kind of article always seems to be the same: you’re 30 now, so your life is over. Stop pathetically trying to enjoy yourself and get in the box we’ve made for you.

Let’s be honest: I’m the sort of person who probably gives those article authors nightmares. I’m nearer 40 than 30 now, but I still go to gigs; most days I still dress pretty much the same way I’ve dressed since I started high school (jeans, trainers, T-shirt); I love going on roller coasters; I explore abandoned structures that I’m not supposed to be in, just for fun; I had a massive buffet of Haribo sweets at my wedding reception; I still go to dance events where most of the attendees are students; I hang out with people for whom a good party is one that involves stripping naked and running into the nearest body of water; I called my largely pointless blog “Gcat’s World of Stuff”; when I go travelling I stay in cheap hostels like a gap year student, not because I desperately need to save money (though that is a nice side effect), but because I feel more at home in places like that. In short, “acting my age” is not really a concept that exists for me.

Front row on Nemesis

Front row on Nemesis

I have zero intention of stopping doing those things any time soon. If and when I do stop, it’ll be because that’s what feels right for me at the time, not because I happen to have been alive for some arbitrary, meaningless period of time. Hell, I didn’t even start doing about half of that stuff until I was already over 30!

At this point you may be thinking “Hang on, it’s not fair to compare ageism with racism and sexism. It’s different, because everyone gets the chance to be young once, so it’s reasonable to judge people who failed to get the ‘young person stuff’ out of their system at an appropriate age, people who refuse to grow up and move on”.

And I, in turn, could respond by pointing out that not everyone does get the same chances when they’re young. Many people’s childhood and adolescence are blighted by abuse, mental illness, physical illness, or any number of other circumstances that might make it difficult for them to spend time on enjoyable activites. In my own case those circumstances included bullying as well as very long lasting depression and anxiety… and now that I’m finally making real progress on getting over all that, I’m damned if I’m going to miss out on having some fun at long last, just because it makes some judgemental idiots squeamish to see over 30s enjoying themselves.

But I think to go down that line of argument would be to miss the more fundamental point. I’d be trying to justify something that should require no justification, buying into the underlying assumption that I should somehow be ashamed of what I’m doing, that I should feel I have to make excuses for my behaviour. I don’t have to make excuses, because there is nothing to excuse: I’m not hurting anyone.

DSC_6428

I suppose people might argue that I’m hurting myself, though, and missing out on proper adult experiences by not acting my age. I disagree. I’m married, I work in a fulfilling and highly skilled job, I own a nice house and a nice car. I don’t think I’m missing out on anything… and I think the people who believe you need to stop doing what you love and start putting on some dull, soul-destroying act of “maturity” in order to succeed in the fields of dating and career are utterly, utterly wrong. You have a MUCH better chance of finding a partner or a job that’s right for you if you’re happy, relaxed and enjoying life than you do if you’re uptight, repressed and wasting all your energy on putting up a front to the world. Believe me, I know this from bitter experience!

It seems highly ironic to me that people who claim to value maturity so much are often the ones who judge others based on trivialities like what clothes they choose to wear or what activities they enjoy in their spare time. That doesn’t look much like mature behaviour to me… in fact that looks very much like someone who’s desperate to appear grown up to cover up the insecurities underneath, but lacks any understanding of what being grown up actually means. I’m reminded of the famous C.S.Lewis quote, “When I became a man, I put away childish things… like the fear of childishness, and the desire to be very grown up”.

But why does it matter?

You’re probably wondering why I chose to write a blog entry about this. After all, I could have just ignored it… I could have rolled my eyes, muttered “idiots” under my breath and moved on. And that is what I usually do these days, because if I let every ignorant comment get to me the way I used to, there wouldn’t be enough bandwidth on the internet to convey all the things I wanted to say back.

But this issue, I thought, merited a response, because I think it could easily turn into more than just an annoyance, to some people at least. I mentioned above that I was clinically depressed for a long time. There were a number of factors that helped me to get better a few years ago, but by far the most important one was re-learning to listen to my feelings and do things that would make me happy, regardless of what I felt I “should” be doing. In other words, it was mainly starting to do all of those supposedly age-inappropriate activities I listed above that finally lifted me out of the depression I’d been mired in for well over a decade.

Mattresses

In light of my experience, I think it’s downright irresponsible for anyone to be dishing out “advice” that amounts to telling people to give up on the things that make them happy. I’m sure the article authors would retort that they’re not forcing anyone to take their advice, and that’s true; but knowing what it’s like to be in a deeply depressed and vulnerable state, I suspect that the people who are least likely to be able to brush off things like this are also the most likely to be damaged by them. Of course some vapid, click-bait list that even the person who wrote it probably doesn’t really believe isn’t going to ruin someone’s life in itself, but I can easily see it pushing someone over the edge if they’re already in a precarious state. So I stand by what I said: it is irresponsible.

But then I’m 36 and I still wear trainers, so I suppose that disqualifies me from talking about responsibility anyway.

In defence of “Safe Spaces”

Also, why a broken brain is a bit like a broken leg. And why I’m suspicious of people who don’t like trigger warnings. I’ve been meaning to write this post for a while… but recent events have made it feel a lot more pressing, to the point where I felt like I wouldn’t be able to rest until I’d written it out, just to stop it from bouncing around in my head.

Lately, “Safe Spaces” are coming in for a lot of criticism online. The discussion around them generally seems pretty one-sided: the anti-safe space side tend to set themselves up as the voices of reason, staunchly defending free speech and all that is rational from the hysterical, hand-wringing, over-emotional, politically correct do-gooders on the other side. I don’t think this is right, for several reasons. In this piece I’m going to argue that there are good, logical reasons to support safe spaces, and that some of their vocal opponents who appear to pride themselves on rationality and pragmatism are actually being quite irrational and idealistic.

 

What are “safe spaces”, and what’s wrong with them?

First things first: I’m aware that not everyone might be familiar with the term “safe space”… so what is a safe space? Basically, it’s when a group or institution has a policy that tries to make certain groups of people feel safer and more welcome by disallowing conduct that those people might find threatening or anxiety provoking. (I know that’s not a fully comprehensive and correct dictionary definition, but for the purposes of this blog it will do). These groups may include lesbian, gay, bisexual and transgender people, sufferers of mental illnesses (such as anxiety disorders and Post Traumatic Stress Disorder), members of ethnic minorities, survivors of various sorts of abuse, and so on. (From what I’ve read online, it seems safe spaces may have originated as homophobia-free spaces, but I’m going to talk about them more from the point of view of mental illness sufferers, since that’s where my personal experience is). For this blog post I’m going to draw on the Safe Space Policy of my local students’ association as an example – I don’t think they’ll mind as it’s posted online in a publicly accessible location, but if it is a problem please contact me and I’ll remove any references to it.

Skimming through the safe space policy (it’s only 3 pages long), the first thing that struck me was how basic and uncontroversial most of the points are. They’re things you’d hope civilised adults would do anyway without having to be told. You could pretty much sum the policy up as “Don’t be a dick” (in fact, one organisation that I know of actually does sum up its policy using those four words!). The main points are: don’t discriminate against people on the basis of factors such as age, gender, sexuality, race, disability, etc.; don’t talk over, interrupt or heckle people during meetings, or make rude gestures; be respectful towards other people. That’s about it.

Given how straightforward and benign the policy actually is, why do “safe spaces” generate so much animosity? From what I’ve seen, the main arguments against them boil down to: 1. they restrict free speech; and 2. they mollycoddle people who should be facing up to the realities of the world rather than being shielded from them.

I’ll talk about the free speech argument first. I think a lot of this stems from people misunderstanding what safe spaces actually are. You see a lot of ranting online about “special little snowflakes who can’t cope with hearing opinions that are different from theirs”, but this view doesn’t seem justified going by the safe space policies I’ve read. Both the policies I have open right now are very explicit that expressing differing opinions is fine, even something to be encouraged. It’s expressing them in disrespectful or intimidating ways that’s a problem. In fact, surely in some circumstances safe spaces could actually increase people’s exposure to different points of view, by allowing people to take part in debates who might otherwise feel too anxious or uncomfortable to participate.

And while I would agree that national governments clamping down on free speech would be worrying and should generally be resisted, the clubs and societies setting up “safe spaces” are not governments. They’re independent organisations and as such they have every right to decide for themselves what sort of behaviour they’re willing to accept at their meetings and on their premises, and people who don’t like their decisions have every right to go elsewhere or even set up their own organisations with different rules instead.

It strikes me that the sort of conduct that’s typically prohibited in safe space policies has also been prohibited (in practise, if not in any formal written document) in many work places for decades without anyone really batting an eyelid. Most people wouldn’t expect to be able to go to work and heckle their boss during meetings, flip them the V-sign, or make racist and sexist remarks without any consequences. Yet when a voluntary or educational organisation tries to hold its members to the same standards and calls it a “safe space”, certain people go nuts about it.

 

The other argument is, I think, more complex and more interesting. Let me tell you a story about how I tried to overcome some of my own difficulties, and in the process completely changed my opinion on the subject of “mollycoddling”…

 

“Tough love”, and why it doesn’t work, no matter how much you’d like it to

Many years ago now, I joined an internet support forum for people with certain mental disorders, having been struggling with depression and anxiety for a while. One of the most heated debates that would rage on the forum from time to time was what I’ll call the “free speech vs. mollycoddling” debate. On one side were the people who felt the forum should be strictly moderated to remove personal attacks and other things that members might find upsetting; on the other were the people who felt it should be mostly left unedited and shouldn’t try to shield people from reality. (The poor moderators, of course, were caught in the middle of this and couldn’t win no matter what they did… either way, whether they deleted abusive posts or left them up, lots of people were unhappy about it!).

At the time, I was firmly on the “free speech” side. Although I was in a very low and unstable state emotionally and frequently did find posts on the forum upsetting, I felt it would be counter-productive for those posts to be removed – after all, if I was ever going to get better (and I wanted to get better more than anything), I would have to get used to the things I found difficult… what was the point in avoiding them?

Most of the anti-safe space commentators seem to take a similar view to this. If they do ever give advice to people who are struggling emotionally, it tends to be in the form of a curt “get over it”, “man up”, “grow up”, “pull yourself together”, or “stop being pathetic”. Let’s be charitable for the moment and assume that this really is intended as advice (“tough love”, if you like) rather than as kicking people who are already down: what would it look like to try and follow that advice? Well, that’s pretty much what I tried to do all those years ago, so let’s return to my story.

For years, I pushed aside my bad feelings as best I could and just got on with life. I forced myself into situation after situation that I hated and really wasn’t ready for. When I found things online that upset me, I didn’t avoid them, in fact I would keep reading them for hours at a time, looking for other similar things, convinced that no matter how painful this was I would eventually become desensitised, eventually become a man, become an adult who could deal with anything life could throw at him without flinching. I did the same in real life as well: I kept going back into situations and social groups that all of my feelings were telling me were completely wrong for me, but I ignored them and did it anyway. After all, feeling were for wimps, for people who thought they were “special snowflakes” and deserved special treatment, right? I wouldn’t need them anymore once all my hard work finally paid off and I became a Real Person, fully pulled-together, manned-up and no longer pathetic.

Although I did hear alternative, less extreme suggestions for things that might help me from therapists or self help books from time to time, I ignored everything that didn’t fit my preconceived narrative and carried on with my plan. I knew it had to work eventually if I could just keep going for long enough!

But… it didn’t work. It never could have worked, not if I’d kept at it for 50 years. I can see that now.

After several years of this, I still wasn’t feeling any better… in fact with hindsight I can see that I was actually in a much worse state than I had been before I started trying to get better. Although the intense anxiety had mostly gone, it had been replaced by a constant, never-ending morass of depression, resentment and apathy. I’d lost the ability to enjoy anything, even things that used to really excite me. I seemed to have lost the ability to feel sadness as well – losing two close family members had frighteningly little effect on me. So in a sense, I had got what I’d thought I wanted – I had lost most of my feelings, but it hadn’t made me better. It had just made life feel like a pointless, soul-destroying drudge.

At this point you might be thinking “Whoa, whoa, whoa! You can’t blame that on people who said harsh words to you! They may not have been very helpful, but they didn’t force you to do all that!”. And no, I don’t blame them, not entirely at any rate. But my point is: if your only advice to people who are struggling badly is along the lines of “grow up”, or “get over it”, what do you expect them to do with that? It’s not exactly much help, is it?

Maybe you think those people aren’t really struggling badly but are just acting out for attention, and need to be shown that they’re not going to get any sympathy for it, then they’ll stop it. But here’s the thing: some people really are struggling badly, probably far more of them than you think, and being overly harsh with them is not just unhelpful, it can be intensely damaging.

 

If tough love doesn’t work, then what does?

Well, that all got a bit intense and gloomy, but keep reading, it’s about to get better. I’m happy to report that I did eventually find a way to reverse the damage and I’m now well on my way to recovery. In order to explain what worked for me, and why it’s even relevant to the topic of this blog entry, I’m going to use an analogy with physical illness and injury, something that I find is often helpful when trying to explain mental disorders.

Rather than viewing my emotions like an adversary that needs to be crushed because it’s too pathetic for any kind of redemption, I prefer to look at my “broken brain” in much the same way as I’d look at a broken leg. Just as a broken leg can’t perform its normal functions of holding up the body’s weight, walking, and so on, a broken brain can’t necessarily cope with things a normal brain would be able to. But there’s no point getting judgemental about either of them – they are what they are, and hurling abuse won’t change that. Calling someone with an anxiety disorder “pathetic” won’t stop them being anxious any more than calling someone with a broken leg “pathetic” will make their leg instantaneously mend itself.

There are quite a lot of similarities between the two. Broken legs can heal, given time and the right treatment… and so can broken brains! But time and treatment are both crucial here. What I was doing in the past when I kept pushing myself into difficult situation after difficult situation with no respite was the psychological equivalent of getting up and trying to run across the room on a broken leg every five minutes – it not only puts you in a lot of unnecessary pain, it also disrupts the healing process and puts you back to square one (or worse) every time. One day, if you give your leg a chance to heal, you’ll be able to walk again, and you might even be able to run a marathon on it. But that day isn’t going to come if you don’t let it heal properly first.

Further trauma doesn’t help either broken legs or broken brains. Trying to help someone “get over” a mental disorder by being harsh with them is a bit like trying to help them get over a broken leg by hitting it with a sledgehammer (and then acting like they’re the one who’s out of order when they don’t immediately leap out of their wheelchair fully cured).

The key in both cases is to take small steps, baby steps if necessary. It may take longer, but in the long term it’s a much more reliable way to get better than overreaching yourself and potentially making things worse. During this process, it’s a good idea to listen to the signals coming from your leg/brain. A little bit of pain and fatigue is to be expected if you’re doing something you haven’t done in a while or that you find particularly difficult… but if it’s screaming at you that you’re going to collapse if you don’t take the weight off it right now, you should probably listen to it. One of the most valuable lessons I ever learned was that I could listen to what my feelings were telling me and use them constructively to get more of what I wanted in my life, rather than trying to shut them out.

In both cases, you might need professional help in order to get better (a physiotherapist for your leg, a psychotherapist or counsellor for your brain), but there’s no shame in that.

In both cases, you need a combination of rest, and gently pushing yourself when you’re able to. You need to push yourself sometimes or you won’t make any progress, but the resting is just as important, because your leg/brain needs time to recuperate if it’s going to build up its strength again. Back when I was pushing myself way too hard, I was keeping my brain in a highly stressed and anxious state pretty much the whole time. When it’s in that state it’s just focused on surviving – it’s not receptive to making the kind of constructive changes required to recover from a mental disorder.

(I’m still bad for pushing myself too hard and too fast and not taking enough time to rest. I’m a lot better than I used to be, though, and it shows in terms of the progress I’ve made recently).

Finally, depending on how badly damaged it was, a broken leg or a broken brain might never quite heal 100%. You might still get twinges of pain from it years later, or you might still have trouble coping with situations that other people manage more easily.

 

Nice, but what’s this got to do with safe spaces?

Viewed in light of the “broken brain/broken leg” analogy, safe spaces become not places to hide away from reality forever, but places to build yourself up ready to face it. They can be wheelchairs and crutches for the broken brain, until it’s ready to walk unaided. In my experience, being able to take gradual steps towards coping with more and more situations is absolutely critical to overcoming an anxiety disorder, but that is only possible if there are relatively non-threatening situations available to start from, as well as places where it’s safe to switch off for a while and relax without having to worry too much about people doing things that trigger your anxiety. The people who advocate removing safe spaces and making everywhere harsh and unforgiving are, whether it’s their intention or not, advocating creating a much more difficult world for people who want to recover from psychological problems.

You might say “Well, it’s not the job of a university to provide that sort of space. The sufferers should create that space for themselves with help from their family, friends and therapists”. The problem with that is that not everyone has supportive family or friends, or access to therapy. Even the ones that do could probably benefit and make faster progress by having more places they can feel safe.

Or you might be thinking “Fine, if everyone used safe spaces that way I wouldn’t have a problem with them. But most of those people have clearly got no intention of getting better, they’re just hiding away in the safe spaces, avoiding things that make them feel uncomfortable”. In response I would say: how on earth can you possibly know that? Are you close friends with everyone who uses a safe space? Do you know the intimate details of all their lives, so that you know which ones are trying to get better and which aren’t? Or are you just looking at them and making a sweeping judgement that happens to fit your world view, based on very little actual information? I find it highly unlikely that anyone is “hiding away” in a safe space… safe spaces make up such a tiny proportion of the social world that it would be virtually impossible to live your life completely within them.

In any case, I don’t see anything wrong with spending some of your time in safe spaces even if you’re recovered or mostly recovered. It’s just nice to relax in situations where you don’t need to worry too much about getting hassle from people. Think of it this way: you may not need a wheelchair any more once your broken leg’s healed, but that doesn’t mean you’re never going to sit down in a chair again, does it?

 

So what about “trigger warnings”?

“Trigger warnings” are when people put a note at the start of a piece of writing (usually an online post of some sort) warning about any content within that certain groups of people might find upsetting – for example, references to child abuse, or homophobic terms. The idea of them seems to generate a lot of derision from the same sort of people who dislike safe spaces.

To be honest, while I can just about understand the “free speech” argument against safe spaces (although I don’t agree with it), I’m really struggling to get my head around how anyone could rationally object to trigger warnings. They don’t stifle free speech, in fact they don’t do anything at all unless you let them! No-one is going to force you to put them on your own writing, or to take any notice of the ones other people have put on theirs. They’re like the “May contain nuts” warning on a chocolate bar – if you don’t have a nut allergy, just ignore it and move on with your life.

The fact that so many people object to trigger warnings despite their total innocuousness makes me question their motives… for all the lofty talk of defending free speech, I can’t help thinking that for a lot of people this is motivated more by contempt (or even outright hatred) for groups they perceive as weak and undeserving. They hate trigger warnings because they hate the thought of those people being given the tools to avoid something that might upset them and take control of their own recovery. They’d rather watch them suffer and fail than have them be able to make their own decision about whether reading a particular article at a particular time would be beneficial for them or not.

 

Why we can’t just go back to the “good old days”

You know, the good old days when men were men, and although life was harder, people just got on with it. They didn’t complain about their situation, and they certainly didn’t go and get themselves diagnosed with a mental illness, or rely on medication to get them through. They just stiffened their upper lip and carried on.

You don’t have to look too far to find sentiments like this expressed online. In fact some variant of this opinion tends to come up in pretty much any discussion involving mental health sooner or later. It seems to be a commonly held belief that mental health problems are over-diagnosed these days; that some of the supposed illnesses aren’t even real health issues at all, just people being lazy or weak; that people in the past were much stronger than today’s cry-babies; that we as a society are medicalising things that shouldn’t be medicalised; that drugs such as anti-depressants are prescribed much too freely to people who don’t actually need them at all.

In this piece I will argue that this way of thinking is misguided and, in fact, quite self-centred.

Actually, that’s not entirely true… there are a couple of points there that I sort of agree with. Firstly, the over-reliance on drugs: I do think there is too much reliance on anti-depressants for treating depression and related conditions, but not because I don’t think the recipients need treatment: rather, because I don’t think drugs are the right treatment for everyone, and tend to be prescribed a lot because they’re relatively cheap and simple (compared to, for example, long term talking therapy) rather than because they’re actually the most effective.

And secondly, I think it would be great if there was more tolerance at all levels of society of people who are different in some way, rather than immediately labelling someone as having a problem and needing treatment just because they don’t fit in with those around them. This would undoubtedly have a very positive effect on many people’s mental health, but it wouldn’t eliminate the problem completely.

The other points, though, are nonsense, and destructive nonsense at that.

For a start, let’s lay to rest any notion that today’s mental health problems didn’t exist back in the 1940s, or 50s, or Victorian times, or whenever this supposed golden age of stoicism is meant to have taken place. Of course we’re never really going to know for sure how many people were suffering from clinical depression, or social anxiety, or ADHD several decades ago, because there wasn’t really any awareness of those conditions back then. But what we do know for sure is that a lot of people ended up killing themselves, or turned to destructive coping strategies like alcohol or drugs, or spent their lives locked away in grim asylums. The same problems that we have today almost certainly existed, and wreaked the same havoc on people’s lives that they do today if left untreated. The only difference is that people back then didn’t talk about how they were feeling or have a name for it.

Of course, a lot of people did just “get on with it”. They didn’t have any other choice, because often their conditions weren’t well enough understood to be diagnosed, and even if they were there wouldn’t be any effective treatment available. A lot of those people would have lived pretty miserable lives, constantly battling demons in their own heads and getting no help or understanding from those around them. But is it reasonable to demand that people should do that now, just because that’s what people had to do in the past? The situation has, after all, changed dramatically. We understand mental illness a lot better than we did even a few decades ago, and there are treatments available that can relieve or even cure many conditions. To me, saying that the mentally ill shouldn’t get help now because their ancestors had to go without is as pointless and cruel as suggesting that people undergoing major surgery should do without anaesthetic, because that’s what people had to do before anaesthetic was discovered.

Even if there has been a genuine increase in the incidence of mental health problems in recent decades, it doesn’t follow that it must be because people now are somehow “weaker” than in the past. Whilst many aspects of life have undoubtedly got a lot easier and more comfortable in the past 50 or 100 years, that doesn’t automatically mean that everything is becoming more conducive to good mental health. The human brain evolved to live in small hunter-gatherer tribes, but that society has been turned upside down in a remarkably short timescale, the blink of an eye in evolutionary terms, and the pace of change shows no sign of slowing. Although most people would probably agree that the changes are largely for the better, if you look at the bigger picture we really haven’t had a lot of time to adapt – it doesn’t seem at all surprising that some people are struggling.

I think a lot of the antipathy I was describing at the start stems from people not really understanding how and why mental health problems are diagnosed. They’ll read a description of, for example, social anxiety and think “That’s just shyness! It’s ridiculous that people are being given therapy and medication just because they’re shy! They just need to get over it!”.

It’s true that social anxiety does have a lot in common with shyness… but the key deciding factor between the two is more about the impact on someone’s life and happiness rather than any innate biological difference. One person might be quite happy with being shy and mostly keeping to themselves, and in that case no-one is going to force them to label themselves as “clinically socially anxious” or to accept treatment for it. But another person might find their “shyness” to be seriously getting in the way of what they want to do with their life and causing them a lot of distress (like I did), and feel powerless to change it on their own, in which case they would probably welcome the chance to get some help. This seems entirely reasonable to me – I don’t understand why anyone, other than a terminally grouchy misanthrope, would object to someone getting treatment for a condition that’s massively impacting their quality of life, even if it’s not something that would have historically been considered a medical problem.

It’s true that the bar for a diagnosis of depression or social anxiety might be set lower than you’d expect: I’ve seen estimates that a full 7% of adults are suffering from clinical social anxiety at any one time, and 25% of adults will experience some form of mental health issue in any given year, which does sound a lot. But there’s a good reason for this, namely that even relatively mild cases of these disorders can cause a huge amount of disruption and distress to sufferers. As Dr David Burns says when talking about a scale for measuring levels of depression in his famous book Feeling Good, “Don’t be fooled by the term ‘moderate’. A score in this range can indicate pretty intense suffering”.

And I’ve always remembered something similar that was once said to me about social anxiety: “‘Mild’ social anxiety isn’t necessarily mild in terms of its impact on your life. It can mean, for example, no love life” – in fact, in my case that was exactly what it did mean. My social anxiety was “mild” compared to some people’s in the sense that I was able to leave the house and (mostly) function day-to-day, but even a mild case was enough to essentially close off an entire area of life (and, I think most people would agree, a pretty important and rewarding one) to me until I had treatment to bring it under control.

I find it quite disturbing that so many people seem to think they are qualified to decide whether others have mental health problems or not, whether they deserve treatment or not, despite having next to no knowledge or experience of the subject themselves. Personally I would rather trust the professionals who’ve dedicated their lives to studying and treating psychological disorders, and the direct experience of the people who live with such disorders every day, but it seems as if there is a growing distrust of experts in all sorts of fields lately (climate science being another big one just now). Thing is, it’s fine to be sceptical. It’s fine to research things yourself rather than just blindly believing whatever you’re told. And it’s fine to acknowledge that so-called “experts” have been spectacularly wrong sometimes in the past. But what’s not so fine is starting from a position of assuming that the experts must be wrong, assuming that they’re either incompetent or corrupt and that you know better, based on no evidence whatsoever, just because you don’t happen to like the implications of what they’re saying. Science may not be perfect, but it’s still far and away the best tool we have for understanding the world and making it a better place.

Ultimately, I think the people wishing we could go back to the “good old days” before mental illness existed are being very selfish. Because there never were any such days. What most of them really mean is “I wish we could go back to the good old days when I didn’t have to think about mental illness, when sufferers knew their place and kept their mouths shut, before they started getting all uppity and wanting to talk about their experiences, wanting people to understand and help them”.

Or, to put it another way, “I want ill people to suffer in silence so that I can maintain my comfortable illusion about how the world works”. Well I’m sorry, but it ain’t gonna happen.

Couch to 5K: my experiences

I’d normally be going for my Tuesday lunchtime run about now, but I think I’m getting a cold so I’m going to skip it in case the exertion makes it worse. So I decided the next best thing would be to write a blog about running instead… maybe I’ll get slightly fitter by osmosis just from thinking about exercise? … OK, maybe not, but I’m going to write this anyway.

c25k

I started the Couch to 5K plan back in late May, in the hope that regular exercise might help me not to feel so tired all the time, as well as a vague sense that it would be nice not to be dying from preventable health problems before I hit 60. For those of you that haven’t heard of it, it’s a beginner’s running programme designed to do exactly from the title says: get you from not running at all to being able to run five kilometres, in the space of only nine weeks.

The programme appealed to me, firstly because by the sound of it it’s designed to be achievable for people even less fit than I was at the start; secondly because I could do it outdoors and wouldn’t need a gym membership (I find gyms expensive, uncomfortable and boring… I’d much rather brave the weather, even in Scotland); thirdly because I could do it myself with the aid of just a phone app. I wouldn’t need to join a group or anything, which I didn’t feel like doing yet – I didn’t want that level of commitment or pressure.

So I downloaded the NHS Choices Couch to 5K Android app to my phone and got started. The app is designed to be listened to on headphones while you’re running, with someone called Laura telling you what to do (nothing like my normal life, then… har har). I believe you can also get the programme in the form of MP3s that you can listen to, but the app has a few advantages, such as being able to track how many runs you’ve done, and showing a countdown clock on the screen so you can easily see how long you’ve got left in the current run.

The app mostly seemed pretty good, though I think it must have been pretty new when I started, as there were a few quite major bugs: the countdown timer ran at the wrong speed when the phone screen was off, so to begin with I had to run with the phone in my hand and the screen on the whole time, needlessly draining the battery. Then later on, the app started to crash every time I completed a run. To the developers’ credit, they did fix both of these issues within a few days, and it seemed a lot more stable after that.

But enough about the app… how was the actual running? Surprisingly painless, actually. As I was pretty unfit, I’d expected Couch to 5K to be much more of a struggle than it turned out to be. I think the level of build-up must be set just right as I didn’t have serious trouble with any of the weeks, not even week 5 where the length of time spent continuously running suddenly jumps from 8 minutes up to a very daunting 20 minutes in one go. At first I thought it was strange that the programme reaches 20 minutes with a full four weeks still to go and then ramps up to 30 pretty gradually after that… at the beginning I thought, “surely once I can run 20 minutes non-stop, 30 minutes can’t be that much harder, so why take a full 4 weeks to get there?”. But I think it does make sense; the purpose of the programme isn’t to get you to struggle through a 30 minute run once and then collapse in a quivering heap moaning “That’s it, I’m never running again!” – it’s to make 30 minutes actually seem manageable and give you some confidence in your ability.

The most difficult bit was actually finding the motivation to go out running three times a week and not getting distracted by other things. Once I was actually out there and got going, I almost always enjoyed it. Overall I managed to fit the runs in around the rest of my life quite well, even though I was doing a lot of travelling over the weeks of the plan – I ended up doing runs in Berlin, Glasgow, Frankfurt, Heidelberg and Ghent as well as at home. The only thing that majorly disrupted me was an illness that struck when I had nearly finished (I think I had just started week 8) and then dragged me down for several weeks before I was finally rid of it. At that point I did what the instructions suggested and backtracked a couple of weeks, but I was able to build my momentum back up reasonably easily, and then went on to finally complete the programme. Since then I’ve managed to keep up running for around 30 minutes three times a week, a big improvement on the level of exercise I was getting previously.

Overall, I was pretty happy with Couch to 5K, which succeeded in getting me running greater distances than I would have imagined possible. I’ve definitely noticed an improvement in my general fitness – at Alton Towers, a few of us decided to sprint uphill to the Nemesis queue line to try and ride it one last time before it closed for the night, and a few months ago I know that by the time I got there I would have been doubled over and feeling like I was about to die. But as it was, I felt fine, not even particularly out of breath.

One slight disappointment is that I haven’t lost any weight since I started running, though it’s only a slight disappointment because weight loss wasn’t really my motivation for doing it. I suspect that to lose weight I’d need to actually cut back on what I eat as well as exercising – I’ll probably get round to it one day, but for now I’ve decided there are other priorities, and that I’d rather be slightly overweight than be hungry and irritable all the time (which was what happened last time I made a real effort to lose weight). Anyway, weighing 100 kilos but being able to run 5km has surely got to be an improvement on weighing 100 kilos and not being able to run at all.

This is a very minor, nit-picky point, but I think the programme would be more accurately named “Couch to 30 Minutes”, because it actually measures the time you run for rather than the distance, and I’m not convinced I can actually quite run 5K in 30 minutes – if my rough Google Maps measurements of my normal running routes are accurate, I’ve been doing closer to 4K. But that’s splitting hairs really, because I suspect most people who’ve managed to complete the programme would be capable of running for 5K by the end, even if it takes them a little longer than 30 minutes.

I haven’t decided where to go next with the running. I definitely want to at least keep it up at around this level. Maybe I’ll try doing an actual organised 5K run soon, and then try to build up to a 10K? That seems a daunting prospect, but nowhere near as much as going from nothing to 5K did.

Overall, I’d definitely recommend it to anyone interested in starting running. It starts with a nice gentle introduction but builds you up to being able to do some serious distances, which is all you can ask really. But be careful with your choice of route: ideally you want somewhere with not too many obstructions (so that you don’t have to keep slowing down or stopping), not too many hills (unless you like a challenge!), but most of all, no concrete or tarmac paths! I made the mistake of running round the neighbourhood on the pavements for one of the early runs, but my legs hurt like hell after a few minutes of that. Gravel paths or grass are much, much easier on the shins. I tend to just do laps of my local park. The wooded hill nearby is a nicer location, but the steeply sloped paths add an extra challenge so I have to be feeling energetic for that.

 

Benefits rant: is cracking down on the “scroungers” really worth this?

So, apparently, a man who was suffering from depression was found “fit for work” in a Work Capability Assessment, and then killed himself. The enquiry into his death identifies the fitness for work verdict as the thing that pushed him over the edge.

As someone who’s suffered a lot from depression myself, this obviously makes me very upset and angry. The welfare system in this country is failing vulnerable people badly, and yet hardly anyone seems to care. This wasn’t the only case that’s resulted in a death that was directly attributable to the system: the case of David Clapson, a diabetic ex-soldier who died after his benefits were stopped, leaving him unable to pay for food or for electricity to keep his insulin refrigerated, has become quite well known. There are many other cases documented online as well, although shamefully very few of them seem to get reported in the mainstream media.

Of course, it would be virtually impossible to run something as large and complex as a whole country without sometimes causing problems for some of your citizens. Any big change, even if it’s clearly for the best overall, will still have adverse consequences for a few people. For example, if the government opens a big new hospital out of town and closes several old ones, some people who lived closer to the old hospitals might die because they can’t get to the new one in time in an emergency situation, even if the superior facilities of the new hospital save more lives overall. Although that would be a tragedy for the individuals and their families concerned, most people would understand that the decision made sense in the bigger picture.

I don’t believe the same thing can be said of the benefit-related deaths, though. These events weren’t random tragedies, or one-in-a-million corner cases that nobody could possibly have predicted. Those deaths were direct consequences of two current welfare policies: firstly, “sanctioning” people on Jobseekers’ Allowance for trivial (and sometimes even non-existent) infractions, leaving them with no income whatsoever; and secondly, forcing people who aren’t in a fit state to work into a system they can’t cope with. If you’re going to take away support from people who don’t have any other support, or bully them into doing things they’re not at all ready for, of course it’s going to end badly. It was obvious to any intelligent person who bothered to think about it what was likely to happen.

But apparently I’m on the wrong side of public opinion here; we’re endlessly told that the welfare cuts are popular and long overdue. It’s true that a lot of people do want the benefit system tightened up to make things harder for “scroungers”, but when you talk to them about it, most of them also want truly vulnerable people to be protected. It’s just a shame that they’re cheering on, and voting for, “reforms” that are hugely damaging to those same vulnerable people they supposedly want to help.

The trouble is, outside of articles in the tabloid press and anecdotes in the pub, there really aren’t that many scroungers and frauds. When you actually look at the statistics of the welfare system (which are by no means perfect, but still the best tool for understanding that we have), they consistently tell the same story: the fraud rate is very low (generally around 0-2%); unemployment benefits don’t cost account for very much of the welfare budget (compared to, for example, old age pensions and housing benefit); most people on Jobseekers’s Allowance are on it for a relatively short time between jobs, rather than living off it for years on end as the Sun and the Mail would have you believe.

So all of the “toughening up” of the benefits system is actually solving a problem that, for the most part, didn’t actually exist in the first place. But in the process, it’s creating much worse problems, like the deaths mentioned above. Of course there will be a few scroungers and cheats claiming benefits. No system is perfect, so it’s never going to be possible to eliminate them entirely. The statistics show that the number of them is already very low, which is probably about the best we can hope for.

But even if you’re determined that even so much as one undeserving scrounger living off the state is an unacceptable travesty, it’s doubtful that making claimants jump through ever more hoops is going to help much. Who do you think is really going to be more inconvenienced by having to pass ever-more stringent checks… someone who’s perfectly capable of working but instead chooses to game the system, or someone who’s genuinely struggling with a mental or physical illness? Who is going to be better able to deal with negotiating the increasingly harrowing system… someone who’s already adept at getting as much money out of it as possible, or someone who’s been pushed close to the edge by events beyond their control and is stressed, exhausted and confused? Making the system even tougher is only going to hurt those who need it the most.

“What would you do different, then?” you might reasonably ask. “At least the government is trying to reform the system. What’s your answer, just keep giving out free money to anyone who wants it?”.

Here’s what I would do differently:

  • Scrap the Work Capability Assessment and have people signed off sick by their own doctor instead. Apparently GPs don’t want this additional workload, but they already manage to sign working people off sick, so I don’t see why passing a sick note to the DWP is so much harder than passing one to an employer. The GP is much more likely to have a full and accurate picture of an individual’s situation, so this would radically cut down on the number of spurious “fit for work” decisions.
  • JSA sanctions should be monitored much more robustly to make sure that they’re fair and reasonable. In addition, only a maximum of 25% of someone’s benefits should ever be removed. This would still be enough to give people an incentive not to get sanctioned, but wouldn’t leave anyone completely destitute. I’m aware that this would lead to people still getting paid benefits even if they refuse to look for work, but frankly I’d much rather have that than risk another David Clapson… and if you disagree, I think you need to have a good long think about it.
  • Publicise the statistics I mentioned above a lot more, and show people that there’s a good side to the welfare safety net. For far too long, the Tories and the tabloids have made out that it’s nothing but a burden, “stealing” money from hardworking people and giving it to the lazy. The facts simply don’t back up that point of view and it needs to be challenged.

I could rant a lot more about this, but that’ll do for the moment.

 

Things I’ve Learned in my struggles with depression (part 1… probably)

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I pledge my commitment to the Blog for Mental Health 2015 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.

The official Blog For Mental Health 2015 site.

I mentioned my depression and anxiety last year. I’ve been meaning to post more about it for a while and taking part in Blog For Mental Health 2015 seemed like a good way to do that.

One thing that’s become very obvious to me over the years is that there are a lot of misconceptions around depression and indeed mental illness in general. In this post I’m going to attempt to address some of them, from the point of view of a mostly-recovered depressive. A lot of these things do wind me up quite a lot, so this post may come across as a bit strongly worded… but hopefully you’ll appreciate that there’s a good reason for this; namely, when you’re already struggling daily with an illness that makes your life feel not worth living, the last thing you need is to have to deal with other people’s ignorance on top of that.

Anyway. On with the things!

Sometimes mental health issues don’t have any identifiable cause. But sometimes they do.

For some people, depression and anxiety just seem to appear for no obvious reason, maybe caused by chemical imbalances in the brain. But in other cases they can be caused, or at least aggravated, by life events. My own illness was definitely in the latter category.

I’ve seen both sides of this belief put forward by people in the past… on the one hand, the belief that no-one has the “right” to be depressed unless they’ve gone through something truly horrendous; and on the other hand, the idea that depression is 100% caused by random chemical changes in the brain and has nothing to do with your life experiences, so you should just suppress it with drugs and forget about analysing your past. I don’t think either of those tells the whole story.

In fact, this is the same for many physical illnesses. Some people get lung cancer from smoking twenty a day or working with asbestos for decades; others have led apparently healthy lives but just seem to get it anyway for no identifiable reason.

 

The amount of psychological suffering isn’t necessarily proportional to how bad your experiences were.

Again this is the same with various physical ailments. Some people get struck by lightning and survive while others die after getting a much lower voltage shock from their household wiring. The result doesn’t necessarily correlate with the apparent severity of the accident.

It’s the same with mental health issues. Some people go through the most horrific experiences and only seem to have mild problems afterwards. Others go through something less extreme and end up severely depressed or anxious. There isn’t necessarily any rhyme or reason to it, at least not one that can be ascertained without doing a lot of soul searching. I used to beat myself up constantly for being in such a bad state when others who’d been through worse than me were coping much better, but eventually I learned that there’s no point in thinking that way. Mental illnesses are complicated and often unpredictable things. They don’t follow a nice neat scale where if you get stung by a wasp you feel mildly depressed for exactly one day but if your entire home town is destroyed in a hideous disaster you get twenty years of severe depression and anxiety.

 

Different treatments work for different people.

One of the things that made me feel the most hopeless over the years was the fact that it felt as if I’d tried every treatment on offer and nothing was working. Medication, Cognitive Behavioural Therapy (CBT) and exercise are often touted as being good for depression, but they did almost nothing for mine. It wasn’t for want of trying either… in despair I filled several notebooks cover to cover with CBT exercises and spent many years taking various different drugs that were giving me nothing but side effects.

This wasn’t helped by the attitude of some of the people I talked to. Some of them seemed to assume that if these treatments didn’t help me, it had to be my own fault… I wasn’t trying hard enough, I had a negative attitude (I’ll come back to that particular accusation later on), or even that I “didn’t want to get better”. I’m sorry to say, a few of these people were former sufferers themselves… you’d hope they of all people would be more understanding, but I think they had a bit of a “zeal of the converted” thing going on and were determined that what had worked for them had to work for everyone else too.

Thankfully I eventually discovered things that did help me, and gradually I recovered. It wasn’t that I didn’t want to recover or wasn’t putting in the effort before, it was the simple fact that not all treatments work for all people. So if you haven’t found what helps you yet, please don’t give up hope… the next thing you try could be the one that helps you finally turn the corner. And PLEASE don’t listen to anyone who tries to tell you that the fact you haven’t got better yet is your own fault… they have no idea what they’re talking about.

 

“If you’re well enough to do X, you’re well enough to do Y” is a nonsensical statement when it comes to mental health.

This often seems to come up in the context of someone who’s claiming some sort of sickness benefit for mental health issues, and when it’s revealed that they went to the pub/went on holiday/did some other leisure activity, there’s a chorus of people proclaiming, “If they’re well enough to do that, they’re well enough to work!”.

It really doesn’t follow, though. Different situations present very different mental challenges and it’s perfectly possible (indeed common) for someone to struggle with some of these but not have much trouble with others, sometimes in combinations that seem to make little sense to an outside observer. For a while I was fairly comfortable with giving presentations at work, even to quite large audiences, but at the same time the thought of dating or even having a relaxed conversation with someone at a party terrified me. For some people it’s the opposite.

Even “simple” phobias can often be strange and seemingly contradictory things. For example, I’ve handled tarantulas before (in fact I think there’s even a picture of me holding one on a very old post on this blog) and they didn’t bother me in the slightest… but if anyone tried to get me to hold a large house spider, you wouldn’t see me for dust. It doesn’t make any sense, but that’s just the way it is.

 

Being fit for work is not a binary thing.

I’m fortunate in that I’ve been able to carry on working throughout most of the period when I was depressed. But at the same time, I’m not under any illusions about it; I know it’s only been possible because I was lucky enough to find a very understanding and enlightened employer. They’ve supported me when I needed it and made a few adjustments to help me cope more easily. I’ve been with them over ten years now and am very happy with how they’ve treated me.

But I also know it could have been so different, and for many depressed people it unfortunately is. If I’d ended up in an environment where I was pushed into things I wasn’t ready for, where my time off sick was held against me, where the employer wasn’t willing to compromise an inch to help me, I don’t think I would have lasted long in work. I could easily have ended up on benefits and in a worse state than when I started. I’m not being negative here, just realistic… I know what a close call it was at times even with a very good employer, and I know that if I’d been placed in one of the nightmare situations I’ve heard about from other sufferers, I simply would not have coped.

Unfortunately the medical profession and the government don’t seem to take this into account. In their eyes, you’re either fit for work or you’re not. You’re either fit to handle any gruelling, draining, high-pressure situation that life might throw at you, or you’re not fit to do anything productive at all. This seems ridiculously black and white to me… surely almost any person, depressed or not, will be able to cope well with some jobs and not at all with others? And surely it would be better for everyone concerned if the government would actually recognise this fact.

I remember once at a particularly difficult time, I realised it would help me a lot if I could work from home some days, as being around people was making me stressed, and most of the tasks I do in my job can just as easily be performed at home. I went to the doctor and explained this and asked him if he could write to my employer and recommend that I be allowed to work from home for some of the week. The answer was no… if I felt I wasn’t coping he could sign me off sick completely, but there was seemingly no middle ground. I didn’t want to be signed off completely, I felt I was still able to do my job but that more time to myself would give me some breathing space and help me recover faster. Thankfully in the end my employer was willing to do this for me even without a letter from the doctor, but I know a lot of other people who might benefit from something similar would not be so lucky.

 

“You won’t get better without a positive attitude” is the last thing you want to hear when you’re depressed… and I don’t think it’s necessarily true, either.

In all sorts of areas of life, you often hear about how important it is to have a positive attitude, and how you won’t achieve anything without one. A lot of self-help books will tell you it’s the most important thing that you need in order to get better. I used to hate reading things like that. I think it’s supposed to be motivational and inspiring… and maybe it would be if your goal was to lose 20 pounds, or start your own business, or overcome your fear of flying, or whatever. But when you’re suffering from depression, having a positive attitude seems like literally the last thing that’s ever going to be achievable. People who are depressed have trouble thinking positively, almost by definition in fact. So reading that I needed to have one would reliably make my mood sink even further and make me think “Oh great, in that case I’m going to be stuck like this forever”. I honestly think that I’d have felt less despondent about my chances if the book had said “The most important thing is to build a rocket out of household items and fly to the moon in it”.

Ultimately, though, I don’t actually think a positive attitude is the be-all and end-all that some people make it out to be. I got better eventually and I don’t think my attitude through most of my recovery could really be described as “positive”. I was pretty pessimistic about my chances of ever getting better, but I reasoned that it was better to keep trying anyway, because maybe I was wrong and I would get better some day, and that would be so amazing that it was worth trying for even if the chances seemed slim. I was probably 95% convinced that I’d be depressed and miserable for the whole rest of my life… I wouldn’t call that positive by any reasonable definition. But that 5% of doubt was all I needed to stop myself from giving up completely.

Don’t get me wrong… I’m not saying that a positive attitude isn’t a good thing… it most definitely is. My recovery would have been a lot quicker and easier if I’d had one, no question. But it annoys me to read “advice” that talks as if you can just conjure one up from thin air, no matter how bad your experiences have been, no matter how badly depression is dragging you down. It’s nowhere near as simple as that, and it’s misleading and damaging to talk to people as if there is no hope for them unless they can manage to do that.

 

Some problems have to be dealt with by accepting them. Others can (and probably should) be changed.

I sometimes feel as if there’s too much of an emphasis on accepting things the way they are, even when it’s not the way they should be. Now, obviously in some cases there is no other choice – if someone close to you has died, for example, there’s no way in the world anyone can change that. But some problems are less clear cut.

One of the things that kept coming back to haunt me over a period of many years was the idea that I’d missed out on a lot of social experiences that most people have in their teens and early twenties, because that’s when my depression and anxiety were at their peak and I’d spent much of those years isolated. When I talked to counsellors and therapists about this, their “solution” was usually the same: I needed to “mourn the loss” of what I’d missed out on. I also read a number of self help books that said much the same thing.

But I didn’t want to mourn the loss. I wanted to find a way to have those experiences. To me, a life where I couldn’t have the same social experiences as other people wasn’t a life that was worth working towards and was never something I was going to willingly accept. And with hindsight I’m very glad I stood my ground and didn’t accept it, because over time I managed to find ways to get what I felt I’d missed, to a much larger extent than I ever dreamed would be possible, and I’m a lot happier and healthier for that. (I also found one brilliant self help book whose author agreed with me wholeheartedly that this was the right way to tackle the problem; it’s nice to have your feelings validated!).

To an extent I suppose I can understand my therapists’ response to this issue. Their role is mostly about helping people deal with their feelings… helping someone to find (sometimes unorthodox) ways to do things most of their peers did a decade earlier is not really in their remit, even if that happens to be the most helpful course of action. “When all you have is a hammer, everything looks like a nail” and all that.

 

That’s all for now. I had more things to write up but this post has got long enough already. I’ll probably write a follow-up at some point with some more items in the same vein.