Depression

Frequently people mistake depression for other problems and think they are depressed when they are merely sad, down or lacking in some physiological way. Depression is a significant life affecting disorder that is more than just transitory. Sometimes depression has the pre-word “clinical” to help differentiate it from when people feel down and misidentify themselves as being depressed. There are things you can do to address depression including lifestyle change, medication and cognitive therapies. People diagnosed with depression of a significantly higher likelihood to suicide.

Diagnosis

First of all, let us define depression. Depression is a clinical diagnosis given to people who find their emotions depressed, find they are despondent, are amotivational (without motivation), and or lacking in energy to the point of incapacity. According to the DSM V (the Diagnostic and Statistics Manual 5, formed in the USA):

“A. Five (or more) of the following symptoms have been present during the same 2- week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.
• Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
• Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
• Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
• Insomnia or hypersomnia nearly every day.
• Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
• Fatigue or loss of energy nearly every day.
• Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
• Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
• Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

B. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).” – DSM V

Let’s pull that apart a little. First of all, there need to be some significant symptoms in multiple categories – physical, psychological and ontological. At least one of the symptoms needs to be a depression of mood or joy. These symptoms should not be due to another aspect of a different disorder. For example, a negative trait (a trait missing from most people) of schizophrenia can be anhedonia, an inability to find or feel joy. Because it is part of the diagnosis for schizophrenia , it should not also be used to also diagnose depression (but only, in this case, if you are diagnosed with schizophrenia).

Secondly these symptoms have to be significant enough that they are causing distress in your life. Significant is measured externally by the effect the symptoms are having on your social interactions, necessary work or another major, externally measurable effect. When we humans have an emotional reaction to something, we can easily misperceive a molehill as a mountain. Other external people may not see it the same way. Internal psychology is hard to measure, but the effect of what we are feeling on our lifestyle is quite easy to measure. This gives an objective measure to severity via the impact it has on our day to day existence. This does not mean to belittle how horrid we feel, it just contrasts it to how well we cope or manage. Each human has traits (happy, sad, guilty etc). When a trait becomes an extreme it generally becomes a problem and we change its classification to a clinical disorder.

Thirdly these symptoms cannot be caused by a physiological disorder such as nutritional deficiency (vitamin D or B12, iron etc), a side effect of medication, or some other specific biological disorder such as a hypothyroidism (where the thyroid doesn’t produce enough of certain hormones). When all of these factors are considered, what is left is a disorder that is debilitating and isn’t caused by the presence of another substance, isn’t a deficiency in nutrition and isn’t caused by another diagnosis.

Depression is a description of symptoms, but not of causes. Exactly what is the source cause for depression is not really known. Some fMRI (functional Magnetic Resonance Imaging) scans of peoples brains have shown suppressed activity in areas generally associated with joy and happiness, others have lower levels of serotonin or serotonin re-uptake inhibitors in their brains and some have all the signs and symptoms with nothing showing in any of the tests. Yet they are all labelled as depression even though it is thought that each of these has variable causes. As medical knowledge advances, this will get teased out and specific causes will be identified which lead to specific treatments. Until then, the simple method of treating depression is to brute force attack (that is systematically try the best combinations) the known treatments.

Medication

The most common first step is to start on some antidepressants. There are a host of common ones that work on the most common forms of depression. These drugs are directly targeting the chemistry in the brain for the most common things that are out of balance that lead towards depression. Because each person is different, different forms of the medication may have a greater or lesser affect on an individual.

Balance comes in three flavours:

  • Excessive neuro transmitters, which need to suppressed.
  • Deficit transmitters, which need to be boosted.
  • Errors in the cycling of the transmitters, which need correction.

People can have a combination of two or more of the above. Keep in mind, this is a vastly simplified explanation.

Even if two people have the same form of depression caused by the same problem, their differences in weight, gender, genetics, diet and lifestyle can affect the efficacy of taking the same drug. Some find that one brand works better than another, or that an alternate pharmacological method of eliciting the same end result (such as increasing the amount of serotonin) is more efficient, or that the dose needs to be higher or lower to get the same results. In summary, the first medication you go on may not be affective, and it will most likely need to be tweaked to get the best results.

Medication works well for roughly 1/3 of people diagnosed with depression. Initially it allows them to get back on track with how their lives were before the depression hit (if it is a recent thing), or find their lives if they never experience a depression free life (lifelong depression is fairly rare, but can happen). It is not intended as a solo solution.

For another 1/3 of people diagnosed with depression, it has some positive effect, but is not enough to get back to the old life (or for some a new life). This might be because the right combination hasn’t been found, or the symptoms are being caused by a combination of both chemical imbalance and poor psychosocial patterns. More on this later in the section about changing your life.

For those who are doing the maths, you will note that roughly 1/3 of people are left – they experience no positive effect of the medication. For them, this seems like a massive waste of time, each time hoping for being saved, only to have the hopes dashed when a few weeks later the medication again has no positive result. This is both true (as described) and false, because you are missing the bigger picture. There is no easy method of measuring if you are going to be responsive to medication or not until you try and are successfully – or not. Also medication should not be given in isolation, it should be coupled with non pharmacological therapies. And lastly you have now ruled out a treatment method that won’t be effective for you.

All medications have listed side effects. A side effect is an effect the medication can have on a percentage of the people who take it that is not the primary effect desired from the medication. Side effects are fairly minimal and generally safe, or vary rare if unsafe – else the medication would not be allowed for public use for long. It is important to know what the side effects can be so that if you are affected you know that the likely cause of the effect is the medication you are on. Report to your treating doctor the side effects (if any) you experience. Sometimes these side effects are rough and make being on medication worse than not being on medication. This is not common, although you will hear a great deal of people talk about it, giving a distorted prevalence of this via their poor confirmation bias. Basically the vast majority of people who have no significant side effects don’t talk about all the lack of side effects, so you only hear the occasional squeaky wheel in the dark and assume that all wheels are squeaky.

Cognitive Therapies

There are a number of cognitive therapies that are available for depression. Cognitive therapies rely on a person being able to analyse their existing behaviour patterns (sometimes with help), identify positive and negative patterns, then adjust their lives to promote positive patterns and address negative patterns. This doesn’t work for people who lack the insight needed to analyse the patterns, or people who are unwilling to change their lives.

Many people think that talking to someone is stupid and ineffective, a sign of weakness, or exposing themselves to scrutiny and judgement. There is an element of truth to this, but it’s the wrong angle.

  • Stupid and ineffective – If you are talking to someone that you don’t connect with, or is not qualified to help you then you make no progress and you resent the discussion. You don’t have to be pally with the therapist, but you need to feel a level of trust in your discomfort. Discomfort is actually a good thing, but terror is not. Often people lie to their therapists and that just doesn’t help at all. The qualification of your therapist is important. While there are some naturally good conversationalists, having a plan on how you are going to work collaboratively on your problems to overcome and defeat them takes training. Anyone can call themselves a therapist or counsellor – so beware of what actual qualifications the practitioner actually has.
  • A sign of weakness – it is a sign of weakness. If you were able to help yourself, you wouldn’t need help. You need help. Avoiding admitting you need help by avoiding therapy is like admitting you are falling from a plane and refusing to pull the cord on the parachute, as if that last step is going to stop you from the nasty end you are heading to. Dramatic, I know. But really, go talk to some professional.
  • Exposing yourself to scrutiny and judgement – this is absolutely true. If you aren’t willing to examine yourself in front of someone who can help you, why are you there at all? The point is to examine and jointly judge what is working, what is not and discover what needs to change. The fear is that the therapist will judge that you are faulty, a failure, a horrid person and so on. Generally the therapist will see that you are someone who needs help to make it on your own, the rest doesn’t matter. Even if they do see you as those things, isn’t that why you are there? To get help to not be that any more?

It is important that you develop a comfortable relationship with your therapist. This is referred to as “rapport”. It is a professional relationship built on trust and a desire to achieve a goal – your independence. If you can’t trust your therapist, then find someone you can trust. The therapist is not your friend, they are your employee. Unless you are court mandated to work with the therapist, you can always chose another (with the minor exception of small towns – and even then, if you have the internet or phone, you have access to more).

There are three main components to therapy:

  • Identifying and understanding the problem
  • Making change
  • Evaluating the change

A lot of therapy gets stuck in the first or last stage and forgets the middle. Also keep in mind it is not a linear thing – you don’t just do the three steps and you are “cured”. You repeat with your therapist until you can do this on your own.

Changing Your Life

If you don’t make changes in your life, then you won’t make any changes in your life. It amazes me how such a simple sentence can sum up the power you have in your life and your future. There are four main components you can manipulate about your life and they are summed up in four categories.

  • Biological
  • Psychological
  • Social
  • Spiritual

I have written about this before. In short:

Biological – may mean taking medication, doing exercise, managing your sleep cycle, changing your diet and or change in your weight. Without your body motor running efficiently, how can you work with your feelings and motivation? It’s like trying to hammer a nail into wood with a twisted nail and a broken hammer.

Psychological – This is about working out your patterns and modifying them. Patterns include how we perceive our environment, how we react to things, our habits and tool kit of coping mechanisms and strategies.

Social – Humans are social animals and we need to factor in our interaction with others. Do we have friends, and if so do we like them and do they bring out the best in us? Who are the professionals in our life and what are we using them for – is their a plan to become independent of them? Do you hide from people or just pretend while around them? Who do you turn to when you need help and how are they coping – is it just one or many?

Spiritual – We live in a world of people, animals, plants and things. Without any of these life is not possible. We are influenced and influence other things. How we see ourselves in this mix is vital to our health. When we forget our importance (and we are all important), then we diminish our worth in our own priorities and stop doing things like eating, doing activities, seeing friends and so on. When we stop doing these things, we stop living. It is only a matter of time before we stop being alive. It is vital to rediscover our worth, not only in our own eyes, but in the eyes of others. It is easy to hide from the system and be missed – but you are so much more than that. You can make a difference, and it is a good difference.

Examine each of these things – judge yourself against them, identify some things (no more than 3 at a time) that you are going to work on, define what basic step you can take to adjust these and how to tell if it has succeeded. Then, most important of all, act. Do it.

Suicide

People who are depressed are 10-2o times more likely to suicide than those who have no diagnosis (or could be diagnosed). While this sounds horrid, it isn’t quite as scary as it seems. Most people who are depressed do not suicide, but many people who suicide are depressed. That’s statistics for you. We still need to look at suicide square in the face though.

There are three major types of suicide.

  • Hopeless suicide
  • Angry suicide
  • Accidental suicide

Hopeless suicide is attempting to end the pain. The victim has concluded that this is the only escape because nothing can help. This is the last ditch escape from an intolerable situation. They have lost their self worth and have succumbed to the belief that there is no way out. Often this is hallmarked by gifting self identified meaningful things to those who they think were good to them or they cared about. It is important to get help before this happens, because it is not true. Just because you can’t see a way out doesn’t mean there isn’t one, hence why you get help to find a way.

Angry suicide is generally sending a message to others. Most depressed people do not have the energy to maintain enough anger to suicide for this reason. There is a danger when people start on medication and begin to get better. They still see the horror of depression but now have the energy to do something about it. This is a crucial time to seek strategies to hold on until the medication has a stronger effect and you pass this danger point.

Accidental suicide usually comes from those who are calling for help. Calling for help is a method of externalising the internal pain, frequently through self harm (cutting, substance abuse, self harming sexual relationships, financial harm etc), or “suicide attempts” that are timed for people to find them. Either the self harm goes to far, or the people didn’t come, or didn’t come on time. These behaviours are an attempt to get people to see that help is needed and to invite them in to do so. It is better to ask directly than to use these methods, or to identify that this is what is happening and get help to manage.

As an aside, it is frequently the wrong thing to go cold turkey (total cessation) on self harm. The idea is to introduce harm minimisation strategies around this safety valve, change your life so you no longer need the safety valve, then delete the self harm.

Suicidal ideation is talking and or thinking about suicide without actually enacting any further steps to achieve suicide. We humans always consider options and given grim times some of those options are unpleasant. Contemplating suicide can be a powerful incentive to change, or to feel like we do have a choice – “I could always kill myself – aka I choose to be alive”. Flirting with the idea of suicide is a good time to get some counselling. When the flirtation with the idea becomes planning, this is a good time to call suicide help lines for help and go and see your doctor.

Every major country has suicide prevention numbers (Australia Life Line – 13 11 14), talk to your therapist, and talk to your general doctor. Once you have a strategy, involve key friends. Generally friends are not trained to help with suicide and it is better to get professional help.

Conclusion

Depression is a diagnosis that is given due to a significant negative impact to an individual’s lifestyle. It describes a life that is quite literally depressed from what would be commonly expected. Most depression is treatable with a combination of medication, therapy and lifestyle changes. Many people recover from depression while some people manage it. While suicide is an important consideration in conjunction with depression, it is not inevitable and has well researched methods to address it too.

Explaining Mental Illness to Children

I was asked recently wow do you go about explaining mental health to children, especially if it is your own?

It will vary from child to child. The very young need simpler concepts, while the older ones can deal with greater detail. However here is approximately how I explained mental illness and health to my child when she was about 4 years old. I have changed it a bit with hind sight.


 

You know how there are tall people and short people, dark haired people and light haired people, dark eyed people and light eyed people? You know how some people are fat and some are skinny, and with all of those people are many other people fitting in between? That is because people are all different from each other. We can easily see those outside differences.

Even so, most people have hair, most people have two eyes and most people have the same number of limbs. For all our differences, we all work roughly the same way.

Some people have differences inside them, some are based on bits that are different – do you remember that your mother had her gallbladder taken out? You still have yours, as do I. One of my friends was born with an extra half kidney, which is rare, while some people are born with less bits. These are still physical differences.

Your mother and her father are terrible at following street directions and will often get lost, while you have seen me glance at a map and know where I am going. This is a difference in how we think. We all have difference in how we think, much like how people are different in their height – how tall and short they are. These differences are not physical, but can sometimes have physical reasons. Do you remember that party we went to and how Bobbie was acting all strange? That was because he drank something called alcohol, and that can mess with how your body and mind work for a short time (unless you use too much for too long, then it can become permanent!) Some things can make permanent changes, because they make a permanent damage.

You know how Niki’s family are all tall? That is because they all have inherited being tall. You get your dark eyes from me, and your blond hair from your grand mother. Jenni colours her hair with a chemical called hair dye and that is because she likes to have red hair rather than her brown.

So long as all of the differences are not interfering with us living our lives, no one really cares too much. Sometimes a difference can interfere with how we live our lives. Like that man we saw yesterday with only one leg – he needed to either use a wheel chair to get around (can you imagine trying to use stairs with that? That’s why he uses the elevator) or he needed a prosthetic like a pirate’s wooden leg so he can walk (it’s still hard to skip though). He uses these tools to help him live a more ‘normal’ life.

When our bodies have problems like that, we call it a disability. When our minds have problems like that, we call it mental illness. It’s often managed by making changes in our lives, like the man in the wheel chair avoiding stairs and using the elevator, or using a tool like medication, much like the man with the wooden leg (they are usually made of metal and plastic these days) and the wheel chair.

Sometimes these methods aren’t enough and we just have to put up with it being really awkward. That is why sometimes I have troubles creating stories to tell you, I’m using all my effort to hold my mind together so I do the things I need to do and some of the things that can wait just have to wait until I can concentrate better. At those times, I’m very grateful that you can tell me stories instead. My mind, that is my thoughts, can be doing very strange and unhelpful things in those times. I can be very angry for no reason, or really tired when I shouldn’t be, I can be too happy, or I can start thinking very strange and weird thoughts. At those times I need to recognise that I’m thinking strangely and decide to act normal anyway, because you need it, my life needs it, and your mother needs it.

You know that thing you did at school where you wore a blind fold and had someone tell you where to step and which way to turn and you had to find the items around the school? That was a good introduction to some of the challenges of being blind. Imagine if the person telling you which way to go didn’t like you, or didn’t care about the task, or you had a bunch of them yelling at you all at once. Sometimes that is what it is like in my head. I can’t trust what I am feeling, or sometimes what I am thinking, so I have to consider everything that I do very carefully. That can be very tiring and slow me down, or make it impossible to make decisions. At those times, I put off the big decisions and rely on habit – this is what I did before.

For me there is no handy tool to manage this situation, there is just avoiding the problem and holding on until it goes away. Fortunately it always goes away. It doesn’t for all people. This is like the man with only one leg choosing to take the lift instead of the stairs, or deciding that going up that extra floor wasn’t really needed right now. It can mean going without a few things, but it’s better than having nothing.

Other people experience different things, like hearing voices of people that aren’t there, seeing things that no one else does, or finding it really hard to get out of bed for days – not just the morning! Just like there being lots of differences in what people look like, there are lots of ways we can think, and many ways that it can go wrong for lots of reasons. But only when those difference cause a problem do we need to do something about it. The problem is called mental illness, the solution (the thing we do about it) is called mental health. While it is important to understand what is going wrong, it is just as important to work out how to manage it so our lives work out all right. Many people forget that second part.

I think that some of what is going on in my head is because of what I grew up experiencing, and some of it also comes from my family (like the tall family). Our experiences shape us. You know how Katie does gymnastics, and how she can do all of those flips and bend her limbs in interesting ways? She couldn’t do that if she didn’t do gymnastics. Her life experience has lead to a good thing for her. Some of our life experiences lead to bad things. That is how that man lost his leg, he was in a fight called war. In that fight his leg got very badly damaged and he lost it to save his life. Sometimes the damage is not just outside our bodies. For me, some of the damage was in my mind.

Do you remember when you fell and hurt your ear? The doctors were able to fix it up and now you just have a scar. Some of what is going on in my mind is the hurt that is healing, some of it is the scar of what is left. Most of my mind works great though. I believe that if I keep practising, like Katie, I will get a more flexible mind and I can heal the hurt better.


And I did. It took 10 years of effort to heal. I still sometimes get problems, but it is so rare now that they are mere blips on my otherwise sunny life. Each time I blip, I just think “oh, this. I know what to do.”

 

Time enough

Tragedies happen. It is sad and often painful. Eventually though, we heal from that event and get on with our lives.

The phases of grief have already been covered, describing the common processes that people go through towards adjusting to the changes that have happened in the world with the changes that must occur within. At the end of grief is a time of remembering that the world is different and a time of moving on. This length of time varies from person to person.

For some it can be fairly quick, not because they don’t care, but because they have simply adjusted quickly to change. Perhaps they have more practice, perhaps they are more resilient, perhaps, perhaps, perhaps. Some take a long time to heal, measuring months, years or decades. Usually if months or more is where you find yourself, looking for some professional help is advisable.

At some point we are going to find ourselves experiencing the emotion known as “fun” and “joy”. We may reflect on this and feel guilt because we can’t believe that we are enjoying ourselves when we consider the tragedy we have experienced. We may berate ourselves for allowing ourselves to have fun as if this disrespects the memory of those we have lost. There is a danger here, if we continually associate fun with tragedy we lead ourselves to a path of potential clinical depression.

It is okay to laugh, okay to smile, okay to enjoy ourselves. This is not disrespecting those who have gone, it is acknowledging that we have healed. We don’t owe a fixed time of mourning, nor do we prove ourselves the more deeply affected because we mourn for longer or deny ourselves enjoyment.

Sometimes we are still grieving while those around us are done. We can look at them and feel anger that they didn’t mourn for long enough, as if they didn’t truly care. We can mistake their resilience as a sign of hollow grief, or their coping mechanisms as disrespect. While it is normal to feel this, it is mistaken.

Each of our grieving is its own path. We must accept that others follow a different path and that at some point it is okay for us to begin enjoying life again. We must trust ourselves as much as we trust others to be true to themselves without reading disrespect and disregarding into their actions.

Grief – Adapting to change

When things change, we grieve. The bigger the change, the more sudden the change, the harder the change, then the deeper is the grief.
Grief is an adjustment in the way we see the world. The harder that adjustment is, the more complex our grief end up being.
We humans go through many predictable stages. They can be in any order, and we don’t have to go through them all.
* Shock – This is the recognition of change. It often sets us back and we can demonstrate this phase by running around trying to get facts, or sitting in stunned silence. We can’t plan – we just have to get it through our heads this happened.

* Anger – We feel helpless that this has happened and we feel violated. Anger is the emotion that tells us this. We typically become aggressive to others, or to those we have lost, or we try to find someone or something to blame. We frequently aren’t very subtle. We find reasons to sustain our anger.

* Denial/disbelief – This is a little related to shock – where we first learn of the change, but this is a different as we have had this information for a bit and we know intellectually that it is so, yet we emotionally can’t accept it and so we try to find a way to prove it isn’t so, or just point blank refute the “in the cold of light” evidence.

* Bargaining – We try to find a way to change what has happened so it returns to the old model. This stage makes more sense when you can see change coming (someone is leaving, the task is over) yet we do it with sudden loss too (what if I did this, or if that happened, what if we tried this other thing). Change is inevitable and you can never go back. You can just make a new thing. Yet we want the old familiar, comfortable old, even if we loved or hated it.

* Pain / guilt – It hurts. Change does that. We miss those who have gone and we can express this in the form of weeping, crying, keening, sleeping, silence and so on. To justify this pain, we often try to find someone to blame – when we can’t blame others, we blame ourselves. We try to find a reason to justify our guilt, seeking minor things we might have done wrong, escalating them to things that we did do wrong and would have staved off this thing that created change. This is false. People make decisions and you aren’t responsible for them. If it isn’t a person’s choice, then it is another random factor (rock falling on someone’s head, car accident, animal attack etc) that no one could have affected. Only if you point the weapon and pull the trigger can you be held responsible, and that is a legal matter we aren’t getting into. In the vast majority of times, it wasn’t you.

* Depression – When the emotions are too much for us to bear, we shut down. This is kind of like the automatic cut off switch in electrical goods – it’s too much, so rather than being damaged, we shut down. We do less, we avoid stimuli, we find it hard to feel (whether it is emotional, sensory or taste etc), and we just seek to escape. This is okay. It just means the rest is too hard right now and you need to regather your strength. Avoid too much stimulation, either physical or emotional. Avoid getting stuck in here – you have to go out sometimes and do a bit even if you don’t feel like it, but aim for bite sized portions and give yourself leave to back off and take a break.

* Acceptance – Once the mind has reoriented to the change we have a new pattern of seeing the world and behaving installed. We have accepted the change and processed how we need to change as a result. We accept that this is as it is and we feel at peace. Hopefully this is the end of the journey, but often times it is a temporary reprieve as we realise that there is more to process. Don’t be disheartened, it is natural to bounce between feelings.

Each of these is a stage. One can experience multiple stages together and frequently we will revisit stages. Each is important in processing the external change that has occurred and how we will internally change as a result.

We don’t have to be alone in this. We can talk to others. If experiencing significant difficulties with any stage or the whole process, seek professional help. Why have them all trained up and not used? Seeking professional help is a sign of wisdom, not weakness.

It is a mistake to think that because you know these stages it will be easier. No, the emotions are just as deep, the pain just as sore, the feeling of being lost just as acute. It is a hard journey. Knowing these stages exist and are likely to be travelled helps us see that we are progressing, or recognise why we are doing what we are doing. It helps us to feel less like we have lost control and see that we are in fact making our way to the change we need to make to adapt to this new world we find ourselves in.

Existing vs Living

If we only do as our urges instruct, we merely exist. Learning how to not do as our urges instruct allows us to choose when we do as our urges suggest, or not. That choice allows us to live instead of exist.

That doesn’t mean rejecting all of our urges. It means listening to them and making a choice.

Short enough for you this time?

Is That a Fact?

The word Fact comes from the Latin word factum,  neuter past participle of facere or ‘do’. It’s original intent was as ‘an act’ or ‘action’, particularly of evil origin, which was later used to define ‘a crime’. It survives in this old form in the still modern phrase “before or after the fact”. This old meaning lapsed in the 16th century as the word was redefined to mean “known truth”.

The current dictionary meaning of ‘Fact’ is something known to be true. The legal definition is “an actual or alleged event or circumstance”, which is a bit looser, and relies on evidence to tell the difference between “actual” and “alleged”.

We come into a sticky situation with the words “known” and “true”, mostly due to evidence and change.

For something to be known, someone must know it. I have plenty of experiences that I have shared with others, and I have others that I have not. As such, there are some things known by me that are not known by others. If I relay an experience that occurred when I was out walking as a child, I am relaying a known something from my perspective that is unknown by any other. Does that make it known? Does that make it unknown? Or perhaps a-known?

In my shared experiences with someone else, my perception of the experience may not match that of the other person who shared it with me. I may make a statement about what I know of the event that is denied by the other person. As such, what is known about this event? Is my knowledge better than another’s? Or worse?

To negate this problem, the principles of science require multiple measurements by multiple people in circumstances where another can replicate the outcomes if they meet all of the pre-conditions. I can claim that I can telelport from one location to another and that I have done so many times. Perhaps I can, but if I can’t demonstrate it to another, my accounting of it has no real meaning, as far as a scientific perspective is concerned. It might impress my friends with my story, but it will probably disturb my therapist.

If I demonstrate it to a friend, and they concur with my statements to others, will another be able to trust the two of us? The easiest way to satisfy the test is to demonstrate it. If I can teleport on demand to any reasonable people that request it (this isn’t entertainment, it’s science! – but I should be able to demonstrate it to anyone), then the knowledge of my teleportation becomes scientifically relevant, it becomes known. (How is another matter entirely!)

Truth is another problem. There are no fixed things in this universe. We would love for there to be, but there isn’t. All of our measurements of everything are taken with an error margin and an acceptance that new evidence will supersede the previous knowledge.

Take a measuring stick and place it against an object. The closest you can definitely state the object is to a measurement is half a unit of the smallest notch of your measuring stick. So if the object I am measuring comes to 2 cm and I have mm accuracy, then the object is actually 2 cm +/- 0.5 mm (this varies depending on the measurement and the equipment). It is our confidence with the equipment we have to measure. Another way to consider this is imagine you are trying to measure Pi. I have a stick that is exactly Pi cm long. I try to measure it with my measuring stick and I will get 3.14 cm, +/- 0.5 mm, or 0.005 cm. I can’t get any closer to the number Pi with that stick, because it isn’t any more accurate than that. This doesn’t mean that pi is 3.14 cm, or 3.135 cm, or 3.145. It means it is between 3.135 cm and 3.145 cm, but not lower 3.135 cm and not greater than 3.145 cm. A more accurate method of measuring will generate a more accurate result.

As I grew up, it was theorised that a planet may revolve around a star somewhere in this universe, hopefully this galaxy, that had an Earth like planet. We knew of only one planet that fit the bill, and I was born on it, and that was the truth. Maybe there was another – but we had no evidence of it, just a possibility, so there was no truth to a statement such as “an Earth like planet orbits around another star” – because we had no evidence it did, or that it could. A few years ago it was announced that exo-planets had both been detected in space and also in orbit around other stars. The possibility of an Earth like planet increased, although none had been found.  After all, we now had evidence, not just a hypothesis, of a planet around another star! There was still no truth to the statement “an Earlth like planet orbits around another star”. It was just a matter of time, we hoped, to find an Earth like planet.

Today I read an article that said we have found Gliese 832 C, a super Earth and the current best candidate as “Earth like planet” in a habitable zone around the star Gliese, only 16 light years away. It’s orbit is measured in 36 Earth days – that’s it’s year vs ours of 365 Earth days. Today this is the new truth. That is, new evidence has superseded the old truth of “we know of no Earth Like planet orbiting another star” with “we know of an Earth like planet orbiting around another star”. This is the best candidate for life on another planet around another star and it is measured in several ways. The planet is bigger than Earth, but not too much. It is closer to it’s star (a red dwarf), but well within the habitable region of energy from the star (closer because it is a red dwarf). While there are two other contenders for the “best”, Gliese 832 C wins because it is the closest planet we have found.

If we were to find another planet that was more Earth like only slightly further out, it may defeat our measure of “best”, especially if we detect intelligent life on it. This is the nature of truth. It changes as we learn more. And what we learn is based on what we know.

Coming back to facts. A fact is something that we “know” to be “true”. Know requires many people knowing about it for it to become knowledge, and knowing about it means being able to verify that it is true as far as we can test, but allows for new evidence to change what is true.

The more we know, the more facts become wrong. The opposite of a fact is not fiction. That’s just a library convention and implies an intent to deceive. Tells you a lot about librarians, doesn’t it. Or is that more authors? Superseded information has no intent (we hope) to deceive.

So what is unchangeable Truth (note the capital T)? Some believe they find it in a god, or a certainty that they have about something, such as no humans ever having reached the Moon. There are two conflict of Truth versus truth.

The first has to do with “truth is verifiable”. You can run a test, that is anyone can run a test, and get the same or very similar result. That gives us the truth. As I grew up, no matter who looked through the telescopes, no one saw a planet around a star other than ours.

The second has to do with the variable nature of truth. That is, truth can be superseded with a newer truth. Anyone that looks at the data can verify the calculations and the observations and demonstrate that Gliese 832c is indeed an Earth like planet approximately 16 light years away. This is a new truth. This doesn’t make the old truth a deception, it just makes it wrong, however at the time it was the best truth we had.

Gods cannot be verified by tests. Nor can a certainty about something, such as the idea that man has not been on the Moon. Both of these types of Truth require belief instead of evidence. After all, no new evidence will allow for a believer of these Truths to adjust their idea of what is real and reject their Truth. As such Truth is not truth.

Superseded facts are not necessarily wrong either. If I give you a the fact that this object is 3.14 +/- 0.005 cm in length, then measure it with a better tool and discover that it is 3.14156 +/- 0.00005 cm, then my first measurement, while inaccurate, is not really wrong. If my more accurate measurement were to give me 6.282 +/- 0.0005 cm, then I would certainly consider my first measurement as wrong while my new measurement is right (so long as the new measurement isn’t the wrong one… and science is basically all about checking which measurement is the right and the wrong one!). In the first now inaccurate measurement of 3.14 vs 3.14156 (let us call this “A”), the ratio is minimal. In the second one 3.14 vs 6.282 (let us call this “B”), the ratio is huge. A is supporting previous evidence with a greater degree of fidelity, while B is conflicting with previous evidence – one of them is clearly wrong.

In re-measurement A, to suggest that 3.14 was wrong may be to commit a logical fallacy. That is to ignore the point of the discussion because a single point is not accurate enough. To assert the same point if B was our second measurement would be fair enough because the ratio is way out.

To summarise, a fact is something that is accurate at the time of writing or stating. It is accurate because it is a knowledge based on evidence and tests. It can be updated as new evidence and tests are created and used. An old fact should be out by a significant ratio to be considered out right wrong, rather than less accurate.

Pensionism

I think I’m starting to develop Pensionism. That is, I begin to fear those elderly people who have a particular type of pension from the government.

To explain it a little. There are three primary kinds of pension in Australia – the standard aged pension, disability support pension and veterans pension.  I meet nice and rotten examples of all three, so that certainly isn’t my criteria for discrimination. Many feel that they deserve more special treatment than everyone else.

The ones who get me are the veteran pensions. Not because I disagree with war, but because frequently the obnoxious members of that particular group wave their pension as the reason why they should get special treatment.

As a result of this classical conditioning, I begin to wince when I see someone come in with a veterans pension even before they demonstrate that they are reasonable, or that they are obnoxious and not using their pension as an excuse. (Classical conditioning – consider Pavlov’s thought experiment where he fed a dog and rang a bell. The dog would salivate for the food, but when he rang the bell on its own, the dog would salivate without food. Here the veterans pension is becoming the bell.)

I think this is sad.

Those who wave their pension status around as an excuse for special treatment are no better or worse than any of the others who want special treatment, they have just linked their behaviour to a specific discernible difference – the bell here is the veterans pension – and thus I react even if the obnoxious behaviour is not present.

I wonder if other forms of discrimination are formed this way. While my reaction is to cringe, the action I choose is to wait until I meet the person before cringing.

Lunacy

I suspect this topic will be contentious.

Around about the year 2000 I recognised that I was struggling through extreme moods. These extremes would last between a few days to ten and were separated by several weeks of minimal moods. It was during this year that I reviewed my life to find that this was not a recent phenomena, it had just got to a level that was interfering with my life enough to do something about it.

The first thing I tried to do was to map it. When did these peaks occur and what could I correlate it to? I was working on the premise of “know thyself”. I figured that if I knew more about these moods, I could start to address the critical factors that affect me. I had ruled out medication at this point in time as a solution.

I found a regular pattern to my moods. They tended to peak when the moon was full. The bad ones where in the month when mercury was in retrograde (or more to the point, the nearest full moon). There may have been some confirmation bias in this or self-fulfilling-prophecy, but I took quite a bit of care to minimise the likelihood of these. This correlation allowed me to plan ahead and avoid putting into my calendar critical things, like applying for jobs, or caring for people. Initially all I could do was manage the symptoms and hold on, knowing it would end in time and life would return to “normal”.

I came up with many hypothesise for my observed correlation. Perhaps it was the light of the moon reflecting on the atmosphere changing the ionic charge of the world, or the combination of the alignment of the sun/earth/moon gravity, or some kind of light sensitivity I had and so on. I thought up many excellent, seemingly reasonable explanations on how the correlation could be a causal factor. Under examination, they all failed. Especially trying to figure out mercury gong into retrograde (where it seems to go backwards in the sky to it’s usual path of travel due to orbital mechanics and point of reference). Perhaps my moods were causing the moon’s phase cycle and mercury going into retrograde? Not likely either.

It was tempting to discard the correlation because of this in ability to find a causal link, yet it was a powerful predictive tool. It let me time things for when I was less than able to cope. There were times when I failed in my timing (because I don’t control everyone else) and had to suffer through my extreme mood while trying to perform some kind of task. It was hard. Discarding this useful tool seemed idiotic.

Similarly trying to find a causal link seemed foolish too, although that didn’t stop me trying. After all, if I could figure out the cause, I could address that cause instead of managing symptoms. I never did figure out “the cause”. Instead, like most things in life, it was far more complicated than that. I addressed several stressors (I’ve written about that in the past) and the combined effect of these strategies was to mitigate my extremes of emotion giving me a far more regular mood pattern (still more passionate than most it seems, but not out of control). I no longer needed to predict vulnerable times, as I had learned not to be vulnerable.

Time for an analogy, and time seems like a smart thing to use. I get hungry several times a day. I can find a pattern to that hunger and find something that I can use to predict my hunger. It seems when my phone’s clock (lets just call it the clock, okay?) indicates it’s between 7-8 in the morning, I tend to get hungry. Sometimes it’s a bit later, sometimes a bit sooner. Frequently between 12 and 1 in the afternoon I get hungry again. Sometimes that goes as late as 2-30, but it is usually around 12. I get a small hunger around 3-4, but that isn’t always universal. I also become quite hungry around 6-7, and again this can range up to 8-9. The correlation isn’t tight, but it is a great predictive tool. I can try to figure out a causal link between the two, such as electronic emanations, light levels and so forth , but that will all prove faulty upon examination. Perhaps my hunger is changing the time on the clock? Clearly not, there are other clocks beyond my range and many that existed before I was born and my hunger doesn’t seem to shift the time that appears on my clock. Does that mean I should discard my clock simply because I can’t find a causal link? That seems foolish. I don’t understand the mechanism, but as a predictive tool, the clock is very useful for planing my activities such that I can address my hunger.

Just recently I experienced one of those extreme moods. I recognised it for what it was – a mood with no source. Nothing happened to directly trigger the mood I was in (such as a nasty confrontation, winning a million dollars, a death etc), and the basic emotion was consistent for several days. This had all the indicators of being one of my old extreme moods. Once recognised I knew what to do about it – I minimised my responsibility to others, put my work mask on, deferred critical tasks, prioritised things ‘things that must be done’, and held on until it passed. It’s better, but not gone yet.

It’s been several years since I’ve had one this bad. I can come up with lots of hypothesise to explain why this one was bad, but really, who knows? It disturbs me that I am still prone to these. Kind of like an ex-alcoholic who has been drinking responsibly for years waking up after a drunken night out. There is a level of disgust at what I have gone through again and dismay that it may never go away.

One of my friends who studies and works in occult fields pointed out to me that this Friday is a full moon. Oh, and by the way, mercury is in retrograde. Well, gee. It’s been years since I have felt the need to track the phase of the moon, and I can never remember when Mercury is going to be in retrograde (it happens 3-4 times a year), so clearly this wasn’t a self-fulfilling prophecy. There have been many times that Mercury went into retrograde that did not prompt a significant extreme mood (at least, not extreme enough for me to check), so the correlation is not rigid.

To some extent I’m a bit annoyed that this correlation still works. I am also relieved to note that it still works – I got that feeling of “oh, no wonder” when I was told about the astrological/astronomical phenomena. Does this mean that the moon and Mercury did this to me? I have no evidence of that. Nor do I have evidence that it didn’t. So long as I accept that it is just a correlation, I can use it as a tool.

I should also be careful not to turn it into a false correlation too. How many times has my mood been out of whack, that I dismissed because the moon was not full, or Mercury was not in retrograde? How many times was the moon full and I didn’t have a strong mood? We humans find patterns all the time, whether they exist or not. It is a part of being human.

Tim Minchin has a line in one of his songs “Storm” – ‘Do you know what we call alternate medicine that works? … Medicine’. From this, do you know what we call magic that works? Science. What this misses though, is the transition stage where scientists are looking at the alternate medicine that works to find out how it works such that they can make it more reliable, and the same transition stage where a series of events that are considered reliable magic are examined and the causal links are teased out and incorporated into the fields of science. So many previously considered fields of magic have been systematically investigated, understood, and are now labelled science. So many fields of magic have been shown to be faulty. There are still many more to be investigated.

It is an error to dismiss the consistent result because the mechanism is unknown or the current explanation is faulty. I covered this in the post Logical Fallacy Fallacy. It is an error to attack the person who tries to explain how they think something works just because it doesn’t line up with what you know. That was also covered in the post Logical Fallacy – Ad Hominem. It is an error to assume the correlation is causal – covered in the post Logical Fallacy – Mistaking Correlation with Causation.

So where does that leave us? Be cautiously open minded, be polite, be careful of your judgements and remember, we while we don’t know everything, what we have actually tested is fairly accurate.Lunacy

Villainy

Villainy – it’s an interesting topic.

As a social worker, I need to make some decisions that are not necessarily well received by those whom those decisions affect. I also make many decisions that are well received – so it isn’t all bad. My hope is that more people bless my name than curse it. Reflecting on this prompted me to think – at what point do I turn into a villain? After all, don’t many villains justify their ‘evil’ acts by doing the best thing despite the will of the people? Isn’t that what I do?

You can’t make an omelette without breaking some eggs. Commonly attributed to Joseph Stalin, this proverb is attempting to justify the cost of the eggs to make a good ending, the omelette. Many of my clients lack the insight, motivation and or intellect to make intelligent choices. Many lack relevant support and resources to manage their preferred outcome. At these times I need to step in and make recommendations, enforce rules of the organisation (policies, program guidelines and legislature). This may take the form of counselling, educating and or referring to relevant government bodies.

Many times families of the clients welcome the necessary intervention, sometimes they don’t. Sometimes the client is grateful that someone has stepped in, often they aren’t. On average though, most of the clients and families that I work with are happy with the result that our facility has supported them achieving.

The times when both the client and the family are angry with me prompts me to review the actions that I have taken. Did I really do what was best? Did I really follow the rules and did I need to? Was there another way? Frequently my result is that for the definition of ‘best’ within the program and my conscience, for the definition of the rules as I know them, I did the right thing and there was no other, better way.

Best is a strange word. I have had a client, who lacked competence due to memory and lack of insight, who had five children all trying to do the ‘best’ thing for their parent. Each had a different but reasonable idea of what ‘best’ looked like. Each child’s view was incompatible with at least half the other children. Who is to define what the ‘best’ thing was for their parent? Who am I to decide for them? To protect ourselves from this, we make a decision as a team to ensure that we have checks and balances in place and that all decisions are team decisions, each of us working within our consensus ethics, work place procedure, program guidelines and the law.

That all sounds fine and dandy. Usually it works really well, although I am sure that those who receive the more intrusive interventions on their hopes and aspirations are not happy with the role we play. What if we tinkered a little with some of these settings. Let us say that our personal ethics were a little more broad than they are, perhaps the work place procedure was written up by us to reflect these broader ethics, perhaps the program guidelines are self funded and also written by us and the law, while something we must comply with locally whenever convenient, is something we need to measure against the cost of achieving our goal. How villainous can we become?

Personal ethics are derived from a combination of genetics, culture and experience. While some would like to suggest they are sourced in religious doctrine, there have been more than enough religious people committing “sins” and crimes against common law ethics to combat this notion, and more than enough non religious (athiest) people demonstrating altruism and cooperation to dismiss the perceived requirement for a religious upbringing. Basically, the spectrum of ethics in people is broad regardless of your cultural upbringing and absence or presence of a belief system. Often the caring fields call to a more select group of the general population, mostly those whose ethics run strong in representing and assisting those who need help. A company is generally looking for individuals whose ethics lie more towards making money with minimal harm – where harm can be broadly defined. This can include allowing the breaking of eggs to make that omelette. A study of psychopathy in Chief Executive Officers (CEO’s) of companies has demonstrated that the CEO population has an inflated representation of people who score high on tests designed to identify psychopaths. Please note that psychopaths are not all out to kill you, in fact psychopaths just generally don’t care whether you live or die – there is generally no murder agenda. The perceived cost of killing you just because you are in their way – jail time, loss of social status, difficulty in finding future employment – keeps most psychopaths from seriously considering this solution to your inconvenience, despite what the media and common fear states. Additionally it is not just psychopaths that commit murder, whether as an immediate solution or a planned execution. The point to discussing psychopaths at this point is all about empathy and how it plays a part in personal ethics.

Choosing what to do with and or on behalf of another has a great deal to do with identifying with that person and imagining yourself in their situation. This is empathy. Most people have it to varying degrees, however as a general rule, psychopaths don’t. The emotions that psychopaths feel is a closed system. It is about only them, and sometimes psychopaths also experience a limited range of emotions. Rarely does a psychopath feel for someone else. This can create a very egocentric system for valuing everything. While psychopaths are aware that others can be hurt, can love, can feel happy and sad, it has no emotional reflection on them unless it helps or hinders their plans. Around about now, many people will be wondering if they are psychopaths. Looking at the way we think psychopaths work can be scary because we all share some of these traits. It is the abundance of these traits and the absence of others that can define you. Most people reading this will empathise with others, appreciate beauty beyond it’s acquisition value and love their family and friends. If that is you, you are most likely not a psychopath, even if there is an element of calculation in all of the things I just mentioned.

If a group of CEOs form a panel to promote a cause, what are the odds that the panel is only personned by psychopaths? Once they figure out that they are not being judged by the others from an empathy perspective, it is quite easy to see that they could subtly change all of the settings of the panel to be far more calculating for profit than for empathic driven ethical good.

Laws are written by people. Not all people write the laws, just those who go into the correct branches of government. Mostly laws are well thought out comprehensive. Often they are very complex allowing for wriggle room via a good lawyer. Even so, laws are local phenomena, an international company or committee can transgress the laws of man. While people can be sent to jail, a corporation cannot, that entity can only be fined. Often enough the cost of complying with the law can be more expensive than paying the fines for breaking the law. A company may choose to not follow the law for economic reasons. The law may not be as binding as one thinks.

Another consideration is the person who has gone through some kind of experience that has fundamentally changed their value system. Values are a priority system for things, emotions and concepts. Consider this ‘joke’:

Sam asks Lee if they would sleep with them for one million dollars, after some consideration Lee agrees. Sam then asks about the same activity for one dollar. Lee exclaims that they aren’t a prostitute to which Sam states that was already established with the acceptance of one million dollars, now they are just haggling over price.

This humour is derived at finding the value of money verses sex and that many people do actually have a “price” or value hierarchy. Another example it the classic rail cart thought experiment.

You find yourself at a railway, there is a cart (weighing several tons) hurtling down the track and it is going to run over five people stranded on the track. You see that there is a fork in the track and a lever to switch the cart to that fork, but there is one person stuck on that track. You have insufficient time to help either party off the track, but you do have time to get to the lever and switch the track. Do you leave the cart to run over and kill the five people, or do you switch the lever and kill the one?”

This value experiment is to prompt people to consider if they would rather not act and by inaction cause five people to die, or to act and by acting be responsible for the one persons death. It can be followed up with this:

The five people are pensioners and the single person is a teenager – does this change your decisions?

How we value things depends on our upbringing, our society, genetics and our experience. People who have gone through traumatic events, such as rape, war and domestic violence can have an altered value system due to their trauma. Even within a single society the value system of each individual is on a fairly large spectrum.

So what happens if each of the people on the team have had traumatic experiences, or have a fairly alternate value system? The values and ethics held by each team member are now non-standard. It is likely that the goal they will attempt to achieve will be driven by their fears and dreams, which may be mundane or quite extraordinary. The method to which they wish to traverse to achieve these goals may be unacceptable by society. Or to use a nice cliché, these people may feel the ends justify the means, while Western society tends to promote that the ends do not justify the means.

How would each person on the team now plotting the commonly unthinkable plan justify their position? Probably they will say something like “we know best”;”the people this affects clearly are unable to make these decision themselves” because they are “not smart enough, not able to comprehend so lack insight” and so on; “it is the ethical thing to do”; “while there are people who will think this is wrong and will hate me for it, it is the thing I have to do”; and probably “you can’t make an omelette without breaking some eggs”. Basically the same reasons that I use to make my hard decisions.

So I console myself that I have empathy and a good value system – yet so would they – that I don’t have too much power to make significantly harmful mass decisions and that on average people think I am doing the right thing. My question is, what ratio of commonly regarded “good outcomes” to “bad outcomes” do I need to achieve to not be a villain? Or is that an example of a cold calculation?

Logical Fallacy #23: Tu quoque – appeal to hypocrisy

t turns out I missed #19, so all the numbers are out by one after that. Fixed now… (and the previous posts too!).

Tu Quoque is Latin for “you too” or “you also”. There are three flavours to this logical fallacy. The appeal to the common error in both sides of the discussion to excuse a mistake, the appeal to justify ones one errors based on a faulty perception of the others perceived mistakes and the discrediting of another’s failure to act consistently to their position.

The Pot Calling the Kettle Black

This is tantamount to a child in the playground excusing their bad behaviour with “X was doing it too!” Regardless of who else makes the error, it was still bad behaviour.

In the instance that a member of a discussion is caught using faulty logic or poor evidence, the perpetrator can either plead guilty, or may attempt to justify the error by citing the accuser of making the same or a similar error. This is a specific ad hominem attack attempting to shift the focus away from ones own mistakes to target the mistakes of another. In one flavour of this, the other may have indeed been mistaken, and in the other flavour, they are not. Either way, the fallacy is the same. Instead of addressing the noted error, the defendant diverts attention to some other error, whether real or not. The solution to this as someone who is called out on an error is to address the error. If the person receiving this logical fallacy, keep the focus on the error noted first, then address the accusation afterwards.

Dismissing the the Position

In this form of the logical fallacy, the position is ignored because of a self referential error in the arguments. This is a special case of the Fallacy Fallacy in that the fallacious argument becomes the focus instead of the position, which is dismissed. This can be best demonstrated in the following example:

Person A makes criticism C.

Person A is also guilty of C.

Therefore, C is dismissed.

Person 1: Drinking is bad for your health

Person 2: But your drinking!

In this case, the premise is that drinking is bad for ones health, which is dismissed by the second person because the arguer is currently drinking. Just because someone is guilty of participating in the activity or idea that is described does not make the activity or idea wrong. I can equally say that bashing my head against a wall is bad for your head whilst bashing my head against a wall. That doesn’t mean my head is not damaged by bashing my head against the wall.

 

Pot Kettle Black