Why we’re in an epidemic of depression, my little theory

Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. Journal of Abnormal Psychology, 128(3), 185–199. https://doi.org/10.1037/abn0000410

Our culture influences our feelings and how we express them. I used to think that the rates of depression are on the rise because suffering and unhappiness itself became medicalised, so people come to the doctor. Now, my culture-based theory has evolved*.

Some time after the Reagan/Thatcher ideas of absolute personal responsibility seeped through our economy, they also made their way into our psyche. The rise of positive thinking coincides with the advent of the neoliberal economy. If you think positively, good things will happen. Conversely, if good things didn’t happen, that’s because you didn’t believe in yourself enough, didn’t try hard enough, didn’t rise when you were knocked enough.

Byron and Keats wrote about their souls being dark and looked to nightingales as they indulged in their emotional pain. Even as late as the 1960s, T.S. Eliot got away with pretty dark musings and they were still considered art**. Radiohead may have gotten away with it with “Creep” in the 1990s. But who indulges in their sadness anymore?

What happens these days when you express negative emotions? Society says: you’re so negative. We can’t have these toxic attitudes in our lives. Goodbye. P.S. The matter is in your own hands – and you need to find where you went wrong, resulting in these terrible feelings. Now, fill yourself with some motivation and go out there again. Then we may talk to you once more.

To circumvent the problem of being left to deal with it all alone (impossible) or coming out and being called a loser, a complainer, to avoid being unfairly blamed, shamed and devalued, one reaches for the protections of a medical diagnosis. Humanity got backed into a corner, so it picked up the shield provided by the DSM***. Then one can talk about bad things that happened, the pain it caused and actually expect a bit of acceptance.

* There are many reasons why depression is on the rise – well described in the literature – and they are outside the scope of my little theory

** I would have liked to invoke Virginia Woolf, Sylvia Plath, Amy Winehouse and Kurt Cobain, but their art is inevitably seen through the prism of suicide – which is kind of prejudiced if you ask me.

*** The Diagnostic and Statistical Manual of Mental Disorders

Tara Westover’s “Educated” – a review of reviews

In short, one of the best books I’ve read in a while.

I finally got around to reading this beautiful memoir this autumn (and felt the need to write about it! Hello to anyone who has missed me on here).

My reluctance to read it when I first came across it came from the fear that it would be an opinionated political piece masquerading as a memoir, but my fears were unwarranted.

In the absence of a bookclub, I read other people’s reviews. I was surprised to find a lot of negativity. The criticisms can be summarised as follows:

  1. the story is fishy because a person wouldn’t keep going back to their abusive family again and again
  2. the story is fishy because people struggle to get into Cambridge and Harvard after many years of stellar education and this girl basically had none
  3. the story is repetitive describing similar abuse incidents again and again
  4. the story doesn’t have a resolution
  5. it’s a poor-me story
  6. it’s not a well written book
  7. the medical aspects are hard to believe
  8. this isn’t negative, but it featured as an introductory comment in a lot of reviews: the author suffered because she came from a conservative, Mormon, survivalist family
  1. the story is fishy because a person wouldn’t keep going back to their abusive family again and again

She goes back because they are family. Many people, especially religious people, put family on a pedestal that family may or may not deserve, believing that family is sacred and nothing could possibly break these bonds.

A victim of parental neglect, child labour and domestic violence, Tara kept going back and felt a duty to fix the situation. Abuse victims have been known to behave this way. Entirely believable.

2. the story is fishy because people struggle to get into Cambridge and Harvard after many years of stellar education and this girl basically had none

Surprisingly many people see a connection between one’s worth and one’s education, dismissing the uneducated outright, I feel – and this goes hand in hand with some of the ongoing political turmoil in the US. Someone who “hacked” the system from her father’s junkyard would appear as a fraud to them.

The beautiful narrative, the balanced dynamic of the arguments and reflections and the genuine insights that permeate this book serve as a testament to this woman’s talent. I believe her.

3. the story is repetitive describing similar abuse incidents again and again

The Iliad is also repetitive, describing many, many men bleeding from their spear wounds until darkness veils their eyes. I don’t think repetition is the marker of a failed narrative…

It’s a memoir, so a certain amount of the narrative has to be driven by fact rather than plot dynamics. Moreover, the repetition underlines the family relationships, the commitments and beliefs held by the characters.

4. the story doesn’t have a resolution

Tara no longer speaks to most of her family and delivered such an insightful book for anyone who struggles with gaslighting and abuse. I feel that’s quite the resolution.

5. it’s a poor-me story

What if a person deserves our sympathy? Some reviewers resented having spent their 9.99, some of which will, God forbid, enrich this junkyard upstart.

6. it’s not a well written book

A matter of opinion, I guess. For me, it’s one of the best written I’ve read in some time.

7. the medical aspects are hard to believe

The description of the medical aspects did shock me: the father’s heart stopping multiple times and restarting seemingly all by itself after an overwhelming inhalation injury, large areas of burns soaking in a garbage can, brains pulsing through skull fractures – all surviving and making a spectacular recovery with none or very little modern medical intervention.

I don’t know what to make of it. Perhaps, it’s an impressionable young person’s memory and the real injuries weren’t quite as dramatic. Perhaps, it is just a spectacular set of recoveries – they do happen, it’s just unusual that there is a whole string of them.

8. the author suffered because she came from a conservative, Mormon, survivalist family

It would be discriminatory to say that her suffering arose from any of those things.

I don’t know any American conservatives, Mormons or survivalists personally, however I believe that people are entitled to their political and religious views and even some eccentricity. We don’t jail people for running ultramarathons, breeding falabellas or hoarding hundreds of pairs of shoes, so why not let a man stockpile fuel and canned peaches?

It’s easy to conflate abuse that’s congruent with a set of beliefs and those beliefs. For example, when Tara insisted that her version of reality is legitimate and didn’t want to accept her parents’ lies, they deemed her “possessed”. This is abusive regardless of the mythology behind it. “A hormonal teenager” is as good as “possessed” – dismissive and devaluing – but congruent with mainstream culture, hence it doesn’t stand out as much. There are many examples where her family invoke God for their self-serving manipulation. Similarly, canned peaches are harmless, but depriving the family of basic comforts to buy more SKSs is abuse.

All in all, I wish I had read this book the day it was out!


“What you seek you shall never find. 
For when the Gods made man, 
They kept immortality to themselves.
Fill your belly.
Day and night make merry.
Let Days be full of joy.
Love the child who holds your hand.
Let your wife delight in your embrace.
For these alone are the concerns of man.”

Why do they make us study Hamlet, with his thousand natural shocks, rather than the very reasonable Gilgamesh?

The above is excellent advice for most people I know.


Another utopia gone wrong

In 1972, animal behaviorist John Calhoun built a mouse paradise with beautiful buildings and limitless food. He introduced eight mice to the population. Two years later, the mice had created their own apocalypse. Here’s why.

Universe 25 was a giant box designed to be a rodent utopia. The trouble was, this utopia did not have a benevolent creator. John B. Calhoun had designed quite a few mouse environments before he got to the 25th one, and didn’t expect to be watching a happy story. Divided into “main squares” and then subdivided into levels, with ramps going up to “apartments,” the place looked great, and was always kept stocked with food, but its inhabitants were doomed from the get-go.

Universe 25 started out with eight mice, four males and four females. By day 560, the mouse population reached 2,200, and then steadily declined back down to unrecoverable extinction. At the peak population, most mice spent every living second in the company of hundreds of other mice. They gathered in the main squares, waiting to be fed and occasionally attacking each other. Few females carried pregnancies to term, and the ones that did seemed to simply forget about their babies. They’d move half their litter away from danger and forget the rest. Sometimes they’d drop and abandon a baby while they were carrying it.

The few secluded spaces housed a population Calhoun called, “the beautiful ones.” Generally guarded by one male, the females—- and few males — inside the space didn’t breed or fight or do anything but eat and groom and sleep. When the population started declining the beautiful ones were spared from violence and death, but had completely lost touch with social behaviors, including having sex or caring for their young.

Source and Wiki

This blew my mind.

On another note, I spent a week away in Croatia and Bosnia of all places. I highly recommend it.

The People Vs Tech: How the internet is killing democracy (and how we save it) by Jamie Bartlett, Review

This book is a summary of the recent news, research, non-fiction bestsellers and popular science relating to tech, in a political context. The author tries hard to maintain objectivity, but he ends up sitting on the fence and stating the non-offensive obvious rather than creating new insights. Perhaps, there is a certain irony in that: serious journalism doesn’t hit as hard as divisive tripe we’ve gotten used to on Facebook. Overall, it’s an entry level book for people who want to learn about tech vs politics.

On a personal note, I recently attended a conference on digital health where an IBM Watson guy described how it could make decisions that are 93% congruent with health professionals (source). That’s impressive. But just because it can, doesn’t mean it will. Ireland has decent IT in healthcare compared to most countries. Yet I still fax things a lot (welcome to the 80s). As a doctor, I often serve as a photocopying machine. I’ve seen radiology software pick some cool stuff up using algorithms, but it will be a long time before AI is on the front line of medicine, in my view anyway.

My highlights below (this is not to say I highlight things I agree with!)

…The digital technologies associated with Silicon Valley –social media platforms, big data, mobile technology and artificial intelligence –that are increasingly dominating economic, political and social life. It’s clear that these technologies have, on balance, made us more informed, wealthier and, in some ways, happier. After all, technology tends to expand human capabilities, produce new opportunities, and increase productivity. But that doesn’t necessarily mean that they’re good for democracy.

While there are certainly contradictions in minimising tax while claiming to empower people, doing so doesn’t necessarily betray insincerity.

The machinery of democracy was built during a time of nation-states, hierarchies, deference and industrialised economies. The fundamental features of digital tech are at odds with this model: non-geographical, decentralised, data-driven, subject to network effects and exponential growth.

We won’t witness a repeat of the 1930s, everyone’s favourite analogy. Rather, I believe that democracy will fail in new and unexpected ways. The looming dystopia to fear is a shell democracy run by smart machines and a new elite of ‘progressive’ but authoritarian technocrats.

Chapter 1: The New Panopticon

Social media platforms are the latest iteration of the behaviourist desire to manage society through scientific observation of the mind, via a complete information loop: testing products on people, getting feedback and redesigning the model.

The notion that with enough data the mysteries of the human mind can be understood and influenced is perhaps the dominant philosophy in Silicon Valley today.

Scientific theories were unnecessary, he [Chris Anderson, editor of Wired] said, now that we have big data.

Google engineers don’t speculate and theorise about why people visit one site over another –they just try things and see what works.

Our modern panopticon doesn’t have just one watchman: everyone is both watching and being watched. This kind of permanent visibility and monitoring is a way to enforce conformity and docility.

Being always under surveillance and knowing that the things you say are collected and shared creates a soft but constant self-censorship.

Diagnosis by AI will outperform professional doctors within a few years (it already does in many areas, but regulation is slower than tech).

Deny it if you want, but we already rely on the machine for moral choices.

I can imagine this kind of utilitarian thinking will take over the world, because it’s amenable to data and AI.

Chapter 2: The Global Village

We are living, as McLuhan predicted, through a great re-tribalisation of politics.

Humans were perfectly good at killing each other because of politics long before the iPhone turned up. But Silicon Valley, in its optimistic quest for a global village of total information and connectivity, has inadvertently let tribalism back out of the cage that modern representative democracy built for it.

At times ‘post-truth’ has become a convenient way to explain complicated events with a simple single phrase. In some circles it has become a slightly patronising new orthodoxy to say that stupid proles have been duped by misinformation on the internet into voting for things like Brexit or Trump.

Anyone who is upset can now automatically, sometimes algorithmically, find other people that are similarly upset. Sociologists call this ‘homophily’, political theorists call it ‘identity politics’ and common wisdom says ‘birds of a feather flock together’.

The point is that every individual now has a truckload of reasons to feel legitimately aggrieved, outraged, oppressed or threatened, even if their own life is going just fine.

Note how, for example, so many people who disagree with Brexit use the language of a small child that has yet to develop a theory of mind: why should I accept the result, I didn’t vote for it and I want my country back.

The liberals’ hopeful theory about the role of debate is that coming into contact with opposing views and opinions can help resolve difference.

Several inconvenient studies have found that if two groups of people debate with each other they often consequently hold more extreme views than when they started. 15

I see opposing views to mine online all the time; they rarely change my mind, and more often simply confirm my belief that I am the only sane person in a sea of internet idiots.

But being apparently neutral is itself a kind of editorial decision. Everything on social media is still curated, usually by some mysterious algorithm rather than a human editor.

But the problem is that no one is intentionally programming it to be sensationalistic –it’s just a mathematical response to our general preference for edgy and outrageous videos. This is both a mirror and a multiplier: a giant feedback loop powered by big data. You feed data in, and you get results that replicate themselves. Newspapers have always traded on outrage and sensationalism, because they’ve long known what algorithms have recently discovered about our predilections. However, the difference is that newspapers are legally responsible for what they print, and citizens generally understand the editorial positions of various outlets. Algorithms, however, give the impression of being neutral and can’t held to account –even though the YouTube algorithm alone shapes what 1.5 billion users are likely to see, which is more than every newspaper in the world combined.

In her masterpiece The Origins of Totalitarianism Hannah Arendt warned that if citizens float around like corks in a stormy sea, unsure of what to believe or trust, they will be susceptible to the charms of demagogues.

If the medium is the message, is there a way to escape the drift toward ever more extreme ‘system one’ tribal politics? Of course. Laws, regulations or education can help.

The qualities we associate with human greatness –such as sensitivity, empathy, compassion, kindness, and honesty –are also keys to political success.

At a campaign rally in Iowa in January 2016, Trump told his supporters that he could ‘stand in the middle of Fifth Avenue and shoot somebody and … wouldn’t lose voters’. There is a distinct and terrifying possibility that, in an era in which emotion outranks truth, bias outranks objectivity and tribe outranks compromise, he was right.

Chapter 3: Software Wars

Every election now is a mini arms race.

Just like Brad [Trump’s digital campaign guy], Cummings set up Vote Leave like a Silicon Valley start-up, with physicists, data, innovation and constant testing of ads or messages. One especially smart move involved inviting people to guess the results of all 51 matches in the Euro 2016 football tournament with the chance of winning £ 50 million, in exchange for their phone number, email, home address and a score of 1–5 in respect of how likely they were to vote for staying in the EU.

I was surprised when Theresa [Trump’s digital campaign figure] told me that social media employees –and ones who shared the campaign’s political views –were working directly with the Trump team, but perhaps I shouldn’t have been.

We used to call this sort of thing propaganda. Now we call it ‘a behavioral approach to persuasive communication with quantifiable results’, and give awards to the people who are best at it.

It is important that everyone receives the same message –or at least knows what others are receiving. That’s how we are able to thrash out the issues of the day. If everyone receives personalised messages, there is no common public debate –just millions of private ones.

When I was at Alamo, Theresa told me that she wrote many of Donald Trump’s Facebook posts. That was odd. I’d always assumed Trump wrote his own posts. I’d read many of them, and they certainly sounded like him. Nope, it was Theresa, sitting in her San Antonio office. ‘I channelled Mr Trump,’ she told me, smiling. ‘How do you channel someone like Donald Trump?’ I asked. ‘A lot of believe mes, a lot of alsos, a lot of verys … he was really wonderful to write for. It was so refreshing. It was so authentic.’ She seemed unaware of the irony.

Mark Zuckerberg seems to have had a Damascene moment towards the end of 2017, when he acknowledged that the company needed to behave more like a responsible publisher that takes editorial decisions, rather than as a neutral platform that treats all information equally. This will certainly help.

Far too many otherwise-intelligent people, unable to comprehend Trump’s popularity, believe that voters were duped by Brad or Theresa, or even by Vladimir Putin, into ticking the box for Trump. Those involved are happy to propagate this myth, because it’s good for business.

I don’t recall similar levels of outrage when it was revealed in 2012 that President Obama’s team had placed voters into 30 buckets and ranked them according to persuadability, and that Google’s Eric Schmidt advised the campaign. Liberals were apparently extremely comfortable with the idea when it was their guy doing it. That was a mistake.

Chapter 4: Driverless Democracy

When AI techniques transform medical diagnosis –within the next few years –it won’t mean fewer doctors, but better patient care because our busy doctors won’t need to spend hours staring at scans.

A specialist in machine learning at Starsky Robotics or Google performs a non-routine job, since it involves a lot of intuition, creativity and independent thinking in unpredictable situations. So does a gardener, carer or Deliveroo cyclist. It’s the jobs in the middle –what you might call ‘routine cognitive’ jobs –that will be most at risk. If you are a train operator, a mortgage adviser, a stock analyst, a paralegal, a credit analyst, a loan officer, a bookkeeper, a tax accountant or a radiologist, you might consider retraining.

High levels of inequality also wear away the fabric of society. The more unequal life gets, the less we spend time with people not like ourselves, and the less we trust each other.

‘There are40 million people in the US that live in poverty,’ he [Sam Altman, Y Combinator] said. ‘If technology can eliminate human suffering, we should do that; if technology can generate more wealth and we can figure out how to distribute it better, we should do that.’ There was no hint that tech has played some role in creating the problem that tech is now supposed to fix.

Chapter 5: The Everything Monopoly

Back in the 1990s many predicted that the internet would slay monopolies, not create them. The popular thinking of the time –repeated over and over by the era’s digital gurus and futurists –was that the net was decentralised and connected, and so would automatically lead to a competitive and distributed marketplace.

Market leaders in AI like Google, with the data, the geniuses, the experience and the computing power, won’t be limited to just search and information retrieval. They will also be able to leap ahead in almost anything where AI is important: logistics, driverless cars, medical research, television, factory production, city planning, agriculture, energy use, storage, clerical work, education and who knows what else.

At some terrible point, these tech giants could become so important to the health and well-being of the nation that they are, like large banks, too big to fail. Armed with the best tech and the most skilled engineers, maybe Google or Facebook could be the only ones who could solve sophisticated cybercrime (perhaps committed by a powerful AI from a hostile country?), fix computer bugs, predict and pre-empt economic shocks, run the National Grid or protect the cyber defences of the big banks –cyber security in the public sector is predictably understaffed and under-skilled.

Every politician, with only a few exceptions, values the support of business. But politicians need tech platforms to reach voters in a manner that they don’t need other businesses, and these companies own and run the platforms on which so much of our political debate occurs.

Chapter 6: Crypto-Anarchy

(Public key) encryption is the crypto-anarchist’s barbed wire. It allows people to communicate, browse and transact beyond the reach of government, making it significantly harder for the state to control information, and subsequently, its citizens. This is because of a simple-but-magic rule: due to some arcane properties of prime numbers, it takes far more computing power to decrypt something than to encrypt it. 3 It’s like an egg: a lot easier to crack than to put back in its shell. Julian Assange, who was an active contributor to Timothy May’s email list, puts it this way: ‘the universe believes in encryption’.

In the well-intentioned pursuit of privacy and freedom, we might risk undermining the entire edifice on which these rights are based. Most liberals have been very short-sighted about this, because they want total freedom and equality, without realising that the two are sometimes in tension. This is why the issue of encryption and privacy throws up peculiar political alliances. (The most notable of recent years is surely the idiotic social democratic love affair with crypto-anarchist Julian Assange.)

Democracy is about individual liberty of course, but that’s only half the picture. It is also a system of coercion because your liberty must sometimes be taken away too. The state must be able to force you to pay tax, remove your passport, restrict your right to assemble and back it up with the use of force if it needs to by arresting you and throwing you in prison.

A blockchain social media platform would be untouchable – no government would be able to edit or remove hate-speech, illegal images or terror propaganda, unless the whole network was somehow vaporised. Blockchain advocates hate ‘middle men’.

For reasons still not entirely clear to me, humanity is currently embarked on a quixotic quest to connect everything to everything else.

A recent survey in the Journal of Democracy found that only 30 per cent of US millennials (the demographic made up of those born since 1980) agree that ‘it’s essential to live in a democracy’, compared to 75 per cent of those born in the 1930s, and results in most other democracies demonstrate a similar pattern.

Conclusion: Say Hello to the Future

In the hands of a techno-authoritarian, all the digital tools of liberation could easily become powerful tools of subtle coercion that might make society run more smoothly but wouldn’t make us more free or hold the powerful to account.

Digital technology is behind the slow unravelling of power and control in democracies. The obvious monster is Scylla – turbo-charged inequality and social breakdown. But in trying to avoid it, democracies could end up in the thrall of Charybdis, a digitally powered techno-authoritarian, and wind up with China and Russia undermining democracy in the name of order and harmony.