Pain Avoidance

For the record I do think that Kamala Harris won tonight's debate with Donald Trump because she looked "more Presidential" than he did. Regarding the content, I keep up with enough political news to know that each debater made claims about the other that were false, but I wasn't the target audience, which presumably was the low-information undecided voter.

Cheryl Obermiller in Missouri, and Jonathan Chiaramonte in New York.
Both started politics-free Facebook groups. (WSJ photo)

However, one should not demean the latter by assuming they're unintelligent. They could be rationally avoiding politics because they can't stand the vitriol. [bold added]

Some Americans are avoiding [politics] at all costs.

They are canceling subscriptions, deleting apps, silencing notifications and unfollowing rabble-rousers. Many want no part of Tuesday night’s presidential debate or its fallout. Political discourse has infiltrated everything from the Sunday church service to afternoon football, and they have had enough.

Even those with firm political views say they feign ignorance rather than join impassioned discussions. It isn’t, they say, that they are uninterested or uncaring about world events, but they are inundated by the sheer volume of news headlines. Deciding it is bad for their mental health, they are retreating or seeking apolitical havens.

Cheryl’s Amazingly Positive, No Politics Allowed, Interesting People Group, with 11,600 members, is one. “Not only do I not care who you voted for, in this group you aren’t allowed to tell me,” wrote creator Cheryl Obermiller, 66 years old, welcoming “fellow snowflakes” to post photos of flowers, funny road signs and tasteful jokes.

Obermiller, who founded the group after friends engaged in political flame wars, said, “Things are so contentious right now that people are just starving for a place they can go where someone doesn’t have to know who I am going to vote for.” She helps monitor comments, a time-consuming task for the Kansas City, Mo., construction-services firm owner with eight children and 21 grandchildren.

About 62% of U.S. adults say they are worn out by so much coverage of the campaign and candidates, according to the Pew Research Center, which surveyed 8,709 adults in April...

Politics is a chronic stressor and disengaging is among the most effective coping methods, said Brett Q. Ford, an associate professor of psychology at the University of Toronto. Ford and a colleague tracked hundreds of Americans in recent years and found political events often triggered negative emotions that left people exhausted...

Jonathan Chiaramonte, a 43-year-old high-school teacher, in 2020 started a politics-free community Facebook group in Sayville, N.Y., where he lives. Chiaramonte, who teaches a peer-education class that promotes community, confidence and eradicating bullying, noticed adults in town behaved worse than his students when it came to political discourse. “It was so upsetting to see my neighbors fighting,” he recalled.

Today, the Sayville Politics-Free Zone has 3,000 members in a town of about 17,000. He said people know they can share or seek information without any spin or political blowback. He once used the forum while redoing his kitchen. “I was looking for a contractor,” he said, “not for a lecture on politics.”

Count me in the feigning-ignorance crowd. Stress harms one's mental and physical health. Our jobs, finances, and family problems are stressors enough, and voluntarily seeking more in political discussions seems crazy to your humble blogger.

I'll do my civic duty, cast my vote in person in November, then move on.

We'll Miss It When It's Gone

Graph from https://allisonkyff.domains.trincoll.edu/

Related to last Sunday's post ("A Progressive Sees the Social Benefits of Religion"): a "growing body of research" covering many thousands of people showed religiosity is correlated with good mental health.

“There is a mounting body of empirical evidence suggesting that people who are active in their faith tend to be the recipients of a number of important physical and mental-health benefits,” says Byron Johnson, professor of social sciences at Baylor University.

Believing in a higher power can foster a sense of connection, research has shown. Helping others, which many religions facilitate through organized-outreach programs, builds compassion, which psychologists have found can improve mental health.

Now that religion is on the wane its societal benefits have become more obvious, even to social scientists who are not religious advocates. Let's hope that it's not too late for organized religion to escape its own "doom loop."

Primary Election Day

Foster City Library

I did my civic duty and cast my ballot in person earlier today at the Foster City library.

There were a limited number of offices to vote on, and only one proposition, Proposition 1, a $6.4 billion bond to build mental health treatment facilities and housing for the homeless. I voted "no" on Prop. 1, not because I don't want to spend money on mental health and/or the homeless but because I have little faith that the monies will actually help the intended recipients. They'll probably be diverted to consultants, planners, government agencies, and non-profits. We've been fooled before: in 2014 Californians approved a $7.5 billion bond measure to build more water storage; ten years later not one reservoir has been built.

The U.S. Senate race I also found interesting because of the way in which Democrat Adam Schiff "picked his opponent," Republican Steve Garvey. In California the top two vote getters in the primaries face off in the general election, and Adam Schiff ran ads that warned against Steve Garvey's conservatism, boosting the latter's profile amongst Republicans and some independents. A Democrat like Katie Porter would have likely proved a tougher opponent in November. If one is a fan of political strategy, one has to give credit where it's due.

Revival, But Not in the Way Imagined

(CBC news photo)

There are very few indoor, relatively safe, public gathering places--with restroom facilities--that remain open to all. That's why Libraries Are the New Front Line in America’s Mental-Health Crisis

Librarians are helping more patrons in crisis, and many cities are hiring social workers to help them. About two-thirds of nearly 600 library workers surveyed by Urban Librarians Unite in 2022 said they had experienced violent or aggressive behavior from patrons.

One of the few indoor public spaces open to all comers, libraries are now the scene for all that ails a public scarred by the pandemic and an opioid epidemic. For staff, that means reversing overdoses in bathrooms; confronting patrons watching pornography; or defending against people brandishing guns, or a snake in a jar. Some people come to the library to sleep, get warm or use the bathroom. Others are looking for jobs, housing or just somewhere safe to read.

Libraries have been transformed from mere repositories of books to ad hoc community centers. They provide free internet access and a growing array of services, e.g. job placement, mental-health treatment, and housing assistance.

If a person is idle, reading in a comfortable setting is an edifying and even useful way of passing the time.

When we contributed to the construction of the town library in the mid-1990's, we had hoped that it would become a valuable resource in the community.

Little did we imagine the form that it would take.

The Religion - Health Connection

(WSJ illustration)

Despite the commonly held belief that religiosity is connected with good health, the causation arrow has been difficult to prove. Northeastern Professor of Psychology David DeSteno describes the current state of the research .

In a study published in JAMA Internal Medicine in 2016, using data from over 70,000 women who were part of the Nurses’ Health Study from 1992 to 2012, [Harvard epidemiologist Tyler] VanderWeele and colleagues found that those who attended religious services at least once a week had 33% lower mortality, from any cause, over a 16-year period. In particular, deaths due to cancer or cardiovascular disease were 75% the rate among non-attenders. While religion-associated reductions in smoking and increases in social support explained some of the benefit, the data suggested that religion worked through other, as yet unexplained, avenues too.

VanderWeele’s team found a similar benefit when it came to suicide risk. Among the nurses, attending services at least once a week or more cut the suicide rate by 80%, even when controlling for diagnoses of depression, cancer and cardiovascular disease. Researchers asked detailed questions to isolate the effect of social support from that of religious activity and found that while social connection did have a positive effect, it didn’t completely explain the benefits religion offered.

Using data from other large-scale, longitudinal studies, VanderWeele found that religiosity improves mental health. Attending services at least weekly or meditating regularly reduces feelings of depression and increases feelings of life satisfaction and purpose, even among adolescents. The health benefits are greater for those who attend services once a week or more than for those who only attend intermittently.

The aforementioned studies show that religion and health are positively correlated, but it's not clear that religion itself, as opposed to its attributes, is the key ingredient. After all, atheists can engage in healthy social interactions, lay off cigarettes, and meditate, all behaviors that have been shown to improve health.

Prof. DeSteno says that there is an additional "unexplained" health benefit that he doesn't quantify here. I guess we will have to take his claim on faith.

Oversharing

(Image from mobile app daily)

Facebook's rapid growth 10-15 years ago coincided with a rise in teen mental health issues. Young people were bombarded with images about the happy, fulfilling, exciting experiences of their peers; they were reminded how their own lives supposedly paled in comparison.

Depression, anxiety, and the fear of missing out afflicted millions (2019: "there were almost 42 million adolescents between the ages of 10 and 19 in the United States.")

A more recent (but not new) tech tool, location-sharing, has aggravated emotional problems: [bold added]

Location sharing has become such a fixture that many teens say they’d be overlooked socially if they didn’t use it...

Many teens say location sharing can make them self-conscious about where they live and where they go. Some fear being stalked. Yet, by far the biggest cause of anxiety, they say, is knowing when they’re missing out.

The already-acute youth mental-health crisis has worsened since the pandemic.

Teens feel worse knowing immediately that their friends are having fun without them.

Addison [Figel, 16] and other teens say they can shrug it off when they see a photo or video of friends gathered without them, posted after the fact. Witnessing exclusion in real time hits differently.

Your humble blogger has always believed that more information--even information that is fragmented and incomplete--is better than not having it.

But it does require both good judgment--to view the information in context and question what is being left out--and strength of character to withstand actual or perceived slights. Wisdom and character are attributes that take time to develop.

Adolescents' inexperience and powerful emotions make them particularly vulnerable. Perhaps tech can develop solutions--for example, requiring non-family users to opt-in to location sharing upon powering up--to lessen the dark side of social media.

They're Not Stupid

Two people sleeping at Kuhio Beach, Waikiki

The Honolulu Star-Advertiser runs an evergreen headline (right):

East Honolulu’s percentage of unsheltered homelessness in 2022 has grown to 24%, or 575 of the 2,355 unsheltered homeless people recorded during the March 10 Point-in-Time count, a gain of 6 percentage points from the 2020 count and a 10-percentage-point rise from the 2019 count.

The article covers the usual subjects/solutions of building shelters, buying unused land, increasing rental assistance, and lamenting the high cost of housing.

But the interesting part of the story to your humble Honolulu-born blogger is that the homeless population is migrating from the residential and industrial sections to East Honolulu, which includes Waikiki.

And why not? if you are going to be homeless, you may as well live in a tent on the nice white-sand beaches that tourists pay $thousands to see; there's a better chance that a few will slip you a few dollars on Kalakaua Avenue than on North King Street. Some homeless may be mentally ill, but they're not stupid.

Related: economist Scott Sumner uses similar logic in explaining why the homeless prefer to live in high-cost California: "homeless people in Arkansas are already homeless, so [by moving to LA] they benefit from all of the positive factors that make LA a desirable place to live, without the drawback of paying high prices for an apartment."

Inexplicable and Tragic

Stanford University is on everyone's top-10 list of colleges. It has an admit rate of 3.95% (2,190 out of 55,471), comparable to Harvard and Yale. Once a student has been accepted, it's not too difficult to get a Bachelor's credential---at least that's what Stanford degree holders have been telling me for 50 years. (Of course, if a student wants to go to graduate school, she has to keep up her grades.)

Katie Meyer captained the soccer
team to the national championship.

A Stanford degree opens a lot of doors, and the hardest part is getting admitted. There are no guarantees of career success, but there's no question that attending Stanford confers work and life advantages.

That's why it has been inexplicable, and tragic, that there have been a number of undergraduate suicides in the past year.

[Soccer captain Katie] Meyer was at least the fourth Stanford student to unexpectedly die in just over a year, and the third to die by suicide. As the Stanford community reeled, many called on university administrators to do more to change what’s been described as a toxic culture for mental health — one that encourages students to brush aside their personal dilemmas.

Rose Wong

Last February, Stanford said medical student Rose Wong was found dead by suicide in an on-campus residence. Six months later, engineering student Jacob Meisel was killed in Palo Alto after being struck by a train in what the Santa Clara County coroner ruled a suicide. This year, in late January, law student Dylan Simmons was found dead in an on-campus residence...

Just a month ago, university officials recognized a mental health crisis on campus, writing in an email to students and staff following “publicly visible medical emergency” that students “have shared feelings of high levels of stress and disconnect over the past few months.”

Jacob Meisel

The suicide of any young person is tragic. From experience we know that eventually the intense feelings about the worst losses and disappointments will diminish and there will be moments of joy again.

While their lives were not worthier than others on the scales of cosmic justice, Katie, Rose, and Jacob stood an excellent chance of leaving the world a better place and of finding eventual fulfillment, if they had chosen life, and we are all poorer for their decision.

Depression and Dementia

(Image from sharpbrains.com)

As if life wasn't difficult enough for teens and young adults with depression, UCSF researchers say that this condition is highly correlated with dementia. [bold added]

Depression in young adulthood might increase risk for cognitive impairment in old age, a new UCSF study has found.

The study — which used predictive models to determine depressive symptoms over a lifetime — found that the chances of cognitive impairment were 73% higher for those estimated to have elevated depressive symptoms in early adulthood, and 43% higher for those estimated to have elevated depressive symptoms in later life.

The conclusions find a receptive audience because they play into our belief that brain disorders are related. However,....

1) There are a great many years between youth and old age. Youthful disease is not destiny.

2) Depression is better understood today than in the past. Therapy and changes in attitudes and behavior (gratitude, social interaction, self care, hobbies, and "cognitive restructuring") can help, and for severe cases medications are available.

3) By social interaction we mean the in-person kind, not social media, which can be mentally toxic to teenagers.

4) The UCSF study is based on "predictive models" that have not been verified by observation:

The study pulled data from 15,000 people in different age cohorts, ranging from 20-89 — divided into older, midlife and young adulthood — and used predictive methods to estimate the average trajectory of depressive symptoms. That trajectory is used to make a “best guess” of how older adults with dementia might have been in early adulthood.

While this methodology isn’t as good as studying someone over a lifetime,[ Dr. Willa] Brenowitz said, it’s the best researchers have now — and should spotlight the need to start observation for dementia risk factors earlier in life.

Predictive models are works-in-progress, as we have seen from much more elaborate climate, epidemiological, and econometric models that have made predictions that proved to be wildly inaccurate.

It's useful that the connection between depression and dementia is being explored. It's also true that the models can be wrong, and even, if true, there is time to take the steps that can break the connection.

It Doesn't Read Your Mind.....Yet

(Images from Frontiers in Psychology)

Apple is pouring billions of dollars into developing medical applications for its devices. Although the emphasis continues to be on wearables, the iPhone is at the center of the push into mental health.

Apple Inc. is working on technology to help diagnose depression and cognitive decline, aiming for tools that could expand the scope of its burgeoning health portfolio...

Using an array of sensor data that includes mobility, physical activity, sleep patterns, typing behavior and more, researchers hope they can tease out digital signals associated with the target conditions so that algorithms can be created to detect them reliably....

The research projects are still at early stages, and may never lead to new device features...While prior academic studies have shown some evidence that people with certain mental-health conditions use their digital devices differently than others, it remains to be seen if reliable algorithms can be created to detect the conditions...

If they are successful, Apple and its partners could improve the detection of the conditions, which affect tens of millions of people world-wide. But the extent of user tracking that may be required could spark privacy concerns. To address them, Apple aims for algorithms that work on users’ devices and don’t send the data to Apple servers...

The pandemic drove an increase in mental-health-related complaints. The percentage of adults reporting anxiety or depression-related symptoms reached 41% in January, according to the Kaiser Family Foundation, nearly quadruple the early-2019 figure. Mild cognitive impairment, which can develop into dementia, affects around 5 million Americans over 60 years old, estimates the Alzheimer’s Association...

UCLA has said its research studying signs of stress, anxiety and depression began with a pilot phase last fall tracking Apple Watch and iPhone data from 150 people and will continue with a main phase tracking similar data for 3,000 people starting this year.

UCLA researchers will track data from the iPhone’s video camera, keyboard and audio sensors, and data from the watch related to movement, vital signs and sleep, according to the documents and people familiar with the study. The data that may be used includes analysis of participants’ facial expressions, how they speak, the pace and frequency of their walks, sleep patterns, and heart and respiration rates. They may also measure the speed of their typing, frequency of their typos and content of what they type, among other data points, according to the people familiar with the research and the documents...

Biogen and Apple said in January they are collaborating on a study to use the iPhone and Apple Watch to track cognitive function over time and identify mild cognitive impairment, a condition that can develop into Alzheimer’s. The two-year study aims to follow about 20,000 participants—half of them at high risk of cognitive impairment—and will use device data in a way similar to the UCLA mental-health research, according to the documents and people familiar with the matter. The work follows a 2019 feasibility study that showed that 31 adults with cognitive impairment exhibited different behavior on their Apple devices than healthy older adults.

Biogen is collaborating on the study because it hopes it can help Apple develop an iPhone feature to detect mild cognitive impairment early and encourage relevant users to seek care earlier, according to a person familiar with the matter. The company will compare the data against standard tests of brain health including traditional cognitive assessments and scans that track plaque buildup in the brain, according to the documents and the person familiar with the work.

Biogen’s drug Aduhelm, which costs about $56,000 a year, was approved earlier this year by the FDA for people with early-stage Alzheimer’s.

Diagnosing mental health conditions is difficult even for trained clinicians who are able to interact with patients in person. An iPhone algorithm that matches facial expressions, eye movements, etc. with depression or early-stage dementia can be beneficial. If a mental health app is able to screen millions of people quickly, and users are made aware that a positive reading is private, should be checked out and does not necessarily denote illness, that should lessen user concerns.

Note: it would be ironic if the same smartphone whose use triggers depression in teen-age girls is the device that warns that the user may be depressed.

Facebook Knows Instagram Is Toxic for Teen Girls, Company Documents Show

“Thirty-two percent of teen girls said that when they felt bad about their bodies, Instagram made them feel worse,” the researchers said in a March 2020 slide presentation posted to Facebook’s internal message board, reviewed by The Wall Street Journal. “Comparisons on Instagram can change how young women view and describe themselves”....

“Teens blame Instagram for increases in the rate of anxiety and depression,” said another slide. “This reaction was unprompted and consistent across all groups.”

Among teens who reported suicidal thoughts, 13% of British users and 6% of American users traced the desire to kill themselves to Instagram, one presentation showed.

Your Choice: The Dumbest Idea or the Worst Slogan Ever

Willie Brown in SFPD's 2018 lip-sync video

Grey eminence Willie Brown--rich, fashionable, extremely successful as California Speaker and Mayor of San Francisco--doesn't hesitate to call 'em as he sees 'em though it may not be what his Democratic Party colleagues want to hear.

According to Willie Brown there is no way "defund the police" is a winner: [bold added]

The call to “defund the police” as part of the anti-racism, anti-police-brutality movement is either one of the dumbest ideas of all time or the hands-down winner of the worst slogan ever.

...But many defenders of the concept say they don’t really mean defund — they mean reimagine. Take away dealing with homeless people from police, for example, and re-steer the money for that to social services programs.

Fine. Let’s talk about how to do that. But we’re starting from a terrible disadvantage because of that “defund” slogan...

People are legitimately shocked by the police misconduct they see on TV and social media. But everyone still wants the assurance that when they dial 911, a cop is on the way.

You take away people’s feelings of personal safety, and you lose voters.

While I do agree that we should restrict the number of interactions between armed public servants--for example, taking accident reports, clearing homeless encampments, and reporting internet scams may well be offloaded to someone other than the police--asking the public to distinguish types of incidents then calling the right number is too much of a burden. I like the simplicity of "911", which like Google's home page can branch off in a multitude of directions.

Final thought, not original: they meant "defund the police" and tried to retreat to "re-imagine the police" after the outcry. A sensible riposte is why didn't you say "reimagine" in the first place?

Bringing the Condition Home

Walking in someone else's shoes even for a brief period fosters empathy. And so it is that today many people, including your humble blogger, can better identify with the struggles of those with obsessive-compulsive disorder (OCD). [bold added]

Howie Mandel has been afflicted with
ADHD and OCD since childhood.
(Psychology Today)

Life for everyone in the Bay Area right now---with the intense handwashing, fear of leaving the home and fear of causing harm to others---resembles some of the classic OCD struggles. And indeed, OCD sufferers with contamination-related compulsions are facing heightened anxiety during the pandemic.

But many others are reporting that years of therapy have made them the calmest person in their household. And the sheltering has the potential for a big positive — a turning point for a disorder that has been marked by a lack of understanding in the media and popular culture.

Jeff Bell, a KCBS radio anchor and mental health awareness advocate who documented his own OCD struggle in the 2007 memoir “Rewind, Replay, Repeat,” said he’s already seeing signs of empathy from the public, who are getting a sample-size version of the trials of an OCD patient.

Fictional characters like Sheldon Cooper of The Big, Bang Theory and Adrian Monk of Monk depicted OCD in characters whose quirks were highly irritating....at first. But as the audience grew to know them over the series' 12-year and 8-year respective runs, the disorder became recognized as integral to their characters' positive attributes. The overwhelming majority of people do not have OCD, but society's fear-filled response to COVID-19 brings the condition home.

Monk, 2002-2009, was a dramedy about a brilliant detective. Tony Shalhoub and some of the cast reprised their roles in this new YouTube short.

The Mean Streets

The fact that one-third of San Francisco's homeless population of about 8,000 suffers from mental illness has spurred calls for free mental health care. A proposed November ballot measure [bold added]

would be a gargantuan undertaking meant to hit at the heart of the city’s homelessness crisis. But with no guaranteed source of funding, public health officials say it could also force the city to more than double its budget for those services.

The City already spends $400 million per year.

In other news about City services, San Francisco refuses to maintain 148 miles of City streets because they're "unaccepted,"

often because they’re on steep hillsides and were never paved or because they’re narrower than regular streets. The city, therefore, has no responsibility for maintaining those stretches. According to the city itself, of course.

The Chronicle runs a good-news story about how volunteers, with the help of charities, fixed up public lands that the City refuses to maintain in Bernal Heights (close to the intersection of Hwys 101 and 280):

Trees were uncared for and overgrown, making it dark and sketchy, even during the daytime. Homeless people set up camp. Drug dealers peddled their wares. Thieves dumped empty Amazon boxes, briefcases and backpacks after swiping their contents. The concrete staircase became broken and unsafe.

“It was disgusting,” explained Vicky Rideout, who lives near the stretch. “Full of weeds. Full of trash. Twenty years’ worth of trash had accumulated here because it was no one’s job to pick it up...It stank. That’s what I remember the most — how much it smelled. There was a lot of human feces, animal feces.”

In 2016

Kudos to the residents of Bernal Heights (Chron photo)

Andre Rothblatt, an architect, designed a gorgeous new staircase with zigzags of colored tile, getting approval from Public Works to redo the staircase and from the Arts Commission for the tile work. The neighbors also secured permission from the San Francisco Municipal Transportation Agency to close the stairs for repairs.

Yes, even though the city doesn’t want to care for the beleaguered street, it still put the neighbors who stepped up through the bureaucratic wringer.

“The structure of government right now is there are way more people whose job it is to slow you down and stop you than to help you,” Rideout said. “We did encounter challenges and slowdowns and obstacles and ‘No, you can’t cut these trees down’ and ‘You have to turn in these tile plans three times.’

That's San Francisco--it decides whether or not to "accept" street maintenance, a basic function of government in the rest of America--but still insists on controlling volunteers trying to remedy a problem that it won't fix.

Meanwhile, back to the proposal at the beginning of this post,

the city would be required to build a drop-in center, and create a new Office of Coordinated Care

How much of the hundreds of millions of dollars would actually be delivered to the mentally ill homeless population? Will another byzantine bureaucracy be created? Can you tell that these are rhetorical questions?

Jean Vanier

(WSJ drawing)

Words of wisdom from philosopher Jean Vanier (1928-2019), founder of L'Arche: [bold added]

Mr. Vanier was asked what could be contributed by those unable to devote themselves full time to serving others. “Try and find somebody who is lonely,” he said. “And when you go to see them, they will see you as the messiah. Go and visit a little old lady who has no friends or family. Bring her flowers. People say, ‘But that’s nothing.’ It is nothing—but it’s also everything.”

Appalled by conditions in a French mental asylum, Jean Vanier invited two inmates to live with him in 1964. His house became the first L'Arche (inspired by Noah's Ark), and the charity "has spread to more than 150 communities in 38 countries, providing homes for about 5,000 people."

Those suffering from mental illness or mental disability require attention for hours every day over a long period of time. Solutions are not easily "scalable", and treating everyone who needs help is frankly impossible. Another quote:

The great thing about people with intellectual disabilities is that they’re not people who discuss philosophy. What they want is fun and laughter, to do things together and fool around, and laughter is at the heart of community....What I’m trying to live and trying to say is that people with disabilities are important—in themselves but also they have a message to give to humanity.

Once in a while we chance upon a profile, a biography, or obituary that gives us hope for humanity. R.I.P.

Often Wrong But Never in Doubt

(Marijuana map from governing. com)

In addition to taxes and regulations stunting sales, there may be another reason for business projections falling short where marijuana has been legalized: the public doesn't trust the enthusiasts who say it's no worse and may even be less harmful than alcohol.

Headline: Marijuana Is More Dangerous Than You Think. Coincident with the rise of marijuana use has been an increase in the incidence of psychosis and paranoia, though we must be careful to state that marijuana has not been proven to be the reason because correlation is not necessarily causation. [bold added]

And last September, a large survey found a rise in serious mental illness in the U.S. too. In 2017, 7.5% of young adults met the criteria for serious mental illness, double the rate in 2008.

None of these studies prove that rising cannabis use has caused population-wide increases in psychosis or other mental illness, although they do offer suggestive evidence of a link. What is clear is that, in individual cases, marijuana can cause psychosis, and psychosis is a high risk factor for violence. What’s more, much of that violence occurs when psychotic people are using drugs. As long as people with schizophrenia are avoiding recreational drugs, they are only moderately more likely to become violent than healthy people. But when they use drugs, their risk of violence skyrockets. The drug they are most likely to use is cannabis.

The most obvious way that cannabis fuels violence in psychotic people is through its tendency to cause paranoia. Even marijuana advocates acknowledge that the drug can cause paranoia; the risk is so obvious that users joke about it, and dispensaries advertise certain strains as less likely to do so. But for people with psychotic disorders, paranoia can fuel extreme violence. A 2007 paper in the Medical Journal of Australia looked at 88 defendants who had committed homicide during psychotic episodes. It found that most of the killers believed they were in danger from the victim, and almost two-thirds reported misusing cannabis—more than alcohol and amphetamines combined.

What about predictions that legalization would reduce violent crime?

The first four states to legalize marijuana for recreational use were Colorado and Washington in 2014 and Alaska and Oregon in 2015. Combined, those four states had about 450 murders and 30,300 aggravated assaults in 2013. In 2017, they had almost 620 murders and 38,000 aggravated assaults—an increase far greater than the national average.

The broad effects of legalization---public health and mental illness, criminal justice, economic activity, taxation--will take years to make themselves known.

But it's called a social experiment for a reason. We can guess at but don't know the results in advance. Possible harmful effects are already appearing. A little humility is called for, especially in the advocates, but I'm not expecting to see it.

Tripping Again

(Image from Live Science)

One Sixties trend that petered out quickly was the use of psychedelic drugs. While LSD use could be mind blowing, there were many credible reports of "bad trips that sent people to the psych ward". (Whether or not it influenced their behavior, LSD became associated with the Manson Family serial killers.)

New research into psychedelics, however, has shown that they could have powerful positive effects: [bold added]

a single guided psychedelic session can alleviate depression when drugs like Prozac have failed; can help alcoholics and smokers to break the grip of a lifelong habit; and can help cancer patients deal with their “existential distress” at the prospect of dying. At the same time, studies imaging the brains of people on psychedelics have opened a new window onto the study of consciousness, as well as the nature of the self and spiritual experience. The hoary ‘60s platitude that psychedelics would help unlock the secrets of consciousness may turn out not to be so preposterous after all.

Brain imaging and other techniques not available to Timothy Leary show how psychedelics may work:

When scientists at Imperial College began imaging the brains of people on psilocybin, they were surprised to find that the chemical, which they assumed would boost brain activity, actually reduced it, but in a specific area: the default mode network...

Our ego defenses relax, allowing unconscious material and emotions to enter our awareness and also for us to feel less separate and more connected—to other people, to nature or to the universe. And in fact a renewed sense of connection is precisely what volunteers in the various trials for addiction, depression and cancer anxiety trials have all reported.

This points to what may be the most exciting reason to pursue the new science of psychedelics: the possibility that it may yield a grand unified theory of mental illnesses, or at least of those common disorders that psychedelics show promise in alleviating: depression, addiction, anxiety and obsession. All these disorders involve uncontrollable and endlessly repeating loops of rumination that gradually shade out reality and fray our connections to other people and the natural world. The ego becomes hyperactive, even tyrannical, enforcing rigid habits of thought and behavior—habits that the psychedelic experience, by loosening the ego’s grip, could help us to break.

As is often true in science, something that we thought we knew about can turn out to have surprising, new, beneficial applications.

Peripherally related: writer Tom Wolfe, 88, died today.

Mr Wolfe was also on the cutting edge of the so-called New Journalism that exploded onto the scene in the 1960s along with sex, drugs and rock and roll. Mr Wolfe travelled with Ken Kesey, one of the apostles of psychedelic drugs, and captured the experience in “The Electric Kool-Aid Acid Test” (1968).

TEKAAT is an acclaimed depiction of Sixties phenomena that according to admirers helps us to understand what is going on today.

Eat Right, Be Happy

Foods in the Mediterranean diet (USA Today)

What we eat can dispel sadness; scientists say, sadly for some of us, it's not ice cream or chocolate cake:

a healthy diet—high in fruits, vegetables, whole grains, fish and unprocessed lean red meat—can prevent depression. And an unhealthy diet—high in processed and refined foods—increases the risk for the disease in everyone, including children and teens. [snip]

Depression has many causes—it may be genetic, triggered by a specific event or situation, such as loneliness, or brought on by lifestyle choices. But it’s really about an unhealthy brain...A bad diet makes depression worse, failing to provide the brain with the variety of nutrients it needs.

These assertions about eating right are supported by a study that observed the diets and moods of 67 people diagnosed with depression:

Half of these people were given nutritional counseling from a dietitian, who helped them eat healthier. Half were given one-on-one social support—they were paired with someone to chat or play cards with—which is known to help people with depression.

After 12 weeks, the people who improved their diets showed significantly happier moods than those who received social support.

"Nutritional psychiatrists" are developing an understanding of how diet affects mental health.

A bad diet makes depression worse, failing to provide the brain with the variety of nutrients it needs, Dr. [Drew] Ramsey says. And processed or deep-fried foods often contain trans fats that promote inflammation, believed to be a cause of depression...A bad diet also affects our microbiome—the trillions of micro-organisms that live in our gut. They make molecules that can alter the production of serotonin, a neurotransmitter found in the brain.

The science is somewhat new, so I'm still holding out hope for ice cream and chocolate cake.

Like a Fox

WSJ columnist Peggy Noonan, not an anti-Trump conservative, tries to put her finger on the ambivalence that many Republicans have about their leader.

First, the positives from a Republican point of view: [bold added]

[President Trump] has established in his government a deregulatory spirit that is fair and helpful....excessive regulation, especially when it springs from ideological animus or practical ignorance, kills progress, growth, jobs, good ideas and products.

Mr. Trump has put a sober conservative on the Supreme Court, and many conservative judges on the lower courts. This provides greater balance in the judiciary. In a split country, split courts—balance—is probably the best we can do.

The economy is improving. And Mr. Trump helped pass a tax bill that was better—maybe a little, maybe a lot, but certainly better—than what it replaced.

Not bad for a first year in office!

The negatives, however, are hard to brush off:

You look at his White House and see what appears to be epic instability, mismanagement and confusion. You see his resentments and unpredictability. You used to think he’s surrounded by solid sophisticates, but they’re leaving. He’s unserious— Vladimir Putin says his missiles can get around any U.S. defense, and Mr. Trump is tweeting about Alec Baldwin. He careens around—he has big congressional meetings that are like talk shows where he’s the host, and he says things that are both soft and tough and you think Hmmm, maybe that’s a way through, but the next day it turns out it was only talk. This has been done on the Dreamers, on guns and we’ll see about tariffs. He loves chaos—he brags about this—but it isn’t strategic chaos in pursuit of ends, it’s purposeless disorder for the fun of it. We are not talking about being colorfully, craftily unpredictable, as political masters like FDR and Reagan sometimes were, but something more unfortunate, an unhinged or not-fully-hinged quality that feels like screwball tragedy.

To summarize, in 13 words, "On some level this is working. And on some level he is crazy."

The nub of her worry [bold added]:

Crazy doesn’t last. Crazy doesn’t go the distance. Crazy is an unstable element that, when let loose in an unstable environment, explodes.

I may be whistling past the graveyard, but I am not as concerned as she is. Here's an alternative narrative, some of which may be true!

A lifetime in the public eye has enabled Mr. Trump to perfect his public persona, which is the following: he's a bully; he makes impulsive decisions, and he says what's on the top of his mind without thinking of the consequences. He doesn't appreciate the seriousness with which everyone takes the words of the American President. The staff turnover indicates that people who have seen him up close for just a few months can't stand him.

Yet while the media and political opposition obsess over Russia! Russia! Russia! and the Trump insult of the day (North Korea, immigrants, s******e countries, Mexico, China, Sweden, Nancy Pelosi, Hillary Clinton, Alec Baldwin, the list goes on and on and on), his Administration chugs along, ruthlessly pruning regulations, lowering taxes, and appointing judges. If the public persona were reality, very little would have been done.

The impulsive shoot-from-the-lip President has puzzlingly refrained from talking about two key longer-term projects: the counter-Mueller investigation, led by the recused Attorney General Jeff Sessions, of powerful government agencies that spied on the Trump campaign, and the slow-motion strangulation of North Korea.

Last week there was near-universal condemnation of the upcoming tariffs by allies, Republicans, Wall Street, and economics professors. A few days later, after the meeting with Kim Jong Un was announced, other experts weighed in on how our Dealmaker-in-Chief will be taken to the cleaners by the 34-year-old dictator.

Just a question, chicken littles: could these moves be related? The tariffs are clearly aimed at China, which for decades has viewed the United States as a pitiful, helpless giant in trade negotiations. The falling markets, reinforced by Mr. Trump's public persona, believe that this time the American President means business about Chinese dumping.

What if Mr. Trump is using tariffs as a bargaining chip in the North Korea negotiations? What if, in exchange for Chinese help in de-nuclearizing Korea, he relaxes or removes them? Without having tariffs in the first place the United States can't apply pressure to China, so the President took the hit now in order to strengthen his hand for the Korean talks.

Of course, what do I know? Peggy Noonan is probably right: he's crazy.

Get This Story Out of the News, United

When we first saw the video of the passenger being dragged off of United Flight 3411 at O'Hare, we, probably like you, had three reactions:

1) he was brutally treated by the airline;
2) the passenger could have behaved better;
3) there were other ways the airline could have opened up a seat without reaching this point.

Modern journalism insists that we know more. The video will not stand on its own; we need to fill out the backstory. Was the passenger basically a victim or a partial instigator? (The answer does not change our judgment of the airline's actions, however.)

First reaction: he doesn't sound like a good guy. LA Times:

[David] Dao had previously been convicted of six felonies related to his medical practice in 2004, in which he was accused of illegally prescribing painkillers to a patient in exchange for sex.

He was given five years of supervised probation.

Dao surrendered his medical license in 2005

Second reaction: he was trying to turn his life around.

[Dao] applied for reinstatement, telling regulators it was a matter of “family honor.” In a 2014 letter, his attorney described Dao as "a grandfather, an active participant in his local church" who supports an organization that helps the homeless in his community, Elizabethtown, Ky.

Third reaction: he had mental challenges that the United police likely exacerbated.

Dao has a history of mental health problems, including depression, anxiety and post-traumatic stress disorder, for which he has received treatment. A 2011 psychological evaluation of Dao concluded that he "lacked the foundation to navigate difficult situations, both inter-personally and in a complex profession.” [snip]

But another psychological evaluation administered in 2013 concluded that Dao “emotionally was free of debilitating anxiety, depression, or psychological turmoil to the extent that it would affect his ability to function in activities of daily living or manage the practice of medicine.”

Regulators cleared Dao to return to medical practice in 2015, in which he was initially restricted to working one day a week, supervised by another doctor.

From sin to repentance to making amends to a violent encounter with authority--a progression that resonates during Holy Week. Settle at any cost, United, and get this story out of the news.

San Francisco's "Unsolvable" Problem

Diane Feinstein was the first mayor
to confront the problem (Chron--1986)

This week the Chronicle runs a landmark series of articles on San Francisco's homeless problem. Despite many millions of dollars spent and the attention of six mayors, the headline reads:
"SF homeless problem looks the same as it did 20 years ago."

The limitations aren't just financial. Estimates of San Francisco's homeless population run between 7,000 and 10,000, of which about a third are mentally ill. [bold added]

SF Chronicle--they tried and failed:
Mayors Agnos, Jordan, Brown and
Newsom. Will Ed Lee succeed?

The city would need hundreds of new psychiatric-care beds to get them off the sidewalks — the current inventory of fewer than 1,000 is not nearly enough. But even if it created those beds, getting people into them is difficult. Unless they are judged a danger to themselves or others, the mentally ill can’t be forced into care.

As someone who has encountered the homeless in off-and-on charity work over two decades, your humble blogger has the glimmer of appreciation for how intractable the problem is. Keeping above water in our rapidly changing society is difficult enough, but for those who are mentally ill, disabled, and/or engaged in substance abuse, getting a job and getting off the streets is usually out of the question.

Turning one's life around requires an unwavering commitment that would have probably forestalled homelessness in the first place.

"Mayor Willie Brown...ultimately — and famously — declared the homeless problem unsolvable."