Winter is coming

The autumn equinox this year was 22 September. From then on the sun peaks at midday overhead somewhere in the southern hemisphere until the spring equinox late next March. In practice, day and night are of equal length on the equinox, or would be if our earth fortunately didn’t have an atmosphere. In London, on 21 June the sun rises at 4.43 and sets at 21.21; on 21 December the corresponding times are 8.03 and 15.53. That’s nearly nine hours more light in the summer. With such a dramatic difference at this latitude, no wonder so many react to the difference.

Light plays a central role in regulating our biological clock. …

Winter is here – almost.

The autumn equinox this year was 22 September. From then on the sun peaks at midday overhead somewhere in the southern hemisphere until the spring equinox late next March. In practice, day and night are of equal length on the equinox, or would be if our earth fortunately didn’t have an atmosphere. In London, on 21 June the sun rises at 4.43 and sets at 21.21; on 21 December the corresponding times are 8.03 and 15.53. That’s nearly nine hours more light in the summer. With such a dramatic difference at this latitude, no wonder so many react to the difference.

Light plays a central role in regulating our biological clock. We live on a natural rhythm called the circadian rhythm, and our internal clock is set by the action of light on the retina of the eye, transmitted by special tracts of nerve cells to the pineal gland. The pineal gland, situated near the centre of the brain, manufactures a hormone called melatonin. Melatonin helps send us to sleep, so much so that in some counties it is available without prescription as a sleep aid, and melatonin is also used in overcoming jet lag.

Light then is essential for keeping us awake, and sleep plays an important role in maintaining our mood. Most people have heard of seasonal affect disorder (SAD). The definitive mental illness diagnostic system, the American Psychiatric association Diagnostic and Statistical Manual of Mental Disorders (DSM, now in its fifth edition) officially classifies seasonal effects on mood as “recurrent major depressive disorder with a seasonal pattern”. In winter people with SAD are – well, sad. Some people become depressed only in the winter months, and maybe autumn and spring too, and for some people their pre-existing depression becomes worse. Unsurprisingly, given that in winter days are shorter the further north (and south in the southern hemisphere) you go, there are substantial geographical variations in the incidence of SAD, In the USA, in Florida the figure is very low, just over 1%, and in Alaska nearly 10% of the population is affected. Pity the three hundred thousand inhabitants of Murmansk, situated north of the Arctic Circle, which does not see the sun at all between 2 December and 10 January.

I should point out that not ever researcher accepts the existence of SAD. Some studies have failed to find any correlation between mood and time of the year. As with all studies on this sort of subject, much depends on the detail of exactly how mood is measured, how many people are studied, and whether or not they are receiving any treatment.

If people’s moods are affected by the amount of sunlight available then you would expect the suicide rate to vary with the seasons. It does, but not in the simple way you might expect. In the northern hemisphere the suicide rate increases dramatically in May and to a lesser extent June, and in the southern hemisphere in November. This pattern is strange and there is no accepted account of why it happens. One explanation is that when people are very depressed they are too ill to kill themselves, and need the upsurge in energy when they are starting to feel better. I don’t find this explanation wholly satisfactory because I have always felt most suicidal when I feel most depressed; it’s then that I want the pain to end. Most people when they start to recover feel relief. Another possibility is that when people are improving there is a surge in the chemical, or neurotransmitter, serotonin in the brain, and serotonin is associated with aggression as well as mood. In depressed people aggression can be directed towards themselves, leading to self-harm and suicide.

Suicide rates also vary across regions. If you look at a map of Europe there is an increase as you go from the south and west to the north and east, and again it is not simply the case that suicide is always more common in cold, dark regions; socio-economic and cultural factors play a large role too,

I graph my own mood, as I suggest everyone with a depressive disorder does, and have noticed a slight seasonality effect, but it is much less pronounced now I that I am on fairly effective medication.

We are not completely helpless when the nights start drawing in. Those fortunate to be able to overwinter in southern California should now start thinking about packing their bags. Those a bit less fortunate should book their winter holidays, going somewhere likely to have as much sunshine as possible. For the rest of us, there are still things we can do. SAD lights, which emit very bright light (look for at least 10,000 lux) and which produce light in the shorter, bluer frequency range, are now cheaper and much more widely available than they were just a few years ago. But one of the best therapies is free: being outside in natural light as much as possible, particularly in the morning, especially if it’s sunny. Wrap up and get outside.

(The above is an expanded version of my new column in What’s hot London!)

Student depression

University terms are starting all over the country. When I was an undergraduate, the Cambridge term started late, in early October, and our terms were only eight weeks long. That first one was seven weeks six days too long for me.

I have had several responses from students to my blog on dysthymia – low-level persistent depression, or what is now called persistent depressive disorder. The people who contacted me are just the tip of the iceberg. In your class of a hundred fellow students it could be that as many as nearly twenty of them are mentally ill, to some degree, right now. That’s a lot of sick people; imagine a class where twenty people were sneezing and coughing non-stop. Who are these people? Can you tell? Are you perhaps one of them? And a couple of lecturers are probably depressed right now, too.

What’s the leading cause of death for young people aged 20-35 in the UK? Those risky boys speeding round blind bends in their sporty cars? Drugs? Falling under a bus blind drunk? Being mugged and murdered? No, by some way, it’s suicide. Suicide is also the leading cause of death for men under 50. And most people kill themselves because they can’t take the hopelessness and pain of depression any longer. And if suicide doesn’t kill you, depression is associated with a host of disorders, such as heart disease, cancer,  and dementia, which might get you later.

Depression and anxiety are closely related, and usually go together. Epidemiological studies show that anxiety and mood disorders are remarkably common: it’s estimated that one in three people will suffer in their lifetime, and between one in six and one in ten are ill now. The reporting of mental illness has increased, but whether that’s because of better understanding of the disease, better diagnosis, reduced stigmatisation of the ill, increased pressure of contemporary life, or, most likely, all of these, is unclear.

When I was young (under twenty, say), I didn’t know what depression, anxiety, and obsessive-compulsive disorder were, although in retrospect I suffered from all of them. I was aware of something my relatives talked about in rather hushed tones called “a nervous breakdown”. I’m still not entirely sure what one of these was, but I think it was a sudden mental illness requiring some kind of treatment, and even incarceration in an “asylum”. Treatments were very limited back in the 70s; remember that chlorpromazine wasn’t released to the market until 1953, the first benzodiazepine, Librium, in 1960; and the first antidepressants in 1957 (iproniazid, a MAO inhibitor) and 1958 (imipramine, a tricyclic), although these drugs have many serious side-effects. The relatively more benign Prozac (fluoxetine) wasn’t available until 1987. I don’t think I knew about these drugs until I switched as a student from Natural Sciences Physical to Psychology. Indeed when I was a teenager, I thought of treatment as shock treatment; that’s about all there was.

Attitudes started to change when Prozac became widely available; perhaps that’s generally true – diseases only begin to lose their stigma when there is some hope. When I was young “cancer” was another dirty word, sometimes just called the “c word”. Don’t ask my younger self about swearing though; when I was ten, I thought the filthiest word in English was “pub” (where my father went Sunday lunchtime).

I was the first person in my family to go to university, and I had no idea what was involved, no idea really what a degree was (although I knew students “read” for it on University Challenge), no idea how to manage money (fortunately credit cards weren’t available then), no idea how to manage my time, no idea how to study independently, no idea how to live, no idea how to make use of what was available, no idea what a girl was, and no idea of how to cope when I was a raving loony without realising it. I was extraordinarily shy, which didn’t help. I wasn’t lazy; I tried my best, but I had no idea how to organise my time. I expected university to be like school, which of course it isn’t.

I stuck out the first year, mostly because I drift through things and staying was the easiest thing to do, and I was just clever enough to get by in spite of my deficits. The turning point was joining a society where I met other people. I still can’t say that I felt at home, and at the end of the first year I got a summer job where I did. I was earning good money, I had friends of sorts, I seemed to have some purpose, I felt like I was part of a community, and I wondered why go back to Cambridge. At that point I nearly gave up.

I don’t really know why I didn’t; it was easier to stay than not. And when I went back to Cambridge I discovered psychology, and things started to look up.

If I knew then what I know now I would have got professional help. I would have started with meta learning rather than learning. I would have been bolder about asking questions. Mostly I would have realised that I was ill, I wasn’t alone, and that I should talk to people.

Just do it

“There may be some writers who contemplate a day’s work without dread, but I don’t know them. … It’s a bad business, this writing.” (Mary Gordon, American writer)

 

I am suffering (again) from what is usually called “writer’s block”. I have things I have to write and I just can’t settle to doing them.

Writer’s block is notorious; it’s a favourite subject for novelists, in a rather incestuous way. It’s a specific example of procrastination – putting off until later what you should be doing now. There are whole shop-loads of books on writer’s block specifically (which I find rather paradoxical) and procrastination generally. I have read them all very carefully and learned nothing whatsoever useful from them. Examples of the advice can be found here, here, and here. Enjoy.

Essentially they all come down to the advice “stop messing around and just do it; just make a start, no matter how small”. Well, if I could do that I wouldn’t be procrastinating. They are also keen on eliminating distractions, but when you’re severely proscratinating, after you have eliminated all the obvious ones, you will create new ones.

Now at this point I know what some of you are thinking. The kinder among you will say we know about procrastination; the only solution is indeed to make a start and just get on with it. He’s said he knows that, so why can’t he do it? Surely he could bring himself to write a word, even a little rubbish one? The less kind will say what is he talking about – he can write this blog, so why can’t he write his book? Shut up moaning. You will have no sympathy with me, you say, while you get on with writing your thirty-six volume autobiography.

On the other hand I have discovered in writing this blog that there are many people out there who are a little like me, but are too frightened to say so. Some of you, sadly for you, are even a lot like me, and are terrified to say so. Procrastination is very common. After many years teaching I know countless students who have left things to the last minute – they only start that essay or report the night before the deadline; sometimes well into the night. They know their behaviour is bad, just as I do, so I really do share their pain. They know that at best it will be a bit rushed and that they won’t have time to put it aside and think about it and check it, that they will make mistakes and miss sources, thereby most likely losing precious marks, and at worst they’ll miss the deadline altogether and get zero. So why do they do it? It’s not helpful to say that it’s because of bad planning and laziness when it happens so often; it’s not helpful to say we should just have done it.

As I have said before, we should also be wary of pathologising everything. Am I being slow because I’m ill, or is it something less sinister? Am I just very, very lazy, or is something more complicated going on? A very few people really just don’t care about what they’re doing, but most of us do, so I think when something happens repeatedly it is at least worthwhile considering possible deeper causes. Looking deep into myself I see:

 

Fear of a deadline. After twelve years of being head of the psychology department at Dundee and then dean, I am exhausted. I still have nightmares about writing reviews and reports and plans and strategies and completing financial spreadsheets, and being sent emails at 5.01 p.m. Friday asking for something FIRST THING Monday, before the 8.30 meeting. Burnout need not be restricted to middle-aged executives: the average undergraduate will now have undergone years of assessment, even before the GCSEs and GCES (or Higher equivalents in Scotland). It’s assessment after assessment – one damned thing after another, for years. Until you can’t take it more.

Milder versions of exhaustion abound. Many studies show that many of us are on the edge of exhaustion, or simply don’t get enough sleep. A period of prolonged rest might be best but not many can take it easy for more than a weekend. So I don’t know what the best way is to cope with deadline fear, and welcome suggestions. However I have resolved to try to deal with the exhaustion and the following might help. I hope that with more energy the fear will recede.

Sleep – I have vowed to sleep whenever possible. I have long thought too much sleep to be a waste of time (we know that some sleep is essential), but what is “too much”? What is the point of forcing yourself to get up 30 minutes earlier if you then only function at 75% efficiency?

Multi-tasking – doing two or more things at once is not effective. I found myself making tea this morning while trying to pack a bag. Not good. I need more mindfulness in my life.

Saying no – partly I commit to annoying little jobs that then have to be done, and which I like to get out of the way before the big jobs. I find it quite difficult to say no when I see the hurt on a person’s face, but I must learn to get over it.

Stop rushing around – leave plenty of time for things. The possibility of saving three minutes by leaving just a bit later for the gym is outweighed by the damage perpetrated by the additional stress of the journey.

Relaxation – I can distinguish between physical and mental exhaustion, although I find they are correlated. The brain uses a lot of energy, and many argue that glucose levels in the brain can be rapidly depleted – so that we have limited willpower, although controversy rages about this subject (see here and here, for example).

Doing if for myself – My fear of a deadline goes hand in hand with being evaluated afterwards. If you don’t hand something in, you can’t get a poor mark, or unpleasant feedback, can you? It’s bizarre reasoning I know but I am falling foul of it. I find that I become lost in things that I enjoy and that aren’t going to be evaluated, so one strategy is to try to turn evaluated things into things we’re really doing for ourselves. We’re doing it to learn, or to write our great life’s work (in my case), and the deadlines and feedback are things on the side – things that might even help us, by ensuring progress and making it a better work. We call this type of approach recasting our thinking. I don’t find it easy: to make it work we have to make ourselves believe it, deep down.

What else is there?

The job is too difficult. I missed this out of the “first edition” of the post, but I don’t know why: the more I think about it, the more important it is. It’s easy to get going on small jobs where you know what you have to do, but much of good writing isn’t like that. Writing a whole book on the science of consciousness, in my case, isn’t easy; the material is complex, difficult to understand in places, and even more difficult to synthesise and evaluate for a reader who hasn’t spent more than thirty years in the area. Sometimes I start work, look at my screen, and I don’t know what to say. Students might start writing a lab report and realise they don’t have a clue about the statistic used or the design of the experiment. No wonder we put our laptops aside and make a nice cup of tea.

Somehow we have to make difficult tasks easier. It’s difficult to do the research and thinking while looking at the screen trying to write the final document, I find, so that means it has to be done before. That means reading multiple sources about a topic, and perhaps making notes, drawing diagrans, even mind maps if that’s your thing; and thinking and organising. All that takes time. I can write a thousand words in an hour, easily, if I know exactly what I’m talking about, am enjoying myself, and have a modicum of focus. If I don’t know (as is usually the case), or have to remind myself, that rate plummets. If you leave your writing to the last minute, so you’re up against the deadline, there often just isn’t enough time. No wonder we procrastinate when facing the impossible!

If you’re doing something difficult and you’re up against a real deadline, you’re a bit screwed. You just have to learn the lesson and resolve to leave research time for the next deadline – plenty of it. Fortunately (although it might be a curse) many writing deadlines are in fact a bit flexible, so if you’re a little late it’s not the end of the world. It’s not good form though so again lessons have to be learned.

Doing research with plenty of time left seems less intimidating to me; all I have to do is convince myself that the pleasant reading in the conservatory really is work. You do though need to be clear about you’re researching and why, which means planning what you have to do and finding out what you don’t know first. You need to read for a purpose, trying to answer a question, and to do that you need to be clear about what the question is first.

The job is unpleasant. Then one has to ask why are you doing it? Let’s think about what “unpleasant” really means. You might be doing a psychology agree, and enjoy it all apart from statistics. In that case if you think the overall aim is worthwhile you have to contextualise the problem – relate the subtask to the whole. You can’t understand behaviour without understanding how we should study behaviour. I think mostly though we confound the unpleasantess of jobs with their difficulty – I don’t really think that writing a book on consciousness is an unpleasant task, I’m just finding passages of it difficult at the moment. Students would enjoy statistics if they found it relatively easy. In which case see above.

Perfectionism. I can’t bear the thought of seeing something with my name on it that isn’t perfect. But the first draft doesn’t have to be perfect; in fact unless you are peculiarly gifted the first draft will be far from perfect. You are more likely to produce something imperfect by leaving it late and little time for checking and revision. And the first draft might be rubbish, but it’s easier to turn a thousand words of rubbish into something better than start with no words at all.

Too big a task. This is an important factor in my fear, and of course is easily solved by splitting it up into smaller tasks – as small as it takes to stop being daunting. Splitting large jobs up and listing the components takes time, and there’s always a concern that you’re wasting useful time carrying out useless tasks – that you’re just engaging in just another distraction activity. But spending time working out how you’re going to do a big unpleasant job and then doing these small chunks is much better than doing nothing at all related to your most important job.

Something immediately at hand is more immediately satisfying. Note I’ve said immediately twice: it has to be instant and easy gratification relative to the big job. If you’ve split a big job into lots of little jobs then you can have the instant gratification of ticking them off your list as you complete them. Some people suggest turning off your internet connection, using special software and apps to cut off temporary access to distraction, or smashing your router on the floor, but I will still manage to find something else to do. That washing is piling up, or perhaps needs sorting. Better to deal with the root cause than use gimmicks. (Believe me, I’ve tried them all.)

 

I will try my own medicine and report back. Meanwhile I hope this help ssomeone else. Please feel free to comment or contact me.

 

(Note to readers: I’ve revised this blog a few times as things occur to me. No more. This version is final.)

 

UPDATE

What is “normal” for a depressed person?

“Dysthymia, now known as persistent depressive disorder (PDD), is a mood disorder consisting of the same cognitive and physical problems as depression, with less severe but longer-lasting symptoms … dysthymia is a serious state of chronic depression”. Wikipedia.

As part of my mental maintenance, I keep a mood diary. I’ve experimented with several kinds, including apps, but now just use the very simple system of noting one number at the end of each day, on a scale of 1 (extremely, suicidally depressed) to 7 (ecstatically happy), with 4 being “average”. Here is my chart for the last 18 months or so.

moodgraph

The first point to note is that this graph is by no means representative of my life. It begins in April 2016, when I had already been in weekly therapy for well over a year and had at last found the medication that worked (to some extent) for me. I’ve shown the trend line (a guess at the average) which shows a continuing slight improvement over time, although I think this is line is affected by a prolonged and severe relapse I had in the summer of last year. To complete the statistical background, my scores do seem to follow an approximate Gaussian (“normal”) distribution, with my mean score in the middle of the range, at about 4. (Actually it’s very slightly beneath, at 3.8.)

It’s the word “normal” that causes me trouble. What is normal? How can I gauge my mood and experience against what other people feel? And is it reasonable to expect mood scores to follow a Gaussian distribution, and if so what will the mean be?

To give a concrete example, consider someone with PDD (persistent depressive disorder). Their daily mood ratings will presumably be low every day, for long periods of time. Hence compared with people without PDD you would expect their mood rating, if they were comparing themselves with the rest of the population, to be low (as they’re not severely depressed, probably in the 2 to 3 range).

But how do people give ratings of their behaviour? Maybe, completely reasonably, people compare their mood with what they think other people experience – so the moods are relative to the population rather than the individual. But how do we know what others feel?

I use a strategy between the two. And I’m not happy about treating a rating in this inconsistent if not incoherent way. I think a 7 should be “extremely, unusually happy”, although no one should expect to be ecstatic all day long. A 4 should be average for me but not too bad. When I rate a day as “average” I mean I’ve been a bit depressed that today, but no more so than average for me

If you have PDD, your normal is low. I don’t know how other people feel most of the time, but I suspect it must be better than I do. Do you wake up looking forward to the day? Does a day pass without you thinking about suicide and death? Does your day bounce along when you’d say you feel happy? Does your life have meaning? Can you sleep naturally? Do you feel like you have the energy to do everything you want to do? Does the thought of emptying the dishwasher or taking a shower fill you with despair? If so I envy you. Your 4 is not my 4.

The opposite is also presumably true: someone who isn’t depressed has no idea how those of us who are feel. So please keep your comments about “when I’m down I always find going for a good run sorts me out” to yourself.

As I have said before, being depressed steals your life.

Does a psychiatric diagnosis mean anything?

I have a new psychiatrist and a new tentative diagnosis. Or rather, a new additional diagnosis. So at the moment I have been diagnosed at some time by somebody with: severe depression, bipolar disorder, obsessive-compulsiveness disorder, obsessive thinking, anxiety disorder, social anxiety disorder, panic disorder, dissociative disorder, autistic spectrum disorder, narcissistic personality disorder, borderline personality disorder, and now adult attention deficit disorder. I have might forgotten one or two. Although I am certain I have depression and a batch of severe anxiety disorders, parts of all these diagnoses seem right, but none of them alone fits perfectly. I don’t think I’m special in feeling confused, even frustrated, about the problems in getting a clear diagnosis.

When you have a problem with your gallbladder or spleen, the diagnosis and treatment are comparatively obvious. Your just look at the spleen and you can usually see what’s wrong with it, and if that doesn’t work (I’m no spleen specialist) you run a few simple tests, like a blood test, and look at those results. But looking at the brain won’t help for mental illness. You can see a brain tumour easily enough, but you can’t see depression or anxiety. (I admit that this claim isn’t quite true, as there are some correlations between some structural changes to the brain and some mental illnesses some of the time, but the correlations are complex and not perfect predictors – yet – so I think my statement is essentially true.)

And then there is the pathologising of the extremes of normal behaviour. It is perfectly normal to grieve when a loved one dies, or to be upset when something important goes wrong. When does grief edge over into depression? It isn’t easy to say. When is a child abnormally hyperactive and not just rather boisterous? When is a person manic and bipolar rather than just lively and extraverted?

So at the moment mental illness is different from physical illness. Things might change in the future, with more sophisticated imaging and the means of visualising neural circuits and neurotransmitter system in real-time action. But even then we are left with the fact that the brain is a hugely complicated organ and the relation between what it does and its structure is also extremely complicated, and mental illness results from the interaction of developmental, situational, and genetic structures to the whole brain. Although we obviously have many working hypotheses, we don’t have any good complete models of mental illnesses and how exactly they arise, and how changes to the brain and its neurochemistry changes behaviour. I think this difficulty in seeing what is wrong contributes to the stigma of mental illness: with a physical illness, you can see, and therefore point to, your problem – look at my swollen spleen! – but people with mental illness look the same on the outside and on the inside.

Simple diagnoses make life easier for clinicians. You have a label, and then you also have a range of possible treatments: the label will determine that treatment. If you are diagnosed with depression and are given anti-depressants, and you respond to anti-depressants, then you must have had depression. Everything else, like poor concentration, tiredness, anger, lack of empathy, and inability to sit still, or whatever, must have been caused by the depression. But why should disorders of a very complex organ that we barely understand map nicely on to simple linguistic categories devised by clinicians in order to enable them to classify and treat people? I doubt if they do.

I don’t see that for mental illness we are in any better situation than physicians at the time of the Black Death who thought that the plague was caused by a miasma rising from the ground. But at least they could see the buboes. Just look at the mess the idea that depression is caused by a lack of serotonin is in.

In practice there is no point going in to see your doctor, psychologist, or psychiatrist, saying that their diagnosis is rubbish and unscientific. They have busy, difficult lives and can’t know everything. Do though make sure that every symptom that troubles you is taken seriously, and that you receive appropriate treatment for these symptoms. And if after a while things don’t get better you need more or a different sort of help. If your mood improves a lot but your concentration doesn’t, then you shouldn’t feel bad about trying to find out why. Good luck.

Dream a little dream

I’ve been experimenting with lucid dreaming by taking supplements last thing at night, including lecithin, choline, huperzine A (an alkaloid found in some plants that’s been investigated for treating Alzheimer’s disease), GPC (l-alpha glycerylphosphorylcholine), and galantamine (found in snowdrops), They’re all available from retailers such as Amazon and pretty harmless in terms of side effects, at least, it seems, for me. All of them in some way or another increase the amount of the neurotransmitter acetylcholine. I’ve tried taking them in isolation and in combination, and in combination is the only thing that has had any effect on me. My sleep and dreaming appears to be remarkably robust.

I still haven’t had a proper lucid dream, which as I understand it is an awareness that you are dreaming, and therefore you have an ability to influence your dream. I have though on many occasions had the curious sensation that I can only describe as that I am dreaming that I am having a lucid dream, or dreaming that I know I am dreaming, but lack any ability to influence my dream. These supplements reliably promote this “dreaming of lucid dreaming” state in me.

I also on two occasions have dreamt of what others call “the shadow” – a shadowy hostile figure who lurks threateningly close by (see here and here for examples from others). On both occasions this dream has started with a feeling that someone is in the room or outside, or outside the bedroom window. If I catch a glimpse of them, they are grey and featureless. I’ve had them for years; I remember very clearly being terrified as a young child by a grey shadow figure standing like a statue beside the bed. In my case they are not accompanied by sleep paralysis. Figures of this sort are widely described across time and cultures (in olden times it might have been called an incubus), so clearly are some fundamental, but poorly understood, feature of dreaming.

Most people love to talk about their dreams, and once you tell someone that you’re a psychologist, you’re in trouble. I have always been fascinated by my dreams – those strange images that arise unbidden with sleep, sometimes with frightful clarity, that follow complex and often bizarre storylines, and surely, surely must tell us something important about ourselves? And if you could have a lucid dream, could you not systematically manipulate some of the variables of dreams to find out more?

There are many theories about the origins of dreams, and they are covered in detail in my forthcoming book, The Science of Consciousness, to be published by Cambridge University Press (hopefully next year). Many people are familiar with Sigmund Freud’s psychoanalytical theory that dreams disguise repressed and unwelcome thoughts so that they do not wake us; hence for Freudian psychoanalysis dream interpretation is a question of interpreting the surface of the dream, particularly its symbolic nature. Hence for psychoanalysts dreams are the most important method of treating mental illness. Other depth psychologists think that dreams serve different functions (e.g. Jung thought they addressed issues to do with individuation and spiritual growth), but all these approaches share the idea that dreams have some meaning, and that interpreting dreams is a means to recovery and growth. Revonsuo views dreams as an evolutionary adaptation to dealing with threat; we can safely rehearse methods of escaping threats in dreams. Many researchers link dreams with creativity, and there are several accounts of ideas being generated and problems being solved in dreams (see here for a discussion of Kekulé’s famous account of dreaming of a worm swallowing its tail seen in flames in a dream). And then there is Allan Hobson’s idea that dreams are essentially random constructed by the cortex from random activation of thoughts and ideas by subcortical input.

I kept a detailed dream diary for a year, and still record as much of my dreams as I can. I don’t think there is any one correct theory of why we dream; I am sure all of the above are true at times. (Another thing I am sure about is that there is little merit in dictionaries of dream symbols.) I never cease to be amazed at the bizarreness, complexity, and creativity shown in my dreams, but I doubt if I am alone in this regard. The activation-synthesis hypothesis has a great deal to commend it, but I don’t think internal activity is random: some memories are stronger than others, some anxieties occupy us more than others; we desire some things more than others; and some threats are more worrying than others. The mind is always bubbling away, and some bubbles sometimes come to the surface. Dreams are the default mode network, the system that generates daydreams, running without control or censorship.

But can we learn from our dreams, and can recording and interpreting dreams help us on the path to spiritual growth and healing mental illness? I was slightly surprised that during my therapy my therapist seemed totally uninterested in my dreams (and this is in the context of that therapy being one of the most useful experiences of my life). If the idea that dream content is the interpretation of randomly generated but largely prominent memories, ideas, and emotionds is correct, you might expect an analysis to be revealing. However, when I analyse the dreams in my collection, I find there is little obvious to learn from them. They show recurring thoughts and concerns, but I am aware of them from everyday life. I dream of death, dying, and nuclear war most nights. We can’t learn much from dreams because we already know most of what they tell us.

The one surprise is how often I dream about my father, when I think about him so little in waking life – or at least did. He left when I was aged ten, and I barely saw him again afterwards. He died, alone, in 2004, 15 years after I had last seen him. This persistent dreaming makes me realise that I wish I had tried to contact him, if only to ask him why he had co up my life.

A warning though: some dreams take on a life of their own. I have for decades dreamed about watching a plane fall out of the sky, I think this idea has just become a very highly activated idea, one likely to bubble to the surface some nights. That’s why we get recurring dreams. So perhaps my dreams of my father are no more than a simple recurring dream, and reveal nothing deeper.

Note that I am giving a talk on the meaning of dreams in London on 4 July 2017. Please come along. I promise to try and answer every question I get.

Stay well, and dream on.

 

Loneliness

Lonely people tend to die younger. They have more health problems when they’re still alive, and tend to be more anxious than average. They tend to suffer more from high blood pressure. They have weaker imune systems. And I’m lonely.

Lonely people tend to die younger. They have more health problems when they’re still alive, and tend to be more anxious than average. They tend to suffer more from high blood pressure. They have weaker imune systems. Bummer.

Of course as with all findings about mental health, you must be careful talking about causes when all you have are correlations (feeling unwell might prevent you going to social events, for example), but it does seem likely that being lonely is bad news. The findings on the positive effect of social support – people with plenty of good friends and a strong social network tend to be happier and healthier – are after all just the other side of the coin.

We can distinguish acute loneliness (loneliness that persists for a relatively short period of time and that arises as a result of loss or transition, such as the death of a partner, change of job, or a geographical move) from chronic loneliness (loneliness that goes on and on and is part of a person’s life over some years). I’m currently reading Emily White’s book Lonely, about her chronic loneliness, and enjoying (or identifying with it perhaps) very much.

I think there is now more of a stigma attached to being lonely than there is to being mentally ill. Most people now accept that mental illness is a result of many factors, and that the ill person is not to blame. However, many people appear to believe that if you’re lonely, it’s your fault. You should just try a bit harder: join a club, do volunteering work, or take a dancing lesson. Or perhaps, they think, you’ve got no friends because you’re not a very nice person.

I admit it: I am chronically lonely – and I’m a very nice person.

Being chronically lonely (just lonely from now on) is related to many other things. White clearly thinks that being lonely and being depressed are very different; the main evidence for this claim is that many people report average levels of depression. I’m a bit sceptical that people have good insight into their mental states (we know from cognitive psychology that our insight is limited), but loneliness does seem to be related to social anxiety and personality factors independently of depression. I can feel lonely at a crazy party. In fact I sometime feel loneliest at a crazy party, where everyone else is obviously enjoying themselves, playing party games and singing songs. I have been in a packed football stadium where everyone else is singing and chanting and cheering and I just can’t join in; it feels false, wrong. I’m not looking down on the people who join in – although it must often look that way to other people – I just can’t make myself feel like other people. I’m an outsider (or as my mother used to say, “weird”, the irony being that she also is a lonely outsider).

I do wonder if people who think of themselves as very lonely mean “lonely” in the same way as others do. I think most people have acute loneliness in mind, whereas I think people like White and me are struggling for a word to capture a sense of alienation and otherness that pervades our lives even when others are present. A lot of what White talks about in Lonely makes me wonder if she just means “single”: a lack of intimacy, having somewhere there, the sound of voices and feet padding on the carpet at home, havint someone to touch, having someone with whom to share everything. But then I have felt lonely when with other people, including partners. Perhaps some of us are just destined to feel different. And for me it is entwined with depression.

But these are simple labels for complex experiences. I have no advice for others in the same party. I don’t want to go to a party or start dancing. Perhaps that’s why I enjoy the gym so much: I can be with other people, who vaguely share the same aim, but who don’t expect anything of me.