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.

 

 

How to lose weight (continued)

I posted some time ago about my great success in applying science to losing weight. At one point I had lost about 30 pounds in 6 months. Most people who lose weight go on to regain it, sometimes even eventually weighing more than they had when they started, so after six months I thought it was time to revisit my diet – or more precisely, my lifestyle.

The news is mixed.

I posted some time ago about my great success in applying science to losing weight. At one point I had lost about 30 pounds in 6 months. Most people who lose weight go on to regain it, sometimes even eventually weighing more than they had when they started, so after six months I thought it was time to revisit my diet – or more precisely, my lifestyle.

The news is mixed. I have regained a bit of weight, but I am now fitter than ever before, as measured by endurance capability, maximum weight I can lift, resting pulse, and blood pressure. Most of the weight I have put back on (about 12 pounds) is muscle, not fat. My visceral fat is down to 11%, and my body fat 17%. I still feel flabby around the middle though, and would like to lose more weight there. Some of the weight gain – a few pounds – is fat, so it is a work in progress with many gains and a few losses.

So I think overall the verdict is that a version of this “diet” works, at least for me.

As with most things, life gets in the way sometimes. It’s difficult to stick to a particular lifestyle  when there are events such as Christmas come along, or when you’re travelling. I try, but relax things a bit. After all one of my greatest pleasures is eating out, and one has to have some fun. I nearly always pass on the dessert though.

I have also had time to consider what were the essential aspects of my original diet. I still think for me then the big thing was obsessively weighing and measuring food, and calculating the nutritional content of what I ate. This monitoring enabled to stick to a diet of around 2000 Calories a day, with about 75 g protein, 25 g fibre, and 50 g or less of carbohydrate (and often less than 1 g of salt a day). (I didn’t and still don’t care about the fat/oil content because I am convinced by the data showing that fat does good rather than harm.) Note again that this intake is the inverse of the traditional food “pyramid” with a large carb intake at the base. I also aimed for as wide a variety of micronutrients as possible, by supplementation and by eating as many different vegetables, and some fruit, as possible.

I stick by these things although I have relaxed the carb limit a bit. In particular I enjoy baking, and make my own gluten-free bread, which is largely seed rather than grain-based, containing walnut pieces, linseed, flaxseed, sunflower seeds, chia seeds, and pumpkin seeds. It tastes good (others say that too), but doesn’t keep well. I still try and avoid sucrose (sugar) like the plague.

I think the increased carb intake, especially bread, makes it more difficult to lose more weight. My main struggle however has been finding a way of eating that enables me to continue gaining muscle while losing fat. I don’t yet have an answer. When you work out six times a week for 45-60 minutes a day you’re going to need more calories, but what is the ideal proportion of fat, carbohydrate, and protein? How many times should you eat a day, and when, relative to the workout? I have scoured websites and books on exercise physiology without finding any answers that convince me. It is also difficult to work out how many calories you need when you have a complex exercise regime with many different types of exercise. I’m pretty certain the answer is more than 2000 though!

I recently saw a television programme that monitored someone trying to lose weight rapidly by calorie restriction over a week. At the end he had lost weight – but it was all fluid and muscle, and muscle is the last thing I want to use. On the other hand this was a television programme not a scientific study (although the measurements appeared to be taken under laboratory conditions), his diet was extreme, and he was very fit and lean in the first place.

I am sure that the principles of my diet work if you want to lose weight and become healthier. Restrict your carbohydrate intake, watch the total calorie intake, drink plenty of water, and exercise – the more and the more different sorts the better. But to become super-fit and super-lean is a further challenge. If you know anything about the science of doing so, please let me know.

The other issue outstanding is why so many people who start to diet do well at first and then go downhill. There are of course several possible reasons.

  • You don’t really like the food in your diet. I am lucky in that I don’t like the taste of sugar that much and love blueberries and fish. It would be much more difficult if it were the other way round. So you have to include as much good food that you like and also re-educate your palate.
  • You’re not really too bothered about your current weight and appearance. That’s fine, it’s your life – just remember if you’re obese it might be quite a short life.
  • Not giving yourself enough rewards. Rewards work! If you find the going tough, decide on a reward programme. You’re doing something important so the rewards should be reasonable: stay on the diet for a week and you deserve that new book you thought was a bit of a luxury. I’m not a great fan of “treats” in the diet as rewards: after all a diet with two days of cake treats is really just dieting for five days. Similarly all these points-based systems are over-complicated for many people (like me) and it’s easier just avoid the cake than working out if you can have it, and buy a trip to California instead.
  • Lack of support. It’s difficult if everyone around you is gorging all the time. It’s difficult if you’re trying to diet alone. One of the reasons diet clubs work better than other things isn’t because of the system, but because they provide social support to encourage you.
  • Yo-yo dieting. Going on a diet and then stopping and starting again, perhaps with a new system, and your weight oscillating as you diet – and don’t. You have to ask yourself why do you stop after a while. Perhaps you don’t like the food. Perhaps there is no support around. Perhaps you haven’t rewarded yourself sufficiently.
  • Thinking of it as a diet rather than a lifestyle. I know I’ve used the word diet, but that’s just a shorthand. You should realise that you’re not just eating fewer cases, but embracing a new, better way of living. You’re not going just going to lose a few pounds, but you’re going to become a healthier, happier person, with a longer life expectancy and better quality of life. And a healthy body is important for a healthy mind.

Now pass the blueberries.

Getting the words out

I’ve been silent because I’ve been busy. I have found that writing my “great work”, The Science of Consciousness, is good for my mental health – although whether I’d be able to write at all without a certain level of mental health is a moot point. Writing gives my life direction and purpose, and structures my day. The amount of work involved makes a mockery of any notion of being “retired”; writing is fulltime job. Consciousness is the most difficult subject I’ve ever written about: to paraphrase the British psychologist Stuart Sutherland “an awful lot has been written on consciousness, mot of it rubbish”; why do I think what I’m writing isn’t rubbish too? I suppose you can only do your best and then just hope. I’m not going to fall into the trap that many psychologists fall into, of equating consciousness with attention, or even just visual attention. I recognise it’s a big, difficult topic.

I have been reflecting about why I have found this writing so enjoyable and so therapeutic. Perhaps it’s obvious, but it’s because I really want to do it. I would probably write it even if I didn’t have a publisher and a contract. The only downside of a contract is often a fairly tough deadline – but if I didn’t have a deadline I almost certainly would work more casually, so it’s an advantage as well as a curse. (And usually the deadline wouldn’t be so bad if only I had started earlier.)

In the odd spare moment that I have, I wonder if my mood would be as good without this purpose. As ever there is circularity: doing stuff makes your mood better, but you have to be well enough to be able to do any stuff in the first place.

Of course in the end I will die (unless I decide to have my head frozen, and even then I expect eventually to die regardless) and eventually my books will go out of print, and I will be forgotten. At this point I envy people with children; they will live on through their genes. As others have observed, our lives are like stones thrown into a pool, causing ripples to spread out. Eventually the ripples fade and it is, for most of us, as though our stone was never thrown into the pool.

When writing a book I try not to think about it too much. I have 150,000 words to deliver before the summer. If I think of it in that way, the task is an enormous one. So I break the task down into 1000 words a day (number of words left divided by number of days left, allowing Sunday off – or rather do those jobs that have accumulated in the week) come what may. I think deciding to miss one day is a slippery slope; of course choosing to miss one day wouldn’t make much difference, but it’s easy for that one day to become two, and before I knew it, a month would have gone, and a 1000 words a day has become 1250. And then there’s reading, researching, and checking. You have to treat it like a job, or any other job I suppose, and just get on with it. I know there’s no point putting off starting to write every day because I know that it has to be done regardless, and starting at 5 pm is much more miserable and difficult than starting at 9 am. I still procrastinate a bit first thing, but I gather many writers do. I think it was Derren Brown who said something like “all self-help books just boil down to – just do it”. If you’re writing a book, writing an essay, or just have to mow the lawn – get on with it now.

Also on the positive side, I have had three outputs this week, and nothing lifts my heart more than seeing my name somewhere.

First, the second edition of my book, Talking the talk: Language, psychology, and science has just been published by Psychology Press. See:

 

 

This book is a gentle introduction to psycholinguistics, the science of how we produce and understand language. I still think the first edition was the best thing I have ever written (so far).

Second, I had a letter in the Daily Telegraph on Tuesday about futurology, robots, AI, and the implications for the economy. I’m a pessimist about these things:

 

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Rather to my surprise, it generated a great deal of interest. There were letters in reply (none of which really addressed the problem, I thought) and offers to write about the subject elsewhere. I think the future is a pretty scary place, and although I would have loved a laptop with fast internet connection when growing up, it could be that I have lived in the best of times – a rather optimistic conclusion for someone as usually as negative as me.

And third, finally, I gave a talk at Durham University on How to be successful in academia, particularly if you’re suffering from mental illness. I’m told it was very successful.

So a good few weeks. Success and achievements lift the spirits – just as you would expect. If you can, do something. But there will be times when you are too depressed to do anything. My advice, based on my experience, is to sit it out. Things will get better eventually, because they always have in the past. I promise.

 

Emptying the mind

It’s been a while since my last blog. Who would have thought that being self-employed would mean being so busy? I have been trying to focus on what’s important: my goals in taking early “retirement” from the full-time job have always been to increase my reading, thinking, and writing time.

But we live in a world of distraction. Distraction makes procrastination very easy. I even know of academics who have been encouraged by their “line managers” (what a repellent phrase) to “multi-task” their administration and research. I’m not sure at what level they’re supposed to multi-task – reading a paper while giving a lecture perhaps? – but we know that multi-tasking reduces efficiency: it just doesn’t work. Doing two things at once has a cost (which is why even speaking on the phone while driving increases the chance of an accident, let alone texting and driving). It also increases stress. And we know that doing important, creative work requires focus – you can’t carry out great research while students back their essays. I even have my doubts about one of those great sacrosanct beliefs in academic life that great teaching and research must go together: good teaching requires time, and research requires time, and you can’t be doing two things at once (see above).

I have tried to simplify my life, for peace of mind both for being mentally ill, and in order to be able to think more clearly. I have just been reading Timothy Ferriss’s excellent (if lengthy) Tools for Titans, and it is obvious that I am not alone in pursuing this strategy. Physical clutter is distracting – some of us even find it distressing. Mental clutter is just as bad, perhaps worse.

And how much mental clutter we all must have! How can you live in the moment when you are worrying about what you did wrong this morning and what you have to do this evening? How can you write well when your mind is on the telephone bill?

So here are some of the things that I’ve done to reduce mental clutter.

  1. Write down as much as possible. First I carried out a brain dump of everything I had to do, everything I was worried about, and everything on my mind. This task took a while, and I kept adding to the dump over a few days.
  2. Make structured lists. Over the years I have experimented with several types of list and time management systems. Now someone with an obsessional personality has to be careful of lists – they can easily take over and become an obsession and a distraction in themselves. I recently tried a complex system of email folders with tasks for doing today, tomorrow, the day after tomorrow, this week, waiting for, and so on … (I am familiar with Dave Allen’s Getting Things Done system and implement a simplified version of it. I have tried dedicated software but am aiming for a simple solution.)
  3. To do. Currently I am using Apple’s Reminders, with several types of list organised by location and time. I am trying to keep it simple. I have tried complicated systems and apps and remain to be convinced that a to do list can be bettered. The important thing is that nothing gets lost, and that I know everything will be dealt with by the deadline. I don’t want to have to think about peripheral things.
  4. Removing distractions. Social media distracts us and increases mental clutter. I can’t go as far as some and remove myself completely from Facebook and Twitter, and I don’t want to delete all my email accounts (and I don’t think it would be a good idea for future employment possibilities). But I don’t need to check my email every hour. Emails generate emails. I have reached the fabled “Inbox zero”, partly by moving things I can’t do now to an appropriate folder. (Actually as I write it is Inbox 1.) There are some emails I can’t do anything about just now, either because they refer to future events or because I need to do something to be able to answer them – they are moved to a “Waiting” folder. I do feel bad about several emails in my “Weather” folder that I plan to get round to when I have time. These are questions about or suggestions for or things to add to my British weather pages (http://www.trevorharley.com/trevorharley/weather_web_pages/britweather.htm). I do feel a bit bad that people have gone to the trouble of writing to me, and I always thank them, but it’s not my day job, and my time is very limited, so I can’t process them all at once. Recognising that we have limited time is a big part of the fight. WE CAN’T DO EVERYTHING. And that means MAKING CHOICES. (Apologies for shouting these statements.)
  5. Meditation. Everyone says meditation is good for clearing the mind and improving mental focus and clarity. I though with my monkey mind find the process very difficult, and probably as a result find the benefits – so far – limited. I will persevere though. I am using Andy Puddicombe’s Headspace site; I like the structure it provides and the implicit coercion. My jury is still out on meditation.
  6. Mindfulness. At all other times I am trying to be mindful of what I am doing now. If a distracting thought arises I try to push it away or if it is something I need to pay attention to add it to my list. It is easy though for obsessive people to get obsessed with clearing our minds, so we are for ever writing down minor thoughts. We all also occasionally at least need to plan what we’re going to do: living in the present doesn’t imply drifting.

Interestingly, as I was half way through writing this blog, the following landed in my inbox and caught my eye (I know, I know):

http://calnewport.com/blog/2016/12/18/on-digital-minimalism/

Finally, we should think about whether it’s even a good idea to strive for an empty mind. Life isn’t that simple. Things are always cropping up, and surprises are always happening. Rather than avoiding shit we must learn to respond to shit in the right way. The more I think about it, the more important I think this point is: we will never achieve a perfectly empty mind. It’s our responses we need to change.

Have a good Christmas and New Year everyone. It’s a difficult time of year for people with mental health problems – if nothing else it’s so dark in the northern northern hemisphere. So just hang on in there.