Archive for the Mental Health Category

World Mental Health Day

Posted in Maynooth, Mental Health with tags on October 10, 2018 by telescoper

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Today is World Mental Health Day 2018, so I’m going to treat myself to lunch in the splendid surroundings of Pugin Hall and then take a walk around the campus in the autumn sunshine. That is all.

UPDATE: That was nice. It’s actually rather warm today – 20°C – and St Joseph’s Square is looking very bonny.

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My Time Out in Astrophysics

Posted in Biographical, Brighton, LGBT, Mental Health with tags , , , , , on July 13, 2018 by telescoper

Last week I did a little talk in Cardiff for LGBT Stem Day, which was similar to another I gave earlier this year at the IOP in London at the launch of the LGBT Physical Sciences Climate Survey. I intended to post a summary of the earlier presentation but somehow never got round to it. Doing the more recent one reminded me that I’d forgotten to write up my notes, so here goes.

What I was trying to do in these talks was to explain why I thought (a) the Climate Survey and (b) LGBT STEM day were so important, from the perspective of someone who has been `out’ for over thirty years while pursuing a career in astrophysics. I thought it might be useful to include some personal reminiscences along the way as in both cases most of the audience members were too young to remember what things were like over thirty years ago.

Although I knew I was gay when I was an undergraduate at Cambridge, I wasn’t very open about it except to my closest friends. I also didn’t do much about it either, apart from developing a number of crushes that were doomed to be unrequited. In my final year I decided that I would try to get a place to do a PhD (or, as it turned out, a DPhil). I applied to a few places around the country, and was very happy to get an offer from Sussex and started my postgraduate studies there in 1985. The reputation of Brighton as being a very `gay’ place to live was definitely part of that decision although it was really the topic of my research project that was the decisive factor.

One of the first things I did during `Freshers Week’ at Sussex was join the GaySoc (as it was called) and I gradually became more involved in it as time went on. Initially, though, I kept that part of my life separate from my academic life and wasn’t really all that open in the Department in which I worked. My decision to change that was largely because of things going on in the outside world that convinced me that there was a need to stand up and be counted.

One of these was the AIDS `panic’ exacerbated by the Thatcher Government’s awful advertising campaign, an example of which you can see above. It was a very frightening time to be gay, not only because of the fear of contracting AIDS oneself  but also because of the hostility that arose as a reaction to the `gay plague’.

Although I wasn’t really sexually active as an undergraduate at Cambridge, I had been while I was at school in Newcastle up until 1982. At this time gay sex was illegal with a person under the age of 21, but I had no difficulty finding partners when I was a teenager. I assumed that, as a result of this period of my life,  I would be found HIV+. When I eventually did have a test in 1986 I was quite shocked to find I was negative, so much so that I had another test to make sure. I was lucky, countless others were not.

The second thing that made me want to come out was the Local Government Act (1988), which included the now infamous Section 28 (above). This was the subject of the first political demonstrations I ever attended, but we failed to stop it becoming law.

Anyway, I just got fed up of hearing people making ill-informed generalisations during this time. Rather than make a big public statement about being gay, I just resolved to not let such comments pass. I think it only took a few intercessions in the tea room or Falmer Bar for it to become widely known in the Department that I was gay. That was how I came out in astrophysics, and thereafter almost everyone just seemed to know.

I have to say that for quite a long time in this period my general presumption was that a majority of heterosexual people were actively hostile to LGBT+ people, and that would always remain the case. There were quite a few gay people in Brighton who felt the same and their reaction was to become separatists. The logic was that straight people were always going to be horrible, so to hell with them. You could drink in gay bars, eat in gay restaurants, live in a gay part of the town, etc, and thereby minimise interaction with the hostile majority. This seemed an attractive lifestyle to me for some time, but I gradually began to feel that if there was ever going to be a chance of things changing for the better, LGBT+ people had to engage and form alliances. That strategy seems to have worked for the wider community, and I applaud the many straight people who have become allies.

It hadn’t been fear that my sexuality would have a negative impact on my academic career that had held me back – I never really thought I was going to have an academic career until near the end of my time as a research student – it was more fear of confrontation with colleagues who would be hostile. That never really happened. Over the past thirty-odd years, the vast majority of people I’ve known through astrophysics have been friendly and welcoming. There have been exceptions of course, but I won’t waste my time on them here.

Now fast forward to 2018. Not only has Section 28 gone (it was repealed first in Scotland in 2000,  and then nin England & Wales in 2003), but since 2003 the Age of Consent is now equal for everyone and more recently we now have Equal Marriage. If you had asked me back in 1985 whether I thought there was any chance of this happening even on a thirty year timescale, I would have laughed at you.

But although many things have changed for the better, the fact remains that LGBT+ people still face widespread hostility and violence. Bullying is rife in schools, many people are still afraid to come out in their workplace, and in many situations there is still a threat of violence. I know what impact the latter can have, as I have experienced it myself and is has caused me mental health problems throughout my life. In fact, I have found it much harder to be open about my mental health problems than I ever did about being gay!

There are increasing signs of a backlash against LGBT+ people, most obviously in Trump’s America. The rights we have won over the years could so easily be taken away and my fear is that if we are complacent and pretend that everything is fixed because we have equal marriage then we will soon see those rights being eroded. We have to remain active and visible, and keep pushing against all forms of discrimination, harassment and bullying wherever it happens. And the first step in doing that is to raise awareness among everyone that it is still a problem.

Now to some specific points about working in STEM.

First, my own experiences caused me not to perceive science being a difficult environment to be gay, but I am aware that many people have quite different perceptions, often with good reasons. One thing that feeds negative perceptions is simply the lack of positive statements. I remember, over a decade ago, being asked by representative of a major STEM organisation if I could think of anything they could do to make them appear more inclusive to LGBT+ people. I looked at the `equal opportunities’ bit on their website and found that it mentioned gender, race, disability, etc but entirely omitted sexual orientation. What message does that send to an LGBT+ person? The omission was not deliberate, but the perception might well be otherwise. Many institutions display posters about LGBT+ matters, and some staff (either LGBT+ or `allies’) wear rainbow lanyards to carry their ID cards. But what if you’re a student who sees these everywhere else other than your own department? Has nobody bothered to put posters up, or has some arsehole torn them all down?

Another important issue is visibility. Students and early career researchers may be deterred from continuing a career in STEM simply because they don’t see other LGBT+ people doing likewise. I know of at least one student who was on the verge of dropping out of a physics degree because `there are no gay people in physics’. Fortunately he said that to a member of staff who knew he was wrong, as her office was next door to mine, but this does illustrate another problem of perception in STEM fields. In Arts and Humanities subjects it’s much easier to be visible as LGBT+ through your work. You even research matters related to gender or sexuality in literature, for example. It’s rather harder when you do theoretical astrophysics. But what’s wrong with having a rainbow icon on your powerpoint?

When giving my talk at the IOP I got into a discussion about `role models’. I am horrified at the thought that anyone would think of me as a `role model’. I don’t like using that term because it seems to me to imply some sort of ideal to which others should aspire, which seems to me rather arrogant. What I do think is important is for as imany LGBT+ people as possible to say `I’m LGBT+ and I’m in STEM: if I can do it and be like me, warts and all, then you can do it and be like you!’

A comment that I’ve heard about LGBT+ people in STEM goes along the lines of `We don’t need all this political stuff in science. You should just concentrate on your research’. Another version I heard from a senior scientist recently was effectively `I’m not prejudiced at all. I don’t care about your sexuality. I’m only interested in your research!’. I think this kind of stance is not uncommon, actually, but I couldn’t disagree more with it.

Science is, above all, a human activity. It’s not done by robots or calculating machines. It’s done by people. And I don’t think you will get the best science out of your research time unless you create a working environment in which everyone feels comfortable and happy being themselves. Just a few small gestures can go a long way towards creating a department or research group that’s genuinely inclusive for all the people in it.

Of course some STEM subjects have other diversity and inclusivity issues to address. For example, there is a persistent gender imbalance in UK Physics that has resisted many initiatives to encourage more women to enter the field. I’m not arguing that LGBT+ matters more than this or indeed more than race or disability or anything else. It is, however, my firm belief that taking measures to make workplace as inclusive as possible actually benefits everyone  in it. That’s partly because it’s the way to build the best team, and partly the way to get the best out of the team once you have assembled it, but it’s also a good thing to do for its own sake.

Another comment I got on Twitter a few weeks ago `When is it Straight STEM Day?’ Well, perhaps when 69% of heterosexual people feel uncomfortable in the workplace because of their sexuality, or when students are bullied at school for being straight, then perhaps there’ll be a need for it. In the meantime, you just need to recognise that despite the undeniable progress there has been over the past decades, there still isn’t anything like full symmetry between straight and gay.

Finally, and I think this brings me more-or-less back to where I started, events like the LGBT+ STEM Day and initiatives like the LGBT+ Climate Survey are vital because they acknowledge that we’re involved in a  process, not a fixed state and we have to recognise that this process could easily be pushed into reverse. All that’s needed for that to happen is for people to assume that everything is fine now and close their eyes to the overwhelming evidence that it really isn’t.

POSTSCRIPT: A thought that occurred to me while I was writing this relates to inclusivity within the LGBT+ community itself. When I arrived at Sussex in 1985, I joined `GaySoc’. A few years later that became `Lesbian & Gay Soc’. It took a lot longer for Bisexuals to be acknowledged, and even longer for Trans people. Only last week the annual Gay Pride March in London was disrupted by anti-transgender campaigners. Some of us still have a lot to learn about what it means to be inclusive.

 

Peripheral Visions

Posted in Biographical, Mental Health with tags , , on May 29, 2018 by telescoper

A few days ago I came across the following video, and I thought I’d share it here for two reasons. The first reason is that you might find it surprising, possibly amusing and possibly also bit scary. Keep your eye on the cross in the centre of the screen and observe what happens to the faces either side:

Most people who I’ve shown this to report peculiar distortions of the (familiar) faces either side. This phenomenon is clearly related to the limitations of peripheral vision.

The second reason for posting this is much more personal and relates to my struggles over the years with a form of panic disorder (which I’ve blogged about before, e.g.,  here). The term `panic disorder’ has a very broad definition, so that different individuals experience different forms of panic attacks and they can also take very different forms for the same individual. For me, a “typical” panic episode begins with a  generalised feeling of apprehension or dread. Sometimes that’s as far as it goes. However, more often, there follows a period of increasingly heightened awareness of things moving  in my peripheral vision that I can’t keep track of,  accompanied by auditory and visual hallucinations.  I’ve tried to explain the latter in conversations with friends and colleagues and usually when I do so I describe how the faces of people around me become distorted in a grotesque and terrifying way. When that happens I usually run as fast as I can in whatever direction I can to get away.

On top of the effect of these attacks themselves, there is also the frustration, when they are over, of not really understanding what had happened. What is happening in my brain when a panic episode begins? What is going on with my peripheral vision when it goes awry like it does? Why do some particular places  or circumstances trigger an attack but other, apparently similar, ones don’t?

When I first saw the above video it struck me immediately that it might contain a big clue about these episodes, as the facial distortions that appear there are very similar to what I experience.  Perhaps what goes wrong is that peripheral vision takes over from central vision, i.e. a kind of opposite of tunnel vision,  as a result of some malfunction in the way my brain deals with peripheral data.

Most of the time we just discard data from outside our line-of-sight unless it’s something extremely dramatic and disturbing (whether good or bad); presumably we can’t process everything across our entire field of view so we usually filter out observations coming from the edges. What seems to happen with me is that something interferes with this filtering process so that almost everything gets flagged with a danger signal. My response to these is to look about manically trying to establish whether the threat is real before, usually, just getting out of there as quickly as I can when it becomes overwhelming.

Obviously, this isn’t a complete  answer to any of the many questions I’ve asked myself about this but somehow seeing the effect in the video makes me feel more comfortable with what happens because at least I can see that others can experience a similar phenomenon, even if in very different circumstances.

P.S.  I should say that although about two years ago I quit the medication I was taking to control them, I haven’t had any of these psychotic episodes since then. Reducing stress by leaving my job at Sussex was almost certainly a contributing factor.

 

 

 

 

It’s Mental Health Awareness Week Again

Posted in Mental Health with tags , , on May 14, 2018 by telescoper

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This year the focus is on stress. Research has shown that two thirds of us experience a mental health problem in our lifetimes, and stress is a key factor in this. By tackling stress, we can go a long way to tackle mental health problems such as anxiety and depression, and, in some instances, self-harm and suicide.

For further information about how we can tackle stress and help improve our mental health see the Mental Health Awareness Week website.

Death and Shingles

Posted in Biographical, History, Mental Health with tags , , , , , on August 31, 2017 by telescoper

So it is now twenty years to the day since news broke of the death of Diana Spencer, formerly the Princess of Wales, along with Dodi Fayed and driver Henri Paul, after a car accident in Paris. I’ve noticed many people posting their memories on social media of where they were when they heard that Diana had died so I thought I’d do the same as I remember it very well.

In the weeks leading up to 31st August 1997 I had been suffering from shingles, a very unpleasant condition that results from the reactivation of the virus responsible for chicken pox, which I’d suffered from as a kid. Shingles causes nasty skin rashes, but on this occasion I was also treated to a spell of almost total deafness. This is a fairly unusual side-effect of the disease but is well known to occur in some cases. Hearing loss caused in this way can be permanent, but thankfully mine wasn’t.  I responded rather well to the anti-viral drugs I was given and it took only a matter of weeks for my hearing to be fully restored.

Suddenly becoming deaf was an unsettling enough experience, but it was even stranger to have been unable to hear anything during the period just after Diana’s death, which turned out to be one of the weirdest times of my life.

On the morning of 31st August 1997, which was a Sunday, I got up rather late and went to the local newsagent to buy a Sunday paper. They were sold out of everything. I thought that was a bit strange but walked out unaware of the reason everyone was buying papers that morning. I went back to my flat – I was living in London at the time – made breakfast, and did some reading. I was looking forward to the football match that was going to be live on TV that afternoon – Liverpool versus Newcastle Utd – but didn’t switch on the TV until it was just about the start. All I saw was a shot of an empty Anfield and some football pundits talking. I assumed there had been a bomb score or something, but I couldn’t hear so had no idea. I decided to have a look at Ceefax (remember that?) and then found out the story.

I was shocked, of course. She was still young when she died and I was fully aware of the reputation she had earned through numerous acts of kindness, e.g. towards people living with AIDS. That said, I was completely unprepared for the events of the following week which seemed to me to amount to an outbreak of national hysteria. I don’t know if it was more extreme in London than elsewhere in the UK, but I felt the whole country had lost its grip. Together with the sense of isolation caused by my deafness, it was a most uncomfortable time. I was saddened by her death, but I just couldn’t feel the extreme grief that others seemed to be displaying about someone that I didn’t know personally. Worse, there was a palpable sense of pressure being exerted on people to fall into line with the deification of Diana. Anyone who expressed anything even slightly short of devout praise was treated as some kind of blasphemer. It is probably the only time in my life I’ve felt that I was the only one to have remained sane while everyone around me had gone mad.

As my hearing slowly recovered I decided to go out with some friends for a drink in a pub in Bethnal Green. I mentioned in a conversation that I never knew her personally and therefore found it hard to understand how the feelings of grief people professed to having could be genuine and that the whole atmosphere that had been created seemed to me to be profoundly unhealthy. A bloke from another table came across and threatened me with violence unless I stopped `insulting Diana’. Insulting Diana was not at all my intention, though I think what the bloke was angry about was the (probably correct) interpretation that I was criticising those who had bought into the Diana cult.

Anyway, over the week following her death my hearing had improved a little bit, so I decided to watch the memorial service on TV. I couldn’t hear the music or speeches very well, but I remember watching the soldiers carrying Diana’s coffin into Westminster Abbey. It must have been a very heavy coffin as it was a very wobbly process and I thought at one moment the pall-bearers might drop it. They slowly approached stone structure on which the coffin was to be laid. Then I heard the commentator on TV solemnly announce that it was “placed on the catapult”.

This is novel, I thought. She’s going to be launched into the hereafter on a ballistic trajectory through the stained glass windows.  However, that didn’t happen and the service continued without an aerial display.

I found out much later that the word used was not catapult, but catafalque….

 

 

 

Der Doppelgänger

Posted in Mental Health, Music with tags , , on July 12, 2017 by telescoper

Writing yesterday about depersonalisation for some reason brought this song by Franz Schubert to mind. I heard it on the radio recently and found it profoundly moving. Der Doppelgänger is a setting of a poem by Heinrich Heine that Schubert composed in 1828 near the end of his life; it was published posthumously in 1929 as part of Schwanengesang.t’s relevance to the topic of depersonalisation lies in the middle verse, in which the poet describes seeing a tormented figure only to realise that the figure is he (the last line says `The Moon shows me my own form’):


Da steht auch ein Mensch und starrt in die Höhe,
Und ringt die Hände, vor Schmerzensgewalt;
Mir graust es, wenn ich sein Antlitz sehe –
Der Mond zeigt mir meine eigne Gestalt.

It’s a very bleak piece, its desolate atmosphere underlined by the inexorable piano accompaniment which consists mostly of block chords. I think you can tell that this is written by a man who knows his days are numbered, but the simplicity and beauty of the composition and pervading sense of loneliness and desolation mark it as a work of genius, which Schubert undoubtedly was.

The singer is the late great Dietrich Fischer-Dieskau.

On drugs (and off them)

Posted in Mental Health with tags , , , , , , on July 11, 2017 by telescoper

I came across an interesting piece in the Guardian the other day written by Deborah Orr, who had just taken antidepressants for the first time (with unpleasant consequences). This was followed by an explanatory article by blogger and author Dean Burnett who explains that nobody really knows how anti-depressants work, and why it is not surprising that they can have unexpected side effects. I hope that the articles I mentioned above help make it clearer what is involved being on medication of this sort. These drugs are in widespread use, but ignorance about them is spread even wider.

I remember a while ago, when I was working at the University of Sussex, sitting on a bus in Brighton with two people behind me talking – in a very unhelpful and ill-informed way – about depression, and how anti-depressant drugs were a `soft option’. It made me quite angry listening to some of the comments they made but I didn’t intervene. I toyed with the idea of writing a blog then but I didn’t get round to it, partly because I didn’t really want all the staff and students in the School of which I was Head to know I was taking heavy medication for much of the time I was working there.  I only told a handful of people at the time. Now I am no longer in that job I think it’s safe to be a bit more open, and add a little bit here from my own experience to the articles mentioned above.

The most widespread anti-depressant drugs currently available are called Selective Serotonin Reuptake Inhibitors (the best-known of which, Fluoxetine, is known by the trade name Prozac). Deborah Orr’s article concerned her experience with an SSRI called Citalopram, which I was using about five years years ago. More recently, for much of the time I was at Sussex I was taking Paroxetine (trade name: Seroxat). The latter is not available on the National Health Service through a General Practioner, but must instead be prescribed by a consultant psychiatrist.

Anti-depressants are not only prescribed for the treatment of clinical depression but also for, e.g., anxiety disorder, panic disorder, and post-traumatic stress disorder. Nobody really knows why anti-depressants work against depression (although there is clinical evidence that they do), and there is even less understanding why (and, in some cases, evidence that) they are effective for these other conditions. Like many treatments they seem to have been discovered empirically, by trial and error.

As Dean Burnett explains in his article, SSRIs work by increasing the level of Serotonin (a monoamine neurotransmitter). However, taking an SSRI increases the level of Serotonin almost immediately whereas the effect on depression takes weeks to register. While low Serotonin levels may play a part in depressive illness, they’re clearly not the whole story.

My experience contrasts a bit with Deborah Orr’s, in that I have never experienced significant problems going onto this sort of medication – the worst by far has been when I’ve tried to quit. I had awful problems in the summer of 2012 largely as a result of trying to come off the medication I had been on since the previous autumn. The withdrawal symptoms then included shaking fits, insomnia, visual and auditory hallucinations, nausea, and hypervigilance.

The effect of this extreme collection of withdrawal symptoms was that I didn’t eat or sleep for a couple of weeks, and ended up in a high-dependency unit at a psychiatric hospital under sedation while they figured out what to do with me. Fortunately, I recovered well enough to return to work after a couple of months.

At the end of the summer of 2012, I was offered the job of Head of the School of Mathematical and Physical Sciences at Sussex University. I moved from Cardiff to Brighton in early 2013 to take up this new position. I hadn’t been there for long when my old problem returned. The stress of the job obviously played a role in this, and I soon realised that I couldn’t keep going without help from medication. It was then that I was tried out on Paroxetine, the dose being gradually increased until I was at the maximum recommended level (60mg daily).

While this medication was effective in controlling the panic disorder, it had some unpleasant side-effects, including: digestive problems; dizziness; difficulty in concentrating; fatigue; and the weirdest of all, a thing called depersonalisation. Deborah Orr describes the latter very well in her piece but she seems to have experienced it as soon as she started taking medication, whereas in my case it came on  gradually.

 I found myself living a kind of half-life, functioning reasonably well at work but not having the energy or enthusiasm to do very much else outside of working hours. Eventually I got fed up with it.  I felt I had to choose between staying in my job as Head of School (which meant carrying on taking the drugs indefinitely) or leaving to do something else (which would mean I might be able to quit the drugs). I picked the latter. The desire to come off medication wasn’t the only factor behind my decision to stand down from my job, but it played a big part.

I knew however that Paroxetine  is associated with notoriously difficult withdrawal symptoms so, mindful of my previous experience in 2012, I followed the medical instructions to the letter, gradually cutting down my dose over a couple of months during the course of the Autumn in 2016. I still had significant withdrawal symptoms, especially the insomnia, but not as bad as five years ago. I’m hoping that my current (part-time) job allows me to manage for the foreseeable future without the need for any medication – apart, perhaps, from the odd glass of fine wine!

So those are my experiences. All I can say that I hope I’ve convinced you that anti-depressants are not a `soft option’!