The Reason For Now

After a lecture by my son's headmaster wherein children are regarded by the Catholic Church as divine we say that wonderfully influences expectations of our kids which moulds behaviour and self esteem which is one of the main determinants of success in life. Andy my co presenter related this to his own experiences with Attention Deficit Hyperactivity Disorder. We then segway onto social media which destroys self esteem, social skills , causes depression and dissolves concentration in its frenzy of instant gratification and dopamine hits making us all ADHD. We look at how trauma and behavioural shifts can be passed across generations by epigenetics. We discuss one of the fundamental differences in the thought processes between adults and children. Whereas children combine reality with their imagination and inner self so that anything may seem possible , adults close their minds to reality and stay with their limited set of beliefs and dreams. We summarise that true clarity of mind only exists at two points in life: once when you are born and after you have had good therapy. Enjoy .

Responsibility: Progress in any system is by trial and error. This is how nature works in evolution and how our children grow up through experiences and teaching. Models only work for specific unique situations. Eg laws of gravity , motion etc. in fact many scientific concepts. In fact even those only stay valid until they are disproven or someone comes up with a better concept. The idea that models can be produced for complex systems is not realistic. Yet this is what ‘experts’ are constantly doing in the search for certainty about future predictions of risk or growth. They are almost always invariably wrong. In order to make progress with trial and error there must be room for and consideration of disparate views in order to reach a consensus for going forwards to see if the idea worked or not . Trial and error. It has been known for a long time in the business world that large companies stop being creative. The reason is that they get so large that centralised control from head office is all about homogeneity within the company to maintain its identity and integrity. Anything challenging that is expelled rapidly. At this point the only way they can do more business without new products is to increase market share by monopolisation and by marketing. This is why all companies have a sine wave life. A slow start, an exponential rise , a tailing off and sudden decline as the ‘new idea’ company takes off.  Coca cola , Amazon , Tesla, Apple have no new ideas but are experts at monopolisation and marketing. They also lobby to suppress competition for  new ideas. There has been research looking at the decline of civilisations in the past and all of them collapse after they reach a point of maximal communication within the empire. Ie at their equivalent of globalisation. Wherever there is no progress and suppression of new and or better ideas there is always regress. Now we have social media where the crowd narrative expels, vilifies and suppresses anything that disagrees with that narrative. Unfortunately social media is often manipulated by the powers that be to create a crowd narrative . Additionally, fake news, which is usually more shocking  and more likely to spike the pleasure hormone dopamine, travels through social media six times more rapidly than real news. Humans are hard wired to respond to structure hierarchy and leadership and crowd opinion and to respond to fear stimuli automatically without thinking. Therefore any tool of mass manipulation such as social media in the wrong hands can and has had disastrous consequences . Indeed the psych ops teams used by individual governments to get their citizens to comply with useless and at worst highly damaging measures during the  ‘covid epidemic’  have been legally termed a military weapon. In other words governments used a military weapon against their own people. This was only necessary as the measures used were dictatorial, illogical, inconsistent and dangerous.  Wherever you hear the term ‘we are following the science’ combined with suppression of alternative views -especially suppression of the truth- you know its a scam. For sure.  Of course this is also an example of our leaders not taking any responsibility at all.  Political correctness is another mass media crowd narrative driven by the powers that be to destroy structure within society. It demands compliance no matter how illogical the requirement. It demands equal outcome for all which is often damaging as we are not all the same. We have the same rights but all of us are different.  Compliance is usually effortless and gains approval of the mass media and carries with it no responsibility. This is called virtue signalling. Eg I am wearing a mask. Aren’t I a good citizen? Worse than that is virtue signalling of the minorities which carries with it entitlement eg I am gay or I am LGBT aren't I special just for existing and everyone can and should recognise this talk about me and celebrate me. For doing nothing. Therefore virtue signalling and the entitlement associated with it is the opposite of responsibility and in fact carries something else dangerous which is blame and fault. Eg : You are not complying , you have not employed more gay people , you have not converted half your toilets to LGBT even though we are a tiny minority and the rest of you will have to queue up to use the rest. It is your fault and you must be punished. Being gender fluid is virtue signalling instead of taking responsibility for being the sex that you are.  Men, you are all bad. It is your fault. Take no responsibility and be punished or vilified.  Women: don’t take responsibility for being women, you can now be men so you can sleep with lots of men and women  and you must all be having careers and employers must preferentially employ you even if you are less qualified than your male counterpart. The result? Women who go to university have a 50% chance of hitting their 40s childless and often single or in dysfunctional relationships. Birth rates in the West have dropped off a cliff and now the birth rate is 80% that of the death rate. IIn Norway adult diapers are outselling baby diapers. In developing countries not hit by mass media and political correctness the birth rate is much higher than the death rate.  People confuse fault and responsibility and they are totally different. Fault looks at the past and usually requires punishment. Progress is usually a casualty of this process and in the rare cases there is progress it is accidental. Responsibility is being self aware and admitting when something goes wrong and taking steps to rectify the consequences and to improve future endeavours.. Now you can see that the mass narrative by global communication is purely set up to run on mindless compliance and blame and punishment if you do not comply . Responsibility taking is the trial and error approach in a complicated system which is the only way to progress. It is also the only way to be tribal or what I call tribe compatible behaviour. We are hardwired to be tribal. Our health, both mental and physical, even depends on it.  We take responsibility to function better within the tribe and to collaborate and help others which we are hard wired to do. You can imagine a tribe run by blind compliance and punishment and expulsion of original thinkers would quickly wither and die. This is what is happening to us right now.  Our leaders for decades have been reversing  their leadership style from command and control where everything is centralised and produced and implemented by the government  for the good of the people and has now changed to one of  abrogating all responsibility through the implementation of commissioned and or imported policies and models . In the vacuum which is left comes the chaos of political correctness and global mass media and social media narrative.  It also causes far more corruption amongst politicians. Since they have no responsibility and everything they do is responsibility avoidance it encourages self serving behaviour and entitlement.  Taking responsibility is core to the mental and physical health of the individual . It is a commitment on a daily basis to algorithmically be better than the previous day. As a society it is the same . If our leaders do not go back to this and if social media is not severely restricted and controlled we are being led off the cliff face of our existence virtue signalling as we do so. GetBlueMail for Android

All the great minds including religion tell us that if we are to progress in life we need to shoulder responsibility which involves hard work and pain. They don't make life sound too appetising with the partial exception of religion in which faith is innate . We argue that they miss out one of the key secrets of life which is self esteem. Thanks to Angela who made this a lovely Podcast touching on many issues affecting our lives including narcissism , the universal wage, Dave Mustaine and Socrates.

PTSD first defined in soldiers returning from the Vietnam War and officially recognised since 1980. The distilled essence which you won't find anywhere else is as follows: Similar to phobias there is a processing block causing an emotion logic gap: I know I should not feel like this but I can't help it. This is because we are hard wired to avoid or reduce anxiety so the brain actively suppresses anything causing anxiety so you can't think about it long enough to bring the emotion down to the logic. No amount of sense or education helps here which is in contrast to a real danger where you need tools and education without which just thinking about it will not help at all. There can be minor and major processing blocks. There can also be a processing block from a misperception of an event so here the processing needs to overcome the discomfort of having got it wrong and the consequences of that. It's easy to see how we all have various degrees of emotion logic gap. For instance have you found that no matter how well you explain something to someone they won't change their minds? Even if you know they have understood the logic? It is because it is too painful to do so and they have no reason to go through that pain. Or how many times have you done something knowing it is wrong just because you want to for various reasons? Here again there is a type of processing I teach bit it needs self awareness and motivation. Yet the harm from chronically raised cortisol from even mild processing gaps can be measured by improvement in all aspects of mental and physical health when it is dealt with. It is why I say you only have clarity of mind at two points in your life: 1 when you are borne, 2 after you have had good therapy by a true expert which you pay for. (The payment indicates your motivation versus just turning up). Life time prevalence of PTSD 8% of the population, about 90% are exposed to trauma including unexpected death of a loved one, equating to a lifetime occurrence of 5 separate traumas in men and 4 in females. Women are less likely to be exposed to traumas than men but the traumas they are exposed to are more likely to cause PTSD such as rape and sexual molestation where as males are more likely to be exposed to combat and witnessing trauma to others. About 30% of women view their child birth as traumatic with 30% of those developing PTSD hence about 10% of all mothers have PTSD. About 25% of acute medical problems including ITU have PTSD. Psycholgical sequalae of PTSD: Clinical depression , alchol and drug abuse. Predisoping factor: Clinical depression. Self report questionnaire: PCL-5 Post traumatic stress disorder Check List for DSM 5 20 questions scored 0-4 relating to the previous month. DSM 5:  SIACAD Stressor Intrusion Avoidance Cognition Arousal Distress More than 1 month Can specify whether dissociation or delayed onset. Routine debriefing re living trauma may make it worse CBT 4-5 sessions, EMDR, Reprocessing Live Exposure SSRI SNRI Psychedelics FDA approval pending Transcranial Magnetic Stimulation Atypical Antipsychotic , ECT Important nuances: Chronic loss of control eg bullying or lock-down = Prolonged Duress Stress Disorder Minor trauma still causes processing blocks or impaired processing which needs to be properly processed either with self journaling or with reprocessing therapy. In fact Professor Pennebaker showed that in Yale University students self journaling difficult events reduced cortisol and improved mental and physical health and exam results. Naomi Breslau The Epidemiology of Postraumatic Stress Disorder Jounral of clinical psychology 2001

Stutz Dr Theo I would be fine if I knew what direction to go in I would fly instead I become lazy . We also discussed the first step in therapy which is connecting with your internal energy You do that in 3 steps: 1: Diet exercise and sleep  2: Connecting with others as we are tribal 3: Connecting with yourself your underlying feelings which is self awareness most effectively done by self journaling. The Part X is  that part of you stopping forward progress which could include the Shadow self or the Maze or the Snap Shot or simply the judgmental antisocial part of you. Eg you’ll never be good at that, or who wants to do that , or you are wasting your time trying this. Radical acceptance is a tool to help you get over something bad. Grateful Flow helps deal with negative thoughts and Loss processing deals with loss The key is to understand that for forward progress  and overcome Part X you need to go through a life time of: Uncertainty pain and constant work. It is this process you need to enjoy ie the journey rather than the destination.It is overcoming Part X that leads to growth. Failure pain embarrassment connects you to the universe you are saying I need your help I cannot do this without you. Stutz says confidence is an appetite for uncertainty . I say this is not true because confidence is knowing how to do something which by definition is being certain. Rather self esteem is an appetite for uncertainty because  self esteem is the degree of positivity with which you view yourself and therefore an expectation of positive outcome . If things do not go well self esteem protects you from the negative effects and instead helps you learn and move on and  apply those lessons in your next steps. I am the one who gets to decide and take the next step. It will almost certainly be imperfect but progress is made by taking the steps  aka string of pearls each with a turd in them Indeed research shows that dopamine hits come from achievement and reward in general but it is much greater if the reward is unexpected. Hence watching sport has an element of unpredictability which is why so many people enjoy it.  . Indeed when Formula 1 became too predictable the audience ratings fell so they changed the rules to make it more unpredictable. It is a positive expectation of an outcome that raises dopamine rather than the known outcome itself. The positive outcome will raise dopamine only if is unexpected. This explains how you can enjoy the journey of uncertainty pain and constant work. Your self esteem gives you an expectation of a positive outcome. It is the positive anticipation raising dopamine that makes this process enjoyable. This is especially important because it helps with sense of achievement and growth. The greater the effort the more meaningful the achievement. This then enables the parallel step of balance : Effort and reward must be balanced. Since more of life is effort rather than the result then the mechanism of being able to tolerate the effort is a  positive expectation of success. Once you put in the effort the sense of achievement is fulfilling and makes you grow. Positive self esteem also helps us use failure as a growing opportunity and simply includes  lessons learnt as part of the effort to  the next step all under the umbrella of positive expectation of overall outcome. Snap Shot relates to setting of a goal  eg the perfect wife, the perfect success , the perfect amount of money in the bank which is static concept and has  no depth and does not allow for ongoing progress with pain uncertainty and constant work. There is no perfect nirvana. Goals are illusionary needs and living life like this is one of the worst inventions of the Western World.  When the snap shot does not give you nirvana and cure your inner unhappiness you get much more depressed. The Shadow is the part of yourself you are ashamed of.: This is how I see myself and I felt so much shame that I was denying myself and  and others would no longer see this if i got more successful Visualist a time in your life you felt inferior embarrassed ,rejected, despondent ashamed its a part of yourself that you that you wish you were not and you cannot get rid of How does he feel about you, how you have dealt with him how you have treated him and see what he says Denying and being ashamed of it THe shadow feels hurt angry and upset The shadow wants attention not from the world -does not need an academy award-  but from you The shadow wants to be acknowledged and included and celebrated as a beautiful part of you So in high pressure high stakes situations the goal is not create a faultless performance but to include the shadow self and tolerate whatever happens. Because if I cam content with my true self then other peoples opinions affect him less Ignore the shadow self and he will make you do destructive things. Connecting with your shadow self and having a sense of wholeness means you are happy the way you are, you don’t need to anything else to make you feel better.itis very freeing Maze refers to when someone does an injustice to you and you remain angry seeking or hoping for restitution which usually never comes. Stutz says instead take the love you wanted from the world around you  Active Love - you are unlikely to be paid back by the person so you may as well take it from the universe around you.  by closing your eyes and imagining this is happening then concentrating it in your heart and then sending it and physically feeling it go into the other person so that you become one with love. This is not for their good it is for your own good to free you from the maze. In terms of my coaching this reflects forgiveness but is not as powerful as understanding. For instance you can understand why something happens because it is in someone's nature. That does not need forgiveness.  It requires understanding of reality and what is possible and what you can then do about it. You understand their nature and have expectations according to their nature and act accordingly. For instance you dont put your hand in the mouth of a tiger. You now it will probably bite and you certainly dont get angry. Ask yourself do you want to be right or do you want to create something. Radical acceptance: when something bad happens you don't just think that you will sooner or later recover from it, or stay stuck in a cycle of self pity ,you have to squeeze the juice out of it. Learn your lessons in whatever happens First: dont tell yourself anything negative Second: find something that is positive about it So squeezing the juice out of it suggests that not only do you have the will but also the faith that there is something valuable there If you see all events as having value you are in the zone of tremendous opportunity The Grateful Flow wants to choose the positives. Every thought will affect your mood whether positive or negative.  Part X wants you to have the negative thoughts to just see clouds even though sun is behind the clouds and coming. The grateful flow is not the grateful thoughts but the process. You name 4 things that you are grateful for, the smaller the better as you can connect better then continue in your head. After a while you feel you will create another grateful thought but you dont you block it  so all you feel is the force that would create a grateful thought and as it gets stronger and stronger you  feel taken over by it. You don't just repeat the same grateful thoughts you look for new ones and that process of creating grateful thoughts will change your mood. Gratefulness is a state you want to be in as much as possible. It helps you break through the cloud, What you don't do is argue with negative thoughts. You cant reason with emotion. Loss Processing: The potency of Non attachment . You want to pursue it  and pursue it hard but you are willing not to have it, you are willing to lose Think of something you don't want to lose and imagine grasping it like you are hanging onto the branch of a tree. Then visualise letting go but its not a bad sensation.Its slow and gentle to your surprise. Then you say silently I am willing to lose everything but really feel the intent behind that. Then you imagine you fall into the sun and burn up losing your body (so you lose everything) and instead become part of the suns rays radiating out a very loving giving outflowing sensation and that sun is surrounded by other sons doing the same thing as part of the sun world all saying we are everywhere. All you can do is give you cant take. You cant grasp onto anything. If you have difficulty with that then think of yourself as moving towards non attached. In fact as a human it would not be good if you were totally non attached. If you are moving towards non attachment then no one thing or person leaving you can take away your sense of wholeness. Happiness depends on how you accept that  you cannot completely figure things out and what you do about it.  RAGL The Active Love, Grateful Flow , Loss Acceptance,Radical Acceptance

"Where are you from" is considered a micro aggression. Of course in a harmonious society this is a reasonable question indicative of genuine interest. Indeed in a harmonious society to suggest any other motive would be nonsense. However it has become a problem for two reasons in this age of societal collapse where political correctness has been the latest disintegration stage.The first is people are easily offended because they are unhappy and are insecure about their own identity and feel they have no control apart from the politically correct right to offence for which there is no cost and no responsibility. Of course people should be proud of who they are and pride inspires respect and interest and education. Indeed who you are is simply reality and that is the healthiest thing to deal with. Not edging anxiously round political correctness.The second is that the indigenous population is also feeling unhappy and insecure about their identity as they see it collapsing around them manifested by discussions over whether Christmas should be cancelled or summer school exams moved due to Ramadan.As usual we are all too blinded by the symptom to really address the real problem which is something far more sinister.The real fault lies with our leaders. It is their responsibility to provide leadership including national identity. If someone wants to move to any country it should be clear to them that they will be respected for who they are and where they come from but the priority is to integrate and take on the identity of that country and it's customs. In evolutionary terms if something is familiar it's probably good as it has not already eaten you. If it's not familiar it could be a danger. Hence we dont like people who are different. Studies back this up by showing certain of our brain cells which respond to social queues -mirror neurones- either don't respond or respond less when observing someone of a different skin colour. It can be remedied by education. Hence the phenomenon of racism is a natural phenomenon but the fact it happens is a sign of a badly run society. People don't feel integrated and instead stay close to those they identify with which is why cities become mosaics of different cultures and religions with limited mixing. For instance we all know which cultural groups live in China town, Finchley, Hownslow, Walthamstow, Lambeth -or even large swathes of Birmingham.... Once you have coalescing of cultures each rubbing shoulders with each other then you have friction and strife. Add into that increased immigration recently with no effort or requirement of integration then you have a dry tinder box where small incidents can act as kindling for the underlying problem. For instance the UK is a Christian country. The King of England is the head of the Church of England. At citizenship ceremonies you have to swear allegiance to the King of England. Saudi Arabia is much clearer. It has strict requirements for cohesion to its own culture and religion and forbids public display of other religions. Do you think they would consider moving Ramadan to allow foreign students to study for exams? Who is the stronger more harmonious society? The problem with our leaders is that being a democracy they have to get elected hence they have to please the vast majority of the population who make decisions emotionally on top of which they are misinformed by the media. Therefore logical well infirmed voting is not only a pipe dream but those seeking election just make promises that sound good emotively for quick votes. This is nothing to do with firm fair leadership which will displease the politically correct mass media. Try enforcing British culture, identity, values let alone the Church of England. This general collapse is seeping into every fibre of our society including health, social services police. Everyone avoids responsibility behaves obstructively and destructively rather than constructively and takes offence. It is Marxism with the eradication of the middle and upper class -often and preferably unceremoniously- leaving only the elite and the vast mass of everyone else and this always ends in disaster and revolution.

Gut Immune Body Brain Axis.Dr Gundry:Leaky Gut, gut microbiome and dietRenowned Cardiovascular Surgeon who realised that all he was doing was treating thesymptoms so he studied the underlying causes.The lining of the gut is one cell thickAs bacteria break down the gut that is when ageing startsIbuprofen or roundup disastrous the bacteria populationSkin is a mirror of the lining of the gutJoints do not naturally wear out.Animal model C Elegans as bacteria begin to break down the wall of the gut that is whenageing starts105 year old people have a diverse set of bugs identical to a healthy 30 year old. It is notattacking the wall of the gut.Ecermansia musinophilia. Lives in the mucous layer whose job is to trap lectins plantproteins looking for sugar molecules and to protect the wall of the gut from harmful bacteria.Ecermansia musinophilia eats mucus which in turn makes more mucus.Metformin works by increasing mucous and this change in bacteria makes some peoplehave mild diarrhoea as the bacteria change.If we damage this lining eg ibuprofen or food with roundup destroys the bacteria populationand gut lining.Glyocosade an antibacterial damages Ecermansia Musinophilia even though it does notdirectly affect human cells.Antibiotics in food or direct prescription eg ladies who take low dose for UTI have a higherincidence of heart disease.Heart disease is an autoimmune disease starting in the gut.Cholesterol is an innocent bystander which gets sucked into the inflamed wall of a bloodvessel.Infants with heart transplants have coronary artery disease with pathology identical withtypical coronary artery disease.Lectins which are a foreign protein which can stick to sugar molecules on the surface ofblood vessels are the cause of atherosclerosis and removing lectins reduces those markers.Lectins are one of the plant defence systems. Sticky proteins that look for specific sugarmolecules to stick to which insights an inflammtory response.Joints do not normally wear out. Usually you can find bacterial particles in the joint fluid ofarthritisBecauseLectins broke down the wall of the gut. 65% of the immune system is behind the wall of thegut because the gut is where the outside word gets through. A reason why we store fat inthe gut is to provide energy to the immune system. Similarly fat on the outside ofatherosclerotcic blood vessles correlates with the severity of inflammation.Fat is not the cause . It is there because of the inflammation and the inflammation is theredue to the leaky gut.The immune system responds to antigens on bacteria of viruses. Lectins have antigens withcross reactivity with other proteins in the body. Eg thyroid.Nightshade vegetables or peanutsLectins disrupt the microbiome and break up the lining of the gut allowing entry by lectinsand by bacteria or bacterial particles.Hence if you inject a bacterial lipopolysaccharide into a person you can induce septic shock.Alzheimers Parkinsons is neuroinflammation.Most amyloid is produced by bacteria in the gut. Therefore 40 billion dollars invested inantiamyloid drugs has been a waste because amyloid is produced by the amyloid producingbacteria inthe gut fet by western diet. Then the amyloid has to get through the wall of the gut.Once they get through the gut wall and goto the brain it will produce more amyloid.Cholesterol and amyloid coexist in dementia in those with the apoE gene.The apo E gene codes for a carrier molecule because it is less efficient at transportingcholesterol. It cannot get out of the cell after it has been attracted by inflammation.Faecal microbial transplant:1970s broad spectrum antibiotics came out which made it much quicker to treat infectionsbut it also wiped out the gut bacteria. Normally 10000 species of bacteria.Pseudomembranous colitis was caused by Clostridium Difficile over growing. Initial studydone from the faeces of medical students.Faecal enemas treated the pseudomembranous colitis.Meat with animals treated by antibiotics can also cause problems.60% of faeces is bacteriaOral microbiome and cloud of bacteria around us –Holobiome . This defines our personalspace.Kissing is a human and ape characteristic. Exchanging oral microbiome. Bacteria decidewhether the other person's bacteria are compatible with them.Women have a gut feeling because they are more capable of listening to their microbiome. We inherit our microbiome from our mother. All of the mitochondria are involved with bacteriainherited from our mother. Bacteria communicate to their ‘sisters ’ie the body’s mitochondria.Autism: kids have a different microbiome than ‘normal’The placental microbiome is important in educating the foetal immune system.Oral faecal transplants for 6 weeks in autistic kids. Almost immediately 50% autismsymptoms reduced.Ecermansia like tubers, mushrooms, -study in Asia find 90% reduction in Alzheimers withtwo cups of mushrooms a week.Inulin containing compounds eg chicory, radicchio, jerusalem artichoke.Exercise women who exercise routinely from midlife have a 90% reduction in Alzheimers. Inthose who get AD it happens 11 years later. Housework can be important part of exercise.Meditation and yoga also changes the gut microbiome.Lymph system in the brain in deep sleep -early in the sleep cycle-shrinks by 20% and thesebad proteins are squeezed out. You need a 3-4 hour window between sleep and dinnerbecause blood flow diverts to the gut.Olive oil /walnuts / mediterranean low fat diet: first two groups improved memory after 5years. 3rd group lost memoryThose with CVD had a 30% reduction in events, the low fat group continued CVS events.Polyphenos in olive oil grow proteinsTMAO is made by gut bacteria primarily from animal protein especially choline eg egg yolkand carnitine . TMAO damages blood vessels. Polyphenols in certain olive oil and red winebalsamic vinegar that paralyse enzyme systems in the bacteria so they do not make TMAO.However the logical error here is that eggs which are high in choline are not associated withincreased morbidity.Vitamin D at least 5000 units a day . Almost all cancer patietns and autoimmune pateitnshave low vitamin D. HIgher your VItamin D the longer your telomere. Stem cells in the gutare simulated by vitamin D.VItamin CLectins are present in most plant foods but especially high in:legumes, such as beans, lentils, peas, soybeans, and peanutsnightshade vegetables, such as tomatoes and eggplantdairy products, including milkgrains, such as barley, quinoa, and riceThe Roll of Inflammation in Depression and FatigueFrontiers In Immunology:CH Lee 2019:Immune system link to depression first noticed with immunotherapy eg INFa (which activates an inflammatory antiviral response) for Hepatitis C : associated with raised proinflammatory cytokines and depression and fatigue.20% of patients treated with INFa developed depression which resolved on discontinuationbut also increased the risk of depression in future.Also people with higher IL6 aged 9 were more likely to have depression aged 18 in a dosedependent manner.Innate immune system seems to be lower in depression eg NK cells and also less antiinflammatory regulatory T cells whereas inflammatory monocytes are activated.There is commonality in immune activation from autoimmune disorder such as multiplesclerosis or immune reactions in sepsis.Antidepressants reduce inflammation while a higher baseline level of inflammation predicts apoorer treatment response.People with depression have been shown to have higher inflammatory markers which canbe used to predict treatment efficacy and future recurrences of depression.Elevated inflammatory markets eg TNFa after an MI disrupt the blood brain barrier causingdepression.Inflammatory changes in the brain with raised TNFa in the hippocampus and striatumprecede development of depressive symptoms.Neurogenesis is inhibited by the kynurenine pathway which is rescued by both inhibitors ofthis pathway and traditional antidepressants.TNFa also increases glutamate release causing exocytotic damage to surroundingsneurones.Conditions associated with chronic immune activation such as asthma, atopy, diabetes mMS, RhA, SLE are all associated with raised levels of depression eg 36% of asthma havedepression who also had higher TNFa than those who were not depressed. 75% in RhAMS up to 50% risk of depression.Acute inflammation with sepsis also causes depression and raises the risk of depression infuture which in animal models can be reduced by using steroid during the acute sepsis.Antidepressants reduce inflammatory markers perhaps SNRI more effective than SSRI andalso ECT adds in return to normal of NK activity.Directly reducing the immune response eg anti TNF a or Caspase Inhibitors have beenshown to reduce depression. Rituximab which is an antibody that targets and depletes Bcells in the treatment of RhA also reduces depression.Aspirin can reduce depression but can also reduce the effect of an SSRI.

Eliot Jacks 1965 Mid-Life CrisisParadox of prime of life fulfillment in life but seeing it as dated as death is just over the hillNational Geographic 2012Apes Have Midlife Crises, Too—And It May Help ThemMiddle age ruts may act as natural motivators, scientist says.BYAMANDA FIEGLNATIONAL GEOGRAPHIC NEWSPUBLISHED NOVEMBER 20, 2012A national survey of Midlife in the United States conducted a poll to determine how many people experience midlife crises. Approximately 26% of the participants reported having a midlife crisis.Most survey participants reported that their midlife crisis occurred before age 40 or after 50, however.That raises the question about whether these crises were truly related to midlife since midlife is typically considered age 45.Out of the one in four people who say they had a midlife crisis, the vast majority say it was brought on by a major event, rather than age. Factors that triggered the crisis included life changes such as divorce, job loss, loss of a loved one, or relocation.Happiness SlumpMany studies indicate that happiness is U-shaped. A gradual decline in happiness begins during the late teen years and continues until an individual is in their 40s. Happiness begins increasing again in an individual’s 50s.Data on half a million Americans and Europeans found this trend to be true. Individuals in their 60s reported they’d never been happier, but people in their 40s felt like they were at an all-time low.This U-shaped curve doesn’t appear to be universal, however. It’s more prevalent in high-income nations. A gradual decline in happiness may explain why some people seem to hit a midlife crisis—they’re in a happiness slump.Even though data suggests people become happier again later in life, there’s a pervasive belief that happiness continues to decline as we age. So, some people in their mid-40s may think life is only going to get worse, which may spark a midlife crisis.Some people may experience depression during midlife and refer to their depressive state as their midlife crisis. Women between the ages of 40 and 59 in the United States have the highest rates of depression (12.3%) of any group based on age and gender, according to the Centers for Disease Control and Prevention.Suicide rates are highest during middle age—among white men in particular. People between the ages of 45 and 54 are more likely to kill themselves than any other age group. A 2016 study published in the International Journal of Behavioral Development found an upside to the midlife crisis—curiosity. Researchers found that people who were experiencing a crisis—whether it was a quarter-life or a midlife crisis—experienced enhanced curiosity about themselves and the wider world around them.1 The distress and uncertainty participants experienced brought about openness to new ideas, which could bring insight and creative solutions. That curiosity could lead to new breakthroughs or new opportunities, which might be the silver lining in the midst of a crisis. Professor Mark Jackson Royal Society  Psychological: Identity CrisisBiology: Awareness of ageing and deteriorating vigour. Includes women with menopause and empty nest.Middle of 20th Century standardised life course. Ie not just biological but socially prescribed. Time to marry, have children and retire.By the 1950s life expectancy had significantly increased and women had started marrying earlier. Women 20-24. Fewer children clustering them earlier in the marriage. So a longer period of life after childbearing.Men’s life was determined by occupation . Decades in the same job until retirement. Hence everyone was going through the same changes at the same ages.Ageism started growing with a greater sense of where we should be at certain times of life. Failure to meet expectations. Keeping up with the Jonses started in 1913 in a comic strip.Middle age was sandwiched between adolescent crisis of children and old age of parents.Inheritance happened decades later increasing pressures on couples bringing up children.The extended life course also led to the question ‘is this all there is, do I want to live with the person for the next 30 years’The realistic prospect of a life long marriage was questioned and the concept of serial marriages was introduced.1969 the divorce act changed removing the concept of marital offence making it easier to divorce. Pull to a better life eg Life begins at 40. First used in 1914 by the widow of an army officer  Theodora Parsons, who had trained ladies in physical fitness to keep the mind fit.We do not begin to live until we begin to die. She was addressing middle aged women who were overweight and let themselves go therefore she wanted these ladies to get fitter to aid the war effort. However that phrase became key in self help literature from the 1930s onwards. Indeed it encouraged older people to enjoy life and work less in order to allow younger people into work during the recession of the 1930s.The American Dream was also sketched out:  the dream of a social order in which each man and woman is able to attain their maximum potential. We could look forward with some hope.After WW2 the collapse of the American Dream was replaced by  the dream of motorcars and high wages as well as human consumption.  Happiness in a hurry. The idea of life begins at 40 ie life getting better not worse was a sense of narcissistic belief thinking they are due happiness love approval  sex excitement all this is denied me in this stale marriage let me get rid of her.We are aged by our minds our bodies and by history and culture. Midlife crisis is much more marked in Western than in Eastern cultures.  Barbara Waxman Tedx 2021:People believe their best years are behind them  

Not medical licensed advice . Always consult with your doctor:New Treatments For ObesityBMI: 25-30 : overweight  >30 ObeseWHO 2016 40% are over weight and 13% obese slightly higher in females . This is triple that in 1975UK 2019 House of Commons Library  40% are overweight and 30% obese higher in middle aged and elderly menNHS 2021: Children Obesity has gone up in 12 years from 19% to 25% The Surprising Link Between Chronic Inflammation & Obesity—Plus What You Can Do About ItMay 5th 2021Leptins are hormones produced by adipocytes that communicate with the hypothalamus to reduce eating. If you have too much leptin you become leptin resistant and do not stop eating. High leptin levels are also associated with  chronic inflammation.Conversely losing weight reduces systemic inflammation. REVIEW articleFront. Physiol., 29 January 2020Sec. Clinical and Translational PhysiologyChronic Adipose Tissue Inflammation Linking Obesity to Insulin Resistance and Type 2 DiabetesFrederika ZatteralThe key mediator of inflammation in obesity is the innate immune system cell the macrophage that can account for up to 40% of adipose tissue and it differentiates into a pro-inflammatory M1 macrophage setting up chronic inflammation.Obesity and Inflammation: A Vicious CycleDoes obesity cause inflammation or does inflammation lead to obesity?Jun 25, 2020Jennifer LutzObesity causes chronic inflammation via a chronic immune reaction initiated in the adipose tissue but inflammatory cells can go round the body. In addition gut inflammation may be a result also of the poor diet that led to the obesity.We know that obesity has tripled in the last 50 years such that 40% of the western world are obese. In fact 75% are prediabetic.Cardiovascular disease leading to cardiac disease and strokes, diabetes, cancer, depression, osteoarthritis all feed back and make it more likely you will continue to be obese.Higher adiposity and mental health: causal inference using Mendelian randomization Francesco Casanova,Jessica O’Loughlin,Susan Martin,Robin N Beaumont,Andrew R Wood,Edward R Watkins,Rachel M Freathy,Saskia P Hagenaars,Timothy M Frayling,Hanieh Yaghootkar... Show moreAuthor NotesHuman Molecular Genetics, Volume 30, Issue 24, 15 December 2021, Pages 2371–2382, There is a bidirectional relationship between depression and obesity.Genetic sorting showed that it is obesity per se and not the metabolic unhealthiness due to the obesity such as diabetes that leads to depression.That said diabetes from obesity causes depression although obesity itself causes systemic inflammation which is an independent risk factor for depression and cancer.There are also huge psychosocial effects of obesity on mood.Once-Weekly Semaglutide in Adults with Overweight or ObesityNew England Journal Of Medicine March 2021John P.H. Wilding,Once a week subcutaneous Semaglutide reduced weight by up to 20%Semaglutide is a GLP-1 agonist so suppresses Glucagon and increases insulin hence controlling blood sugar. It also slows gastric emptying  increasing satiety and acts on Receptors in the Arcuate Nucleus in the brain to increase satiety.It is already licensed to treat Type 2 diabetes.It also reduces the risk of cardiovascular complication in Type 2 diabetes and at a cellular level reverses atherogenesis. There is a question on worsening the risk of retinopathy.Other GLP-1 agonists : Liraglutide Setmelanotide.CpdFDA Approved Medication for treating ObesityPhentermine, diethylpropion,benzphetamine, phendimetrazine , Orlistat, Phentermine/topiramate Qsymia, Bupropion/naltrexone, Semaglitide, Liraglutide, setmelanotideCpd Phentermine-topiramate: First combination drug for obesityInt J Applied Med Res 2015Singh et alPhentermine is a centrally acting sympathomimetic that reduces appetite and topiramate enhances GABA ergic transmission reducing Dopamine Response to food.This combination causes up to 10% weight loss maintained in 50% for 2 years.The relationship between early weight loss and weight loss maintenance with naltrexone bupropion therapy.THe Lancet Discovery Science 2022Le Roux et alNaltrexone blocks opiate receptors and bupropion (wellbutrin/zyban) blocks reuptake of dopamine  -reward pathways- .and noradrenaline . Weight loss is maintained at 1 yearBoth medications enhance each other on feeding and satiety

Depression:The most important thing anyone reading this needs to know is that everyone with depression will get better. The sooner you treat it the quicker and better the results.LIfe time prevalence 4%, in fact in the USA up to 10% struggle with depression.280 million people world-wide suffer from depression.20% risk of suicide in untreated depression.Used to be the 5th commonest cause of illness and death, now it is the commonest.It is not because we have all become genetically susceptible to clinical depression, rather we have become more and more unhappy and stressed with modern life. What has risen is social media with the pressure to be perfect compare and online bullying and economic uncertainty as well as recent lockdown and health hysteria and vaccine mandates and most recently Ukraine War and spiralling energy prices. Mental health referrals are at all time highs.Neuroscience New and Research July 2022 Ruairi J Mackenzie: Serotonin theory has been seen for years as an oversimplification. SSRI medications do often work in depression but depression is multifactorial and likely more than one illness.  The Biopsychosocial model of depression is preferred.Even Epicurus 2,500 years ago and before him Buddha both said that seeking of pleasure would cause unhappiness as pleasure is transient and leads to more seeking of it hence is not only meaningless but destructive. Yet as a society that is exactly what we have become: cyclical reflex dopamine seekers especially with social media.Furthermore the teaching of socialisation has been reversed with smart phone hunched pleasure seekers. We are all becoming depressed children with no effective parental supervision apart from the social media CEOs temping us ever further down the rabbit hole of instant gratification..One of the definitions of the most dysfunctional members of our society namely personality disorders is self obsession as this is not tribe compatible yet the rest of us are rapidly heading that way pulling apart the integrity of our society and even civilisation itself if it continues. Close on the heals of self obsession is loss of boundaries and rules aka political correctness which is a Marxist view of demanding the same outcome for everyone despite the fact that everyone is different.Without boundaries we are lost  because we have evolved to function in tribes with structure hierarchy and leadership. Now we are led by self serving politicians who will say anything that gets them elected which is what they think the voters want but voters are influenced by mass and social media. Add into that that 98% of what we do and think is emotional and not logical which means that currently we are being led by media driven hysteria which the politicians respond to. Even more dangerous is that media controls the masses on a global scale now almost instantly.Diagnosis of clinical depression:Diagnostic and Statistical Manual 5th Edition Americal Psychiatric Association  and International Classification of Diseases 11th Edition 296. And F32 codes respectively:Require are certain number of symptoms for a certain period of time typically 5 symptoms for at least 2 weeks although this can be altered according to severity.Symptoms making up depression include:Low mood typically worse in the morning improving as the day goes on (diurnal mood variation)-  said to be due to raised levels of cortisol in depression with the coritsol peak being in the morning and lowest in the middle of the night-  I have seen severely depressed people walking around the ward at 2am feeling fine. This is one the reasons metyrapone is used with is a cortisol synthesis inhibitor in a resistant depressionL Ted Dinan et al.Disturbed sleep typically waking early in the morning unable to get back to sleepReduced appetite and weight loss (although people can comfort eat) reduced energy concentration enjoyment motivation confidence libido and suicidal thoughts.Treatment of depression:Firstly there needs to be a risk assessment of suicide . in 2005 1.5% of all deaths were suicide and the commonst cause was depression and it is going up.Investigation:Biological:Thyroid , metabolic, autoimmune, dietary, epileptic , raised indices of inflammation. Females my have hormonal issues including sensitivity to progesterone in oral contraceptives.Psychological:Aristotle argued that virtue is functioning according to you values and beliefs . A blunt knife is not a vrituous knife as knives are designed to cut. A virtuous human being is a human able to function according to their values and beliefs which is socialisation and reproduction. However in todays goal oriented society the pressure is one of endless goal seeking and perfectionism. That alone severely raises stress and cortisol levels but also makes you more unhappy as you not functioning according to your values and beliefs. It also means that if you achieve something at the cost of your values and beliefs you value it less in any case. Hence it is impossible to ever be happy with he result that more and more of us are depressed.Note that chronic sleep deprivation causes clinical depression.Treatment of depression:Classically it is a combination of medication and psychological treatment eg cognitive behaviour therapy.However one third of patients have raised indices of inflammation and those are likely to be resistant to antidepressants and can respond to aspirin.Furthermore for moderate depression regular exercise is as effective as antidepressant.Antidepressants: Currently they all work on a combination of serotonin noradrenaline and dopamine and a couple work additionally on melatonin receptors. None are better than the other although the newer ones have less side effects.The new generation coming through are going to be based on psychedelics and glutamate receptor antagonists . In fact the latter has a drug licensed in the UK for 3rd line treatment of depression s ketamine nasal spray.Treatment resistant depression:Requires a review of diagnosis and physical investigations then switching to a different antidepressant and raising the dose according to plasma levels , combining antidepressants and adding in thyroid hormone, lithium or antipsychotic such as risperidone.-Electro Convulsive Therapy-rTMS daily for 4 weeks.-Neurofeedback can be an alternative to antidepressants.Sleep Deprivation and Depression: National Library of Medicine Jan 2021Why is ECT becoming a preferred treatment for depression March 2022 Maclean Hospital Harvard Medical School AffiliateUsing neurofeedback as a means of reducing self blame in depression: Dr Zahn  Kings College News Centre  Sept 2021Review of social participation interventions for those with mental health problems Social Psychiatry Psychiatric Epidemiology March 2017 Martin WebberExercise is an all natural treatment to fight depression: Harvard Health Publishing Dr Miller February 2021The relationship between excessive internet use and Depression:Morrison Gore Psychopathology 2010 43: 121-126Treatment Resistant Depression: Web Med:  Dr Bruce  May 2022Esketamine For Treatment Resistant Depression: BMJ Sept 2019 JauharAn evidence based approach for augmentation and combination strategies for treatment resistant depression Psychiatry July 2006 BarowskiKey differences between Venlafaxine XR and Desvenlafaxine: An analysis of pharmacokinetic and clinical data Michelle D. Colvard, PharmDMental Health Clinician (2014) 4 (1): 35–39. A Popular Theory About Depression Wasn’t "Debunked" by a New ReviewPublished: July 22, 2022 | Ruairi J MackenzieA Popular Theory About Depression Wasn’t "Debunked" by a New ReviewPublished: July 22, 2022 | Ruairi J MackenzieA Popular Theory About Depression Wasn’t "Debunked" by a New ReviewPublished: July 22, 2022 | Ruairi J Mackenzie

Coaching: Anxiety Disorder:We all have anxiety, not only is it normal it is essential for survival, in fact as a caveman themore anxiety you had the more likely you were to escape predators and achieve survivalneeds. The irony is that in todays society it these people that suffer the most as just like therest of us they are hard wired to continue escaping illusionary predators and acquireillusionary survival needs that marketing and social media imprison us with.We discussed stress last week which is mostly a normal response for an individual to asituation where they do not feel in controlHowever if severity of anxiety or duration exceeds what is reasonable then it may become aclinical disorder.Anxiety Disorder:33% life time prevalence of anxiety disorder often co morbid with depression or otheranxiety disorders, and 4% life time prevalence of GAD higher and more impairing in highincome countries. Females twice as likely as males.Generalised Anxiety Disorder: DSM V 300.02Generalised Anxiety Disorder: 8 studies of biological interventions:Current Psychiatry July 2022 Saeed MajarwitzGeneralised Anxiety Disorder usually starts in early adulthood and persists throughout life.Anxiety about a variety of events is excessive and unreasonable and causes distress andimpairs functioning.There is a big variability in the effectiveness of physical intervention for Generalised AnxietyDisorder.SSRI, SNRI, agomelatine (melatonin 1 and 2 R agonist and 5HT 2c R antagonist –antagonism increases noradrenaline and dopamine)- as effective as SSRI maybe with fewerside effects eg nausea and sexual side effects.Less used: Buspirone - 5HT 1a R agonist.Acute anxiety: Benzodiazepine.rTMS (FDA approval for Clinical depression 2008) right parietal cortex or right dorsolateralprefrontal cortex with reduced relapse after completion of treatment.CBT alone and improves response to medication.Plus:Diet exercise reduce alcohol and cigarettes, structure , self awareness , sleep with positivestudies for magnesium, chamomile extract and antioxidants.Cross-sectional Comparison of the Epidemiology of DSM-5 Generalized Anxiety DisorderAcross the GlobeAyelet Meron Ruscio, PhD1; Lauren S. Hallion, PhD2; Carmen C. W. Lim, MSc3; et alDialogues Clin Neurosci. 2015 Sep; 17(3): 327–335.Epidemiology of anxiety disorders in the 21st centuryBorwin Bandelow, MD, PhD*Ann Behav Med. Author manuscript; available in PMC 2016 Aug 1.Generalised Anxiety Disorder: 8 studies of biological interventions:Current Psychiatry July 2022 Saeed MajarwitzPublished in final edited form as:Ann Behav Med. 2015 Aug; 49(4): 542–556Exercise as Treatment for Anxiety: Systematic Review and Analysis

Coaching: Stress:The key to stress is : control. If you have control you are not stressed, if you don’t have control you are stressed.Mental Health Foundation 2018 study:In the past year 75% had at some point felt overwhelmed with stress. Elderly less stressed than younger.Of those who were stressed 50% felt depressed and 60% felt anxious, 50% overate or ate unhealthily,30% increased alcohol and 15% started or increased smoking.Of those who felt stressed at some point in their life 30% had suicidal thoughts and 15% had self harmed.30% felt lonely.40% of stress was due to worries about health of self or others and 20% was due to debt.18-24 year old had more stress with social media egPressure to respond immediately to messagesComparing yourself to your peers -50% and pressure to succeed: 60% Females more stressed about body image than men: 40% versus 20% The American Institute of Stress:●      About 33 percent of people report feeling extreme stress●      77 percent of people experience stress that affects their physical health●      73 percent of people have stress that impacts their mental health●      48 percent of people have trouble sleeping because of stress80% of work place accidents are due to stressYearly cost to business of stress in the USA: $300 billionPsychological and physical Symptoms:Depression anxiety anger fatigue tension diabetes cardiovascular disease high blood pressure cancer substance abuseStress is increasing. American Psychiatric Association: APA 2011 : 5% increase to 49% of Americans had felt stressed. 33% of children.APA 2021: Covid has caused significant stress in 80% worse in young adults associated with a sense of uncertainty about the future of their country and their own future.Up until the pandemic stress had been rising more in the middle aged who were less able to cope with technological advance , work pressure and  job losses.APA 2022: 90% of Americans feel stressed and 70% think Ukraine is the beginning of WW 3Hormones of stress response:Adrenaline then the Hypothalamus Pituitary Adenal Axis producing CRF ACTH and Cortisol Cortisol is catabolic breaking everything down increasing energy supply.  It is anti inflammatory and suppresses the immune system. However chronically raised cortisol causes cortisol hypofunction leading to chronic systemic inflammation.Raising stress levels in the last 30 years is almost certainly the reason for the drop in vitamin D3 levels in the West which was already very low.  This is because the stress hormone cortisol blocks the receptors which absorb Vitamin D3. This in turn drops our immunity and makes us susceptible to infection and cancer.We are naturally tribal and designed to function in relatively small groups of about 150 (Dunbar’s number).We require structure , hierarchy and leadership with common identity and goals.This is why religion works well. It is a transcontinental tribe with clear identity and rules. Destruction of this with globalism , political correctness, mass media with constant hysteria generation and social media designed to take control away from you as well as making you feel compelled to answer messages immediately and to negatively compare yourself to others are a modern catastrophe to our mental and physical health. Attempts to medicalise it are misguided and happen more out of a sense of duty and despair by the medical professionals. It is a leadership and political issue and a sign of a catastrophically badly run society. Freedom of speech? Freedom of Movement with hoards of people happy to work on minimum wage? Debates on whether to cancel Christmas and whether women can have penises?These remove certainty and any sense of structure and clarity of direction.What we can do:Firstly:   Is self awareness. Ie stop worrying about our anxiety but accept it. This drops activity in the fight flight centre of the brain and gives you a chance of logical reflection. Secondly: Don’t worry or even think about larger issues beyond our control. Hence the key here is ‘thinking’ it is usually a matter of perception. Eg I can’t stop it raining but perhaps rain is good thing for many reasons. Instead I will use an umbrella or stay in or simply go out and enjoy the rain. Or there is lock down so I can t go to the gym. Let me review what other types of activity I can do, I may find something even more beneficial such as exercising outside. In short there is always a solution of some kind. It may not be what you originally wanted but as soon as you have a level of control your stress will drop by definition.Thirdly:  Focus on family, close community, keep active, eat healthily and sleep well. If this is not working seek professional help as there is always a solution.

PTSD first defined in soldiers returning from the Vietnam War and officially recognised since 1980.The distilled essence which you won't find anywhere else is as follows:Similar to phobias there is a processing block causing an emotion logic gap: I know I should not feel like this but I can't help it. This is because we are hard wired to avoid or reduce anxiety so the brain actively supresses anything causing anxiety so you can't think about it long enough to bring the emotion down to the logic. No amount of sense or education helps here which is in contrast to a real danger where you need tools and education without which just thinking about it will not help at all.There can be minor and major processing blocks. There can also be a processing block from a misperception of an event so here the processing needs to overcome the discomfort of having got it wrong and the consequences of that. It's easy to see how we all have various degrees of emotion logic gap. For instance have you found that no matter how well you explain something to someone they won't change their minds? Even if you know they have understood the logic? It is because it is too painful to do so and they have no reason to go through that pain. Or how many times have you done something knowing it is wrong just because you want to for various reasons? Here again there is a type of processing I teach bit it needs self awareness and motivation.Yet the harm from chronically raised cortisol from even mild processing gaps can be measured by improvement in all aspects of mental and physical health when it is dealt with.It is why I say you only have clarity of mind at two points in your life: 1 when you are borne, 2 after you have had good therapy by a true expert which you pay for. (The payment indicates your motivation versus just turning up).Life time prevalence of PTSD 8% of the population, about 90% are exposed to trauma including unexpected death of a loved one, equating to a lifetime occurrence of 5 separate traumas in men and 4 in females.Women are less likely to be exposed to traumas than men but the traumas they are exposed to are more likely to cause PTSD such as rape and sexual molestation where as males are more likely to be exposed to combat and witnessing trauma to others.About 30% of women view their child birth as traumatic with 30% of those developing PTSD hence about 10% of all mothers have PTSD.About 25% of acute medical problems including ITU have PTSD.Psycholgical sequalae of PTSD: Clinical depression , alchol and drug abuse.Predisoping factor: Clinical depression.Self report questionnaire: PCL-5 Post traumatic stress disorder Check List for DSM 5 20 questions scored 0-4 relating to the previous month.DSM 5:  SIACADStressorIntrusionAvoidanceCognitionArousalDistressMore than 1 monthCan specify whether dissociation or delayed onset.Routine debriefing re living trauma may make it worseCBT 4-5 sessions, EMDR, ReprocessingLive ExposureSSRI SNRIPsychedelics FDA approval pendingTranscranial Magnetic StimulationAtypical Antipsychotic , ECTImportant nuances:Chronic loss of control eg bullying or lock-down = Prolonged Duress Stress DisorderMinor trauma still causes processing blocks or impaired processing which needs to be properly processed either with self journaling or with reprocessing therapy. In fact Professor Pennebaker showed that in Yale University students self journaling difficult events reduced cortisol and improved mental and physical health and exam results.Naomi BreslauThe Epidemiology of Postraumatic Stress DisorderJounral of clinical psychology 2001

FIrstly about 1 in 10 children have ADHD and about half will grow out of it leaving 1 in 20 adults with ADHD. The long term studies in adults have not been done but the oldest patient I have diagnosed and treated with ADHD was 68.There is a strong genetic component and it is almost certain that other members of the family will have symptoms of ADHD. There is also a greater than average association of ADHD with bipolar disorder and dyslexia.People with ADHD often present with an inexplicable failure to succeed in life. In other words they are intelligent and affable and try to apply themselves but they fail.ADHD can make is so difficult to function that there is a high incidence of depression and anxiety alcohol and substance use.It is also not an uncommon cause of relationship problems amongst couples as the ADHD person will be impatient and irritable and impulsive and difficult to communicate with.often appearing not to listen.Notably of patients diagnosed with clinical depression then 25% will have ADHD and unless it is treated the depression will not resolve.As a child ADHD can have severe direct and indirect consequences on self esteem, socialisation and general ability to function and be consistent which are all hugely involved in success in life.One can imagine a child with ADHD being relentlessly hyperactive impulsive and inattentive will be hard to manage for the parents who typically chastise verbally and physically. This negativity erodes the green shoots of self esteem . The child gets used to criticism, and also gets used to failure and comes to expect both.  One patient was so out of control that his father used to take him out into the garden and hose him down with cold water. They will have difficulty with socialisation and will tend misbehave as a consequence of the ADHD at school and be punished.There are two issues as far as schools are concerned. ADHD -unless it is very mild- is a disability and is covered under the Disablity discrimination act 2010. Additionally even if the child is treated with medication the disability criterion applies as if the child is not on medication. Therefore if the school is sanctioning a child for behaviour as a result of disability or if they are insisting on behavioural targets such as a behavioural contract then they are setting up the child to fail.Not making reasonable adjustments is part of disability discrimination and is illegal.The second is abuse by neglect. If either parent or school knowingly do not take steps to help their child once they know they have ADHD then that is abuse by neglect.Parents should be wary of the paradoxical reinforcement of shouting or physical punishment. Either may arouse the child so much that their dopamine goes up producing a compliant calm child. The parent in desperation learns this is an effective way of curbing unruly ADHD behaviour and the child gets used to being scolded criticised and punished and absorbs that into their self esteem and personality. One of my patients as a child was so hyperactive the only way his father could get him to calm down was to take him out and turn the high pressure water hose on him. That raised his dopamine.This is also the rational when an occupational therapist recommends ‘Play breaks’ at school if an ADHD is getting unrully or for quiter play ‘hard putty’. All these provide physical stimulation hence raising dopamine.Far preferable of course to take a simple tablet rather than treating the child differently to the others.Medication for ADHD:Stimulants: Methylphenidate and different types of preparation of this. They come is standard release or sustained release (modified release)In the USA there is also Dexedrine (adderall) which is a mixture of standard and slow release salts.All these are Class B drugs and have to be prescribed with a CD Pad (controlled drug pad)National Institute of Clinical Excellence Guidlines state that one a consultant psychiatrist has made the diagnosis and continues supervision of the patient then the GP can prescribe it. Many GPs however do not. Either because they dont understand it, or they are anxious about a class B drug or they don’t believe in ADHD.Unlicensed stimulant : Modafanil (Provigil) is a histaminergic agent which at high dose has been shown to treat ADHD. note that antihistamines sedtate so histaminergic agents will stimulate.Non stimulant medications:Atomoxetine (Strattera) : this raises dopamine and noradrenaline but it is a cumulative effect similar to an antidepressant and needs to be taken constantly . Stimulant medication can be taken according to the requirements and then not taken if not required.Guanfacine: a central alpha 2 receptor agonist which raises dopamine in the Pre Fronatl Cortex.Psychological:This is required often due to the direct negative effects of ADHD and the indirect  effects eg therapy will teach good habits such as reflection, communication, impulse control. We also have to fix fractured self esteem. All this is almost completely useless -although it depends on the precise degree of ADHD-  if the patient is not on medication as they cannot concentrate enough to cooperate.Family Therapy is important as the parents need to be educated on how to best help their child and also be reassured they are not bad parents.I help them try and be mindful using a visualisation based on the film the Mask with Jim Carrey who played a gentle hopeless romantic with no confidence. Putting on the Mask exponentially magnified these qualities restoring his confidence and turning him into a mischievous charming hyper energetic caricature of himself. I say they are are getting angry with the Mask of ADHD not their child but their child absorbs all negative input and chastisement into their personalities.Parents also benefit from education about the law as it applies to their child’s eduction:All publicly funded nurseries, per-schools, state schools and local authorities must try and identity and assess children with Special Education Needs(SEND).There must usually then be an Educatinoal Health Care Plan (EHCP) which must be reviewed annually and from Year 9 there must be a full review preparing the child for adulthood.From the age of 5 onwards it is the law that every child has a right to full time education.Schools will need to take appropriate steps such as expert assessment by educational psychologists, occupational therapists, speech therapists and referral to local child and adolescent mental health services. If necessary the EHCP will be submitted to the local health authority for extra funding if one to one is required although most schools do have some extra budget themselves for this but of course they dont like using it and usually need ‘encouragement’ by an ‘informed’ parent. The trouble is not all parents are informed. I remember seeing a Polish mother picking up her 7 year old son at lunchtime as the school had enforced half day attendance. This is illegal and refers back to one my basic rules of human behaviour: people do what you let them.Private schools are bound by OFSTEAD and usually align themselves on their website to rights of equal access to full time education for all. I recently had to write a report for a 15 year old with ADHD -and the school knew he had ADHD- who had been put by the school on a behavioural contract which he broke as he could not stick to it and was sanctioned for it. This is not only failure to make reasonable adjustments but direct harm to the child. It is disability discrimation and therefore illegal. As far as physical treatment goes the American Text Book of Psychiatry states that after assessing for diagnostic criteria in DSM V then a definitive diagnosis is obtained by a positive trial of treatment with a stimulant, the point being that only someone with ADHD would become calm and focused on a stimulant and everyone else without ADHD would experience the stimulant effect.Indeed many people with ADHD will self medicate with some kind of stimulant ie sippling coffee or coca cola throughout the day. Many will resort to Cannabis that does not so much focus the mind as give a blanket of relaxation that some equate with better functioning but it is not a direct cognitive effect and in some results in an amotivational syndrome.Highly suggestive of ADHD is someone who has no difficulty getting to sleep after an espresso. Some people with ADHD also report paradoxical responses to cocaine so that while everyone was partying the night away after a line of coke they sat quietly on the sofa. (this will depend on the dose of cocaine as I will explain later).Indeed Donald Trump drinks 6 diet cola day and will well known to not be able to sit through meetings and tends to be impulsive and disinhibited. Look at Boris Johsnon, impulsive and disinhibited and who apparently is not interested in the roll of prime minister, just the position of power. Since the work of the prime minister is not interesting to him he actually genuinely cannot do it. However he is a classic scholar and self professed lover of ancient Greece the writings of which have been the basis of study of oratory and because he likes the classics he has no difficulty writing a book on Ancient Greek.The neurotransmitter deficit is dopamine. People with ADHD do not have enough dopamine and treatment seeks to bring dopamine levels back into the normal range. Taking too much stimulant may push dopamine above normal levels whereupon overstimulation would occur.Precisely because the idea is to bring dopamine back to normal levels there should be few if any side effects.Since dopamine is the pleasure neurotransmitter then this is why people with ADHD can focus if they like something  their dopamine goes up into the normal range so performance at school can be starkly binary being either great or awful at something. Indeed if they like something they can hyperfocus.

The reason why Depp and Heard are the tip of the ice-berg Personality DIsorder Part 2Personality disorders ie those whoes behavior is by nature consistently anti-tribal are this way due to a combination of nature  (genetics) and nuture. They can be born this way or they can be affected by trauma of different types. For borderlines and psychopaths sexual trauma is especially important. Anything that fractures or does not affirm self esteem either acutely or chronically risks going onto also affect socialisation and both together will then create an individual who's behavior purely due to who they are is tribe incompatible aka personality disorder. The specific way in which anti tribal behavior reduces internal anxiety defines the type of personality disorder.Interestingly the American Psychiatric Association talks about oversly sensitive overly reactive children  being a risk factor for developing personality disorder and I think this may refer in some cases to genetically overanxious children but more importantly , becausethis is somethign easily addressed it is referring to is ADHD. Parents often cannot cope and often dread dealing with their own children when they have ADHD and this not helped by an increasingly avoidant educational system who need to be strong armed by assertive parents who have read all the rules and guildelines into providing any useful support. The problem is that kids with ADHD are constantly chastised and scolded and have difficulty learning normal socialisation (without making serious compromises such as taking on the role of the charming misichieve maker who people are entertained by) and also get used to failure as schools often reject them or do not give them adequate learning support. Its important for parents to undersatnd they are getting angry with the ADHD not their kid . However it is the child's self esteem and self pereception that is being damaged . This is the most persuasive argument for discussing medication with parents who understandably do not want their children on tablets but equally do not want to harm the fundamental rewquirments for success in life ie self esteem and socialisation ie tribal living and how well you can do within the tribe.Recently I had to write a report for a 15 year old who had been put by one of the UK's great public schools in the North on a behavioral contract. But he had ADHD. He could not stick to it and was expelled. The school have now lost aginst the parents during formal proceedings and rightly so. The damage to self esteem was incalculable. This directly through discrimination and inderectly through neglect of duty abuse of the child. This is the case if parents and professionals do not properly manage ADHD.The commonest personaltiy disorder is Obsessive Compulsive characterised by individuals being socially awkward and often withdrawn, liable to routine and ritual and perfectionism and hard work. This is likely to be a misclassifaction or at least a duplicate classifcation for more functional Aspergers Spectrum disorder. Even more simply we are all on the emotion/autistic spectrum with females generally shifted left of centre to the more emotional end and males generally shifted right of centre towards the autistic end. The main mediator is the level of exposure to intrauterine testosterone. It means that a female with Aspergers tendencies is even more of an outlier than a male with Aspergers tendencies as the general female poplulation lies more the left than males. Indeed a right shifted narcissit female is especially toxic to the tribe often exactly because they can fly under the radar but they have most access to and responsiblity for raising chiildren and someone who is self serving and likely to be critical and controlling and unable to teach proper attachement and socilaistion to the kids is going to be very damaging to those kids. Furthermore females tend to be the social centres of tribes so a right shifting narcissist will be especially toxic to the tribe.The reason personality disorder exists at all without being selected out by natural selection is that it confers a survival advantage. In times of strife famine or war etc the tribe needs an assertive leader able to make cold calculated decisions. Such as Churchill versus Hitler or Trump versus Putin. (Biden is of course a joke and a plant by the higher powers to be manipulated in an attempted Great Reset). Current society and emphasis on careers values hard work and persistence which is a key trait in obsessive compulsive/right shirters. Also right shifters are more resistant to trauma as they lack the normal emotioanl responses. They are able to pragmatically accept what has happened but their main distress is with the consequences and change in routine caused by the trauma . Hence my suggestion is that you will find a high proprotion of right shifters among refugees as the right shifters were able to remain functional enough to leave their coutnry whereas those closer to the population mean were overcome by stress and so less functional and less albe to leave and seek safety.Society is changing infront of our eyes. Unregulated capitalism  and materialism and the destruction of religion morals and ethics and national identities combined with globalisation leading to different cultures being forced into close juxtaposition to one another is leading to increases stress and unhappiness especially in the West which is leading the way in this. Unfortunatley the digital age which selects for binary thinking right shifters who are especially suited to softtware programming  has resulted in narcisistic binary thinkers becoming the richest men in the World. The consequence of having intelligent binary thinking narcissists in charge is that they will in the blink of an eye (ie reflexly -hence the personality disorder nature) justify subjugation of the unhappy strife riven population with biometric passports and ultimately computer chipping in a bastardised biblical simile of God creating Man in his image. You will own nothing and be happy is the mantra of the Great Reset.Since peronalit disorder causes suffering to the indvidual and those around them through being antirbal then the defining criteria are relative to the tribe. If we are all turned into subjugated robotic compliers then those seeking collaborative warm human contact would be considered the anti tribal personality disorders as they would be damaging to the binary thinking tribe. You think this is unlikely? Think again. How about those speaking the truth about COVID and vaccines being cancelled and revilled and subjgated by the media as well as the law? Now we know it was mostly lies and vested interest of large pharma and govenerments defining policy by public opinion which was manipualted by mass media and those controoling them. For instance BIll Gates controls the WHO and has interests in Pfizer and the same entity controlling Pfizer also controlls Thomson Reuters the golbal fact checker which was used by Twitter. The end of society as we know it is happening infront of our eyes.How are personality disorders treated? Since they are not ill there is no treatment. However some may have the insgiht that if they want to benefit from what society has to offer then they have try and act agaisnt their nature and integrate more functionally. There exist therapeutic communities who mainly follow the method of putting these people on behavioral contracts exactly because they are responblle for themselves. So if they break the rules such as being voilent or self harming or generally being antitribal they are punished by being excluded from the community for a time or discharged alltogether. Some have come to me stressed by the pressure of society for them to be nicer ie less psychopathic or less narcissistic. Basically they are stressed as no one likes them so they are lonely and running out of victims or work is suffering and they want things to go better. My answer is dont try and act against your nature. It causes stress. Be yourself. Be a psychopath openly .It means that people can engage with you on fair terms. They then know what they are dealing with and are less likely to be damaged. Look at Boris Johsnons multiple relationships and multiple children. Look at his superficial charm yet talk to his ex wife and she is excoriating of him. Close prolonged contact with personality disorder can be devasting as they are entirely self serving and therefore destructive .Indeed the Oxford English dictionary defines ''Evil'' as something wicked and amoral. If you look at amoral it means not moral. If you look up moral it means knowing the difference between good and bad and doing good. If you look up wicked it says something unpleasnat eg an unpleasant wind or something harmful. Therefore by definition in the two golbal classificaiton systems which state personaltiy disroder causes suffering to the individual and those around them lifelong then by their nature they are evil.How does one respond to a personality disorder? Three ways. The first two require knowledge of the spefic antitribal mechanism they are using ie are they a psychopath, are they a narcisist , or a binary thinking micro controller? Are they an insecure attachment seeking borderline ? Ie you have to know the currency of their internal peace. Then you apply fear of losing that currency or reward with that currency.  The problem is that in order to that consistently and not be stressed in so doing it has to be in your nature it is not for most of us and generally not in the nature of victims seeking advice on how to deal with a personality disroder then fhe first two options are not practical which leaves the 3rd option of geographical separation.Returning to Depp and Heard. How many witnesses did Depp have give evidence for him? Many. How man did Heard have ? None apart from her sister who clearly was a genetic close match to Heard .

This is the best overview of personality disorder currently available as understanding the distilled rules of human behaviour allows us to analyse the patterns in the world around us with a clarity some may find challenging but most find liberating. We look at the current diagnostic systems and what they try and do and their shortfalls.Simply put most living organisms with self awareness are tribal because nature worked out millions of years ago that living in a tribe conferred a survival advantage to wondering the planes as a nomad.The most fundamental behaviour we all exhibit is that we are hard wired to reduce our internal anxiety -our baseline arousal. This is our primitive survival mechanism. If we see a tiger we instantly run. There is no conscious thought . The quickest way of survival is to bypass the cortex -the amygdala hijack- so we are hard wired for reflex anxiety reduction.Since we are tribal and the coexistence of any number of reflex anxiety reducers will instantly lead to chaos then were have a secondary hard wiring to reduce our anxiety by relating to and taking on the opinion of the majority around us -the mass narrative- to respond to authority, structure hierarchy, leadership.This tribal consistent reflex anxiety reduction exists on a spectra with the majority of us lying around the mean so we are pretty good at it. However everything in nature exhibits variability and this is no exception. There are individuals who lie further from the mean of tribal consistent reflex anxiety reduction until you get to the extreme outliers where their tribal consistent reflex anxiety reduction has in fact inverted 180 degrees to be entirely self serving. The mechanism by which they reflexly reduce their anxiety by self serving defines the type of personality disorder.It is globally accepted that personality disorder has to be present from birth or at least start in childhood following which it persists life long. As it is anti-tribe it leads to erratic destructive behaviour for the individual concerned and or more frequently for those around them which is why they are usually sooner or later rejected by the tribe.Forensic psychiatry has been caricatured as using one of two diagnoses: Mad or bad but unfortunately this is not nuanced enough and can lead to miscategorising of individuals in either group.The first things to say is that these people are therefore hazardous by their nature and not due to mental illness.Unfortunately political correctness that gives centre stage to the outliers of society by insisting on equal outcome for everyone without considering whether this is appropriate or even healthy gives these individuals the power of the full force of the law -indeed positively discriminated for by political correctness. A basic understanding of their psychology shows how disastrous this can be.A common mistake made by the police is how can this lady make these claims if they are not true?The answer is that there is no logic involved. In order to reflexively achieve even a small degree of internal peace the personality disorder won’t think what they do to achieve this or the consequences there of. If the law allows them to utter a few simple words which lifts them out of the drudgery of normal existence into one of cossetted abrogation of responsibility then this will be their reflex action.Similarly for mass murderers or serial killers. SInce everything for personality disorders is self referential rather than for the good of society then when they are inevitably rejected they will view themselves as hard done by victims and depending on other parts of their nature they will respond vindictively of which the outliers are the extreme actions, but plenty of personality disordered spurned spouses show remarkable and consistent degrees if vindictiveness.Indeed the basic tenet of forensic psychology is that the main predictor of crime is opportunity. In other words if you let something happen it will. Almost anyone is capable of almost any atrocity given the wrong environment. We are products of our environment and our behaviour is bounded by structure hierarchy and leadership and within this ethics , morals, cultural norms, religion , law.  GIven the presence of this then break through velocity comes with different degrees of personality disorder which is why 50% of the prison population has personality disorder . Unfortunately our modern materialist society has also resulted in psychopaths being 20x more common amongst CEOs than in the general population. In other words modern society is being led off a cliff by self-serving outliers of the population who are predators and yet are worshipped as role models.We look at some ways to deal with personality disorders in the likely event that one will cross your path.

We take a historical and macroeconomic look at patterns over the centuries that keep on repeating with the different players of various societies. Typically the life span of a society is marked by a slow start a rapid acceleration phase a plateau and a rapid drop off the edge. It's the same for bacteria in a Petri dish in fact. It's a matter of the build up of scale and then the sheer power of mass making competition useless with the big kid on the block until the resources have been used up at which point it is no longer viable or weak enough to be challenged and overthrown.Typically the more extreme the distance between polar views of the society the higher the likelihood of collapse. This is also the point of maximally inequitable distribution of resources amongst the population. Western society is at such a point. It is almost always about the inability to service government debt usually due to exponential expansion or simply debt to gain or remain in power. Once the currency starts being devalued by printing money or as the Romans did putting less gold in the coins then confidence in the government drops. It is always the case. Roosevelt did it and Nixon did it. Currently 70-80% of government debt repayment goes to interest. Germany infact orchestrated the euro so it could have tarrif free trade as it is the major manufacturing nation in Europe. When countries ran out of money then Germany just leant more money to it's customers so they could continue buying their goods. Even though Greece was broke it lent so much money to the Athenians they had the largest number of Porsche SUVs in Europe. The European Central Bank is now broke . It cannot service bonds issued since 2014. Interest rates are stuck at zero or negative but instead of spending money citizens have simply taken money out of the banks and horded it. Pension funds which require an 8% annual return to break even are now also going bust. Western governments cannot and never intend to pay off their debt. Claus Schwabe of the World Economic Forum has been training and nudging heads of state for years with the idea of a Great Reset. 'build back better " is the phrase coming out of all heads of state lips from the global marketing firm Edleman. The idea is cancellation of government debt. Governments will default on debt. Bonds will not be honoured and pension funds will collapse. In order to stop riots all public debt will be cancelled so no mortgages or credit card debt. We will then all be put on a universal wage in this ultra Marxist regimen. However central control always fails as no one has the skills experience or vested interest in each enterprise and it's why Stalin after the crops failed in Russia stole the Ukrainian grain causing millions of deaths. Therefore covid which is easily proven to be a scam and the war in Ukraine which is clearly staged as the Americans via Kamala Harris purposefully broke the Bucharest agreement hence "triggering Putin" have been attempts to cause increasing global instability and hardship putting ever more people into debt so that people will be too weak and tired to resist a regimen change and only too ready to accept a solution. The Reason For Now.

Depression used to be the 5 th commonest cause of illness and death 25 years ago go and now it is the commonest we have not suddenly become genetically susceptible to clinical depression people are stressed and unhappy and are not designed for modern life The key element of stress is whether or not you have control if you have control you are not stressed if you're not in control you're stressed Stress via the hormone cortisol is the grim reaper and destroys mind and body. Although all of us experience stress it can become a longer term problem as in post-traumatic stress or prolonged duress stress disorder. However throughout life there are often many psychological blocks which are signs that you haven't been able to process your experiences fully and safely and can be associated with mild raises in cortisol. Notably two major studies one in 2020 and one in 2022 showed a very strong association between vitamin D3 deficiency and severity of covid illness. It's also notable that the levels of vitamin D3 in the west have fallen stratospherically over the last 20-30 years just as as depression has been rising and of course it's not depression it's stress and cortisol prevents absorption of vitamin D3. You can imagine the the extreme stress caused by lock down and mask wearing and all the unnecessary restrictive measures associated with coronavirus. Never in the history of the world has global lockdown ever been recommended and the office of National Statistics freedom information shows that there were only 6,120 deaths exclusively with covid on the death certificate. Therefore there is no pandemic and all emergency measures are illegal. Not only has stress over the last 25 years worsened vitamin D3 deficiency but the increased stress over the last 2 years will have been catastrophic for D3 levels as well as causing excessive inflammation and pathology within the body which will have made people even more vulnerable to viruses as well as increasing death from other causes. We discuss specific therapy and we also discuss what can be done to maintain a sense of control.

It is a great privilege to discuss with my mentee Alexi the lessons he has learnt over the last 20 years with me. Firstly we all need therapy because it gives us self awareness. The purest our minds will ever be is the moment we are borne and after therapy. We are sensitive recording instruments of everything we experience from the first breath we take and how we express that going forwards is largely determined by the chassis we layer these experiences onto -- our personality. Self awareness usually lies deep within the strata of psychological blocks and damage that we pick up from the moment we are born. The journey to self awareness depends on many things including internal motivation , external events and personality. No man is an island and such is the emotional unpredictable nature of humans that we need to be constantly guided with structure and rules and values. Alexi surmises what he has learnt and what is really important in life. Suffice to say it as family and close community and not chasing your career.

The 3 contributors discuss 2021 and whether our predictions came true , the why and the how. Lessons to learn, wisdom for the future or just croissants and coffee amongst friends