Difficult Decisions About Antidepressants

By 2020, depression drug sales worldwide are expected to soar to over 20 billion dollars US. More than ever before, people are unhappy and looking to pills as part of the solution. If a drug can be part of alleviating anxiety and depression, they no doubt should. However, when money comes into play, motivations can be skewed, and so some important questions should be asked.

Do antidepressants (SSRI and similar) work?

The consensus is that psychotherapy combined with medication is an effective way to combat anxiety and depression spectrum disorders, but the details are more nuanced.  Pharmaceutical companies have cited “neurotransmitter imbalances” as part of the cause of depression, but as more research is performed, there is little to back that up. Trials using drugs that increase serotonin levels in the brain were found to have similar effects to those that decreased serotonin levels. Many FDA approval trials have concluded that the effects of SSRIs and other similar “next-generation” antidepressants have similar effects to that of placebo.

Placebo Isn’t Nothing

Before we go after pharmaceutical companies for selling placebos, it’s important to understand that there is something of value in a placebo. The brain is immensely powerful and can adjust its chemical functioning based on belief.

If a doctor gives a patient a placebo and tells that patient it’s something else, they will experience improvement in the symptoms of disorders like depression and anxiety. In fact, what may have given the SSRIs an edge over placebo in the clinical trials was the side effects of the drugs. Patients were not told whether they were given a placebo or a real drug, but they were notified of possible side effects. Side effects usually begin appearing in the first week of treatment, so naturally those who experienced side effects would assume they had been given a real, and thus more effective drug. In fact, in one study, 89% of the patient group were able to accurately guess whether they had received placebo.

Side Effects and Ethics

If doctors give a patient a sugar pill and tell them it’s an antidepressant, that could violate the trust between caregiver and patient, causing irreparable damage to the relationship and making recovery even more difficult for the patient.

On the other hand, if they give the patient a drug which has been approved for use and is effective primarily because its side effects reinforce the belief that it works, safety concerns arise. It’s important to give an effective placebo, but antidepressant drugs have a substantial side effect portfolio. Besides sexual dysfunction, the potential for withdrawal after cessation (called “discontinuation syndrome”), and potentially making relapse more likely, antidepressant drugs also carry a black box warning about increased risk of suicidal thought.

What does this mean for patients?

What does this mean for people deciding how to deal with depression and anxiety, both of which are real and devastating?

The first step is not to judge yourself (or others) for how they deal with their struggle. If an antidepressant provides a safe way to ease symptoms and helps someone to live a better life, that should not be looked down upon.

The second step is to think seriously about treatment decisions. Pills are less work than psychotherapy, but generally have shorter term effectiveness and may make depression worse in the long run if the treatment is stopped. They also have serious side effects, which psychotherapy does not.

I personally have been on the entire gamut of medication for a variety of diagnoses including dysthymia, generalized anxiety disorder, and panic disorder. Therapy seemed like difficult, uncomfortable work, so I tried these medications for more than nine years, but I found they dulled both the highs and the lows (in addition to the miserable side effects).

At the end what got me out of the woods was plain old talk. I don’t take medication anymore, and while I won’t say I’m always happy, I do get to appreciate the full range of emotions that life has for me.

Remember, nothing good was ever easy.

Open Circle Finds Redemption for Prisoners

Hank Dixon, Director of Open Circle, is a friendly guy who welcomed me with a firm handshake and a smile, asking, “Where do I know you from? I feel like I know you from somewhere…” The greeting was appreciated, as I had my usual pre-interview nerves, and I suggested it might be because he’s worked with my dad.

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Hank Dixon, Director of Open Circle

“Oh, no, I think your dad has a few pounds on you. Maybe somewhere else…” Hank proceeded to introduce me to some of the other people who work at Initiatives for Just Communities as though I was family, despite the fact that I’d only spoken to him once via email.

We sat in his small office, furnished with what Hank described as, “second hand… but, you know, nice second hand,” furniture from downstairs that would have otherwise gone to the Salvation Army. Open Circle runs on a very tight budget. It seems its stock and trade isn’t the easiest thing to raise money for. “Try to sell people on the idea that they should support people who go to jail… That’s not an easy sell. It’s a real struggle in our society.”

“These aren’t boy scouts you’re going to visit. Some of them have done pretty terrible things in their lives.”

Open Circle is a non-profit organization that matches volunteers with inmates at Manitoba prisons to foster relationships, which isn’t easy even when volunteers and funds are available. “These aren’t boy scouts you’re going to visit. Some of them have done pretty terrible things in their lives. Some people want to change, but they don’t know what the path is. Some people are just lonely and want someone to talk with.”

The relationships that volunteers build with prisoners help them acclimate to society when they get out, as well as navigate the difficult waters of being in prison — an immensely lonely place. The connections benefit not only the prisoners, but the volunteers as well. “You develop some pretty good friendships over the years… people enrich each other, and that’s really what we’re trying to do here.”

By this point, a few things had struck me about Hank. Not only has he worked extensively with inmates through Open Circle, but previous to that he served as a chaplain at a number of prisons throughout Canada. In his words, “I think one of the things that has consistently attracted me to this work… [is the ability to help] what society looks at as waste. To be a part of that, and to be able to find redemption, is something I’d like to carry on.”

He seems like the quintessential pastor type. The kind of guy you’re not sure you could ever be, but damn it, you’re glad there are folks like him around.

“To be a part of that, and to be able to find redemption, is something I’d like to carry on.”

The thing about Hank, though, is that he was a lifer too. He’s been an addict. He went to prison for second degree murder when he was nineteen. It would have been equally hard, all those years ago, to find money to put towards helping him.

The perfect ending to this story is that Hank now runs an organization that exemplifies the kind of change he himself went through. “We’re reminding people that lives are redeemable. There’s always hope.”

For more information about Open Circle, visit their website: http://www.initiativesjc.org/wpblog/open-circle/

Thanks to Hank Dixon for being my interview subject and sharing his story.

3 Keys to Making Your Passion Your Career

Our assignment this week for PR writing was an “influencer” interview. There are a couple Winnipeg writers that come to mind that I suppose I could have interviewed, but another related topic seemed better.

My good friend, Brett Lowey, is a successful, self-made game designer. He holds a computer science degree from the University of Manitoba and worked at a number of what he calls “real jobs” before deciding to follow his passion and design games out of his home.

Following your passion is an interesting one, particularly for writers. How many people would love to write for a living but don’t pursue it because blog writing pays very little, and breaking into the fiction world is nigh impossible?

I asked Brett what his advice for someone wanting to follow their passion was, particularly against financial and social odds. He had the following points as advice:

Live Cheaply

His first piece of advice was that if you’re going to pursue your passion (and not work a salaried job), you need to minimize your living expenses. Ask yourself some (hard) questions: Do you need a car? How thrifty can you be about your grocery choices? What things (55” TV, new furniture, expensive clothing) can you live without?

“The Eggs Go In Many Baskets!”

The second piece of advice was have multiple streams of income. Not necessarily all at once, but have the option of writing blogs for a local business or doing some consulting work. Have a lot of little, low-commitment ways to pay the bills if things get tight. And make sure you have the option to go back to your “real job” if quitting is a part of you pursuing your passion.

Learn Tangential Things

Thirdly, work on a lot of things related to your passion at once. Brett got a degree in computer science so he can program the games he designs (design and development are two very different sets of skills). For a writer, it might mean finding copy-writing jobs (i.e. directly related to your passion), or alternatively learn to, say, do marketing so that you can do better to promote your novel when you do write it.

What the conversation came down to is that doing what you love as a career isn’t easy. It’s also not free. You may have to give up a level of comfort to pursue your passion. You may have to do more work for less money to even get started.

Passions Aren’t Free

A helpful exercise, says Brett, is to assess your situation and determine what it will cost you (time, money, effort, comfort, etc.) to realistically get to a place where you can spend most of your resources doing something you love. Do that cost-benefit analysis and see if it’s acceptable to you.

At the end, it might not be acceptable, and according to Brett, that’s okay! His perspective is that some people are more happy with having their passion be a hobby, and finding that out might save you a lot of headache.

Thanks so much to Brett Lowey for being my interviewee. Go check out his latest creation and put it on your Steam wishlist!

Image Credit

3 Dystopian Books to (Re)Read over the Holiday

One of the things I’m going to do with my Christmas break is dig back into some old novels I haven’t touched in ages. A big part of becoming a good writer is reading other people’s writing – the first time for fun, and then the second (third, fourth…) time to find out what they did to make you like the story so much.

Here are three books I’m going to reread over the holidays. You’ll notice these have a bit of a dystopian tone, which is maybe fitting given the way 2016 went.

The Last Policeman – Ben H. Winters

The Last Policeman follows Hank, a detective from New Hampshire, as he tries to solve a crime while a meteor hurtles towards Earth. Everyone else thinks Hank should give up on the case because the world will be dust soon anyway, but he feels he has to pursue it. This one is definitely worth checking out, and it’s part of a trilogy so there’s a lot to dig into here!

Fight Club – Chuck Palahniuk

If you’re not a heavy reader, you’ve probably seen the film adaptation of this book about an overtired office worker who starts a fight club. The movie is probably one of the better adaptations of a novel I’ve seen, but if you haven’t read the book, you’re missing out.

Fahrenheit 451 – Ray Bradbury

451 degrees Fahrenheit is the temperature at which paper burns. This novel is about censorship, book burning, and the death of feeling. If you didn’t read this in high school, I say it’s mandatory reading. If you did, now’s a great time to reread it and see just how applicable this 1953 novel still is today.

Which of these looks like the best read to you? Leave a comment and please remember to share!

Featured Image: Source

Fast Car – A Short Story

This week I decided to take another approach to talking about writing process. What good is talking theory if I provide no means of applying it? This week, I decided to write a short story and share it. If I have some short stories up here I can refer back to them as examples. Enjoy!

Music dribbles out of tinny speakers onto the patrons.

You’ve got a fast car.

They’re all frozen in place, awkwardly strained to look past their reflections in the floor-to-ceiling windows.

I want a ticket to anywhere.

A twenty-something in a peacoat strokes his patchy beard while he stares. His girlfriend tugs at her scarf. She cocks her head and her hand hesitates over her phone. “Should I take a picture?” is the guilty question she’s asking herself. Gravity seems to pull her face down and she pushes the phone away.

Starting from zero got nothing to lose.

I let myself look out to the parking lot again. Just past the “Exit Only” sign, the front end of a Civic straddles a teetering lamp post. Rain mingles with steam from the engine block.

Maybe we’ll make something.

The arc of granules rattled against the window on impact.

There’s a mist on the window distinctly darker than the raindrops.

Did they feel anything?

All we hear is distant sirens and the words: I got a plan to get us outta here.

“Should I go help?” Anna says. Her words are disjoint.

“I don’t… I dunno,” I say. The soft orange ambiance is interrupted by flashing red lights. A fire truck slows down on the opposite side of the street, passes, then comes back around and pulls into the parking lot.

Anna stands. She looks unsure of what to do, but something must be better than nothing, right?

“No, no, honey,” comes a booming, age-laden voice from behind me. I turn to see an older man shaking his head gently. “Let them do their work. It’ll be alright.”

You got a fast car.

Anna’s hand shakes a little as she holds the arm of the chair to set herself down. Her back faces the window and she doesn’t turn around again.

Is it fast enough so we can fly away?

I lift my phone but there are no notifications. I thought everyone heard the crash. They wanna know I’m okay, don’t they?

That’s just adrenaline, Anna would say. That’s your mind playing tricks on you.

We gotta make a decision.

It’s only just beyond the window that the world fell apart. Already, paramedics scramble to put it back together. A silhouette hangs off their gurney and disappears into the back of the ambulance.

Leave tonight or live and die this way.

“Did you wanna…” but Anna’s not listening and the only way back to my car is past the wreck, so I don’t finish the question. I come around to her side of the table and sit close. It’s better not having to look.

Please leave a comment and share your thoughts. I’ll be here next week with another story or some analysis!

3 Types of Writing Ideas (and How to Find a Great One)

Last time, we talked about setting aside time for writing and priming your imagination with writing prompts.

Whether your story is about a dark, dystopian future, tangling with the mob, or sitting at the University of Winnipeg writing blog posts, you’re going to go through a lot of bad ideas.

Bad Ideas

“How do I know when an idea is bad (or good for that matter)?”

Good question, reader. Well, the easiest ones to filter are the purely bad ones. Those ideas are not very interesting to you, and by extension, you won’t be able to make them interesting to anyone else. This seems obvious, but more than once I’ve spent time trying to force a bad idea into a story.

(Seemingly) Good Ideas

Next come the ideas that seem good. These are initially very interesting but lose their shine after a few words, sentences, or even pages. “Good” ideas are tricky, and I know this because most Hollywood movie fare is comprised of just such ideas.

I’ll use the movie The Accountant as an example: a troubled genius accountant falls in love with a beautiful girl and takes on cartels with lots of guns. Sure, it’s flashy, and maybe we want to be that troubled-but-badass guy who gets the girl, but is it interesting?

A good way to tell is to see where the story goes later on. I can watch nearly any movie for the first half hour and be interested. Who knows where it could go, right? There’s so much potential in those first few minutes, but then they go downhill (check the bottom of this review of The Accountant for an example).

My theory (which is strengthened every time I go to the theatre or library) is that if you try to take a flashy idea and make it into a story, you’ll run into issues tying it up at the end. You’ll resort to cheap tactics like plot twists, or worse, you’ll write in awful leaps of logic to get where you wanted to go and hope no one notices (if you want an excellent example, check here).

So how does one determine whether an idea is good? Not only have we thrown out bad ideas, but we’re also discounting ones that seem flashy and pique interest immediately. What’s left?!

Great Ideas

A great idea will come up like a little blip on the radar. It’s gonna be innocuous and it won’t seem flashy, but you’ll get a good feeling from it. Every great idea I’ve had hasn’t given me the same sort of rush as novelty (guns, sex, intrigue) does.

When you find a great idea, the first reaction is something like, “Huh, that’s interesting.” With Love Drug, it was the premise, but then the characters became more fascinating. Then the world surrounding them, and the politics of pharmaceuticals… When you find your great idea, you’ll feel like you’ve found the rabbit hole.

When you try to write about your great idea, it won’t be a chore. It won’t be difficult to figure out what the next scene is and you’ll stop dreading word count goals.

Although you might be in awe of your great idea, other people might think it’s weird, or silly, or just not interesting. Do not be surprised by this. Strip down any classic piece of literature to its basic premise and you’ll have something that sounds strange or boring to write about.

Your idea may be really mundane, or personal, or even just odd, but that’s the exciting part of it. Your job now is to make other people see your idea the way you do. Carve the excess marble from around your sculpture, so to speak.

The punchline of all this is that you don’t need to stress about finding a good idea for a twist, or a new fantasy world, or the sexiest thing you can imagine. You need to find an idea that’s the most you and take it from the depths of your mind to the page. The only thing between you and that goal is practice – something we’ll deal with next time.

Until then, leave me a comment about your successes and failures in the search for great ideas!

Image Source: Luis Beltrán

6 Keys to Success from a Professional Communicator

Author’s Note: This post is a bit of a departure from my usual theme because I had an assignment for PR Fundamentals. It still has to do with communication, though!

Ron Arnst, the Assistant Vice-President in the Brand Management & Media Relations department at Investors Group, agreed to meet with me to give me an idea of what it looks like to be a successful communications professional in Winnipeg.

Ron started his career in broadcasting (mostly radio and some television), but he was given the opportunity to expand his horizons by moving into politics. By becoming a press secretary to cabinet for the Gary Filmon government, it allowed him to make more money and do more interesting work (Ron was press secretary during the Meech Lake Accord negotiations).

He left government in 1995 to work in the private sector during the dot-com boom. After being laid off at the end of the boom, he found an opportunity at Investors Group and has risen to his current Assistant VP position.

During the interview, Ron graciously explained some of the unique aspects of his work in communications for a financial services company in the Winnipeg market.

We discussed the concepts of communications integration and communications alignment, and how they’re not always the same. Although marketing, public relations, and advertising may not always be part of the same department at a firm, what’s most important is that they are aligned in their messaging, goals, and priorities.

We also discussed doing business in Winnipeg compared to bigger cities like Vancouver or Toronto. Ron says working in Winnipeg is both a challenge and an advantage. You have to do more to get recognized, but you’re also removed from the groupthink that can occur in bigger centres.

We began to get into the challenges of regulation in the financial services industry, and I knew I was out of my depth, so I decided to redirect. I asked if he had any advice for someone (like me) just entering the communications profession, to which he replied a strong, “Yes.”

Now, I’m not an experienced enough communicator to ask probing questions about the nature of the profession, but Ron had some excellent advice on getting me there. Here are six of the best quotes he had for me:

  1. “You’re never doing as well as what the next opportunity might bring”
  2. “It’s not your corporate history, it’s your ability that makes you employable”
  3. “Go into areas where you’re uncomfortable. Don’t limit yourself”
  4. “In your chosen area, do as much and as many different things as you possibly can. Especially when you’re starting out”
  5. “Education tells me what you should know, experience tells me what you can do”
  6. “Regardless of what you’re told by others… have fun. Do things that you enjoy, ‘cause you’re automatically going to be good at those… you’re going to put the time in… The worst thing you can possibly do is go into a job that you’re not really sure about, that you really don’t like that terribly much, because somebody thought it’d be a great place for you”

I’d like to thank Ron for taking the time to meet with me and give me (and you) this advice. I wanna know what you have to think of this advice, so leave me a comment!