Seth's Blog

At the Shangri-La Diet forums, Anima writes:

I have been diagnosed with ADHD and Bipolar II disorder.  I am also a Non-24, a chronic circadian rhythm disorder where one’s body thinks a day is longer than 24 hours. . . .I’ve been using amber safety glasses (around $3 in the hunting section of the sporting goods store) for dark therapy.  I put them on 3 hours before I want to go to sleep.  They block blue light, allowing dark therapy without the dark.  I also wear an eye mask while I sleep.  The glasses make me look like a big weirdo, but they really work.  It’s easier to get to sleep, and they prevent hypomania (the milder form of mania that people with Bipolar II experience) better than any medication I have tried.  It makes sense that almost anyone could benefit from them, because our ancestors were not exposed to blue light after dark. (more…)

Five years ago I heard from someone that he had been successfully using my discovery that seeing faces in the morning improved my mood the next day. Recently I asked him to write about his experiences with it. Here’s what he wrote:

I’m a male professional in my 30s and have had mild to moderate depression since my early teens. I am a considerable rationalist and skeptic, so when I read about Seth’s morning faces therapy in a New York Times article about 5 years ago, my first thought was to doubt its effectiveness. But it was so easy and simple to try, with nothing to lose, that I gave it a shot. To my surprise, it really worked, and the change was quite noticeable. (more…)

With the ability to measure individual genes has come interest in learning what they do. Perhaps Person X is depressed and Person Y is not depressed because Person X’s genes differ from Person Y’s. A whole generation of psychiatry researchers now believes this is plausible. There are “general reasons to expect that GxEs [gene by environment interactions] are common,” says a new review paper in the American Journal of Psychiatry. By “common” they mean large enough and common enough to do research about. (more…)

A colleague I’ll call John has decided to start tracking his mood for a long period of time (years). He explains why:

A few years ago, after a severe manic attack, I was diagnosed with bipolar disorder. The attack was preceded by an intense period of stress, then two weeks of elevated mood, increased social activity (hanging out and meeting people), and racing thoughts (hypomania). Then I skipped a few nights of sleep, wandered down roads in the middle of the night, and eventually became psychotic, in that I could no longer distinguish between reality and imagination. I was chased by cops on several occasions, and was involuntarily committed to the mental health wing of a hospital for a month. It put a massive dent in my life.

Family, medicine, and time helped me recover. Being out of control like that was fun only for the first two weeks. Having my life turned upside down was not fun either. As I recovered I became increasingly interested in finding ways to prevent a relapse. One doctor said: You have a vulnerability. You need to protect yourself. I agreed.

Looking back on the experience, I realized there was a rise in odd behaviors two weeks before I started to skip nights of sleep and fell into psychosis. There was an even longer buildup of stress, anxiety, and fear in the months before the mania hit. During the last two weeks before the mania, my behavior was different from what is normal for me. I felt elated and had a sense of general “breakthrough”. I suddenly felt no fear and anxiety. I felt on top of the world. I was constantly taking notes because ideas and thoughts were running through my head. I scheduled meetings and social activities almost constantly throughout these two weeks and shared my experiences as my new self. As I started to sleep less and skip nights of sleep, others later told me I seemed agitated and down.

Maybe it is possible to catch these early warning signs and take counter measures before they worsen into mania or depression. This is why I have started to track my behavior starting with mood and sleep. If I can get a baseline of my behavior and know what is ‘normal’ for me, it will be easier to notice when I am outside my normal range. I can alert myself or be alerted by others around me who are monitoring me. Long-term records of mood will also help me experiment to see which things influence my mood. This may give me more control over my mood.

Mood tracking might be a good idea for anyone to do, but it may be especially helpful for people with a bipolar diagnosis. Everyone has mood variation. For bipolars, however, mood swings can be more extreme (in both directions, up and down) , have far worse consequences (psychosis on one end and suicide on the other), change more rapidly, and be more vulnerable to environmental triggers like stress. The good news is that the first changes in mood can happen hours or days before more extreme changes. This gives people a chance to take countermeasures to prevent more extreme states.

The project name refers to the fact that Van Gogh had bipolar disorder.

• Western Governors University: An innovative online university focused on students.
• Tucker Max’s talk at the Ancestral Health Symposium about the paleo movement’s neglect of fighting
• Van Gogh is Bipolar, a restaurant in Quezon City, the Philippines.
• “Behind every great fortune is a great crime.” The Rockefellers by Edward Jay Epstein.

If you want to find out about using morning faces to improve your mood, go to this page, to which I will be slowly adding links. If you have suggestions about what to include, please leave a comment or email me. The page is meant to be an easy way to learn more.

I loved Ned Zeman’s new book The Rules of the Tunnel, which I read during a long plane flight. Not only does it combine three of my favorite subjects — high-end magazines, bipolar disorder, and the crappiness of modern psychiatry — but it’s very well-written and revealing. I haven’t enjoyed a book so much in a long time.

Zeman once wrote for Spy, as did I. Long ago, I met him at a Spy party. I suppose I could have gotten a free copy of his book but I bought it. I wanted something great to read on the plane.

In the 1990s, I discovered that if I see faces on TV early in the morning, I feel better (happier, more eager, more serene) the next day, but not the same day. Faces Monday morning, for example,  make me feel better on Tuesday but not Monday. I studied this effect extensively. The results suggested that a circadian oscillator controls our mood and sleep and needs morning face exposure to work properly.  Absence of morning face exposure, this theory says, increases your risk of depression — a view not compatible with the “chemical imbalance” explanation of depression but one supported by the strong association between depression and insomnia.

I told friends about this. One of them had devastating bipolar disorder. As he describes here and here, he got great benefit from looking at faces in the morning. After I posted his account of his experience, a man I’ll call Rex wrote me that he was going to try it. At 29, he was diagnosed with bipolar disorder. At 32, he slit his wrists. He is now 37.Since then he’s been in and out of mental hospitals. Now he lives at home. I wanted to follow his use of morning face therapy “prospectively” — before knowing what would happen. I posted this, about his background, around the time he started. (more…)

Joseph Biederman is a professor of psychiatry at Harvard. He recently received a far-too-mild sanction for behavior that included this:

Biederman was then placed in charge of the institute and began a study of 40 children between 4 and 6 years old who were given Risperdal [made by Johnson & Johnson] and Lilly’s Zyprexa, another antipsychotic. At the time, Harvard and MGH [Massachusetts General Hospital] rules forbid researchers from running trials with [drugs] if they receive more than $10,000 from a company that makes the drug.

Dr. Jay Amsterdam, a professor of psychiatry at the University of Pennsylvania, recently lodged a very interesting complaint against five authors of a 2001 study that compared Paxil to another drug and placebo for treatment of bipolar disorder. The paper reports research paid for by SmithGlaxoKline, the makers of Paxil.  For a subgroup of patients, it says, Paxil worked better than the other drug and better than placebo. Paxil supposedly had fewer side effects than the comparison drug. Amsterdam accuses the five academic authors of plagiarism — meaning they put their names on a paper they didn’t write (like a student who buys a paper). He also says the paper grossly misrepresents the results (because the subgroup analysis was completely ad hoc and the side effects description utterly wrong). So if they did write it . . .

The paper has been cited hundreds of times.  Given the actual results — Paxil had worse side effects than the other drug, and the subgroup result means little — this is no small matter.

As Spy magazine has said, if you cheat your customers, don’t fire anyone. Email included with Amsterdam’s complaint suggests he was upset because he was not an author on the paper. Why? Well, the study was done at many sites and there could be only one author per site — according perhaps to SmithGlaxoKline. At Penn, the work (enrolling subjects) was first given to a junior faculty member named Laszlo Gyulai. However, Gyulai couldn’t enroll enough subjects. Amsterdam was asked to help and paid for doing so. He ended up enrolling more subjects (12) than Gyulai (7). Yet Gyulai was an author and he was not! This greatly bothered him. He considered it  “misappropriation” of his data, said Gyulai had engaged in “the theft and publication of a professor’s data”, and wanted Gyulai censured. Perhaps Gyulai had considered Amsterdam’s non-authorship okay because many professors who contributed subjects were not authors. Whatever the reason, it appears that authorship was determined by the firm that did the ghostwriting, Scientific Therapeutics Information, presumably following orders from SmithGlaxoKline.

I don’t know why Amsterdam waited ten years to complain. Since 2001, however, the ghostwriting problem has become much clearer. In 2001, Amsterdam complained to his department chair, Dr. Dwight Evans, about the situation. In 2010, Amsterdam learned that Evans had benefited from ghostwriting. That’s how common it was.

There’s also this:

POGO [Project on Government Oversight], in a letter to President Obama [related to Amsterdam's complaint], asked that he remove Amy Gutmann, president of the University of Pennsylvania, from her position as chairman of the Presidential Commission for the Study of Bioethical Issues, until the two cases involving Dr. Evans are fully investigated and resolved.

Chairman! Another indication how common and tolerated ghostwriting is. It is as if an obesity expert, appointed head of the most important obesity committee in the country, charged with recommending how to stop the obesity epidemic . . . is fat.

Perhaps British journalistic phone-hacking has been more common than misrepresentation of results by med school professors but the latter, I’m sure, has done more damage.

Attachments to the Amsterdam complaint. Pharmalot weighs in. Some of the accused defend themselves.