Melancholia

Via Neuroskeptic, from the British Journal of Psychiatry:

Melancholia - in 100 words

Max Fink and Michael A. Taylor

Melancholia is a classical episodic depressive disorder that combines mood, psychomotor, cognitive and vegetative components with high suicide risk. In the present psychiatric classification it is buried as a modifier in both bipolar and unipolar depressions. It is hardly used to characterise patients in the clinic or research. The syndrome is frequently recognised in delusional and agitated depression, and in the elderly. Cortisol or sleepEEG abnormalities are prognostically helpful. Melancholia is particularly responsive to tricyclic antidepressants and electroconvulsive therapy but not to selective serotonin reuptake inhibitors or psychotherapy. Recognising melancholia as a distinct disorder improves clinical care and research.

Fibromyalgia Awareness Week, Sept 4-11

www.fibromyalgia-associationuk.org

Caffe Nero

I like Caffe Nero - or some of them. The new one in town is in a good location and is nicely decorated. Nero's coffee is OK - my expectations are pretty low 9 years after leaving Auckland with it's fantastic coffee culture. So I was in yesterday and got a little card inviting me to do a survey. I wouldn't normally bother, but they were offering a chance to win free coffee for a year.

So I filled in the survey which has some mental questions like: "did the barista serve you with pride". How the fuck should I know? And especially in this country where shop drones generally hate their jobs, and hate talking to people. The guy talked to me, and seemed less than averagely surly. Does that translate into pride? Can one feel pride working as a coffee machine operator for a huge chain, wearing a cheap company teeshirt, and earning minimum wage? Could I? Doubt it, Harry.

Anyway I got through and was dumped on the Nero homepage. Here it says

"Caffè Nero Group Ltd was founded in 1997 and is currently the largest independent coffee retailer in the UK, with over 400 stores in the UK."

What does it mean to be independent when you are one of the largest chains in the country?Independent of what, or from whom? Is this English idiom, or is it business jargon? Anyway I'm not impressed. The words "independent" and "over 400 stores" cancel each other out. They're just a large coffee retailer, with all that this implies. But I will drink a shit load of coffee if I win the prize.

Stomach problems.

So I looked back on my posts and see that I haven't mentioned my stomach problems. About 3 or 4 months ago I had an attack of chest pain that was frightening. It started off a bit like heart burn, but it kept getting worse until I was in a panic. The NHS direct person, asked me all the heart attack questions, ascertained that my life wasn't in danger, and talked me down. After about 3 hours in total the pain eased off and I felt OK.

Then more recently I had another attack that again was very painful and frightening. This time I got to the limit I could bare and it kept getting worse. One of the MEBs called NHS Direct who then sent an ambulance. The paramedics checked me out and once again ascertained it wasn't life threatening and suggested going to the late night doctor - not to A&E because it can take many hours to be treated there.

Cut a long story short I kept having minor attacks and the doctor sent me to the specialist, who ordered some tests. The ultrasound showed no all stones. The next one was a gastroscopy. I knew this would be stressful, but getting someone to go with me seemed even more stressful, so I elected not to have sedation. I took some valium in the morning, thinking it would take the end of anxiety. This was foolish in retrospect. A gastroscopy is a very invasive procedure. My body rebelled and was actively trying to expel the scope throughout the whole 5 minutes. By the end I was in shock and non-responsive. It took a while to come around, and if I bring it to mind I can feel the panic starting all over again!

The moral of the story is that if anyone ever offers me sedation for a medical procedure then I should definitely accept.

The upshot is that I have a hiatus hernia - the sphincter at the top of my stomach doesn't close properly and part of my stomach is protruding up through it (or something like that). Stomach acid is leaking into my oesophagus, and the intense burning pain is the result. There was also bile in my stomach, but I put this down to my gut going into drastic reverse with the tube down my throat.

Treatment is Proton-pump Inhibitors (stomach acid suppressant) and Gaviscon^®. My problem is that I also take anti-inflammatory drugs for chronic pain. These drugs suppress the body's inflammation response, but problematically this is the same response that protects the stomach lining from acid - this exacerbates the problem by making my stomach more sensitive to irritation.

The maxim of the British people is 'Business as usual'.

- Winston Churchill, Guildhall, 9 Nov 1914.

We're doomed.

They're saying that Prince Charles pissed Tony Blair off with his interfering. I like Charles for having pissed of architects who make ugly buildings, and even more now that I've learned that he got up Blair's nose. Yay Charles!

In other political news in a leaked memo Eric Pickles has warned the current Prime Minister that welfare reforms could make 40,000 people homeless, and ultimately cost more money than they save. Some sense slipping through the blitzkrieg of propaganda from IDS's DWP.

One wag on the Guardian website has suggested the homeless move into vacated Habitat and Thortons. Habitat is already furnished as another commenter points out, though they doubt the homeless folk would appreciate the class of furniture in that now insolvent business. Both commentators seem to have forgotten that the government has just decided to make squatting illegal, so moving into unoccupied building is not on the cards. Besides have you seen the red tape involved in housing here? Hundred's of years of unscrupulous landlords have left the housing market massively over-regulated and hostile to most of their tenants. I was aghast to learn that you almost never get your bond back in this country if you're renting. In NZ you almost always get it back.

They just don't have a clue, do they? If ever there was an example of a university graduate being full of themselves, filled with theories and ideologies, but no practical understanding of how anything works it's David Cameron. He just has no idea what he's doing, no idea how to run the country or the economy. And, lord save us, the opposition are no better.

We're doomed! We really are doomed. Unless maybe Charles get's stuck into IDS and the ConDem coalition: "I say! Leave one's fucking people alone, you monstrous carbuncle!" (in my dreams, eh).

Chuggers

I think I've written before about how and why I hate chuggers. The (southern) English norm is not to talk to strangers, not even to make eye contact. Walk around a typical urban mall (pronounced to rhyme with 'well') and you see a lot of people milling around like they're the only person there, carefully avoiding the human shaped objects in their path - and if you do happen to come to another persons attention, by being tripped over or run into, then the thing to do is apologise. I've started doing this! In shops the people behind the tills are like this as well - they'd rather not be talking to you most of the time. England is the ideal place for self-service checkouts. I've had conversations with strangers here, but not with English people, only with Kiwis, Aussies, Yanks, and more recently a Thai student.

What's more I'm 45 and chronically ill, so I don't look very attractive to a 20-something, and the young women especially just don't see me any more. It's one of the things about getting older, and I can see why men my age sometimes go wild and have a crisis! For myself I'm heading towards conscious celibacy, but that's another story.

Chuggers break these rules. They approach strangers in the street. Not only do they break the rules, but they employ very clumsy and obvious ruses. The men are suddenly a long lost friend, very pleased to see you. The women are similar except some of them flirt at the same time.

You see English people caught in this trap. Politeness dictates that when someone approaches you with this kind of ruse that you stop and make contact - they may need directions, or they may want to know the time. There's a tension because they may be a drug addict wanting "a pound for a cup of tea" (yeah, right!), but the chuggers are well dressed and smiling. Then they realise they've made a mistake and they can't be rude and just walk away, they have to explain why. It's not that English people are ungenerous. No. English people are incredibly generous and give huge amounts to charities, and the govt. has just committed to increase overseas aid at a time when it is slashing local spending. Often you'll hear the victim explaining that they support a number of charities already and I believe them.

Now a couple of days ago I was wandering home - tired, depressed, minding my own business (fitting in) - when a chugger approached me from behind. Normally I see them coming, make eye contact - I'm better than most English people at this game - firmly shake my head, and mouth the syllable "no". It works about 80% of the time. The more persistent chugger keeps on going like it's the most natural thing to talk to strangers, and that I seem like just the kind of person they want to talk to. But I give my initial response and just keep walking. Because under normal circumstances these scumbags wouldn't give me the time of day, let alone engage me in a pleasant conversation! But being approached from behind is something new. I had this young women tagging along behind me trying to get my attention. I'd seen her out of the corner of my eye as I'd left the shop, so I knew she was a chugger - fortunately they wear uniforms of a sort. So I just kept walking. I didn't want to talk to anyone, let along a chugger. And she kept it up, chasing me down the street for about 10 or 15 seconds. This is quite a long time if you think about it. If someone didn't answer their phone in this time, you'd think they weren't in and hang up. Then I didn't quite catch the parting comment, but the tone of voice was incredibly sarcastic. Like I was being an arsehole for not responding.

Chuggers: you guys are the arseholes. I hate been approached under false pretences, whether you be a junky, a politician or a charity worker. You don't want a chat, you don't think I'm interesting, you don't think I'm attractive, I'm not your mate. So please, cut the crap. Don't bullshit me. You approach me because you've done a calculation in your head that you might be able to get money out of me, and this is how you make your living. You are parasites on the generosity of other people. So just fuck off. If I was to give to charity it would be directly, bypassing the need for your salary to eat into my donation.