A Note on Suicide and the Black Dog

May Robin Williams now rest in peace. May his family have strength, be treated with kindness and empathy, and be given privacy at this time.

Like many others I wish to add my own thoughts on this recent sad event, and the discussion it has sparked on suicide and depression. Sadly, we hear of suicide all too often – people kill themselves every day, and chances are throughout your life a number of them will be people you know.

Whenever I hear of someone committing suicide (famous or otherwise), I am reminded that the Black Dog is never far away. He sits in your shadow, always alert  for a moment when your defences are down, when he can rip your throat out. I am reminded of this, and I am scared. Scared that one day I might do the same.

No matter how much support and love you have depression, and other disorders, are very personal experiences. You literally have to fight against what’s in your mind, and other people can only help you to an extent.

Robin’s experience is also a reminder that external things or events can’t ‘fix’ you – so often we think, ‘As soon as I’ve done or received X, I’ll feel Y and everything will be better.’ But that’s not the case, life is a continuum and there will always be something else – some other challenge or thing you want. What’s more is that the Black Dog doesn’t care about your success, your relationships, or your achievements.

In some ways I understand Robin’s decision. Indeed, when I think of another 50+ years of living this same battle as I have for the last 12-14 years, I picture an almost eternal battle of attrition. One that I might not win. Many people, including Robin, have fought the battle and succeeded for many years, but eventually they lost in the end.

For the vast majority of the time I’m glad to be alive, but of course I’ve considered suicide. Who has depression and hasn’t? Mostly two things stop me from seriously contemplating this as a course of action: I have a very intense existential fear of death and I couldn’t imagine hurting my loved ones like that. But I could imagine at some point the thought of family and friends might not be enough, that you can’t keep living for the sake of others.

My thoughts are with those all souls who have died by their own hand and the people they left behind.

#613: How do I reach out to my friends who have depression?

From the wonderful Captain, excellent advice on being a friend to someone who’s ill.

Captain Awkward

Today is a weird, sad day in social medialand and also with various life stuff and brain chemistry stuff and street harassment. To be honest, I have been crying or on the verge of crying off and on for the last 20 hours with occasional breaks for sleep and a much needed breakfast and movie (a movie …that made me cry) with a friend this morning. I almost started crying in the Apple Store a little while ago when I thought I’d have to pay $80 for a new power cable, and then I really cried when it was under warranty and it was free and this big bear of a man was so nice to me and didn’t call attention to the crying and just gently handled my transaction. Crying is good, btw. It’s better than numbness, avoidance. But this question is well-timed.

Dear Captain Awkward,

This…

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Resilience

I had been feeling much better – while my anxiety levels were still quite high, for the first time in months I wasn’t depressed. Then last Monday I didn’t go to a scheduled appointment with my psychologist, and it’s been a downward spiral from there.

What I truly lack and struggle to build, is resilience. Most little things feel like big blows and are difficult to recover from. One thing goes wrong and I completely lose control.

I’m thankful, at least, for my partner. On Thursday and Friday he managed to coax me out of bed and force me out of the house to go to work – which helped me build some resilience. It feels like somewhat of a waste since I didn’t go to work today, and I will have to try and get the fortitude to go for the rest of the week.

Publishing News I

This weekly series of publishing news will serve a dual purpose:

1) I’ve just started a Grad. Cert. Editing and Publishing at UTS, so it will help me be prepared for class.
2) It will encourage me to keep up-to-date with publishing and to actually think about current events.

I’m posting this is a few days later than intended, I will try to have this done by Saturday or Sunday at the end of each week.

Highlights from last week (28/7 – 1/8)

Amazon and Hachette’s fight continues
Amazon has announced what the very public disagreement with Hachette is actually about.  Amazon wants the majority of e-books to sell for $9.99, instead of $14.99 or $19.99. Amazon claims that by lowering the price of e-books more units of each book will be sold, therefore increasing overall profits. Amazon also want a 30% cut of sales. The remaining 70% would go directly to Hachette, though Amazon think they should give authors 35% of that. In their release Amazon said:

A key objective is lower e-book prices. Many e-books are being released at $14.99 and even $19.99. That is unjustifiably high for an e-book. With an e-book, there’s no printing, no over-printing, no need to forecast, no returns, no lost sales due to out-of-stock, no warehousing costs, no transportation costs, and there is no secondary market — e-books cannot be resold as used books. E-books can be and should be less expensive.

It’s also important to understand that e-books are highly price-elastic. This means that when the price goes up, customers buy much less. We’ve quantified the price elasticity of e-books from repeated measurements across many titles. For every copy an e-book would sell at $14.99, it would sell 1.74 copies if priced at $9.99. So, for example, if customers would buy 100,000 copies of a particular e-book at $14.99, then customers would buy 174,000 copies of that same e-book at $9.99. Total revenue at $14.99 would be $1,499,000. Total revenue at $9.99 is $1,738,000.

Just because some books may sell more if they are cheaper, doesn’t mean that every book will. For some authors pricing it at $9.99 may be a disadvantage. Furthermore, while production costs for e-books are lower than print books there are still costs associated with e-books: editing, cover design, layout etc. I think it’s reasonable to pay a decent price for an e-book if it means that it will be a quality item.

And speaking of e-book quality …
Publishers concerned about e-book production quality

Data Conversion Laboratory & Bowker Survey on Digital Publishing Industry Shows Publishers’ Increased Concern about eBook Quality Conversion quality, formatting, and complexity are among top concerns.

Publishers are increasingly concerned with quality as they move towards digital productions, according to a new survey on trends in the digital publishing industry. Of the respondents, 84 percent are planning to publish digitally in 2014 (an increase of 21 percent over the prior year), and 52 percent of respondents said quality of digital conversion was the aspect of greatest concern.

“Books in digital formats are continuing to become the norm,” said Laura Dawson, Product Manager at Bowker. “More and more publishers are planning to publish digitally. As a result, quality in conversion has become more important than ever, and cost is no longer as big a factor as it has been in the past. The challenge for publishers now is to ensure that all conversion and content quality is done with the greatest amount of care, especially to meet reader expectations.”

As a reader, I certainly agree that when e-books are converted to a digital format they need to be high-quality and retain the integrity of the original texts. I would like to see publishers just as concerned about the quality of digital first or digital only books. I know that many publishers care less about e-books (especially digital first or digital only) than print books, but digital really is just increasing in popularity so publishers should start caring about the quality of all e-books, not just those converted from print. I’m particularly thinking about editing in this respect – the same level of editorial care should be given to digital formats as is given to print.

Toronto book fair launches self-publishing awards

Another step forward for self-publishing is the news of a new award for Canadian self-published books that will be launched at Inspire! the Toronto International Book Fair in November. The award is titled ‘The Creating of Stories: Canada’s Self-Publishing Awards’ and has three categories based on audience age: adult, young adult and children. According to the Rules and Regulations, the criteria for judging is:
a. Excellence in approach to subject matter
b. Creative use of images & graphics
c. Overall ability to appeal to a large audience
d. Creative use of language or text
e. Overall design
f. Cover art

It’s great to recognise self-published authors in their own category, especially since it’s a growing sector of the book publishing industry. I like the judging criteria as well, it really acknowledges the whole package that self-published authors need to create.

Psychological treatments: A call for mental-health science

Psychological treatments: A call for mental-health science

Emily A. Holmes Michelle G. Craske& Ann M. Graybiel

But evidence-based psychological treatments need improvement. Although the majority of patients benefit, only about half experience a clinically meaningful reduction in symptoms or full remission, at least for the most common conditions. For example, although response rates vary across studies, about 60% of individuals show significant improvement after CBT for OCD, but nearly 30% of those who begin therapy do not complete it3. And on average, more than 10% of those who have improved later relapse4. For some conditions, such as bipolar disorder, psychological treatments are not effective or are in their infancy.

Moreover, despite progress, we do not yet fully understand how psychological therapies work — or when they don’t. Neuroscience is shedding light on how to modulate emotion and memory, habit and fear learning. But psychological understanding and treatments have, as yet, profited much too little from such developments.

It is time to use science to advance the psychological, not just the pharmaceutical, treatment of those with mental-health problems. Great strides can and must be made by focusing on concerns that are common to fields from psychology, psychiatry and pharmacology to genetics and molecular biology, neurology, neuroscience, cognitive and social sciences, computer science, and mathematics. Molecular and theoretical scientists need to engage with the challenges that face the clinical scientists who develop and deliver psychological treatments, and who evaluate their outcomes. And clinicians need to get involved in experimental science. Patients, mental-health-care providers and researchers of all stripes stand to benefit.

This article calls for collaboration between neuroscientists and clinicians for a truly interdisciplinary approach to mental health. The authors argue that by doing so we can learn more about how and why psychological treatments work, which will ultimately lead to better outcomes for patients.

I highly recommend this article and I am completely persuaded by their argument. I’m always a fan of interdisciplinary approaches and in the case of mental health it is clearly not happening at present. As a mental health patient myself, it would be great for there to be solid research around both psychological and pharmaceutical treatments. Hell, more research into mental health in general since we currently have such little knowledge about causation and treatment.

Stories

“We read books to find out who we are. What other people, real or imaginary, do and think and feel – or have done and thought and felt; or might do and think and feel –  is an essential guide to our understanding of what we ourselves are and may become.

And a person who had never listened to, nor read a tale or myth or parable or story, would remain ignorant of his own emotional and spiritual heights and depths, would not know quite fully what it is to be human. For the story – from Rumpelstiltskin to War and Peace – is one of the basic tools invented by the mind of man, for the purpose of gaining understanding.”
– Ursula K. Le Guin 1

Books, novels, comics, games, movies, web series, blogs and oral storytelling are all mediums that we use to tell a story. Each medium allows a unique tale to be told in a way that reaches different people and touches them differently. I love stories and I love them in all their forms, however my favourite way to engage with stories is through reading books.

My beliefs about the power and usefulness of stories has been shaped by the ideas expressed by Ursula K. Le Guin (above) and other writers. While I enjoy novels and short stories as entertainment, their greatest value is in facilitating understanding. By which I mean that they help us understand ourselves, others and the world at large by making us think and feel. We become empathetic by seeing the world through the character’s eyes and gaining an insight into how other people think. What other way is there to do this, but in stories? The best books, the ones that stay with you the longest, are the ones that make you think, reflect or see things differently. Nor do these texts need to depict an ideal – many authors, such as Joe Abercrombie, create dark and gritty realms and often depict unsavoury characters.2 In some ways, I love these kinds of novels even more because I am given access to the thoughts and motivations of people I least understand.2

Growing up I mostly read science fiction and fantasy (predominately fantasy), and this still constitutes a large part of my reading life. Precisely because it is set apart from reality, fantasy is an excellent genre to explore the human condition, the norms of our society, and our cultural beliefs and values. We are able to envision a completely (or slightly) different reality, where we are invited to contemplate, in depth, theoretical people and societies: to analyse their structure and morals, and to compare them against our own.

Stories that are well-researched can also give you general knowledge – so many times someone’s asked me how I know something and my response has been that I read it somewhere. Of course not everything you read is true, but learning to analyse what you read gives you good critical thinking skills. Indeed, storytelling is a valued teaching tool; the Bible, for example, is full of parables.

Storytelling has always been a part of human culture and I imagine it always will be, albeit in different forms. Stories are so inherent to humans, so necessary, that it makes sense that we experience our world and process our understandings through them.

1 Le Guin, Ursula K., from ‘Prophets and Mirrors: Science Fiction as a Way of Seeing,’ The Living Light 7 (1970) quoted in The Language of the Night: Essays on Fantasy and Science Fiction (1979) Putnam Pub Grou
2 For example, his First Law trilogy: The Blade Itself, Before They Are Hanged and Last Argument of Kings.