A Stigma-Free Label for Depression

We have words to describe what the medical world normally labels as “depression.” Since that word conjures up weakness and even mental illness, we’ve found words that suggest that we are just working too damned hard: burnout or exhaustion. Makes those who have burned out or are simply exhausted simply in need of a little time off to be better. Oh sure, you can in fact exhaust yourself with long hours performing strenuous labor, but these words often apply to those engaged in normal work hours, at least for their respective fields of endeavor. There is a difference. The prospect of years of the same old, same old, no relief in sight… or the notion of “is that all there is” can sink in as long hours turn into escalating depression. Or you can just be tired.

“Given that depression also tends to involve lethargy and detachment, some have argued that burnout is just a stigma-free label for the same condition. In her book, [literary critic and medical historian at the University of Kent in the UK and burnout sufferer, Anna Katharina] Schaffner quotes one German newspaper article that claimed burnout is just a ‘luxury version’ of depression for high-flying professionals. ‘Only losers become depressive,’ the article continued. ‘Burnout is a diagnosis for winners, or, more specifically, for former winners.’

“In general, however, the two conditions are generally considered to be distinct. ‘Theorists generally agree that depression entails a loss of self-confidence, or even self-hatred or self-contempt, which is not the case for burnout, where the image of the self often remains intact,’ Schaffner says. ‘Anger in burnout is generally not turned against the self but rather against the organisation for which one works, or the clients with whom one works, or the wider socio-political or economic system.’ Nor should burnout be confused with chronic fatigue syndrome (CFS), which involves prolonged periods of excruciating physical and mental exhaustion for at least six months, with many patients reporting physical pain at the slightest activity…

“These feelings will be familiar to countless others, from Pope Benedict XVI to Mariah Carey, who have been diagnosed with exhaustion. If the media are to be believed, it is a purely modern ailment; almost every time Schaffner turned on the TV, she would see a debate on the trials we face in our 24/7 culture. ‘All the commentators represented our age as the most terrible one out there – that it’s the absolute apocalypse for our energy reserves,’ she says.” BBC.com, July 22^nd.

We live longer, have more stuff, and whether it is simply paying property taxes on property we fully own, or a mortgage or rent, a car loan or lease payment, student loans or the costs of educating one’s children, we need to be generating enough money just to meet our perceived obligations. And we live in truly complex and dangerous times. So we work, and where we can make more money, often work harder. But then, for some anyway, there are the lifestyle-threatening questions. And perhaps even physical illness finds its way into a body weakened by depression. So this just must the price of living in our hyper-accelerated, modern, over-connected world? Right?

“There is no doubt that exhaustion is a pressing concern today, with some particularly startling figures emerging from emotionally draining sectors such as healthcare. A study of German doctors found that nearly 50% of physicians appeared to be suffering ‘burnout’, reporting, for instance, that they feel tired during every single hour of the day and that the mere thought of work in the morning left them feeling exhausted. Interestingly, men and women seem to deal with burnout in different ways: one recent Finnish survey found that male employees reporting exhaustion were far more likely to take extended sick leave than burned out women, for instance…

“According to one argument, our brains are simply ill evolved to deal with the modern working environment. The increasing emphasis on productivity – and the emotional need to prove one’s worth through one’s job – leaves workers in a permanent state of ‘fight or flight’. This state originally evolved to deal with acute danger. But if we face that kind of pressure day in, day out, we endure a steady surge of stress hormones – an onslaught that our bodies struggle to continually fight

“For many, moreover, the pressure does not end with work. Cities (and technological devices) are always buzzing with life, and this ‘24/7’ culture can make it difficult to rest at any hour of the day or night. With no chance to recharge our minds and bodies, our batteries are constantly running dangerously low.” BBC.com. Except, burnout and exhaustion, depression style, seems to have been a human condition for at least as long as we have had written history.

“When Schaffner explored the historic literature, however, she found that people suffered from extreme fatigue long before the rise of the modern workplace. One of the earliest discussions of exhaustion was written by the Roman physician Galen. Like Hippocrates, he believed that all physical and mental ailments could be traced to the relative balance of the four humours – blood, yellow bile, black bile and phlegm. A build-up of black bile, he said, slowed the body’s circulation and clogged up the brain’s pathways, bringing about lethargy, torpor, weariness, sluggishness and melancholy. Although we now know it has no scientific basis, the idea that our brains are filled with a tar-like liquid certainly captures the foggy, clouded thinking that many people with exhaustion report today.

“By the time Christianity had taken hold of Western culture, exhaustion was seen as a sign of spiritual weakness. Schaffner points to the writing of Evagrius Ponticus in the 4th Century, which described the ‘noonday demon’, for instance, that leads the monk to stare listlessly out of the window. ‘It was very much seen as a lack of faith and a lack of willpower – the spirit versus the flesh,’ says Schaffner. She points out that one monk reported compulsively and restlessly seeking out his brethren for idle chit-chat rather than engaging in useful employment – in much the same way that 21st-century sufferers may find themselves compulsively checking social media.

“Religious and astrological explanations continued to abound until the birth of modern medicine, when doctors began diagnosing symptoms of fatigue as ‘neurasthenia’. Physicians now understood nerves transmitted electrical signals, and they believed that someone with weak nerves may therefore dissipate energy like a badly insulated wire. Intellectual figures from Oscar Wilde to Charles Darwin, Thomas Mann and Virginia Woolf were all diagnosed with neurasthenia. Doctors blamed it on the social changes of the industrial revolution, although delicate nerves were also seen as a sign of refinement and intelligence – some patients languished with pride in their condition.

“Although few countries tend to diagnosis neurasthenia today, the term is often used by doctors in China and Japan – again, with the occasional accusation that it is an alternative, stigma-free way of labeling depression.” BBC.com. Feel better now? I didn’t think so, but hey, at least you might understand that lethargy in a whole new (old?) light.

I’m Peter Dekom, and I am really, really sleepy….

Another Simmering Kettle in the Middle East

Iran continues to sabre-rattle; hardliners are calling for a reinstatement of that country’s nuclear program. American right wingers are calling for an abrogation of the nuclear accord with Iran, reinstating the sanctions that decimated Iran’s economy for years. There is no love lost between the parties. But one of the greatest forces aligned against ISIS – an ultra-fundamentalist Sunni jihadist force – is the ultra-fundamentalist Shiite nation of Iran. ISIS appears to despise the mystical side of Islam represented by Shiism even more than ‘apostate’ Christians and Jews. Their actions tell us that they believe the only good Shiite is a dead Shiite. For a more detailed explanation of the difference between Sunni and Shiite Islam, see my October 20^th blog.

Shiites constitute between 15% and 20% of all of Islam, but they are heavily concentrated in the traditional Middle East, particularly Iran and Iraq (where Shiites are by far the clear majority) with major political constituencies in Lebanon and Syria, where the political leadership is Shiite.  ISIS gained traction in the region as Sunni farmers, who lost their farms to desertification from global warming, were ignored by the Shiite leadership in Iraq and Syria. Claiming the noble cause of representing disenfranchised Sunnis in these regions against the “evil” Shiites, ISIS imposed its unforgiving brutality, implemented its genocidal vectors and its determination to march unflinchingly towards global domination across its conquered lands… and into the heart of its declared enemies.

Iran is engaged in and preparing for an expansion of regional sectarian wars. Note the plural: wars. Its top military commanders have actively trained (and even led) Iraqi forces in the war against ISIS. It has also armed Yemeni irregulars (Houthis) against local Sunni forces, including Saudi Arabia. Iran has provided combat forces to Iraq in the fight against ISIS. And its malevolent equivalent of the French Foreign Legion, its political and military surrogate, Hezbollah (a small Hezbollah military unit is pictured above), has morphed from a ragtag catch-as-catch-can force into a “tested” and well organized military force, with a particularly well-trained force in Lebanon. Massive Hezbollah forces have fought side-by-side with Assad’s Syrian army.

Given Iran’s extreme hatred of Israel, having a massive concentration of Hezbollah in a neighboring country is deeply discomfiting to Israel… and rising to intolerable. Sooner or later, Israel has pledged to eradicate that open sore, that direct and immediately threat to its existence.

“Ten years after Israel and Hezbollah fought a bloody but inconclusive 34-day war that left more than 1,000 soldiers and civilians dead in July and August of 2006, the Lebanese Shiite militant group has been transformed… Hezbollah is now a regional military power, a cross-border strike force, with thousands of soldiers hardened by four years of fighting on Syrian battlefields on behalf of President Bashar al-Assad. There are 7,000 Hezbollah fighters in Syria, Israeli commanders say.

“Hezbollah troops have been schooled by Iranian commanders, funded by Tehran and have learned to use, in combat, some of the most sophisticated armaments available, such as fourth-generation Kornet guided anti-tank missiles. They pilot unmanned aircraft and fight alongside artillery and tanks. They have taken rebel-held villages with Russian air support… More than 1,000 Hezbollah fighters have died, the Israelis say; they do not describe Hezbollah as ‘demoralized’ but ‘tested.’

“‘In 2006, Hezbollah fought a guerrilla war. Today, Hezbollah is like a conventional army,’ said Elias Hanna, a retired Lebanese army general who teaches at the American University of Beirut.” Washington Post, July 23^rd. The fuse is lit… and burning down to an explosion that could impose a level of death and destruction on Lebanon not seen even during the long-lasting civil war that ripped that country to shreds.

“When Israeli army commanders describe how the next war against Hezbollah could unfold, they often search for words not used in military manuals. The future conflict, they warn, will be ‘ferocious’ and ‘terrible.’… For both sides, the Israelis fear… Yet far worse for Hezbollah and the civilians of Lebanon, they promise…

“Ten years ago, Hezbollah fired 4,000 short-range, relatively crude rockets at Israel, about 100 a day, killing some 50 Israeli civilians. Today, the group has 100,000 rockets, including thousands of more accurate mid-range weapons with larger warheads capable of striking anywhere in Israel, including Jerusalem and Tel Aviv, according to Israeli army commanders and military analysts in Israel and Lebanon.

“Hezbollah poses a far greater threat to Israel than it did 10 years ago. The challenges posed by Islamist militant movement Hamas in the Gaza Strip are almost trivial by comparison, Israeli senior commanders say… Earlier this year, Israel Defense Forces Chief of Staff Lt. Gen. Gadi Eisenkot called Hezbollah Israel’s “main enemy” now that Iran’s nuclear ambitions may have been delayed by a decade or more.

“Whether Hezbollah’s arsenal of rockets and the overwhelming retaliatory response promised by Israel serves as a dual deterrent is one of those questions that can never be answered — but probably keeps commanders on both sides awake at night…

“Speaking publicly, the Israeli generals promise that if Hezbollah launches mass strikes against Israeli cities, Israel will be compelled to respond, similarly, with 10 times as much force. The commanders say they cannot allow Israeli cities to face 1,000 Hezbollah rockets a day.

“Historians say the 2006 war came as a surprise for both sides. Hezbollah kidnapped two Israeli soldiers at the border, which sparked a sustained aerial and ground war by Israeli forces — and tough resistance by Hezbollah.

“Both claimed victory, but neither won. In Israel, the 2006 Lebanon war is widely viewed by Israelis as a military failure. Hezbollah boasted that it had stood toe-to-toe with the most powerful army in the Middle East, but the widespread destruction and civilian deaths were unpopular…

“As the 10-year anniversary approached, both Hezbollah and Israel stressed that they do not want another war — even as both declared themselves ready for one… ‘Israel knows Hezbollah has missiles and rockets that can strike anywhere in its territory,’ the group’s leader, Hasan Nasrallah, said in a speech delivered by video in February.

“Nasrallah warned that Hezbollah rockets could strike ammonia plants at the port in Haifa in any future fight, saying that the damage would be equivalent to an atomic bomb and could lead to the deaths of 800,000 people.” Washington Post. But both sides sit on a hair trigger, where one or more incidents could result in a massive retaliatory response, crossing the point of no return and inflicting unparalleled decimation to both sides. But the big winner in such a regional conflict would indeed by ISIS, watching two of its enemies in mortal combat.

I’m Peter Dekom, and I wonder how a diplomatically untrained, slogan-driven president would move to deny ISIS this rather clear regional triumph.

Damn That Wall is Such a Good Idea

When you think about Donald’s proposal to build a wall along the length of the entire continental border between the U.S. and Mexico – all 1,989 miles (3,201 km) of it – you get this gut feeling that to some extent, that wall has to be a deterrent to undocumented crossers. Yet, the hard numbers, even the nature of those who continue to cross, however, are showing that people crossing the border are not the problem they used to be.

“As the Department of Homeland Security continues to pour money into border security, evidence is emerging that illegal immigration flows have fallen to their lowest level in at least two decades. The nation’s population of illegal immigrants, which more than tripled, to 12.2 million, between 1990 and 2007, has dropped by about 1 million, according to demographers at the Pew Research Center.

“A key — but largely overlooked — sign of these ebbing flows is the changing makeup of the undocumented population. Until recent years, illegal immigrants tended to be young men streaming across the Southern border in pursuit of work. But demographic data show that the typical illegal immigrant now is much more likely someone who is 35 or older and has lived in the United States for a decade or more.” Washington Post, 6/27/15. Not exactly the criminal and rapists the Donald fears.

Today, the biggest problems are illegal U.S.-sourced guns flowing south and illegal cartel drugs moving north. Maybe a wall would be a good thing for both sides, huh? Okay, we know it won’t cost a mere $8 billion, more like three times that amount, but isn’t that worth it? At least it will be job-creating infrastructure construction, right?

Given the resources of the mega-wealthy cartels, experts at sophisticated tunneling, able to fund bribes on both sides of the border, knowledgeable on how to smuggle drugs and guns through seeming legitimate border-crossing vehicles, ships and planes and now mass-producing drug-carrying submarines that can dive increasingly deeper under ocean waves, maybe they’d welcome an excuse to raise drug prices. With so many options, cartels could still flow drugs into the U.S., but the wall might slow down under-financed competitors, possibly creating a wonderful (to them anyway) and hefty increase in prices and hence their profit margins.

You’d think we could ask farmers, ranchers and others who own border property in the United States what they think. And those folks are pretty clearly not made up of those tree-hugging liberals! You know, I think someone just did. The New York Times (July 23rd), for example. The cover page in the NY Times Magazine sections reads: “Migrants and Smugglers Won’t Be Stopped by Trump’s Wall, Ranchers Say. Ranchers near the Mexican border see smugglers and sometimes find bodies, but they favor a different approach to illegal immigration to Donald Trump’s wall…

“If pixie dust sprinkled into the dry earth could make all the eye-crossing obstacles disappear, beginning with the multibillion-dollar cost, would a concrete divide constructed to Donald J. Trump’s aesthetics (‘beautiful,’ with ‘a big beautiful door’) and ever-changing specifications (25 feet high! 35 feet high!! 55 feet high!!!) serve its intended purpose?

“The answer heard time and again from [John Ladd, an Arizona rancher who owns 16,000 border acres] and others along the border is a weary no. ‘The wall?’ says Larry Dietrich, a local rancher. ‘I mean, it’s silly.’

“But what if this beautiful wall — and ‘wall’ is the term used in the Republican Party platform — had a foundation deep enough to discourage tunneling? What if the beautiful concrete panels were designed to thwart climbing over or plowing through? And what if it stretched for hundreds of miles, its beauty interrupted only by rugged, virtually impassable terrain?... ‘It isn’t going to work,’ Mr. Ladd says.

“Ed Ashurst, 65, an outspoken rancher who manages land about 20 miles from the border, is more assertive, but he needs to address something else first. ‘I’ll be straight up with you,’ he says with a scowl. ‘If Hillary Clinton gets elected, I’m moving to Australia.’

“Time will tell whether the Arizona rancher is forced to blend into the Outback, but his assessment of Mr. Trump’s plan is just as succinct. ‘To say you’re going to build a wall from Brownsville to San Diego?’ he says. ‘That is the most idiotic thing I’ve ever heard. And it’s not going to change anything.’” Those conservative landowners do want greater border control. They fear for their own lives as well-armed cartel caravans cross their lands with a “dare me” chip on their shoulders. What do the locals who live with border threats day after day want and what are we currently doing?

“The solution favored among ranchers is infused with a fatalism that nothing will change — government being government, and the cartels always one step ahead — so why bother. But here it goes:

“Intensive, round-the-clock patrols along the border are required for a fence or wall to work; otherwise, those determined to cross will always find a way. But, they argue, if you have boots on the ground, you will have no need for anything so beautiful as the Great Wall of Trump.

“It is easy, from a distance, to dismiss the ranchers along the border as right-wing Chicken Littles whose complaints hint of racism. Too easy, in fact.

“Ranchers will say they saw people with backpacks trekking across their property last week, last night, early this morning. Some will say they have grudging agreements of access with drug cartels, as long as trespassers stay far from their homes. Dogs bark, motion lights flicker, things go missing…

“[The] overall number of migrants has plummeted in the last 15 years or so. Here, in what the Border Patrol categorizes as the Tucson sector — about 90,000 square miles, with 262 miles of border — there were 63,397 arrests in the 2015 fiscal year, compared with 10 times that in the 2001 fiscal year.

“Paul Beeson, the patrol’s chief agent for the Tucson sector, attributes the drop to an increase in officers and tactical equipment, an improvement in the Mexican economy, and the fencing erected along the border about a decade ago.

“But Mr. Ladd and other ranchers say there has been an unsettling swap: fewer migrants, but many more drug traffickers… Mr. Beeson acknowledges the change in demographics, and the challenge in facing an adversary with comparable intelligence and surveillance abilities. ‘They don’t have to move their product today,’ he says of the cartels. ‘They can move it tomorrow. They can sit and watch, and they do that. Watching us. Watching us watching them.’

“But he says the Border Patrol continues to bolster its ‘tactical infrastructure’ — higher resolution cameras, for example, and an increased use of drones. ‘It’s unacceptable to us that folks along the border should be experiencing this type of activity,’ Mr. Beeson says. ‘We’re doing all we can.’” NY Times. Tactical infrastructure, eh? Not a ceeement wall? Hey if we make them pay it, and then they raise drug prices as a result to make us pay for it, who wins? I mean addicts who pay those higher prices will need to get the required extra cash… somewhere!

I’m Peter Dekom, and even lots of Trump voters don’t expect a victorious Donald actually to build that wasteful and clearly ineffective edifice, a tribute to the gullibility of slogan-believing voters.

“We Must Not Let Them Vote”

We’ve never seen such negative casts on the presidential nominees from each party. One clearly compromised legal requirements by keeping our nation’s most sensitive secrets on an easily-hackable private email server, engendering the lowest voter trust numbers I’ve even seen. The other is prepared to ignore the constitution to deliver his country to the control of a smaller constituency of angry white Evangelicals and their partners.

While the issues are cast as “big change” vs. “the status quo,” the real battle is between those attempting to turn the clock back to the 1950s where minorities were still marginalized simply by numbers and yet-unreversed legally-reinforced tradition, the United States was a superpower that was challenged only by the Soviets and the economy was exploding versus an irretrievably globalized planet (from competition to mutual economic interdependence) in which the United States is just one large player in a world of asymmetrical warriors representing semi-stateless zealots with global domination as their goal.

Deeply in debt, the United States risks domestic unraveling – as infrastructure drops to substandard, educational opportunities are now thoroughly class-driven and otherwise underfunded and government research to provide future economic opportunities vaporizes – in order to fund a massive military that hasn’t won a major conflict since WWII. We’ve disenfranchised our inner city black communities by allowing public schools to deteriorate, watching as jailed black men generate job-killing convictions (mostly for non-violent crimes) leaving families to be maintained by single moms, and saddled young recent college grads with unsustainable debt.

I was not amused by a recent Obama administration report that this massive student debt was the reason for so many more people going to college. It was the wrong lesson from obvious facts. Yes, having lots of young people getting educated is both terrific and necessary, but one cannot believe that crushing debt is a good way for them to start their adult lives.

But the reality remains that we are not going to un-globalize. We are not going to be able to dictate unilateral economic policy to the rest of the world; we simply do not have the bargaining power. White Evangelical incumbents can continue to use gerrymandering and denying “minorities” voting rights to maintain their grip on a majority of state legislatures and governorships… and perhaps on both houses of Congress… to delay their inevitable loss of political control due to irreversible demographic changes. But the clock is ticking, and the 2020 Census will send shock waves through that ever-shrinking (as a percentage of the whole) body of white rural-values traditionalists. Donald Trump is probably their last great hope to “take back America” from the rest of America. Or we could do what the Civil War prevented, splinter into separate nations with dramatically different systems of government. Change is coming, good or bad.

As Texas becomes increasingly Hispanic, for example, even the big red Lone Star State will lean purple in a redistricting that must come sooner or later. In the meantime, after the Supreme Court eviscerated federal oversight over those states whom the 1965 Voting Rights targeted for past discriminatory practices, those same states rapidly reinstated statutory schema unambiguously intended to use voter-ID requirements to limit or eliminate too many with an obvious socio-cultural proclivity to vote Democratic (see the above chart). And the courts stepped back into the fray to rebuild those equal protections that would make such new, obviously discriminatory, voter ID laws illegal.

In mid-July, the United States Court of Appeals for the Fifth Circuit, in New Orleans, found that the Texas voter ID law had a discriminatory effect on blacks and Latinos, who often lack the required forms of identification required under the law. This Texas effort simply violated even those provisions of the Voting Right Act left intact by the Supreme Court. With a divided Supreme Court, that decision is likely to stand. But Fifth Circuit decision remanded the case to the federal trial court to fashion changes to reduce the discriminatory aspects of the statute. More easily said than done.

“[After] a federal appeals court ruled that the law discriminated against minorities, there is a new, equally vexing question: how to fix it… The appellate court’s decision kept the law in place but instructed a lower court judge to come up with procedures to minimize the law’s effect on those who do not have an approved form of government-issued photo ID or who face hurdles in easily obtaining one, many of whom are black or Hispanic. North Carolina, South Carolina and other states that have passed voter ID requirements have had similar court battles over how, and whether, to loosen their rules to accommodate poor and minority voters.

“One option is allowing voter-registration cards to be used as ID. Those cards are mailed to voters and do not have a photograph, and might be more readily available to an impoverished voter than a government-issued photo ID. Another option is expanding the list of acceptable IDs to include student IDs or government-employee IDs. And yet another possible solution involves having the state exempt the poor from having to show a photo ID to vote, an exception modeled on Indiana’s voter ID law.

“Election law experts and opponents of voter ID restrictions cautioned, however, that softening the effect of voter restrictions is more easily ordered by a court than accomplished in reality.

“‘These softening measures work better in theory than in practice,’ said Richard L. Hasen, an election law expert and a law professor at the University of California, Irvine. ‘Voters don’t understand what their rights are, poll workers don’t always understand, and there’s not adequate publicity about the options.’” New York Times, July 21^st. How about killing the law in its entirety?

As two presidential candidates, strong only within their respective “Base” constituencies and otherwise almost equally unpopular, square off, they are mired in an election process with loads of unfairness built into any vote that relies on state-defined voting districts (electoral or Congressional districts) and applies discriminatory voter ID laws. If such districts were simply based on raw popular votes across the entire state, the GOP would most probably no longer control a majority of state legislatures, and Congress would reconfigure dramatically. Since U.S. Senate seats are not defined by such districts, the Senate is much more vulnerable to a change of party control, while the district-driven House is not.

Biases were built into our form of government. Two Senators from every state, regardless of population, disenfranchises states with large urban populations to the benefit of rural states. Allowing states to form their own districts was an invitation to corrupt the ballot. The system was designed that way. But there are checks and balances that can, to a certain limited extent, reverse that inherent unfairness… and let all American citizens of voting age cast a “one person, one vote” ballot. Today, with those biases and restrictive voting statutes, one rural vote equals 1.8 urban votes.

I’m Peter Dekom, and I wonder why we tolerate an incumbent minority rejiggering the voting process to allow them to have a hugely disproportionate per-person voting advantage over everybody else.