J.D. Moyer

sci-fi writer, beat maker, self-experimenter

Category: Mental Health (Page 2 of 5)

5 Things You Can Eat to Improve Your Mood and Brain Function


As part of my daily writing log I also track my mood and energy levels. Over the past few years I’ve noticed a trend — my mood and energy levels are consistently “good” or “very good.” This wasn’t always the case. Though I’ve never suffered from major depression, I know that I’m vulnerable to anxiety and mild depression, especially during times of stress (I wrote about one such time here).

When I’m not under stress my baseline mood is pretty good, but I’ve been wondering what’s going on with my increased resilience over the last few years — feeling steady and optimistic even in the face of big stressors (members of my extended family have weathered some serious illnesses — both physical and mental — during that same time period).

Could be I’m just older and wiser. But I’m not that old, or that wise. I suspect my nutrition and supplement regimen has the greatest effect. This post lists my “core five” substances for mental health and improved disposition.

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Why I’m Joining the Maximizers

Maximize your sound ... and everything else.

Maximize your sound … and everything else.

I first became familiar with the term maximizer from Penelope Trunk’s blog. According to Trunk, a maximizer always wants the best, and spends a great deal of time and energy trying to make the best decisions, acquire the best things, and have the best life. Maximizers are competitive, ambitious, and according to Trunk, have more interesting lives.

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How To Trigger Super-Momentum

Super-momentum: life in the productivity fast lane

Super-momentum: life in the productivity fast lane

No more than a dozen times in my life, I have experienced a state of what I call “super-momentum.” For days, sometimes weeks at a time, I operated at a extremely high level of energy, excitement, and creativity. I became so absorbed in my work that becoming distracted wasn’t an issue; I was distraction proof. I slept less and ate less, but had more energy. At times ideas came so quickly that I struggled to capture them, getting up in the middle of the night or pulling over in traffic to write them down.

There’s a clinical word that describes aspects of this psychological state: hypomania. But whereas hypomania is often associated with distractibility and thrill-seeking behavior (gambling, shopping sprees, sexual promiscuity, etc.), I associate super-momentum with extreme focus in a single work area, and the application of 100% of the excess energy to the work in question.

There are multiple advantages to having a singular focus. With project immersion, the subconscious mind is always engaged with the material (though other life areas may suffer from lack of attention and processing power). Project progress increases because there is less “loading” time; since the mind is continually engaged, you don’t have to “remember where you were” when you start working. You already know! This also reduces initial resistance/willpower expenditure for starting each work session. Instead of knowing and dreading the mentally strenuous work of reviewing your work for half an hour (or longer) to “get back in the groove,” you just pick up right where you left off the night before. You’re already in the groove — you never left.

Super-momentum is similar to Csikszentmihalyi’s flow, but I consider super-momentum to be more agitated, more based on heightened physiology (dopamine, sex hormones), and less reliably triggered. And while flow is characterized as “enjoyment in the process of the activity,” I would describe super-momentum as an ecstatic, near-frantic, inspired, completely focused work hustle.

It’s a great drug, and I’d like more of it. But it’s not something money can buy.

So, the questions:

  • Is super-momentum worth triggering? Does it actually result in value being created? Or is it just another high to be chased?
  • Is it possible to trigger super-momentum, and if so, how? What circumstances lead to this explosive burst of energy, enthusiasm, motivation, and productivity?
  • Are there negative effects of super-momentum, in terms of psychological strain, physical stress, and general wear-and-tear? Is the comedown painful? Is “project completion letdown” inevitable?

Is Super-Momentum Worth Triggering?

Absolutely yes. While not every period of super-momentum in my own life has paid off in every way, all have paid off in some way. To list just a few examples:

  • I spent weeks in a state of super-momentum writing an artificial life emulation program that took my programming skills to the next level. I still sometimes reference the source code of this application when solving similar problems.
  • For at least a full month I became complete absorbed in Minecraft, sleeping very little and thinking about the game constantly. My brain was so “activated” that I made major breakthroughs on completely unrelated problems (client work) during this period of time.
  • Momu and Grayarea collaborated during a very short window of opportunity. A sixteen-hour work session led to a week of very intense follow-up work, resulting in the track “One” which has generated thousands of dollars in royalty income.

In the long-run, these brief periods of super-momentum are mere blips when compared to productivity and results from consistent daily disciplined work. But still, these blips interest me. Not only are they fun when you’re in them, but many artists and writers I respect and admire seem to be able to consistently generate super-momentum, dramatically increasing their productivity during focused periods of being completely ON.

Is it Possible to Trigger Super-Momentum? If So, How?

Since flow is a possible subset of super-momentum, what have psychologists already determined are the prerequisites for the former?

In order to achieve flow, Csikszentmihalyi lays out the following three conditions:

  1. Goals are clear
  2. Feedback is immediate
  3. A balance between opportunity and capacity (the task is sufficiently challenging but not overwhelmingly difficult)

On most days I can enter a flow state (as characterized here) for at least a few hours. But I don’t know if I can consistently generate the heightened physiological state I associate with super-momentum. As a start, in terms of reverse-engineering, here are the factors (in addition to the above) that I associate with super-momentum:

  • a great idea
  • competition (personal, not abstract)
  • a crush/a muse
  • hunger for success and recognition
  • decent tools and working environment
  • an inflexible deadline
  • powerful collaborators or helpers
  • creating something that will really help or inspire other people
  • breaking new ground (in terms of knowledge, style, or genre)
  • some drugs (modafinil, bromocriptine, caffeine, etc.)
  • being in good physical shape and generally healthy
  • incremental success (power-ups)
  • emotional intensity (including heartbreak, joy, grief, love)
  • working hard, playing hard
  • terrible consequences if I don’t succeed
  • a big payoff if I do succeed
  • getting “amped” because of excitement around an activity or an upcoming event or release (anticipation)
  • extended hyperfocus (for example videogame immersion)
  • an extended period of quiet solitude or near-solitude, time and space to completely relax, decompress, reflect, and even become bored

I have personal experience with all of these factors except for modafinil (which I am curious about, but wary of). Some of these factors are within personal control, but just as many aren’t. Part of super-momentum might simply be utilizing the enormous energy that comes with momentous life events (births, deaths, falling in love, getting dumped, etc.).

Drugs are within one’s personal control, but to me that seems a dangerous route (for example, I could imagine quickly and efficiently writing an absolutely worthless one-thousand page novel under the influence of modafinal).  I once tried bromocriptine (which increases dopamine levels) as an experiment, and  once was enough. I consume a moderate amount of caffeine from dark roast coffee, but medium roasts leave me dehydrated and jittery — I’m not interested in increasing my caffeine intake.

What other factors are controllable?

  •  Setting an ambitious but achievable goal
  • Agreeing to a tight, inflexible deadline, such that other people are depending on you to deliver
  • Choosing subject matter than can potentially have a real impact or break new ground
  • Maintaining and optimizing your infrastructure and work environment so that when inspiration and energy do strike, you are not slowed down with mundane “fixit” tasks and distractions
  • Underscheduling and undercommitting, so that you end up with “empty space” in your life (and not filling that space with distractions like television — get bored enough so that your mind starts racing for its own entertainment — see Oates tweet above)
  • Engaging in a rich social life (ideally centered on or related to your work area) so that you increase your potential exposure to mentors, muses/crushes, rivals, and collaborators, all who can dramatically spur your motivation and amp up your nervous system.

This is the first time I’ve thought about this analytically. I’m surprised by how many super-momentum associated factors are potentially controllable. Maybe super-momentum can be engineered.

Can you Create Your Own Motivation and Excitement?

According to Neil deGrasse Tyson, yes.

“The problem, often not discovered until late in life, is that when you look for things in life like love, meaning, motivation, it implies they are sitting behind a tree or under a rock. The most successful people in life recognize, that in life they create their own love, they manufacture their own meaning, they generate their own motivation. For me, I am driven by two main philosophies, know more today about the world than I knew yesterday. And lessen the suffering of others. You’d be surprised how far that gets you.

– Neil deGrasse Tyson’s response on Reddit when asked “What can you tell a young man looking for motivation in life itself?”

What Tyson doesn’t explain is how. How do you go from sitting on the couch feeling blah to firing on all cylinders?

Well first, get off the couch. As Tony Robbins likes to say, “emotion is created by motion.” [Tony Robbins “Ultimate Edge — Hour of Power” mp3, link borrowed from this Tim Ferriss post]

Exercise generally stimulates dopaminergic systems, which generally increases motivation (though the neuroscience is complex; higher dopamine in some brain areas increases motivation, while higher dopamine in other brain areas increases awareness of the costs of certain behaviors).

So daily exercise is a must if you want to boost your “get up and go,” with the caveat being that you don’t want to overdo it and end up in a state of chronic inflammation. Lifting heavy weights or going on long runs every day will just exhaust most people. Walking or bicycling or yoga everyday plus short bursts of more intense exercise (sprints, weights) is probably a good balance.

But brisk walks won’t get you to super-momentum. You need to be excited about your work.

Well, what if you aren’t excited? Can this be changed?

Author Rachel Aaron has a good perspective on this. In this blog post she describes how she went from writing 2000 words a day to 10,000 words a day. She breaks her approach into three core requirements:

  1. Time (track productivity and evaluate)
  2. Knowledge (know what you’re writing before you write it)
  3. Enthusiasm (get excited about what you’re writing)

She has valuable insight into all three areas. I’d recommend her post to all writers. But for the more general purposes of this post, her insights into generating enthusiasm are the most relevant. From Aaron’s post:

The answer was head-slappingly obvious. Those days I broke 10k were the days I was writing scenes I’d been dying to write since I planned the book. They were the candy bar scenes, the scenes I wrote all that other stuff to get to. By contrast, my slow days (days where I was struggling to break 5k) corresponded to the scenes I wasn’t that crazy about.

This was a duh moment for me, but it also brought up a troubling new problem. If I had scenes that were boring enough that I didn’t want to write them, then there was no way in hell anyone would want to read them. This was my novel, after all. If I didn’t love it, no one would.

Fortunately, the solution turned out to be, yet again, stupidly simple. Every day, while I was writing out my little description of what I was going to write for the knowledge component of the triangle, I would play the scene through in my mind and try to get excited about it. I’d look for all the cool little hooks, the parts that interested me most, and focus on those since they were obviously what made the scene cool. If I couldn’t find anything to get excited over, then I would change the scene, or get rid of it entirely. I decided then and there that, no matter how useful a scene might be for my plot, boring scenes had no place in my novels.

This applies to all creative/innovative pursuits — not just fiction writing. If it’s boring, why are you working on it? Skip ahead to the good part or the interesting part.

You may need to come back to the “boring bits” of the project later, but if you’re already in a state of super-momentum, you’ll blast through them effortlessly.

Are There Negative Effects of Super-Momentum?

Obviously, being amped up physically and mentally for an extended period of time (even if drug free) is going to take its toll. More free radicals, more stress hormones, and accelerated aging are probably inevitable to some extent.

Super-momentum is not the fountain of youth. It’s burning the candle at both ends. Even if the high is natural, all highs are followed by a low.

In addition to physical and mental stress, focusing all your energy and attention on a single life area means that other parts of your life (household, relationships, children, eating well, sleeping well, other work areas) are going to be temporarily neglected.

In addition, when you come down (and you will eventually come down), you won’t have the energy to energetically deal with these neglected areas. You’ll be drained. After expending an enormous amount of energy and delivering or otherwise completing your project (or possibly abandoning it), you’ll experience letdown. While life coaches and therapists might distinguish physiological depression from post-project depletion, they feel about the same.

The advantage of going through the latter is that you know why (you just pushed yourself like a maniac, and now you’re out of gas), and you know that with rest and recuperation, you’ll bounce back and regain that life spark.

So pursue super-momentum at your own risk. There will be downsides. A near constant state of super-momentum without corresponding periods of rest and recuperation might lead to gigantic leaps in terms of career success, but long-term health life effects might include:

  • obesity, from sleep deprivation and circadian disruption
  • insulin resistance, see above
  • chronic inflammation, manifesting in joint pain, back pain
  • chronic depression
  • drug and alcohol abuse
  • damage to personal relationships, from neglect and/or volatile emotions
  • self-doubt, loss of sense of purpose, “Why am I doing this?”

To these risks you might say “So what?” In the famous words of a super-momentum enthusiast:

“Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming “Wow! What a Ride!”

– Hunter S. Thompson

He was a man true to his word.

On the other hand, there are equal or even greater risks to not pushing yourself, to eating and resting too much, to not discovering and stoking your inner fire. These risks are both physical and psychological. Chronic stress is terrible for health, but acute stress is necessary. A sedentary life devoid of all challenges is a fast track to obesity, heart disease, cancer, and dementia. Consider:

Work “sprints” (via super-momentum) are not necessarily bad for your health as long as you take some downtime to recover. Here are some basic life and health precautions to take if you are chasing the dragon of super-momentum:

  • stay super-hydrated
  • get at least five hours of sleep a night
  • eat at least one healthy meal a day
  • don’t use stimulants stronger than tea or coffee
  • rely on “natural” sources of motivation (see above) instead of drugs (including all so-called “smart drugs”)
  • start with “money in the bank” (literally, but also in terms of relationships, core infrastructure, etc.)
  • take extra care to be polite, patient, respectful, and considerate to your loved ones (your agitated, hypersensitive, hyperactive state will make you prone to snapping and snap judgements)
  • when its time to come down, come down gracefully (sleep more, eat well, decompress, pamper yourself, recuperate, thank everybody who supported you during your sprint, return the favor)

This cautionary tale from author-turned-cocaine-and-videogame-addict Tom Bissell is worth reading. It’s possible to amp yourself up into a state of hypomania and hyperfocus that feels like super-momentum, but moves your life backwards instead of forwards. While I’ve never gotten into recreational drugs, I can relate to the lure of videogames. These days I have a simple rule of “no entertainment during the workday” (including web browsing) that keeps me from falling into false “feeling productive while doing nothing productive” traps.

So Who Wins, The Tortoise or the Hare?

Well, we all know that slow and steady wins the race. There is no substitute for establishing rock-solid daily habits that inch you closer to your goals, day by day.

But there is a place for sprints, for extremes. Especially to reach the heights of artistic or innovative greatness, these sprints might be required.

So the tortoise wins the horizontal race, but the hare gets more air.

Or maybe, once in awhile, the tortoise bursts into a sprint.

Motivation Force Multipliers (3 Ways to Sustain and Expand Energy)


How can we leverage any sparks of “natural” motivation we might have (our interests, passions, and desires) into steady and dependable motivation that does not fluctuate with our mood? How do we keep working when external rewards are few and far between (for example anybody who is starting out in a new career)?

I spent a few hours last week getting an error fixed for a particular Loöq Records music release on a particular website. The correction involved a number of emails, comparing spreadsheets, auditing code in our database software, rescheduling promotional activities for the release, and so on.

Fixing the error had nothing to do with my love of music production (my original “passion” that led to co-founding a record label). It was just work that had to be done. I didn’t mind doing the work, and then I started to wonder why I didn’t mind doing it. What elements were “bridging the gap” between my love of making beats and this laborious administrative fix that was taking up my time?

“Passion” is never enough to create and sustain a career or an organization. There are always boring bits; there are always difficult bits. You will never accomplish much if you rely only on your “natural” motivation (the things that interest you and excite you).

It’s a no-brainer to organize your career (or careers) around the facets of existence that you find most compelling. But how do you transform this “natural interest” into the kind of day in, day out drive and energy that propels you forward, regardless of external rewards (or lack thereof) and internal mood?

First, if you’re not feeling motivated, it’s important to determine if the problem is external or internal.

If there’s no flow …

If you are really having trouble getting motivated in a particular life area, it might be time to reevaluate. Maybe you should be doing something else instead. There is no merit in grinding away year after year if you are not experiencing any significant external rewards (money, prestige, appreciation) or internal rewards (pleasure, excitement, satisfaction, sense of meaning, enjoyable anticipation of external rewards) from the work.

It’s important to carefully consider major decisions about life areas (jobs, relationships, artistic goals) when you are depressed or discouraged. If possible, fix your brain chemistry first, then make the decision. This is easier said than done, as a heinous job (for example) might be the cause of depression or anxiety. If you’re not sure, ask your family and friends for advice. If they all say your job sucks, your job probably sucks. Some problems really are external (like abusive partners, or dangerous working conditions, or lack of demand for your product or service), and have nothing to do with your mental state or attitude.

For me, this happened with DJing. I had a good run, but at a certain point the “grind” aspects outweighed the rewards. So I stopped.

But if the problem is in your head …

On the other hand, if you basically enjoy the work (or life area), and nothing is obviously messed up about your situation, but still need a motivation “pick-me-up,” consider these three approaches:

1) Serve others

I often ask myself “Who am I serving?” when I work on something. When I work on Loöq Records, I serve the both the artists and music fans. It’s not charity work, but I do remember what a huge deal it was to release my first record on a label, and I try to create good experiences for artists on our label (with good communication, fair royalty rates, and sharing ownership of the process/artistic control).

Bottom line: I feel more motivated when my work is connected to a community, and when I’m empowering others as well as myself.

2) Go for greatness/highest possible quality

Quality doesn’t guarantee success, but releasing sloppy work pretty much dooms a project to failure. If nothing else, going for “great” allows you to feel proud of your work. Before I release or deliver a final version of something, I try to ask “is this the best I can do?” Usually the answer is no, and I’m back to tweaking, editing, or even starting from scratch.

This doesn’t apply to drafts and sketches. Sometimes it’s good to get something rough out there to your trusted inner circle. How else are you going to know if it’s worth pursuing further? Not every idea has to reach completion.

It’s not a good feeling to get feedback or a review that points out an issue that you were already aware of (especially of a “finished” product or release). Why didn’t you fix it? Avoiding that feeling can be a good source of motivation. You probably already know what needs to be fixed and improved, so do it!

Bottom line: pushing up the quality bar almost always increases my desire to work on something.

3) Challenge yourself/blast through your self-imposed limits

Do you ever catch yourself saying “I’m not …” (creative, musical, organized, good at math, etc.)?

How hard have you tried to achieve that result or state of being? What evidence do you have that you truly “can’t” do that?

I’m not saying everyone can be good at everything — obviously not. But it’s easy to underestimate yourself, and it’s easy to be lazy.

If you want to progress, create a simple, smart daily program for yourself and stick to it. If you are serious, commit to that program for five years.

If you don’t have any results after five years, then maybe your efforts are better spent elsewhere. But with any less of a commitment, saying “I can’t …” or “I’m not …” is just self-defeating talk.

Challenge yourself. Make a 5-year commitment to become the kind of person you want to be, and work towards that daily.

Bottom line: it’s tremendously energizing to become something that you weren’t, to do something that you once could not do, to shed the skin of your old self and assume a new form.

What are your own techniques to refocus your energy and increase motivation?

Mental Health System Rant, and What Can Be Done Better (a Pipe Dream)

Who takes over when you get a mentally ill family member to the ER? Nobody.

Who takes over when you get a mentally ill family member to the ER? Nobody.

Lately I’ve been trying to get help for a relative who is mentally ill. What passes for a “mental health care system” in the United States is a joke. There is no system. There is a patchwork of uncoordinated crap.

I try to be positive and constructive on this blog, and to offer something of value to my readers. This post will be no exception, but I need to get a short rant out of the way first.

Some observations …

  • HMOs tend to farm out mental health services to independent clinics, and then refuse to coordinate with those clinics (like transferring medical records to the psychiatrist). This means the person with mental illness needs to deal with such logistics (which means a family member or caregiver needs to do it — if they have access and permission).
  • There is an incredibly low bar for “well” or “ok” among most psychiatrists. If you are not currently committed for violent or suicidal behavior, you are doing “well” or “fine.” Even if the patient is delusional and suffering from severe memory issues, they are deemed “ok” if they are not hospitalized.
  • All psychiatric drugs are prescribed on pretty much a crapshoot “let’s see if this works” basis.
  • It is extremely rare for a patient with mental illness to be able to work with a single qualified psychiatrist, or even a single team. The patient is much more likely to see a psychiatrist who is new to their case, ignorant of their history, and under too much time pressure to carefully consider the needs of the patient.
  • Getting committed to psychiatric lockup is horrible for the patient, even if the facility is run well. Everyone is aware of losing their freedom when they lose it. But often it’s the only way for a patient to get care. Usually the care is sub-par, and consists of sedation, cursory evaluation, and rapid discharge.
  • The “residential treatment” options I have seen are really dismal. Ratty houses, cramped quarters, no psychiatrist (or therapist) on staff, lots of TV watching, lots of sitting around. Not a healing environment.

I could go on and on, but my point is simply that there is massive room for improvement. The Mental Health Parity Act (2013 technical amendment) is a start. But what would real improvement look like? What’s the best case scenario?

I’ll put forth my own pipe dream. Here’s what I would want the experience of trying to provide help for a mentally ill family member/loved one to look like:

1. Let’s assume the patient has HMO coverage with Kaiser Permanente, either through employment (unlikely if they are chronically disabled), through Medicare, or independently purchased. (Already we’re in pipe dream land, right? Many people with mental illness don’t have *any* medical insurance).

2. I notice my family member or friend is having severe psychiatric problems (serious depression, mania, psychosis, delusions, hallucinations, confusion, memory loss, etc.). Let’s assume I manage to notice these symptoms before they reach a point of “decompensation” (med speak for losing your shit entirely — especially with schizophrenia).

3. I convince the friend or family member that it’s time to seek help, and (depending on the seriousness of the symptoms) we go to the ER or make a regular doctor’s appointment. Those who have been in the situation know what a Herculean feat of patience, persuasion, and persistence this single step entails.

4. Medical tests (blood work, blood pressure, exam, interview) are run to rule out stroke, side effects of new meds, etc. These tests are either run in the same intake location (ER or doctor’s office) or a medical escort is offered to help the patient and caregiver navigate the system (pipe dream — I know!). If it’s clear the problem is psychiatric in nature, the patient is referred (immediately) to a psychiatrist on call.

5. The on-call psychiatrist begins the diagnostic process, considering recent events in the patient’s life, meds history, family history, nutrition, sleep, past episodes of mental illness, etc. At this point the on-call psychiatrist refers the patient to a permanent psychiatrist (the patient would have the option to change doctors later if desired), and provides the option of a short-term residential voluntary stay in an HMO-managed facility.

6. The permanent/longer-term psychiatrist meets with the patient and caregiver(s) in the context of the short-term residential program or regular appointment. The in-depth diagnostic process begins, and includes the following tests and considerations:

  • detailed patient history (previous episodes, past and current medications, life circumstances)
  • genetic (family history and complete DNA sequencing)
  • nutritional (eating habits, allergen testing, gluten sensitivity, tests for vitamin and mineral deficiencies)
  • infectious disease, as related to psychiatric conditions (neurosyphilis, toxoplasmosis, etc.)
  • recent traumatic events (death in the family, divorce/breakup, loss of a job, etc.)
  • sleep patterns, sleep deprivation
  • changes in medications, side effects of medications
  • recent chemical exposure/toxicity
  • drug/alcohol abuse
  • meditation (not kidding here — I know of two cases of meditation-induced psychosis)
  • recent head injury or concussion
  • brain scan/other neurological tests (looking at both activity and organic structure/pathology including injury or tumor)

7. The patient, psychiatrist, and (if invited) caregiver(s) come up with a treatment plan, and treatment goals. The treatment plan would contain the following elements:

  • conservative medication (conservative both in dosage, and in the number of concurrent medications, and in the duration of the prescription — not every psychiatric patient needs to be on meds for the rest of their lives)
  • medication tapering (if the side effects are suspected as being part of the problem, powerful psychiatric medications may need to be tapered off slowly, over a number of weeks or even months)
  • nutrition (high nutrient/low junk diet, with food restrictions if tests indicate such restrictions might be helpful, correcting any nutrient deficiencies)
  • exercise
  • social (time with family and friends)
  • therapeutic (group, music, talk, addiction, whatever is appropriate for the patient)
  • treating any infectious diseases or other treatable organic causes discovered during the diagnostic process

Not all of these elements would be required for every patient … it might be more effective to devise a simpler treatment plan with fewer elements. But they should all be considered by the psychiatrist.

8. The patient should have the option to stay in a voluntary residential program (HMO-managed, covered by insurance), under psychiatric observation, for as long as they need. In cases where powerful medications are being added, tapered off, or modified, months of observation and supervised meds might be required.

9. Follow-up. The patient should be able to meet with the same long-term psychiatrist for years, as needed.

Those who have had experience dealing with the mental health “system” in the United States know how far we are from anything remotely resembling the scenario described above.

But it’s not impossible.

A few years ago I had a hernia repaired, through Kaiser. The entire process was incredibly streamlined and well-managed. Every step of the process was well-organized. The level of care was excellent. Even with insurance, I paid a lot out-of-pocket, but it didn’t bankrupt me.

So large HMOs can provide excellent care. But most of the time, people with mental illness fall through the cracks. They are treated like 2nd-class citizens. They are blamed (or partially blamed) for their own condition. Their treatment is outsourced to poorly funded, haphazardly run clinics. Caregivers must navigate a Byzantine maze of services. The left hand doesn’t talk to the right hand. The ball is constantly dropped. Nobody is willing to take responsibility for the patient’s medical care. Doctors say “it’s a psychiatric problem,” as if the brain were not an organ of the human body.

Psychiatric care should be medical care. One system, accountable and responsible for the wellness of the patient. Just like any other disease!

Psychiatric care is incredibly complicated (and expensive). The patient isn’t thinking clearly, and won’t necessarily comply with recommendations. So HMOs like to avoid the sticky wicket, and outsource the care. But they shouldn’t be allowed to. They should step up and deal with these patients like they do with every other kind of patient. That’s why the Mental Health Parity Act and continued improvements to psychiatric healthcare are important.

Is “Wealth Addiction” an Illness?

Crazy money.

Crazy money.

Sam Polk’s piece in Sunday’s New York Times chronicles his journey from greedy derivatives trader to nonprofit founder. It brings the concept of “wealth addiction” into the mainstream.

Is “wealth addiction” really an illness? Left untreated, the accumulation of wealth generally doesn’t lead to ruined life, or death. But Polk claims that this malady tears apart the social fabric, and hurts us collectively. Polk writes: “Wealth addicts are responsible for the vast and toxic disparity between the rich and the poor and the annihilation of the middle class.”

I think it’s valuable to consider the psychology of the ultrarich. What drives their behavior? Maybe it’s important to call out extreme asset accumulation for what it is: pathological fear-based hoarding, a scarcity mindset in the midst of abundance.

But even more important is to examine the system that enables such behavior. How do the ultrarich accumulate so much wealth, and hang on to it? Corporatism enables such behavior, with four simple methods:

  • a corporate charter that criminalizes putting any priority ahead of shareholder profit
  • an upper income tax rate of less than 40% (the upper rate averaged around 75% between 1932 and 1981)
  • corporate lobbyists influencing lawmakers to loosen regulation on Wall St.
  • media corporations that glorify extreme wealth

We aren’t going to address extreme income inequality by rehabilitating Wall Street traders one-by-one (or by waiting for them to become moderately enlightened and drop out of the rat race). We’re going to fix radical income inequality with a return to historical, more sensible progressive taxation, intelligent reform of the corporate charter (California’s “Flexible Purpose” and “Benefit” corporate structures are a good start), restricting corporate access to lawmakers, and support for independent media.

Four causes, four solutions. Questions? Difference of opinion? Please comment below.

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