The Anxious Physicist

Personal blog of Dr Alex Mendelsohn

Welcome

Hello to everyone who happened upon this blog. My name is Alex Mendelsohn*. There isn’t much here in the form of sunshine and flowers (unfortunately, I couldn’t find those emoji’s – all I could find were these red flags: 🚩🚩🚩). Instead, you are free to feast on a collection of thoughts from a physicist going through severe mental illness. Yippee!

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How imprecise language can lead to the loss of scientific knowledge: part 2

This blog post is in reference to my article in the May 2023 edition of the Lancet Psychiatry – Lithium Story: Eight Guidelines, Eight Recommendations. It is adapted from notes I sent to one of the editors when constructing the article

The blog post discusses the issue of imprecise language in scientific literature, specifically in the context of lithium pharmacokinetics. Alex provides two examples of unclear messaging from the literature and suggests solutions to improve clarity. Example 3 involves the lack of specificity about the timing of serum concentration values mentioned in a paper by Grandjean and Aubry, while Example 4 highlights a graph by R Hunter that is misleading due to the use of two scales on the x-axis and unclear labelling of subjects. Alex suggests that authors should provide clear and concise statements to remove ambiguity in their writing and improve the accuracy of their research.


In a previous blog post, I looked at two examples of imprecise language in a Grandjean and Aubry paper about lithium pharmacokinetics (which I used in my May 2023 Lancet Psychiatry article). In this post, to show that the problem is not limited to a single paragraph in a single review paper, I have included a couple more examples of unclear messaging.

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How imprecise language can lead to the loss of scientific knowledge: part 1

This blog post is in reference to my article in the May 2023 edition of the Lancet Psychiatry – Lithium Story: Eight Guidelines, Eight Recommendations. It is adapted from notes I sent to one of the editors when constructing the article.

The blog post is a criticism of the clarity and precision of the language used in lithium pharmacokinetic literature. The post focuses on a specific paragraph of the Grandjean paper that contains two examples of imprecise language. Alex explains the implications of the authoritative and inaccurate language used, which can lead to a false sense of understanding and clarity in a reader not familiar with the subject, and may cause a slow deterioration of the original research finding citation to citation, decade to decade. Alex also argues that imprecise language can cause the loss of scientific knowledge, using as an example the case of Amdisen and colleagues, who proposed taking patient serum concentrations at 12 hours in the 1970s, and soon after became standard practice worldwide, but with time the original research finding has been lost.


It might seem strange to say from someone writing a blog post criticising clarity and precision of language, but I personally find it very difficult to write clear and precise language. Goodness, if you could see my first-year PhD report!

But, because I had to work very hard to clarify the muddled thoughts in my head, I recognised mistakes in lithium pharmacokinetic literature similar to those I used to make in my writing.

In the Lancet Psychiatry article, I focus on the paper “Lithium: updated human knowledge using an evidence-based approach” by Etienne Marc Grandjean and Jean-Michael Aubry. It is an extensive collation of knowledge on lithium treatment. However, producing a paper with such breadth of knowledge, can in turn, lead to unclear and imprecise language given how much the authors are required to understand.

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Last winter I decided to disregard GMT and stay at BST: why isn’t this a thing yet?!

The blog post describes the experience of dealing with the time shift that happens twice a year due to daylight saving time. Alex decided to stick to British Summer Time (BST) and adjust half of the clocks in their house to GMT, instead of adjusting their medication schedule. Initially confusing, Alex became accustomed to this change and felt that their mood was significantly better due to the later daylight hours of BST. Alex argues that year-round daylight saving time could be a better option than switching back and forth between BST and GMT.


There are very few upsides to living with a severe mental illness. One of them is quite a bit of free time. Previous times the clocks have gone back have been a nuisance to me. Especially since I started taking antidepressants. For whatever reason, my brain is very sensitive to the time I take them. If I take my dose late, even by only half an hour, my reality is thrown from side to side like a ship in rough seas.

To be taken safely, my medications have to be taken a set time apart (therefore at fixed intervals in the day). This means that twice a year the time I take my medication shifts by an hour each day. Why don’t you take your medication at the same time all year round? I hear you ask…

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The errors of Matt Hancock: A Yoda-inspired analysis

With the ongoing uncertainty regarding one of my medications not looking to end anytime soon, I have tried to distract myself with other absurdities going on in the world. In this blog post, I have combined two: ChatGPT and Matt Hancock. I hope that regardless of your political background, you agree that the UK health secretary during the covid-19 pandemic, Matt Hancock, made many mistakes (some with terrible consequences). I have been in and out of the loop of his, frankly, bizarre story. So, I asked ChatGPT to write an article for me by the wisest person I could think of… Yoda.

Mistakes, Matt Hancock made, hmmm? The Conservative politician, he was, yes. Many errors, he made, hmm? Mistakes, let us discuss.

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The pharmaceutical industry just stopped producing the only antidepressant that has worked for me

The blog post discusses the recent stoppage of the production of Bupropion (Zyban) and Varenicline (Champix) due to the detection of impurities that could increase the risk of cancer. Alex, who suffers from chronic depression, argues that the benefits of the antidepressant outweigh the minimal risk of cancer. Alex also criticizes the lack of availability of alternative treatments for depression and smoking cessation, particularly MAOIs and the lack of supply of smoking cessation drugs in the UK. Alex questions the logic of discontinuing acute treatments for smoking cessation due to a small risk of cancer over a few months.


Imagine the scenario. Potential impurities are found in some HIV retroviral drugs that produce a small increase in the probability of contracting cancer over their lifetime. I think the last thing you would expect would be the immediate stoppage of the production of the antiretroviral drugs in question. Leaving a patient vulnerable to imminent death as HIV progresses to AIDS is of greater importance than a tiny increase in lifetime cancer risk.

Yet, in the world of mental health treatment, this type of scenario has recently unfolded with the stoppage of the supply of Bupropion (Zyban) in the UK, leaving me and many others without the drug keeping them out of depression.

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I don’t like calorie tracker apps

Alex discusses his negative experience with calorie tracking apps. He attempted to use several apps to track his calorie intake but found that they all had fixed daily calorie targets, which he believes are not helpful for most people. He also found that the apps did not track calories accurately and only focused on how many calories were left to consume. Alex believes that these types of apps can contribute to mental health problems and eating disorders. He argues that apps need to be regulated to prevent coercing healthy and vulnerable people into obsessive behaviour. In the end, Alex decides to go the old-fashioned way and simply remember his calorie intake, believing that as long as he keeps his average calorie intake just below his calorie deficit and exercises regularly, he will lose weight.


I went into the Christmas period with the goal of not putting on weight. Long story short, I failed. In the past, I have been very fortunate to have a metabolism quick enough to remove the excess fat from my waist. It only required a slight modification in diet. In the last few years I have made the definitely new discovery, that, erm, metabolism slows with age.

No matter, I thought. I shall jump on the bandwagon with all the other health-focused people in January – hoping I don’t fall off before February. First stop, counting calories.

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Why I have decided to stay anonymous (for now)

Alex has had negative experiences with clinicians in the past and has struggled to find a psychiatrist they trust. After finding a psychiatrist and a combination of medications that have helped ease their symptoms, they plan to share their experiences through various platforms. However, they wish to remain anonymous for now as they criticize aspects of psychiatry, psychotherapy, and neuroscience and do not want their current psychiatrist to discontinue their service. Once their symptoms have improved and they feel safe enough, they plan to reveal their true identity while keeping the pen name Alex Mendelsohn. They hope to use their unique perspective to help others and prevent similar negative experiences from happening to others.


In the past, I have been refused treatments that eventually worked, and had interactions with past clinicians that unintentionally drove me towards suicide, rather than away from it.

It took me a very long time to find a psychiatrist I trust. Once I did, we landed on a combination of medications that have progressively eased my symptoms over the last couple of years. I take one of these medications off-label (this means that the medication is licensed for another condition, not the one I am taking it for). My current psychiatrist is the first I have met willing to prescribe this medication.

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Why not use bodycams for experimental work?

The blog post discusses Alex’s experience as an experimental physicist and the difficulties he faced in keeping track of important events during experiments. He suggests that using bodycams, similar to those used by police officers, could be a solution to this problem. Alex explains that the use of bodycams would provide a wide field of view and record all the problems that arise during an experiment. This would make communication between the experimenter and the supervisor more efficient and improve the replicability of experiments. Additionally, Alex argues that using bodycams would make experiments more rigorous, as it would be easier to catch mistakes and improve methodology. Alex concludes by pointing to NileRed’s YouTube channel as an example of how video recordings can be used to counter positive publication bias.


I wasn’t exactly a natural at experimental work. My undergraduate lab marks were, erm, not brilliant. A poor memory mixed with a lack of practical intuition, a good experimental physicist, does not make. So, it is a tad ironic that I decided to do a PhD in electron microscopy – a mostly experimental field.

I liked planning experiments and analysing their results. I just didn’t very much like doing them. Sessions on the electron microscope always felt clunky. I had to frequently stop doing the experiment to note down significant events in my lab book and I was not the best at deciding which ones were worthy. Actually, I was terrible at deciphering happenstance from important experimental happenings.

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This photographer has out Dunhelmselves (sorry, couldn’t help it!)

I recently received an email from my mum with the subject heading “Dunhelm invisibility cloak”. The only words in the body were “Enjoy!” followed by three hyperlinks to Dunhelm’s website (a furniture store).

The first link was to a “Darcie the Deer” printed throw blanket. At first glance, nothing seemed out of the ordinary. I mean, the colour was not really to my liking, but other than that it seemed like a regular, relatively inexpensive, blanket. My joy levels had not exactly skyrocketed.

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The secrets to anxiety are inside my head – all someone needs to do is look

This is quite possibly going to be the most self-aggrandising article I will ever write. Maybe I have finally descended into pure and utter delusion. But the experimentalist in me strongly believes that what I say in the title is true. I think my life accidentally became the near perfect experiment to discover biochemical causes of anxiety.

Alex shares his personal experience with anxiety, which they believe was initiated by taking the antidepressant Sertraline. He discovered several case studies that also describe the development of anxiety symptoms in patients shortly after taking Sertraline. However, Alex’s anxiety symptoms persisted and worsened after cessation of the medication, unlike the patients in the case studies. Alex believes that their experience could be a special case that could help uncover the biochemical causes of anxiety disorders. Alex advocates for a more complex approach to understanding the causes of anxiety disorders that takes into account both nature and nurture.


“How did I miss this?” I say to myself. I had just found a case study by Catalano et al. [1] describing the development of panic attacks in two patients shortly after initiation of the antidepressant Sertraline. Importantly, the patients had no personal or family history of any anxiety condition. I had been searching for an article like this since 2015. It was now 2021.

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