Personal blog of Dr Alex Mendelsohn

Author: Alex Mendelsohn (Page 3 of 4)

I had a severe reaction to an antidepressant which, overnight, turned me from someone who had no anxiety symptoms whatsoever, to someone who had all of them. I then spent 8 months learning psychological methods (a lot of which I came up with myself) to 'reanimate my Frankenstein brain'. I then returned to my physics PhD where I finished the last 3 years of my PhD in 20 minute intervals, meditating in between to keep myself functional. After I finished, I collapsed from exhaustion, due to the slow progression of my physiological illness. I spent a harrowing couple of years in an indescribable hell, before we eventually got to medications that finally started to work. I am still recovering, but the closest to remission since that awful night in November 2015.

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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The story of how my Physics World article came to be

Referring to the article: A physicist’s experience of the mental-health system

and podcast: Start-up simulates quantum photonics devices, a physicist’s experience of the mental-health system

Alex wrote a manuscript about their experiences with mental illness that they shared with a psychiatric researcher, but received no response. Undeterred, they cold-emailed psychiatric researchers and scientific magazines but only received rejections. Eventually, the editor of Physics World magazine reached out and expressed interest in publishing the manuscript. Despite being surprised and skeptical at first, Alex’s article was eventually published after six months. Alex thanks the editor for being courageous enough to publish something not typically seen in a physics magazine and wonders if there are more people out there willing to act and care about mental health issues.

A while ago, my counsellor asked me to write something to give to a psychiatric researcher she knew from her work at a mental health hospital. She felt strongly that the things I was talking about in our sessions needed to be heard.

I obliged. I wrote a sort of manuscript looking thing. At that time I didn’t have the energy to write it in any sort of structure to help the reader. All I could do was splurge what was in my head onto paper. I cleaned it up as much as I could, then sent it off to her.

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My work routine

Alex discusses how they struggled with overworking and stress while doing their PhD work. They explain how they started meditating between 25-minute work sessions, which helped them to focus better and catch mistakes. He also talks about how they switched from task-oriented scheduling to theme-oriented scheduling, which allowed for more flexibility. They used a large whiteboard and created a crude week layout, which included headings like “Before Work,” “Morning,” “Afternoon,” and “Evening,” and a column for each day of the week. Alex assigned themes like “PhD Work,” “Personal,” “Gym,” “Admin,” and “Cleaning,” and then assigned associated tasks to each theme. This approach allowed them to structure their day, while also providing flexibility to move things around as needed.

I realised quite quickly on returning to my PhD that it was immensely difficult to pull myself away from work when I was in the middle of trying to do a task or solve a problem. The “I can’t leave the problem until it is solved” feeling. As time went on, it would feel like I was getting closer to a solution, that I had laser focus, but in reality, I had tunnel vision. As time went on I became more and more stressed meaning my ability to solve the problem worsened. Further, if I went past the 25-minute mark, my stress levels would rise almost exponentially. It would potentially wipe me out for the day, or for a particularly frustrating problem, two. During which I would be limited to very simple tasks which would still feel quite painful to do. Meditating as a break in between 25 minute work sessions seemed to allow me to work for the full day.

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Imposter syndrome – part 2

Starting a PhD is daunting to say the least. The gap in knowledge between research and undergraduate study is a rather large one. Therefore many students, like myself, have experienced ‘imposter syndrome’ – the feeling that it was a mistake on the academics to choose you for the PhD project but they do not know yet. Here, I suggest perspectives that might help deal with this phenomenon. Part 2 of 2

Alex writes about his experiences with mental health and how talking about it has led to fruitful conversations with others. During one such conversation, he realized that seeing imposter syndrome from the PhD supervisor’s point of view may help those who are afraid to ask for help. Alex explains that the fear of being kicked off the PhD is a primary symptom of imposter syndrome and that seeing the situation from the supervisor’s perspective can counteract this fear. He notes that a PhD student is at the beginning of their career, while the supervisor is likely closer to retirement, and choosing a PhD student is a major commitment. Alex emphasizes that a supervisor invests in a PhD student and it is within their interest to help with any problems or feelings the student has. He encourages students who feel like they are struggling to reach out to their supervisor and colleagues and that imposter syndrome does not have to last any longer than they decide. Alex concludes by saying that his PhD experience taught him that it is rather overrated and that he was no different the day after his viva than the day before.

Opening up about my own experiences of mental health through talks had a surprising side effect. People started to message me about their experiences and problems, some I go on to meet. I have found these conversations fertile ground for new ideas involving mental health. An important one of the many reasons why discussing mental health is beneficial. In one such conversation, an individual came to me about imposter syndrome. During our conversation, I realised that seeing imposter syndrome from the point of view of the PhD supervisor may help those feeling afraid of asking for help.

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Imposter syndrome – part 1

Starting a PhD is daunting to say the least. The gap in knowledge between research and undergraduate study is a rather large one. Therefore many students, like myself, have experienced ‘imposter syndrome’ – the feeling that it was a mistake on the academics to choose you for the PhD project but they do not know yet. Here, I suggest perspectives that might help deal with this phenomenon. Part 1 of 2

This blog post discusses imposter syndrome, the feeling of inadequacy despite having achieved success. Alex suggests that understanding and knowledge are two different concepts and that a researcher’s job is to extend their understanding to gain new knowledge. He argues that while it is normal for new researchers to feel like imposters when they are surrounded by people with more knowledge than them, they should focus on their ability to draw new lines of understanding. Alex believes that vivas test understanding, not knowledge, and that one’s ability to derive new understandings from previously known concepts is what defines a good researcher.

My PhD supervisor and I were standing in the lab preparing a sample for the electron microscope. It is a semi-dull activity, rich in opportunity for conversations about the minutia of life. I mentioned to him I was worried about the viva. I have always struggled with thinking on my feet. When my mind is stressed in such a way it takes the option of shutting down completely, leaving the occupier (i.e. me) to stare blankly at the wall. After some much-needed reassurance and useful advice, he says something which piques my interest. He mentions the viva is a “test of your knowledge”. Curious, I respond “I thought it was a test of my understanding?”. “Well”, he says in a semi-throwaway manner, “what really is the difference between understanding and knowledge.”

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Hope is found in a corridor of darkness, feet and hands chained to the ground, only the faintest speck of light far off in the distance.

It is not found at the start of a race or in the bleachers of a stadium.
It is not found in political offices, on posters or a ballot paper.
It is not found in forward-thinking companies, in school halls or lecture theatres.

It is not the search to find a friend or lover.
It is not in a lottery ticket or job position.
It is not following a pop star, motivational speaker or politician.

It is not a yearning or an ambition or a heroic figure.

Hope, is keeping your head turned towards the light, even after it seems to fade from view.

Misconceptions about mental illness

Alex discusses some misconceptions about mental illness that exist in society. He notes that mental illnesses are complex and individual experiences of mental illness vary greatly. Environmental and genetic factors can play varying roles in the development of mental illnesses in different people. Alex also emphasizes that mental illnesses cause both emotional and physical pain, and depression is not just a loss of emotion, but rather the twisting of emotions. He also points out that anxiety is not just worry, but it can be a debilitating condition that takes away an individual’s control.

During the editing and proofing process of the Physics World article I wrote, a few misconceptions slipped in. Which is understandable. Before I became mentally ill, I believed many of the misconceptions I have listed below. As I slowly got sicker and sicker, I realised just how wrong most of the common perceptions of mental health conditions are.

A poor understanding of the brain in society leads to films, T.V. shows, articles and other forms of media misrepresenting what mental illness actually is like. Ironically, this misrepresentation can come from the mentally ill themselves. It can be immensely difficult to describe what it is like to have a mental illness because the very nature of the illness affects the organ that we use to describe what it’s like.

Our society is therefore filled with misconceptions galore. Which makes having a mental health condition or illness all that much harder to deal with. Something I hope to rectify very slightly here.

I want to emphasise that the article is based on my experience. The following will likely differ from person to person. Which brings me on to my first misconception.

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Physics World article context #4 – why I didn’t put Venlafaxine in the article

This is the fourth of a series of blog posts on the context behind my Physics World article: A physicist’s experience of the mental-health system. There is a lot of backstory. So during the editing process, I sent documents to the editor to help explain some of the views I express in the article. I have decided to add them as blog posts.

This blog post discusses why Alex decided not to include information about their use of Venlafaxine between 2016-2019 in their Physics World article about their experiences with the mental-health system. Alex explains that the drug did not give them much benefit and may have even made their condition worse. He also felt that including even a brief mention of Venlafaxine would have confused the reader and distracted from the points they were trying to make. The post goes on to discuss the complexity of antidepressants and the importance of understanding their binding affinities for different receptors. Alex believes that misinformation about antidepressants led to their prescription of Venlafaxine.

I didn’t want the fact that I took Venlafaxine between 2016-2019 to be in the PhysicsWorld article.

I left it out for reasons I hope will be made clear in this blog post. It was difficult, perhaps impossible, to include without a lot of background information and the drug did not give me much, if any benefit. I actually think it made my condition worse. 

It is true that I believed that I could achieve remission solely through psychotherapeutic methods during the PhD and also true that I actually require medication to treat my illness.

I feel including even a short mention of Venlafaxine would have confused the reader and distract from the points I was trying to make later on. I hope this is made clear in the following story:

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Physics World article context #3 – the problem with rating scales

This is the third of a series of blog posts on the context behind my Physics World article: A physicist’s experience of the mental-health system. There is a lot of backstory. So during the editing process, I sent documents to the editor to help explain some of the views I express in the article. I have decided to add them as blog posts.

Alex discusses the use of rating scales in the mental health system, which he encountered during his rTMS treatment. Alex provides an analogy of how rating scales can be problematic by comparing them to rating the weather over a two-week period. He explains that symptoms of mental illness are complex and unpredictable, and that they fluctuate and change over time, making it difficult to provide accurate ratings. Alex attended a support group meeting with other patients receiving treatment and found that none of them knew how to answer the rating scale questions. The author concludes that rating scales are not very good at capturing the complexities of mental illness.

It was during my rTMS treatment that I first encountered the rating scales. And, had I been completely honest, I would have said that I could not answer the questions. That I could not give a rating at all. Especially as every scale asked for an average over the last 2 weeks. I have thought of an analogy that I hope might get across the reason why I felt it was pretty much impossible to give a rating.

Say you have lived in Southern California USA for your entire life. You are used to warm, dry and sunny weather year-round. In the previous two weeks however, the weather has been very unCalifornian. On the first day it was foggy and a bit chilly out, the next few days were pretty warm for this time of year (winter) temps going up to 24 Celsius, with a lot of Sun. On the weekend though it rained persistently. Last week however started extraordinarily with snow, possibly the first time you had seen it in your life. The rest of the week then stayed pretty chilly, five or six degrees Celsius, before returning to warm and cloudy.

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Why has no one taken any measurements of my brain?

This is the original draft of the Physics World article: A physicist’s experience of the mental health system (which then lead to the 24th February podcast)

I sent this draft to the editor around August 2021, when I was quite a lot sicker than I am now. I am proud of what I wrote given I could barely make breakfast at the time. So bear this in mind if some of it doesn’t make sense!

The article is a personal account of a physicist’s experience with mental illness and the mental health system. Alex describes their experiences in experimental physics and how it taught them the importance of accurate, precise, and direct scientific measurements to derive meaningful understanding. They then go on to talk about their experiences with the mental health system and how they have not received any concrete measurements or tests to diagnose and treat their mental illness, which has led to a lack of progress in their treatment. Alex questions why mental health treatment is based on generalizations and guesswork instead of direct measurements, similar to how their work in physics evolved from guesswork to accurate measurements.

I entered my experimental physics PhD way out of my depth. I, like many others, was taken aback by just how much rigour goes into the experiments. “Did you check this?” my supervisor would say “Or that?” he would continue, as I stood there with a feeling of dread knowing that my answer was going to be an inevitable, “No”. “Well, we will have to redo the experiment then” he would say, knowing full well that by “we” he meant “me”.

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