This is a story about self-experimentation...

It's very difficult to conduct a scientific study involving human beings. Our innate ability and inclination to adapt to our ever-changing environment means that we can't control the variables as we would be able to in vitro.

Sample sizes are always tiny - statistically impossible to gain any insight from - because of the difficulty of recruiting so-called ideal study candidates and being able to follow them for long enough to gather any meaningful data. Each individual will have wildly varying personal circumstances, which render any studies of hundreds or thousands of participants, complete and utter pseudoscience hogwash; nonsense; garbage.

Aggregating data from all the antidepressant controlled trials, as well as thousands of other studies into the efficacy of those medications, concludes to a high degree of statistical significance, that in more than 80% of cases the person's depression would have 'cured' itself on its own - medication makes no difference at all.

Clearly, psychoactive medications do have perceptible effects, just as you're able to tell if you've drunk 4 pints of beer or 4 pints of water. Thus, a double-blind placebo trial is not a placebo trial at all, because those who are in the placebo group know that they're unmedicated.

The question then arises: can we prove that some medications have positive effects?

Problematically, we are as superstitious as an animal with a bird-brain, quite literally. If a food pellet is randomly released to feed a pigeon kept in a cage, the pigeon begins to believe that whatever it was doing when the food pellet was released caused the food pellet to be released. If the pigeon was - for example - turning 360 degrees clockwise when the pellet was randomly released, it will continue to spin in circles, believing that its actions are causing the food pellets to be released. This is called magical thinking and humans are just as prone to it as a bird-brained pigeon.

Extrapolating, if we take up yoga, start eating kale, listen to whale music, start believing in imaginary sky monsters, wear lucky underwear, read self-help books, use homeopathic remedies or start doing any one of the many billions of similarly stupid and futile superstitious rituals, these are at least 80% likely to co-incide with a natural improvement in our mood which would have happened anyway. However, we will falsely attribute our better mood and more hopeful future, to something which actually had absolutely no effect whatsoever so far as good empirical evidence-based repeatable science is concerned.

To control the variables is extremely hard, in complex modern life.

I had a very good night's sleep last night, woke up early, ate a healthy breakfast, got to work early, had a productive day, and I felt like I had the energy and enthusiasm to do some exercise. My quality of life was manyfold better today than it has been for a very long time. My hope and optimism were sky high today.

Let us deconstruct the reason for my good day.

Last night I swallowed two 7.5mg zopiclone tablets, which are a sleeping pill. Perhaps it's high quality sleep, delivered with some help from medicine, that's the reason I had such a good day - I was well rested and refreshed.

No.

Earlier in the year - and in fact quite recently - I had completely quit all sleep aids and I was sleeping very well without them. I have no problems initiating sleep and remaining asleep. This variable is eliminated.

Last night I swallowed one 2mg Xanax tablet, which is a short-acting benzodiazepine hypnotic-sedative muscle relaxant, generically known as alprazolam. Perhaps it's relief from anxiety delivered with the help of medicine that is the reason why I had such a good day - my anxiety was subdued.

No.

Earlier in the year - and in fact quite recently - I had completely quit all sedatives, tranquillisers and tranquillising painkillers and I was coping very well with my anxiety without those medications. I am fully functional despite my very high-stress and demanding life. This variable is eliminated.

Last night was my 5th consecutive night without alcohol. Perhaps it's the healthy decision to quit booze and become teetotal which is the reason why I slept better, woke up refreshed, had improved concentration and felt more full of energy and enthusiasm for other healthy activities than I have done for a long time. I thought about catching up with a friend. I thought about doing some exercise.

Ah. We have a problem.

On the face of it, we have 3 significant changes, and those changes all concern mind-altering substances.

I can be fairly certain that I'm able to sleep and I'm able to cope with my anxiety without medication, but I combined two medications which should have helped with both, which is already complicating the clinical picture, but then I also quit heavy drinking quite abruptly and managed to get through 5 consecutive sober days. 3 changes is far too many changes to attribute my improved mood to any one of them, or even all 3 in combination.

But.

Oh no.

There are other changes too.

I got paid on Monday. Getting paid is always a good day. Sure, Monday I was off work sick, but it wasn't until yesterday that I started doing some sums and I realised that I can pay off half my debts at the end of the month. It's something worth considering.

I went back to work on Tuesday. Not losing my job is always a big relief when I get sick. Sure, it'd be pretty bad luck to lose my job after just one day off sick, but it's always a relief somehow to go back to work and find everything's fine and people are cool with me. It's something worth considering.

I have 8 working days - less than two weeks - until I go away on holiday. I haven't had a week-long holiday since July 2016, over two years ago, so that's a massive relief to know that I'm going to get a relaxing break soon. It's something worth considering.

I spent the weekend in the company of old friends. I took a flight to Prague. Socialising and travel are exciting and stimulating. I played with my friends' children. We did activities, like sightseeing and mushroom picking in the woods. All of those things are very nice and normal and pleasant. Sure, it was exhausting, but now that I've gotten over the travel I have some really nice memories of that trip. It's something worth considering.

At work I'm starting to feel like I'm really making a difference and I'm a valued member of the team. My colleagues were glad to have me back and people are keen to work with me. I feel cherished and a little bit more secure every day. I feel increasingly confident in my own skills, knowledge and experience. It's something worth considering.

My sister picked up my mountain bike from my parents, so that I can collect it from her. I'm looking forward to seeing her and maybe my niece too. I'm looking forward to having my bike back. I'm looking forward to getting my bike repaired, upgraded, and being able to use it to get a bit more fit and active. It's something worth considering.

Lives are complicated.

Life is complicated.

It's impossible to control the variables.

If you were looking for the perfect test subject - a guinea pig - you would fail to find a better one than me, because so many things in my life are constant. I stay in the same hotel, I eat in the same gastropub, I do the same job I've done for 21+ years. I'm a creature of habit and I'm not destabilised by anybody else, such as family, a partner or children. I've cut every variable out of my life that's possible to do, short of locking myself in a laboratory cage. I'm the perfect test specimen.

I can't tell you why I had a good day today, but I have very good reason to believe that it was a combination of a multitude of factors, including the sleeping tablets to help me get back into a good sleep pattern, the anxiety tablets to help me cope with intolerable stress levels, the sobriety, the travel, the socialising, the money, the job satisfaction and a million and one other little things, all of which are very positive. For example, my Apple Macbook was repaired under warranty, saving me the cost of a £1,500 replacement or a hefty repair bill, which is a big relief. Who could have predicted any of this and why would we attribute my life improvements to any one particular thing, such as the favourable mood of an imaginary sky monster? Stuff was just going to get better on its own.

As you can tell, I'm not the superstitious type.

I will, however, be taking a zopiclone and a Xanax again tonight.

Tags: #medication #depression #anxiety