Family, friends and colleagues

Gladys Berejiklian & Jack Dikian

Welcome to the Loony Bin

Welcome to the Loony Bin tracks attitudes and approaches in psychiatry and the law over 55 years. The cases illustrate miraculous cures as well as blundering repetition of harmful excesses. Bell's book (autobiography) is certainly does not shun from calling the whatever, whatever. For decades he has taken iconoclastic and often unfashionable positions in relation to what he has regarded as fads and unscientific trends of the day.

Dr David Bell is a well known Sydney neuro-psychiatrist, who has run a psychiatric research unit, developed a therapeutic community, pioneered addiction rehabilitation, been a driving force in forensic studies.

The paradox of voting

I’m no political commentator, not even a columnist. This isn’t yet another piece pretending to make meaning of prevailing political winds. Instead, I wanted to weigh-in on something more paradoxical than even our continued, albeit weary, belief in the goodness of our political system - compulsory voting. After all, we are only one of a small number of countries (22) that have us turn-up to vote. Other nations in this small but noteworthy club include; The Congo, Costa Rica, Ecuador, Honduras Uruguay, you get the picture. But does compulsory voting really lead to a fairer more democratic system? This is a particularly pertinent question when election results are extremely tight.

As far back as the late 18th century, French philosopher, mathematician, and early political scientist Marquis de Condorcet described what is known as the paradox of voting. Marquis de Condorcet noted that collective preferences for a cause, an ideology, a political party can be cyclic rather than transitive despite the achievements of the incumbent. This is so even when the preferences of individual voters are not cyclic. The conundrum arises because it means that majority wishes can be in conflict with each other. This occurs because the conflicting majorities are each made up of different, albeit large groups of individuals polarised in a political faith, however lacking real and practical ability to govern in their own right.

If we fast track to the mid-1970s the American economist Anthony Downs posited the paradox of voting; here the closeness of an election result coupled with voter self-interest can explain significant elements of political life.  Downs showed that in democracies the aggregate distribution of political opinion forces political parties in democracies to adopt more centrist positions. Note Malcolm Turnbull’s immediate attraction of less conservative voters.

Downs’ paradox of voting is that for a balanced, self-interested voter, the costs of voting will normally exceed the expected benefits. However, because the chance of exercising the pivotal vote is minuscule compared to the anticipated benefits of the different possible outcomes, the expected benefits of voting are less than the costs. Again, this paradox is acutely germane to elections like the one we just had – ones where a small number of votes tips the scale one way or the other. Suffice to say, the fact that people vote at all is a problem for those juggling good economics management and political longevity – read the self-interested politician.

Fermat's Last Theorem - a Tree house of Horror

The popularity of The Simpsons is well known. It is after all the longest-running sitcom of all time. It’s canny; it’s also one of the most literate television programs on air - containing many references to subject matter and scholars from various academic fields. One of the instances of mathematics appears in the "Treehouse of Horror VI" episode.

The equation 1782¹² +1841¹² =1922¹² is visible, just as the dimension begins to collapse. The joke is that the twelfth root of the sum does evaluate to 1922 due to rounding errors when entered into most handheld calculators; notice that the left hand side is odd, while 1922¹² is even, so the equality cannot hold. Instead of 1922, it is approximately 1921.99999996.

Some will recognize this as Fermat's Last Theorem. The theorem states that no three positive integers a, b, and c satisfy the equation aⁿ + bⁿ = cⁿ for any integer value of n greater than two. You may also know this is one of the most famous math problems in history, as it remained unsolved for well over 300 years.

In the margin of his copy of a book by Diophantus, Pierre de Fermat wrote that it is possible to have a square be the sum of two squares, but that a cube can not be the sum of two cubes, nor a fourth power be a sum of two fourth powers, and so on.

Given that there are infinitely many possible numbers to check it was quite a claim, but Fermat was absolutely sure that no numbers fitted the equation because he had a logical watertight argument. Sadly, he never wrote down his proof. Instead, in the margin of a book, he left a tantalizing note in Latin: “I have a truly marvellous demonstration of this proposition which this margin is too narrow to contain.”

Although this is easily stated, it has proved to be one of the most puzzling problems in the whole history of mathematics. Long after all the other statements made by Fermat had been either proved or disproved, this remained.

The correct proof came in May 1995 by Andrew Wiles. Wiles had stumbled upon the last theorem as a 10-year-old and then spent the next 30 years working on the problem. A childhood dream evolved into an adult obsession, and when he eventually figured out a possible strategy for proving Fermat’s riddle, he worked in secrecy for seven years before revealing his 200-page proof.

The proof ultimately uses many techniques from algebraic geometry and number theory, and has many ramifications in these branches of mathematics. It also uses standard constructions of modern algebraic geometry, such as the category of schemes and Iwasawa theory, and other 20th-century techniques not available to Fermat.

Of course there are still problems out there to solve. In order to celebrate mathematics in the new millennium, The Clay Mathematics Institute of Cambridge, Massachusetts established seven Prize Problems. The Prizes were conceived to record some of the most difficult problems with which mathematicians were grappling. There is a $1 million reward for each of these so-called Millennium Problems.

Of the original seven Millennium Prize Problems set by the Clay Mathematics Institute, six have yet to be solved. These are:

• P versus NP
• Hodge conjecture
• Riemann hypothesis
• Yang–Mills existence and mass gap
• Navier–Stokes existence and smoothness
• Birch and Swinnerton-Dyer conjecture

Social networks and increases in anxiety about motherhood.

Research from Ohio State University may make new moms reconsider why they use Social Networks to post about their children – particularly the impact of frequent posting by some and increases in anxiety about motherhood.
The results (the study has some with important limitations) published in Sex Roles, found that when women felt more societal pressure to be perfect mothers and viewed motherhood as central to their identity, they were more likely to share child-related updates and photos. The majority of mums in the study did use their baby's image as a profile photo at some point.

The mothers who strove for perfection as parents and sought external validation for their maternal role also expressed stronger emotional responses — both positive and negative — to the frequency and nature of their friends' likes and comments.
That relationship with Facebook may have come at a cost. Nine months after giving birth, those same mothers reported more depressive symptoms like having a poor appetite, not being able to shake off the blues and experiencing restless sleep.

The study couldn't pinpoint a cause-and-effect dynamic between a new mum's desire for validation, her increased Facebook use and a greater risk for symptoms of depression, but the researchers believe there could be a direct link.

Like with any personal social media post, users are trying to carefully craft their identity. New mothers, in particular, encounter unyielding expectations about how they should behave, which can feel magnified on a platform like Facebook. They may feel pressure to adhere to impossibly high parenting standards, and turn to Facebook for both support in meeting those expectations and validation that they're fulfilling a stereotypical maternal role.

Incidence of psychiatric diagnoses in offspring prenatally exposed to SSRIs

A recent article in the Journal of the American Academy of Child and Adolescent Psychiatry presents a study looking at prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) and associated increased rates of depression diagnoses in early adolescence. The report stresses that these findings are preliminary and should not be construed to change clinical practice.

The study is the first to investigate the incidence of psychiatric diagnoses in offspring prenatally exposed to SSRIs as far out as adolescence, noting however the vital importance of treating maternal depression, which can have significant adverse effects on offspring. Untreated maternal depression has been shown to increase risks of several perinatal outcomes including preterm birth, delivery by C-section, and bleeding during delivery.

Researchers used Finnish national birth registry data to determine the cumulative incidence of depression, anxiety disorders, autism spectrum disorder, and attention-deficit/hyperactivity disorder in the offspring of four groups of mother-offspring dyads: mothers exposed to SSRIs during pregnancy, mothers exposed to psychiatric disorder but not to antidepressants, mothers who used SSRIs only before pregnancy), and children of mothers unexposed to either antidepressants or psychiatric disorders.

They found the cumulative incidence of depression among offspring exposed prenatally to SSRIs was 8.2% by age 14.9 years, compared with 1.9% in the psychiatric disorder/no medication group and 2.8% in the SSRI-discontinued group. In contrast, SSRI prenatal exposure was not associated with an increased risk of autism spectrum disorder, ADHD, or anxiety.

Forgiveness is a conscious and deliberate decision

We all have had the need to forgive, be forgiven, and more so have an idea of what is and isn’t forgiveness. The basic definition of forgiveness is the action or process of forgiving or being forgiven.

Forgiveness is a conscious, deliberate decision to release feelings of resentment or vengeance toward a person or group who has harmed you, regardless of whether they actually deserve your forgiveness. Experts who study or teach forgiveness make clear that when you forgive; you do not gloss over or deny the seriousness of an offense against you.

Forgiveness does not mean forgetting, nor does it mean condoning or excusing offenses.

Understanding forgiveness is important because when we holding resentment and anger, guilt and shame, impacts our general well being, happiness and our relationships.

And forgiveness is not for the other person – it’s not just about being altruistic. Those who hold anger and resentment are more likely to present psychological and organic illness. Forgiveness doesn’t have to follow the other person’s apology. Forgiveness is an internal event where you give up the need for an apology, a need to maintain anger, and perhaps disappointment. But also, you can’t affect the past. Forgiveness is an acceptance of what happened and asking yourself; "What can I do now?"

Think about the person you would like to rekindle a relationship with: What do you miss about them? Maybe laughing with them or sharing family traditions. You don’t have to wait for the other person to act. Why not you take the first step? Even if you were not the person who initially did the wrongdoing, you probably had some role in this. Could you be the first to apologize? Can you do it sincerely?