If "they say" that about 5% of people have depression...then it's time once again to bust out "the map is not the territory" and remind people that diagnosis is a hugely political endeavour, which is administered unevenly, badly, and harmfully; who has access to it at all, and of those, who has access to any expectation of due diligence by medical staff, are extremely relevant questions in all medical matters.

In my experience, rates of depression and anxiety are markedly higher than basic demographic assessments will report. For people unfamiliar with how we operate in the field when studying large groups of people, you need to know a few things about the mass-noun problem. Here's just a few basic questions to interrogate your understanding with:

1. Can you verify the reported condition meets criteria per DSM-5?

• If so, which variant of Depression are you addressing? MDD (Major Depressive Disorder) is not Bipolar 1, for example.

2. Has this been recorded in medical records?
3. Are you comparing documentation to interviews and/or self-report?
4. What population biasing do you have?

• Classic example: the MMPI-2 is compiled largely based on white Michigan state residents, and may have limited explanatory or predictive effects for other populations; hence why we have new variants such as the MMPI-2-RF.

5. Are your metrics by which you ask the question Psychometrically Valid?

• You will get very different results depending on how you word something, EG: "I have been diagnosed with a form of Depression by a doctor" vs "I have been feeling extremely sad and unmotivated to the point that it interferes with daily life".
• Your response metrics will influence this, such as a YES/NO binary, a 3, 5 or 7 point Likert Scale (Mostly True / Partly True / Neutral / Partly False / Mostly False), or specific rated responses (Never, 1-3 Days, 5-7 Days, Almost Every Day, All of the Time).
• Metric verification is easiest if you use existing resources, such as the many options for measuring (PHQ-9, HAM-D, MDQ, etc;)

I think this quick version is better than the text blob I have beneath. I don't even talk about Substance Dependency (I wanted to); but there wasn't enough space because I get into a zoomed-out picture for the sake of my perpetual framing of the country as nested within the world.

For those suffering with Suicidal Ideation or Self-Harm, I can only recommend you seek assistance where and how you can within your means. U.S. Residents can dial 988 for the National Suicide & Crisis Lifeline, the website link is here if you click.

TLDR: It's worse than it seems, better than it looks. Demographics are not destiny, but they provide us relevant data to make informed policy decisions upon. Hopefully, we can choose to learn from them for once instead of deny problems exist.

Folks I am again mad that corporate “wellness” grifts have ruined the word “mindfulness” by prescribing a watered down version of it as a cure all solution to worker stress that is being actively induced by a hostile and inadequate work environment.

Because mindfulness, as in the actual therapy skill most commonly used in dialectical behavior therapy, is an extremely useful skill that basically makes you into Neo from the Matrix allowing you to achieve a level of slowed down self awareness which lets you think through how you’re feeling and what coping skills will help in a moment of stress rather than acting on impulse without thinking or getting stuck spiraling or panicking. And I never stop finding even more ways that it has improved my life.

And most people hear the word and think of the Amazon warehouse guided meditation closet

When I was handling the workload I had during 2020 which was still bonkers despite lower overall admissions (lower in this case being: not being full to capacity at our 144 bed facility, but not dipping below 100), part of my confrontation with HR included choice words about managing my mental health. There's an idea in the Industrial Psychology world that you can hijack Mindfulness as a form of Traumatic Compartmentalization; putting barriers up around oughts and shoulds of decent societies and peoples where they exceed the designation as "within your control". This trick was used by basically everyone I knew at the facility when it came to managing stress, a fundamental lack of capacity to acknowledge their situation as unworkable while also being powerless.

People talk about Millenials' so-called Learned Helplessness, and this is the kind of strategy seen in the professional field that creates actual Learned Helplessness. Wage theft, forced vacations, no-notice mass layoffs and the like characterized my Rehab job during 2020, my boss and I got yelled at constantly for still clocking in 40 (often 50+) hour weeks because our duties in the psychometrics and diagnostics roles did not permit us to take 32 hour weeks and perform our duties within an acceptable output. Eventually, you're handling multiple observation assessments for every one of those 100-144 patients, spaced roughly every 8-10 days per patient; that means your workload is around 300 routine assessments. Those methods due to our ongoing Measurement Based Care initiative were important to be consistent on the timing and quality of the assessment window, it was a mess.

During a strategy meeting one week, my boss and I had worked out that I was handling (for normal people) a workload of about 100 hours a week, and was prioritizing urgent priority cases and working non-stop around the clock to push things out. I even had a few computer science pals working on a program to automate my job partially, as we were still handling data entry with manual 10-key into a custom coded excel spreadsheet for virtually everything. It was, to put it bluntly, not a problem that could be solved by a Tibetan bowl meditation and a simple "namaste" at the end. We needed staff. They cut that staff. Then they told us to effectively check our privilege when we were stressed out of our minds during a novel pandemic (which data scientists understood quite well the potential implications, even when we're psychology nerds).

I generally don't publicly talk about my employment while I'm working there, but I was affected by this. If y'all know any full stack engineering openings that are generally aligned with any/all of cohost's principles, feel free to reach out.

I had been trying to work to make things better from the inside, but I simply ran out of time, I guess

Edit: Some good to go with the bad -- my greatest achievement at Discord was that I was the person who hand-picked all the default sounds for soundboard. I was the one who added a dedicated quack button.

🦆

When I worked in my cool Rehab job, I told my boss the same thing each and every time we sat in her office drinking tea and trying to balance our humors after yet another brain-dead "all staff meeting" where Corporate types said shit like "we're all in this together".

The quote I think virtually every tech company needs to learn at the top level is this:

You cannot replace talent. You can only hire new talent.

The tech sector has had a rough one. Mass Layoffs have been coming in waves ever since 2020, but it seems like those smaller ripples are vibrations of the tidal wave of layoffs hitting virtually every job in the tech sector. In the U.S., workers who want to work in the fields of software development are routinely subjected to the kind of work we in the Rehab and Clinical Psychology field understand as fundamentally traumatic.

The Trauma Spectrum in diagnostic terms is limited to "PTSD", but we can often characterize the origin of traumas distinctly due to the symptom variations. While triggers and various maladaptive behaviors are common throughout the many origin points of PTSD, what I think a lot of people miss is that Trauma is about as flexible to circumstance as your general stress tolerance. Being under strain for a long time is an easy way to end up traumatized, and nothing in the U.S. does this as reliably as working Overtime while having your entire life and livelihood dangled precariously on next week's paycheck.

The hard thing about working from home is that I'm so ridiculously productive I finish everything I set out to do in substantially less time but unlike when I'm on-site, any time I spend not actively working is "time theft" or "not really working and invalidating of remote work as a legitimate option" whereas when I'm on-site there is a substantial amount of time spent chit-chatting with coworkers or being interrupted from my work by random pointless things that aren't my primary job duties, or literally just sitting at my desk reading a book in a mostly empty library on-call in case a patron needs something during those particular 2 1/2 hours.

All of those things are valued and validated as legitimizing the need to physically be on-site, but when I work remotely things that constitute reproductive labor like household chores or other things I need to do to maintain myself as a worker and keep myself going are seen as things I shouldn't be doing while on the clock, even though they do seem more relevant to my ability to be a productive worker than small talk with coworkers or reading a book at my desk.

For instance, my main goal for the day was to write a collection development guidance document. This would have taken me multiple days on-site because it would be frequently interrupted and juggled with other things to do. Working remotely, I completed a rough draft in just one hour. So like, now what do I do for the next 6 and a half hours. That was my assigned duty for the day. Read a book and wait for emails to come in?

I end up just reading a lot of Kirkus Reviews and Book Riot after I finish my goals for the day.

The disconnect between people who talk about the value of in-person office work being "community" and the ability to socialize while also acting like remote or flexible schedule workers are less productive and less valuable or more likely to be off-task is so like weirdly obvious and visible that I never understand how they don't get it...

When I go to the office I talk with my coworkers all day about what TV shows we're watching, movies, videogames, my team lead talks about his teenage & college age kids alot. I don't like really pay attention to sports but about half my team talks about the Eagles games. Me and the new team member talk about our media piracy setups, we spent all last week talking about the pros and cons of jellyfin over plex.

I get like a fraction of the work done if I'm in the office. And yet, here they are, mandating that our 2-remote/3-office schedule now means 3-office takes priority on holiday weeks so i lose a work from home day this week for seemingly no reason, and for what? So I can do less work at the expense of having to take the bus or drive? It's stupid.

So practices like Rehab Hospitals / Surgical Centers / Etc have only so much wiggle room, but behind the front line of Nurses, Therapists, Doctors, and other Medical Professionals are people like me: Data nerds, support staff, IT, data techs, medical records people, business admin people. Offices full of cubicles, office chatter, office politics. Nothing is inefficient like office co-workers, I was one of them. Though admittedly my issue is brevity, not unproductive chatter. My boss and I often had high level talks with management, I had to relay complicated clinical data to the psychologists, and don't get me started on our research program or the staffing there-in.

You can't replace some of these jobs, for sure, because uh... holy fuck Integrated Care is a huge boon. Being able to walk down the hall to the patient's therapist to check in on something is incredible for efficiency and the corporation that owned us made it hard to do business if you didn't bring an A game to your key positions and talent. But on the flip-side, much of the support staff and back-office lurkers were so lackadasical and unbothered with speed, I can't help but think that their proximity to the CEO's office was why they were kept over some of us. This is your Psychology of Community and Salience lesson for the day: being around someone ambiently makes you often more favorable compared to noteworthy peers who are not. Especially if the person you're around is making decisions and sees you work at a decent pace, compared to the me's of the world who slam out data charts and figures without so much as a peep.