The old person's lament

The poem below is about Ulysses -- more accuratey rendered as Odysseus -- Homer's hero in ancient Greece and king of Ithaca. Its line "I cannot rest from travel" summarizes a lot of old people today

Ulysses
BY ALFRED, LORD TENNYSON
It little profits that an idle king,
By this still hearth, among these barren crags,
Match'd with an aged wife, I mete and dole
Unequal laws unto a savage race,
That hoard, and sleep, and feed, and know not me.
I cannot rest from travel: I will drink
Life to the lees: All times I have enjoy'd
Greatly, have suffer'd greatly, both with those
That loved me, and alone, on shore, and when
Thro' scudding drifts the rainy Hyades
Vext the dim sea: I am become a name;
For always roaming with a hungry heart
Much have I seen and known; cities of men
And manners, climates, councils, governments,
Myself not least, but honour'd of them all;
And drunk delight of battle with my peers,
Far on the ringing plains of windy Troy.
I am a part of all that I have met;
Yet all experience is an arch wherethro'
Gleams that untravell'd world whose margin fades
For ever and forever when I move.
How dull it is to pause, to make an end,
To rust unburnish'd, not to shine in use!
As tho' to breathe were life! Life piled on life
Were all too little, and of one to me
Little remains: but every hour is saved
From that eternal silence, something more,
A bringer of new things; and vile it were
For some three suns to store and hoard myself,
And this gray spirit yearning in desire
To follow knowledge like a sinking star,
Beyond the utmost bound of human thought.

This is my son, mine own Telemachus,
To whom I leave the sceptre and the isle,—
Well-loved of me, discerning to fulfil
This labour, by slow prudence to make mild
A rugged people, and thro' soft degrees
Subdue them to the useful and the good.
Most blameless is he, centred in the sphere
Of common duties, decent not to fail
In offices of tenderness, and pay
Meet adoration to my household gods,
When I am gone. He works his work, I mine.

There lies the port; the vessel puffs her sail:
There gloom the dark, broad seas. My mariners,
Souls that have toil'd, and wrought, and thought with me—
That ever with a frolic welcome took
The thunder and the sunshine, and opposed
Free hearts, free foreheads—you and I are old;
Old age hath yet his honour and his toil;
Death closes all: but something ere the end,
Some work of noble note, may yet be done,
Not unbecoming men that strove with Gods.
The lights begin to twinkle from the rocks:
The long day wanes: the slow moon climbs: the deep
Moans round with many voices. Come, my friends,
'T is not too late to seek a newer world.
Push off, and sitting well in order smite
The sounding furrows; for my purpose holds
To sail beyond the sunset, and the baths
Of all the western stars, until I die.
It may be that the gulfs will wash us down:
It may be we shall touch the Happy Isles,
And see the great Achilles, whom we knew.
Tho' much is taken, much abides; and tho'
We are not now that strength which in old days
Moved earth and heaven, that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.

East German revival picking up

East Germans make up 14% of the country’s overall population but remain underrepresented in elite positions in big German companies, universities and government. None of the 40 blue-chip businesses traded on the Frankfurt stock exchange are located in the five states that used to form the German Democratic Republic, where GDP per capita is about 22% lower than in the west.

But a boom in eastern German cities, and the clusters of industry that surround them, is changing the picture. After years of dragging behind the rest of the country, Berlin – divided during the cold war but geographically very much an eastern city – has seen its GDP rise above the national average since 2020. Surrounding Brandenburg has been lifted by the arrival of Tesla’s first factory for electronic cars in Europe.

As supply chains fray around the globe, branches of industry are choosing Germany’s east for their return to Europe. Chipmaker Intel announced in March it would build two semiconductor factories in the city of Magdeburg, while a Canadian clean tech company is building Europe’s first lithium converter in Guben, Brandenburg.

Ample space, locally sourced renewable energy and federal subsidies exclusive to the eastern states are proving incentives, as is a high-speed rail network completed in 2017, connecting Saxony, Saxony-Anhalt and Thuringia to Berlin in the north and Munich in the south.

A feeling of being “left behind” in a transforming economy, one analysis by the left-liberal thinktank Progressives Zentrum found, was now as likely to be found in western regions such as the Ruhr valley or the Saarland. “East versus west, that’s a story of the past,” said Andrä Gärber, of the Social Democratic party (SPD)-tied Friedrich Ebert Foundation.

A newfound swagger was also on display when Schneider last week hosted a delegation of UK Labour party delegates searching for lessons to be drawn for England’s north, which has been economically outperformed by eastern Germany for over a decade.

“Their challenges are in a different league,” said one SPD delegate in the Thuringian state parliament after a lunchtime discussion in the spa town of Bad Tabarz with Lisa Nandy, the British shadow minister for levelling up, housing and communities.

At last September’s vote, Scholz’s SPD swept to victory in part due to massive gains in the north-east, where it fought back the conservative Christian Democratic Union and the far-right Alternative für Deutschland (AfD) mainly by focusing on economic issues such as wages and leaving culture wars to one side.

Identity politics, Schneider said, were toxic to voters in the east: “Because the East German state invested so much effort in telling its people how to speak, people are absolutely allergic here to being educated through language.”

Yet eastern Germany’s economic success stories remain fragile. Half a year into its job, Scholz’s government has moved quickly to pass a new minimum wage increase to €12 (£10.20) an hour, which comes fully into effect as of 1 October and will benefit every third or fourth worker in low-income regions such as Brandenburg or Mecklenburg-Vorpommern. But as Russia’s war in Ukraine is massively driving up the cost of living with rising gas prices and spiralling inflation, such political victories may soon barely register with voters as vows on wages are put to the test over the coming months.

One instrument through which the SPD and its Green and liberal coalition partners have vowed to drive up wages and union memberships is the Tariftreuegesetz – a law to make sure public contracts are only awarded to companies that are party to collective bargaining agreements.

While similar laws are already in place in 14 out of 16 German states, they are not always enforceable. “If we can only find companies that aren’t bound by collective bargaining agreements, then we have to go with them,” said Diana Lehmann, an SPD delegate in the Thuringian parliament.

Near Erfurt, where Schneider gained a direct mandate at least year’s federal elections, the Chinese battery manufacturer CATL is now building its first non-Chinese production facility for €1.8m, which it says will offer about 2,000 jobs in the area in the long run. But, for now, the Chinese company has mainly brought in Chinese workers, with rumours that the management is put off from hiring locally by German labour laws requiring eight-hour working days. Wages are said to be lower than hoped for.

With public attention focused on gas pipelines and arms deliveries, the government has also barely started to make the politically sensitive case that Germany needs to find political answers not just to a shortage of gas to power its industry, but also of workers.

“We have a massive labour shortage in all areas,” said Schneider. “Germany will need 7 million more workers by 2030. For this reason we are going to introduce one of the most liberal immigration laws in the world. And we will do it in such a way that it won’t lead to wage dumping.”

https://www.msn.com/en-au/money/markets/a-new-confidence-the-east-german-economy-finally-gets-a-boom/ar-AAZLVNG?li=AAgfYrC

Insomnia breakthrough as scientists discover the two most effective drugs yet

Oxford University experts examined more than 150 studies that tested the effects of 30 different drugs on thousands of adults suffering from sleeping problems.

Eszopiclone, sold under the brand Lunesta, and lemborexant, marketed as Dayvigo, were best for easing insomnia symptoms.

They worked better than benzodiazepines and Z-drugs, two powerful sleeping pills NHS bosses are trying to phase out.

Both pills are already used across Europe and the US. They are hypnotics which work by calming the brain to get someone to sleep very quickly.

Study leader Professor Andrea Cipriani said he expects British regulators to consider approving both drugs in light of the findings.

However, he noted they can trigger side effects, such as headaches, dizziness and nausea — similar to addictive benzodiazepines.

Professor Cipriani said non-pharmaceutical treatments, such as therapy, should still be the first-line treatment.

The problem, which affects one in six Britons, can usually get better if sufferers change their sleeping habits.

Symptoms include finding it hard to sleep, waking up several times in the night, waking up early and struggling to get back to sleep.

It can be triggered by stress, anxiety or depression, noise, a room that is too hot or cold, an uncomfortable bed, shift work, alcohol, caffeine or nicotine, as well as recreational drugs.

Adults need seven to nine hours of sleep per night.

Insomnia a can be short term – lasting three months or less  or long-term if it persists for more than 12 weeks.

Treatments include cognitive behavioural therapy (CBT) sessions with a therapist, which can help change thoughts and behaviours that stop people from sleeping.

GPs rarely prescribe sleeping pills over concerns about their side effects and drug dependency.

Insomnia — defined as regular sleeping difficulties — is thought to affect up to one in 10 people in Europe.

It can lead to reduced productivity, increased absence from work and a higher risk of accidents.

Insomnia is also heavily linked with mental health disorders like depression as well as alcohol dependence.

First-line treatment includes encouraging 'sleep hygiene', simple methods like going to bed at the same time every night, exercising and limiting caffeine before bed.

Some patients may be referred for cognitive behavioural therapy — talking therapy that aims to manage problems by changing the way a person thinks. Britons can also be prescribed an app that provides a six-week self-help programme.

GPs may also prescribe sleeping pills. But this is rarely done as the drugs can trigger serious side effects and addiction.

However, 300,000 people in England are thought to be long-term users of Z-drugs and benzodiazepines.

Some take the drugs for other reasons, such as anxiety.

Professor Cipriani told a briefing for health and science journalists today there is 'little evidence' about how effective sleeping pills are in comparison to each other.

This raised the question of whether doctors are 'prescribing the right medication' to those who need it, she said.

Their study, published in The Lancet, reviewed 154 published and unpublished trials — completed by November 2021.

Experiments assessed tested effectiveness of 30 different insomnia drugs, in 44,089 adults with sleeping difficulties.

They looked at patients who were given drugs for four weeks — as well as those who took medication for three months.

Three-quarters were given a sleeping pill, while a quarter were given a placebo drug.

Volunteers reported their quality of sleep, whether they stopped taking the pill and any adverse events — such as dizziness, nausea, fatigue, headache and drowsiness.

The findings showed that eszopiclone and lemborexant out-performed other drugs.

A quarter of short-term eszopiclone-users reported that their symptoms improved, while 38 per cent of those who took it for three months said they were able to sleep more easily.

Meanwhile, one in five volunteers on lemborexant said their symptoms improved at four weeks, while 35 per cent said they had eased after three months.

However, researchers warned that up to half of patients on the two drugs were left feeling unwell.

For comparison, benzodiazepines, which is offered to patients in the UK, were found to be effective in the short-term — easing up to three in 10 users' symptoms.

But the researchers noted that information on their long-term effects is not available and patients do not tolerate them well, with up to six in 10 reporting side effects.

Z-drugs, such as zaleplon, benefited as few as 16 per cent of patients and also lacked long-term data.

And melatonin, another drug offered on the NHS, failed to show any material benefits, with only 18 per cent noticing an improvement and four in 10 reporting side effects, the team said.

The researchers stated the safety data on lemborexant was inconclusive but there appeared to be a risk of headaches, while eszopiclone-users reported dizziness and nausea.

Further studies are needed to determine how safe the two drugs are over time, the researchers said.

Professor Cipriani, a psychiatrist at the University of Oxford, said the findings are 'the most transparent and comprehensive picture of all the data available' on insomnia drugs.

He said the results can help doctors identify the most appropriate drug for their insomnia patients and said regulators should take the findings into account when deciding whether to approve eszopiclone and lemborexant.

'Clearly, the need to treat insomnia as effectively as possible is very important, as it can have knock-on effects for a patient’s health, their home lives and the wider health system,' Professor Cipriani said.

However, he warned that the study is 'not a recommendation that drugs should always be used as the first line of support to treat insomnia', warning that some can have 'serious side effects'.

But Professor Cipriani noted that the research shows some drugs 'can also be effective, and should be used in clinical practice, when appropriate'.

'For example, where treatments such as improved sleep hygiene and CBT have not worked, or where a patient wants to consider taking medication as part of their treatment,' he added.

https://www.dailymail.co.uk/health/article-11013087/Insomnia-breakthrough-scientists-discover-two-effective-drugs-yet.html

Antidepressants Overprescribed, Linked to Suicide Risk

Cases of depression and anxiety increased by 25 percent in the first year of the COVID-19 pandemic alone by some counts, up from 1 in 20 adults worldwide, and the use of antidepressants has become more common. However, studies have found that antidepressants have unexpected risks.

In the 1960s, it was discovered that depression could be due to a lack of serotonin in the brain. Back then, people believed that serotonin was the “happiness factor” in humans. Serotonin is actually a neurotransmitter. The presynaptic neurons release serotonin and can also reuptake it into the brain to maintain homeostasis.

Thus, drugs were designed with the crude understanding that if the “recycling” pathway for serotonin is blocked, serotonin levels in body fluids will increase, and the symptoms will be relieved.

The main mechanism of the most common classes of antidepressant drugs, which include selective serotonin reuptake inhibitors (SSRIs), noradrenaline, and serotonin and norepinephrine reuptake inhibitors (SNRIs), involves the regulation of serotonin and the uptake of other neurotransmitters.

Although there may seem to be many options available, all of these drugs actually work based on similar mechanisms.

The current antidepressants have a large flaw in their mechanisms, but they are still used in large quantities.

Antidepressants Are Being Used Heavily
People suffer from depression for various reasons, and the degree of depression also varies greatly, so there should be a more comprehensive consideration of medication use. However, many doctors may prescribe antidepressants in the same way as painkillers: in increasing dosages after the effectiveness of the drugs diminishes, resulting in drug abuse.

Currently, approximately 13 percent of adults and 18 percent of adult women in the United States have taken antidepressants in the past 30 days. This is an alarming number.

In addition, there has been a rapid increase in the number of young antidepressant users. While it used to be mostly adults taking these drugs, a significant number of adolescents aged 13 to 19 are now taking them as well. Adolescents are prone to emotional instability, and taking medication whenever they have emotional problems will cause them to develop a dependence on medications, instead of figuring out the problems they encounter as they grow up, getting mature emotionally or seeking help from their family, friends, and other sources.

Antidepressants May Raise Suicide Risk

So, is there a risk associated with the use of antidepressants in such a large population?

A study published in Frontiers in Psychiatry looked at the antidepressant prescription rates and suicide rates in Australia since 2012 and found a consistent upward trend in both data.

The Food and Drug Administration (FDA) warned in 2004 that children and adolescents taking antidepressants were at increased risk of suicide, including suicidal thoughts and behaviors.

At that time, the FDA used a “black-box warning” label for all classes of antidepressants, which is the highest warning level given by the FDA for an approved drug, and it can be seen on the drug packaging. The warning went into effect in 2005; and in 2006, the warning was expanded to include people 25 years of age.

The “black box warning” is used to warn the public and prescribers about serious, permanent, or fatal side effects—it thus requires evidence of significant risk, meaning that these warnings are generally added after drugs have already been on the market.

Although the warning was once taken seriously by the industry, it did not stop the social environment from encouraging the use of chemicals to control mental problems. As a result, the use of antidepressants declined only briefly and rose again after 2006.

Moreover, antidepressants have brought large profits to pharmaceutical companies worldwide. In 2020, the market for antidepressants reached $15 billion.

A research published in the British Medical Journal further confirms that the risk of suicide attempts is significantly higher in the 28 days after taking antidepressants than before. Moreover, symptoms may rebound severely in the short term after stopping the medication, so suicidal tendencies are also elevated during the withdrawal phase.

If a patient is suffering from severe depression and urgently needs help, it takes a long time to see the effects of the medication.  Under this circumstance, many doctors often prescribe a higher dose of antidepressant drugs for patients.   However, the higher dose of drugs may further worsen the patient’s symptoms.  This is also a major problem like a vicious cycle.

Our Understanding of Serotonin Was Wrong

A more critical issue is that our understanding of depression may have been wrong from the beginning.

Many are raising questions about this.

A review by experts from Canada and the University of Virginia was published in the journal Neuroscience & Biobehavioral Reviews. This article collected a large number of studies related to serotonin and found that the concept that the amount of serotonin determines changes in people’s mood is wrong.

It was first discovered that the association between the amount of serotonin and mental status is not a single one. When depressed, the amount of serotonin does not necessarily drop, and in many cases, it actually rises. This is because serotonin changes in the brain are difficult to measure, and previous testing techniques had its limitations.

Moreover, serotonin is not just a “happiness factor.” It is a complex system that is closely related to the energy regulation of many organ systems in the body.

In addition to the brain, serotonin also acts on many other organs throughout the body. And it affects the operation of many bodily functions, including mitochondrial energy production, which involves energy storage. Serotonin also directly affects the metabolism of sugar and the distribution and absorption of energy in different organs, as well as the immune system, the body’s growth and development, and fertility. SSRIs can actually disrupt the energy balance of many systems in the body, thus bringing many problems.

The review also pointed out that after some people took antidepressants for a period of time, their depression symptoms were alleviated, but the improvement might not actually be brought about by the medicines. Rather, the drugs disrupted the serotonin and energy balances, prompting the body to make self-protective and compensatory adjustments.

This is equivalent to a complete overturn of the antidepressant mechanism developed in the 1960s.

Unfortunately, this was not widely reported in the media, as it was a rather profound academic paper.

With further advancement in brain science and neuroscience research over the past few decades, scientists have continued to discover that the effects of serotonin on the brain are not as simple as we once thought, and that these concepts were unknown at the early time of antidepressant drug development.

For example, if there is a problem with the serotonin level in the hippocampus, it will cause memory loss and reduces the brain-derived neurotrophic factor signaling; if there is a problem with the serotonin level in the hypothalamus, it will affect the body’s ability to grow, reproduce, and do physical activities.

It can be seen that the brain is a complex system, and the effects of a substance on different parts of the brain are different. The use of drugs to directly disturb the balances of serotonin and other substances will cause greater disruptions in the body.

Side Effects of Antidepressants

The side effects of antidepressants also vary. Examples include severe insomnia, drowsiness, sexual dysfunction, and a higher probability of bleeding death after surgery, among others. In addition, antidepressants and many drugs, including hypertensive drugs, should not be taken together.

A study published in the Journal of Clinical Medicine found that many antidepressant drugs can cause sexual dysfunction, with the prevalence of some being as much as 20 percent to 30 percent.

In addition, the discontinuation of long-term use of antidepressant medications will also lead to numerous side effects, including sensory problems. This is because when people become accustomed to chemical dependency, their level of cognition is lowered, making them prone to numbness, sensory and cognitive disturbances, insomnia, nightmares, and other problems.

The body functions can also become dysfunctional when an antidepressant drug is discontinued. Since more than 90 percent of the serotonin acts on different organs of the body, the effects of the drugs are systemic. Diarrhea, nausea, muscle stiffness, problems with reflexes, hypothermia, and even shock may occur.

Therefore, it is still important to pay attention to the dosage when taking medication at home.

Conventional medicine focuses on using material changes to explain everything and using chemical changes to explain mental illnesses, and then developing drugs based on this “explanation.” However, with further research, it may be found that the initial “explanation” is wrong, and that the drugs developed can do more harm than good.

So, besides chemical drugs, what else can be used to treat depression and other mental illnesses?

Some psychologists will perform cognitive therapies for patients before prescribing medication, and one of them is cognitive behavioral therapy (CBT). Psychologists talk to patients to understand their problems and help them find ways to relieve them. This type of communication is helpful to many people to a certain degree.

https://www.theepochtimes.com/antidepressants-overprescribed-linked-to-suicide-risk_4585634.html