I think thoughts and conversations like this in my head all the time. What follows is heavily redacted compared to what I would wish I could say and do. That is just my nature, and something I failed to find a way around. I feel I needed to find a way through, and failed. What I write here is kind of a cross between a lament and an epilogue. Perhaps one day someone on the Exterior will understand and progress will be made, perhaps not.
So there is a lot that Anxa simply didn't permit me to say. I had a major go at blasting through it: 2017 and 2018. The only result was a few pages of paper with the art therapist in hospital. Essentially everything I came up with with the counsellor is lost to the winds of time.
So Anxa. If there is some contingency marked 'avoid at all costs', and there are such contingencies, quite a few of them in fact, that I can't write here even now. Any path leading to that contingency is labelled 'avoid'. Then any path leading to a place labelled 'avoid' is also labelled 'avoid. And so it goes recursively. So the 'black hole' of no-go areas grows. Moreover, if I try something, like I did in 2017, and it fails, more paths are marked 'avoid': many options are one-shot affairs, like trying to break through the walls of anxiety. I tried that, it failed. I tried to explain what I am describing here, again in 2017 with Amanda and 2018 with the art therapist on Russell. That failed too: basically nobody wanted to know. All sold on the simplistic (naively hopelessly simplistic) idea that I had an illness that was some kind of chemical balance, and that all I needed to do was take my medication and all would be well.
The trouble with suppressing warning signs is that, if those warning signs aren't erroneous, then what they warn of is still festering away, as it is with me. Later on, perhaps much later, something bad happens that those on the outside world can see. Perhaps somebody whose depression was treated by antidepressants suddenly finds themselves in a position where the depression-suppression of the chemicals no longer works sufficiently, the underlying problem comes to the surface, and they throw themselves off a bridge. And then people will have the gall to say that there were no warning signs: the reason there were no warning signs is that the medical people, in their infinite wisdom, suppressed those warning signs with chemicals and then, seeing no warning signs, considered the treatment a success, their job done.
Now some may talk of 'evidence of efficacy' of medication through clinical trials. Again things are hopelessly naive. The brain is a neural network composed of neurons, not simply a random mass of neurons in the way that a muscle is a random mass of muscle fibres. How those neurons are connected matters massively, and the number of possible qualitatively distinct ways those neurons can be connected is astronomical. So to take a representative sample of people exhibiting symptoms of mania, you need a representative sample of the space of possible brain configurations: you need a representative sample comprising more people than exist on our planet. Then there is the mania=mania problem: two people exhibiting mania may have the same problem, or their problems may only have the symptoms of mania in common. How many qualitatively distinct ways can a brain misbehave so as to exhibit what would be considered symptoms of mania? If the answer isn't 1 (and I expect the answer is greater than the number of humans living on our planet), then it is no longer valid to simply collect together people with a diagnosis of mania, split them into groups, and try different treatments on each group. Just as one sometimes needs to differentiate patients based on things like blood type, so it is necessary to ask "is Alice's mania the same kind of mania as Bob's?" There isn't a single, uniform type of mania, and without that simple uniformity, a clinical trial to test for treatments for mania has problems.
To give simple examples of this naivety, consider if we grouped people together based only on their having some kind of pain in their head. Some had dental pains, some had migraines, some had brain tumours. Then we find that prescribing strong pain killers makes the pain go away, and that if the person stops taking those strong painkillers, the pain comes back. In the case of the one with a brain tumour, simply suppressing the pain with painkillers is likely a fatal mistake. So it is with mental health. Or suppose we tried suppressing angina with painkillers, and if and when the sufficiently strong painkillers stop the person feeling the pain of their angina, we consider the problem solved. What then?