One of the most important habits that I’ve formed in my life is daily writing.
Without question, writing every day has brought me many great things: A better career, fulfillment, self-improvement, and most importantly, the ability to share my ideas with you, the reader.
I wanted to be a writer for a decade before I became one. All it took was a decision. At some point, you have to look at yourself and say, “I’m a writer.” And then, start doing your job by writing every day.
I recommend that to everyone because of these 5 reasons:
- Better self-discipline
Living a life of pleasure is simple. Everyone can “Netflix and chill.” It’s easy to “hang out” all the time. But those easy things will not give you inner satisfaction. The reason that we don’t do anything useful with our precious time is that we lack self-discipline. But when you write every day, you strengthen your discipline. You can use that better self-discipline to achieve virtually anything in life.
- Improving you persuasion skills
Writing is nothing more than persuading the reader with words. But your tools are limited—you can only use words to tell a story. And when you write for yourself, you’re trying to convince yourself of your own thoughts. So the more you write, the better you become at persuasion.
- Cultivating self-awareness
Nothing will help you to get to know yourself more than translating your thoughts into words. When you force yourself to write every day, you automatically become more aware of your thoughts. And self-awareness is one of the most important skills that predict career success.
- Better decision making
Too often, we do something without fully understanding why we do it. Think about it. How often do you answer “I don’t know” when someone asks you “Why did you do that?” That’s the sign of weak thinking. Sure, we don’t know everything. But we must aware of that too. And when you write about your decision-making process, you will automatically become more aware of the “why.”
- Seeing the power of compounding in action
When you do something every day, you don’t notice any difference at that moment. You think, “Where are the benefits?” But when you keep doing it for a long time, the positive effects compound. Writing every day will demonstrate the power of compounding like very few other things can.
To be honest, there are many other benefits to writing every day. It’s great for reflection, dealing with anxiety, coming up with new ideas. On top of that, you can use writing to inspire others or achieve your goals.
“That’s great and all. But how do you even form a daily writing habit?”
Here are 4 tips that can help you with that:
- Read & study
Start by stealing other people’s writing styles. It’s a strategy I learned from Austin Kleon. Stealing is an effective way to develop your own style. Plus, when you can steal ideas, you can never use the excuse of: “I don’t have any inspiration.” But take the craft of writing seriously. Study it as much as you can by reading books and taking courses/workshops.
- Set a daily reminder to write
Nothing is more important to a writer than having a routine. First, think about what time is the best for you to write. In the morning or evening? Before/after the kids are awake? Then, set a daily reminder on your phone—when it goes off, sit down and write.
- Set the bar low
Your goal is to write only one true sentence. Just one. The beauty of that goal is that the first sentence that comes up in your mind is always the truest of them all. So never say that your writing sucks. Avoid aiming for setting goals like, “I want to write 1000 words a day.” That’s too absolute. Instead, strive for writing one sentence. Then, keep going.
- Remove distractions
Tell the people in your life about your daily writing habit. Ask them to not disturb you during the time you’re writing. I block 3 hours every morning. During that time, I put my phone in do not disturb mode, don’t take calls, and don’t answer to messages—I write. I’ve told my family and girl about this too so they don’t disturb me during that time.
Often, people give advice like, “just get started!” And there’s truth in that. Starting is important.
But here’s the thing: Everyone can write for a day—or two, or three. But there are very few people who write consistently for years. But you need to write for a long time to see the actual benefits.
So don’t just get started. Keep going.
There are several reasons, but one of the most important is that it is far cheaper to keep computer servers cool when they’re on the seafloor. This cooling is not a trivial expense. Precise estimates vary, but currently about 5 percent of all energy consumption in the U.S. goes just to running computers—a huge cost to the economy as whole. Moreover, all that energy used by those computers ultimately gets converted into heat. This results in a second cost: that of keeping the computers from melting.
These issues don’t only arise in artificial, digital computers. There are many naturally occurring computers, and they, too, require huge amounts of energy. To give a rather pointed example, the human brain is a computer. This particular computer uses some 10–20 percent of all the calories that a human consumes. Think about it: our ancestors on the African savanna had to find 20 percent more food every single day, just to keep that ungrateful blob of pink jelly imperiously perched on their shoulders from having a hissy fit. That need for 20 percent more food is a massive penalty to the reproductive fitness of our ancestors. Is that penalty why intelligence is so rare in the evolutionary record? Nobody knows—and nobody has even had the mathematical tools to ask the question before.
There are other biological computers besides brains, and they too consume large amounts of energy. To give one example, many cellular systems can be viewed as computers. Indeed, the comparison of thermodynamic costs in artificial and cellular computers can be extremely humbling for modern computer engineers. For example, a large fraction of the energy budget of a cell goes to translating RNA into sequences of amino acids (i.e., proteins), in the cell’s ribosome. But the thermodynamic efficiency of this computation—the amount of energy required by a ribosome per elementary operation—is many orders of magnitude superior to the thermodynamic efficiency of our current artificial computers. Are there “tricks” that cells use that we could exploit in our artificial computers? Going back to the previous biological example, are there tricks that human brains use to do their computations that we can exploit in our artificial computers?
More generally, why do computers use so much energy in the first place? What are the fundamental physical laws governing the relationship between the precise computation a system runs and how much energy it requires? Can we make our computers more energy-efficient by redesigning how they implement their algorithms?
These are some of the issues my collaborators and I are grappling with in an ongoing research project at the Santa Fe Institute. We are not the first to investigate these issues; they have been considered, for over a century and a half, using semi-formal reasoning based on what was essentially back-of-the-envelope style analysis rather than rigorous mathematical arguments—since the relevant math wasn’t fully mature at the time.
However, this early work was also limited by the fact that it tried to apply equilibrium statistical physics to analyze the thermodynamics of computers. The problem is that, by definition, an equilibrium system is one whose state never changes. So whatever else they are, computers are definitely nonequilibrium systems. In fact, they are often very-far-from-equilibrium systems.
Fortunately, completely independent of this early work, there have been some major breakthroughs in the past few decades in the field of nonequilibrium statistical physics (closely related to a field called “stochastic thermodynamics”). These breakthroughs allow us to analyze all kinds of issues concerning how heat, energy, and information get transformed in nonequilibrium systems.
These analyses have provided some astonishing predictions. For example, we can now calculate the (non-zero) probability that a given nanoscale system will violate the second law, reducing its entropy, in a given time interval. (We now understand that the second law does not say that the entropy of a closed system cannot decrease, only that its expected entropy cannot decrease.) There are no controversies here arising from semi-formal reasoning; instead, there are many hundreds of peer-reviewed articles in top journals, a large fraction involving experimental confirmations of theoretical predictions.
Now that we have the right tools for the job, we can revisit the entire topic of the thermodynamics of computation in a fully formal manner. This has already been done for bit erasure, the topic of concern to Landauer and others, and we now have a fully formal understanding of the thermodynamic costs in erasing a bit (which turn out to be surprisingly subtle).
However, computer science extends far, far beyond counting the number of bit erasures in a given computation. Thanks to the breakthroughs of nonequilibrium statistical physics, we can now also investigate the rest of computer science from a thermodynamic perspective. For example, moving from bits to circuits, my collaborators and I now have a detailed analysis of the thermodynamic costs of “straight-line circuits.” Surprisingly, this analysis has resulted in novel extensions of information theory. Moreover, in contrast to the kind of analysis pioneered by Landauer, this analysis of the thermodynamic costs of circuits is exact, not just a lower bound.
Conventional computer science is about all about trade-offs between the memory resources and number of timesteps needed to perform a given computation. In light of the foregoing, it seems that there might be far more thermodynamic trade-offs in performing a computation than had been appreciated in conventional computer science, involving thermodynamic costs in addition to the costs of memory resources and number of timesteps. Such trade-offs would apply in both artificial and biological computers.
Clearly there is a huge amount to be done to develop this modern “thermodynamics of computation.”
Be on the lookout for a forthcoming book from the SFI Press, of contributed papers touching on many of the issues mentioned above. Also, to foster research on this topic we have built a wiki, combining lists of papers, websites, events pages, etc. We highly encourage people to visit it, sign up, and start improving it; the more scientists get involved, from the more fields, the better!
HEMLIBRA® is indicated for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adult and pediatric patients ages newborn and older with hemophilia A with or without factor VIII inhibitors.
Important Safety Information
Boxed WARNING: THROMBOTIC MICROANGIOPATHY and THROMBOEMBOLISM
Cases of thrombotic microangiopathy and thrombotic events were reported when on average a cumulative amount of >100 U/kg/24 hours of activated prothrombin complex concentrate (aPCC) was administered for 24 hours or more to patients receiving HEMLIBRA prophylaxis. Monitor for the development of thrombotic microangiopathy and thrombotic events if aPCC is administered. Discontinue aPCC and suspend dosing of HEMLIBRA if symptoms occur.
Warnings and Precautions
Thrombotic Microangiopathy (TMA) and Thromboembolism Associated with HEMLIBRA and aPCC
In clinical trials, TMA was reported in 0.8% of patients (3/391) and thrombotic events were reported in 0.5% of patients (2/391). In patients who received at least one dose of aPCC, TMA was reported in 8.1% of patients (3/37) and thrombotic events were reported in 5.4% of patients (2/37). Patients with TMA presented with thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury, without severe deficiencies in ADAMTS13.
Consider the benefits and risks if aPCC must be used in a patient receiving HEMLIBRA prophylaxis. Monitor for the development of TMA and/or thromboembolism when administering aPCC. Immediately discontinue aPCC and interrupt HEMLIBRA prophylaxis if clinical symptoms, imaging, or laboratory findings consistent with TMA and/or thromboembolism occur, and manage as clinically indicated. Consider the benefits and risks of resuming HEMLIBRA prophylaxis following complete resolution of TMA and/or thrombotic events on a case-by-case basis.
Laboratory Coagulation Test Interference
HEMLIBRA affects intrinsic pathway clotting-based laboratory tests, including activated clotting time (ACT); activated partial thromboplastin time (aPTT); and all assays based on aPTT, such as one-stage, factor VIII (FVIII) activity. Therefore, intrinsic pathway clotting-based coagulation laboratory test results in patients who have been treated with HEMLIBRA prophylaxis should not be used to monitor HEMLIBRA activity, determine dosing for factor replacement or anti-coagulation, or measure FVIII inhibitor titers.
Results affected by HEMLIBRA: aPTT; Bethesda assays (clotting-based) for FVIII inhibitor titers; one-stage, aPTT-based single-factor assays; aPTT-based Activated Protein C Resistance (APC-R); ACT.
Results unaffected by HEMLIBRA: Bethesda assays (bovine chromogenic) for FVIII inhibitor titers; thrombin time (TT); one-stage, prothrombin time (PT)-based single-factor assays; chromogenic-based single-factor assays other than FVIII (see Drug Interactions for FVIII chromogenic activity assay considerations); immuno-based assays (ie, ELISA, turbidimetric methods); genetic tests of coagulation Factors (eg, Factor V Leiden, Prothrombin 20210).
Most Common Adverse Reactions
The most common adverse reactions (incidence ≥10%) are injection site reactions, headache, and arthralgia.
Characterization of aPCC Treatment in Pooled Clinical Trials
There were 130 instances of aPCC treatment in 37 patients, of which 13 instances (10%) consisted of on average a cumulative amount of >100 U/kg/24 hours of aPCC for 24 hours or more; 2 of the 13 were associated with thrombotic events and 3 of the 13 were associated with TMA. No TMA or thrombotic events were associated with the remaining instances of aPCC treatment.
Injection Site Reactions
In total, 85 patients (22%) reported injection site reactions (ISRs). All ISRs observed in HEMLIBRA clinical trials were reported as mild to moderate intensity and 93% resolved without treatment. The commonly reported ISR symptoms were injection site erythema (11%), injection site pruritus (4%), and injection site pain (4%).
Other Less Common (<1%) Reactions
Rhabdomyolysis was reported in 2 adult patients with asymptomatic elevations serum creatine kinase without associated renal or musculoskeletal symptoms. In both instances, the event occurred following an increase in physical activity.
Clinical experience suggests that a drug interaction exists with HEMLIBRA and aPCC.
Pregnancy, Lactation, Females and Males of Reproductive Potential
Women of childbearing potential should use contraception while receiving HEMLIBRA. It is not known whether HEMLIBRA can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. HEMLIBRA should be used during pregnancy only if the potential benefit for the mother outweighs the risk to the fetus. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for HEMLIBRA and any potential adverse effects on the breastfed child from HEMLIBRA or from the underlying maternal condition.
You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.
- Data on file. Genentech, Inc.
- Oldenburg J, Mahlangu JN, Kim B, et al. Emicizumab prophylaxis in hemophilia A with inhibitors. N Engl J Med. 2017;377(9):809-818, Supplement, and Protocol.
- Bos MHA, van ‘t Veer C, Reitsma PH. Molecular biology and biochemistry of the coagulation factors and pathways of hemostasis. In: Williams Hematology. 9th ed. McGraw-Hill Education; 2016:1915-1945.
- Dahlbäck B. Blood coagulation. Lancet. 2000;355:1627-1632.
- Kitazawa T, Esaki K, Tachibana T, et al. Factor VIIIa-mimetic cofactor activity of a bispecific antibody to factors IX/IXa and X/Xa, emicizumab, depends on its ability to bridge the antigens. Thromb Haemost. 2017;117:1348-1357.
What is HEMLIBRA?
HEMLIBRA® is a prescription medicine used for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adults and children, ages newborn and older, with hemophilia A with or without factor VIII inhibitors.
What is the most important information I should know about HEMLIBRA?
HEMLIBRA increases the potential for your blood to clot. Carefully follow your healthcare provider’s instructions regarding when to use an on-demand bypassing agent or factor VIII, and the dose and schedule to use for breakthrough bleed treatment. HEMLIBRA may cause the following serious side effects when used with activated prothrombin complex concentrate (aPCC; FEIBA®), including:
- Thrombotic microangiopathy (TMA). This is a condition involving blood clots and injury to small blood vessels that may cause harm to your kidneys, brain, and other organs. Get medical help right away if you have any of the following signs or symptoms during or after treatment with HEMLIBRA:
- swelling of arms and legs
- yellowing of skin and eyes
- stomach (abdomen) or back pain
- nausea or vomiting
- feeling sick
- decreased urination
- Blood clots (thrombotic events). Blood clots may form in blood vessels in your arm, leg, lung, or head. Get medical help right away if you have any of these signs or symptoms of blood clots during or after treatment with HEMLIBRA:
- swelling in arms or legs
- pain or redness in your arms or legs
- shortness of breath
- chest pain or tightness
- fast heart rate
- cough up blood
- feel faint
- numbness in your face
- eye pain or swelling
- trouble seeing
If aPCC (FEIBA®) is needed, talk to your healthcare provider in case you feel you need more than 100 U/kg of aPCC (FEIBA®) total.
Before using HEMLIBRA, tell your healthcare provider about all of your medical conditions, including if you:
- are pregnant or plan to become pregnant. It is not known if HEMLIBRA may harm your unborn baby. Females who are able to become pregnant should use birth control (contraception) during treatment with HEMLIBRA.
- are breastfeeding or plan to breastfeed. It is not known if HEMLIBRA passes into your breast milk.
Tell your healthcare provider about all the medicines you take, including prescription medicines, over-the-counter medicines, vitamins, or herbal supplements. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
How should I use HEMLIBRA?
See the detailed “Instructions for Use” that comes with your HEMLIBRA for information on how to prepare and inject a dose of HEMLIBRA, and how to properly throw away (dispose of) used needles and syringes.
- Stop (discontinue) prophylactic use of bypassing agents the day before starting HEMLIBRA prophylaxis.
- You may continue prophylactic use of factor VIII for the first week of HEMLIBRA prophylaxis.
What should I know about lab monitoring?
HEMLIBRA may interfere with laboratory tests that measure how well your blood is clotting and may cause a false reading. Talk to your healthcare provider about how this may affect your care.
The most common side effects of HEMLIBRA include: redness, tenderness, warmth, or itching at the site of injection; headache; and joint pain.
These are not all of the possible side effects of HEMLIBRA. Speak to your healthcare provider for medical advice about side effects.
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use HEMLIBRA for a condition for which it was not prescribed. Do not give HEMLIBRA to other people, even if they have the same symptoms that you have. It may harm them. You can ask your pharmacist or healthcare provider for information about HEMLIBRA that is written for health professionals.
You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.
Antidepressants Cause Severe Withdrawal Symptoms like “Hallucination”, “Mania” and “Anxiety”, New Study Reveals
New research reveals severe withdrawal symptoms in over half of those who discontinue antidepressant drugs, including lasting and even permanent damage.
A concerning new study published in the journal Addictive Behavior and titled “A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based?” reveals that antidepressants are far more addictive and harmful than previously assumed, and vindicates the long-time activism on this issue spearheaded by American psychiatrists like Kelly Brogan, MD and Peter Breggin, MD.
Highlights from the paper are as follows:
- More than half (56%) of people who attempt to come off antidepressants experience withdrawal effects.
- Nearly half (46%) of people experiencing withdrawal effects describe them as severe.
- It is not uncommon for the withdrawal effects to last for several weeks or months.
- Current UK and USA Guidelines underestimate the severity and duration of antidepressant withdrawal, with significant clinical implications.
This study aimed to assess the veracity of the the U.K.’s current National Institute for Health and Care Excellence and the American Psychiatric Association’s depression guidelines which state that withdrawal reactions from antidepressants are ‘self-limiting’ (i.e. typically resolving between 1 and 2 weeks).
In order to accomplish this goal the systematic review used the following methods:
“A systematic literature review was undertaken to ascertain the incidence, severity and duration of antidepressant withdrawal reactions. We identified 23 relevant studies, with diverse methodologies and sample sizes.”
The results were reported as follows:
“Withdrawal incidence rates from 14 studies ranged from 27% to 86% with a weighted average of 56%. Four large studies of severity produced a weighted average of 46% of those experiencing antidepressant withdrawal effects endorsing the most extreme severity rating on offer. Seven of the ten very diverse studies providing data on duration contradict the UK and USA withdrawal Guidelines in that they found that a significant proportion of people who experience withdrawal do so for more than two weeks, and that it is not uncommon for people to experience withdrawal for several months.”
Side effects were wide-ranging, lasting several months or longer (including permanent dysfunction), such as:
“Typical AD withdrawal reactions include increased anxiety, flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal. Dizziness, electric shock-like sensations, brain zaps, diarrhoea, headaches, muscle spasms and tremors, agitation, hallucinations, confusion, malaise, sweating and irritability are also reported (Warner, Bobo, Warner, Reid, & Rachal, 2006, Healy, 2012). Although the aforementioned symptoms are the most common physical symptoms, there is also evidence that AD withdrawal can induce mania and hypomania, (Goldstein et al., 1999; Naryan & Haddad, 2011) emotional blunting and an inability to cry, (HolguinLew & Bell, 2013) long-term or even permanent sexual dysfunction (Csoka & Shipko, 2006).”
The study concluded:
“We recommend that U.K. and U.S.A. guidelines on antidepressant withdrawal be urgently updated as they are clearly at variance with the evidence on the incidence, severity and duration of antidepressant withdrawal, and are probably leading to the widespread misdiagnosing of withdrawal, the consequent lengthening of antidepressant use, much unnecessary antidepressant prescribing and higher rates of antidepressant prescriptions overall. We also recommend that prescribers fully inform patients about the possibility of withdrawal effects.”
The researchers also noted that the rising numbers of antidepressant prescriptions used throughout the world may be fueled by the antidepressant drug withdrawal side effects themselves:
“As the lengthening duration of AD use has fuelled rising AD prescriptions over the same time period, we must understand the drivers of such lengthening use. The evidence set out suggests that lengthening use may be partly rooted in the underestimation of the incidence, severity and duration of AD withdrawal reactions, leading to many withdrawal reactions being misdiagnosed, for example, as relapse (with drugs being reinstated as a consequence) or as failure to respond to treatment (with either new drugs being tried and/or dosages increased). This issue is pressing as long-term AD use is associated with increased severe side-effects, increased risk of weight gain, the impairment of patients’ autonomy and resilience (increasing their dependence on medical help), worsening outcomes for some patients, greater relapse rates, increased mortality and the development of neurodegenerative diseases, such as dementia.”
The concerning implications of this study to millions around the world who are on antidepressants were immediately recognized by the media, as evidenced by mainstream reporting on the topic with the following headlines: