Transcript -- Bipolar Disorder, Dysregulation, and AI

L0001 [00:00] All right. So, my uh my mate uh Keen
L0002 [00:03] said quite last minute, would you uh
L0003 [00:05] submit a paper for this conference? And
L0004 [00:08] I thought, I'm really busy. I'm going to
L0005 [00:09] struggle to put anything together. I'm
L0006 [00:11] going to struggle to kind of like talk
L0007 [00:12] about engineering. I'm too busy doing
L0008 [00:14] it. So, I thought I'll submit this. No
L0009 [00:17] chance. Um fortunately or unfortunately,
L0010 [00:22] uh we're doing this one. So, I'm going
L0011 [00:24] to talk about bipolar disorder. uh what
L0012 [00:27] living with it has required me to learn
L0013 [00:30] and to become aware of and then I'm
L0014 [00:32] going to talk about the idea of
L0015 [00:33] regulators and disregulators. So these
L0016 [00:35] are things that can you know change or
L0017 [00:37] alter your state physically or mentally.
L0018 [00:39] These are a lot of ideas that have been
L0019 [00:41] in my head for a long time which is why
L0020 [00:42] I chose this topic because I thought I
L0021 [00:44] can probably put something together uh
L0022 [00:46] probably not talk about it very well but
L0023 [00:48] at least talk about it authentically. Um
L0024 [00:52] so here we go. Just a bit of a
L0025 [00:54] disclaimer. Mental health. It's a
L0026 [00:56] complex topic. Be kind to each other.
L0027 [00:58] You don't know what other people are
L0028 [01:00] living through or going through. Be kind
L0029 [01:02] to yourself. If you're not sure about
L0030 [01:04] yourself or friends or others, talk to a
L0031 [01:06] medical professional. Um or talk to the
L0032 [01:09] Samaritans. They're really good as well.
L0033 [01:12] So, that's the disclaimer done.
L0034 [01:16] So, when I was diagnosed with bipolar
L0035 [01:19] disorder, I didn't agree with the
L0036 [01:21] diagnosis and I didn't understand it
L0037 [01:23] because I thought bipolar was kind of
L0038 [01:25] like this. You know, you're a little bit
L0039 [01:27] up, you're a little bit down. That was
L0040 [01:30] my understanding of bipolar disorder.
L0041 [01:32] And that was not what was happening with
L0042 [01:35] my life or my experiences or my
L0043 [01:37] symptoms. They were far more complex.
L0044 [01:39] They were far more chaotic. there were
L0045 [01:41] things that had happened that I didn't
L0046 [01:43] understand or didn't even really
L0047 [01:45] remember. Um, so what I learned is that
L0048 [01:49] uh bipolar disorder can be sometimes a
L0049 [01:52] bit more like this where you can appear
L0050 [01:55] well and going through normal states or
L0051 [01:58] these states can get very very very
L0052 [02:00] intense both up and down and very
L0053 [02:03] chaotic and then it can all kind of
L0054 [02:05] normalize again. So this is uh this is
L0055 [02:10] what it is. it's more disordered and
L0056 [02:11] these uh higher states can be very
L0057 [02:13] extreme. They can be hyper manic which
L0058 [02:15] is just often high energy, not sleeping,
L0059 [02:18] lots of pressure talking, this sort of
L0060 [02:20] thing. They can go into mania which is
L0061 [02:23] prolonged periods of severe impulsive
L0062 [02:25] behavior, damaging behavior, complex
L0063 [02:28] behavior. And it can go all the way to
L0064 [02:30] psychosis um in its most extreme forms.
L0065 [02:33] In the lower zones, it can be very
L0066 [02:37] similar to unipolar depression and it
L0067 [02:39] can be similar to uh major depression or
L0068 [02:42] treatment resistant depression. And all
L0069 [02:44] of these states are complex states to be
L0070 [02:46] in.
L0071 [02:47] So that's what I learned bipolar could
L0072 [02:50] be. I also learned it could be like
L0073 [02:52] this. This would be what type one
L0074 [02:54] bipolar might look like. Sorry, type two
L0075 [02:55] bipolar, which is prolonged periods of
L0076 [02:58] severe depression followed by a kind of
L0077 [03:01] uplifting state and then potentially an
L0078 [03:04] extreme uplifting state again into manic
L0079 [03:06] episodes or psychotic episodes. Um,
L0080 [03:10] and you can appear well for a lot of the
L0081 [03:13] time.
L0082 [03:14] Could also be like this. This could be
L0083 [03:16] something like type one bipolar disorder
L0084 [03:18] where people are in a kind of fairly
L0085 [03:20] level state and then long prolonged
L0086 [03:23] intense periods of severe mania um or
L0087 [03:26] psychosis. Um so it's complex. Um and
L0088 [03:30] one of the challenges is that you often
L0089 [03:32] appear well when you're managing bipolar
L0090 [03:34] well, but you can also get very very
L0091 [03:36] ill. Um so it can be that can also add
L0092 [03:40] to the challenge of living with the
L0093 [03:41] condition. So all in all, what is
L0094 [03:42] bipolar disorder? I don't know. I did a
L0095 [03:45] little bit of research. It's highly
L0096 [03:47] heritable. It's about 70% inherited.
L0097 [03:50] It destabilizes mood regulation. Uh
L0098 [03:53] compromises limbic system regulation.
L0099 [03:56] You have hypersensitivity sensitivity to
L0100 [03:59] dopamineergic effects which can affect
L0101 [04:01] addiction. There's intercellular
L0102 [04:03] signaling stuff that goes on which is
L0103 [04:05] why things like lithium which is a heavy
L0104 [04:06] metal can actually help treat bipolar
L0105 [04:08] disorder. There's all sorts of circadian
L0106 [04:11] biology. There's the con there's the
L0107 [04:13] effect that's called kindling. So

L0108 [04:14] kindling is the wood you use to start a
L0109 [04:16] fire. Kindling means that often will
L0110 [04:18] people have people will have episodes
L0111 [04:20] which are clearly caused by a
L0112 [04:21] significant event but each episode is
L0113 [04:24] degenerative. Each episode damages the
L0114 [04:26] brain's neural pathways. Meaning that
L0115 [04:28] later events may seem to be completely
L0116 [04:31] unrelated to the external environment.
L0117 [04:33] So untreated bipolar is a degenerative
L0118 [04:35] disorder.
L0119 [04:37] Um, I hesitated to mention these numbers
L0120 [04:40] because they're horrifying, but one in
L0121 [04:42] three people with bipolar disorder will
L0122 [04:44] attempt suicide. And untreated, one in
L0123 [04:47] five people will complete suicide. So,
L0124 [04:49] bipolar disorder is a a severely complex
L0125 [04:53] and damaging and difficult condition. I
L0126 [04:56] hesitated to mention the numbers because
L0127 [04:57] they're shocking and upsetting, but also
L0128 [05:00] I think it was important to do justice
L0129 [05:01] to the reality that a lot of people are
L0130 [05:03] living with. So living with bipolar
L0131 [05:07] disorder means uh managing dysregulation
L0132 [05:09] and also what you call wellness
L0133 [05:12] management. So medication is the first
L0134 [05:15] part of this. So medication is going to
L0135 [05:18] try and limit these peaks and these
L0136 [05:20] troughs. So this is done by mood
L0137 [05:24] stabilizers that will be the foundation
L0138 [05:25] of most treatments which will stabilize
L0139 [05:27] mood as it sounds like. It could also be
L0140 [05:30] uh sedatives. It could be
L0141 [05:32] anti-depressants. Anti-depressants can
L0142 [05:34] trigger mania. So it might be
L0143 [05:36] anti-depressants combined with
L0144 [05:38] antiscychotics.
L0145 [05:39] Going on to mood stabilizers can take
L0146 [05:41] months because you titrate slowly to
L0147 [05:43] monitor side effects. And it may take
L0148 [05:45] multiple attempts as there are different
L0149 [05:47] drugs and they work very very different
L0150 [05:49] with different people. So building a
L0151 [05:52] medication regime takes a long time. It
L0152 [05:54] takes a long time to establish a regime
L0153 [05:56] like this. And while you're doing that,
L0154 [05:58] you're essentially unmedicated or partly
L0155 [06:00] medicated. So these are difficult times.
L0156 [06:02] Um, however, when you get onto a
L0157 [06:04] medication regime, you often then have
L0158 [06:06] the ability to adjust for yourself to
L0159 [06:09] kind of manage your own state based on
L0160 [06:10] what's going around you.
L0161 [06:13] The next hugely important thing about
L0162 [06:15] bipolar disorder treatments is support.
L0163 [06:17] It's other people. So, who are the
L0164 [06:19] people you trust to know about your
L0165 [06:21] condition and the symptoms of your
L0166 [06:22] condition? And who are the people you
L0167 [06:24] will give the agency to say you can tell
L0168 [06:28] me when I appear unwell and you can tell
L0169 [06:31] me from my wellness plan what I've said
L0170 [06:33] I should be doing. Maybe it's adjusting
L0171 [06:35] medication or stopping travel. Um and
L0172 [06:38] also you may give some of these people
L0173 [06:39] agency to say if I don't make the
L0174 [06:41] changes that I've said when I'm well I
L0175 [06:44] will do. I'm giving you the agency to uh
L0176 [06:47] take control away from me. Um, and you
L0177 [06:50] you do this and you do this in advance
L0178 [06:52] so that the trauma of that experience is
L0179 [06:54] less afterwards. It can be traumatic to
L0180 [06:57] have freedom taken away from you, but if
L0181 [06:59] you've agreed in advance that this is a
L0182 [07:00] consequence of not following your
L0183 [07:02] wellness plan, then that gives you a
L0184 [07:04] better pathway to uh recover from some
L0185 [07:07] of these experiences.
L0186 [07:10] So support is an essential part of
L0187 [07:12] medication. medication on its own
L0188 [07:14] without support typically fails and
L0189 [07:16] there's typically uh a lot of relapse.
L0190 [07:19] Um support also can be therapy. It can
L0191 [07:22] be doing things like dealing with grief.
L0192 [07:24] Grief comes from loss. With bipolar
L0193 [07:27] disorder, you have loss of agency. You
L0194 [07:29] have loss of self. You have loss uh from
L0195 [07:32] the experiences that can happen. Uh
L0196 [07:34] hypermanic or manic states can lead to a
L0197 [07:37] lot of harm. They can damage
L0198 [07:38] relationships. You can spend lots of
L0199 [07:40] money. You can do very impulsive or
L0200 [07:42] risky or dangerous things. All of these
L0201 [07:44] things have to be processed um and may
L0202 [07:47] involve processing grief and processing
L0203 [07:50] your relationships and and how you feel
L0204 [07:52] about things. Um so support and
L0205 [07:55] psychotherapy and the people around you
L0206 [07:57] is is essential. And one of the most
L0207 [07:59] effective treatments for bipolar
L0208 [08:00] disorder is a regime called
L0209 [08:02] interpersonal u social uh relationship
L0210 [08:06] therapy which is about understanding
L0211 [08:08] yourself and the people around you and
L0212 [08:10] trying to regulate.
L0213 [08:12] So
L0214 [08:18] now we got to regulation which is a key

L0215 [08:20] part of this topic. So regulation is
L0216 [08:25] we've got medication, we've got the
L0217 [08:26] support of the people around us, but
L0218 [08:28] regulation is something that you can do
L0219 [08:29] for yourself. This is when you try to
L0220 [08:33] manage the the kind of red lines which
L0221 [08:35] are the things that destabilize you and
L0222 [08:38] counterbalance them with these green
L0223 [08:41] lines which are the things that will
L0224 [08:43] stabilize you. It's a very active form
L0225 [08:46] of treatment. You have to kind of commit
L0226 [08:47] to doing it. You have to take action.
L0227 [08:50] You have to make changes. If you're
L0228 [08:52] someone, for example, who I don't know
L0229 [08:54] is a flight attendant, that means that
L0230 [08:56] you're changing time zones a lot,
L0231 [08:57] changing time zones a lot is actually
L0232 [08:59] very dangerous for bipolar disorder
L0233 [09:01] because it causes sleep dis uh sleep
L0234 [09:03] issues and um disregulated sleep is one
L0235 [09:06] of the biggest causes of uh mania or
L0236 [09:09] hypermania. So, it's effort and your
L0237 [09:11] ability to engage in these activities
L0238 [09:14] when you're in an altered state is also
L0239 [09:15] compromised. If you're very depressed,
L0240 [09:17] it can be difficult to do things that
L0241 [09:18] lift. If you're very manic, you don't
L0242 [09:21] necessarily want to come down. You're
L0243 [09:23] compromised. You have a compromised
L0244 [09:25] sense of interception.
L0245 [09:27] So perception is your understanding of
L0246 [09:29] what's around you. Interception is your
L0247 [09:32] understanding of yourself, your internal
L0248 [09:34] self, your state. And compromised
L0249 [09:37] interception is uh one of the symptoms
L0250 [09:40] of bipolar disorder.
L0251 [09:43] I don't know how we're doing for time.
L0252 [09:45] Could be good, could be bad. If it's
L0253 [09:47] bad, I'll go to the bathroom.
L0254 [09:49] So common regulators and disregulators.
L0255 [09:51] The first one is sleep. Sleep is one of
L0256 [09:54] the most important essential things to
L0257 [09:56] get right. Disregulated sleep is the
L0258 [09:58] biggest trigger for hypermania.
L0259 [10:00] Hypermania will cause more disregulated
L0260 [10:02] sleep which will be a trigger for mania.
L0261 [10:04] By the time you're manic, you're not
L0262 [10:06] sleeping potentially not for days.
L0263 [10:08] Sometimes people for weeks and that can
L0264 [10:10] be the path towards even more severe
L0265 [10:11] states like psychosis followed by um by
L0266 [10:14] a big crash. So uh sleep hugely
L0267 [10:18] important uh and managing sleep might
L0268 [10:22] mean changing your job. So I used to
L0269 [10:24] live in Singapore. I used to travel to
L0270 [10:25] Australia at the beginning of the week,
L0271 [10:27] sometimes to India at the end of the
L0272 [10:29] week. That's a lot of time zone
L0273 [10:31] shifting. Incredibly bad for managing
L0274 [10:33] sleep and I had to change the nature of
L0275 [10:36] the work that I was doing to um to
L0276 [10:38] account for that.
L0277 [10:41] The next one is uh rhythm. So we're
L0278 [10:45] incredibly embodied creatures and our
L0279 [10:47] psychological state is intimately tied
L0280 [10:49] to our physical state. So when you eat,
L0281 [10:52] when you sleep, when you talk to other
L0282 [10:54] people, when you do exciting things,
L0283 [10:56] when you do calming things, all of these
L0284 [10:58] things are about rhythm. When you
L0285 [11:00] exercise and so on. Uh a predictable
L0286 [11:03] cycle of rhythm is for everyone a way to
L0287 [11:06] stay very very healthy. And disruption
L0288 [11:08] to rhythm is a very easy way to become
L0289 [11:11] disregulated. Um again interpersonal
L0290 [11:13] social relationship theory uh therapy is
L0291 [11:16] uh and social rhythm therapy uh I mean
L0292 [11:19] is all about managing rhythm and all
L0293 [11:21] about managing processing things with
L0294 [11:23] other people.
L0295 [11:25] Stress um unsurprisingly is uh a big
L0296 [11:28] disregulator. Uh stress can require
L0297 [11:32] interventions and and changing things.
L0298 [11:34] Stress comes from chaos, from conflict
L0299 [11:36] but it can also come from excitement. It
L0300 [11:38] can come from uh achieving goals. that
L0301 [11:40] can come from big changes
L0302 [11:43] but and stress is hard to manage
L0303 [11:45] especially in this world now which will
L0304 [11:47] be the next part of the talk the world
L0305 [11:49] of AI the world of stressful AI
L0306 [11:52] I keep pressing the button uh for the
L0307 [11:54] next pieces sorry about that um
L0308 [11:57] substances okay so substance use
L0309 [12:00] disorder in bipolar is very very very
L0310 [12:02] very high one of the highest for any
L0311 [12:04] psychological condition psychiatric
L0312 [12:06] condition uh that might be because
L0313 [12:08] people are self-medicate with substanc
L0314 [12:10] es to you know control mood but that
L0315 [12:12] will often have a backlash but also the
L0316 [12:15] pharmarmacology that you're dealing with
L0317 [12:17] the the medication you're taking these
L0318 [12:19] are also substances as well so they can
L0319 [12:20] be regulators they can be uh
L0320 [12:23] disregulators
L0321 [12:25] um most people or many people with
L0322 [12:26] bipolar disorder will suffer from

L0323 [12:28] substance uh use disorder and management
L0324 [12:31] of that can be very very important. Next
L0325 [12:34] you have awareness. So the more aware
L0326 [12:36] you are of your states, the more aware
L0327 [12:38] you are of how you're feeling and also
L0328 [12:40] the symptoms and so on is a way to
L0329 [12:43] manage your condition. Uh it's also
L0330 [12:46] awareness of the fact that things can
L0331 [12:47] get very very bad but hopefully they
L0332 [12:50] will also get better and more episodes
L0333 [12:52] you have the more you realize that you
L0334 [12:54] can recover from them and that they
L0335 [12:57] don't necessarily mean it's the end.
L0336 [13:00] People are regulators sometimes. people
L0337 [13:03] who you know about, who you care about,
L0338 [13:05] who you can be your authentic self with.
L0339 [13:08] Um, but people can also uh be
L0340 [13:10] disregulators. People can be chaotic.
L0341 [13:12] Family can be chaotic. Friends can uh be
L0342 [13:16] helpful. Friends can uh not be helpful.
L0343 [13:19] So people is an important part of this.
L0344 [13:22] Um but again, they can be a source of
L0345 [13:24] conflict and instability.
L0346 [13:26] Therapy and integration. So this is the
L0347 [13:29] the other part we spoke about briefly
L0348 [13:31] before. So how you therapize, how you
L0349 [13:34] talk through experiences and then
L0350 [13:35] integration is how do you process the
L0351 [13:38] things that have happened? We all need
L0352 [13:39] to integrate complex experiences
L0353 [13:42] uh grief, conflict, excitement,
L0354 [13:45] achievement, whatever these experiences
L0355 [13:48] need to be integrated for us to be able
L0356 [13:50] to kind of continue. Otherwise you build
L0357 [13:52] a backlog of stuff that you you haven't
L0358 [13:53] processed and become very scattered,
L0359 [13:56] very disjointed um and very unfocused.
L0360 [14:00] There are some other surprising things
L0361 [14:02] as well uh that are regulators or
L0362 [14:04] disregulators. Goal attainment is known
L0363 [14:07] to be quite disregulating. It's an
L0364 [14:09] exciting event but it can also lead to
L0365 [14:11] unknowns afterwards. It's a big change.
L0366 [14:13] Change is complex to deal with. So goal
L0367 [14:16] achievement can be uh challenging.
L0368 [14:18] Uh changes to your foundational beliefs
L0369 [14:22] can also be disregulating and AI is
L0370 [14:24] doing a lot of that and that will be uh
L0371 [14:27] a bit of a theme of what we talk about a
L0372 [14:28] little bit. uh afterwards.
L0373 [14:32] Uh anti-depressants you would have
L0374 [14:34] thought are good for managing
L0375 [14:35] depression, but they're bad for mania.
L0376 [14:37] So, you know, these things are not
L0377 [14:38] necessarily simple. Uh sunny days can be
L0378 [14:42] disregulating because it can affect
L0379 [14:44] circadian rhythm. We don't get a lot of
L0380 [14:46] sunny days in the UK, so maybe that's
L0381 [14:48] the right place to be. But the longer
L0382 [14:51] days, the shorter days, all of these
L0383 [14:52] things can affect sleep. And it can't be
L0384 [14:54] overestimated how much uh sleep is
L0385 [14:57] important. um ex intense exercise. Uh
L0386 [15:00] the other one is pregnancy. So typically
L0387 [15:02] when people are pregnant, they won't be
L0388 [15:04] able to take mood altering medication
L0389 [15:07] and that's really really hard. That's a
L0390 [15:09] tremendous challenge for people going
L0391 [15:10] through pregnancy. Postpartum can be
L0392 [15:12] complex um as well. Again, we're very we
L0393 [15:16] are embodied creatures. The hormones
L0394 [15:18] that go through us, whether it's through
L0395 [15:19] excitement or pregnancy or whatever, can
L0396 [15:21] change our states um enormously. So all
L0397 [15:25] of these different things are happening
L0398 [15:26] and the risks when you get into
L0399 [15:29] different states can be extremely
L0400 [15:31] severe. So what ends up happening as you
L0401 [15:34] kind of go through this and start to
L0402 [15:35] understand it and learn about it is what
L0403 [15:38] I've called pathizing happiness.
L0404 [15:42] So
L0405 [15:43] when you're starting to get more happy,
L0406 [15:45] more excited, um having more fun,
L0407 [15:48] getting more engaged with things, really
L0408 [15:50] really getting into things, you start to
L0409 [15:52] pathize that. Am I going into
L0410 [15:54] hypermania? Am I going into uh mania? Am
L0411 [15:57] I over excited by this? Am I
L0412 [15:59] overstimulated by this? Am I losing
L0413 [16:01] myself in this too much? Is this a safe
L0414 [16:04] place to be? Do I need to downshift? Do
L0415 [16:07] I want to downshift because this feels
L0416 [16:09] like a great place to be? Hypermania is
L0417 [16:11] an incredibly exciting and it's awful to
L0418 [16:15] say but wonderful state to be in. You're
L0419 [16:18] happy. You make friends. Uh you care
L0420 [16:20] about the people around you. All new
L0421 [16:22] experiences are exciting rather than
L0422 [16:23] frightening. You're creative. You're
L0423 [16:26] doing more exercise. You're seeing more
L0424 [16:28] people. So you don't want to avoid being
L0425 [16:30] in states that make you happy. But you
L0426 [16:32] also know that these states can lead to
L0427 [16:35] worse states. So you pathize constantly.
L0428 [16:38] You're always monitoring what's around
L0429 [16:40] you. You're always monitoring how you're

L0430 [16:42] feeling. And if you've ever got into
L0431 [16:45] that state of monitoring, am I feeling
L0432 [16:46] happy? Am I feeling happy? Am I feeling
L0433 [16:48] too happy? That itself is quite
L0434 [16:50] anxietyinducing and a bit Um, so
L0435 [16:53] you often end up feeling quite depressed
L0436 [16:55] from that because this constant
L0437 [16:57] attention and this constant checking
L0438 [16:58] into state is is a sort of manic thing
L0439 [17:02] and it's not a particularly um
L0440 [17:04] [clears throat] happy state to be in. So
L0441 [17:06] you ask yourself, am I shutting myself
L0442 [17:08] out from the outside world? Am I not
L0443 [17:10] having the social contact that I used to
L0444 [17:13] have? Um are my beliefs changing
L0445 [17:16] enormously? Um and that's when I'm going
L0446 [17:19] to transition now into AI because
L0447 [17:22] talking to lots of people in the world
L0448 [17:25] of AI, aentic engineering or whatever,
L0449 [17:27] there's a lot of this change in state
L0450 [17:30] excitement but also lack of focus um and
L0451 [17:33] so on. So that's going to be kind of the
L0452 [17:35] theme of what we talk about next. What
L0453 [17:37] the disregulators are that I'm hyper
L0454 [17:40] aware of and that I see in the world of
L0455 [17:43] AI and sort of reflect on for how it
L0456 [17:46] feels for myself. But I also see these
L0457 [17:48] states in other people. I see other
L0458 [17:50] people in states that feel grandiose or
L0459 [17:53] hyper manic or overexited or
L0460 [17:55] disconnected. I see a lot of behavior
L0461 [17:58] around me which is exciting. I also see
L0462 [18:00] behavior which is maladaptive. And that
L0463 [18:02] if it was me performing that behavior, I
L0464 [18:05] would actually be concerned and be
L0465 [18:06] thinking about what do I need to do to
L0466 [18:08] downshift and control this and intervene
L0467 [18:11] on this one.
L0468 [18:16] So there we go. Been pathologizing
L0469 [18:17] everything. The world of AI, people are
L0470 [18:21] changing the way people are acting uh is
L0471 [18:24] changing. The way people are focusing,
L0472 [18:26] the way people are collaborating is
L0473 [18:27] changing. So
L0474 [18:30] what are some of the disregulators or
L0475 [18:32] the things that can disregulate? So the
L0476 [18:34] first one um I worked with a therapist
L0477 [18:37] called Margot Orum and she has uh severe
L0478 [18:40] type 1 bipolar disorder and one of the
L0479 [18:42] things she told me that was quite
L0480 [18:43] surprising is that foundational changes
L0481 [18:45] in your core beliefs can be profoundly
L0482 [18:48] disregulating. So she went on a kind of
L0483 [18:51] 4-day meditation uh retreat. It was a
L0484 [18:54] very intense experience for her. It was
L0485 [18:56] followed immediately by a severe
L0486 [18:58] psychotic episode. 5 minutes left.
L0487 [19:02] AI itself, the way it's changing us, uh,
L0488 [19:05] is disregulating. Uh, it's changing our
L0489 [19:07] beliefs. So, how do you deal with this?
L0490 [19:09] I'm going to go a bit faster now, maybe
L0491 [19:10] skip through a few of the less
L0492 [19:11] interesting ones. You have to integrate
L0493 [19:13] experiences. How do you feel about this?
L0494 [19:16] Is it making you happier? Is it making
L0495 [19:17] you less happy? Is it changing your
L0496 [19:19] behavior?
L0497 [19:20] Addiction. I won't go into this too much
L0498 [19:22] then. The short cycle dopamine loop. A
L0499 [19:25] lot of people have spoken about with AI
L0500 [19:27] uh it is very very addictive to have
L0501 [19:29] this fast reward mechanism. There's lots
L0502 [19:31] of material out there about how to deal
L0503 [19:32] with addiction. People with bipolar
L0504 [19:34] disorder are much more likely to suffer
L0505 [19:36] from addiction.
L0506 [19:38] Grandiosity. I'm going to spend less
L0507 [19:40] time on that one because I think uh I
L0508 [19:42] have a better section that talks about
L0509 [19:43] this. This one I'll I'll talk about in
L0510 [19:46] my anarchctic way. Aggression and
L0511 [19:48] competitiveness a symptom of these
L0512 [19:50] highly elevated states. The world of AI
L0513 [19:52] is pretty aggressive. So, I read an
L0514 [19:55] article by someone saying like, I've
L0515 [19:56] asked a bunch of people in my
L0516 [19:58] organization. I've only got space for
L0517 [19:59] the 100x developers. Everyone else is
L0518 [20:02] not as important. Now, that's pretty
L0519 [20:04] aggressive. These 100x developers, are
L0520 [20:06] they the best developers or are they
L0521 [20:08] just the most noisy ones who are saying
L0522 [20:09] that no one else is collaborating?
L0523 [20:12] This uh capitalist environment we're in
L0524 [20:14] actually fosters aggression and
L0525 [20:16] competition. So, how do you deal with
L0526 [20:18] that? Have empathy with other people.
L0527 [20:20] Don't don't fight them. How are they
L0528 [20:22] feeling? Are they enjoying this world?
L0529 [20:24] And also have fun. Not everything has to
L0530 [20:26] be competitive. We're supposed to enjoy
L0531 [20:28] our lives.
L0532 [20:30] Attentional lang. So lang a great grind
L0533 [20:32] core band. Uh it means death by a
L0534 [20:34] thousand cuts. I'm going to briefly talk
L0535 [20:36] about this because you probably all know
L0536 [20:37] about it. Your attention just gets
L0537 [20:39] destroyed. Short cycle work that you're

L0538 [20:41] doing, being able to work on everything
L0539 [20:44] uh kills your attention. We're
L0540 [20:46] constantly multitasking. I think most of
L0541 [20:48] us are feeling things like this. So how
L0542 [20:50] do you deal with it? focus. Uh creating
L0543 [20:53] um space for the work that you're doing,
L0544 [20:56] running tasks to completion, recognizing
L0545 [20:59] when you're engaging in displacement
L0546 [21:01] activities, prioritizing, creating
L0547 [21:03] protected time,
L0548 [21:05] pressured speaking. Um we'll skip past
L0549 [21:09] this one except for the fact that your
L0550 [21:12] AI speaks to you like someone who's on
L0551 [21:14] cocaine. It's like nonstop.
L0552 [21:17] Doesn't listen. No space for
L0553 [21:18] interruptions. That's pressured
L0554 [21:20] speaking. It's awful to listen to.
L0555 [21:22] What's even more awful is when a bunch
L0556 [21:24] of your colleagues take all the
L0557 [21:25] pressured speaking from their AI and
L0558 [21:27] throw it at you and then you're like,
L0559 [21:28] "God, it's coming from all directions."
L0560 [21:30] So, what do we do about that? Compress
L0561 [21:32] signal to noise. Like, what's the highle
L0562 [21:34] message? What should this mean? Not
L0563 [21:36] what's the 30 pages of stuff that is
L0564 [21:38] your stream of consciousness that I
L0565 [21:40] don't necessarily want to see.
L0566 [21:43] So, this is the key one that I'm
L0567 [21:44] interested in. Maladaptive creativity.
L0568 [21:47] So, this is going to get a bit
L0569 [21:48] philosophical.
L0570 [21:50] Mental model on the left is me building
L0571 [21:52] a system. My my model of it. Mental
L0572 [21:56] model on the right. In the middle is the
L0573 [21:58] system itself. Similar but different.
L0574 [22:01] Next mental model is the model my
L0575 [22:03] colleague has. They're slightly
L0576 [22:05] different but they're sort of roughly in
L0577 [22:07] sync because we talk a lot. We make
L0578 [22:09] small changes. We have to look at what
L0579 [22:11] we've written. Now when AI does a lot of
L0580 [22:14] this for you and it does it very fast,
L0581 [22:16] the mental models start to look like
L0582 [22:18] this. One person can create this palace
L0583 [22:20] of stuff. They don't really necessarily
L0584 [22:22] know what's in it. What they've created
L0585 [22:24] is very different to their mental model.
L0586 [22:27] The mental model from the person who is
L0587 [22:28] trying to understand it is even more
L0588 [22:30] different. When people say to me, you
L0589 [22:32] don't need to review pull requests. You
L0590 [22:34] don't need to review specs. That's
L0591 [22:36] that's wrong. You do because it's not
L0592 [22:39] about quality control. It's about
L0593 [22:42] engaging with the mental model so I can
L0594 [22:44] see what someone has built and how it
L0595 [22:46] works. Because part of my job and your
L0596 [22:48] jobs is also to understand that system
L0597 [22:51] so that we can fix it and maintain it.
L0598 [22:53] This is the hardest thing to manage, but
L0599 [22:55] it's the thing that I think will help
L0600 [22:56] people the most. So you share, you
L0601 [22:59] collaborate, you build your models
L0602 [23:01] together.
L0603 [23:02] So here we go. Bipolar disorder,
L0604 [23:05] dysregulation, and AI challenges, but
L0605 [23:08] also things that you can do about it.
L0606 [23:10] I'll finish now with some awful things.
L0607 [23:12] I brainstormed some of this with AI. I
L0608 [23:14] write everything myself by hand, but it
L0609 [23:17] came up. It was riffing on some ideas.
L0610 [23:19] Tokens are cocaine. Okay, not very
L0611 [23:22] sensitive. How I learned to stop
L0612 [23:24] shipping and love the spec.
L0613 [23:27] Kind of all right. Um, hypermania driven
L0614 [23:30] development. Very tasteless. Really
L0615 [23:31] tasteless. Uh, engineering with a brain
L0616 [23:34] on fire.
L0617 [23:36] Um, the magic and madness of aentic
L0618 [23:40] engineering. Thoughtless. And then this
L0619 [23:42] one, uh, three agents, four work trees,
L0620 [23:45] two laptops, no sleep, code shipped,
L0621 [23:48] marriage didn't, uh, all caps.
L0622 [23:53] Uh, when I said this was all it
L0623 [23:55] said, "Lesson noted, drop drug
L0624 [23:57] metaphors, drop wonderfing on
L0625 [23:59] psychological topics, uh, treat them
L0626 [24:01] with care." Um, so that's it. Thank you.
L0627 [24:04] Thanks for your attention. [applause]
L0628 [24:14] >> [applause]
L0629 [24:15] >> Thank you. Thank you so much for a very
L0630 [24:17] honest, very um exposing talk that was
L0631 [24:21] hugely interesting. Um somebody is
L0632 [24:23] neurode divergent myself as well. Some
L0633 [24:25] of that I went yeah I can see that
L0634 [24:27] happening too. Yes. Um there is a lot of
L0635 [24:30] stress out there from the what the
L0636 [24:31] models are causing for us mentally too.
L0637 [24:34] So does anybody here have any questions?
L0638 [24:39] Can we get a microphone over here
L0639 [24:40] please?
L0640 [24:42] >> Or I can repeat the question if that
L0641 [24:44] makes it easier.
L0642 [24:44] >> Might be easier.
L0643 [24:46] >> Um you talked about um sort of
L0644 [24:50] transforming core beliefs being quite

L0645 [24:52] disregulating and I'm wondering about
L0646 [24:55] whether I'll start again. Um you talked
L0647 [24:59] about transforming your core beliefs
L0648 [25:00] being quite disregulating. Um, I'm
L0649 [25:04] wondering whether that includes things
L0650 [25:06] like sort of moments of resol re
L0651 [25:08] revelation um sort of if you're working
L0652 [25:11] in science um or or something creative
L0653 [25:15] when you're you know a bit flips in your
L0654 [25:17] head and you see the world differently.
L0655 [25:19] Um I mean to me those moments are
L0656 [25:22] they're almost what I live for. I think
L0657 [25:24] they're just you know they feel
L0658 [25:25] brilliant. But is that the kind of thing
L0659 [25:27] that you're talking about?
L0660 [25:28] >> Well it's exactly that. It can feel
L0661 [25:30] brilliant. It can feel like everything
L0662 [25:32] has changed. There's so much scope to do
L0663 [25:34] different things. It leads to that real
L0664 [25:35] real excitement that can kind of take
L0665 [25:37] you down these paths. It's not to say
L0666 [25:39] that they're bad. Once you've had these
L0667 [25:41] beliefs changed, you might learn a lot
L0668 [25:43] more and know a lot more. It's just that
L0669 [25:46] that's likely going to be
L0670 [25:46] counterbalanced with how do you
L0671 [25:48] integrate that? How has the world
L0672 [25:50] changed for me? Am I at peace with that?
L0673 [25:52] What's my role in this new world? So
L0674 [25:54] none of these things are necessarily
L0675 [25:56] intrinsically bad, but they may require
L0676 [25:58] that kind of counterbalance of space
L0677 [26:01] afterwards.
L0678 [26:03] >> Thank you.
L0679 [26:06] >> Another question over here.
L0680 [26:10] >> Should I go? Um, you talked about
L0681 [26:13] collaboration and working with LLMs and
L0682 [26:16] agents is inherently very solo activity.
L0683 [26:19] Have you found any good ways to uh build
L0684 [26:23] in collaboration into agentic workflows?
L0685 [26:26] >> Uh yeah, so at the divergent stage where
L0686 [26:29] you're thinking about lots of ideas,
L0687 [26:31] maybe that's something that's solo. When
L0688 [26:33] you've got your ideas and you're
L0689 [26:34] starting to think about turning it into
L0690 [26:36] a specification or a plan, that's when
L0691 [26:38] you move into a convergent phase with
L0692 [26:40] another person. I've had these ideas.
L0693 [26:42] How can we narrow the aperture?
L0694 [26:45] Aperture. Sorry, I work at McKenzie. Uh
L0695 [26:47] so how can we narrow that down to
L0696 [26:48] something that we can understand and
L0697 [26:50] also can we do a handoff you came up
L0698 [26:53] with the idea you've built the
L0699 [26:54] specification with me I'll move to the
L0700 [26:56] implementation will you then take the
L0701 [26:58] implementation and tell me if it's okay
L0702 [27:00] and if it's ready to be uh integrated
L0703 [27:03] the fact that AI can offload toil should
L0704 [27:05] actually mean that we get more space uh
L0705 [27:08] to collaborate so all of my standups are
L0706 [27:10] 1 hour because we don't need to go
L0707 [27:12] through the small bitty things we can
L0708 [27:14] use it as kind of pair programming or
L0709 [27:16] pair specifying sessions or to talk over
L0710 [27:18] these things. So I think there are some
L0711 [27:19] techniques but I think it's the biggest
L0712 [27:21] challenge that I see in terms of the
L0713 [27:23] tech world we're in the breakdown of
L0714 [27:25] collaboration.
L0715 [27:26] >> Yeah. Thank you.
L0716 [27:29] >> What's next?
L0717 [27:35] Have you found uh or would you be able
L0718 [27:38] to share any specific prompts or maybe
L0719 [27:41] agents or things that would help you or
L0720 [27:45] us uh regulate our mood and you know
L0721 [27:48] sort of control our our feelings.
L0722 [27:53] >> Uh I mean I'm I'm using AI mostly to
L0723 [27:55] build software but for me what's
L0724 [27:57] important to regulate is more how I do
L0725 [27:59] that. I do it in the mornings. That's my
L0726 [28:01] creative time. I'll rarely have my
L0727 [28:03] laptop open from about 5:00 onwards and
L0728 [28:06] I won't be doing creative work then at
L0729 [28:08] that point I need to be kind of
L0730 [28:09] transitioning down into a state where uh
L0731 [28:12] I'm less stimulated. So some of this is
L0732 [28:14] about saying to AI don't give me lots of
L0733 [28:17] information give me small pieces and I
L0734 [28:19] will direct where we go next. Um other
L0735 [28:21] parts of it are simply about when you
L0736 [28:23] decide to switch off and say I'm not
L0737 [28:25] going to listen anymore. I need time to
L0738 [28:27] kind of go away calm myself down and
L0739 [28:30] then I'll come back to it tomorrow. So
L0740 [28:31] creating space but also creating
L0741 [28:33] friction which is also how people manage
L0742 [28:35] um addiction is to create friction in
L0743 [28:37] systems.
L0744 [28:40] >> Okay. Um I think we are going to have to
L0745 [28:42] I know there's another question. Please
L0746 [28:44] do feel free to ask a question
L0747 [28:46] afterwards.
L0748 [28:46] >> Yep. That's that's fine.
L0749 [28:48] >> I I am going to have to reset for the
L0750 [28:50] next next session. So thank you very
L0751 [28:52] much for joining us today. Dave, thank
L0752 [28:54] you so much. [applause]