The Case for Insanity November 21, 2013Posted by Crazy Mermaid in Delusions, Hallucinations, Hearing Voices, mental illness.
Tags: Delusions, Hallucinations, mental illness
add a comment
The case for insanity is compelling
In early February 2008, at the beginning of my traipse into a world of make-believe, I had ESP. How cool is that? I talked with people in my head. Powerful people. Bill and Melinda Gates. The Dalai Lama. Oprah Winfrey. My (then) bosses. All of these people and more were at my beck and call.
Then there was my job situation. In my fantasy world, my (real) boss, via ESP, directed me to quit my (real) job. So I did. Then, via ESP, he begged for my return, promising me more money and better control over my job. In the meantime, Bill and Melinda Gates offered me a job at The Bill and Melinda Gates Foundation. For twice the money.
And yet money had no real value. I had access to Bill and Melinda Gates’ money. I had a friend who was a time traveler who could make it so that I had money whenever I wanted it. Because money meant nothing, I wrote a (NSF) check for a beautiful, gold, brand new Lexus Convertible car. Bill and Melinda Gates were going to reimburse me for the purchase as part of my new employment package. I bought a new wardrobe for my new job.
I owned $2 million in jewelry, including a 3 carat yellow diamond in a platinum setting, and an abalone bracelet that had once been owned by my (Mermaid) grandmother.
I talked with trees, dogs, and cats.
Last but not least, I was a genuine Mermaid. Fish talked to me (literally). I had fins for feet. I had a beautiful tail.
I was beautiful. I was energetic. I was wealthy.
Now tell me that mental illness is terrible.
Halloween: Damage Control October 28, 2013Posted by Crazy Mermaid in Insanity, mental illness.
Tags: Delusions, Hearing Voices, Insanity, mental illness
add a comment
Halloween’s coming around, and with it comes the worn-out old stories about the mentally ill. The slasher movies and the guts and gore of the horror-filled inspirational costumes- all coming to a theater near you.
Norman Bates in Psycho, a 1960 horror movie, was inspired by Wisconsin serial killer Ed Gein. The insane Leatherface from Texas Chainsaw Massacre, a 1974 horror movie, and Buffalo Bill in Silence of the Lambs were both inspired by the same serial killer, a man whose “guilty but insane” conviction landed him in a mental hospital. In The Shining, Jack Nicholson gave a good impersonation of a psychotic man. Dr. Jekyl was clearly insane when he became Mr. Hyde in the 1931 classic Dr. Jekyl and Mr. Hyde. Then there’s the classic: Halloween, about a young insane murderer who escapes from his Sanitarium (mental hospital) after being locked up for 15 years- ever since he was 6. Over and over the mentally ill are exploited for the benefit of the media. In fact, out of the top 50 best horror movies of all time, over half involve mental illness. Mental illness is, after all, scary.
Unfortunately for those of us who are mentally ill, the media makes no distinction between delusional people in the middle of a psychotic episode, insane murderers, schizophrenics, and what I like to call garden-variety mentally ill people (bipolar, depressed, OCD, etc). We’re all, in their collective minds, the same as Ed Gein, the Wisconsin serial killer who inspired both Psycho and Texas Chainsaw Massacre. There’s nothing scarier, after all, than a mentally ill person. Especially a psychotic one. It’s no wonder that nobody wants to be identified as mentally ill. Who, after all, wants to be Ed Gein?
National Mental Illness Awareness Week Oct 6-12 October 6, 2013Posted by Crazy Mermaid in mental illness.
Tags: mental illness
Today is the beginning of National Mental Illness Awareness Week, which runs October 6th through 12th. In 1990, the U.S. Congress established the first full week of October as Mental Illness Awareness Week (MIAW) in recognition of NAMI’s efforts to raise mental illness awareness. Since then, mental health advocates across the country have joined with others in their communities to sponsor activities, large or small, for public education about mental illness.
MIAW coincides with the National Day of Prayer for Mental Illness Recovery and Understanding (Oct. 8) and National Depression Screening Day (Oct. 10.)
National Depression Screening Day®
October 10, 2013
Take an anonymous depression screening at www.HelpYourselfHelpOthers.org
Screening for Mental Health offers National Depression Screening Day programs for the military, colleges and universities, community-based organizations and businesses.
Held annually during Mental Illness Awareness Week in October, National Depression Screening Day (NDSD) raises awareness and screens people for depression and related mood and anxiety disorders.
NDSD is the nation’s oldest voluntary, community-based screening program that provides referral information for treatment. Through the program, more than half a million people each year have been screened for depression since 1991.
National Depression Screening Day (NDSD) will be held on Thursday, October 10, 2013. In recognition of this national outreach, Screening for Mental Health — the sponsor of NDSD — is offering members of the public the opportunity to take a confidential and FREE screening for depression, anxiety disorders and bipolar disorder.
The screening allows you to find out whether or not a professional consultation would be helpful to you. Please know that no specific information about individuals is collected.
Many screening sites across the country are hosting National Depression Screening Day events in the next several weeks. To find a screening site near you, visit the www.helpyourselfhelpothers.org. To learn more about Screening for Mental Health, go to www.mentalhealthscreening.org. If there is not a screening site listed in your area, you can find a treatment facility near you by going to the SAMHSA Mental Health Services Locator.
Hearing Voices Network August 7, 2013Posted by Crazy Mermaid in Hallucinations, mental illness.
Tags: Delusions, Hallucinations, Hearing Voices, mental illness
add a comment
What Are Voices & Visions?
When we talk about voices and visions, we simply mean someone is hearing, seeing or sensing something that others around them aren’t. These experiences can include all five senses, hearing, sight, smell, taste and touch. These experiences can occur in one sense at a time (hearing a voice, for example, or smelling something), but they can also happen in combination.
For some, these experiences can be comforting. For example, someone who is lonely may really value a voice that becomes a trusted confidant. A person who has recently lost someone they care about may benefit from talking to them at the end of the day, or smelling their perfume/aftershave. Others find these experiences to be a source of inspiration. Authors, for example, sometimes talk about how the characters can come to life and write the story for them. However, for some people these voices and visions can be extremely distressing – criticising, threatening or causing confusion.
How Common Is It?
Statistics vary, but it’s generally accepted that between 3 and 10% of the population hear voices that other people don’t. If you include one off experiences (like hearing someone call your name when you’re out shopping, or feeling your phone vibrate in your pocket) this figure goes up to 75%. So, having at least one experience of hearing or seeing something that others around you don’t is incredibly common. Those that have never had this experience are in the minority.
A number of famous and important people (past and present) have experience of hearing or seeing things that other people don’t. Without these people, the world would be a very different place. This list of famous people who have talked or written about hearing voices includes: Gandhi, Socrates, Joan of Arc, Freud, Anthony Hopkins, Philip K Dick, John Frusciante, Carlos Santana, Robert Schumann, John Forbes Nash, Zoe Wannamaker and Charles Dickens.
What’s It Like?
We’re all unique, so it’s unsurprising that voices and visions can be equally individual in terms of their identity, content, interpretation and impact. The following gives a brief overview. If you don’t recognise your experience here, that doesn’t mean you’re ‘weird’ or ‘unusual’.
Some people hear voices talking when no-one is around. These could be like the voices of people they know, or complete strangers. They might hear many voices, or just one. Voices can shout, whisper, be clear or muffled. They can speak in sentences or say single words. These voices can be male, female, genderless, old or young. Sometimes they have names, but not always. Voices can speak constantly (24/7), but they can also utter occasional words or phrases. People can hear other types of sounds too, including knocking, rustling, crying, screaming or music.
Some voices can be positive – providing the support and encouragement someone needs to get through the day. Other voices can be confusing, perhaps echoing thoughts or repeating strange phrases. Some voices can be very frightening, saying things that are critical, threatening or commanding. Voices can claim to have great power and knowledge, which can sometimes leave the voice-hearer feeling scared and powerless. Some voices can leave a person feeling very vulnerable and exposed (e.g. hearing a crowd of people jeering at you, or discussing intimate details of your life).
Some people see things that others don’t. These visions can be very clear and realistic, but they can also include fuzzy shapes, shadows and beams of light. Some people see the voices that they hear, others see insects or spiders. For some, the visions are very complex (like entering into another world). For others, the visions sit alongside their everyday world (an added box, person or animal for example). Sometimes, it can seem as if people or objects are changing shape. Their faces may turn to stone, they may be surrounded by a coloured aura or, for example, their eyes may change colour. As with voices, these visions can be reassuring, funny, frightening or distracting.
Some people smell things that remind them of their past. This could be something nice, like a loved one’s perfume/aftershave or a favourite food.
Sometimes people smell things that remind them of a particularly traumatic experience. For example, someone who survived a house fire may smell smoke when they feel anxious. Someone who was hurt by someone wearing a particular scent may, sometimes, smell this when there is no-one there to account for it. This can be extremely frightening, especially if they don’t recognise that this sensory experience comes from the past.
For others, the smell isn’t linked to a particular memory or traumatic event. For example, some people smell gas, burning or rotting food. These smells can feel very real and leave them fearing for their safety.
It can be difficult for someone to know that they’re tasting something that others can’t – unless they get someone else to try it too. This can make taste experiences particularly difficult to deal with. Some people get a strong bitter taste in their food or drink and, understandably, start to worry that there is something wrong with it. This can lead people to worry that they are being poisoned, or that someone is tampering with their food. Others have taste sensations when they are not eating. This might be when they are hearing a voice, watching a TV programme or thinking about something. These taste sensations can be pleasant (e.g. chocolate or a favourite food), but they can also be unnerving or unpleasant (e.g. something bitter or metallic).
Some people can feel things on their skin when there doesn’t seem to be anything there. They might feel something crawling over their skin, tickling them or pushing them. Sometimes people feel something underneath their skin, and this can lead them to feel really worried about what is happening to their body.
Understandably these experiences can be very confusing and frightening. It’s not as simple as this, though. For others, these experiences can be reassuring. Someone who feels lonely and hears a reassuring voice may feel comforted if they feel a hand on their shoulder. They might interpret it as a sign that the voice is trying to support them.
Why Do People Hear Voices
There are lots of different theories and ideas to explain why people hear voices or see visions. These include:
- A special gift or sensitivity
- Trauma or adverse life experiences
- Spiritual experiences
- Biochemical (e.g. excess dopamine)
- Paranormal experiences
- Emotional distress
- Physical health problems
- Cognitive error (misattribution of ‘internal speech’)
- Individual difference
The truth is that we do not know why people hear voices or see visions. As the experience is so diverse, it’s likely that there are a number of different explanations. Whilst this can be frustrating for those who feel confused and would like a simple answer or some certainty, it means that the most important explanation is the one that the voice-hearer themselves finds useful. It is important not to impose your own belief on someone else’s experience – this is fundamental to the Hearing Voices Network approach. Rather than providing a dogmatic view of voice-hearing, we recognise and celebrate a festival of explanations.
Whatever someone believes about their experiences, the most important thing is to find ways of dealing with that belief and finding some sense of power, control and hope within it.
Is Recovery Possible?
At the Hearing Voices Network we use the word recovery to mean ‘living the life you choose, not the life others choose for you’ (whether those others are family, friends, workers or voices). Many people who hear voices simply don’t need to recover – they are already living lives that they love. The voices might enhance their wellbeing, or their experiences may simply not detract from it.
For those who have particularly overwhelming experiences that lead them into the mental health services, recovery can feel like a distant dream. The good news is that people can, and do, find ways to deal with (and recover from) distressing voices. Perhaps more importantly, people can also recover from the situations that can make voices and visions so hard to deal with. Many people who recover continue to hear voices. Sometimes these voices change during the recovery process (being an ally, rather than an attacker). Other times these voices become quieter, less intrusive or even disappear altogether. Others find that the voices stay the same, but that they are no longer ruled by them. They feel stronger and more able to choose whether to listen to the voices or not.
We have witnessed many amazing journeys of recovery in the Hearing Voices Network. These journeys are, by their very nature, very individual. However, these journeys have led us to believe that no matter how overwhelmed or distressed the person is by their experiences (or whatever labels they have collected throughout their time in the mental health system) – recovery IS possible.
(Reprinted from Hearing Voices Network- http://www.hearing-voices.org)
Gains Sequential Intercept Model July 21, 2013Posted by Crazy Mermaid in Law Enforcement.
Tags: Insanity, Law Enforcement, mental illness
add a comment
The Sequential Intercept Model is a framework for understanding how people with mental illness interact with the criminal justice system. The model, which was described by Mark Munetz and Patricia Griffin in 2006 in Psychiatric Services, presents this interaction as a series of points where interventions can be made to prevent a person from entering the justice system or becoming further entangled.
The points of interception include law enforcement and emergency services; initial detention and hearing; jails, courts, forensic evaluation and forensic hospitalizations; reentry from jails, prisons and hospitalization; and community supervision and community support services. According to the model, at each of these points, there are unique opportunities to assist a person in getting appropriate services and preventing further justice involvement.
Without intervention, these stages can become a revolving door – with individuals encountering law enforcement during a crisis, and progressing through the various stages of involvement, until they are released from jail or prison. Without support or intervention during this process, there’s a high likelihood that the individual will ultimately come back into contact with law enforcement during another crisis and repeat the cycle.
Ideally, the best point of intervention is in the community, before law enforcement becomes involved, and treatment needs can best be met by community mental health services. Unfortunately, if these services do not adequately address the needs, a person in crisis may be drawn into the criminal justice system. Even with adequate community services, a few people may slip through the cracks and encounter police. In a system with appropriate interventions at each intercept, fewer and fewer people will slip through the cracks, so by the time of release from jail and prison, most people should be connected with services to help them recover and prevent further contact with the justice system.
How can Communities use the Sequential Intercept Model?
While many communities have successfully implemented some response to the crisis of criminalization, such as police-based diversions (like CIT) or mental health courts, most communities do not have comprehensive plans that address the entire spectrum of criminal justice involvement. Few communities now meet the ideal, but many are striving to become more responsive and effective by using the model for planning. According to leaders in many communities, the Sequential Intercept Model has helped them move forward in planning a systematic response to the criminalization of mental illness in their communities.
Michele Saunders, a leader of the Florida CIT Coalition, says that the Sequential Intercept Model has been the basis of planning sessions in several Florida communities that helped to “map” the path that a person with mental illness takes through the criminal justice system. Saunders says communities have “mapped the process of a person with mental illness who has contact with the criminal justice system from the point of contact with law enforcement to the time of release from jail or prison.” This process helps identify where there currently are opportunities to divert someone out of the justice system, and also where there are gaps in services.
Saunders reports that using the Sequential Intercept Model for planning brings together a very broad group of stakeholders, and helps them work together rather than in isolation to problem-solve. The process builds better relationships between stakeholders, and helps them create a common vision for responding to people with mental illness involved in the criminal justice system. The result is better-coordinated services and more people diverted from the criminal justice system.
Stephen Bush, an attorney with the Shelby County (TN) Public Defender and coordinator of the county’s post-booking jail diversion program, the Jericho Project, agrees that the Sequential Intercept Model has been a useful tool for planning. While Shelby County has long been known for its pre-booking jail diversion strategies through the Memphis Crisis Intervention Team model, the county has embraced the Sequential Intercept Model as a conceptual framework to develop comprehensive systems to engage persons with mental illness at key points in the interface between mental health and justice systems.
Shelby County has developed a new strategic plan based on the Sequential Intercept Model which allows them to see where resources are needed and prioritize the types of services and interventions that will be most effective. The model, according to Bush, is helping the county expand beyond relying solely on CIT and respond to people “who are already under parole or probation supervision; at the point of re-entry from local corrections systems; caught deep within the court system; and to gain fast track release of persons shortly after arrest.” Says Bush, “This strategy will guide local systems development and capacity expansion for years to come.”
(Reprinted from NAMI National’s website)
The DSM-5 May 21, 2013Posted by Crazy Mermaid in DSM 5, mental illness.
Tags: DSM 5, mental illness
On May 18, 2013, the American Psychiatric Association released its latest version of the Diagnostic and Statistical Manual of Mental Disorders, called DSM-5. This manual provides a common language and standard criteria for the classification of mental disorders. It is relied upon by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, and policy makers.
It is news, then, when the National Institute of Mental Health’s (NIMH) director, Dr. Thomas Insel, said they will no longer be using the recently updated manual. In his latest blog entry, Dr. Insel diagnosed the problem with the new manual as follows: “The weakness is its lack of validity”.
Dr. Insel had the following to say about the new manual:
“Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.
Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system. Through a series of workshops over the past 18 months, we have tried to define several major categories for a new nosology (see below). This approach began with several assumptions:
- A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories,
- Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior,
- Each level of analysis needs to be understood across a dimension of function,
- Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.
It became immediately clear that we cannot design a system based on biomarkers or cognitive performance because we lack the data. In this sense, RDoC is a framework for collecting the data needed for a new nosology. But it is critical to realize that we cannot succeed if we use DSM categories as the “gold standard.”2 The diagnostic system has to be based on the emerging research data, not on the current symptom-based categories. Imagine deciding that EKGs were not useful because many patients with chest pain did not have EKG changes. That is what we have been doing for decades when we reject a biomarker because it does not detect a DSM category. We need to begin collecting the genetic, imaging, physiologic, and cognitive data to see how all the data – not just the symptoms – cluster and how these clusters relate to treatment response.
That is why NIMH will be re-orienting its research away from DSM categories. Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system. What does this mean for applicants? Clinical trials might study all patients in a mood clinic rather than those meeting strict major depressive disorder criteria. Studies of biomarkers for “depression” might begin by looking across many disorders with anhedonia or emotional appraisal bias or psychomotor retardation to understand the circuitry underlying these symptoms. What does this mean for patients? We are committed to new and better treatments, but we feel this will only happen by developing a more precise diagnostic system. The best reason to develop RDoC is to seek better outcomes.
RDoC, for now, is a research framework, not a clinical tool. This is a decade-long project that is just beginning. Many NIMH researchers, already stressed by budget cuts and tough competition for research funding, will not welcome this change. Some will see RDoC as an academic exercise divorced from clinical practice. But patients and families should welcome this change as a first step towards “precision medicine,” the movement that has transformed cancer diagnosis and treatment. RDoC is nothing less than a plan to transform clinical practice by bringing a new generation of research to inform how we diagnose and treat mental disorders.”
With the power of the Federal Government behind him, Dr. Insel’s brave step of disregarding the DSM-5 has the capability to transform the entire mental health field.
Mental Illness: Worst Disease in the World? March 14, 2013Posted by Crazy Mermaid in mental illness.
Tags: Involuntary Committment, mental illness
1 comment so far
As the worst possible disease, mental illness isn’t even on most people’s radar. But consider, for a moment, the facts.
Unlike cancer, mental illness has a lousy public relations campaign. It doesn’t have a public personality attached to it- at least nobody positive. There’s no Lou Gherig or Lance Armstrong or Stephen Hawking to bring a sense of empathy to the masses. Unlike breast cancer, hundreds of millions of dollars aren’t spent on events to publicize mental illness- events like the Susan G. Komen Walk for the Cure – where the color pink has come to symbolize breast cancer in everything from headbands to hand mixers. Unlike Lance Armstrong’s Livestrong cancer campaign, where yellow bracelets signify triumph over cancer, there is no little plastic bracelet color for mental illness awareness. In fact, because of its enormous stigma, you would be hard-pressed to find victims and family members willing to take the spotlight for mental illness.
Everyone recognizes that the term “cancer” is a blanket term for a multitude of illnesses all sharing the same basic characteristic: improper cell division. Unlike cancer, the general public doesn’t perceive mental illness as a blanket name for illnesses caused by brain chemistry imbalance. Both are breakdowns of normal bodily functions, yet cancer doesn’t have the reputation of being a character flaw or a sign of moral bankruptcy that mental illness does.
Patients with cancer are not embarrassed to tell their friends and family their diagnosis. They aren’t afraid of being thought less of as a person for that diagnosis, that somehow they fell short. But with mental illness, the stigma is so great that the fear of rejection and isolation is a legitimate concern. You just don’t tell anyone.
Because their loved one’s illness isn’t associated with moral bankruptcy and character flaws, friends and relatives of cancer victims don’t have the same incentives to keep anyone from knowing their loved one has cancer. Protecting themselves from the unspoken charge of moral bankruptcy by association isn’t a top concern of the families of cancer patients, so they get emotional support from those around them.
Other diseases, like cancer or ALS or a stroke, don’t cause its victims to commit heinous crimes. You don’t see a breast cancer victim as the lead-in story on the nightly news because she murdered a bunch of school children. You don’t hear about a stroke victim trying to assassinate the President. A lung cancer victim doesn’t jump off a bridge to get away from the horrible voices in his head. And yet the connection between these types of actions and mental illness, if the news media even bothers to make one, is voyeuristic rather than sympathetic.
No legitimate insurance company would dare decline to authorize or pay for mainstream treatment of a cancer victim, but up until a very recent change in the law, insurance companies had little or no such coverage for mainstream treatment of mental illness, reasoning that it wasn’t, after all, a real physical illness. When they do cover it, it’s under a separate policy from “physical” health, called “Behavioral Mental Health”. We don’t see major insurance companies splitting off cancer from a list of diseases, calling it “Cell Divisional Health”, severely restricting its access, and farming out its administration to an entirely separate company.
When it comes time for hospitalization, there isn’t a question of whether a cancer victim or stroke victim even needs to go to a hospital. If they’re seriously ill, a cancer patient doesn’t have to be at death’s door before he’s admitted to the hospital. But a mentally ill victim has to either be about to hurt or kill himself or others (as determined by a third party) or needs to have tried (and failed) to kill himself before a mental hospital will consider admitting him.
If they’re hemorrhaging, but not near death, a cancer patient isn’t turned away for lack of space. Cancer patients don’t have to wait until there’s room for them at a hospital. Unlike hospital space for the mentally ill, hospital space for cancer victims hasn’t decreased over the past 20 years.
Alzheimer’s patients aren’t routinely discharged from hospitals onto the streets, left to fend for themselves. Cancer patients aren’t routinely discharged before they are stabilized. And yet the mentally ill are routinely discharged out onto the streets before they’re ready all of the time.
The cancer patient doesn’t have to give up his civil rights in order to be treated. He can leave the hospital whenever he wants. But in order for a mentally ill patient to be treated, he has to give up his civil rights. Mental patients are locked in, physically unable to leave the hospital until someone else- the attending psychiatrist- says they can go- however long that takes.
Once in a hospital, a cancer patient has the option to discontinue medication at any time. Mentally ill patients who have been involuntarily committed, on the other hand, must leave their civil rights at the door when they enter a mental hospital. Whether they want to or not, they are forced to continue medication while they are hospitalized.
Comparing the physical pain of the cancer or the effects of cancer treatment with the effects of mental illness is in some ways like comparing apples to oranges. Whereas the cancer victim fights for her life, the severely depressed victim fights to die. Is the physical pain of cancer worse than the emotional pain of continually hearing horrible voices in your head nonstop? Is radiation sickness worse than lithium side effects? Is prostate cancer preferable to schizophrenia?
I’m not trying in any way to minimize the pain and suffering that these diseases engender. My point is that each of these diseases -all of them- including mental illness-engenders tremendous pain and suffering. None of them- including mental illness- is any less severe than any other.
For too long, mental illness has been a quiet disease. Quietly terrible, but still quiet. This is a disease- or a family of diseases- on par with cancer and ALS and strokes, and yet there is a huge vacuum out there. Nobody even thinks about mental illness as a true physical disease. It’s not even on the radar. This needs to change. We need to raise people’s consciousness about mental illness, and give it the parity it deserves. We’ll know we’ve done our job when “mental illness” takes its rightful place on the list of Terrible Diseases in the public consciousness.
Anosognosia Rears Its Ugly Head (Again) October 17, 2012Posted by Crazy Mermaid in Hearing Voices, Insanity, mental illness.
Tags: Delusions, Hearing Voices, mental illness
Anosognosia is the term for the most dangerous symptom of mental illness. It’s the belief that you’re not mentally ill and don’t need your meds. I have been suffering from this symptom a lot lately. I have almost convinced myself that my diagnosis is a big mistake and that I don’t need my meds. If I go off them, my memory and reasoning ability will return, as will my ability to get up at a reasonable hour. I will be employable once again, and because I’m so good at my job, I will easily find a position as a project manager and be back to my beloved profession, building buildings. All of this is not possible while I’m on my meds.
I know consciously that going off my meds would be a bad idea, but because of this symptom, the concept seems perfectly reasonable.
Unlike many others, I have the sense to discuss my plan with my loved ones.
My sister, when confronted via phone with my idea, told me to open my copy of An Unquiet Mind by Kay Redfield Jamison. It’s a book where Jamison details out what it’s like to have a mental illness. My sister pointed out that Jamison, like me, convinced herself that she’s the exception to the rule of needing her meds. In her book, she goes off them and repeats her cycle of mental illness, finally coming to terms with it and returning to her meds. Reading that passage gave me doubts about going off my meds. Maybe that wasn’t the answer, but maybe it was.
If I stop taking my meds, the voice will probably- but not necessarily-return. But I’ve been hearing that voice for years, so it’s not a big deal. In my mind, it doesn’t mean I’m psychotic. I can manage to keep living in the “real” world without my medication as long as I can put up with a voice. My backup plan would be a return to the mental hospital if my psychotic state returned.
Bouncing this idea off my husband brought up a little problem. If I went off my meds, and a voice returned, wouldn’t this mean I was psychotic again? he asked. I disagreed. One voice doesn’t make you psychotic. But if the definition of psychotic excludes hearing one voice, then how do I know when I’ve crossed the threshold into my definition of psychotic again? How many voices and delusions does it take to be psychotic? And would I recognize it if it was happening? Therein lies the problem.
Between my sister and my husband, I gave in to their logic and stayed on my meds. But the battle never ceases.
Book Review: Surviving Manic Depression by E. Fuller Torrey September 3, 2012Posted by Crazy Mermaid in Bipolar Disorder, Book Reviews.
Tags: Bipolar Disorder, mental illness
I just finished reading Surviving Manic Depression: A Manual on Bipolar Disorder for Patients, Families, and Providers by E. Fuller Torrey, M.D. and Michael B. Knable, D.O. I’ve read books devoted to exploring Bipolar Disorder, but none of them hold a candle to this one. I heard about this book when a gentleman from NAMI graciously provided me with the name of this book after I asked him how Manic Depression re-branded itself to “Bipolar Disorder”. Dr. Torrey meticulously wades through society’s current beliefs, making a compelling argument that Manic-Depressive is a more accurate term and should be brought back into general use. Besides providing an excellent platform for his argument, the book delivers on many different levels.
I found my hardcover copy at Amazon.com, for about $4 plus $4 in shipping in the Used Books section. The publication date of my copy is 2003, but there is a 2005 paperback version that I can’t speak to. Anyone with information on the newer book is welcome to send me your thoughts. I’d love to hear them.
Dr. Torry wrote his first book on Schizophrenia (which I haven’t read yet), which qualifies him to compare the two illnesses with authority. He takes advantage of his knowledge to bring his audience on an expedition to explore those differences in great depth. When I finished the book, I had a better working knowledge of Schizophrenia, which I wasn’t expecting from a book on Manic Depression.
My only complaint is that he doesn’t really get into depth on definitions until Chapter 3, and I would have liked to see that done right up front in Chapter 1.
Risk factors, causes, medications, and treatment strategies are all areas I’ve found in other books, but this one is done better than most I’ve read. He uses the lens of the Scientific Method to standardize knowledge, allowing him to easily gut some of the urban myths that have grown up around Manic Depression, while moving others from that urban myth category into reality. No sleight-of-hand here.
The coup d’gras is the appendix section. It’s amazing. He’s done a review on every major book I’ve ever heard of having to do with manic depression as well as on ones I never would have known about any other way. He’s reviewed websites, and in the process opened my eyes up to organizations I’ve never heard of but want to explore now that I know about them. This part, at the very end of the book, is worth the price of the book. He wraps up the book by declaring that we need a 21st century Dorothea Dix- someone to research and meticulously take note of the existing system and shine a public spotlight on the broken parts. I couldn’t agree more.
Here We Go Again: Reducing Mental Hospital Beds August 19, 2012Posted by Crazy Mermaid in Delusions, Mental Hospital, mental illness, Schizophrenia, Uncategorized.
Tags: Delusions, Hallucinations, Mental Hospitals, mental illness, Schizophrenia
1 comment so far
Here we go again: more psychiatric hospital beds are disappearing in Washington State. How do I know? Not from anything in the news. It’s because I got a phone call from a 75 year old woman whose 54 year old schizophrenic son is being released from Western State Hospital. She called because she was desperate to find housing and help for her son before he is released, which will be soon. She explained that she is an old lady and can barely care for herself, much less her son, who has been at Western for many years.
At Western, he has case managers and people who make sure he takes his medication as well as living support. He never learned how to shop or care for himself because his symptoms were so severe that they required him to be permanently hospitalized. I’m guessing that even with proper medication, he isn’t symptom-free or he would have been released years ago. Even with proper medication, delusions and hearing voices is fairly common in hard-to-treat cases like his. Once out of that protective environment of the hospital, she is concerned that when he stops taking his medication, his symptoms will increase and he will become unmanageable. She is looking for housing for him that will also provide help in adjusting to life on the outside. And she doesn’t have much time.
This situation is tragic. They’re taking a man who has spent most of his life in an institution getting the help and support he needs in order to function, and throwing him outside to fend for himself. Had there been any adjustment support for him, she wouldn’t be so desperate. Programs like those he needs are overfull. He won’t be able to get into those programs for years because they’re at or over capacity right now. And with the State releasing more people like this man, more people will fall through the cracks. The State hasn’t funded stop-gap programs for people like him. There simply isn’t anywhere he can go. Who knows what will ultimately happen to this man?
Although I understand the need to balance the State budget, balancing it on the backs of the more vulnerable population is unconscionable.
Contrary to popular opinion, 99.9 percent of people housed in institutions like this aren’t dangerous when released. So we shouldn’t be afraid of him. In fact, statistically they are the ones who are more likely to be assaulted and victimized because they’re not equipped to survive outside their institution. Turning a man out who has been taken care of most of his life will not make his quality of life improve. In fact, the type of living situation that he was in had allowed him to have his “home base” at the hospital, able to freely come and go at will. The point of the hospitalization was to keep him taking his medication allowing him to live with and manage his schizophrenic symptoms. If he is left to his own devices at this late stage of his life, he will likely discontinue taking his medication, which will mean the symptoms of his illness, barely contained anyway, will return in a big way. I’m not saying he will be a danger to others. I’m just saying that hearing voices and other negative symptoms will likely return in a big way without proper medication and supervision. Clearly, his case must be particularly difficult because had he had an “easy” case, he would have been released years ago. He’s there because that’s where he needs to be.
His institutionalization is very different from involuntary commitment, so his release shouldn’t scare anyone from the standpoint of him being a threat. Far from it. He is allowed to come and go at will, but his base is always at Western State Hospital. He goes on outings and to visit his parents, but he never stays there for any length of time. He always has to return to Western so they can give him the care he needs. He hasn’t gone grocery shopping or done the dishes or any number of things we are all used to doing in order to survive. If left to his own devices without any education in performing these relatively easy tasks, he will risk his well-being to the point of being dangerous. Just turning him loose out into the world will be a hardship. His 75 year old mother won’t be much help, and because of his symptoms he can’t live with her- especially once he’s off his medication.
They say the mark of a civilization isn’t how they treat their rich. It’s how they treat their poor and vulnerable population. And from the way this gentleman is about to be treated, it’s clear that we’re not exactly the best civilization in the world.