Psychotic States of Mind March 13, 2015Posted by Crazy Mermaid in Psychotic.
Tags: Delusions, Psychotic
Last night, I had an opportunity to talk with two people who were either in the middle of a psychotic break or had recently suffered a psychotic break. We had a lot in common.
The important concept to understand about a psychotic break is that the reality imposed by the break is as real to the person suffering from it as your reality is to you. If we think there’s someone hiding under our porch or standing outside our bedroom window, then someone is in fact doing that. That is our reality. And it’s scary stuff.
A psychotic break isn’t just limited to the brain thinking a psychotic thought. Our senses support that reality. In my psychotic state, all my senses supported my reality. Nothing was amiss. I smelled the perfume of someone (who wasn’t there and never had been there). I felt a (nonexistent) flap of skin between my toes that made my feet into fins. When I had my mask and snorkel on in the water, people surrounding me had green skin. I trusted my senses, since they had never failed me before. As they had throughout my entire life, my senses confirmed my reality.
Right before I was involuntarily committed, I came to the realization that as a mermaid, I was in extreme danger. Over the course of a month or so, I noticed that while I was swimming in the pool next to the wall, my body emitted a pink powder that built up on the sides and in the corner of the pool. The powder, which was warm to the touch and dissipated like flour in water, was actually a form of energy that could be harnessed to generate electricity. Right then, I knew I was in danger of being captured by some evil people and hooked up to a power plant. That thought was in the back of my mind as I returned to the swimming pool for the third time that day.
As I made my way to the pool from the parking lot, everyone I passed- men, women and even babies- were all zombies. Their white skin hung on their bodies, and they had black holes where their eyes were supposed to be. I was disturbed by what I saw, but not afraid enough to forgo swimming.
That was my reality, and no one could have persuaded me that the people I saw weren’t really zombies.
Last night, all three of us shared similar delusions. All of our delusions were real to us, and they were for the most part scary and negative delusions. If you think zombies are after you, you live in terror of being captured. If you think someone is waiting outside or under the porch to grab you, you live in terror of being captured by those people. If you think the mob is trying to kill you, then you fear for your life all the time.
Delusions feed on themselves, and we start to see patterns where none exist. We notice four red cars in five minutes while driving, and those red cars reinforce the fact that the mob is trying to kill us.They confirm our worst suspicions. Patterns confirming our delusion are everywhere. We see what our reality tells us.
We looked for solutions to our common problem: how to tell if we’re in a delusion. But the problem with looking for solutions is that when we’re in the middle of a delusion, that is our reality. We don’t have the presence of mind to wonder if our perceived reality is the truth. Of course it’s the truth! And anyone who tries to persuade us differently is an enemy.
The best way to solve the problem of being terrified of our delusions is to get assessed by a psychiatrist and go on medication to make the delusions go away. But this is difficult, since the delusions include not trusting anyone who tries to persuade us that our perceived reality isn’t real. It’s a catch 22.
The real trick is overcoming the lack of trust the person in the delusion has. They trust no one, especially anyone who challenges their reality.
Right now in Olympia, legislators are debating new legislation that would make it easier to get people suffering in a delusion help. The standard for involuntary commitment- which is what has to happen in the case of severe psychotic delusions- would be lower than it is now. You wouldn’t have to harm yourself or someone else in order to start treatment. You would have to be assessed as having a likelihood of harming yourself or others rather than having injured yourself or others. This legislation would improve the quality of life of someone in the middle of a severe psychotic episode because it would force them to start their medication, which would make the delusion fade enough to stay on their medication willingly. It’s a huge step forward in the treatment of mental illness.
With enough medication, my zombies disappeared. With enough medication, the mob stopped trying to kill my friend. And I trust that the people standing outside the bedroom window and under the porch will disappear for my other young friend, if only he can stay on his meds long enough. It takes weeks or sometimes even months for that medication to work, which is a long time if you’re suffering. Sometimes the delusions win the fight, and the person is stuck in their negative reality for life.
Hopefully, you get an idea of the power of these delusions. But there are solutions, if only people let those solutions happen, both on a State level and a personal level.
It’s important that we have conversations about mental illness and perceived reality. If someone’s quality of life improves because the delusions go away, that’s enormous progress.
Hearing Voices at Boeing October 25, 2014Posted by Crazy Mermaid in Hearing Voices.
Tags: Hearing Voices, Psychotic
NAMI has several signature programs (all free), including one called In Our Own Voice. In this very structured program, two co-presenters talk about what it’s like to live with a mental illness on a daily basis. The program is about an hour long, with time for questions and answers at the end.
For me, stress brings on hearing voices. In my daily life, I live a fairly stress-free life. I have my routines, and my husband and family do a good job of insulating me from stress. We live frugally, but have no major money problems that I am aware of. I am no longer aware of any of our financial information because when I became psychotic I blew through lots of money in a short expanse of time, so while I was still in the mental hospital we decided to safeguard our financial future by keeping me ignorant of our finances. The long and short of it is that a lack of information and a trust of my husband’s financial acuity mean that I can relax about money and not worry about it and stress about it.
The one thing that brings stress into my life is the In Our Own Voice presentations. I stand before a group of strangers and share the story of my psychotic break and my resulting life changes. Simply sharing that story brings back a state close to my psychosis as the memories of what was come flooding back. With the return of that state comes a voice. I tell the audience about the voice. It is actually talking to me via ESP in my head during my presentation. The voice is neither a man’s nor a woman’s. It is genderless. As the presentation starts, it starts talking to me in a fairly quiet voice. But as the presentation continues, the voice gets louder. Fortunately, it doesn’t get as loud as it used to when I was psychotic, when I couldn’t hear myself think because the voice was so loud.
The voice tells me things to say to the audience, reminding me not to forget certain parts of the presentation. It also tells me things to remind my partner to say. It makes observations about audience members, especially focused on pepole’s clothing and hair. I don’t notice these things until the voice points them out to me. It is distracting, but I have learned to live with it. I am willing to put myself through this in order to bring knowledge and understanding of mental illness to a broad audience.
I have been told that because I know the voice isn’t real, I should be able to internalize that thought rationally and eliminate the voice entirely. But it simply doesn’t work that way. Even though I know the voice isn’t a real person, it still behaves as a real person, with thoughts of its own. It isn’t simply my subconscious talking. It’s a separate being apart from myself living inside my head and sharing my body.
Recently, my presentation partner, Matt, a chiropractor with a similar psychotic history, and I gave a presentation to a group of Boeing employees. We typically get a few questions from the audience from every presentation, and audiences are usually eager to ask both of us questions, and usually bring up a question or two about the voice. Surprisingly, at the end of our presentation, no one in the audience asked a single question. Not one.
I suspect that the stigma of mental illness played a large part in the lack of questions. If you ask a question, it might mark you as someone with familiarity with mental illness, which might impact your career. I understand that reasoning, but the whole point of the presentation is to break down that stigma and make it okay for people to ask questions. Although we failed in that aspect of our mission, I think it is important to expose people to the reality of mental illness. Telling people that I am hearing a voice during my presentation shows them that you can hear voices and live a fairly normal life, which is the other key part of the presentation. You look perfectly normal, and no one knows what’s happening inside your head unless you tell them.
One day, I hope that people will be free to ask us questions during a presentation like that. But we’re not there yet.
Which Medical Condition Is the Worst? July 15, 2010Posted by Crazy Mermaid in Hearing Voices, Insanity, mental illness, Psychotic, Schizophrenia.
Tags: Bipolar Disorder, Hearing Voices, Insanity, mental illness, Psychotic, Schizophrenia
If you had to guess which medical condition was the worst, which one would you pick?
Most people’s thoughts would go immediately to the most widely publicized, the disease advertised as the most painful and deadliest of all diseases: cancer. With pancreatic cancer, the victim suffers prolonged agony, relieved only by colossal injections of pain medication, until finally he expires, leaving his cancer-ridden body once and for all. The worst possible disease, some would say.
Many would choose Alzheimer’s disease as the worst disease. Your mind slowly loses memory, forgetting things and people and places. Eventually, your heart “forgets” to beat, and you pass on, leaving a wake of pain and suffering by your loved ones. Because you generally become less aware of your surroundings as time goes by, and because the deterioration happens over years or even decades, the pain and suffering are felt more by your family and friends than you.
Some would say that Lou Gherig’s Disease, also known as ALS, is the worst. Like Alzheimer’s, your body slowly forgets to function, but unlike Alzheimer’s, your mind works perfectly. The result is a little like waking up in the middle of a surgery, and being unable to communicate to the staff that you are awake. Your body is paralyzed, but your brain is wide awake. Thankfully (or not), death is generally relatively quickly.
Others would say that a stroke is the worst, for reasons similar to ALS. Your mind is generally awake, but your body is unable to communicate that awareness to the world at large. Thinking that your brain has turned to mush because you undergo the humility of wearing diapers and eating baby food, your family may treat you like you’re a piece of furniture, or as if you’re an infant. Unable to communicate your complete awareness to them, you suffer for years or even decades in silence.
As the worst possible disease, mental illness isn’t even on most people’s radar. But consider, for a moment, the facts.
One of the problems is that 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 public campaign for the little plastic bracelet color for mental illness awareness (silver). In fact, because of its enormous stigma, you would be hard-pressed to find many 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 improper brain chemistry. 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.
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 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.
People with cancer or ALS or all of the other diseases are aware that they are ill and need treatment for that illness. In many mental illness cases, this is not true. The mentally ill patient, in many cases, has no insight into the fact that he is mentally ill and need treatment.
No legitimate insurance company would dare decline to authorize or pay for mainstream treatment of a cancer victim, but most insurance companies have little or no such coverage for mainstream treatment of mental illness, reasoning that it isn’t, after all, a real physical illness. If they do cover it, it’s under a separate policy from “physical” health, called “Behavioral Mental Health”, and the payment for treatment and disability from the disease is very limited. 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 while they are still unwell all of the time. Who do you think the homeless people are?
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 to. 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. Again, a cancer patient doesn’t have to give up his civil rights in order to be treated. Mentally ill patients, 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. That is the treatment.
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 kill herself. Is the physical pain of cancer worse than the emotional pain of continually hearing 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.
Mental Illness and The Law: How We Got Where We Are June 29, 2010Posted by Crazy Mermaid in History, Insanity, Involuntary Committment, Mental Hospital, mental illness, Mental Illness and Medication, Psychotic.
Tags: Delusions, Insanity, Involuntary Committment, Mental Hospitals, mental illness, Mental Illness and Murder, Psychotic
If you want to change things, first you need to understand how they got the way they are. In the case of mental illness law, politicians and lawyers had the best of intentions, but as with other ventures, the devil was in the details. The unintended consequences of their actions continue to remain the source of frustration and even danger.
In his 1946 article “Bedlam 1946: Most Mental Hospitals Are A Shame and A Disgrace” http://www.mnddc.org/parallels2/prologue/6a-bedlam/bedlam-life1946.pdf in Life Magazine, Albert Maisel made the case that mental hospitals were terrible institutions. The final paragraph of his article summarized his point succinctly: “Given the facts…the people of any state will rally… to put an end to concentration camps that masquerade as ( mental) hospitals and to make cure rather than incarceration the goal of their mental institutions.”
While the sentiment is perfectly understandable given the horrific conditions he found when he investigated the state of mental hospitals throughout the United States shortly after the close of World War Two, he threw out the baby with the bath water when he declared, in effect, that nobody should have to be institutionalized. The wildly popular Life Magazine gave Maisel a platform from which to launch his idea of closing all mental hospitals, also called deinstitutionalizing the mentally ill.
Helping this idea along was the development of the first generation of antipsychotic drugs in the 1950’s. Used to treat schizophrenia and other psychoses as well as acute mania, agitation and other conditions, their discovery allowed many mentally ill people once hospitalized to return to their families, hopefully with their illness under control and able to function as productive members of society in many cases. In many cases this was true, but not in all.
The advent of these new antipsychotics lent fuel to the fire of the deinstitutionalization movement, and, combined with the publicity of the atrocities perpetuated in the mental hospitals, served to throw the doors to the mental institutions wide open in the mid-1950’s.
From the mid-1950’s to the mid-1960’s, a small percentage of the eventually deinstitutionalized were released. But from that point forward, the trickle became a flood, culminating in the release of the majority of the mentally ill by the mid-1980’s. And as the mentally ill were released from the hospitals, rather than wait to see whether whether the experiment was going to work, those hospitals were closed down forever, shrinking from a high of around 550,000 beds in the mid-1950’s to around 40,000 today. As this experiment failed,the homeless and prison populations of every major city and State ballooned.
In the meantime, California was the first state to pass the Lanterman-Petris-Short Act in 1967, giving the mentally ill the legal right to avoid treatment for their mental illness, regardless of how damaging that mental illness became. Unless the person was in imminent (immediate) danger of severely harming or killing themselves or someone else, they had the right to be left alone, free to wander the streets, homeless and victimized, eating out of dumpsters, lost in their own world. Other States followed their example, with the former Governor of California, Ronald Reagan, leading the charge on a national level as he ascended the highest office in the land, the Presidency.
The mistakes the do-gooders made in this two-pronged approach of first deinstitutionalizing and then arming the mentally ill with the right to refuse treatment were twofold. Their first mistake was in perceiving all hospitalization to be bad hospitalization. Secondly they assumed that anyone who has a mental illness has the presence of mind to know when to seek treatment for that illness.
Treating mental illness like any other illness, disregarding the fact that one of the symptoms of the illness can be a failure to realize they are ill, and denigrating all mental hospitals as evil are poor choices for which we have all paid dearly, in the form of the fallout from our endless supply of suicides, the incarcerated mentally ill population, the homeless population, and mentally ill people who attack and assault others.
Until we realize that mental hospitals can also be used for good, and that mentally ill people can’t always help themselves, nothing will change.
(Note: Part of my research for this article was done with the help of Dr. E. Fuller Torrey’s book The Insanity Offense. (2008).
Not Guilty By Reason of Insanity May 21, 2010Posted by Crazy Mermaid in Delusions, Hallucinations, Mental Hospital, mental illness.
Tags: Delusions, Insanity, Mental Hospitals, mental illness, Psychotic
Wednesday’s Everett Herald featured an article about a young man who was acquitted of a first degree murder charge. Chad Patterson, accused of breaking into the man’s home Sept. 10 and repeatedly trying to stab him with an 8-inch kitchen knife, was acquitted of the charges by Superior Court Judge Ronald Castleberry on Tuesday. Verdict: Not Guilty By Reason of Insanity.
According to the article, three doctors concluded that at the time of the attack Patterson couldn’t understand that what he was doing was wrong. The Judge ruled that there was enough evidence to support the defense’s position that Patterson was not guilty of the crime because he was legally insane at the time of the attack. Instead of jail time for a murder conviction, Patterson will be locked up indefinitely at Western State Hospital, receiving treatment for a mental illness.
I can already hear the complaints from the general public about this. They’ll say the guy scammed the system. That he got off scot-free. But let’s examine the facts of the case.
In what was said to be his first ever psychotic break with reality, Patterson was out walking his dog when he saw his neighbor watching him, preparing to attack him (so he thought). Deciding he needed to “take care of” the neighbor, Patterson threw himself through a window to get into the neighbor’s house. Fighting off the teen, the neighbor pushed him outside, only to have Patterson return a second time. He pushed Patterson out a second time, and Snohomish County sheriff’s deputies arrived as Patterson, bloodied and cut, was trying to get inside the man’s home a third time.
During the attack, Patterson said that God told him that the man needed to die. After he was arrested he told deputies that he was their god and demanded to be released from his handcuffs. But that’s not all.
Patterson was convinced someone had implanted a camera into his eye and a microphone into his ear, both likely symptoms of undiagnosed schizophrenia according to expert testimony. At the time of his attack on his neighbor, Patterson hadn’t been diagnosed with a mental illness and wasn’t under the care of a mental health doctor, despite the fact that his mother had been trying to get help for her son. She was told that until he hurt himself or someone else there wasn’t anything that anyone could do about the situation.
According to Patterson’s defense lawyer, the insanity defense is rarely pursued because it is almost impossible to meet the threshold needed to prove someone is legally insane at the time of the alleged offense. Adding to this, according to the public defender, is the fact that many offenders refuse to publicly acknowledge they’re living with a mental illness. They’d rather go to jail than be diagnosed with a mental illness.
Those who think the insanity defense is a cake walk have another think coming. In fact, according to Frontline’s A Crime of Insanity, insanity defense acquittees frequently spend twice as much time institutionalized as defendants convicted of a similar offense spend in correctional facilities. And let us not forget what a mental hospital is really like. Locked doors, razor wire topped barbed wire fences all around the compound, structured days, institutional food. Just like a jail, except for one added bonus feature you won’t find at a real jail. In the mental hospital, you’re pumped full of drugs that try to bring your brain as close to “normal” as possible.
So contrary to what the general public thinks, those inhabiting mental hospitals rather than prisons don’t necessarily have it better.
Facts of case excerpted from: http://www.heraldnet.com/article/20100519/NEWS01/705199838
Frontline’s A Crime of Insanity: http://www.pbs.org/wgbh/pages/frontline/shows/crime/trial/faqs.html#gbmi),
Brain Chemistry and Sense of “Self” May 11, 2010Posted by Crazy Mermaid in mental illness, Mental Illness and Medication, Psychotic.
Tags: Delusions, mental illness, Psychotic
During the course of my psychotic break with reality, I had another type of break with reality. As my psychotic break intensified, my sense of self expanded way beyond the confines of my physical body. It’s a hard thing to explain, but my sense of self expanded so far beyond my physical body that it encompassed the entire Universe. The phrase “She was One with the Universe” fit me to a “T”.
After I entered the mental hospital, Job One was to stabilize me, which meant snapping me out of my psychotic state of mind as soon as possible. To that end, the hospital personnel administered large doses of antipsychotics and mood stabilizers.
As the drugs built up in my system, they began to have the desired effect of eliminating my psychotic episode. One of the ways the drugs did this was by reducing my sense of “self” from the global “oneness” back to localization inside the confines of my physical body.
As the medication continued to build up, coursing through my bloodstream in ever-larger doses, it eventually crossed a threshold, building up to a point where my sense of “self” became removed from my body entirely. I was no longer inhabiting my physical body at all. Instead, I viewed my body from a point about a foot above my head at a 45 degree angle, experiencing life as an observer.
Complaining of this symptom to my psychiatrist, he knowingly shook his head, declaring it a side effect of the medication. Reducing the dosage of medication and eventually replacing it with a different drug served to return my “self” back into the confines of my physical body, where it continues to reside to this day.
Based on my experience, it is clear that we can induce an expansive sense of self as well as a minimalist sense of self in the same person using nothing but brain chemistry. The expansive self incident was induced by stress-related changes in brain chemistry, while the minimalist self incident was induced by the introduction of a drug directly into my blood stream. Both incidents acted in a way that changed my brain chemistry. Both incidents were two sides of the same coin.
It’s fascinating to consider the implications of this “experiment”. What does it mean when a sense of “self” can be chemically manipulated? What does it mean when localization of “self” inside our physical bodies is due to brain chemistry?
This new awareness puts events like out-of-body experiences in a whole new light. Isn’t it interesting that by simply changing our brain chemistry, we can induce a sense of Oneness with the Universe? or even an out-of-body experience? What are the implications of this for humanity?
(Note: This blog was inspired by the Neurophilosophy blog of December 2008 titled The Body Swap Illusion)
Mental Illness: Faulty Brain Circuits April 13, 2010Posted by Crazy Mermaid in mental illness, Psychiatrists, Therapy.
Tags: mental illness, Psychotic, Therapy
Faulty Circuits, an article in Scientific American magazine’s April 2010 issue, summarizes the leaps in neuroscience technology that reveals that psychological disorders have underlying malfunctioning physical brain connections, much like faulty circuiting in electrical wiring. This new evidence-based thinking is a paradigm shift in the way mental illness is thought of not just in the scientific and medical communities, but as this thinking infiltrates the mainstream, it will result in a shift in our perception of how people with mental illness are perceived.
The author, Thomas R. Insel, a psychiatrist and neuroscientist, is director of National Institute of Mental Health, the federal agency that supports the study of mental illness. In describing new findings in the neurocircuitry of mood disorders, Insel tries to bridge divisions between biology and psychology by highlighting the inter-relatedness between neural activity and behavior.
For the first time, we can see in real time problems in brain circuitry by the use of the newest imaging technologies, called neuroimaging. While the details of each disorder’s “circuit diagram” are still emerging, the new views are already producing seismic shifts in the way we think about mental illness. We’re getting insight into their underlying causes, and that means quicker and more accurate diagnosis as well as better and more effective treatment.
With the new neuroimaging techniques, brain circuits are diagrammed out like electrical circuits, allowing scientists to see exact locations and nature of specific problems. Some of the problems are coordination problems, where areas that are usually synchronized are out of synch. Other problems involve activity levels in, or communication between, brain areas. Areas that should be talking with each other aren’t.
One of the more interesting points the author makes is that the behavioral and cognitive symptoms that we perceive as a mental illness may be late manifestations of dysfunction in a circuit. He points out that it wasn’t that long ago that heart disease was diagnosed only when a person had a heart attack, just like clinical depression is diagnosed today only when a person exhibits clinically depressed symptoms. But in reality, it’s quite likely that in clinical depression as in heart disease and a whole host of other illnesses, observable symptoms only emerge after other compensatory mechanisms no longer suffice.
With this new view of mental illness, we will no longer have to wait until those other compensatory mechanisms fail in order to diagnose mental illness. A Schizophrenia diagnosis won’t have to wait for a psychotic episode. Not having to wait for the psychotic episode to show up will take some of the fear out of a diagnosis of schizophrenia, since with an accurate diagnosis will come a more targeted therapy that will mitigate some of the more extreme symptoms.
To take clinical depression as an example, we have come a long way in its diagnosis and treatment, and yet we have a long way to go. Back in the early 1960’s for example, there were no predictors of risk, the diagnosis was done by interview, interventions were limited to institutionalization, electroconvulsive therapy and insulin coma, and the outcomes were a very high risk of relapse and a high rate of suicide.
In 2010, we have come a little further. Predictors of risk now include a family history and/or history of trauma. Diagnosis is still done by interview. Interventions are antidepressants and cognitive behavioral therapy, and outcomes are a 50 percent response after 12 weeks. Mortality and relapse are still very high.
The goal for 2020 is ambitious and yet I hope doable. As a predictor of risk, we will use gene and protein analysis as well as brain imaging. Interventions will include preventatives such as a vaccine and/or cognitive therapy as well as treatment options tailored to individual need including improved medications, cognitive therapy and brain stimulation. The goal for outcomes is to have the patient respond to treatment within 24 hours, and to reduce relapse risk and mortality risk to low.
The author notes that although mental disorders are currently classified by their symptoms, which overlap in many conditions and aren’t linked to any particular biological evidence, he suggests that reclassifying disorders based on brain function would be very beneficial because it could yield a system of diagnosis based on biological signs such as chemical or structural changes to the brain specific to the condition. He argues that using this new classification system could allow disorders to be diagnosed earlier and with more precision, based on their biological markers.
Changing the way diagnoses are made from interview-based to biological-marker based will change public perception of mental illness in a major way. A scientific approach to the diagnosis and treatment of mental disorders, he notes, could help eliminate the stigma associated with mental illness.
Source: Magazine Article: Faulty Circuits, Scientific American, April 2010, pgs 44 through 51
Mental Illness and Stalking February 25, 2010Posted by Crazy Mermaid in Delusions, Hearing Voices, mental illness, Psychotic, Stalking.
Tags: Delusions, Hearing Voices, Insanity, mental illness, Psychotic
Stalking is a matter of perspective. From the standpoint of the stalker stalking a celebrity, the stalker is convinced that he has a very real, very personal connection to the person he’s stalking. He would be shocked to learn that what he’s doing- trying to fulfill the celebrity’s perceived request for that contact- is viewed by law enforcement as well as the celebrity in question as stalking. How can it be stalking, he reasons, when the person he’s accused of stalking wants desperately to see him? It must be a misunderstanding.
When I was slipping into the final stages of my delusion (right before I was involuntarily committed to a mental hospital) I was absolutely convinced that I had ESP, and that Bill and Melinda Gates were among my many friends-including the Dalai Lama and Oprah Winfrey- who talked with me via ESP (voices in my head). I used to make beaded jewelry, so it wasn’t surprising that (as part of my delusion) Bill and Melinda Gates had heard of my jewelery-making prowess, and begged me to make some jewelry for them.
I agreed to their request, provided they give me direction on their tastes. One of the capabilities of people who shared ESP with me was their ability to see the world through my eyes. Literally. It’s kind of complicated to explain, but suffice it to say that they saw everything that I saw. So it was natural for Bill and Melinda to wander around the bead shop with me, picking out beads for their own special necklaces as if they were actually in the room with me. When Bill began picking out expensive stones, I balked. But Bill assured me that price was no object, since he (the richest man in the world) would be reimbursing me in the very near future for the money I spent. Payment from Bill established for sometime in the near future, “we” roved the store selecting expensive stones for their necklaces.
“We” returned to my home where I spread the expensive loot out on my kitchen table and began putting the necklaces together with “their” direction. When “we” finished the jewelry, “we” discussed how they were going to get the necklaces from me. Should I mail them? Should I send them via UPS? Should I send them to their house in Medina? Or to Microsoft’s campus in Redmond? At first, “they” directed me to mail them to the Gates’ in care of their (real) nonprofit organization, The Bill and Melinda Gates Foundation. After further discussion, “we” agreed that I would give the necklaces to them when I met them in person, which was going to be in the very near future. Fortunately, I ended up in the mental hospital before I could do any real damage.
It is easy for a delusional person to cross the line into what appears to the real world as “stalking”. I had lost touch with reality to the point where I was convinced that the Gates’ wanted their jewelry so badly that had “they” insisted, I would have, without question, driven to their home in Medina (about 20 minutes from my home) with the intent of personally delivering the necklaces to them as they had requested. I would have been absolutely convinced that they were desperate for my jewelry, and wouldn’t have believed anyone who tried to tell me differently. Had I followed that plan of action (rather than wait to meet them as we finally agreed), I would have been carted off to jail, labeled a stalker. But in my mind, I would have been absolutely certain that the Gates’ were dying to see me, and I would have insisted that this was so.
In revealing this very personal and embarrassing episode that was part of my psychotic delusion, I hope to show how easy it is for someone suffering from delusions to become a stalker. I ask for the law profession to understand that when they are investigating a stalker, in reality they’re likely with a delusional mentally ill person. I ask for them to show that “stalker” some compassion by getting an immediate psychological evaluation before sending him off to jail. With proper medical intervention, their delusion, like mine, will evaporate and the psychotic individual will return to the real world. And when it’s all over and they’re medicated and back in their right mind, they, like I, will be extremely embarrassed and ashamed of their behavior.
Involuntarily Committed to Mental Hospital January 6, 2010Posted by Crazy Mermaid in Involuntary Committment, mental illness, Psych Ward, Psychotic.
Tags: Hearing Voices, Insanity, Involuntary Committment, mental illness, Psych Ward, Psychotic
My husband knew that something was the matter, but had no clue what it was or the magnitude of the problem. He got a few glimpses here and there, like when I wrote a $55K hot check for a brand new Lexus, spent thousands of dollars on plants and flashy trashy new clothes, and started wearing garish makeup (ringing my eyes with a gold makeup crayon). Or when I quit my job (managing a $55 million construction project and making over $100K a year) out of the blue. He knew that I wasn’t doing drugs or drinking, but still- something was very, very wrong.
I finally reached the flashpoint where I realized I could no longer tell reality from fantasy when I encountered an infestation of zombies at my neighborhood (YMCA) swimming pool. Dripping wet and still in my swimming suit, I drove myself home. Scared to death, I begged my husband to take me to the emergency room after I told him I was hearing voices. He didn’t ask, and I didn’t tell him, the nature of the voices or how long I’d been hearing them (3 1/2 months). He was just thankful that I had finally admitted to him that there was something wrong.
Once we arrived at the Hospital emergency room, I immediately changed my mind about wanting to be there. Actually, the voices changed my mind for me. At their direction, I tried to leave, but my husband cornered me like I was a calf at a rodeo. Finally, after taking off all my clothes in the women’s restroom (at the direction of the voices) and parading around naked in the waiting room (and refusing to put them back on or wear a blanket), as well as several escape attempts, I was put in a locked private room, alone except for a talking blood pressure machine, six imaginary people talking to me in my head, and an imaginary tree person drawing leaves and branches on the white walls.
They could guess, but they didn’t know, that I was having delusions, but they could never have guessed at the magnitude of the problem. In the meantime, the staff wouldn’t let me leave the locked room or tell me what was going on. I knew they couldn’t legally hold me, but they were doing it anyway. I felt powerless. I believed they were trying to kill me by radiation so they could drop my dead body on Iraq as a weapon ( but I didn’t let them know that). In frustration, I (at the direction of my lawyer, who was one of the voices in my head) threw a stool at the door, trying to break the little glass window in the door so I could leave. I was unsuccessful, only managing to make a few dents in the drywall around the door.
At the point I threw the stool, I unknowingly entered a new realm of law: involuntary commitment. I had crossed a line, demonstrating in concrete terms that I had become a danger to myself and others, and demonstrating to the hospital personnel that I needed evaluation by an independent (outside the employ of the hospital) licensed mental health professional to determine whether I had to be involuntarily committed to a mental hospital. The Hospital was required by the laws of the State of Washington to have a designated mental health professional interview me once the stool hit the wall. Up until that point, the hospital would have interviewed me without the intervention of the mental health professional, and they would most likely have released me, because there aren’t enough (mental) hospital beds to handle all of the people who need care.
Telling everyone within hearing range that I was a mermaid, walking around the waiting room showing people my feet and asking them if they could see my fins, and even taking off my clothes didn’t demonstrate to anyone that I was a danger as defined by the State of Washington laws. Mermaids aren’t harmful, and believing you’re a mermaid isn’t against the law. Even taking your clothes off in public doesn’t automatically qualify you as a danger. But throwing the stool changed everything. It gave the State the authority to lock me up in a mental hospital. Once there, the mental hospital legally* held me against my will for 120 hours before they went before a judge to get a court order to hold me involuntarily up to 2 weeks. Before the two weeks was up, they had to again go before a judge to continue holding me beyond that 2 weeks. The second court order allowed them to hold me up to 90 days, but they only held me one week longer. I was out in 3 weeks.
*Note: By State of Washington law, the mental hospital can only hold a patient 72 hours before they have to go to court to get a court order. But that excludes weekends and holidays, which is why I was held 120 hours.
Waking Up in a Mental Hospital Psych Ward January 6, 2010Posted by Crazy Mermaid in Involuntary Committment, mental illness, Psych Ward, Psychotic.
Tags: Hearing Voices, mental illness, Psych Ward, Psychotic
I awoke laying on the bed, covered by a sheet and a light yellow blanket. There wasn’t a soul around. I had no idea where I was or what I was doing there. The last thing I remembered was being wrestled and pinned onto a red four-point restraining board at the hospital emergency room and then being strapped in and shot up with some kind of drug. After that, I didn’t remember a thing. I didn’t know what day it was, or what time of the day it was. I had no purse, no money, no identification. No bra, no underwear, no shoes, no pants, no shirt. Nothing but my hospital gown. And my voices and delusions.
My rights had been taken away from me, for no reason. I was a prisoner and I hadn’t even had a trial. I couldn’t go anywhere. I couldn’t leave the locked room with the furniture bolted to the floor. Even if I were allowed to leave, I had no clothes, no shoes, and no money.
Someone asked me later on if I was scared at that point. No, I wasn’t scared. I was angry. No, I take that back. WE were angry. All of my voices and I were very, very angry. We couldn’t get over the fact that wherever I was, I was being held against my will. I was being treated as if I had no rights.
I don’t remember exactly when I learned that I had been involuntarily committed to the psychiatric ward of a mental hospital. But I do remember that I simply couldn’t wrap my brain around the fact that in this day and age I could be whisked away illegally from my home and locked in a room with nothing but a bed bolted to the floor. I couldn’t believe it! I was in shock.
It turned out to be the morning of the 29th of May 2008. It had been 24 hours since I had entered a hospital Emergency Room.
Note: Under the laws of Washington State, the mental hospital could hold me for up to 72 hours against my will without having to undergo any legal proceedings.