Posted in advocacy, Late Night Thoughts, psychology

Learned Helplessness In The Mental Health System

This is a term you may be familiar with if you work in mental health. It’s often used to describe patients who have spent significant time juggling between facilities, programs, and hospitals and as a result struggle with meeting their own basic needs.

It’s no secret that decent mental health care in the United States comes with a high price tag. Community-based programs that are essential for helping shed feelings of isolation and learning social skills (both of which can be necessary for us mental health consumers) are often tagged for those with the thousands of dollars to pay for it. As someone who was working full-time and provided with decent health insurance, I was offered a spot at a program like this free of charge. Unfortunately, the company I work for is switching insurances, and I’m not positive I can work full-time right now anyway.

It’s taken a lot to find that one little place. Through consistent panic attacks, paranoia, nights of hallucinations, I finally got in contact with a hospital who patched me through to a social worker. The social worker took a week to get back to me, just to tell me she didn’t work for that department anymore. She patched me through to a social worker in a different state who found me a program in less than thirty minutes.

Since none of that panned out, since I can’t find any psychiatrists near me and can’t afford holistic care, since I’m not sick enough to be in a hospital but not well enough to be by myself, I’ve resorted to daily breakdowns. My hope for healing waned. My therapist said I was experiencing “learned helplessness.” Let me explain why I’m not and why, if you are ever told this, you should think about it just as deeply.

Learned Helplessness Comes From:

Constant struggle with no perceivable escape.

People with learned helplessness have often accepted that they are unable to care for themselves–they believe they cannot control their outcome. They have been classically conditioned to believe they are inept.

The example my therapist gave me to explain the concept of learned helplessness was that of the experiment by psychologist Martin Seligman. You may know him as a positive psychology backer, and an avid studier of learned helplessness. Seligman and colleagues administered shocks to dogs strapped in a harness in a cage. In this case, the cage represented a trap and the shocks an unavoidable outcome. When the cages were opened, the dogs refused to leave the cage even when escape was made possible. The hypothesis here is that the dogs learned to expect pain and to expect no escape.

If learned helplessness is a result of being trapped, beat down, and losing sight of escape, then the mental health system has been systematically abusing people under the guise of treatment for ages.

When are we going to stop blaming the people who experience mental illness, who are constantly being beat down, held back, vilified, rejected, for feeling hopeless? Why do professionals immediately see fault in the person (just keep trying!) instead of fault in the system of support?

Note: This isn’t to say we should rely on others to pick us up–we’ve got to also work on believing in ourselves and coping properly with our experiences. It’s just a lot easier and healthier to do that with the proper guidance and support. No one can do everything by themselves all the time.

A Possible Reason

In social psychology, there is the concept of external and internal perspectives. There is a term for this I’m blanking on. Those with external perspectives often attribute outcomes to the environment around them, things out of their control, and often come from lower socioeconomic backgrounds. Those with internal perspectives often attribute outcomes to their attributions, things like their personal drive and work ethic and come from higher socio-economic backgrounds. As you can imagine, there are advantages and disadvantages to both perspectives.

I know people on both ends. I know people who consider themselves successful and attribute that to their constant strive for “something greater”, to their hard work, to their positive thinking, without acknowledging the two-parent home they come from with successful, hardworking role models, without acknowledging the support they had in following their dreams or attending college, without acknowledging the financial opportunities they were provided. I know people who don’t consider themselves successful and attribute that to their traumas, a broken economic/social system, and lack of opportunity without acknowledging their effort has waned.

One advantage to having an internal perspective is that when hardship arises, you are more likely to take proper measures to cope. You are more likely to seek support and utilize the support. The disadvantage is you see others as not trying “hard enough.” You also are less likely to support others in coming up because if you did it “by yourself”, they should be able to as well. You are less likely to take part in the community and less likely to advocate for community-based reform. You may be one of those people who see homeless individuals as useless bums.

One advantage of having an external perspective is that you see the structure of the world around you. You acknowledge (and experience) the pain of a system designed for failure. The disadvantage is depression. The disadvantage is that you give in to what you believe is your fate and struggle in seeing the change that could be made. You are more likely to relate to others who have struggled, and you’re more likely to be involved in helping others because you know what it’s like to feel like you have no one and nothing.

Which perspective do you think most (definitely not all) psychological professionals come from?

Cognitive Dissonance

Psychological professionals are trained to see the system as something there to support and guide their clients. They also go into the profession with the aim of supporting and guiding their clients. If it feels like that goal isn’t being accomplished, it may challenge their self-concept something fierce. This leads to cognitive dissonance: the imbalance between what someone consciously believes about themselves (including their attitudes toward different things) versus how they behave.

This is where I believe professionals need to be a little softer on themselves. Acknowledge that money, attitude, trauma, self-discipline, and outside support are just a few of the things that determine someone’s success in their mental wellness. Sometimes people can’t find help, and when they can’t find help, when they are sad about that, when they are feeling hopeless and defeated and angry, those feelings are valid. The system is often not our friend and we have a right to be angry about that–because no matter how hard we try, we can’t fix that by ourselves.

No matter how much I exercise, no matter how healthy I eat, no matter if I take meds or don’t, no matter how much I meditate, no matter how much I breathe during my panic attacks, no matter how many times I tell myself the pentagram on my ceiling isn’t real, no matter what I do to cope, I will not have thirty thousand dollars a month for personalized, integrated, holistic, community based, science based treatment.

What would give me thirty thousand dollars to blow? A really, really good job. What would give me that kind of job? Mental stability. What would help me achieve mental stability? A lot of support. How do I get a lot of support? Thirty thousand dollars.

Now, there are alternatives, and the system has set this up so that in order to receive these services, you must never aim higher than them.

County services, for example, are often provided to those below a certain income limit–this includes those on disability. If someone is stable enough to get a part-time job, and that job pays ten dollars over the state insurance income limit or disability income limit, that person risks losing the services which have been most helpful to them. No one wants to risk that.

And so you have an escape route, you see, much like the dogs. You can be well, work as many hours as you can and lose your integrated services. But much like the dogs, that escape doesn’t feel safe, not after having been shocked for so long. Inside the cage, at least you know what to expect. In a twisted reality such as this, the cage actually feels safer.

There are too many factors that go into being mentally well for this one-size-fits-all system to be as effective as it purports.

Agree or disagree? Leave it in the comments below, or join the discussion here:

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Posted in psychology, Voices

What a Bad Day looks Like

What a bad day, or week, or month, looks like for people with psychosis is variable. This is what it’s like for me this week.

I count today as a bad day, and figured writing in the midst of the experience, if I can continue steady coherency, may paint the best picture. The two sentences above took some rearranging as a bunch of words came out that didn’t make a complete statement at all.

Last night I couldn’t get to sleep until around 4:30 a.m because of a tightness in my chest, anxiety as usual. This comes from a myriad of things. One reason is simply anxiety. I struggle with trauma, and some thoughts were triggering those reactions. Another reason is voices. For the last few weeks they’ve been instructing that I kill myself. They’ve told me I’m going to die, specifically from a heart attack, which has been a fear of mine for many years. After experiencing family members in and out of the hospital for multiple Alcoholism related events, (Seizures, blood pressure spikes, medication mistreatments on the part of the doctors) I struggle with feeling my body and not assuming the worst.

I don’t usually talk about what they tell me, as they also tell me not to tell people. They also tell me no one will believe me, and I often believe that, as a lot of my experience has been internal voices. Although science tells me this is valid (I can site the studies if you’d like), multiple mental health advocacy websites will not acknowledge this. HealthyPlace.com is one of them. I’ll talk about my history with them later. It’s usually the websites that take kickbacks from drug companies and have antipsychotic ads all across their homepage that seek to limit the expression of variable experiences. Internal voices can be just as distressing, more so for some people, and are not the voice of your conscience that you hear when you make a mistake or that inner voice you hear as you’re reading this post. They are separate voices, often pushing their way through clouds of my own thoughts intrusively, spontaneously, and they can get loud. When they push the volume, I experience both external and internal voices. Today I hear nothing external.

But, I bit the bullet and told my therapist. She got concerned, and I worried she’d 5150 me (California’s version of forced psychiatric care). I really just needed to vent about what they’d been telling me, though. This morning I haven’t heard them much, as I just woke up, but the tightness in my chest comes in waves, and my stomach has been upset back and forth. No it’s not Corona, and not it’s not a physical problem, as much as the voices will tell me as such.

I struggle with somatic experiences, and correctly labeling those somatic experiences. Today, I’m convinced my voices–although I don’t hear them as I’m listening to this music–have done something to my body. I believe I hear my ancestors, and I also believe I hear and receive messages from what I call False Angels, kind of like the concept of Jinn. They are tricksters, angery sometimes, nice other times, liars and truth tellers, conflicted and dual in their existence just as we are. I also believe they like to harm me spiritually and internally to try and prevent me from living the life I want to. *For example, as I’m editing this and reading back, the more I read over their identities, the more upset my stomach becomes, because they know I’m talking about them.*

This morning I believe I feel my anxiety because they’ve done something to me overnight. Two parts of me appear when I have this kinds of thoughts.

I am post first-psychotic-break and for many people that means living with an uncanny realization that things you experience are not necessarily the things you think they are. I know my body and mind play tricks, and so at the above thought a part of me pulls me to the side of: “that isn’t real”. It tells me anxiety can cause the same feelings. It tells me what I’m feeling may not exist at all. It tells me to focus on other things.

The other part of me craves the unreality. Not only does my mind concoct surprisingly sensical (to me) impossibilities, it also thrives off it, it seems. I’ve always been an imaginative child, and that talent intensifies in these sorts of thoughts. This part of me believes I am so special that divine and otherworldly entities focus their existence on warping mine. This part of me pulls me toward dissociation, toward long thought, toward staring at the wall, toward lethargy, toward apathy. That is where I am this morning, on the raft of dissociation and a flight of unreal explanations.

I’m forgetting my words, stumbling over these sentences, and quelling my frustration with Kodak Black and A Boogie Wit Da Hoodie.

I’m getting messages from the songs, feeling connected to the artists, and reconsidering my life. I doubt myself constantly, and never has that been more obvious than this last week. I’m worried how long I can keep up working full time. I’m worried if I’ll have to fall back on a medication regimen and risk my long-term physical health. There’s a reason those diagnosed with Schizophrenia have a shorter life-span, and it’s not suicide. It’s medication, poor diet, cigarettes, and lack of support. I’ve corrected my diet, got off medication, never smoked cigarettes–now I just need to convince myself I deserve support.

There are overwhelming senses of failure mixed in with all of this, like no matter what I do I am trapped. I think a lot of us experience that.

I’m not going to lie and say I’m going to “try and stay positive.” I’m going to do the exact opposite. I’m going to plunge as low as I need to. I’m going to fall beneath the voices if I need to. Let myself be absorbed by the unreal thoughts if I need to. The best way I’ve learned to survive this is to let go of this idea of control. Writing this is a good reminder of that.

Bad days are a way of life. They are necessary for life. I am thankful for their boldness, their spiciness, their unequivocal strength. A voice has let me know that I’m genius, that I’ll be famous specifically, and although I’ve always been bright, I learned to squash my ego because it only fuels what the psychiatric industry considers delusions. When he tells me to kill myself, I say “I don’t want to do that”, often out loud, sometimes inside. Other times I’ll ask him “why would I do that?” and that shuts him up. I learned that from a Hearing Voices Network workgroup. The point of it was to initiate a conversation with your voices, really get into the meat of their existence, but for me it seems to scare him away. I’m happy with either result.

I heard a child sometime this week, I haven’t heard since. I don’t hear women often, but when I do they’re usually condescending, external. One woman specifically screams. She mocks used to mock me before I fell asleep, but I haven’t heard her in a while. My sleeping patterns have improved, I think that’s why. I have a kind man, external and internal, who asks me if I’m okay when I’m struggling. I haven’t heard him recently either. I don’t know who I’m left with. This is uncharted voice territory.

I will spare everyone my long-winded thoughts on why I think this most recent string of voices is one deep voice in particular, wanting me to kill myself.

I don’t know what the rest of the day will be like, and I don’t need to waste time assuming things either. Comment what your bad days are like below.

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Posted in advocacy, Community, psychology, science

Black Mental Health in America

ATTENTION:

If you are black in America right now, you’re probably feeling pretty unsafe, especially if you’re in the south. If you are black in America right now with Schizophrenia, you’re probably feeling pretty unsafe, especially if you don’t have a lot of support. Chances are you don’t have a lot of support.

We know racism has been around. This ain’t nothing new to us. Some places you see it more than others. For example, the South tends to be a prime example of blatant, flamboyant displays of hatred. Here in California, in Santa Cruz, things are more subtle. You’ll have the skinhead clerk ring up your groceries, toss them aside, not ask you if you want a bag, never look you in the eyes, whereas he’ll greet the white woman in front of you and the white man behind you with a pearly smile.

(He works at The Dollar Store on Portola, if you’re reading this and from Santa Cruz. At least, he was. I haven’t seen him in a while.)

If you are biracial or light skinned, you might experience a lesser racism here in Santa Cruz if you keep quiet. If they assume you’re hispanic, you won’t be treated as equal but you’ll be offered more opportunities than your black friends, especially in school. If they are confused of who you are, if they see your brown skin, your curly hair, but don’t hear a thick accent industries have coined as “black”, they will treat you as an unknown. An unknown is just as dangerous. I’ve had four cop cars (a total of eight cops) called on me for a license plate light that wasn’t out. They kept my boyfriend and I sitting in the car for a total of thirty minutes while they ran my license, my insurance, huddled in a group behind my car, flooded us with white light from two SUVs. Had I let my anger or fear show, the night may have ended very differently.

Feeling hunted is a prime experience of paranoia. I think the reason this has not exacerbated my paranoia is because there is valid reason to fear existence right now.

It’s different now. The racists are coming out to play.

A local black woman (catch her page: @bellagmo on IG), someone who has been integral in bringing the community together during this time, was chased down the street on Fourth of July by a white person screaming “I”ll be racist if I want, black bitch!”. She continued her rant, saying she was downtown every day, hunting her–people like her. Black women, men, people. She made active, verbal threats caught on camera, things like, “I will fuck you up!” The police gave her a stern finger wag. A rope tied as a noose was seen hanging on a sign up by our University campus: UCSC.

There is so much hate against us in this county, in the world. And where do we get to go to express this pain?

Our white therapist?

Our white psychiatrist?

Our white Primary Care?

The nearest black therapist accepting patients is over 4 hours away.

There is an inherent feeling of being bonded with people of the same ethnicity. This does not mean other ethnicities can’t be helpful, supporting, or amazingly kind. It just means it’s not the same. My white therapist isn’t going to understand when I say watching people with my skin color and darker, people with my culture, people who talk the same as me, eat the same foods as me, like the same music, the same stories, have the same BLOODLINE as me, getting slaughtered on film makes me feel hunted. They won’t understand when I say it brings up a sadness generations deep. They won’t understand when I say I just want to stay inside, and not just because of COVID. They won’t understand when I say I feel like I’m doing all I can to be involved with my community but that I still don’t feel like it’s enough. They won’t understand when I talk about how invisible I felt growing up in a school system that labeled me hispanic and refused to acknowledge my own culture, who refused to teach the reality of my ancestors. They won’t understand the damage done by people who told me I wasn’t black, that I was Oreo, without even knowing my history.

You know what they’ll tell me?

Maybe it’s time to stay away from the news.

Because they don’t understand that when one of us gets shot, hanged, threatened, I will still know. The news doesn’t need to tell me. I feel it in my heart.

If you think this is just another person whining about inequality, you damn right.

I’m not whining, I’m putting the truth in your face.

I grew up unable to talk, terrified to do so, Selectively Mute. My voice was never encouraged and so I never developed one. And that, my friends, is the definition of genocide: to silence a people until their screams are just as invisible as their being. They’ve done it to Native Americans and indigenous people across the globe. They’ve taken their names, their language, tried to warp their culture, shame them as alcoholics, drug addicts, shove them in the corner of the classroom and forget about them after the bell rings.

I’m tired of walking around with this fucking weight on my chest. It feels like I can’t breathe, and it’s not because of COVID. It’s anxiety. It’s all this anger and confusion and sadness that I’m carrying with my ancestors who marched from their native area of what is now called Tennessee down to the western part of what is now called Mississippi. It’s all this anger and confusion and sadness that I’m carrying with my ancestors who were tossed, chained, onto a boat by pale men who didn’t speak their language, who didn’t respect our pleads for our children, for our lives, for our existence as a culture.

And now you expect me to respect yours?

My mother’s family is Polish. They fled Poland to escape World War 2.

No matter what ancestral part of me you rip into, I’ve been running, fighting, fearful, crying. My first instinct, whenever confronted with a problem, even the smallest thing, is to escape, hide, retreat, survive. A white therapist interprets this as chemical imbalance. Do you see the problem here?

I have been carrying this anger and fear since I can remember forming memories. It’s not just coming out because the racists are. It’s always been here and I’ve never talked about it because I’m supposed to keep my composure. I’m supposed to “let the past be the past.” I’m suppose to “just live in the now.” It’s not something therapists bring up because they have no idea it exists. Now I have voices in my head telling me to kill myself, and I attempted it in 2018. I also have voices that protect me, that feel with me, that make me laugh. I have voices I consider my ancestors and that, to me, isn’t a disorder.

I have anxiety that alerts me when I need to run, which is all the time. I’m constantly running. I’m constantly breathing hard. Just as all my brothers and sisters today, I’m having to carry 400 years of agony.

I remember growing up learning how we are apart of the animals, the Earth, the plants, the air, the sun, way before I learned the physics and math that say the same. I remember learning about both The Christian God and The Creator. I grew up with the last name Dauterive, the name of a man I am not biologically related to; my father’s biological father’s last name is Ware. My family is scattered. My grandmother grew up in Jackson, Mississippi. My father grew up in Sacramento. He moved to Santa Cruz, and we didn’t stay in contact with his family very much. I don’t know much about them other than bits of native history, food recipes, and cultural things my dad passed down. His dad grew up in Louisiana. I will never know what boat his ancestors came off of. I will never know what my name really is.

Dauterive is the last name of four different slave owners in Louisiana.

Who knows what Ware is attached to.

If you are black and have struggled with psychosis, anxiety, depression, bipolar, or any other label, understand that the medications you take (I have taken them in the past as well) are tested on white people for less than four months. If you’ve struggled finding one that works well with your body, or one that has strange side effects no one else seems to get, this may be a reason why. Understand that if you are a black woman, most of the med trials are done with white, middle-aged men. The trainings therapists receive are not culturally aware, they are based on white culture. Understand that it is up to you and I to break down the stigma in our own family and help our older parents understand that our mental health is not just some “defect” or “disorder” or “chemical imbalance”, it’s also the result of our genes being bombarded with environmental, traumatic triggers for 400 years.

This trauma is in our nervous system. We aren’t getting anxious for no reason. There is a reason: never having been safe. Never having been free. Being labeled dangerous, disgusting, dirty, less than human.

To my black, native, and biracial brothers and sisters: we no longer need to keep it in. We no longer need to keep our composure. We have a right to be angry. We have a right to demand change. We have a right to rest when we need to. We have a right to make racists uncomfortable.

We have a right to use our voice.

It’s taken me 25 years to learn this, and I’m not ashamed. I’m angry.

I don’t know if you’ve ever seen the kind of passion that can come from an angry person. But let me tell you. It’s somethin.

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Posted in Peer Support, science, Voices

Self-Compassion and Hearing Voices

Let’s talk about this concept of self-love, self-compassion and why it’s so pivotal when hearing voices.

My experience with the diagnosis Schizoaffective (Bipolar Type) may be different than yours, vastly, and much more so if you have been diagnosed with the blanket term Schizophrenia. I read a post the other day on an alternative treatment center dedicated solely to Schizoaffective, discussing their push to separate the label from the umbrella term schizophrenia, citing a need to treat it in its own category. I don’t think it’s so much the category that needs individualization, but the treatment itself. That’s a story for another day.

My point of bringing that into the story is that not everyone hears voices constantly and not everyone hears them the same way. Researchers are starting to catch up with this fact. There have been just a *few* studies into the differences between thought-like voices and external (hearing outside of the ear) voices, and some of the studies are fascinating. One, which I will link later when I find it again, cited 17% as the amount of time people say they heard exclusively external voices. For your personal interest, here is a survey and a study highlighting the differences between external and internal experiences.

Some of the marked differences included the types of responses. The researchers hypothesized that internal voices may have a more distressing quality to them–and this does not mean that external sounds and voices aren’t distressing, it just means they have a particular scale they were using to rate this. They obviously have no idea what it’s like in either experience. Let’s not make this into a petty competition about “who has it worse”. I hate that. It happens a lot in the mental health community, I’ve noticed.

The last table of the study showed some interesting percentages:

Hallucination Type:

Non-Verbal Auditory

Voices Commenting.

Voices Conversing

Voices commanding.

Commands to harm/kill oneself.

Commands to harm/kill others.

Positive/helpful voices

Persecutory Voices

Internal (or both)

63%

85%

55%

83%

30%

33%

32%

73%

External only

59%

68%

26%

66%

37%

13%

46%

53%

If you look at the study, they also listed their Chi-squared test results (statistical measurement) and their P values, bolding the significant differences. I’ve bolded the ones which were significantly different.

What Does This Mean?

They use this as evidence to confirm their hypothesis, I use it as evidence to show that variability in our experiences of the world. I also use it as evidence to show kindness and compassion is a necessity to yourself. If you are constantly being attacked by Persecutory Voices telling you the police believe you’re a murderer or a pedophile or a liar who has put their entire family in danger of the C.I.A, it takes a lot of strength to tell them “I’m better than you’re saying” or “I’m not any of what you’re telling me I am.” It takes double the strength to do so in a composed, neutral manner. It also takes a lot of practice. I still yell sometimes. I try not to do it in public.

It also takes a level of confidence in yourself, and comfortability with yourself, acceptance that what other people say about you isn’t necessarily true, and all of that can be easily stripped away from years of hospitalizations and being told you’re sick, ill, and broken. It rarely gets built back up because people with schizophrenia and psychosis alike are not encouraged into therapy much of the time. They aren’t encouraged to explore themselves. They aren’t encouraged to melt into the darkness because, well, it’s too dark. This prevents the growth necessary to heal.

Therapists and professionals are scared to talk when someone is, to them, incomprehensible, and for some reason they’re also scared to listen, as if they might hear something that makes sense in a bout of babbling that shouldn’t make any sense. And so a lot of the work is left up to us. After all, we are the ones with the voices, the thoughts, and the thought-like voices.

What Does Compassion Mean?

I had an experience a few months ago that was another cog in the machine of changing the way I see my voices. Although they’ve been telling me to kill a lot lately, mostly myself, sometimes other people if I’m around them, they’re not usually as aggressive, not since I’ve accepted them as beings tied down by the law of opposites: good must exist in the bad for the bad to exist, and bad must exist in the good for good to exist. When I realized they can’t possibly exist outside of that truth, I stopped labeling them as demons. For the past two years they’ve shaped into your regular, uncertain, lost souls, just like the rest of us.

But one night I felt particularly scattered, my thoughts weren’t making sense, and one of my voices told me to go for a drive. They urged and urged until I got off my ass and did so. We drove out to the cliffs, and I worried if I stopped the car I’d have a heart attack. So I kept driving and cry-singing because that’s always the best medicine, and at some point I think I asked them “why are you doing this to me?” And the response I got was something along the lines of “pain is necessary”. And I stopped crying not because the answer was profound, it’s certainly not, but because it reminded me of everything I’ve ever read, everything I’ve ever calculated, everything I’ve ever understood. There was a beauty in the pain I’d forgotten about, there had to be because pain cannot exist without the concept of pleasure and visa versa. He reminded me of my own duality and that this too shall pass; it must, for something that comes must also go.

And so part of the compassion involved with dealing with voices is submitting yourself, not in a passive way, but in an understanding way. If you don’t listen to them, they will never listen to you. To talk back is to not be “more crazy”, it’s to learn about yourself. That’s all you’re doing. You’re not “feeding into the sickness”. You’re not “making yourself worse”. You’re learning more than your therapist will ever know.

Another part of compassion is building your self-esteem. This can’t come from repeated mirror mantra’s of “you can do this”. Studies show it can make you feel worse; when you don’t live up to your expectations, you take a harder hit than someone who didn’t look at themselves in the mirror and convince themselves of a lie.

I say it’s a lie because if you don’t actually believe it while you’re saying it, it’s pointless. And telling yourself you believe it is not the same as believing it.

I’ve built my self-esteem along the years through support of others encouragement. Most of believing in myself came from other people believing in me, believing I could do something when I didn’t believe I could. Now, you see the opposite effect a lot of the time: in hospitals, for example, you may encounter a professional who has no confidence in your healing path (although they may consistently say “you can do this) and the less they believe in you, the more you’re convinced you’re sick for life, doomed to a plethora of medication and condescending doctors. Imagine the opposite. Imagine surrounding yourself with supportive people who understanding that falling down, that relapse, is apart of the process. Remember the law of opposites: one thing cannot exist without the other. You will have days of confidence, days of no confidence, and it’s how to grow from each happy and not-so-happy experience that will dictate your future path.

I think there are a bunch of cliche things you can list for self-compassion and care: eat healthy, exercise, reach out for help when you need it. Those are blanket examples, things that promote over-all wellness, but I think when dealing with voices, your self-compassion must be very individualized. What you and your voices need may be different from what me and my voices need, and this is why modern-day psychiatry has failed in so many aspects.

Showing yourself compassion also means avoiding judgement. Be careful labeling a feeling, voice, thought, as good or bad. Be careful labeling yourself as good or bad. What I’ve found more helpful is asking myself how the moment (if I hear something negative or positive, if I think of something strange, bizarre, or scary) can help me grow. If a voice tells me to pick up a rock and kill my partner with it, I ask myself if killing my partner will help me grow. The obvious answer is no. And therefore I respect the request, acknowledge the voice (laugh about it kind of) and continue on with my day, judgement-free.

Is Being Alone Okay?

Yes. This is part of the individualistic plan. For me, I haven’t yet gotten comfortable talking about my voices to anyone other than my significant other, and at times (if I’m feeling spunky) my therapist. Most of you know I work in peer services, and have the opportunity to talk about my voices everyday with others who experience similar things, and I find it very difficult to do so. I was raised to stay quiet and it’s been a long journey realizing that I don’t need to force myself to speak, even if others say that’s what I need to do to heal. I also don’t need to force myself to stay quiet. There’s a delicate balance here.

If keeping to yourself, exploring your feelings and voices with yourself, is what has helped enlighten you, what has helped you process your emotions, then that is okay. Remember how we mentioned it doesn’t matter what other people say? About how accepting that mind-state may help also with voices, particularly ones that accuse you of things? Well, shocker: it also supports you in dealing with pushy people who think they know how you should live.

We get told a lot of things. We get told we have to do this, eat this, act this way, fit this mold, fit this criteria, apply for this, stop doing this, take this, etc. We are rarely given the chance to truly decide for ourselves, and taking away that level of independence doesn’t built self-esteem. You are capable of making decisions for yourself.

I find that processing things in my head is quicker, more efficient, and when I come to a realization I get a warm feeling from the top of my head to the soles of my feet. Those are moments that change my perspective. I rarely have those moments when discussing feelings with people. That being said, there are moments I can’t keep things in my head, when I need to vent to someone, or ask for an outside perspective, and those times are okay too.

Overall . . .

. . . I think it’s important to recognize that no one is one-size-fits-all and that every way of living is an acceptable way of living, as it is life doing what life does. We may not see one person’s life as the way we think it should go. We may see more potential in them than they do in themselves, and that makes us want to help, make us want to push them into being “better” and that’s a judgement. It is. It is inevitable in life that some people will never heal. You may judge or perceive this as sad, but if everyone always healed then there would be no such thing as being stuck. If there was no such things as being stuck, well, there would be no such thing (or need for) healing. We wouldn’t exist as complex beings, only cookie-cutter versions of each other.

Each way to wellness (or not wellness), whether that be medication, no medication, therapy, no therapy, family, or no family, is an acceptable path. Once you are able to avoid judgement of where you are, once you are able to avoid the trap of “I should be here, but instead I’m here“, you will see life get much simpler.

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Posted in advocacy, Community

A Mental Health Resource for African-Americans

I apologize to those of you who were steadily following my mental health month series. It ended abruptly as a result of the necessary civil unrest spanning the 50 states and select countries worldwide. I have been participating in protests, going to work, and trying to figure out how to take care of my mental health in all of this.

What I’ve learned in this personal process is that much of my childhood silence, my fear of people, my feeling of being small, unimportant, invisible, unwanted, does not only stem from a childhood living with a parent prone to aggressive outbursts while drunk or on drugs, but also from growing up mixed race, African-American, and not really understanding what that means.

I live in a predominantly white and Hispanic town. In all of my years of school (from pre-school into this current year of college–i’m 24) I have had two African-American mixed classmates. I have had no dark-skinned classmates.

I have felt alone my entire life. My father, who is dark, grew up with many siblings and in a predominately black neighborhood. He was subject to a lot of trauma, struggled in his relationship with his own alcoholic father, and in his early adulthood was stabbed six times and jailed for a year on a robbery charge that was later proven to be a false claim; he almost spent his life in prison for a crime he didn’t commit. This is real. I cannot make this stuff up, and it’s happening everywhere. I’m thankful police have never shot him or kneed on his neck.

His trauma becomes mine. His mother’s trauma became his and mine. Her mother’s picking of cotton trauma became her daughter’s trauma, my father’s trauma, and my trauma. HER mother’s mother’s mother’s trauma of being forced down the Trail of Tears became all of our trauma. We are African-American and Native American. This trauma spans over 400 years.

What I notice when I talk to Caucasian people about this is that they logically understand the progression of history and genuinely want to abolish a system that is naturally oppressive against people of color. But they don’t have the same emotional connection. They saw the pain in George Floyd’s eyes in the video, are outraged about the life visibly leaving his body on camera. Their spirits ache at this tragedy. Ours do too, but differently. Together, as a collective, we are feeling each other’s pain. We grieve as if this is a death of a loved one, not just another stranger who deserved to live. This man was family. Breonna Taylor was family. Ahmaud Arbery was family. All of the others in the news were family.

This is a deep-seeded spiritual connection that goes back to the tribes of Africa, that includes those of us with Native history, and when that spirit is in pain, we know. Many of us are still up night spontaneously crying, fatigued, tired, scared, hurting, and for people in a similar environmental situation as me–well, we don’t have anyone to talk to.

On my linked-in this morning, an article shared by the American Psychological Association reminded me that my mental health must be looked at from a particular perspective. So I wanted to share it with all of you in hopes someone may find it useful for themselves, or useful for a friend.

This article was posted on Women’s Health, but this is suitable for all genders of color. The author is a person of color who has had a similar experience to me: restless nights, no sleep, anxious mornings, tense muscles, consistent social media usage, and fear of death. They suggest a few points I’ll summarize below:

  1. Get in contact with therapists who are culturally aware and trained in racial trauma. They put a link to the website Therapy for Black Girls. I checked it out. They have a search bar you can use to find ethnic therapists near you. Every therapist I’ve ever had (6) have been white and only one even touched on generational trauma and how that has perpetuated my feeling silenced. They list some social media pages of black therapists, like @askdrjess, @dr.thema, and @dr.nataliejones, all on Instagram.
  2. They suggest practicing meditation to help maintain a lower level of excitement in your nervous system. They suggest meditating on powerful female ancestors in history. I don’t know how helpful meditating on thoughts of any one person will be, but I do know there are select times in my life where meditation has helped me feel all of my feelings, sit with them, and really absorb their raw juices. Remember, you are healing generations, not just yourself. I’m sorry we are burdened with this. But our ancestors are with us, and if we couldn’t handle it, we wouldn’t be alive right now.
  3. Bring some joy into your life. It’s important to balance reform/social justice work with the rest of your life. Smiles keep us alive. Remember that you’re allowed to be happy. You’re allowed to laugh during this time of pain. It’s a way to heal yourself, too.
  4. Hug people, except that COVID is still rampant so maybe don’t?
  5. Space out time for relaxation and time for working on advocacy. I’ve struggled with this and beat myself up today when my body was so fatigued that I passed out on the couch instead of getting up to go to my forth protest. I want to be involved, I want to be an instrument for change too. I want to make an impact, share my story, have my voice heard, and hopefully inspire others to do the same. But I can’t do everything all the time. I still work four days a week at an emotionally demanding job. Be patient and kind to yourself.
  6. Exercise! I went for a walk with some friends today. It helped.

We don’t often talk about mental health in black families. Many ethnic families don’t. Some cultures across the world still see it as internal weakness. This is a harmful mindset. We cannot heal as a people if we do not address raw feelings. If we do not share with our kids our pain, our knowledge, our past, our present.

Please, if you are a person of color, especially in America at this time, and you are struggling internally with what is going on, you are angry, you are sad, scared, hurt, bleeding, talk to someone. Email me. have a discussion with family, with friends, participate where you can. Educate where you can. We are carrying so much pain on our backs.

So much pain.

If no one’s told you yet: you are allowed to express that.

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Posted in psychology, science

Mental Health Month: Substance Use

I’m going to try and write this as coherently as possible. We still have one more week left of Mental Health Month, and this Thursday, Friday, and Saturday (given my brain doesn’t melt from out of my ears) we will be covering the last stretch of diagnoses we could fit in this month: Somatic disorders, eating disorders, and depressive disorders. If you have a story you’d like to share about any of the labels we’ve covered this month, contact me here or on my social media handles (below).

This evening we’ll be covering Substance-related and addictive disorders, with “substance related” excluding any of the typically prescribed psychotropic medications. That seems like a given, but it shouldn’t be; a lot of psychotropic meds can induce mania, depression, panic, and psychosis. This often gets labeled as proof of a disorder, but in the future when we dive more deeply into what kind of industry this is (and how helpful it can be in many circumstances), we’ll talk about how that’s bullshit.

To be frank.

But for now, we’ll talk about what they want to talk about, and that is the illegal substances no agency can make money from.

What we’re talking about here is the big ten: Alcohol, Caffeine, Cannabis, Hallucinogens, Inhalants, Opioids, Sedatives, Stimulants, Tobacco, and unknown.

What Is a Substance Use Disorder?

In order to be classified under this section, an individual has to continue using their choice substance even while recognizing (or not) significant substance-related problems. This is like the alcoholic whose doctor says their liver is fatty and swollen (a sign of cirrhosis) and despite the eventual fatal outcome, the alcoholic continues to drink. This could be because of many reasons. It could be the person is psychologically dependent on the mood alteration provided by the alcohol. Drinking may be the only way to feel “normal” by then. Physically, the person may be dependent on the resulting biochemical reactions of heavy drinking; stopping alcohol suddenly is the same death sentence as cirrhosis of the liver, but quicker. The body becomes so dependent on the substance that the removal of the substance puts the body (the brain mostly) in shock. This is called withdrawal.

It’s the same thing you experience if you stop your medication suddenly: your brain, having gotten used to whatever receptors that medication was binding to, suddenly has a stark depletion in that neurotransmitter and this can cause irregular electrical activity, mood changes, physical changes like heat flashes, cold sweats, muscle aches, etc. Your brain is constantly seeking homeostasis and there are two ways this gets disrupted: ingesting a substance and stopping a substances after long-term use. For those of us who stop, say, antipsychotics, the psychosis that presents itself is not necessarily what would happen if you were substance free. It’s not your “illness coming back”, its the disruption in homeostasis exacerbating your experiences.

Alcohol withdrawal is one of the most dangerous withdrawals and, if I’m still up to date on all my medical understanding of this, the only one in which you have a high chance of dying. I believe it surpasses benzo withdrawal risk. Those in severe Alcohol withdrawal will typically experience Grand Mal Seizures alongside all of the other mental and physical experiences.

How Do These Substances Interact With Our Body?

Benzodiazepines are some of the quickest addictive substances prescribed. Even if you don’t feel psychological dependent on them, you may realize quite suddenly that your body has become very accustomed to them. Some people have stated that even when taking two of their PRN Benzo medication per week for four weeks, their body went through physical withdrawal. The problem with that is benzos also work on GABA receptors, like alcohol. This is why Benzos are often a first choice in easing alcohol withdrawal.

It’s kind of like when they learned Morphine was addictive and synthesized heroin to use as a replacement. That backfired. We just don’t learn.

You can read about that in short-form here. There’s a much more in-depth, dependable review on the history of this on PubMed, I’ve just yet to find it again.

Stimulants, like cocaine, are not addictive as quickly but people still lose their lives to them. They target chemicals like dopamine, serotonin, and norepinephrine, all that handle feelings of pleasure, confidence, and energy.

Opiates target Endorphins, which inhibit both GABA and Dopamine. This stimulates the receptors to increase the amount of dopamine that’s released because there’s not enough in the synapses. This is the same chemical that releases when you exercise.

I’m not up to date on Inhalants, but I’m going to go ahead and say breathing in condensed chemicals probably tears a few cells up in the process.

Hallucinogens, including Acid, are some of the safest drugs, if you want to think of them like that. They still affect the body; some raise blood pressure or cause a racing heart, but their addictive properties are non-existent. These are being studied currently to treat depression, PTSD, and anxiety which means at some point they’ll be monetized, synthesized and eventually ruined. Many have had profound experiences though, and worked through trauma while micro-dosing LSD or being a risktaker and experimenting with one of the most powerful hallucinogens, Ayahuasca. These substances have a rich history in religious ceremony.

Tobacco and Caffeine are very much legal. Tobacco, once used in abundance as a smoking agent, is now full of carcinogens and heavy nicotine doses which trap the user in one of the hardest addiction cycles to break. Caffeine perpetuates anxiety, raises blood pressure, and is also great on cold mornings with a cigarette. So, pick your poison.

Aren’t These All Plants?

The majority of them, yes.

No, that does not make them safe.

Yes, many are not safe in part due to what people put in them.

No, I don’t suggest traveling to South America just to chew on a coca leaf.

Yes, if I didn’t have such bad anxiety, I’d probably be one of those people to travel to South American just to chew on a coca leaf.

Why Can’t People Just Stop?

Some people can, and do.

This is not a problem of disease. It is, however, a problem of weakened and exhausted self-control. This sounds as if it is blaming the user, but it is not.

There was a study I just learned about in a previous course where they tested individuals self-control and whether it could be exhausted. They set a task in front of a set group of people, one by one, and told them one specific instruction: do not eat the cookies, but feel free to have some of the radishes. They set the same task in front of another set group of people, one by one, and told them one specific instruction: have anything you want on the plate.

Those who had to exercise their self-control (by not eating the cookies) had less patience when it came to do the second task, which were some puzzles on paper. Those who did not have to exercise any self-control maintained their base awareness.

This is one of many tasks that shows it may not be indulgence that starts or continues an addiction, but rather a consistent breakdown of self-control; once someone uses a substance, they have went against the cultural norm to NOT use that substance. The physicality of the drug doesn’t make the second time easier, the reduction in self-control does.

There are many ways to continue to test this and could revolutionize how addiction is treated and looked at. It’s not the fault of the person. It’s not a defect in will-power or a weakness. It’s simply exhausting your bandwidth of self-control, which we could all easily do. That’s why addiction has no preference for creed or color.

Some may be genetically predisposed to a shorter self-control bandwidth, not addiction. This is my hypothesis. It’s not disproven, and it probably won’t be any time soon, not by me at least. But having grown up with generations of severe alcoholics behind me, one of which died at 56 because of it, I know what it’s like to feel like your genes might be defective. The truth is, at least between fathers and sons, sons of alcoholics are no more likely to become alcoholics than the average man.

I’m a woman, so I’m not sure of our statistics.

When I was prescribed Percocet for my back injury, the first pill did nothing. So I took two. And had no idea how hard it would hit me. I remember sitting in my research course and the room feeling light as air. My body felt warm and nice and I felt kind, friendly, approachable. I felt social, something I never feel. Then I spent forty minutes trying to keep my eyes awake and my notes were just scribbles. By the end of the class, I’d written nothing worthwhile, and my back still hurt.

But coming out of that I realized how people could get so attached to the feeling. It’s a level of happiness one couldn’t attain naturally, and evolution probably derived that limit for a reason. We’d have no sense, no awareness, no anxiety, no fear. We wouldn’t survive as a species.

I also noticed my need to take more. I told myself no.

I told myself no for two months.

And then I rewarded my self-control with a lack of self-control and two months later my stomach was tore up, I felt I couldn’t make it through the day without at least a half of pill, and I was becoming increasingly dissatisfied with my own natural state of being–the state without the high.

I went into this experimenting; if I focused on my self-control, designated days to take one pill, two pills, a half a pill, one and a half pills, could I sustain myself without becoming attached? And I did for one month until I exhausted that bandwidth; the more times I told myself “no” and then “okay, just take half”, the more likely I was to say “well, half isn’t going to do it, take one and a half.”

So, another way to evaluate this hypothesis would be to ask: is someone more likely to become addicted if they exercise self-control or no self-control? We couldn’t run those trials ethically, but there may be a way to design an experiment without ruining people’s bodies.

I was not addicted. But I felt the pull.

This can happen to anyone, for any reason, at any time, and it’s not a sign of internal weakness or brokenness or some other negative connotation that gets thrown alongside these experiences. We are creatures who often want to alter our moods. We want our anxiety to stop, our depression to ease up, our happiness to never end. We’re a culture ripe for the course of addiction. Think twice before your blame someone for their experiences.

Do Rehabs Really Do Anything?

I’ve never been. They didn’t work for my dad. But they work for many. Some people embrace the programs, like 12 Steps, and swear by it. Others find a different path. Some find no path and succumb to the substance. I’ve only been to an Alanon meeting for myself with a previous therapist and it felt too programed. I’ve went to AA and NA meetings and the cult aspect of it gave me panic attacks. But for those who felt truly touched by the program, there were many success stories and as long as people are living the life of health that they want to be living, I’m not going to knock that.

What About Relapse?

What about it? I hear many people learn new things from their relapses. Don’t get me wrong, these slips can and do kill people. But to regress and then progress and regress again only provides a new insight to the self and a different perspective on life. Relapse is slowly being seen as a natural progression of addiction rather than an added failure of the person.

If we take away the aspect of death (not to minimize it, but for the purpose of this thought experiment) we can think of it as experiencing another depression episode or psychotic episode. We learn more about how we need to care for ourselves. We may have a new respect for friends and family who come through for us. We can look back and see where we slipped up in self-care or evaluate an incident that lead to our regression.

We all fall back into things we don’t mean to. And when we learn to stop attacking ourselves for mistakes we make, we may just give ourselves a chance to heal.

I will be back with Somatic disorders on Thursday. Although, keep your eye out for a post on something a little more personal. I feel the need to express feelings through words. Thank you for reading.

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Posted in Late Night Thoughts

Mental Health Month: Update #2

If this was a full-time position, I’d be fired by now.

I am struggling cognitively in a way that I haven’t in a few years. Writing is difficult. The post on Substance Use will be tomorrow evening after I get off work, granted my mind does not melt from my ears between right now (10pm) and 7pm tomorrow.

You all have been so patient with me, so kind, and have been thoughtful readers.

A big welcome to the many of you who have followed recently in these last three weeks. We will be on a grand writing adventure together.

Until tomorrow, friends

If you want to share your personal mental health experience (anonymously or otherwise) on my website, contact me on here or via my social media below:

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Posted in psychology, science

Mental Health Month: Personality Disorders

Hey everyone. Welcome to this hour of Mental Health Month. Upon checking my notes, I realized I’ve completely skipped the week of the 18th, where we cover Somatic disorders, eating disorders, and depressive disorders, and went straight into the last week which covers Gender Dysphoria, Neurodevelopmental disorders, and personality disorders. So, I’m switching things around a little.

Yesterday we talked about Gender Dysphoria, the meaning of tolerance, and the realities of biological humans–that is, a brain can indeed develop specifically toward a different sex than the sex of the body. Today, we’re going to talk about Personality Disorders. Tomorrow we will cover Substance-Related and addictive Disorders. The following week will be Somatic disorders, eating disorders, and depressive disorders. We will include Neurodevelopmental disorders on the last day of the month so no one feels left out.

If you want to share an experience you’ve had with any of the above conditions, or even ones we’ve already talked about, feel free to contact me here or on my social media (profiles below).

Now, we come to my favorite section of the DSM-5, with one of the only disorders that has been characteristically diagnosed unreliably–that is, psychologists often come to same conclusions on other disorders but can never quite agree who has this one– and with little to no genetic influence detected. I’m, of course, talking about Borderline Personality Disorder. We’ll get to that shortly. 761

Because personality disorders widely controversial, the DSM constructs this section completely differently. First they describe personality disorders, clinically, as a discrepancy between a persons inner experience/behavior and the expectations of their culture. This is stable over time and generates impairment.

Then, they mention because of the “complexity” of the review process (this is a fancy way of saying because research that correlates these labels with “disordered brains” are inconclusive and scarce), they have split the personality disorder section into two. The second section updates what was in the DSM-4-TR, and the third section has a “proposed research model” for diagnosis and conceptualization.

Personality disorders are separated into clusters still. Cluster “A” disorders are:

Paranoid Personality Disorder: this includes someone with a “pervasive distrust” of others. People’s motives are perceived as malevolent and the individual has a preoccupation with doubts about people’s loyalty, and trustworthiness. There is a constant level of perceiving personal attacks where attacks are not intended and believe that others are exploiting them. This cannot occur during schizophrenia or any other psychotic disorder, including Bipolar mania. They may, however, experience brief psychotic episodes that last minutes or hours. I’ve always thought of this disorder as a miniature schizophrenia.

Schizoid Personality Disorder: This one is actually less harmful in terms of relationships because the person does not form close relationships and has no desire to do so. Not quite sure why that’s a problem. But, they have restricted range of expressed emotions and chooses solitary activities. They may be indifferent to praise or criticism and has a flattened affect. I’ve always thought of this disorder as the negative symptoms of schizophrenia, plus one.

Schizotypal Personality Disorder: This includes issues with close relationships as well but includes cognitive distortions, ideas of references but NOT delusions of reference, odd beliefs, bodily illusions and odd thinking. Paranoid ideation and constricted affect are also included. This cannot occur during the course of other psychotic disorders either, and is probably more of a mini schizophrenia than Paranoid Personality. People often seek treatment for the anxiety and depression rather than their thoughts or behaviors and they may experience psychotic episodes that last minutes to hours.

Cluster “B” Personality Disorders are the ones everyone wants to get their hands on.

And by hands on I mean “grasp an understanding of.”

And when I say Cluster B personality disorders, I really mean just the first two. The others no one seems to mention very often.

Antisocial Personality Disorder: This is not sociopathy. Sociopath isn’t even the correct word. Psychopath is. But that’s not who these people really are. We’ll talk about The Dark Triad next month. It’ll be great fun.

Those diagnosed with Antisocial PD do share some things with clinical psychopaths though, and that is their unyielding disregard for other’s natural rights. This includes breaking the law remorselessly, lying, conning, and being otherwise deceitful for fun or personal gain. It also includes impulsivity, aggressiveness, disregard for other’s safety, and irresponsibility. People must be 18 years old before this diagnosis is concluded and must have evidence of a conduct disorder before 15 years of age. None of these criteria can occur during schizophrenia episodes or bipolar episodes.

Borderline Personality DIsorder: This is the controversial one. It’s described as instability of relationships, self-image, and affects, with a sprinkle of impulsivity and efforts to avoid real/imagined abandonment. Individuals may also be impulsive with self-damaging activities, like reckless driving or spending, binge eating, substance abuse. There may be reoccurring self-mutilation and emotional instability around irritability and anxiety that lists a few hours and rarely more than a few days. Feels of emptiness, intense anger, and severe dissociative symptoms may also occur.

The dissociative symptoms should give a clue to what is one of the number one correlations with this disorder.

75% of diagnoses are female. And with every clinician learning that statistic, more females are likely to be diagnosed with it than actually have it. Across cultures as well, according to the DSM, it is often misdiagnosed.

Histrionic Personality Disorder: Not a commonly heard one, but in reading the description you might think you know someone with this personality type.

These individuals are attention seeking excessively, and very emotional. They need to be the center of attention and are often seductive. They have rapidly shifting expressions of emotions and their speech lacks detail. Everything is a theatrical display.

Narcissistic Personality Disorder: The second of the Dark Triad, which we will talk about next month. This is a pattern of serious grandiosity, fantastical or in behavior, and a need for admiration. There is a severe lack of empathy and these individuals generally want to be recognized as superior without reason. They are obsessed with fantasies of unlimited power, love, beauty, and success. An individual may believe they are inherently “special” and are insanely entitled. They are arrogant and envious.

50-75% are male. Again, these numbers also make it more likely they will be diagnosed with this.

Cluster C Personality Disorders are on the softer end of the spectrum. Softer not in intensity, but in personality. These are the people certain Cluster B types would take advantage of easily.

Avoidant Personality Disorder: This is someone who feels inadequate and hypersensitive to criticism, so much so that they avoid anything that may make them feel inadequate. This includes social gatherings, work, and any other interpersonal situations.

Dependent Personality Disorder: These individuals have a pervasive need to be taken care of. This may lead to serious submissiveness and clinging behavior. They fear making others feel bad, and so they will not disagree with people. Initiating projects on their own is hard, and seeks another relationship as comfort when another relationship ends.

Obsessive-Compulsive Personality Disorder: This is kind of like the umbrella diagnosis of OCD, but more inclined toward only orderliness, perfectionism, interpersonal control, and lists. They really like lists, rules, and organization. Money will be hoarded in case of catastrophe and they may be inflexible about morality, ethics, and values.

There are other personality disorders that may be due to medical conditions or are unspecified/otherwise specified.

What’s Up With Borderline Personality Disorder?

Well, what isn’t up with Borderline Personality?

It’s been the hot button in clinical psychology because of the intensity of emotions these individuals feel. It often results in some psychologists refusing to treat people diagnosed with these conditions. Two out of my six therapists have told me some version of a “horror story” of an anonymous someone diagnosed with BPD who stormed out of an appointment or blew up in anger and then stormed out of an appointment.

I feel this attaches a very negative connotation to this set of experiences. Everyone expects the outbursts, the sudden changes, the unruly emotions, and so when they happen it’s just more affirmation that the individual is out of control. Self-expectations and other’s expectations can play a huge role in behavior, even in those with this condition.

The problem is, psychologists actually really struggle in diagnosing this. Back in my research course I learned that studies showed psychologists are quite confident when they make the diagnosis, but when other psychologists evaluate the same patient, they often don’t come to the same conclusion. This is in comparison to someone with narcissistic personality disorder, where most psychologists came to the conclusion that that diagnosis was fit for that person. This could be for many reasons: the background of the psychologist, the presentation of the person, the interpretations of the psychologist. It could also be, though, that this condition presents varying experiences and that makes it harder to recognize patterns.

Borderline Personality usually comes with a decent set of childhood trauma. This article from 2017 talks about how childhood trauma can affect biological systems that are then connected to the development of borderline personality. This article from 2014 talks about Complex PTSD (which is not a DSM diagnosis) and Borderline personality. CPTSD overlaps a lot with Borderline, and so these researchers question the scientific integrity of CPTSD and the role of trauma in BPD.

It could be that we’ve had it wrong this whole time, that BPD is not in fact a personality “disorder”, but instead a trauma response condition. This switch would require absolute links between BPD and trauma, the likes of which would match with PTSD, and right now we have no absolute links for any mental health anything. So let’s not hold our breaths.

The point is, the experience of BPD are very real. The label and possible cause mean nothing when someone’s life is turned upside down, when relationships are constantly crumbling, when someone blames themselves constantly for “not being normal.”

Let me re-frame: the possible cause is important in the sense that it could change how treatment is approached. But it is not more important than affirming people’s experiences. Right now treatment for BPD includes therapies in which the individual learns to recognize, label, and acknowledge when their emotions are exaggerated, and medications normally meant for other conditions. There are no medications registered solely for the treatment of BPD.

People often see this as a hopeless diagnosis. Because of this, I encourage people to read personal stories from people diagnosed with this condition so you can see that many of these individuals are creative, vibrant, determined, beautiful people in many ways. There’s one personal story and one more here to get you started.

What’s the Difference Between Antisocial Personality and Psychopathy?

Well, one’s in the DSM-5 and the other is a checklist, for starters.

Psychopaths often lead pretty normal lives. The likelihood that you will see them in a therapists office or in the cell of a jail getting diagnosed with something is very, very slim. They are charming people, do very well in life, and no, they are NOT only serial killers. That’s romanticized Hollywood bullshit. They will manipulate, remain remorseless, and often create an abundance of wealth for themselves. C.E.O’s can score quite high on the psychopath checklist.

People with Antisocial Personality have trouble leading normal lives and can find themselves in trouble. They may be erratic and rage-prone, which can catch quite a lot of attention.

Criminals, like gang-members, are not necessarily psychopaths or antisocial. The DSM mentions that Antisocial may be misdiagnosed if someone is fighting for what they believe to be is their survival. Often gangs are comprised of people who feel close to the other members and consider them family, people who believe they are fighting for “the principle of the matter”, for honor, for integrity, for power. They know their lifestyle inflicts violence and fear, but believes there is no other way to live. They are willing to die for their street family.

That is the opposite of antisocial. It is criminal, but not abnormal given the circumstance.

Some people with antisocial personality are also psychopaths. Some people who are psychopaths are serial killers. Both overlaps are rare.

You are safe.

If anyone watches SBSK on Youtube with Chris, they did an interesting interview with someone diagnosed as Antisocial. You can watch it here. Again, sociopath is a clinically incorrect term.

Please. Stop using it.

If you want to share your story this month, here are my social media links:

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Posted in psychology, science, Supporting Friends/Family

Mental Health Month: Gender Dysphoria

I’m hoping to write this Mental Health Month post with as much care and thoughtfulness that has been given to the other diagnostic labels we’ve covered this month. I am in severe back pain and terrified of going to Urgent Care in fear they’ll label me a drug addict. I’ve been accused of using meth by doctors in the middle of a panic attack, had my blood taken against my consent, and already had a Percocet prescription filled three or four months ago when I first injured my back. I did well, didn’t need the pills, got into physical therapy, but all of the stress and mental deterioration has set my back aflame. Severely.

I thought about postponing this post tonight because my mind is defeated. But I fear people will assume I’m giving unfair and biased treatment to Gender Dysphoria, as people who struggle with it are often treated unfairly and forgotten. My voices were having a nice time watching my suffering tonight. They told me “look at the fun we’re having!”

I’m defeated and emotionally fragile.

But tonight, we talk about Gender Dysphoria as a label and also as an experience.

There is only one diagnosis of Gender Dysphoria in the DSM (besides the unspecified/ other specified category) and that is called, well, Gender Dysphoria.

In simple terms, Gender Dysphoria occurs when someone (child or otherwise) feels their biological sex is incongruent with the gender they identify with. In children, as well as teens and adults, this must be observed for at least 6 months. Criteria includes a strong dislike of one’s sexual anatomy, a strong desire for one’s body to match one’s experienced gender, cross-dressing and insistence that one is different than what they have been told to present as.

Why Do People Argue About This?

To be honest, I have no idea. Gender is indeed a construction, whether people want to believe that or not. We, as a society, have chosen what is masculine and what is feminine. This influences every facet of our lives, from the clothes we wear, the attitudes we bare, the emotions we stuff down, our careers. It even influences how well we do in math; girls are consistently praised less and encouraged less in elementary math. This is not on purpose, it becomes an unconscious habit.

People think that biological sex is black and white; you are either male or female. Hormones in development tell a different story.

Like the rest of the students who started college the same time I did, I was plunged into the diversity of people on campus. Well–gender diversity at least. There were more people open about their sexual orientation, their preferences, their pronouns. I didn’t care, honestly, if someone who presented as John wanted to be called Caroline and wear dresses. It really doesn’t affect my life. But I didn’t understand. How could someone feel like a different gender? When I was a kid, I preferred playing in the dirt and as a teen I preferred wearing baggy jeans and getting into fights. I made out with a girl in middle school. Did that mean I was supposed to be a man? What the hell was all this transgender stuff?

From someone who has never experienced Gender Dysphoria, let me tell you: it’s impossible to imagine how it feels. At least there’s a simulator for hearing voices, that can give a non-voice-hearer insight to what it feels like and sounds like. There’s no Gender Dysphoria simulator.

The depth of my outside understanding came from my Biological Psychology course my second semester of college. Sex hormones, in fact, have trouble making up their minds sometimes. Testosterone, for example, will get busy forming the physical parts of a man while Estradiol gets charged with forming certain pathways of the brain. Depending on the pathways that get more estradiol than average for what would be a biologically male child, the brain may end up having more feminine instinct.

That’s not exactly how it happens, but you get the drift: one hormone develops more in an area of the body while the opposite develops more in the brain. This has been documented. While I couldn’t find the great sources my professor from 6 years ago had–at least not publicly available ones–I did find this review that might be interesting to you. It talks about hormones, development, and further research specific to brain sex differences.

Gender Dysphoria does indeed appear to have biological and genetic connections. What is there to argue against?

Is Gender Dysphoria a Mental Disorder?

It is, after all, in the DSM-5. In the DSM-3 it was considered “transsexualism” and in the 4th it was called “Gender Identity Disorder”. The name has been through many transformations but the fact is they still want to classify this as a medical condition. I’m not quite sure why.

I don’t see how normally developing hormones is considered a disorder. There are no malformations or diseases that result from your brain developing with more female hormones and your body developing with more male hormones. I see that those who are forced to suck back their truth in fear of condemnation, homelessness, violence, and rejection, suffer from depression, anxiety, and consistently die from suicide. That’s not a result of Gender Dysphoria. That’s a result of societal intolerance and ignorance.

Humans come out in variety. Inter-sex is more common than people think; people are born with two types of sex organs, or half of one, half of another, and you wouldn’t know who they are on the street. The internal fight that carries on with people stuck in a world that sees everything in black and white would kill the average person. People think that the rate of transgender transformations going up means the youth is being corrupted, that too many boys are being told “it’s okay wear a dress” and too many girls are being told “you don’t need to have children”. The reality is spaces are getting safer. People are coming out because they can now. People in their sixties are stepping into a freedom they’ve never had. Children are being raised to embrace their feelings rather than stuff them. Gender Dysphoria and Transgender individuals have been around for as long as your average man and woman.

Gender Dysphoria itself, in my opinion, shouldn’t be in the DSM-5. Instead, I vote for added Gender Dysphoria specifiers on things like depression and anxiety. Hiding inside of yourself can cause a lot of internal turmoil. The cause of the dysphoria, however, is not a disorder. We might as well label being human a disorder at this point.

What About The Children?

I think parents get worried when their kid is learning about all these terms, like Non-Binary, Transgender, Cis, Assexual. They worry it will “confuse” them. And I think, as with anything, there are parents who go too far. Some pull their kids out of health class if they discuss gender differences, and there are some parents who force gender neutrality on their kids. None of this seems to help the cause either of them are so passionate about.

No one cannot hammer your kid into experiencing gender dysphoria.

You cannot force your kid into being gender neutral.

You can encourage them to express their feelings.

You can let them know that if they ever feel like they want toy cars instead of barbies, or visa-versa, that it’s okay.

Children will develop into who they are regardless of what you want from them–that is a given. It’s your choice to accept them, and their level of wellness, especially in the beginning, is in some way dependent on your acceptance. As they grow older, it’s then their choice to accept your position. Are you willing to risk losing your child, metaphorically and physically, just because you think stuff like gender dysphoria is some new-age hippie shit? That’s the question I feel parents should ask themselves.

I grew up hating anything girly. I refused to wear pink, yellow, or anything bright. I ripped apart every Barbie or doll I was accidentally gifted (the gifter not knowing my anti-girl tendencies). I had a collection of hot-wheels and other model cars, and all of the toys I played with were animals mostly, who’d i’d give voices and character to. I remember my mom asking me one day whether one of the toys was a boy or a girl and I shrugged and said I didn’t know. It didn’t matter. I wore baggy clothes, got along better with boys than girls (still do) and I greeted all my friends with a fist bump or one of those “masculine” hand shakes.

The point is, NONE of this resulted in me being confused about how I identify. I am comfortable with my biological, female sex. I have a boyfriend of 5 years, and am considering children in the future. I still dress in baggy clothes sometimes, I have a resting bitch-face I’m quite proud of, and honestly I had that problem guys do with women: I used to get friend-zoned constantly with guys. It’s a horrible experience. I don’t hesitate to punch someone in self-defense, but I like to have my nails done and my make-up on point and my club dress “lit af”.

Talks about tolerance and acceptance can’t turn anyone transgender or create true dysphoria. The arguments about whether people with gender dysphoria, and people who transition, are worthy of kindness is what’s going to confuse kids.

There are so many major points to hit with Gender Dysphoria. I can’t fit them all in this post. If you have more knowledge and experience than I do, please feel free to comment below, correct me, or contact me. If you want to share your story with Gender Dysphoria, let me know. I would love to put it on this site. Although it’s talked about often these days, it’s not always talked about in the right way. We need more voices and experiences to drive home that everyone deserves respect regardless of gender identity.

As always, thank you for reading. Please send good thoughts my way. Judging by the amount of mini breakdowns I’ve been having this week, it’s going to take a lot of self-love and self-care to keep me from going back on medication.

If you want to chat elsewhere, or share your story, catch me on my social media below:

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If you enjoyed this post, please share, like, and follow ThePhilosophicalPsychotic. I appreciate every reader and commentator. You give me more reason to continue encouraging critical thinking for all.

Posted in psychology, science

Mental Health Month: Bipolar

I have been bouncing back and forth between what is healthy for my future and my present. They are often in conflict. We experience time linearly, but our choices can take us in spontaneous, curved, spiked, and winding direction. All of that contemplation has only landed me here. So, as promised, here is last weekend’s Mental Health Month post. We will continue with Dissociative disorders tomorrow evening. On Thursday, Friday, and Saturday we will talk about Gender Dysphoria, Neurodevelopmental disorders, and Personality disorders.

You know how it goes: we list the different diagnoses, what the manual thinks, and then we dive into the experiences. Today we’re talking about the Bipolar spectrum. If you have experience with Bipolar or any other altered state, including substance use, contact me here, or on my social media (below) to get featured.

Compared to the exhaustive lists of other diagnoses, this section is relatively concise. Most people are familiar with all of the terms listed below:

Bipolar 1, which is characterized by it’s key diagnostic criteria: a manic episode. This includes abnormal levels of euphoria and agitation. It will usually be obvious when someone is not themselves. they may be talking extremely fast, floating enough ideas to make your head spin, and getting a lot of things done–at least until things start not getting done. It’s stated that if you experience this while receiving any type of antidepressant treatment (including ECT) and this state persists, you can be diagnosed Bipolar 1. I’d personally like to see the studies that proved these states weren’t caused by the treatment being received, but of course that will never be possible. Take it with a grain of salt, people. Mania can elevate paranoia and distrust, and present confused, racing thoughts. It takes some time to be able to distinguish this state from an acute psychosis state related to schizophrenia.

After this extreme state, Hypomania (a lesser form characterized by an elevated mood, increased energy, inflated self-esteem and the likes, lasting for most of the day, most days of the week) may or may not occur. Depressive states may occur as well, in which a person cannot function, drowns in hopelessness, and lacks energy. In the same way that people who hear voices can miss their voices if a treatment “takes them away”, those with mania may experience a feeling a loss when stuck in a depressive state, particularly when it’s related to medication treatment.

Bipolar II is the next diagnosis. So, imagine constant, and sometimes severe depression, with a sprinkle of hypomania. You need to meet the criteria for hypomania at least once to be considered Bipolar II. Even if you never experience Hypomania again, or someone misdiagnoses your happiness amid all your darkness, you will have the brand of Bipolar II. Often the Hypomania does not impair the individual.

Cyclothymic Disorder may not be too familiar of a term, unless you’ve been diagnosed with it. This is when your Hypomania doesn’t match the criteria for hypomania, and your depressive symptoms don’t meet the criteria for a major depressive episode, for at least two years. Basically, if you’re more happy than usual, but not too happy, or more sluggish than usually, but not entirely hopeless, you’re also disordered. These symptoms must be present at least half the time, and for that 50% of those two years, if you don’t experience being a little too happy and a little too sluggish for more than two months, you’re just normal I guess.

I do not say with this condescension. I have no idea if Cyclothymic disorder throws people out of their normal routine or how it affects their life; I don’t have this. But if you read the wording in the DSM-5, it’s what I said above, without words like “basically.” It SOUNDS very much like they’re labeling normal states as disordered, particularly when they say “well, if you don’t meet the criteria for any symptoms, you’re still sick.”

While looking up some studies about Cyclothymic, I found that Schizothymia is also a thing–not a diagnosis, but a thing. It essentially embodies the “temperament” required to resemble that of someone with schizophrenia, without actually meeting the diagnostic criteria. So, again, normal but still disordered. Schizothymia has yet to make it in the DSM. It’s only a matter of time.

We can guess what Substance/Medication-induced Bipolar and Related disorder is. What’s highly interesting is that if your “bipolar” is activated by Alcohol, Phencyclidine, other hallucinogens, stimulants, cocaine, or sedatives, then you fall in this category. If it’s caused by an antidepressant or E.C.T., treatment that makes money, you don’t. I don’t suggest taking cocaine in place of your antidepressant, but I also recognize there are overlapping neurochemicals involved when we compare street drugs to legal drugs.

You can also have Bipolar and Related Disorder Due to Another Medical Condition, and Other Specified and Unspecified Bipolar and Related Disorder.

If you feel I’ve been tough on this particular category, I have. Wording matters. Wording is what gets people proper and improper support. Wording is how we start to internalize the views of ourselves. Wording is how others see us. Wording is everything. If you’re a studious kind of person, or already in the world of academia, I’d recommend taking a DSM critique course. They rip this manual apart. If not, give the document a read for yourself; it’s in PDF form across the internet and there are available copies in bookstores. If you are unable to separate your own experiences from the diagnoses though (that is, you can’t read one without going OMG I HAVE THAT), maybe just read some articles on critiques.

To get you started, This article is about how much influence pharmaceutical companies have in the revision and editing process. It’s scary. Again–you have substance-induced Bipolar ONLY if your drug of choice is illegal.

What Does Mania/Hypomania Feel Like?

I remember being manic. It’s been categorized as an acute mania, but I remember getting at least a few hours of sleep each night and my functioning wasn’t so impaired, so I’m more inclined to believe I attract the Hypomanic bug. I honestly don’t care, I just know I was managing a 4.0 average across semesters, taking Chemistry, Physics, Calculus, Psychology and Philosophy. I was happy. Very happy. I tackled five classes a semester, spent a lot of time out in the middle of the night, in my car with friends or my boyfriend, and I knew that I was special–beyond special. All of my ideas in science, in philosophy, had never been thought of before and every night I knew the next day brought fame.

My senior year of high school, and my first couple years of college–before I started working at Second Story–I tumbled through a lot of these mood shifts. A lot of my suicidal thoughts and actions, and self-harm, came as a result of these shifts, and so the Mania or Hypomania may not always cause the most damage. Sometimes it’s the aftermath, the picking up the pieces, the coming to a realization that something isn’t going right, that can impede wellness. I did not take care of myself, physically, mentally, every way, nor did I know what that was. I went through medications and doctors and therapy and sometime after one of my more serious depressions, the voices became more prominent and–well, the rest is history.

My experience in many ways pales in comparison to what some people go through. If you haven’t read the book “Mental: Lithium, Love, and Losing My Mind” by Jamie Lowe, I suggest giving it a read. She chronicles her journey fluently, and you get a sense of just how intense and fundamentally altering mania can be.

Many people get a sense of when a manic episode may be near, and this is just one story.

Is Bipolar a Throw-Away Diagnosis?

I believe a lot of descriptions of experiences should be thrown away, but Bipolar is not one of them. Mania can slam the breaks on people’s lives. Hospitalizations become traumatizing. People lose their career, their happiness, their stability, their wealth, their trust in themselves, their families, their possessions, their freedom, their understanding of what life is. All of it can be gained back, one way or another, but the act of starting over sometimes feels like an insurmountable obstacle.

Believe it or not, Bipolar 1 and 2 are quite over diagnosed, and ironically the over diagnosis causes stereotypes and expectations in a clinical setting which, in turn, fuels more incorrect diagnoses. For example, the night I was transferred to the psychiatric hospital over the hill, as soon as they learned I hadn’t been sleeping well–I hadn’t been up for days, I just had trouble sleeping more than a few hours, due to anxiety, panic, voices, and the feeling of being hunted–they diagnosed me Bipolar 1.

When I was released to the hands of the county here, I was interrogated with questions I can barely remember answering. I was still kinda gone, pretty sedated, and confused. The social worker acted more like a detective, or a doctor trying to figure out if I was actually in pain or just wanted opiates. Well, what do doctor’s usually assume? That you’re just trying to pop a pill. What did this social worker assume? That my diagnosis has been bogus because “they always throw that diagnosis at people, it’s a throw away diagnosis”.

That’s what he told me. He said I didn’t need any help and through his line of interrogation concluded my state was a result of marijuana. I had told him I’d smoked two weeks prior, but it had been over a year. As I said, I was gone, had no sense of time, and again slipped through the cracks. I also hadn’t been in contact with many people, my parents were still unsure of what was going on, and my boyfriend who came with me wasn’t allowed to say anything. It felt like I had to make a case in front of a judge without a seasoned lawyer, while hoping for my conviction.

In short, Bipolar is not a throw away diagnosis. People’s experiences are real, they are intense, scary, and incapacitating.

Why Are Manic Episodes confused with Psychosis?

Because they present similarly, and the wording to diagnosis either of these states is vague compared to the amount of variety in symptoms. For a proper separation of diagnoses, the key is to wait. Watch how the state presents itself, how it reacts to what medications, what kind of services, and how is the person after they are more lucid. Are the paranoia and hallucinations persistent without the lack of sleep? What level of insight does the person have to their experiences?

Although not much is known about psychiatric medication, I cannot deny the fact that there are people who are helped a great deal by it, including myself at one point. Sometimes we have data on medications that work better with some diagnoses compared to others. Mood stabilizers may not affect someone with persistent psychosis, and that can help rule out Bipolar 1.

This process is similar to when someone is on a substance, like amphetamines. Once the drugs are out of the person’s system, you observe their behavior and see if the temperament and experiences persist.

What is Helpful?

Two things are very important if you deal with any kind of mood fluctuations, but particularly if you have a bipolar-type condition: sleep and routine.

One thing that made doctors notice I had a mood issue was the fact that I wasn’t consistent in anything that I did, especially taking medication. I’d go on it for a few months, feel well, balanced, and annoyed by the medication side effects, and I’d stop cold turkey. I’d feel okay for a couple days, and then spiral, usually into a depression or severe agitation.

Having a routine includes being consistent with medication: this is true even if you decide to stay off of medication. Forcing your body through the process of adapting to medication, juggling brain chemicals, and then having to re-adapt when you stop isn’t good for your mind or your biological systems. If you choose to stay off medication, what are your limits? It may sound crazy, but mine is hospitalization; if I get hospitalized or feel myself moving toward the idea of voluntarily committing myself, I need to get back on medication. Neither has happened yet. If you choose to stay on medication, what are your limits? Do you believe you will have to stay on them forever or are you open to the idea of working toward getting off of them?

Having a bedtime and morning routine can help develop that stability. Having a set time to sleep and wake up, having rituals even (shower, teeth, pjs, a good book) can aide in that process. It’s important to note that this is not to make you feel “normal”. This is part of self-care. It’s not about being like everyone else, or wanting to feel like a “normal person”, it’s about being healthy and learning what you need to stay well.

And that takes us to sleep.

Get it. It’s important.

Medication is helpful for this in many respects. One thing I miss being on medication is how I got 8 hours of sleep every night, to the second. My body just instinctively took on this role of: wow, my brain has slowed down, I don’t have as many distractions and the sun is going down, you should probably start winding down. Melatonin and chamomile tea can help accentuate this if your normal medication doesn’t quite do the trick. Be wary of sleeping aides like Ambien.

Staying active and nutritious will also help your body get back into the natural sleep-wake cycle. No one will kill you if you have one of those chocolate pies or a doughnut, but if your diet is perpetuated with processed sugars, heavy carbs, and un-nutritious fats, sleep will be hard to come by. Exercise stimulates many different hormones and chemicals in our body, the same ones some psychiatric medications attempt to promote, so adding in a routine if you don’t already have one can dramatically affect how you feel in yourself and about yourself.

These are important for everyone, diagnosis or not, but especially important with a diagnosis. Wellness does not come from one branch on a tree. Wellness is the tree, and its branches are things like exercise, nutrition, attitude, outlook, worldview, medication, physical health, productivity, e.t.c. The more branches, the bigger the tree.

Thank you all for the Instagram messages and for reading this blog. I’ve been so incredibly happy to see that so many viewers are enjoying this content. Tomorrow we will talk about Dissociative Disorders. If you have a story to share with me, or you want to put it on this blog, please reach out to me via my contact page ( linked above) or my social media:

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If you enjoyed this post, please share, like, and follow ThePhilosophicalPsychotic. I appreciate every reader and commentator. You give me more reason to continue reporting poorly executed science.