Posted in advocacy, Emotions, Freedom, Late Night Thoughts, Peer Support, psychology, Supporting Friends/Family, Uncategorized

Mental Health And African-American LIves

There was not a Mental Health Month post on Thursday for Somatic Disorders as I anticipated, not because I ran out of time but because my mind has been engrossed in other disturbing realities and going-ons in America. I will do a post on Somatic Disorders soon. But firstly, we need to discuss something.

For all the mental health websites and advocate pages on Instagram who are American-run and have not mentioned ONE DAMN THING about the riots in Louisville, Kentucky and Minneapolis, Minnesota right now, you should be ashamed of yourselves. ASHAMED.

How dare you claim to be an advocate of mental health and not bring to light the racial issues that are not only causing MORE trauma for today’s generation of colored folks, but is fueled also by the generational trauma of our ancestors.

I am a mixed race individual; my father is African American and my mother is Caucasian. I am light skinned, often mistaken for Mexican, and my mental health and physical health has been impacted by this. Doctors are less attentive. They don’t listen properly. They accuse me of drug use in the middle of my panic attacks.

For African American people in America, there is a lot of grief. There is a lot of trauma, a lot of loss, a lot of pain. We feel unsafe, unheard, tossed aside. That births anger, rage, and perpetuates violence. With the recent murders of George Floyd and Ahmaud Abery and Breonna Taylor (George and Breonna murdered by police; George was already on the ground with three cops on top of him and Breonna was IN HER HOUSE), all of these feelings and this connection we have to each other is growing stronger. Violence is happening because of the angst of hundreds of years of BULLSHIT.

So the fact that so many pages are claiming to talk about Mental Health and are avoiding this issue for political reasons I suspect makes me sick to my stomach. Until this is addressed in all facets, nothing will change. As social media has been circulating: No Justice, No Peace.

Not only does blatantly ignoring this subject aide in the problem rather than the solution, it also sends the message that those of us in the american mental health system who are dark don’t matter as much. We don’t need to talk about this collective pain we feel right now because your page can’t afford arguments in the comments.

I say affectionately, FUCK YOU.

Get off your fucking high horse.

Remember when I said I have made very frank posts on my previous blog? This is one of them.

Get off your fucking high horse and recognize that the deaths of these people, the murders of these people, affect African-American people across this nation. My anxiety, my grief, my voices, my paranoia have all doubled because of what I see happening to the people who are part of my ancestral family. I feel the same for the Native Americans who are hit the hardest with COVID-19 and receiving absolutely no help, except a box of body bags rather than PPE. Part of my family is Native to North America and their suffering has only added to my grief.

This IS a mental health topic. Racism IS a mental health topic. Not because racism is a disorder, but because how it effects people dictates their mental states. To advocate at this time for mental health without reminding followers and subscribers that people of color are collectively struggling mentally with this, to the point that VICE has to be the one magazine to offer self-care tips for African Americans, IS SELFISH.

It’s SELFISH to ignore this as a mental health topic.

I’ve been sick to my stomach all day, lost in my thoughts and my pain and watching Minnesota burn down their police station.

If we truly are all in this together, then where is your support for the black community right now? Where is your acknowledgement of our mental health in a time when we are watching ourselves get killed? Somewhere up your ass?

Good Night.

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:

Instagram: @written_in_the_photo

Twitter: @philopsychotic

Posted in psychology, science

Mental Health Month: Dissociation

As promised, here is last weekend’s OTHER Mental Health Month post. Tonight we’re talking about Dissociative Disorders.

You all know how this works: we talk about what the manual classifies as disorders, then we talk about the experiences. If you would like your mental health story (substance use and LGBTQ+ also!) shared on this site for Mental Health Month, contact me here, or reach me on my social media (linked below). People have seem to like reaching out through Instagram, and I enjoy talking with people. Feel free to contact me just to chat–that’s what’s been happening most recently.

Let’s dive into it.

Like Bipolar, this section is concise in the DSM-5 and tied deeply to studies in cognitive psychology, especially when it comes to the controversy of repressed memories. You’ll recognize the first diagnosis:

Dissociative Identity Disorder: This is not a light diagnosis to come by, although it has a wild history of it’s introduction into mainstream mental health. Formally known as “Multiple Personality Disorder,” DID is characterized with identity crisis. This means someone’s personality states are split into two or more, and can affect memory, behavior, perception, cognition, and other senses. This can be reported by others, or noticed by the individual themselves. Gaps in memory of trauma or everyday events may be obvious. This, obviously, must cause severe distress. We’ll talk more about this below.

Dissociative Amnesia: This is also related to trauma. The individual will be unable to recall autobiographical information related to a trauma or stressor. This is not the same as being stressed out and forgetting your keys. The forgetting must be above and beyond that of ordinary memory decay. This can be with or without dissociative fugue.

Depersonalization/Derealization Disorder: Depersonalization is feeling detached, or outside of your body observing your thoughts, feeling, and bodily sensations. Things feel unreal, your self is absent, and your sense of time is distorted. Derealization is a detachment with respect to what is around you: objects, people, feel unreal, wrong, or are distorted. You do not leave reality but this does cause distress and impairment in everyday life.

Other Specified Dissociative Disorder: Mixed symptoms of the above types.

Unspecified Dissociative Disorder: People experience characteristics of the above, but none of it meets the full criteria. Again, your normal is disordered.

Is Dissociative Identity Disorder Real?

This is the big question everyone asks.

I don’t refute people’s experiences. If someone tells me they have 25 different personalities, I’m not going to sit there and tell them they don’t; I’m not inside their body or their brain, and I haven’t lived their life. And it seems in the science community that experiences aren’t being question either, but rather the onset of symptoms comes into question. So, let’s talk about what we DO know.

  1. People are distressed by these experiences. Some lose control of their lives, bounce between hospitals, treatment centers, group homes. People are reliving traumas in their body and their mind. This is not a joke.
  2. Repressed memories, since their conceptual birth within Freudian times and psychodynamics, have never had any real conclusive studies. Behaviors can be studied of course; biological responses can be studied, of course, but whether or not someone’s memory is correct cannot be studied. If you ever take a cognitive neuroscience or psychology class, you will learn that memories are reconstructive. That is, our brains put memories together as we remember them. They are not snapshots of the past. We retain central ideas and key themes, but we will not remember incidents or scenes as they are. Flashbulb memories, those that are caused by sudden trauma, have been shown just as unreliable as our regular memories. Researchers have actually seen this process; new neurons branch and stimulate growth as we remember something–they are not pulling from neurons that are already there. Memory is not as simple as it seems and research on repressed memories is inconclusive.
  3. DID has a bad wrap. It got a bad wrap from people across the country back in the day opening treatment centers, holding people who are struggled with some sort of mental distress in their lives, tying them down, and telling them they have different people living inside of them. These centers were eventually disbanded for fraudulent billing (they got a lot of money for this breakthrough treatment) and got ousted as a cult. They kept people from their families, told them their families were the ones who had abused them, and ruined a lot of lives. It took years for those people to get real trauma therapy and realize their identity was intact. There’s a documentary on one of these centers that I watched in my Research course least year. If I find it, Ill post the link. The concert today, though, is whether this kind of literal brain washing is still happening.
  4. Planted memories are a little more solid than repressed memories. Again, our memories are reconstructed upon remembering, so it’s been shown that people are inclined to fill-in-the-blanks sometimes, remember something that was there that wasn’t.

So, in the spirit of respecting those who know this to be their experience, and also respecting cognitive science which shows it may be possible to create these personalities in therapy, I looked up an article that compared the two causes of DID: Trauma Or Fantasy? I can’t link the study because I downloaded it from my school’s database, but if you’re interested in reading it, contact me.

Researchers compared four different groups: Genuine DID diagnosed individuals, DID simulating individuals (people acting), people with PTSD, and a healthy control group (“healthy” meaning unaffected by a condition). Long story short, results showed that those in the Genuine DID group were not more prone to suggestive memories nor were they more likely to generate false memories. There are some limitations with this study, one being that it was a small group of people and that their malingering results came back inconclusive; I didn’t see them list any reasons for this. They used reliable and valid testing measures, but didn’t experiment, which is a big problem if they’re really trying to challenge the fantasy model of DID.

The point of all this scientific arguing? People’s experiences are people’s experiences. I honestly don’t care if a therapist put it in your head or if you actually went through a horrific trauma. The point is you’re distressed, you’re suffering, and no one needs that in their life. As far as experience is concerned, DID is as real as any other condition.

Does Your Trauma Need To Be Severe?

This is a hard question. When it comes to DID, it’s highly unlikely those series experiences are going to come after something like your verbally abusive dad. I’m not saying it can’t, we don’t know everything there is to know about the brain or how it processes things that harm us, but it is unlikely. However, derealization and depersonalization are common in people with anxiety and PTSD.

My second depersonalization episode happened when I was 15. I remember (and there’s a chance I’m remembering incorrectly, remember?) sitting in the passenger seat of my mom’s car as she drove me to school. I usually rode my bike or walked, but it was raining particularly hard that day. I felt myself floating, my spirit, and I was leaving my body. The inside of the car didn’t feel real, my arms didn’t feel real, and the experience of life wasn’t real. I told my mom, I said, “see, there it is again, none of this feels real. The car doesn’t feel real. It’s weird.”

I don’t remember if she said anything. But from that point on, dissociation became synonymous with living for me. I walked across four lanes of traffic and the three miles home with friends shouting at me, shaking me, calling my name, and I was lost in a void. I don’t remember them shouting at me. I don’t remember them touching me or that I’d narrowly escaped death. What I do remember is blackness. Becuase that’s all I saw.

It wasn’t painful.

It felt ethereal almost. I’d shed my physicality. I’d shed my ego, my anxiety, my worry, my fear. I’d shed my anger, and I had a lot of it back then. I’d shed my need for escape. I’d shed my uncomfortable reality. And, as strange as this sounds, it felt damp and warm, the blackness did. I couldn’t feel it how we feel, say, water on our skin, but I felt it in a purely infinite, internal sense. I felt spread across eons and for the first time I felt complete.

In our world, we diagnose this as dissociation, but I have not been convinced. This felt like I experienced raw life, real life, what we are outside of these meat sacks. But that’s a whole other conversation.

I remember walking through the door of my apartment and my dad asking me how school was. That, and the void.

I was never sexually abused or physically beaten to the point of hospitalization. I’ve never been in a car accident or a house fire. By big trauma event standards, I’m pretty low on the scale. I have endured repeated emotional and verbal abuse, some physical violence, homelessness, schooling terrors, and an alcoholic/drug addict parent while growing up. There are painful memories and a lot has stuck with me. So, the answer to the above question is, no. If something hurts you, your body and mind respond in the best protective coping mechanisms it can. Sometimes it needs to yank you out of the physical world and remind you who you are.

Does Excessive Day-Dreaming Count?

By DSM standards, no.

But, if your day-dreaming becomes so distracting that you find yourself struggling day to day, it’s worth talking about.

Thank you all for coming down this road with me. Mental health isn’t just my job or my personal affliction, it’s also my passion to share my experiences and knowledge, and to be apart of this kind of writing community. I am terrified of speaking and haven’t yet climbed over that hurdle, so writing is the next best way for me to be active in mental health advocacy. Thank you for being there with me.

This Thursday, Friday, and Saturday, we will continue with Gender Dysphoria, Neurodevelopmental Disorders, and Personality Disorders. If you have a story you’d like to share with me, here are my social media handles. *Feel free to just chat with me, it’s been great getting to know all of you* My email info is linked above as well.

Instagram: @written_in_the_photo

Twitter: @philopsychotic

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

Posted in Uncategorized

Sunshine Blogger Award

Although I couldn’t put the man hours into the usual Mental Health Month blog today, I paused in writing a Case Study on Donald Trump (yes, it’s a real assignment) and blogged something fun. Thank you Caz over at mentalhealthfromtheotherside.com for nominating me. She writes about her experience with mental health, like anxiety, depression, and trauma, from a personal and professional lens. She’s a great writer and the depth of her openness on her blog is inspiring.

Now, I haven’t done one of these awards since I wrote on MentalTruths, my old blog I started in July 2015. I notice there’s been followers from that blog who have jumped over to this one, so if you all are reading this, you know my other style of writing is full of sarcasm, blunt humor, and, well, weird stuff. If you can’t quite picture what that means (I’ve been very formal on this blog), I implore you to read this piece on Clinical Arrogance, and any other piece. A laugh might be needed today.

What I do remember about these posts is that there are rules. And the rules for this one are as follows:

  1. Thank the person who nominated you, because that is common decency here in the blogsphere and in life. Also link their blog so we may all find their wonderful writing.
  2. Answer the set of questions asked by the blogger who hence forth knighted you with this blogging honor.
  3. Nominate others, and ask them to answer new questions. They’re easy to come up with, I promise.
  4. Notify the nominees, of course, with a comment.
  5. Put up these gallant rules and don’t forget to display your badge of honor(the sunshine thing) on this post or your blog.

Is the Liebster blogging award still going on around WordPress? I’m so out of the loop now. Let’s answer some questions.

1.What is your say on an all-positive approach to life?

This made me giggle because you all know how I feel about this. I don’t believe keeping a constantly positive mindset is one that promotes health. I think it’s helpful to remember that a negative moment does not doom one to a negative life. I think it’s helpful to remember all moments in life are temporary, including ones filled with grief, pain, horror, and sadness. However, I think it’s equally as helpful to embrace the pain we feel as a species (like mortality) and as an individual (like our mental health conditions). Pain cannot exist without pleasure, and pleasure cannot exist without pain. We must give both attention to foster a balanced relationship.

2. What do you do in times of Writer’s block? Also mention any reasons for writer’s block.

I read my old writing, or I read other’s writing. What I haven’t shared yet on this blog is that I also write fiction stories and have a novel in the works. I haven’t had much time to work on my short stories, but after finals I will be spending out some for (hopeful) publication. It’s a dog eat dog world out in the creative writing sphere. I took to writing on Booksie some time ago, which I guess is kind of like saying “I’m a Wattpad author”, and that’s kind of the writing equivalent to when your friend calls you and says “hey bro, I sent my SoundCloud link, check it out.” I haven’t written on it for a while, but here’s the link. Yes, I’ve taken creative writing classes and workshops, and was published when I was 17. I didn’t get to go to the ceremony because I’d spent the previous night in the E.R from a panic attack and slept two whole days on the max dose of Ativan they shot me with. They told me it was Ativan, at least. But I slept two days.

I also simply let the writer’s block be. Some people like to force themselves to write but I don’t always have the mental energy for that level of discipline sometimes. If I want inspiration, I will go for a run, a walk, or a bike ride. Nature inspires.

3. Have you ever deleted a frank post, thinking it was too bold? What do you do if that happens?

Ha. Hahaha.

No. I will never delete a frank post. I never did my 5 years of writing on Mental Truths, and that blog tore into so many sensitive topics. I don’t believe people should be shielded. I remember one post I was very angry and I discussed my personal level of aggression, how I felt like I manipulated people sometimes, that I was, essentially, “an unfeeling asshole” and one person commented “you just lost a follower, you say you’re violent.” And I let them know they have every right to unfollow my blog, that they actually don’t need to tell me, and that I’m not a violent person, I am just angry in the moment.

The world is offensive. There is no need to censor that, but rather it can become a strength to acknowledge that, and a strength to know your limits. It’s not enyone else’s job to censor everything because of your sensitivies or your traumas. It’s your responsibility to put up boundaries against what you feel you can handle and what you feel you can’t. I do that often. There are some things that are too violent or sickening or scary for me to read about. I couldn’t watch the Aumaud Arbery shooting video. That doesn’t mean it shouldn’t be posted.

That also doesn’t mean go around purposefully disturbing people. That’s just sadistic. It’s a fine line, people.

4. Do you believe in planning?

Some things I plan. If I am going on a trip, I plan the time I’m going to leave and what I’m going to take. My boyfriend insists on planning activities, and I go along, but I prefer to have a couple things planned and a couple things not planned. I need flexibility in my existence.

5. What is the weirdest flavor or combination you ever found in a drink or snack?

7-up cake. Enough said. I was looking for the Mountain Dew cookies, though.

6. What is your most embarrassing moment?

In High School we had a substitute teacher in my honors class. He spoke quickly, and was a very boisterous, fun personality, and I hated that. He made me very nervous. When he suddenly called on me to answer a question, my anxiety caused me to speak in tongues. Nothing I said was a word. In fact, it came out like this: bleepsdhajfjpeajdjiepad. He said “oooooooookay” and moved on to someone else.

7. Are you a dog person or a cat person?

I own a cat, but I love dogs as well. I want both.

8. If you had the opportunity to pick one superpower for the rest of your life, what would you choose?

There are listed options, like time-travel, teleportation, telepathy, psychokinesis, and invisibility. I already believe I have telepathy so I won’t touch on that. If I had to choose, I’d choose the ability to time travel. I feel I’d learn so much about the universe.

9. How do you cope with stress or anxiety? Any special tips?

The basic ways are breathing exercises, reminders, and exercise. I throw most of that out the window. Math helps me tremendously with anxiety. Any focused, intense task activates my executive functioning, the frontal lobe, and removes focus from my amygdala. If you want to get scientific about it. I’ve had anxiety since I was a toddler, so a lot of my coping comes from pushing through or using biofeedback (blood pressure, heart rate, e.t.c) to show my brain that my body isn’t as broken as it thinks.

10. Is the universe finite or infinite? And why do things even exist at all?

We are physical beings, made of matter. Matter is made of atoms, and atoms are simply condensed energy (once you get past all the tiny particles that make it up). Matter then, is condensed energy. Energy cannot be created or destroyed. Many people have heard of the double slit experiment, where we learned photons and electrons can behave as both particles and waves. If you haven’t read a physics textbook though, you might not know that we can never know whether it is our measurement of the particles that changes its presentation or not. We can never know because when we take away an important part of our measuring tool: the camera with the light, we can’t see the particle’s behavior. Our physicality limits what we can learn about nature. That’s part of a paradox and part of Heisenberg’s Uncertainty Principle.

And so, evidence points toward the universe being infinite, from our limited understanding of how gravity and other forces push through the universe. Will we ever know? Probably not.

Things exist and do not exist simultaneously. If there is a reason, it’s probably beyond physical measurement and therefore we can only speculate. Poorly.

11. If you had one week left to live what would you do?

Eat all the junk food. Reconnect with nature. Mull over mortality and the normalcy of it. Speed-finish my fucking book. That’s such a hard question to answer. I prefer having no clue about when I will die.

Alright.

Nominees. I will do 8. I need to get working on my homework. But all of you are worth nomination. You can still have fun answering the questions if you’re not listed below. I encourage you to, actually. (There are also listed blogs to check out on my homepage on both my current blog–this one–and my old one. Please check them out, they are all great people!)

1.Mellytheblogger.wordpress.com

2.mentallyillinamerica.com

3.collinmintz.wordpress.com

4.bipolarmermaidwriter.com

5.iammyownisland.wordpress.com

6.lampelina.wordpress.com

7.winterdrangonflies.wordpress.com

8.brittianismental.com

No pressure to participate, I remember these things being very fluid and fun. But if you do, here are your questions:

  1. Where do you get strength?
  2. Do you prefer tidiness or some chaos?
  3. What keeps you balanced in life?
  4. What’s one of the scariest moments of your life?
  5. What does writing do for you?
  6. What is your dream career?
  7. Would you swap your life for someone else’s?
  8. Where do you fit in this world?
  9. Any tips for fellow bloggers?
  10. Where will you be five years from now?
Posted in Uncategorized

Mental Health Month: Update

I really tried all I could to finish up my articles for this weekend but it looks like Bipolar and Dissociative Disorders will have to be pushed back to Monday evening and Tuesday evening, assuming I don’t work late on Monday.

If you’re wondering, I am still a student and have a couple finals and a paper to finish. I was at work yesterday too to help hire some people, and I needed some extra self care these last two days.

We will still cover those two diagnoses and continue on the regular schedule next week.

Thank you everyone who has been reading, following, and reaching out to me on social media. If you are interested in sharing your story for any part of Mental Health Month, I welcome all experiences. Please contact me on my social media:

Instagram: @written_in_the_photo

Twitter: @philopsychotic

OR reach out to me on here via my contact me page.

Thanks everyone! Enjoy your weekend.

Posted in psychology, science, Voices

Mental Health Month: Schizophrenia

*This is a post dedicated to my Mental Health Month series, where each week we talk about different diagnoses, share stories, and ways toward wellness. Tomorrow we will cover Bipolar Disorder. If you have some experience to share for any of the topics we cover (or have covered), contact me here or on my social media handles and we will get you featured.*

Today we’re talking about schizophrenia and related diagnoses, one of which I have. I’ll share some of the things I’ve experienced and ways that I’ve dealt with certain aspects.

The reason Schizophrenia is now considered a spectrum is the wide ranges of experiences people have, and the level of distress resulting from those experiences. Our last DSM separated Schizophrenia into subtypes like “paranoid, residual, undifferentiated, disorganized, and catatonic.” I think it was a big sigh of relief when these boxes were removed. The DSM 5 now reads with these diagnoses:

  1. Delusional Disorder: This basically means someone is consumed with different types of delusions (like grandiose or jealous type) for at least one month or longer. If people do experience hallucinations, they are related to the delusions. Usually functioning isn’t as impaired at the same level of someone in an acute psychotic episode.
  2. Brief Psychotic Disorder: This is more like what someone would picture an acute episode: hallucinations, delusions, and some version of disorganization.
  3. Schizophreniform Disorder: I honestly thought they’d removed this a long time ago, but this is like a short-term schizophrenia; episodes are usually between one and six months long. This includes hallucinations, delusions, disorganization, and negative symptoms (apathy, lack of response, e.t.c).
  4. Schizophrenia.
  5. Schizoaffective Disorder: this includes elements of schizophrenia, like hallucinations, delusions, and disorganized speech and combines it with elements of a mood disorder, like depression or mania. The mood symptoms must be present concurrently with the top criteria of schizophrenia.
  6. Substance/medication induced psychotic disorder
  7. Psychotic disorder due to another medical condition.
  8. Cataonic conditions.
  9. Other specified Schizophrenia spectrum and other psychotic disorder.
  10. And of course unspecified.

Are Psychotic People Dangerous?

The thing that gets misconstrued often about psychosis is the level of danger someone experiencing an episode poses. Of course there are cases of those lost in delusion acting aggressively. There are many more cases of abuse and violence against those in psychosis.

The thing that isn’t understood is that when we are in this fragile state, everything is terrifying. Your smile is terrifying–a sign you’ve been conspiring against us. Your tone of voice, your pitch of voice, your very existence in our world means you are, in one way or another, against us. Every person, television, web camera, corporation, government institution, is a hunter and we are the prey, frightened only because we’ve just realized this whole time people have been plotting to harm us. And suddenly every bad thing that happens, or has happened, every innocent mistake we witness, every abnormal movement becomes apart of that plot.

Not everyone is vocal and so obviously outlandish. I, for example, spent a lot of my time in my room with a blanket over my head playing Minecraft in the dark. I spent five or six days a week doing this. Meanwhile, one of my coworkers controlled mby body, blocked the thoughts she hated, inserted new ones, forced me to eat a bowl of cereal, hounded me until I did it. I couldn’t walk properly and I’d lost awareness of my body because it wasn’t really mine anymore.

I spent weeks playing Grand Theft Auto in a room piled so full of trash and clothes my door couldn’t open properly and I couldn’t touch my carpet. The sheriff managed to shove my door open, though. That was when the voices were keeping me up all night with screams and mocking banter and whispers. I sat rigid and silent, only answered their questions with “yes” or “no” even if they asked an open ended question.

My diagnosis is Schizoaffective, first diagnosed as Bipolar 1 and several other things.

What pains me is when I hear about people deep in their experience who trigger the fear in officers that they’re trained to have to protect their lives. One man, over 8 years ago, came at an officer with a boom. This officer knew of the man’s psychosis and still opened fire with 7 shots.

Another man, silent, mute, like me, but naked, walked along a highway in the middle of the night. A trucker stopped him, called police when the man, also diagnosed schizoaffective, crawled up on the roof of his semi. The cops, assuming he was on drugs, gave him a pair of shorts or something, called the paramedics who took his vitals. The Sargent then drove the man to a closed gas station and dropped him off. That man then wandered back to the same highway and was killed by a car that didn’t see him.

The Sargent’s defense was that he’d dropped the man off in a safe place.

Are psychotic people dangerous? Not usually. What’s dangerous is the situations made volatile by people who don’t understand.

What does Research Say?

I’ve written on this before (big surprise) and if you’re curious, you can read the post, “Is Schizophrenia a Brain Disease?” You may be surprised by the answer. If you frequently keep up with psychology research, not the pop psychology agenda, you probably won’t be.

Can People Live Normally With Psychosis?

Yes.

For some people that means taking medication or living in a group home where social skills and independence are prioritized. For others, this means getting off of medication or moving out a toxic living environment. For all of us, though, who choose some version of wellness, it usually means keeping a routine, engaging in consistent self-care, and learning to manage our experiences to the best of our abilities.

Not everyone hears voices 24/7. Not everyone’s voices are external. Not everyone’s voices are negative. Not everyone has visual hallucinations. Not everyone is hospitalized constantly, or for insanely long periods of time.

So what happens to those who don’t reach a stable wellness? A lot of people give up on those who don’t seem to present a lot of insight, as if it’s someone else’s responsibility to make them develop insight. I don’t want to say that stability isn’t achievable for some. What I will say is that the level of insight depends on many things: support, past trauma, current trauma (hospitals, police, doctors), self-esteem, general worldview. All of this gets distorted in psychosis, yes, but the foundation is the same. If someone has spent a lifetime in child abuse where intimidation, violent threats/attacks, and coercion dominates their perception, assuming even bizarre things like aliens probing their thoughts is routed in a feeling of lack of privacy, feeling intruded upon, and invaded. If those underlying feelings are never addressed, if only obvious positive symptoms (like hallucinations) are dulled, and that is called the ultimate progress, then that persons self-esteem, drive, and hope will suffer.

Much of the mental health system stifles the cultivation of wellness for those with psychosis in many ways.

Living normally can mean many things. It could mean working. But it could also mean just steady self-care. It could mean being satisfied. It could mean getting on social security disability and getting back into hobbies and cultivating contentment. It doesn’t have to mean what society wants it to mean.

What Are The Experiences Like?

This varies in intensity and frequency across the spectrum of Schizophrenia. Common experiences are auditory and visual hallucinations, olfactory (smell) hallucinations, tactile (touch) hallucinations, thoughts and feelings of being hunted, attacked, hated, and the reasons for these feelings are what become delusions–for example, if someone feels they are being watched, the delusion isn’t just the action of being watched, but why; the government has tracked their IP address, put bugs in their phones, turned their family against them. They hear the agents outside their window, conspiring.

Other experiences may include a severe drop in drive, motivation, and emotional expression. They may have an affect that is inappropriate, that doesn’t match what they say or the atmosphere of the room. This is the reason one of the top Google questions about Schizophrenia is “why do schizophrenics laugh randomly?” They’re hinting at affect, but also possibly voices. Sometimes they say funny things and we laugh. That’s a normal reaction to something hilarious, but on the outside it seems scary, weird, and bizarre. There is no scientific consensus to whether medication is the cause of these “negative symptoms.” If we get some studies that aren’t done by researchers with severe conflicts of interest (e.g grants from pharmaceutical companies) we may get a definite answer.

When I was on medication, I was more focused and aware of my surroundings, but I was tired and had trouble caring about things. Apathy can come after a psychotic break, especially a first psychotic break, and again, there is no scientific consensus on whether this is result of the medication blockading certain synapses, damaging them, or just a result of the brain restructuring itself after the break.

For me, my voices are often but not constant, internal and external, random, mocking, encouraging, and repetitive. I also hear familiar voices, such as friends or coworkers, particularly when I’m around them. When I worked at the local library at the beginning of 2019 (yes, I tackled two jobs) I often heard the boss and the branch manager discussing me. One afternoon in particular, I was shelving some books. I heard them giggle and the boss (my supervisor) said my name, followed by words I can’t remember and the branch manager said “well, what are you going to do about her?” very loudly, and when I whipped my head around, they were talking, smiling, laughing, and I couldn’t hear them at all. They were across the library.

I took my cart to a different part of the library, felt my heart racing, and tried to look at the event objectively. They were far away, I couldn’t hear them, and maybe they weren’t taking about me. But they’d said my name. Maybe it was something good. Or maybe they hadn’t said anything at all. Every day in that place was me psychically defending my honor. I quit abruptly four months into the job.

I also hear unfamiliar voices, strangers walking down the street. One afternoon, before I was hospitalized this last time I think, my boyfriend and I were on the wharf walking back toward the street. We walked past a couple, and the man growled “you better watch your back”.

This was when I knew there were people placed on the street to intimidate and berate me. I knew some were possessed by the same entities that wanted me dead. I spun around and I asked my boyfriend, “didn’t you hear that?” Of course he didn’t, and I stopped in the middle of the walkway, blocked it really, watching the couple, and spoke loudly; “that guy just told me to watch my back. He thinks I don’t know what’s going on, but I fucking do. They don’t know who they’re messing with.”

I don’t know if my boyfriend remembers this, he may not, but I remember the fear, the anger, and the uncertainty.

Some people see creatures, demons, devils, regular people, spiders. Some people feel things crawling under their skin or in their organs, or smell strange scents. I remember smelling a lot of weird, noxious fumes not of earth and fire smoke. I always feel like someones touching me, grabbing me, trying to pull me in a different world. I feel things crawling on me frequently(not in me thankfully) and I misinterpret a lot of my body’s signals.

All of these things together can be incapacitating, terrifying, and unreal in real way. I still think back on some things and don’t believe that any of it happened, that I made it up, and that belief often has my voices calling me a liar, that I’m some kind of malingerer and my therapist knows it, my coworkers know it, and it’s going to cost me my job and my therapist is going to put me in jail.

How ironic, right?

How Should I Respond?

If your friend, child, parent, or any other relative is experiencing an episode or is home, on medication, and still in the midst of psychosis frequently, panic is probably the most incorrect way to respond. The second most incorrect way to respond is feeding or attacking delusional, disorganized, or otherwise different behavior. Do not agree that the government watches your son, but don’t dismiss it either. Sometimes the underlying feelings of being watched are fear, mistrust, or anger. Address those.

Studies show that the involvement of trusted family members during someone’s hospitalization can enhance and support the person’s recovery. Show up, visit, learn what you can. My mom feared driving over the hill to the hospital I was at and so my boyfriend brought me clothes and visited. It would have been nice to have either one or both of my parents though, so they could not only see the extent of my fear and mental frailty, but also so they could get involved and be a source of comfort. It’s so hard to get them to be a source of comfort sometimes.

Most of all, respond with compassion, patience. Step outside of your world and into ours.

This post is so late (it’s 11:46 pm for me on May 14th) because I have loads of classwork and have been working full-time for the first time in my life. Adjusting to that is taking some time. And so tomorrow, later as well probably, we will cover Bipolar. If you have a story on any diagnosis and you’ like to share it here, CONTACT ME or reach me on:

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Posted in Late Night Thoughts

Happiness

I’ve been thinking a lot about what it means to be happy. Here are some of my thoughts.

I’ve done what all good, sheep-like psychologist eventually do: create categories for something that is probably far too complex for such an explanation.

But, hear me out.

I’ve reasoned there’s organic happiness and there’s constructed, or synthesized, happiness. An organic happiness would be someone’s baseline: how you are when you wake up in the morning, how you respond to the corresponding events of the day. This is the happiness we often feel we need to correct.

A synthesized happiness, then, comes in peaks and waves from an outside source. It eventually decreases gradually or exponentially. It may be uncertain, untrustworthy, or fleeting.

These thoughts came into my head not only because of our humanly need to correct all feelings we feel don’t line well with other’s feelings, but because there is such a stark difference between the happiness I feel organically, the one that sprouts naturally in my consciousness, a simple product of biological existence, versus the happiness I feel after I’ve accomplished something I had doubts about, after spending a day with the people I love, or after I take a pain pill for my back.

I think I’ve made this distinction because I notice I’m often disappointed in my organic happiness, in my baseline of existence.

There are tons of speculated biological and evolutionary reasons why certain chemicals peak at certain times in our brains–to keep us focused, to associate good feelings with good friends so that we build connections which were at one point most essential for survival, to simply bring us enjoyment. But now, there are so many things in life that can trigger intense rushes of endorphins, like substances and fame, that what we experience in the day to day just can’t compete. I am happier and friendlier when traveling. I am happier and friendlier when on pain medication. I am happier and friendlier to strangers when I am also among people I care for and love.

And so I find now, when I have a moment to rest and reflect, I remind myself that everything is enough.

I’ve had three of my six past therapists tell me I need to tell myself that I am enough, and I’ve tried that, but I think this stretches deeper. I think that realizing that life is enough, that how I feel is enough–negative or positive–is what paves the way for accepting myself. If I can truly believe that every negative feeling exists as a moment ripe with the potential for growth, and that every positive feeling exists as a moment ripe with the potential for contentment (as opposed to: oh no, I’m happy, let’s see how long this lasts), then I think that may be the key to actually existing.

But believing something doesn’t mean I create a mantra and repeat it to myself until I drop dead. That doesn’t foster belief and studies show that reiterating positive mantras to yourself can actually make you feel worse. I measure how much I believe in something by the rate and construction of my reactions. Let me give an example.

Last night while watching television, I felt the same disappointment I discussed earlier: I felt sad that I couldn’t spend every day feeling the fuzzy, determined, focused happiness that pain medication brings. I felt sad that I felt sad about that. I felt sad that my own level of being just didn’t seem to be enough; I enjoy my personality, I admire my intelligence, I accept my flaws, but the feeling of existing, the feeling of being human, limited, temporary, often enrages me. Being just isn’t enough.

And in this moment of realization, my mind reacted with a simple thought: let’s be okay with this.

Now sometimes I have voices responding to my thoughts, or voice-like thoughts responding to my thoughts, but this was all me, it was a reaction that I haven’t programmed. I haven’t spent the last two years off medication waking up every morning spewing “learn to love yourself” and “you are enough” quotes until I repeat them robotic, on demand. I’ve spent my time entrenching myself in the madness, the chaos, the pain. I spent time locked in my room staring at the wall, if that was what my pain was. I spent time walking off waves of panic, if that was what my pain was. I spent time being unhappy, if that was what my pain was. I resisted the urges for bail outs–a psychiatrist would have bailed me out, numbed me to my anxiety, tainted the voices and the paranoia, evened the mood swings and depression. And I would have learned nothing.

This is not to be said in a way where everyone taking medication should be offended. For me, medication was another avoidance technique that I’d perfected through years of trauma. For others, medication is the stability key that allows them the time and focus to come to the same types of realizations I have. We all reach wellness in different ways.

I’ve noticed in depression, I am no longer overwhelmed with sadness because I allow the sadness to spread. I choke sometimes with the paranoia, fight it, try and reason with myself and that often cycles me further. I am still growing. I choke with the anxiety as well, get lost in the sensations of my body, and the doom my mind screams. I am still growing. But the depression, which has been with me since I was eleven years old, has become a close friend. I am 24 years old. It’s taken 13 years to cultivate this friendship.

And so happiness for me does not mean contentment or joy or the absence of sadness. Happiness for me means experiencing being without judgement.

I figured I’d share some of these thoughts with everyone as we plunge through Mental Health Month as well as the Covid Pandemic.

This week we are covering Schizophrenia, Bipolar, and Dissociative disorders, starting tomorrow. The post will be later in the evening (PST) as I have some self-care and some things that need to get done at work. If you have a blog post on those topics that you’ve written and would like to share, or if you’d like to submit your own story, contact me here or on my social media handles 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 reporting poorly executed science.

Posted in Community, psychology, science

mental health month: trauma

Welcome back! Let’s talk about Truama and Stressor related disorders. Read more for a great book recommendation for emotional trauma and CPTSD.

What is Trauma?

This can be any event or events which leave lasting psychological distress. This ranges from emotional abuse influencing your world view to the vicious physical flashbacks veterans face after war. A car crash can be a trauma that makes you anxious or avoidant about cars. Divorce is a trauma. Children of alcoholics, such as yours truly, have a specific set of common trauma responses. Sexual abuse, the death of a loved one, a gun to your head are all specific traumas that can cause specific perspectives and responses from people.

Sometimes trauma can cause a person to lash out suddenly, aggressively, or present the opposite characteristics; some will shut down, avoid, and become stagnant or submissive. There’s research supporting the hypothesis that traumatic events can heavily influence the wiring in our brain. This has a lot of implications in all mental health conditions, not just Post Traumatic Stress Disorder. But for the sake of honoring Trauma today, we will talk about that only in the context of trauma.

What Are Trauma Disorders?

I had a similar question. The DSM-5 has somewhat of an answer. Here are the diagnoses they list:

  1. Reactive attachment disorder: This is in early childhood or infancy where the child does not look toward their caregiver for “comfort, support, protection, and nurturance.” If you’re anything like me, psychopathy might pop into your head. There isn’t a lot of research supporting Reactive attachment disorder as a precursor to psychopathy. But if you’re interested, here’s a random presentation I found on the subject.
  2. Disinhibited Social Engagement Disorder: This is basically the opposite of the above disorder. These children will approach strangers and act overly familiar with them, also breaking cultural boundaries. Often they have experienced some kind of pattern of severe neglect from their caregivers. They must be at least 9 months of age to receive this diagnosis. Don’t ask me how that works.
  3. Posttraumatic Stress Disorder: This has some of the longest criteria to meet and is often diagnosed very quickly. Major symptoms can be obvious. However, for those of us who have struggled with emotional abuse, it takes a keen eye to recognize the signs. PTSD is an emotional response to one or more traumatic events. This includes “fear-based re-experiencing, emotional and behavioral symptoms. Experiences range from explosive “reactive-externalizing”, to dissociation.
  4. Acute Stress Disorder: This would be caused by a gun to your head, or anything else that threatens death, serious injury, or sexual violation. This also applies if you witness one of these events, such as someone being shot in the head, threatened to be shot in the head, someone being raped or beaten. If you had a conscience and were the person filming Ahmaud Arbery‘s death, you may develop this disorder. Evidently that person has not. This can happen to police officers or detectives, or any emergency responders who are repeatedly exposed to violent/disturbing/fatal cases. Keep our COVID front-line medical staff in mind.
  5. Adjustment disorders: This is marked by emotional or behavioral symptoms that appear within three months of a stressor. For example, the changes a person may experience after the death of a loved one or sudden death of a close friend.
  6. Other-specified Trauma and Stressor-Related Disorder and Unspecified Trauma and Stressor Related Disorder: These both carry criteria of a person exhibiting trauma like responses that cause significant distress but don’t fit in the categories of the other disorders.

How do People Manage?

Writing this hasn’t been easy. My chest is tight, my hands are shaking, and I keep having to remind myself to breath. My senses are become more sensitive by the minute and I’ve had to change my music to something softer and easy to ignore. My stomach is in knots. I’m not thinking about any incident in particular, but the body has an amazing memory. It encodes emotions, sensations, feelings. That’s why dissociation is such a common respond to trauma: escape your body and the feelings are void. It’s a mistake to think only the mind holds the capacity for feeling.

Therapy is a common go-to for trauma. EMDR has stormed popular psychology but according to my research professor last year, it’s unclear whether the lights/wands used in EMDR are causing an effect or if it’s the CBT you’re doing during the session. After all, CBT is the leading therapeutic treatment for trauma. There are no studies with participants using CBT, EMDR (that includes CBT), EMDR without CBT (which would basically be flickering lights or waving wands with you sitting there awkwardly staring at them) and no treatment which would put you on a “waiting list”, you unknowingly part of the control group.

Much of my own trauma is rooted in emotional events. Being threatened, bad mouthed (an eleven year old being called a bold little motherfucker for expressing distress about something is kind of how that went constantly), and intimated taught me to be suspicious, distrusting, and defensively aggressive. Being homeless created a lot of insecurity, confusion, and depression; the first day I wanted to kill myself I was eleven, sitting outside of the house we stayed in where the owner drank a bottle of Jack Daniels each night followed by a plate of Xanax. Her daughter had sex orgies loud enough to permeate the street and the other went to work and school. I have many more stories about many wild people I’ve encountered. Maybe I’ll tell it sometime.

But the alcoholism and drugs in my own house, coupled with our 3 year homelessness, and my terror of school I’d experienced since I was five in day care, made me closed, submissive, and withdrawn. When I hear certain words today–for example, in a team meeting at work, if I hear the word “activity”, my body flashes cold, my heart races more than it already was, my hands shake, my muscles twitch. This is an example of an encoded emotion from my days in school. There are studies going into this.

I didn’t ever talk. I fainted if I was asked in front of the class, and was so nervous to raise my hand that I often peed on myself in elementary; I couldn’t ask to use the bathroom. By middle school I’d developed a ritualistic routine to avoid asking for anything in class: use the bathroom before school, five minutes before the bell ended break, five minutes before the bell ended lunch. That’s continued through college; I’ve never got up and walked out of a class before the class ended. By high school, my dissociation got so severe I experienced fugue states (only lasting at most a day), one that caused me to walk into four lanes of traffic against the light, with my friends apparently screaming. They eventually caught up to me but I only remember walking through my door at home. I don’t remember the rest of the day or what made me so terribly distressed that I left my body.

There are some medications offered, usually SSRIs but sometimes heavier medications like Seroquel for a knock-out sleep. Sleeping can be hard with trauma. Your body is constantly in high alert.

Meditation helps some. This can be any activity that helps you focus on your breath and rooting your thoughts in your body. We get so used to ignoring, avoiding, or giving in completely to the distress our body and mind feels that we lose sight of reconnecting our system, which is so essential to wellness.

Support groups and other outlets to express the physical and emotional experiences are key. Just typing my physical experiences above helped relieve a lot of the tension; it’s important to acknowledge what your body feels, and get specific about it–write it down, call a friend or support force, schedule a therapy appointment. Resort to emergency medication if the experience doesn’t abate after trying everything, including sitting with yourself. I’ve had panic attacks related to body-trauma flashbacks push through Seroquel, Ativan, Klonopin, Valium.

Drugs aren’t always what you need. Sometimes it’s just your body screaming for you to offer understanding, consolation, and acknowledgment of its distress; it’s been through the same things you have, on a cellular level.

Complex PTSD: From Surviving to Thriving has been on my read list for a while. It covers “Complex-PTSD” which is not a DSM diagnosis no matter how many psychologists push for it, but references the emotional markers left over from childhood trauma.

Today, we are greatful to hear from Caz again, over at mentalhealthfromtheotherside.com. Read about her experiences with childhood sexual abuse here.

Thank you to everyone who has been messaging me on Instagram. Sharing your story is difficult and I appreciate those of you just reaching out with words of encouragement, thankfulness, and those of you asking about my own experience with psychosis. We will continue with Mental Health Month NEXT WEEK.

Thursday May 14th: Schizophrenia

Friday May 15h: Bipolar

Saturday May 16th: Dissociative disorders.

These posts may be a little later than usual as I am on a hiring panel at my job on Thursday and Friday. Finals are also coming up. I will keep everyone updated. If you would like to submit a paragraph, quote, or personal story with any of those listed experiences, please reach out through my CONTACT PAGE, or message me on:

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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.

Posted in advocacy, psychology, science

Mental Health Month: OCD and Related conditions

We’re in day two of our Mental Health Month series where we discuss different DSM-5 diagnoses and the research behind them. Today we’re talking about Obsessive Compulsive and Related Disorders, including Body Dsymorphic Disorder.

What is Obsession?

Let’s distinguish the difference between being obsessed with something and obsession ruling your life.

If you have an obsession with Michael Kors, you probably don’t have a condition.

If you have an obsession with, like, that one show that, like, you stream on Netflix, you probably don’t have a condition.

If you had to touch all of the buttons, one by one, on the television, the remotes, the kitchen appliances, the computer, before you leave the house to prevent a house fire, and this becomes so disruptive you leave the house only twice a week for essentials (even when NOT in a pandemic), then you might think about searching for some support.

But OCD (obsessive-compulsive disorder) is not the only condition that exists under this category. There is also:

1.Body Dysmorphic Disorder

2.Hoarding Disorders

3.Trichotillomania (hair pulling)

4. Excoriation (skin-picking)

5. Substance/medication-induced obsessive compulsive and related

6.Obsessive-compulsive and related disorder due to another medical condition.

7. unspecified obsessive-compulsive and related disorder (like obsessional jealousy).

Is Hoarding Like That T.V Show?

Hoarding gained a lot of popularity after A&E came out with their show HOARDERS, which follows the lives of extreme hoarders, often living in squalor beneath their belongings. The people featured are often reluctant to get rid of their material items because of an obsessive emotional attachment to them. This doesn’t just extend into beautiful or valuable items, like a porcelain doll or an antique speaker; most people will be hard-pressed to give away something that has some semblance of importance or function. For the people on hoarders, even garbage or blankets covered in rat droppings and urine are part of their livelihood, either because of memories or because of the simple fact that that item, along with all the other items in the house, fills a void.

Indeed, those with Hoarding Disorder have “persistent difficulty discarding or parting with possessions, regardless of their actual value”, per the criteria of the diagnosis. That difficulty leads to an “accumulation of possessions that congest and clutter active living areas”, much like what you see on Hoarders. This causes “distress or impairment” in all areas of functioning.

We also see a variety of personalities on Hoarders. Some people have what the DSM calls “good or fair insight”. They recognize their hoarding has been causing problems, but feel both trapped and safe among their things. Some people have “poor insight”, in that the clutter isn’t viewed as problematic. As we see in the television show, some people with this level of insight will accept help but fight against losing too much stuff. Some revert back into their old ways after the trauma of losing things all over again. Those with “absent insight/delusional beliefs”, are absolutely convinced nothing is wrong–yes, to the extent of delusion. These are the people you see who halt the process in the show, and the house or yard is cleaned only in a hundred square feet or so.

These behaviors may be related to the temperament of the person, indecisiveness being a leading trait, and also related to some traumatic or stressful event that exacerbates the behavior. Let me give a personal example.

When I was 11, we lived in a two story, two bedroom apartment next to a registered sex offender and across from a drunken, drug-addled manager. My dad, a musician, also spent most of his free time drinking or working on cars, and it was only a matter of time before him and the manager got into an irreparable fight. The problem is, she was the manager and we were the tenants; her words against ours to property management meant nothing. We were evicted.

My parents’ credit was in the tank, and we were not rich, so no other apartments in town would take us and we bounced around from hotels, to a tent, to rooms in houses of family friends—that doesn’t sound terrible, but three years of much more drugs, alcohol, and uncertainty (in every place we stayed) isn’t all that fun.

A two-story, two bedroom apartment can hold a lot of stuff. Everything in my room except important papers and one hand-me-down banana republic plastic shelf went in the dump–bed included. We didn’t have enough space for all my stuff and my parent’s stuff in the small storage locker we rented, so we sacrificed most of our belongings.

I noticed I started clinging to things later when we finally got another apartment. I picked up stuff from the street I didn’t need–like broken street signs, discarded car review mirrors, desks, and even a bent reflector. I kept that bent reflector for ten years. In fact, I kept all of it for ten years. My closet is still full of junk I picked up from the street or things I thought were valuable from the dump. My room itself is cluttered, disorganized, and it took three years of picking through invaluable things with perceived value to keep at least two feet of walk space from my bed to the door. I still haven’t learned how to organize.

This example doesn’t mean I have Hoarding Disorder. I only share this to show that obsessions with material items don’t make people vain or stupid or rude. Loss and grief of any kind can make us cling to whatever solid, certain, undying thing we can find.

I don’t know how much of A&E’s Hoarders is dramatized for television. Sometimes it seems the film is edited to make the people look disgusting and defeated, and then a sob story told to make us feel pity. At the end we’re supposed to feel amazed the house is clean or disappointed in the person if it’s not, without recognizing the uniqueness of each individual’s process. All in all, the people are real. I don’t know about the show, though.

Is Body Dysmorphic Disorder Real?

Yes.

In fact, it’s the first disorder listed in the category. People struggling with this perceive a defect or flaw in their appearance that seems slight to every one else but causes severe preoccupation for the sufferer. This could cause people to go to drastic measures to fix this flaw–which may include several cosmetic plastic surgery interventions, or cause them to remain indoors, trapped behind the fear that everyone will see, ridicule, and be disgusted by their flaw. This is not the same as being preoccupied with ones weight, and it cannot be Body Dysmorphia if the symptoms of an eating disorder are present.

This is linked to people who have relatives with OCD, and has been seen correlated with high rates of childhood neglect and abuse. Females are more likely to have a co-morbid (occuring at the same time) eating disorder and males are more likely to be preoccupied with their genital region. What does all of this mean?

It means life is a living hell. Being in the view of others causes such distress there are people who hide behind their curtains, in their house, for years. And this is, again, not a vain “omg nobody look at me”. This is such a level of heightened anxiety that an entire life is disrupted. I feel that many obsessive conditions get looked at as people being selfish: the person living with OCD can’t take care of their child because the compulsions take up most of the day–that means they don’t care about their kid enough. Or the people with Trichotillomania has pulled a bald spot on their head, but then complains about being nervous of others seeing the bald spot–they need to just stop pulling their hair. And things just aren’t that simple. None of this is vanity or selfishness, it’s anxiety, it’s stress, it’s trauma response.

Here is a great Ted Talk by Meredith Leston that highlights how body image is spread in the world and how troublesome views can lead to great distress and disruptive conditions for some people. Let’s remember: our environment plays a huge role in dictating which genes turn on and off. Everyone has the potential to develop a mental condition at some pointing their life. Why it happens to some and doesn’t to others not only depends on environment, but social factors and genetic make up too. Not so much brain chemistry.

If anyone watched Barcroft on Youtube, you might like this clip on Body Dysmorphia and OCD. I tend not to watch them too often, but sometimes they have okay material. Let me know how real or not real this is.

What Kind of Treatment is Available?

For some of these conditions, like Trichotillomania, there are no drugs that reduce symptoms. Even in cases of severe OCD, psychotropic medications fail miserable. This is a testament to how much we still don’t know and why some researchers are putting more weight on alternative treatments and Cognitive Behavioral Therapy, the only psychotherapy which has been tested (with high reliability AND validity) and proven to change the course of people’s thoughts.

This Double-blind, placebo controlled, Cross-over study examined the possibility for Milk Thistle as a treatment for Trichotillomania. They concluded their sample size too small to yield any confident results, and that their evidence only weakly supported the use for Milk Thistle.

This placebo study with Trichotillomania only further showed that 1) change is possible depending on expectations of the participant and 2) easy access, simple treatments for this condition remain elusive and the condition reminds misunderstood on a clinical level.

I will say that OCD itself gets a lot of research while these other disorders fall short of people interested in finding treatments. For OCD there is a long list of possible SSRI treatment, ECT treatment (if you don’t mind losing your memory), different therapies, stimulants, and even EMDR. This is why I speak on the disorders we don’t hear much about. Because for the rest of these unknown, quiet, hidden disorders, sloppy therapy and hopeful medication are thrown at patients. Many suffer in silence.

For a condition like Body Dysmorphic Disorder, other alternatives are being studied too. This experiment examines whether an intranasal dose of Oxytocin could cue a helpful response for BDD. This too failed. It increased self-blame and “other-directed blame”, and the researchers “advise against the use of Oxytocin in BDD patients”. Glad science kept us from THAT mistake.

But, for those diagnosed with BDD and Social Anxiety disorder, this study found that Cognitive Behavioral Therapy and attention retaining significantly improved the Body Dysmorphic aspect of the participants life.

There is some progress.

What can we do?

If someone comes to you and tells you they have been struggling with one of these conditions, withhold whatever your initial reaction is. Remind yourself that many who struggle with these types of conditions blame themselves enough. Even those who don’t blame themselves may still feel guilty for the disruption it causes their lives. I feel guilty sometimes for the disruptions my anxiety and Schizoaffective-ness has caused in my life and others lives.

Remember that they are not disgusting or vain or weird. Remember that there may be a whole list of trauma you’ve never learned about. Remember that even clinicians don’t understand this, probably because they’re trying to understand it on a biological level too much–some things need a different perspective in life.

So, this Mental Health Month, let’s keep in mind that there is a lot of suffering going on right now. Let’s not compare our pain to others, but instead use that energy to remind each other we’re not as alone as we feel. If you are suffering in silence, may this space give you the extreme–almost inhumane it feels sometimes– courage it takes to send a text, or call to someone you can trust. You can comment on this blog even, or contact me on my home page; eventually the burden of silence will hurt your back. It’s damn near broke mine before.

I write these posts in this format because I’m tired of articles listing symptoms, bland, over-used, understudied treatments, and urging people to talk to their doctor. It’s a good idea sometimes to seek professional help, but to do so uneducated and so desperate for relief that you’re unable to look at things critically will only trap you in the quantum loop that is the mental health system, especially if you’re in America. Mental Health Month is about education and reducing stigma. We can’t do that if we don’t preach from the side of lived experience AND scientific research.

Tomorrow we cover: Trauma and Stressor related DIsorders.

Next week, we cover: Schizophrenia, Bipolar, and Dissociative disorders. If you’d like to submit your story for any of these, please contact me HERE, or on my social media handles below:

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Twitter: @philopsychotic

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.

Posted in advocacy, Community, psychology, science

Mental Health Month: Anxiety Disorders

Today we start our Mental Health Month series. As a short recap: every Thursday, Friday, and Saturday this month we will be covering different DSM-5 diagnoses, recent research, and featuring personal stories from YOU. This week we’re covering Anxiety disorders, OCD and Related Disorders, and Trauma and Stressor Related Disorders. If you want the FULL LINE UP, click HERE. If you want to submit your story, CONTACT ME, or find my social media handles below.

Now that that’s over, let’s get into today’s topic: ANXIETY DISORDERS.

What Is Anxiety?

We all know feeling anxious isn’t uncommon. It’s simply our body’s natural response to stress. If you look at the state of the world right now, it’s not surprising pharmacies were running out of anxiety medications.

So far, we believe this stress response prompts waves of catecholamines (neurotransmitters like dopamine and epinephrine) which give rise to our flight-or-fight response. From an evolutionary standpoint, this may come in handy if you’re scrounging for food in tiger territory. From a modern standpoint, our sympathetic nervous system is constantly bombarded with new information and new things to worry about. From an epigenetic standpoint, your resulting anxiety from this overstimulation influences the on-off switch in the genes of your child, creating a world of ever-more-anxious, alert, frightened children.

There’s no definitive proof for any of these hypotheses. There is evidence suggesting all sides, and more, but studying humans is hard and concluding one idea over the other might not be practical. Please do not take this ambiguity lightly. Most people want to agree with one of the three hypotheses listed above because it just makes sense to them. This is a trap of confirmation bias.

I find that anxiety becomes a fear of the future, a fear that the present could not possibly (or will exactly) lead to the future, and a fear that the past has ruined the future; anxiety, today, is a summation of fears.

Let’s talk about what happens when this becomes debilitating.

What Is An Anxiety Disorder?

Let’s first consult the DSM-5:

It states, “Anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances.”

Not vague at all, right? You’ll learn much of the DSM is vague and simple in a convoluted way that makes diagnosis tricky: much of it is based on the subjective interpretation of the clinician.

There are 11 total anxiety diagnoses in the DSM-5:

1. Separation Anxiety Disorder

2. Selective Mutism

3. Specific Phobia

4. Social Anxiety Disorder

5. Panic Disorder (with panic attack specifier)

6. Agoraphobia

7. Generalized Anxiety Disorder

8. Substance/medication-induced anxiety disorder

9. Anxiety disorder due to another medical condition.

10. Other specified anxiety disorder

11. Unspecified Anxiety disorder

For the sake of the attention span of the average person (including me), we’re going to list the criteria of two of these diagnoses in depth so that you may see how they are broken down.

Let’s run through criteria, and then we’ll talk “causes” and treatment.

Selective Mutism

For this diagnosis, you must have the following (criteria summarized for all of our sake):

A) Consistent failure to speak in situations where there is expectation to do so, like at school.

B) Interferes with education, occupational, social achievement and communication

C) Lasts at least one month.

D) Not attributed to a lack of knowledge or comfort with the spoken language.

E) Not better explained by a communication disorder and does not occur during the course of autism, Schizophrenia, or another psychotic disorder.

These kids will speak in their homes with their immediate family but not with close friends or second-degree relatives—like grandparents. They “refuse” to speak at school, so says the DSM, although I’d argue it’s much more like an anxious reflex, this coming from someone who had this diagnosis; the anxiety is so severe the only option is for the child to shut down.

This also can include “excessive shyness, fear of social embarrassment, social isolation, and withdrawal, clinging, compulsive traits, negativism, temper tantrums, or mild oppositional behavior.” It is a “relatively rare disorder”, usually appears before 5 years old, but it may not be obvious until the child enters school. The long-term of this disorder is unknown, and “clinical reports suggest that individuals may ‘outgrow’ selective mutism.”

This next line is what happened to me: “In some cases, particularly in individuals with social anxiety disorder, selective mutism may disappear, but symptoms of social anxiety disorder remain.”

Temperamental factors are not well identified. Environmental factors, such as parents modeling social reticence, can contribute to the development of selective mutism. This may include controlling parents or overprotective parents.

Genetic factors: nothing identified.

Social Anxiety Disorder

For this diagnosis, it’s exactly what you think and some of what you may not have thought of. These criteria have a longer list, so I will summarize in a paragraph:

There must be obvious anxiety about social situations when the person is exposed to possible scrutiny of others, like meeting with unfamiliar people. In children this must be observed with peers and not just adults. The person fears showing anxiety symptoms which could be judged negatively. Social situations always provoke fear. In children, this maybe seen as crying, freezing, tantrums. These situations are avoided or endured terribly—very terribly.

Of course the fear must be deemed out of proportion to the actual threat of the social situation. This lasts for six months or more (like my entire life) and influences impairment in social, occupational, and other areas of life. It’s not attributed to substance use or other medical conditions, and can’t be explained with another disorder.

Apparently, “the duration of the disturbance is typically 6 months” and so I would like a refund please—24 years and counting.

It’s seen that individuals with this disorder might be poorly assertive or excessively submissive or even highly controlling of the conversation. They might not use a lot of eye contact—so parents, don’t worry, your anxious child probably does NOT have autism. They may be withdrawn, and disclose very little about themselves, or speak with an overly soft voice.

They may live at home longer.

Self-medication is common.

The median age of onset is 13 years old. If that average were taken with kids also diagnosed with Selective Mutism, the median age, I’m speculating, would be much lower.

Temperament: The trait of behavioral inhibition (shrinking away from unfamiliar situations) has been linked to the development of this disorder.

Environmental: No increased rates of childhood maltreatment in the development of this disorder, BUT maltreatment is a risk factor.

Genetic: Traits, like behavioral inhibition, are genetically influenced. Social anxiety is heritable (NOT inherited). No specific genetic factors have been identified.

So What Causes Anxiety Disorders?

What’s the first thing that comes to your mind? Trauma? For those of us who have been ingrained in the mental health system for a while, you might think “chemical imbalance”. Not even the DSM endorses that as absolute. You will find that genetic factors are no where near being identified, much less a chemical imbalance.

When tackling this, we must remember that your genes, your body, your cells, your thoughts, are incredibly malleable. When we talk about “predisposition” in relation to genes, we’re talking about the propensity for them to switch on and off. For example, it seems that some genes are more likely to, in response to a traumatic event, turn on.

Every cell in your body is influenced by your environment. This makes it extremely difficult to confirm what is solid at birth—were you doomed to live with anxiety?—and what is developed after birth. In fact, we may never know.

If you Google “what causes anxiety”, you will be lead to proper links citing similar things as the DSM: personality traits with an unknown genetic basis has a large influence.

If you Google “what causes anxiety disorders”, you will be fed a mix of “chemical imbalance like diabetes” and “stress”.

If Anxiety, or any mental health condition, was a chemical imbalance like diabetes, we’d have a psychotropic equivalent to insulin.

If you search for a similar phrase in psychology databases, you won’t find what you’re looking for.

I managed to find an article entitled “Biological markers for anxiety disorders, OCD, and PTSD: a consensus statement. Part 2: Neurochemistry, Neurophysiolgy,, and neurocognition”. If you are interested in it, I only have access through a database, so I can email you the full text.

This paper from the World Journal of Biological Psychiatry summarizes all the current biomarkers (as of 2017) for anxiety disorders, OCD, and PTSD. They state “none of the putative biomarkers is sufficient and specific as a diagnostic tool, [but] an abundance of high quality research has accumulated that should improve our understanding of the neurobiological causes of anxiety disorders, OCD, and PTSD.” It cites Serotonin precursors, GABA, Dopamine, Neuropeptides, and even Oxytocin the love neurotransmitter.

My criticism for this starts with their PTSD makers. It states: “Compared with control subjects, PTSD patients showed significantly elevated platelet-poor plasma NE (norepinephrine) levels and significantly higher mean 24 hour urinary excretion of all three catecholamines (NE, Dopamine, HVA).” It cites another study as the source for this, which I can’t find yet. What could other factors be for this rise in stress neurotransmitters? My point: you couldn’t possibly pinpoint this particular rise in catecholamines to PTSD alone because we can’t isolate the PTSD from the rest of the body/brain. Take everything with a grain of salt.

Biomarkers are real. We ARE biological beings, and to ignore that would be, well, ignorant. However, the lack of understanding for how our biology transforms through life means attributing brain states to only chemical differences without connecting the body’s experience of physical life is just as ignorant.

So, we ask, are anxiety disorders a chemical imbalance? The answers is: we don’t know. And we may never know.

Anxiety Disorder Treatments

Medication has been a go-to for years. Benzodiazepines, dangerously addictive and physiologically dependent in a short amount of time (2-4 weeks) do well at cutting panic attacks down for size. Valium, Ativan, and Klonopin have saved me more than once. SSRI’s and SNRI’s, researched for depression and sold for everything else without care, can sometimes help calm anxiety. Lexapro, Effexor, Zoloft, and Trintellix—honestly I couldn’t tell if they did anything at all to my anxiety. But for some people, they work.

Some antipsychotics like Abilify (some, again, sold against the label) are added on to antidepressants with the purpose of easing depression, but can also inadvertently help anxiety and there’s no rhyme or reason for it. It can probably be dedicated to the sedating effect.

Certain therapies, however, have been proven time and time again to be more potent than medication for SOME disorders, and many experiments show a combination of therapy and medication is better than mediation alone or therapy alone. These studies must be scrutinized with care however: some of them have no control group or comparison treatment.

For example, Cognitive Behavioral Therapy has been shown to significantly reduce distress in Panic Disorder and PTSD when compared to medication and no treatment. What will work depends on your willingness to throw yourself into the process. I’ve done much CBT and found that it only started working after I stopped putting off the homework. There are also personalities and onset of the condition that affect this, which you can read about here.

Other treatments are being studied too. We talked about Freespira here, the medication free treatment that is entirely invalid.

There is study going into Chamomile treatment for Generalized Anxiety Disorder. This study concludes there was non-significant reduction in GAD relapse but significantly better GAD symptoms and improved psychological well-being. Part of their funding came from the Nations institutes of health and a cancer center, and the authors have no conflicts of interest. It was a randomized clinical trial. Read it here.

Naturopathic care, including certain vitamins, need more research, but has some success in this article. My criticism is that if the participants were aware that anxiety was being studied, the placebo effect could be huge. I didn’t read through the entire study, admittedly, but if YOU find whether participants were aware or if they were deceived as they should have been, let us know.

Where Can I Get Help?

If you feel you are struggling with anxiety, please reach out. If you don’t have close friends or family, message me.

If you want to speak with someone anonymously, I recommend Peer Support warmlines. These are not hotlines for crisis, but for meaningful conversation with someone who has been there. There is a list at this link. Those are for California, but anyone can call from anywhere. I’ve spoken to people from England before. You can search for some in your own state or region as well.

If you don’t trust any of those, give us a call at 831-688-0967. We are also a peer warm line service where I work, and have gotten calls from people throughout the country. We are open right now, 24/7. We try and keep conversations to twenty minutes, but I’ve been known to stay on longer if nothing else is going on in the house and the person is really needing support. *I will say I won’t necessarily be the person to pick up. We have other staff members.* If something comes up in the house, our current guests are a priority and we may need to get off the phone.

If you choose Therapy, online or otherwise, is another option. I recommend Psychology Today to find a therapist near you, or your health insurance website.

Your general practitioner may also have suggestions. If you choose the medication route, I suggest researching a good psychiatrist, reading your OWN research, and not allowing your general practitioner to run your psychotropic medication case. They are not trained for that.

Our Mental Health Month Featured story is at THIS LINK: Read about Caz and her journey through anxiety and into a mental health nurse career.

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