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.

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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 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 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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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 advocacy, Freedom, Peer Support

When We Can’t Stop Thinking

People say secrets keep us sick.

I’d like to relate this to mental health, but in order to do so, we must read this post with the understanding that I don’t consider our experiences a product of illness or an expression of a sickness. We also must assume this only has to do with secrets in-part. So I suppose it has nothing at all to do with that saying.

What I’m getting at is that there are things we do for ourselves that exacerbate or substantially perpetuate our experiences, and there are things we do for ourselves that foster alleviation. Identifying these things is one of the best ways to care for yourself.

For example, diet plays a huge role in my mental wellness. In one of my most upsetting states, I was eating over 200 grams of sugar a day, an unknown amount of fat, and at least 200-300 grams of carbs. Alongside antipsychotic medication, my weight ballooned. After getting off the medication, radically changing my diet, and implementing a structured exercise routine, my depression lifted for the first time in my life, my anxiety lessened, and heavy psychotic experiences were less frequent.

If I skip meals and eat foods rich in sugar or carbs, my experiences worsen again.

Some of us don’t realize what we put in our body effects our mental state. Some of us know, but struggle in the transition. Some of us just don’t want to transition. None of those ways are right or wrong. But they have different consequences.

Some people have learned to take care of themselves through other peers, others with lived mental health experience. I mention this specifically because it’s what I attribute a lot of my own learning to, and also because it’s part of awareness and advocacy; we’ve been on that kick for a couple days now on this site.

What I’ve noticed is that telling your story can be both freeing and suffocating. There are some people who are able to write a blog about themselves, or speak about themselves, or start a small non-profit advocacy program and live a healthy life. There are others who do the same, but are engrossed on the internet and social media, who tell their story so much that their entire life is dedicated to mental health.

I don’t think that’s a bad thing, either. But what I notice is that it doesn’t seem healthy for everyone. I think it becomes detrimental when all you talk about is your bad days, or your good days, your experiences, what makes life difficult, and all these things that only serve to remind you how different and/or limited you are. The more that mindset is fed, the less life is lived.

What I mean by that is when you separate yourself from the whole of society, in a good way or a bad way, you start forgetting you’re apart of that society.

I remember being so engrossed in my depression and anxiety, before I experienced any altered states. And it wasn’t just the experience taking up all my time, because depression and anxiety are both all-encompassing, but it was the fact that I spent all my time thinking about both. I’d think about it in a positive light too. I’d blog my experience and talk to others about it; we’d relate and it was a positive moment in a lot of darkness. But it kept my thoughts trapped in this bubble.

People also like to say in mental health that “We are not our illness”. Again, assume that for this post, and for any post on this site, I do not adhere to the terminology “illness”, “disorder” or “sickness”, but the fact is if you spend all of your time talking about your experiences, in a positive or negative light, you are basically your “illness”.

NOT being your “illness” would entail you living life. It would entail you understanding that yes, sometimes things are hard, but that doesn’t make you special.

That’s another thing about certain advocates. Everything is about mental health–everything. Why focus so much on the hardships? Why not focus on the things you’ve been able to do because you’ve gotten support and found a healthy path? Why not show people what they could potentially do were they to also find their path? That would encourage me, at least. What doesn’t encourage me is people saying #depresssionfeelslike.

I gained a lot of freedom from getting involved in other things besides mental health and from hanging around friends without mental health struggles. Every once in a while I’ll talk about things, express views, but I do it at appropriate times and if people are willing to hear.

Sometimes people think I don’t blurt my diagnosis or experiences because I’m ashamed. Really it’s because I’m not a sum of any diagnosis or any experience. I don’t need to say, “yes I graduated with schizoaffective”. I just graduated. And that’s the whole of it.

Travel. Show yourself you can do something unrelated to the terror in your mind. Volunteer. Find a passion. Reignite a passion. Meet people. If people are too much, maybe a hobby. I’ve had to push myself away from reading fiction books with mental health characters because I want to remind myself I’m still in the world, even when I feel like I’m not.

I want to remind myself there is so much more out there than what’s just in my head.

I think we often forget that.

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Posted in Emotions, Supporting Friends/Family, Therapy

What Is Trauma?

Today I’m switching up the format a bit. I’ve been doing lists and tips for the past few days because I feel the information has been important and also relevant to many of our lives (if this is an inaccurate perception, please let me know in the comments below). But today has a different vibe to it.

For the longest time, I believed trauma could only exist in the form of a sudden, violent, physical instance, like a car accident or molestation/rape or physical child abuse. It wasn’t until I was 21 did I learn consistently being told to shut up, to not speak, was a form of trauma. It wasn’t until I was 21 did I learn the three years I spent homeless during my childhood was a trauma. I also didn’t know that growing up with an alcoholic and an addict was a very specific type of trauma.

So what exactly IS trauma?

Trauma Is:

Any kind of repeated emotional, verbal, or physical abuse/manipulation that has caused lasting effects. This could range from something seemingly simple like your mother nudging you to lose weight and consistently commenting on what you eat, how much you eat, and what kind of clothes you wear, to your father threatening to kill you if you told the teacher he gave you a black eye.

The thing about trauma is that it doesn’t effect any two people the same way. Not every person who has experienced sexual abuse becomes a drug addict. Not every person who was verbally accosted spends a lifetime struggling with their self-worth. Not every person who was physically abused grows up to be physically abusive.

Many people develop their own ways to process (or not process) their trauma. Some people want to pretend it never happened, and there are times where that helps them move on. We hear a lot that everyone should process their feelings, but as a grief study in Europe showed, sometimes people move on easier and still in a healthy way by just getting back to life rather than diving deep into their feelings. (I will put proper citation for that study when I can find a full copy; I learned of it through my previous professor).

Some people relive the events everyday and it cripples them. It invades their relationships, their school, their work, their own sense of peace.

Some people, like me, don’t really recognize where the trauma has effected their life or how. I think I talked a little about the trauma around my learning to speak for myself in this post, On Mental Health and Freedom.

Some people are in the middle and can function well, but are haunted from time to time with flashbacks or residual effects of their trauma.

Where Is Trauma Located?

Maybe that sounds weird.

What I mean is, where do you feel the trauma?

Often with mental health, we’re told “it’s just in your head”, and with trauma that’s not always the case. As a hypothesis, trauma can also be felt in your body as physical memories. Now, I don’t have a research paper sitting in front of me to back me up with this, all I have is my personal experience of certain physical attributes presenting when preparing certain memories for EMDR therapy.

When I find a paper that has studied this with a proper research method, I will update everyone.

But, if you have experienced trauma, you may get what I’m talking about. You feel certain things in your body. You may feel yourself separating from your body as the result of a specific memory–we call this dissociation. There may be certain words or attitudes or body language from someone else that may activate a tightening in your stomach or nausea or hot flashes with seemingly no explanation.

For me, one of these things is the “inner child”. The last therapist who asked me to talk to my inner child pulled some kind of deep seeded darkness into the light and whenever someone says the words or I think about it, I break down crying. I’m not sad, it’s just my body’s response. I’ll get warm and my chest will tighten and I have no full explanation for it.

So, it’s not “all in your head”, from my personal experience.

We talked a bit about this at a Hearing Voices Network workshop a couple years ago. We talked about how trauma can cause our mind to separate from our body and how that relates to and can be a catalyst for psychosis.

What this means is that, in approaching trauma, we must consider the whole body experience. We must consider reconnecting the mind with the body and this is often done with grounding techniques, similar to those used for anxiety and panic attacks: reminding yourself you are safe, feeling your feet on the ground, pinpointing areas of your body and focusing on them, or pinpointing objects in the room and saying them out loud.

Is EMDR A Proven Therapy?

NO. You’d be surprised to find that mindfulness isn’t either.

For those who don’t know, EMDR (Eye Movement and Desensitization Reprocessing) is a type of specific trauma therapy in which a traumatized patient is guided by someone trained with specific skills in asking particular questions about a traumatic memory (some of which can feel like CBT therapy) while they move a wand back and forth or flash moving lights. The hypothesis here is that eye movement helps your brain process the memory as a whole.

What I will say, for EMDR, is that studies have shown it works for the majority of people. The problem with the majority of the studies is that they often don’t separate the actual therapeutic content (the therapist leading you, asking questions, guiding you to feel your feelings) from the little lights and wand and all that.

So, in order for a valid study to prove that this therapy works, it would need to be compared with CBT with no lights/wand, Lights/wand with no CBT, the full EMDR package of lights/wand, and guiding CBT questions, and of course a control group of no treatment. Haven’t yet read a study like that. (If you know of one, please send it to me or put it down below in the comments! Please link the FULL research article or at the very least the abstract, not a secondary source).

EMDR is very popular. But so is Debriefing Therapy done after a serious natural disaster/crisis and studies have shown that actually makes people worse.

So POPULAR does not equal PROVEN.

What I will say from my current EMDR experience, is that it’s brought up a lot of pain but it also helped me process an incident at work very quickly. And had I not done that, I think the incident would have stuck with me in a different way. A hindering way.

What is Dissociation Like?

Dissociation can become a way of life for those traumatized, and it can also be a savior. It can pull you through tough moments. I’ve been dissociating regularly, and heavily, since I was 14 and I can say the first few years it bothered me. It bothered me mostly because I wasn’t so aware of it happening until I was told I walked into four lanes of traffic and 3 miles home without responding to anyone.

A lot of the time it feels like you, your essence, is somewhere far away and your body is stuck down here in muddy waters. Other forms of dissociation make you feel like your body isn’t real or that none of the earthly objects around you are real. This can be terrifying for a lot of people, and upsetting.

I’ve been experimenting with turning my dissociation into a profit. Not a monetary profit, but a mental profit. Dissociating has helped me learn to share power with my voices and given me a space I can retreat safely when needed.

Am I Traumatized?

Are you? I don’t know. If you experience some of the aforementioned things, perhaps. I’m not going to tell you what you are and what you aren’t, though. If you feel that there are things in the past that hinder your daily activities today or effect your mood or how you interact with people, it may be worth finding someone to talk to about it.

It took me years to realize that the reason I struggled interacting with people wasn’t because I was strange, weird, or a freak, but because I’d been taught my words were invalid, my thoughts were useless, and I didn’t have any right to speak. That mentality has continued to follow me into my adulthood, and it’s only been in the past year I’ve been able to rationally confront it.

So, as terrifying as facing pain can be, if it’s something you feel you need to get off your chest, if it’s something that’s been keeping you from living the life you want to live, it may be worth working toward gaining a new perspective and reaching out for guidance.

I don’t think I’ll want to talk about all my trauma for all of my life. I’d get tired of being weary over it. But a couple sessions of half-ass studied EMDR won’t hurt.

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Posted in psychology, science, Voices

Is Schizophrenia a Brain Disease?

This is hard to write.

I’m sitting here enraged. Confused. Fearful, even, of what I’m about to share.

I told myself I’d only start another blog if I had important things to say, and we’ve covered some very important topics, most recently pertinent information in the series Is Psychology A Science? where we concluded the subject’s only scientific attributes are being ignored and/or underutilized due to political and monetary factors such as an APA president calling randomized clinical trials “fundamentally insane”.

These last few weeks have been incredibly tough for me, hence my lack of posting–because trust me, I have plenty to say–and I’ve spent too much time this week in my head, not exercising, falling into old eating habits and connecting dots that shouldn’t be connected. There are enough thoughts in my mind right now to fill an Olympic pool and they’re not rushing like Olympic swimmers, but they are kind of clustered like when all the palm leaves from the tree near your pool cover the surface until you finally get your lazy ass off the couch to scoop them out.

Jokes aside, there were a few nights I considered voluntarily committing myself. Things have been broadcasted to me, twins are following me, Juice WRLD died not because of Percocet and whatever the fuck “lean” is (I know what it is but because it’s so stupid I just can’t comprehend it’s actual existence), but because of possession, a sign to me–then I remembered I have shitty, low tier health insurance and don’t want medication. So I’m somewhat functioning here in what I’m starting to feel is purgatory. Part of this is stress. My lack of tending to myself. The other part is the effects of Klonopin which does indeed act upon serotonin–I researched it–and had that psychiatrist I ranted about last time listened to my incessant pleas that drugs which so much as touch my serotonin really mess with me–anyway.

In studying for my final, my distracted mind wondered about randomized clinical trials and about psychosis. I wondered if the studies done on those experiencing psychosis for the first time, un-medicated, before the *possible* structural changes due to antipsychotic use, showed structural changes.

This is important. Why?

Well, a disease isn’t a disease unless there is definitive (i.e substantial, valid, reviewed and repeated) proof physical abnormalities are attributed to the alleged progression of the alleged disease.

And so I went onto my favorite place to find psychological research papers. And no, it’s not Healthyplace.com. It’s not some person’s Instagram. It’s not The Mighty or anything related to any kind of advocacy because advocacy is very rarely based in research. It’s NCBI, otherwise known as the National Center for Biotechnology Information. I find myself most often in the PMC section because it’s free and I can use the paper references to find the full length articles in a database. There’s great neuroscience and clinical psychological research articles there, including the PubMed database.

So I’m sure we’ve all heard that “severe mental disorders” like Schizophrenia have notable brain abnormalities such as deformed (enlarged or constricted) ventricles, changes (reduction or increase ) in gray matter, or white matter, or certain neurotransmitters, or this, or that, up, or down, right, or left–and that’s about how accurate all the information you hear is.

Most of it is coming from secondary sources like a textbook or from what I like to call Triple-Source advocacy websites like HealthyPlace that continuously vomit basic and quite honestly uninformed opinions labeled as facts. And I’m not talking about personal stories. I’m talking about those faux information pages that blurt lists of symptoms that pretty much overlap with normal shit and make people worry that hearing their name called in a store means schizophrenia. Here, kind of like this page. Beautiful example of a well-structured, well-written, horribly basic-bitch attempt at explaining something we have no real understanding of.

That’s what I hate the most about advocacy pages I think. I love personal stories and empowerment. I hate the perpetuation of the idea that we really know what’s going on physically in our heads. We don’t. If someone tells you we do, they’re either in the middle of a delusion of grandeur or they’re lying.

And so my first topic to research revolved around first-episode psychosis because that psychosis is *mostly* untouched by heavy psychiatric medications. I researched under the assumption that psychiatric medications influence the structure of our brains and could very well be presenting the “structural abnormalities” which are being used as “evidence” of a “brain disease”. You will find studies that support this. You will find studies that don’t support this. And I found a study tonight, which you can read here, which concluded we don’t really have solid evidence for either hypothesis.

Next post we’ll talk about how to read these papers and determine whether a study has a proper operational definition (is the measurement procedure correct?) and construct validity (is the study measuring what it claims to be?) and how to spot confounding variables (which should be NOTED).

In 2017, a review paper entitled Structural brain changes at different stages of the illness: a selective review of longitudinal magnetic resonance imaging studies concluded there is “adequate evidence that schizophrenia is associated with progressive grey-matter abnormalities particularly during the initial stages of the illness”. These results were concluded after reviewing studies done on patients labeled as “pre-clinical stage” patients, first-episode psychosis patients, and patients labeled with “chronic schizophrenia”.

Even in the abstract, which you can get on the NCBI, they WARN AGAINST using these results as a way to EXPLAIN symptoms of patients. They even mention their confounding variable: antipsychotic medication and long-term treatment.

In 2011, a study entitled Lack of progression of brain abnormalities in first-episode psychosis: a longitudinal magnetic resonance imaging study concluded there were no ventricle abnormalities which could be contributing to symptoms, and that the gray matter abnormalities found have the potential to be easily reversed.

Because they did not list their confounding variables in an easy to find place, and it’s 10:30pm at night as I write this, I searched their references for a study which could either contradict or confirm their findings. I found this study, which you can download as a PDF from Google Scholar. IT concluded gray matter decreases were due to both the natural progression of the illness and use of antipsychotic medication.

They gathered 34 patients labeled with schizophrenia who had been taking medication for 0-16 weeks and compared them, over a year span, to a control group of “healthy” participants. 24 had never taken medication. Those who had taken medication had been taking them for 16 weeks or less. In their conclusion, they admit their findings are in agreement with some studies, but not others, perhaps due to rating differences, group differences, focus differences, and even mental state; some studies, they said, found that the patient’s mental state may have influenced the outcome of the brain volume measurements–those studies I’d like to read too.

I’ve spent the last three hours painstakingly reading variables, reading evidence for grey matter changes, against grey matter changes, for ventricle changes, against ventricle changes, longitudinal studies, short studies, childhood-onset schizophrenia studies, chronic schizophrenia studies, and studies which measured whether or not medication is destroying brain matter.

This was hard to write because I knew there was no definitive answer. And I wanted the answer to be an obvious, valid, no.

But the reality of science is that your wants don’t matter. The reality of science is you read the facts and you either accept them or you start a basic-bitch advocacy site.

What it seems, at this day and age, is that we’ve accepted a bunch of opinion and ignored the facts. My hypothesis? Even as we continue to study this, we will only conclude the same thing as the grief studies in Europe: individual variation is the only certain thing with schizophrenia.

Grief studies showed that some people recovered better by distracting themselves, and others by going into therapy. Both recovered at the same rate when allowed to choose what was best for them.

I purport we’ll find the same for psychosis. Some will do better with medication. Others will do better without medication. We’ll find that medication isn’t the only factor playing the game here, especially if mindset has any influence on brain measurement.

So, is Schizophrenia a disease? As of right now?

There’s no solid evidence pointing in either direction.

What does that mean?

Well, for me it means I need to keep doing what I’m doing, caring for myself in the way that’s been working. Because there’s no study which has proved that won’t help me recover.

For the general public, it probably means ignore all the evidence and keep fighting for mental health to be treated like physical health, as if it isn’t already: in the doctor’s door, out the doctor’s door, five minutes tops.

Posted in Emotions, Freedom

Caring For The Shattered Self

I did not post yesterday as I was in too much pain. Today is better, although I don’t really have a set topic for today’s post. Self-care would be a good one.

I’ve learned a lot about what that means in just the last six months. Some of it came from the guidance of others, and an equal amount came from me learning my body and my brain and what connects the two of them back together. In regards to psychosis and anxiety, although they tend to be categorized as separate, they have similar attributes. I’d say the biggest difference is anxiety you still recognize your physical and mental place in the world during your disconnect. With psychosis, nothing has a place and you are the center of that nothingness.

But they are similar in that you feel dissociated from the people around you, from life, from everything. Panic can make you believe you’re dying, psychosis can make you believe you’re already dead. Anxiety makes you think badly about yourself, psychosis is lazy and will just let the voices reprimand you. And the biggest part of all of this is that separation between the turmoil in your mind and the placement of your body. This is where the idea of grounding techniques come from; there’s this idea–quite an effective one–that if you can center yourself in your limbs, remind yourself who you are and that you exist in this moment, you become more aware of right now instead of tomorrow or yesterday or the future. That’s great for anxiety.

Grounding probably won’t stop you from believing your dead. But it may help ease the anxiety of the idea of being dead, and in that process you learn to accept death. In learning to accept death and the terror and trauma which may be circling death, you accept the idea of being dead. Once you’re there it becomes a little easier to put some weight to both sides: maybe I’m dead, maybe I’m not dead. Either way, I accept what is. That can take some power from the psychosis.

Professionals talk about wanting to break people from their delusions by presenting facts or evidence or saying “well, if that was true, why is this happening?” but that makes zero sense because in delusion everything has a place. And if it doesn’t have a place, we’ll make it have a place with “I don’t know how it works, but that’s how it works” and you won’t have any evidence (to us) against that solid argument.

And so breaking is an illogical step. Telling your loved one that this can’t happen because of that and then getting frustrated at them because they don’t believe you only adds more stress.

The power of unifying the mind and body, accepting uncomfortable thoughts and ideas, giving Anxiety a place to disperse is my greatest form of self-care. Giving my mind a chance to feel how my body is affected by certain thoughts, giving my body a chance to react to my fear and anxiety my mind tumbles through, gives me a chance to tether the two back together and gives me a sense of being a whole person. Because one thing about both anxiety and psychosis is that you feel shattered. You feel like a million pieces being pulled in a million and one directions and none of the directions make much sense. Or they make perfect sense and in that, make no sense because nothing can be perfect.

Self-care doesn’t always mean “doing what makes you feel good”. Sometimes it means doing what you need to in order to grow. And that can be quite uncomfortable.

Reconnecting your physical and mental selves doesn’t just have to be through mindfulness or meditation or mindful-meditation, I’ve learned. Although those ways are quite useful. For example, music reconnects my mind to my body, especially if I’m in my room and playing it on speakers where I can really feel the vibration of the sound and move with it. Japanese Karaoke, the Karaoke in the private rooms, is one of the best ways my mind and body sync up again, my mind riding waves of emotion and my body, my diaphragm and stomach and throat specifically, capturing those emotions into vocalization.

People wonder why medication doesn’t take their mental pain away and that’s because it can’t. We all know this, and if some of us don’t, well, get comfortable with the idea that there’s no such thing as a quick fix. Medication is a bandage. It will do nothing for your thoughts but numb you from them. It will do nothing for your trauma. For a lot of us, it will do nothing for voices besides make them fainter and easier to ignore (which isn’t a bad thing, it can be quite helpful). But, if all you do is throw some chemicals at your brain and roll some dice, you’re essentially allowing yourself to shatter. You’re blockading a chance to be whole again and maybe that’s because the idea of being whole is so foreign to you. Or maybe it’s too terrifying. Maybe it’s too real and too raw and it’s much easier to hide behind numbness than to face sharpness.

And that’s okay too. If that’s where you are your best, if that’s how you function best, if it’s not going to bite you in the ass ten years down the road, great. For me, I didn’t function being a shattered person. And so I listen to myself. I listen to every pain, every ache, every burst of happiness, every drop of sadness, every small voice, every screaming voice, every immovable belief, because all of it means something. It’s not random and useless. It’s annoying and tiring, but it’s a reflection of turmoil and an indication that I’m separating from myself again. That’s a warning sign.

What happens when we bury those warning signs? Or hide from them? Well, they just seem to multiply. And for me, I’d rather care for myself and nurture one warning than feel trampled by thirty.

Posted in Emotions

To Process Emotions

When I stopped seriously blogging about two years ago, it was abrupt and painful. Painful because I missed the writing community of almost five years which had enjoyed stories and laughs and tears and memories and traumas alongside me. They were there when I got my first car. They were there when I quit each job I got. They were there when I became employed at a Peer Respite house. They were there in my largest transformations of self.

Also painful because I was cracking up. Breaking down. In the hospital, confused and somewhat oddly satisfied in my terror of life. I felt alive again in a twisted way. I felt targeted and special and immortal and genius and connected to something greater than myself.

I posted every once in a while, but lost my follower’s attention. I created a slough of new sites, but WordPress changed so much of their format that I got frustrated trying to adapt. So, I went dark.

I told myself I’d be back only when I felt secure in myself. I’d be back only when I knew I had something important to say. I have something important to say.

This journey through depression and delusion and anxiety has given me new insights on darkness. Its introduced me to the true duality of nature so described in daoism. It’s roughly coddled me into accepting not only myself but all of life.

At the beginning of the pain, before I even worked at the respite house, a voice kept telling me “dead man walking”. Considering I’m a woman, it kind of cracked me up and also simultaneously terrified me; someone, something, was coming to kill me I thought. But I don’t think he predicted my future. I think he commented on my present. I was dead. I enjoyed nothing. I faked smiles. I practiced expert avoidance. I ignored myself and my inner processes because they scared me and because of that fear those inner processes found a way to express themselves for the first time in both of our lives. That way was voices, beliefs, depressions, a mania, panic attacks, and the underlying feeling of being broken.

I could talk about childhood stuff here. I could talk about medication and homelessness and the trauma of school. But I spent years reiterating that on my previous blog. I’ve spent time reiterating it to friends and therapists. And now, I can sum it all up in one word: fear.

I feared everything, for many reasons. I feared life. I feared being sad. I feared being happy because sadness came after. I feared anxiety, I feared death, I feared fear.

I think many of us go into therapy or other treatments confused on what “processing emotions” means. I think some therapists and psychiatrists who have never really gone through that heavy process are also confused on what it means. So they blurt it because they’re supposed to, it’s part of the script.

Processing emotions for me meant more than just talking about them and feeling them. It meant not telling myself “tomorrow will be better” or “this is temporary” or “I’ll be happy some day”. It meant not telling myself “you need to get up”. It meant greeting darkness with a handshake and respecting the space it needed within me. The darkness is lonely, too.

It meant sharing my body and my mind with panic and voices and fear and setting boundaries with them; if we all have to live in here together, we need to communicate and I can’t hold the power. But neither can you.

It meant getting comfortable with uncertainty. There is no standard “life”. My experiences don’t make life worse than what life should be, they don’t make life better than what life should be because life doesn’t have a designated “should”. It doesn’t have a designated “have to”. It’s just there.

It meant veering from my psychology degree and studying philosophy, a bit of physics, and leafing through neuroscience articles. It meant studying research. It meant, for me, getting off medication, and really feeling ALL of myself.

I’m sure most people have heard of the double-slit experiment in physics. I remember hearing about it for the first time as I sat high as a kite in High School chemistry. You learn the conclusion is that photons (and other particles) behave as both a wave and a particle, given the observed interference pattern. What high school teachers don’t talk much about is that the reason we come to that conclusion and label it as a reasonable consensus is because, as of right now, we’ll never know if we’re wrong.

We can’t see a single photon pass through anything with the naked eye. And so when we don’t observe it with a camera, when we can’t see what’s happening, the photon behaves as a single photon. The camera we use to observe this particle has a tiny light. That tiny light is a confounding variable–it could be affecting the particle’s behavior. Or maybe it isn’t. But, because we can never see for ourselves with a naked eye, we’ll never know. That’s the paradox, and part of the foundation of the Uncertainty Principal.

We’ll never know. We’re limited in this life we have, and when we’re not okay with that, we run ourselves exhausted trying to fix what isn’t broken.

I’m not scared of darkness anymore. What is there to be scared of?