Posted in Late Night Thoughts, psychology

The Philosophy of Altered States

I’d like to talk about altered states. This includes but is not limited to the resulting mind state of those in psychosis, those who are both recreational and addicted drug users, and the natural state of mood changes. Most specifically, we’ll talk about why the want to alter our state of mind is regarded as dangerous and undesirable.

First, I’ll start off with a story: before the pandemic, I injured my back running on a treadmill.

I have a short leg and a displaced hip, so it’s not that I don’t know how a treadmill works, it’s that my body is broken.

I was prescribed Valium and Percocet. The Valium did wonders for my anxiety, especially when it came to speaking in front of panels, but the Percocet did something more. The Percocet gave me unbridled, unregulated, inorganic happiness, something I could never have without the pill itself. It made me sociable, bubbly, understanding, empathetic. It gave me confidence. It made me feel more human than I’ve ever felt.

And so the other day, while watching a terrible talk show yap about a heroin user, I started yearning for what I’d lost: that inorganic happiness. I found my mind racing, focused on pulling any old name from the archives of people I know, so I could ask them if they knew anyone selling Percocet. Once I realized I was frothing at the mouth at work like some sort of tortured, rabid dog, I stopped and pondered.

What was it about inorganic happiness that made me froth at the mouth? And, more importantly, why was I judging this feeling? Why did I label it bad?

Let me explain.

If you are feeling sad, you want to stop feeling sad. When you can’t stop feeling sad by simply telling yourself to stop feeling sad, you start feeling bad because you can’t stop feeling sad. You fall into a circle of sadness, until something–maybe a hot cup of tea or a friend or a therapist–triggers some thought that triggers some chemical that triggers some electricity that triggers another thought that eventually triggers your sadness to alter itself. You feel okay again.

So, what happens when you feel okay and wish to alter that state? What if we held each emotion to the same standard?

If I feel okay, or I feel happy, and I wish to feel more okay, or more happy, is there a moral, universal law that stops me from making that a reality?

The answer is no.

Now, we all know the consequences of going off our meds suddenly and without proper care (I frequently did that in my earlier psychosis years) and we all know the consequences of long-term, heavy, drug use, including regular, doctor-prescribed medication. So, if you’d like, you can think of that as the only hiccup here: there are physical and mental and life-changing consequences for our actions.

But why is happiness the only acceptable emotion to have? Why do we strive simply for that? Why don’t we focus on respecting our sadness, our anger? Why was my first inclination to seek a stronger happiness than I already have? Why do I want to resort to inorganic happiness?

I’ve asked a lot of questions here with no answers because I really want you to think about this. I really want you to ponder why do we put happiness on a pedestal? Why aren’t we allowed to feel other feelings in the same way we feel happiness? And is that why we constantly want to change our state of being? Because happiness is the only socially acceptable form of emotion?

Think about it.

Any thoughts in the comments are always appreciated.

Until next time.

Don’t forget to hit that follow button and join me on Instagram @alilivesagain.

Posted in psychology, science

Mental Health Month: Substance Use

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

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

To be frank.

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

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

What Is a Substance Use Disorder?

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

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

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

How Do These Substances Interact With Our Body?

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

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

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

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

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

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

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

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

Aren’t These All Plants?

The majority of them, yes.

No, that does not make them safe.

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

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

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

Why Can’t People Just Stop?

Some people can, and do.

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

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

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

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

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

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

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

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

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

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

I told myself no for two months.

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

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

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

I was not addicted. But I felt the pull.

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

Do Rehabs Really Do Anything?

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

What About Relapse?

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

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

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

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

If you want to connect or inquire about sharing your story, catch me here:

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 encouraging critical thinking for all.

Posted in psychology, science

Mental Health Month: Personality Disorders

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What’s Up With Borderline Personality Disorder?

Well, what isn’t up with Borderline Personality?

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

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

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

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

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

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

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

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

What’s the Difference Between Antisocial Personality and Psychopathy?

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

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

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

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

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

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

You are safe.

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

Please. Stop using it.

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

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 encouraging critical thinking about psychology.

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

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