Serious Mental Illness Blog

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Posts tagged personality disorder

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Recovery from Borderline Personality Disorder May Be AttainableBy Ashley Brown, MA, PhDRecovery from Borderline Personality Disorder (BPD) may be possible, and the roots lie in understanding the biosocial model. This model originated with Marsha Linehan’s theory, which argued that there were both social and biological reasons that BPD develops.
Borderline Personality Disorder is often considered one of the most difficult diagnoses with which to work. But in my many years of experience working with individuals with BPD, I found that there are reasons behind their actions which, when understood, can help lead to empathy, acceptance, and ultimately change.
According to the biosocial model, people with BPD frequently have differences in their neurotransmitter and neurological functioning. Research has shown that they many have neurotransmitter issues that make them more emotional, aggressive, or reactive to stimuli – making them more prone to emotionally intense experiences.
People with BPD have usually been invalidated throughout life which leads to emotional sensitivity. For example, imagine a child who is hungry or frustrated trying to communicate this to his or her parents but being told that their feelings don’t matter over and over again. The feelings may be cast aside with statements such as “there’s nothing to cry about” or through cultural stereotypes such as “little girls don’t get angry” or “big boys don’t cry”. And environments of emotional, psychological, and physical abuse are extremely invalidating.
Invalidation serves to demonstrate to children that their feelings are wrong and that somehow they need to look externally, to other people, to know what they are feeling and if their feelings have value. Being told their emotions were wrong led them to believe that emotions were bad things, to be avoided whenever possible. This creates a chronic, internal tension where the person feels that they have to live up to others’ expectations and not experience negative feelings. Yet they also feel anger and worthlessness for having those unavoidable negative feelings, or on a deeper level, for not being able to authentically express themselves.
This tension builds up and causes an emotional explosion. In fact, the individual who has had their emotions invalidated repeatedly growing up will feel that if they don’t demonstrate their emotions through large displays, that no one will believe them. They believe that their emotions are not worthy of being considered, so may in fact subconsciously overemphasize their emotional expression in order to ensure that other people “believe” that what they are feeling is real.
This is one reason BPD results in so many emotional outbursts. People with BPD have been invalidated for so long that they don’t trust what they feel unless their feelings are overflowing and taking over the room. It’s only then that the individual with BPD can relax and say “see, I told you I was upset”.
Having emotions ignored by others for so long also leads to black and white behaviors and beliefs. For someone with BPD, behaviors may swing like a pendulum from distancing themselves from their emotions and other people to feeling needy and dependent on someone else. Although the individual looks for love and approval from others, they have difficulty accepting that love due to the low regard they have for themselves. Chronic invalidation has caused them to feel overwhelmed by distressing emotions. Sometimes their behavior becomes self-sabotaging and self-destructive when they can’t cope with these emotions. Frequently, social relationships merely reinforce these negative patterns.
As children, people with BPD learned these skills to survive in their dysfunctional environment. But these skills no longer serve them. Many people with BPD find the notion of “change” to be invalidating in itself because it implies that there is something wrong with them that needs to be purged. This is why the most successful and well-researched therapy for BPD, Dialectical Behavior Therapy (DBT), focuses on balancing radical acceptance and non-judgment of oneself while recognizing the need for change.
The biosocial model reveals keys to recovery from Borderline Personality Disorder and tells us that this diagnosis does not have to be the horrible life-sentence that many people and medical professionals make it out to be. Marsha Linehan, the inventor of DBT, revealed in a 2011 New York Times article that she had Borderline Personality Disorder when she was younger. Yet, she’s found ways to cope with and grow from the issues that at one point institutionalized her. If she can get through it, anyone can.



For more mental health news, Click Here to access the Serious Mental Illness Blog

Recovery from Borderline Personality Disorder May Be Attainable
By Ashley Brown, MA, PhD

Recovery from Borderline Personality Disorder (BPD) may be possible, and the roots lie in understanding the biosocial model. This model originated with Marsha Linehan’s theory, which argued that there were both social and biological reasons that BPD develops.

Borderline Personality Disorder is often considered one of the most difficult diagnoses with which to work. But in my many years of experience working with individuals with BPD, I found that there are reasons behind their actions which, when understood, can help lead to empathy, acceptance, and ultimately change.

According to the biosocial model, people with BPD frequently have differences in their neurotransmitter and neurological functioning. Research has shown that they many have neurotransmitter issues that make them more emotional, aggressive, or reactive to stimuli – making them more prone to emotionally intense experiences.

People with BPD have usually been invalidated throughout life which leads to emotional sensitivity. For example, imagine a child who is hungry or frustrated trying to communicate this to his or her parents but being told that their feelings don’t matter over and over again. The feelings may be cast aside with statements such as “there’s nothing to cry about” or through cultural stereotypes such as “little girls don’t get angry” or “big boys don’t cry”. And environments of emotional, psychological, and physical abuse are extremely invalidating.

Invalidation serves to demonstrate to children that their feelings are wrong and that somehow they need to look externally, to other people, to know what they are feeling and if their feelings have value. Being told their emotions were wrong led them to believe that emotions were bad things, to be avoided whenever possible. This creates a chronic, internal tension where the person feels that they have to live up to others’ expectations and not experience negative feelings. Yet they also feel anger and worthlessness for having those unavoidable negative feelings, or on a deeper level, for not being able to authentically express themselves.

This tension builds up and causes an emotional explosion. In fact, the individual who has had their emotions invalidated repeatedly growing up will feel that if they don’t demonstrate their emotions through large displays, that no one will believe them. They believe that their emotions are not worthy of being considered, so may in fact subconsciously overemphasize their emotional expression in order to ensure that other people “believe” that what they are feeling is real.

This is one reason BPD results in so many emotional outbursts. People with BPD have been invalidated for so long that they don’t trust what they feel unless their feelings are overflowing and taking over the room. It’s only then that the individual with BPD can relax and say “see, I told you I was upset”.

Having emotions ignored by others for so long also leads to black and white behaviors and beliefs. For someone with BPD, behaviors may swing like a pendulum from distancing themselves from their emotions and other people to feeling needy and dependent on someone else. Although the individual looks for love and approval from others, they have difficulty accepting that love due to the low regard they have for themselves. Chronic invalidation has caused them to feel overwhelmed by distressing emotions. Sometimes their behavior becomes self-sabotaging and self-destructive when they can’t cope with these emotions. Frequently, social relationships merely reinforce these negative patterns.

As children, people with BPD learned these skills to survive in their dysfunctional environment. But these skills no longer serve them. Many people with BPD find the notion of “change” to be invalidating in itself because it implies that there is something wrong with them that needs to be purged. This is why the most successful and well-researched therapy for BPD, Dialectical Behavior Therapy (DBT), focuses on balancing radical acceptance and non-judgment of oneself while recognizing the need for change.

The biosocial model reveals keys to recovery from Borderline Personality Disorder and tells us that this diagnosis does not have to be the horrible life-sentence that many people and medical professionals make it out to be. Marsha Linehan, the inventor of DBT, revealed in a 2011 New York Times article that she had Borderline Personality Disorder when she was younger. Yet, she’s found ways to cope with and grow from the issues that at one point institutionalized her. If she can get through it, anyone can.





For more mental health news, Click Here to access the Serious Mental Illness Blog

Filed under borderline borderline personality borderline personality disorder bpd disorder personality disorder diagnosis psychology mind brain body health healthy recovery hope mental health mental illness mental illness cutting self harm self help dbt dialectical behavior therapy linehan marsha linehan news research hopeful study

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Interview: Borderline Personality Disorder, Fear Of Abandonment, And RelationshipsBy Richard Zwolinski, LMHC, Casac & C.R. ZwolinskiToday we’re talking with therapist Lisa Bahar about Borderline Personality Disorder and how it can affect relationships.Welcome, Lisa. BPD makes it difficult to be involved in a stable, healthy relationship. What are some kinds of behaviors that people with BPD have that are a challenge to a relationship?A person with BPD desires and responds to structure, predictability and communication. When there is lack of predictability, anxiety or fear of abandonment can potentially set in, and disruptive and unstable behavior can escalate into controlling and aggressive reactions.These reactions can occur when their partner’s behavior even slightly differs from what is expected. For example, if a partner, who is “always” on time is 15 minutes late, breaking a pattern of predictability, feeling of anxiousness increase. These feelings trigger feelings of abandonment, which can then lead to disproportionate reactions. These feelings are all rooted in fear.For example, when the partner shows up, the person with BPD might accuse them of cheating, leaving or have a plan to leave them. Or the person with BPD might act out with behaviors used as a way to give the message that the other is being “punished”. These might include not speaking, slamming doors, pouting, and so on. They all communicate I am angry.Tell us more about what this type of manipulative behavior looks like?Manipulation is a way to create control. If it is unconsciously motivated through a conscious act, such as an outward behavior like tantrums, crying, threatening, and attacking, it is what I call sloppy manipulation.Or, it can be sophisticated manipulation. When manipulative behavior takes the form of crafty questions which are intended to trap the other person into saying something that they really did not know mean to say, or give an answer that they really didn’t realize they were giving.The individual with BPD does not always use direct and healthy communication skills and instead acts out behaviorally and/or communicates indirectly.Are people with BPD consciously manipulating others? Sometimes, it seems like these manipulative behaviors are habits or knee jerk reactions rather than conscious emotional manipulation. Can you explain what is really going on?Exactly, these behaviors can be habits. Generally until awareness sets in, the individual may not know that they are unconsciously motivated. Once awareness sets in, and insight is gained, usually through various mindfulness practices, then there can be an opportunity for behavior change.Behavioral change is the real test of insight. Of course, the individual with BPD needs to actually know how to change and that is where the Dialectical Behavior Therapy skills become helpful.What are the underlying reasons and/or mechanisms driving manipulative behavior in someone with BPD?Fear of abandonment. Also, a feeling of disconnect particularly with a sense of self. This happens when an individual feels they don’t have an identity without the other there to define them. When the partner demonstrates behaviors that are interpreted as “leaving” by an individual with BPD it can feel like a loss of identity.Fear of abandonment can feel almost like death to the individual with BPD since it is a kind of “death of self.” That is why some people with BPD have a pattern of jumping from relationship to relationship—they do this in order to sustain sense of self.How does Dialectical Behavior Therapy help those with BPD resolve these issues?Dialectical Behavior Therapy is a set of skills that are very concrete and clear. They allow the individual to decrease emotionally intense reactions by providing a way to decrease the symptoms.DBT teaches a set of skills including:Core Mindfulness skills which help to calm the mind.Interpersonal Effectiveness skills which are designed to help you effectively communicate what you want, express feelings and say no clearly.Emotional Regulation skills which help you manage and deal with emotions rather than emotions controlling you.Distress Tolerance skills which help you be able to handle crisis situations more effectively and deal with reality and it’s terms, as opposed to resisting what reality is.What are some suggestions for people who want to overcome manipulative behaviors that drive people away?The first part is that the person has to want the change—they have to be the one to do the work! Of course, someone else such as the person the client is in a relationship might also want the change, and that is fine—but it can’t be the primary motivation.Next, there must be a willingness and dedication to learning skills that can help. For example the client must be willing to practice the skills he or she learns from DBT. They have to understand: This is a not a quick fix, but the development of a pattern of life skills.What advice do you have for family, friends and colleagues who are trying to cope with these behaviors and who, understandably, don’t want to feel attacked or manipulated?Education is key.Significant others must be aware of their part in interactions and reactions and must learn how best to respond. DBT is most effective if all family members are involved. Each person involved should practice a self care plan. It is so important for clients and family members to not point the finger at any one person.Thanks for speaking to this topic.


For more mental health news, Click Here to access the Serious Mental Illness Blog

Interview: Borderline Personality Disorder, Fear Of Abandonment, And Relationships
By Richard Zwolinski, LMHC, Casac & C.R. Zwolinski

Today we’re talking with therapist Lisa Bahar about Borderline Personality Disorder and how it can affect relationships.

Welcome, Lisa. BPD makes it difficult to be involved in a stable, healthy relationship. What are some kinds of behaviors that people with BPD have that are a challenge to a relationship?
A person with BPD desires and responds to structure, predictability and communication. When there is lack of predictability, anxiety or fear of abandonment can potentially set in, and disruptive and unstable behavior can escalate into controlling and aggressive reactions.
These reactions can occur when their partner’s behavior even slightly differs from what is expected. For example, if a partner, who is “always” on time is 15 minutes late, breaking a pattern of predictability, feeling of anxiousness increase. These feelings trigger feelings of abandonment, which can then lead to disproportionate reactions. These feelings are all rooted in fear.
For example, when the partner shows up, the person with BPD might accuse them of cheating, leaving or have a plan to leave them. Or the person with BPD might act out with behaviors used as a way to give the message that the other is being “punished”. These might include not speaking, slamming doors, pouting, and so on. They all communicate I am angry.

Tell us more about what this type of manipulative behavior looks like?
Manipulation is a way to create control. If it is unconsciously motivated through a conscious act, such as an outward behavior like tantrums, crying, threatening, and attacking, it is what I call sloppy manipulation.
Or, it can be sophisticated manipulation. When manipulative behavior takes the form of crafty questions which are intended to trap the other person into saying something that they really did not know mean to say, or give an answer that they really didn’t realize they were giving.
The individual with BPD does not always use direct and healthy communication skills and instead acts out behaviorally and/or communicates indirectly.

Are people with BPD consciously manipulating others? Sometimes, it seems like these manipulative behaviors are habits or knee jerk reactions rather than conscious emotional manipulation. Can you explain what is really going on?
Exactly, these behaviors can be habits. Generally until awareness sets in, the individual may not know that they are unconsciously motivated. Once awareness sets in, and insight is gained, usually through various mindfulness practices, then there can be an opportunity for behavior change.
Behavioral change is the real test of insight. Of course, the individual with BPD needs to actually know how to change and that is where the Dialectical Behavior Therapy skills become helpful.

What are the underlying reasons and/or mechanisms driving manipulative behavior in someone with BPD?
Fear of abandonment. Also, a feeling of disconnect particularly with a sense of self. This happens when an individual feels they don’t have an identity without the other there to define them. When the partner demonstrates behaviors that are interpreted as “leaving” by an individual with BPD it can feel like a loss of identity.
Fear of abandonment can feel almost like death to the individual with BPD since it is a kind of “death of self.” That is why some people with BPD have a pattern of jumping from relationship to relationship—they do this in order to sustain sense of self.

How does Dialectical Behavior Therapy help those with BPD resolve these issues?
Dialectical Behavior Therapy is a set of skills that are very concrete and clear. They allow the individual to decrease emotionally intense reactions by providing a way to decrease the symptoms.
DBT teaches a set of skills including:
Core Mindfulness skills which help to calm the mind.
Interpersonal Effectiveness skills which are designed to help you effectively communicate what you want, express feelings and say no clearly.
Emotional Regulation skills which help you manage and deal with emotions rather than emotions controlling you.
Distress Tolerance skills which help you be able to handle crisis situations more effectively and deal with reality and it’s terms, as opposed to resisting what reality is.

What are some suggestions for people who want to overcome manipulative behaviors that drive people away?
The first part is that the person has to want the change—they have to be the one to do the work! Of course, someone else such as the person the client is in a relationship might also want the change, and that is fine—but it can’t be the primary motivation.
Next, there must be a willingness and dedication to learning skills that can help. For example the client must be willing to practice the skills he or she learns from DBT. They have to understand: This is a not a quick fix, but the development of a pattern of life skills.

What advice do you have for family, friends and colleagues who are trying to cope with these behaviors and who, understandably, don’t want to feel attacked or manipulated?
Education is key.
Significant others must be aware of their part in interactions and reactions and must learn how best to respond. DBT is most effective if all family members are involved. Each person involved should practice a self care plan. It is so important for clients and family members to not point the finger at any one person.

Thanks for speaking to this topic.





For more mental health news, Click Here to access the Serious Mental Illness Blog

Filed under bpd borderline borderline personality borderline personality disorder personality disorder personality disorder recovery education news research psychology psychiatry therapy sad sadness depression dsm character cbt cognitive cognitive behavioral cognitive behavioral therapy behavioral behavior brain mind body mental health mental illness

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Violence and Mental Illness: The Facts

The discrimination and stigma associated with mental illnesses largely stem from the link between mental illness and violence in the minds of the general public, according to the U.S. Surgeon General (DHHS, 1999). The belief that persons with mental illness are dangerous is a significant factor in the development of stigma and discrimination (Corrigan, et al., 2002). The effects of stigma and discrimination are profound. The President’s New Freedom Commission on Mental Health found that, “Stigma leads others to avoid living, socializing, or working with, renting to, or employing people with mental disorders - especially severe disorders, such as schizophrenia. It leads to low self-esteem, isolation, and hopelessness. It deters the public from seeking and wanting to pay for care. Responding to stigma, people with mental health problems internalize public attitudes and become so embarrassed or ashamed that they often conceal symptoms and fail to seek treatment (New Freedom Commission, 2003).”

This link is often promoted by the entertainment and news media. For example, Mental Health America, (formerly the National Mental Health Association) reported that, according to a survey for the Screen Actors’ Guild, characters in prime time television portrayed as having a mental illness are depicted as the most dangerous of all demographic groups: 60 percent were shown to be involved in crime or violence. Also most news accounts portray people with mental illness as dangerous (Mental Health America, 1999). The vast majority of news stories on mental illness either focus on other negative characteristics related to people with the disorder (e.g., unpredictability and unsociability) or on medical treatments. Notably absent are positive stories that highlight recovery of many persons with even the most serious of mental illnesses (Wahl, et al., 2002). Inaccurate and stereotypical representations of mental illness also exist in other mass media, such as films, music, novels and cartoons (Wahl, 1995).

Most citizens believe persons with mental illnesses are dangerous. A longitudinal study of Americans’ attitudes on mental health between 1950 and 1996 found, “the proportion of Americans who describe mental illness in terms consistent with violent or dangerous behavior nearly doubled.” Also, the vast majority of Americans believe that persons with mental illnesses pose a threat for violence towards others and themselves (Pescosolido, et al., 1996, Pescosolido et al., 1999).

As a result, Americans are hesitant to interact with people who have mental illnesses. Thirty-eight percent are unwilling to be friends with someone having mental health difficulties; sixty-four percent do not want someone who has schizophrenia as a close co-worker, and more than sixty-eight percent are unwilling to have someone with depression marry into their family (Pescosolido, et al., 1996).

But, in truth, people have little reason for such fears. In reviewing the research on violence and mental illness, the Institute of Medicine concluded, “Although studies suggest a link between mental illnesses and violence, the contribution of people with mental illnesses to overall rates of violence is small,” and further, “the magnitude of the relationship is greatly exaggerated in the minds of the general population” (Institute of Medicine, 2006). For people with mental illnesses, violent behavior appears to be more common when there’s also the presence of other risk factors. These include substance abuse or dependence; a history of violence, juvenile detention, or physical abuse; and recent stressors such as being a crime victim, getting divorced, or losing a job (Elbogen and Johnson, 2009).

(Source: promoteacceptance.samhsa.gov)

Filed under violence Questions western emotions evolution Extreme rethinking madness research theory theories unconscious intelligence psychology psychiatry psychoanalysis psychosis psychopharmacology psychopathology psychotic personality disorder psychotherapy post traumatic Paranoid paranoia pharmacy addiction abuse affective anxiety antipsychotic

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artfromtheedge:

“Delusions of Grandeur” (2010)
By Matt Vaillette

Could you describe your submission?
This was a spontaneous piece I created in 2010, during a manic episode. Midway through I decided it represents the delusions of grandeur most of us live with, manic or otherwise.
Could you tell us a little about yourself?
I’m a Bipolar artist. I focus on the experience of creating and think a lot about states of mind and their resulting artistic outcomes. I currently put all my work on mebeingsocial.tumblr.com.
Was your submission created about or in an extreme state?
This was created in a mild manic state.
Would you like to describe the process of creating your submission?
I (stupidly) triggered a manic episode through sleep deprivation in order to create in such a state. From there I rode the waves, and followed strong feelings until it was finished.

artfromtheedge:

“Delusions of Grandeur” (2010)

By Matt Vaillette



Could you describe your submission?

This was a spontaneous piece I created in 2010, during a manic episode. Midway through I decided it represents the delusions of grandeur most of us live with, manic or otherwise.

Could you tell us a little about yourself?

I’m a Bipolar artist. I focus on the experience of creating and think a lot about states of mind and their resulting artistic outcomes. I currently put all my work on mebeingsocial.tumblr.com.

Was your submission created about or in an extreme state?

This was created in a mild manic state.

Would you like to describe the process of creating your submission?

I (stupidly) triggered a manic episode through sleep deprivation in order to create in such a state. From there I rode the waves, and followed strong feelings until it was finished.

(via artfromtheedge)

Filed under Questions western evolution emotions research resilience rethinking madness theory trauma theories unconscious intelligence painting Paranoid psychology paint psychiatry psychoanalysis psychosis personality disorder psychotic psychotherapy psychopharmacology psychopathology art artist anxiety affective science strength

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[Article of Interest] Lives Restored: Learning to Live With a Mind’s Taunting Voices
By Benedict Carey
Joe Holt, a computer consultant and entrepreneur who has a diagnosis of schizophrenia, describes how he’s learned to manage the voices in his head
[Excerpt] Lee’s Summit, Mo. — The job was gone, the gun was loaded, and a voice was saying, “You’re a waste, give up now, do it now.”
It was a command, not a suggestion, and what mattered at that moment — a winter evening in 2000 — was not where the voice was coming from, but how assured it was, how persuasive. Losing his first decent job ever seemed like too much for Joe Holt to live with. It was time. 
“All I remember then is a knock on the bedroom door and my wife, Patsy, she sits down on the bed and hugs me, and I’m holding the gun in my left hand, down here, out of sight,” said Mr. Holt, 50, a computer consultant and entrepreneur who has a diagnosis of schizophrenia.
“She says, ‘Joe, I know you feel like quitting, but what if tomorrow is the day you get what you want?’ And walks out. I sat there staring at that gun for an hour at least, and finally decided — never again. It can never be an option. Patsy deserves for me to be trying.”
“She says, ‘Joe, I know you feel like quitting, but what if tomorrow is the day you get what you want?’ And walks out. I sat there staring at that gun for an hour at least, and finally decided — never again. It can never be an option. Patsy deserves for me to be trying.”
In recent years, researchers have begun talking about mental health care in the same way addiction specialists speak of recovery — the lifelong journey of self-treatment and discipline that guides substance abuse programs. The idea remains controversial: managing a severe mental illness is more complicated than simply avoiding certain behaviors. The journey has more mazes, fewer road signs.
Yet people like Joe Holt are traveling it and succeeding. Most rely on some medical help, but each has had to build core skills from the ground up, through trial and repeated error. Now more and more of them are risking exposure to tell their stories publicly.
“If you’re going to focus on recovery, you might want to ask those who’ve actually recovered what it is they’re doing,” said Frederick J. Frese III, an associate professor of psychiatry at the Northeastern Ohio Universities College of Medicine who has written about his own struggles with schizophrenia.
“Certainly, traditional medicine has not worked very well for many of us,” Dr. Frese went on. “That’s why we’ve had to learn so many survival tricks on our own.”

[Article of Interest] Lives Restored: Learning to Live With a Mind’s Taunting Voices

By Benedict Carey

Joe Holt, a computer consultant and entrepreneur who has a diagnosis of schizophrenia, describes how he’s learned to manage the voices in his head

[Excerpt] Lee’s Summit, Mo. — The job was gone, the gun was loaded, and a voice was saying, “You’re a waste, give up now, do it now.”

It was a command, not a suggestion, and what mattered at that moment — a winter evening in 2000 — was not where the voice was coming from, but how assured it was, how persuasive. Losing his first decent job ever seemed like too much for Joe Holt to live with. It was time.

“All I remember then is a knock on the bedroom door and my wife, Patsy, she sits down on the bed and hugs me, and I’m holding the gun in my left hand, down here, out of sight,” said Mr. Holt, 50, a computer consultant and entrepreneur who has a diagnosis of schizophrenia.

“She says, ‘Joe, I know you feel like quitting, but what if tomorrow is the day you get what you want?’ And walks out. I sat there staring at that gun for an hour at least, and finally decided — never again. It can never be an option. Patsy deserves for me to be trying.”

“She says, ‘Joe, I know you feel like quitting, but what if tomorrow is the day you get what you want?’ And walks out. I sat there staring at that gun for an hour at least, and finally decided — never again. It can never be an option. Patsy deserves for me to be trying.”

In recent years, researchers have begun talking about mental health care in the same way addiction specialists speak of recovery — the lifelong journey of self-treatment and discipline that guides substance abuse programs. The idea remains controversial: managing a severe mental illness is more complicated than simply avoiding certain behaviors. The journey has more mazes, fewer road signs.

Yet people like Joe Holt are traveling it and succeeding. Most rely on some medical help, but each has had to build core skills from the ground up, through trial and repeated error. Now more and more of them are risking exposure to tell their stories publicly.

If you’re going to focus on recovery, you might want to ask those who’ve actually recovered what it is they’re doing,” said Frederick J. Frese III, an associate professor of psychiatry at the Northeastern Ohio Universities College of Medicine who has written about his own struggles with schizophrenia.

“Certainly, traditional medicine has not worked very well for many of us,” Dr. Frese went on. “That’s why we’ve had to learn so many survival tricks on our own.”

Filed under Questions western emotions research resilience rethinking madness theory trauma theories unconscious intelligence Paranoid psychology ptsd psychiatry psychoanalysis psychosis personality disorder paranoia psychotic psychotherapy psychopharmacology psychopathology post traumatic anxiety addiction abuse affective science Suicide

155 notes

[Article of Interest] Mental Disorders And Evolution: What Would Darwin Say About Schizophrenia?
By David Schultz
It’s a question that’s baffled evolutionary theorists for decades: if survival of the fittest is the rule, how have the genes that contribute to serious, debilitating mental disorders survived? It’s been shown that people who suffer from schizophrenia, autism, anorexia and other disorders are less likely to have children. And yet, the genes that cause these disorders aren’t going away. In fact, some of the disorders appear to be becoming more common. Evolutionary theory wouldn’t predict that.
Scientists have a few theories that attempt to explain this paradox: One is that the genetic mutations that cause these disorders occurred relatively recently, so not enough generations have passed to allow the evolutionary process to weed them out. Another theory is that the genetic mutations that cause a disorder in one person somehow make that person’s sibling more likely to have children. In a situation like that, the mutation offers a net benefit to a person’s family.
A team of Swedish and British scientists recently tested these theories by comparing the rates at which people suffering from mental illness have kids to those of their siblings. The data came from a medical database of more than 2 million Swedes.
The researchers found that the siblings of people who suffer from schizophrenia, autism and anorexia had on average the same or fewer children than the general public [and that] the siblings of people who suffer from depression or substance abuse had significantly more children than the general public.

Q& A with Dr. Peter McGuffin
Q: You say at the beginning of your paper that “psychiatric disorders have long puzzled researchers by defying the expectations of natural selection.” Why?
A: It’s particularly the case with schizophrenia, which in this paper and in many other papers has been shown to be a disorder that drastically reduces your fecundity — the number of kids you have. It’s often referred to as reduced fertility but, strictly speaking, people with schizophrenia aren’t infertile. It’s just that they’re less often likely to find a partner and have kids.
Schizophrenia is estimated to have a heritability of around 80 percent. Same is true for autism. So if these disorders are very heavily influenced by genes, but the people who have the disorders are less likely to pass on their genes, why aren’t the disorders becoming less common in the population?
Q: What are some of the theories as to why this might be going on?
A: There are other gene disorders that have selection pressures against them, but are maintained in the population. A brilliant example of that is sickle cell disease. If you have sickle cell disease, the chances are if it’s untreated it’s going to kill you before you reach early adult life. Whereas, if you have the sickle cell trait — which is to say, you have one copy of the gene, not two copies — it protects you against malaria if you happen to live in an area where malaria is rife. So there’s a selective disadvantage to having the disease, but there’s a selective advantage to having the trait.
Q: Your study looked at not just people who were affected by psychiatric disorders, but also their siblings. Why?
A: The hypothesis would be that the relatives of the people who have the disorder, who don’t actually have the disorder themselves, are compensating by having more children. I mean, not deliberately compensating by going out and having more children, but there’s just something about their makeup that makes them have more kids.
So that’s essentially what we were testing in this paper. We were looking at the fecundity of schizophrenics, which we found to be low, as was the fecundity of people with autism. The question is, do their relatives actually make up for this by having more kids because they’re advantaged in some way? And the answer is no in the case of schizophrenia, but yes in the case of depression.
Q: If I’m someone who is the sibling of someone who has a psychiatric disorder, what do I need to know? Do I need to think twice about having biological children?
A: You need to know you’ll have an increased risk of getting the disorder yourself compared with the general population. The risk in siblings is increased, but it’s not increased so dramatically that it ought to stop you from having kids.
These aren’t single-gene disorders. These are complex disorders where being a relative is just a risk factor, not a certainty factor.
Q: So ultimately, if I’m the sibling of someone who has one of these disorders, I should be aware of the risks, but it’s not something that would make me say “I’m not going to have children.”
A: It shouldn’t make you say that. And if you are particularly concerned about it and you have more than one relative affected by it in the family, it might be worth seeking [genetic] counseling from an expert who knows what the risks are.

[Article of Interest] Mental Disorders And Evolution: What Would Darwin Say About Schizophrenia?

By David Schultz

It’s a question that’s baffled evolutionary theorists for decades: if survival of the fittest is the rule, how have the genes that contribute to serious, debilitating mental disorders survived? It’s been shown that people who suffer from schizophrenia, autism, anorexia and other disorders are less likely to have children. And yet, the genes that cause these disorders aren’t going away. In fact, some of the disorders appear to be becoming more common. Evolutionary theory wouldn’t predict that.

Scientists have a few theories that attempt to explain this paradox: One is that the genetic mutations that cause these disorders occurred relatively recently, so not enough generations have passed to allow the evolutionary process to weed them out. Another theory is that the genetic mutations that cause a disorder in one person somehow make that person’s sibling more likely to have children. In a situation like that, the mutation offers a net benefit to a person’s family.

A team of Swedish and British scientists recently tested these theories by comparing the rates at which people suffering from mental illness have kids to those of their siblings. The data came from a medical database of more than 2 million Swedes.

The researchers found that the siblings of people who suffer from schizophrenia, autism and anorexia had on average the same or fewer children than the general public [and that] the siblings of people who suffer from depression or substance abuse had significantly more children than the general public.


Q& A with Dr. Peter McGuffin

Q: You say at the beginning of your paper that “psychiatric disorders have long puzzled researchers by defying the expectations of natural selection.” Why?

A: It’s particularly the case with schizophrenia, which in this paper and in many other papers has been shown to be a disorder that drastically reduces your fecundity — the number of kids you have. It’s often referred to as reduced fertility but, strictly speaking, people with schizophrenia aren’t infertile. It’s just that they’re less often likely to find a partner and have kids.

Schizophrenia is estimated to have a heritability of around 80 percent. Same is true for autism. So if these disorders are very heavily influenced by genes, but the people who have the disorders are less likely to pass on their genes, why aren’t the disorders becoming less common in the population?

Q: What are some of the theories as to why this might be going on?

A: There are other gene disorders that have selection pressures against them, but are maintained in the population. A brilliant example of that is sickle cell disease. If you have sickle cell disease, the chances are if it’s untreated it’s going to kill you before you reach early adult life. Whereas, if you have the sickle cell trait — which is to say, you have one copy of the gene, not two copies — it protects you against malaria if you happen to live in an area where malaria is rife. So there’s a selective disadvantage to having the disease, but there’s a selective advantage to having the trait.

Q: Your study looked at not just people who were affected by psychiatric disorders, but also their siblings. Why?

A: The hypothesis would be that the relatives of the people who have the disorder, who don’t actually have the disorder themselves, are compensating by having more children. I mean, not deliberately compensating by going out and having more children, but there’s just something about their makeup that makes them have more kids.

So that’s essentially what we were testing in this paper. We were looking at the fecundity of schizophrenics, which we found to be low, as was the fecundity of people with autism. The question is, do their relatives actually make up for this by having more kids because they’re advantaged in some way? And the answer is no in the case of schizophrenia, but yes in the case of depression.

Q: If I’m someone who is the sibling of someone who has a psychiatric disorder, what do I need to know? Do I need to think twice about having biological children?

A: You need to know you’ll have an increased risk of getting the disorder yourself compared with the general population. The risk in siblings is increased, but it’s not increased so dramatically that it ought to stop you from having kids.

These aren’t single-gene disorders. These are complex disorders where being a relative is just a risk factor, not a certainty factor.

Q: So ultimately, if I’m the sibling of someone who has one of these disorders, I should be aware of the risks, but it’s not something that would make me say “I’m not going to have children.”

A: It shouldn’t make you say that. And if you are particularly concerned about it and you have more than one relative affected by it in the family, it might be worth seeking [genetic] counseling from an expert who knows what the risks are.

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[Article of Interest]
Seeing Things? Hearing Things? Many of Us Do
By Oliver Sacks
[Excerpt] Hallucinations are very startling and frightening: you suddenly see, or hear or smell something — something that is not there. Your immediate, bewildered feeling is, what is going on? Where is this coming from? The hallucination is convincingly real, produced by the same neural pathways as actual perception, and yet no one else seems to see it. And then you are forced to the conclusion that something — something unprecedented — is happening in your own brain or mind. Are you going insane, getting dementia, having a stroke?
In other cultures, hallucinations have been regarded as gifts from the gods or the Muses, but in modern times they seem to carry an ominous significance in the public (and also the medical) mind, as portents of severe mental or neurological disorders. Having hallucinations is a fearful secret for many people — millions of people — never to be mentioned, hardly to be acknowledged to oneself, and yet far from uncommon. The vast majority are benign — and, indeed, in many circumstances, perfectly normal. Most of us have experienced them from time to time, during a fever or with the sensory monotony of a desert or empty road, or sometimes, seemingly, out of the blue.
Hallucinations can have a positive and comforting role, too — this is especially true with bereavement hallucinations, seeing the face or hearing the voice of one’s deceased spouse, siblings, parents or child — and may play an important part in the mourning process. Such bereavement hallucinations frequently occur in the first year or two of bereavement, when they are most “needed.”
Working in old-age homes for many years, I have been struck by how many elderly people with impaired hearing are prone to auditory and, even more commonly, musical hallucinations — involuntary music in their minds that seems so real that at first they may think it is a neighbor’s stereo.
People with impaired sight, similarly, may start to have strange, visual hallucinations, sometimes just of patterns but often more elaborate visions of complex scenes or ranks of people in exotic dress. Perhaps 20 percent of those losing their vision or hearing may have such hallucinations.
While many people with schizophrenia do hear voices at certain times in their lives, the inverse is not true: most people who hear voices (as much as 10 percent of the population) are not mentally ill. For them, hearing voices is a normal mode of experience.
My patients tell me about their hallucinations because I am open to hearing about them, because they know me and trust that I can usually run down the cause of their hallucinations. For the most part, these experiences are unthreatening and, once accommodated, even mildly diverting.

[Article of Interest]

Seeing Things? Hearing Things? Many of Us Do

By Oliver Sacks

[Excerpt] Hallucinations are very startling and frightening: you suddenly see, or hear or smell something — something that is not there. Your immediate, bewildered feeling is, what is going on? Where is this coming from? The hallucination is convincingly real, produced by the same neural pathways as actual perception, and yet no one else seems to see it. And then you are forced to the conclusion that something — something unprecedented — is happening in your own brain or mind. Are you going insane, getting dementia, having a stroke?

In other cultures, hallucinations have been regarded as gifts from the gods or the Muses, but in modern times they seem to carry an ominous significance in the public (and also the medical) mind, as portents of severe mental or neurological disorders. Having hallucinations is a fearful secret for many people — millions of people — never to be mentioned, hardly to be acknowledged to oneself, and yet far from uncommon. The vast majority are benign — and, indeed, in many circumstances, perfectly normal. Most of us have experienced them from time to time, during a fever or with the sensory monotony of a desert or empty road, or sometimes, seemingly, out of the blue.

Hallucinations can have a positive and comforting role, too — this is especially true with bereavement hallucinations, seeing the face or hearing the voice of one’s deceased spouse, siblings, parents or child — and may play an important part in the mourning process. Such bereavement hallucinations frequently occur in the first year or two of bereavement, when they are most “needed.”

Working in old-age homes for many years, I have been struck by how many elderly people with impaired hearing are prone to auditory and, even more commonly, musical hallucinations — involuntary music in their minds that seems so real that at first they may think it is a neighbor’s stereo.

People with impaired sight, similarly, may start to have strange, visual hallucinations, sometimes just of patterns but often more elaborate visions of complex scenes or ranks of people in exotic dress. Perhaps 20 percent of those losing their vision or hearing may have such hallucinations.

While many people with schizophrenia do hear voices at certain times in their lives, the inverse is not true: most people who hear voices (as much as 10 percent of the population) are not mentally ill. For them, hearing voices is a normal mode of experience.

My patients tell me about their hallucinations because I am open to hearing about them, because they know me and trust that I can usually run down the cause of their hallucinations. For the most part, these experiences are unthreatening and, once accommodated, even mildly diverting.

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[Article of Interest]At Afghan Shrine, Ancient Treatment for Mental IllnessBy Kevin SieffJALALABAD, Afghanistan — No one here knows the man whose left leg is shackled to the wall of cell No. 5. Last week, he finished tearing his mattress to shreds and then moved onto his clothes, ripping his shirt and pants off before falling asleep naked.“He’s insane,” say the villagers who have come to gawk at him. “He doesn’t know whether he’s in this world or another.” “He’s getting better!” said Mia Shafiq, the man responsible for his recovery and the one who shackled him to the wall of a shrine in this eastern Afghan city.The man’s brothers drove him here from southern Kandahar province two weeks ago, drawn by the same belief that has attracted families from across Afghanistan for more than two centuries. Legend has it that those with mental disorders will be healed after spending 40 days in one of the shrine’s 16 tiny concrete cells. They live on a subsistence diet of bread, water and black pepper near the grave of a famous pir, or spiritual leader, named Mia Ali Sahib.Every year, hundreds of Afghans bring mentally ill relatives here rather than to hospitals, rejecting a clinical approach to what many here see as a spiritual deficiency. The treatment meted out at the shrine and a handful of others like it nationwide might be archaic, but the symptoms are often a response to 21st-century warfare: 11 years of nighttime raids, assassinations and suicide bombings. Shafiq wondered: Was the man’s mental state a product of war? Was he a former soldier? A civilian who had seen too much horror? Shafiq had helped check men like that into the shrine. He’d watched them writhe and scream and, eventually, he said, recover.“For a lot of these people, faith is a key part of the healing process, and they have faith in the shrine,” said Humayun Zahir, a doctor and the director of Nangahar Hospital, which is funded by the European Commission.

[Article of Interest]
At Afghan Shrine, Ancient Treatment for Mental Illness
By Kevin Sieff

JALALABAD, Afghanistan — No one here knows the man whose left leg is shackled to the wall of cell No. 5. Last week, he finished tearing his mattress to shreds and then moved onto his clothes, ripping his shirt and pants off before falling asleep naked.
He’s insane,” say the villagers who have come to gawk at him. “He doesn’t know whether he’s in this world or another.”
“He’s getting better!” said Mia Shafiq, the man responsible for his recovery and the one who shackled him to the wall of a shrine in this eastern Afghan city.
The man’s brothers drove him here from southern Kandahar province two weeks ago, drawn by the same belief that has attracted families from across Afghanistan for more than two centuries. Legend has it that those with mental disorders will be healed after spending 40 days in one of the shrine’s 16 tiny concrete cells. They live on a subsistence diet of bread, water and black pepper near the grave of a famous pir, or spiritual leader, named Mia Ali Sahib.
Every year, hundreds of Afghans bring mentally ill relatives here rather than to hospitals, rejecting a clinical approach to what many here see as a spiritual deficiency. The treatment meted out at the shrine and a handful of others like it nationwide might be archaic, but the symptoms are often a response to 21st-century warfare: 11 years of nighttime raids, assassinations and suicide bombings.
Shafiq wondered: Was the man’s mental state a product of war? Was he a former soldier? A civilian who had seen too much horror? Shafiq had helped check men like that into the shrine. He’d watched them writhe and scream and, eventually, he said, recover.
For a lot of these people, faith is a key part of the healing process, and they have faith in the shrine,” said Humayun Zahir, a doctor and the director of Nangahar Hospital, which is funded by the European Commission.

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[Article of Interest]
Research Sees Early Trauma as Source of Schizophrenia ‘Symptoms’
Healthcanal.com 
For more than a century, these hallucinations and feelings of paranoia have been understood to be symptoms of schizophrenia and seen as, primarily, genetic in origin and eventually showing as irregular brain activity. 
They have been considered to be rare because the reported prevalence of the psychotic disorder has been minimal, at between 0.5% and 1% of the population, Professor Shevlin said. 
However, practitioners and researchers are  having to rethink that thesis in light of recent international research that suggests hallucinatory and other delusional experiences are more common in the general population than previously believed. 
Professor Shevlin said analysis of large scale studies in the United States and the Netherlands in the 1980s and 1990 showed that “instead of these kinds of ‘symptoms’ being very, very rare, they were actually quite common in the general population”.
"In the Dutch study something approximately 20% of the population endorsed one or more of these so-called symptoms (of schizophrenia).  Most of the people tended not to find these distressing or a causing of upset and so there was no need for treatment.”
Delivering his Inaugural Professorial Lecture as Professor Psychology, he said that after all the hundreds of millions of pounds that have been spent on trying to identify a biological basis underpinning psychotic disorders, “we are no closer to finding the so-called gene for schizophrenia”. 
The evidence from these studies, he said, profoundly strengthens the case for switching from over reliance on drug treatments towards the proven benefits of cognitive therapy-based approaches. 
There was increasing evidence that cognitive therapy and psychological treatments were a viable option and that people who received them “can function a lot better”. 
Professor Shevlin explained that the results of the USA and Dutch studies had prompted people to question the nature of schizophrenia and to ask whether it was really a disease or whether individuals who experienced these delusional conditions were simply “people at the extreme end of a relatively normal continuum.” 
At the same time, other researchers were keen to look at the affect of traumatic life experiences and whether these might impact on a diagnosis of schizophrenia. 
Childhood traumas or other traumatic events had always been regarded as predictors of propensity towards mental ill-health, such as post traumatic stress disorder, anxiety, depression and alcohol abuse. 
But schizophrenia was also thought of as being in a different category because it was always considered to be biologically-based and genetically driven, rather than being caused by social factors. 
"When they did their research, there was a consistent finding that these people who did have a diagnosis of schizophrenia tended to have had more traumatic experiences. The researchers found in them higher levels of child abuse, physical or sexual, child neglect and so-on. 
“Subsequent studies have also found that people who reported stressful life events have also tended to report hallucinatory or paranoid-like experiences. It now looks like adversity and stressful life events or kinds of disadvantage can influence psychotic disorders and psychotic symptoms.”
Professor Shevlin said the main implication of the rethink about schizophrenia should be the “demedicalisation” of these experiences. 
"It suggests that there is an over reliance on pharmacological treatment and it also suggests that psychiatry in general has ignored the content and meaning of events such as hallucinatory experiences and that they may well be related to earlier traumas."
Professor Shevlin said that a lot of research that supports pharmacological treatment tends just to focus on its effect in the reduction of symptoms. “This research finds that drug treatments can reduce the intensity or frequency of hallucinatory experiences but that doesn’t necessarily mean that the person starts to get on better with their life or can make friends or go out to work.
“Psychological treatments tend to have better outcomes for the individual in terms of them integrating to society and feeling better about themselves.” Professor Shevlin’s lecture was entitled “Modelling Madness: Population Based Analyses of Adversity and Psychosis”.

[Article of Interest]

Research Sees Early Trauma as Source of Schizophrenia ‘Symptoms’

Healthcanal.com 

For more than a century, these hallucinations and feelings of paranoia have been understood to be symptoms of schizophrenia and seen as, primarily, genetic in origin and eventually showing as irregular brain activity.

They have been considered to be rare because the reported prevalence of the psychotic disorder has been minimal, at between 0.5% and 1% of the population, Professor Shevlin said.

However, practitioners and researchers are  having to rethink that thesis in light of recent international research that suggests hallucinatory and other delusional experiences are more common in the general population than previously believed.

Professor Shevlin said analysis of large scale studies in the United States and the Netherlands in the 1980s and 1990 showed that “instead of these kinds of ‘symptoms’ being very, very rare, they were actually quite common in the general population”.

"In the Dutch study something approximately 20% of the population endorsed one or more of these so-called symptoms (of schizophrenia).  Most of the people tended not to find these distressing or a causing of upset and so there was no need for treatment.”

Delivering his Inaugural Professorial Lecture as Professor Psychology, he said that after all the hundreds of millions of pounds that have been spent on trying to identify a biological basis underpinning psychotic disorders, “we are no closer to finding the so-called gene for schizophrenia”.

The evidence from these studies, he said, profoundly strengthens the case for switching from over reliance on drug treatments towards the proven benefits of cognitive therapy-based approaches.

There was increasing evidence that cognitive therapy and psychological treatments were a viable option and that people who received them “can function a lot better”.

Professor Shevlin explained that the results of the USA and Dutch studies had prompted people to question the nature of schizophrenia and to ask whether it was really a disease or whether individuals who experienced these delusional conditions were simply “people at the extreme end of a relatively normal continuum.”

At the same time, other researchers were keen to look at the affect of traumatic life experiences and whether these might impact on a diagnosis of schizophrenia.

Childhood traumas or other traumatic events had always been regarded as predictors of propensity towards mental ill-health, such as post traumatic stress disorder, anxiety, depression and alcohol abuse.

But schizophrenia was also thought of as being in a different category because it was always considered to be biologically-based and genetically driven, rather than being caused by social factors.

"When they did their research, there was a consistent finding that these people who did have a diagnosis of schizophrenia tended to have had more traumatic experiences. The researchers found in them higher levels of child abuse, physical or sexual, child neglect and so-on.

Subsequent studies have also found that people who reported stressful life events have also tended to report hallucinatory or paranoid-like experiences. It now looks like adversity and stressful life events or kinds of disadvantage can influence psychotic disorders and psychotic symptoms.”

Professor Shevlin said the main implication of the rethink about schizophrenia should be the “demedicalisation” of these experiences.

"It suggests that there is an over reliance on pharmacological treatment and it also suggests that psychiatry in general has ignored the content and meaning of events such as hallucinatory experiences and that they may well be related to earlier traumas."

Professor Shevlin said that a lot of research that supports pharmacological treatment tends just to focus on its effect in the reduction of symptoms. “This research finds that drug treatments can reduce the intensity or frequency of hallucinatory experiences but that doesn’t necessarily mean that the person starts to get on better with their life or can make friends or go out to work.

Psychological treatments tend to have better outcomes for the individual in terms of them integrating to society and feeling better about themselves.” Professor Shevlin’s lecture was entitled “Modelling Madness: Population Based Analyses of Adversity and Psychosis”.

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[Article of Interest] Link Between Creativity and Mental Illness Confirmed in Large-Scale Swedish Study
ScienceDaily (Oct. 16, 2012)
Excerpt: People in creative professions are treated more often for mental illness than the general population, there being a particularly salient connection between writing and schizophrenia. This according to researchers at Karolinska Institutet, whose large-scale Swedish registry study is the most comprehensive ever in its field.
The present study tracked almost 1.2 million patients and their relatives, identified down to second-cousin level. Since all were matched with healthy controls, the study incorporated much of the Swedish population from the most recent decades. All data was anonymized and cannot be linked to any individuals.
The results confirmed those of their previous study, that certain mental illness — bipolar disorder — is more prevalent in the entire group of people with artistic or scientific professions, such as dancers, researchers, photographers and authors. Authors also specifically were more common among most of the other psychiatric diseases (including schizophrenia, depression, anxiety syndrome and substance abuse) and were almost 50 per cent more likely to commit suicide than the general population.
“If one takes the view that certain phenomena associated with the patient’s illness are beneficial, it opens the way for a new approach to treatment,” [Simon Kyaga, Consultant in psychiatry and Doctoral Student at the Department of Medical Epidemiology and Biostatistics] says. “In that case, the doctor and patient must come to an agreement on what is to be treated, and at what cost. In psychiatry and medicine generally there has been a tradition to see the disease in black-and-white terms and to endeavour to treat the patient by removing everything regarded as morbid.”

[Article of Interest] Link Between Creativity and Mental Illness Confirmed in Large-Scale Swedish Study

ScienceDaily (Oct. 16, 2012)

Excerpt: People in creative professions are treated more often for mental illness than the general population, there being a particularly salient connection between writing and schizophrenia. This according to researchers at Karolinska Institutet, whose large-scale Swedish registry study is the most comprehensive ever in its field.

The present study tracked almost 1.2 million patients and their relatives, identified down to second-cousin level. Since all were matched with healthy controls, the study incorporated much of the Swedish population from the most recent decades. All data was anonymized and cannot be linked to any individuals.

The results confirmed those of their previous study, that certain mental illness — bipolar disorder — is more prevalent in the entire group of people with artistic or scientific professions, such as dancers, researchers, photographers and authors. Authors also specifically were more common among most of the other psychiatric diseases (including schizophrenia, depression, anxiety syndrome and substance abuse) and were almost 50 per cent more likely to commit suicide than the general population.

If one takes the view that certain phenomena associated with the patient’s illness are beneficial, it opens the way for a new approach to treatment,” [Simon Kyaga, Consultant in psychiatry and Doctoral Student at the Department of Medical Epidemiology and Biostatistics] says. “In that case, the doctor and patient must come to an agreement on what is to be treated, and at what cost. In psychiatry and medicine generally there has been a tradition to see the disease in black-and-white terms and to endeavour to treat the patient by removing everything regarded as morbid.”

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[Article of Interest] A Call for Caution on Antipsychotic Drugs
By Richard A. Friedman, M. D.
[Excerpts] You will never guess what the fifth and sixth best-selling prescription drugs are in the United States, so I’ll just tell you: Abilify and Seroquel, two powerful antipsychotics. In 2011 alone, they and other antipsychotic drugs were prescribed to 3.1 million Americans at a cost of $18.2 billion, a 13 percent increase over the previous year, according to the market research firm IMS Health.
Those drugs are used to treat such serious psychiatric disorders as schizophrenia, bipolar disorder and severe major depression. But the rates of these disorders have been stable in the adult population for years. So how did these and other antipsychotics get to be so popular?
It was also soon discovered that the second-generation antipsychotic drugs had serious side effects of their own, namely a risk of increased blood sugar, elevated lipids and cholesterol, and weight gain. They can also cause a potentially irreversible movement disorder called tardive dyskinesia, though the risk is thought to be significantly lower than with the older antipsychotic drugs.
The original target population for these drugs, patients with schizophrenia and bipolar disorder, is actually quite small: The lifetime prevalence of schizophrenia is 1 percent, and that of bipolar disorder is around 1.5 percent. Drug companies have had a powerful economic incentive to explore other psychiatric uses and target populations for the newer antipsychotic drugs.
There is little in these alluring advertisements to indicate that these are not simple antidepressants but powerful antipsychotics. A depressed female cartoon character says that before she starting taking Abilify, she was taking an antidepressant but still feeling down. Then, she says, her doctor suggested adding Abilify to her antidepressant, and, voilà, the gloom lifted.
The ad omits critical facts about depression that consumers would surely want to know. If a patient has not gotten better on an antidepressant, for instance, just taking it for a longer time or taking a higher dose could be very effective. There is also very strong evidence that adding a second antidepressant from a different chemical class is an effective and cheaper strategy — without having to resort to antipsychotic medication.
Atypical antipsychotics can be lifesaving for people who have schizophrenia, bipolar disorder or severe depression. But patients should think twice — and then some — before using these drugs to deal with the low-grade unhappiness, anxiety and insomnia that comes with modern life.

[Article of Interest] A Call for Caution on Antipsychotic Drugs

By Richard A. Friedman, M. D.

[Excerpts] You will never guess what the fifth and sixth best-selling prescription drugs are in the United States, so I’ll just tell you: Abilify and Seroquel, two powerful antipsychotics. In 2011 alone, they and other antipsychotic drugs were prescribed to 3.1 million Americans at a cost of $18.2 billion, a 13 percent increase over the previous year, according to the market research firm IMS Health.

Those drugs are used to treat such serious psychiatric disorders as schizophrenia, bipolar disorder and severe major depression. But the rates of these disorders have been stable in the adult population for years. So how did these and other antipsychotics get to be so popular?

It was also soon discovered that the second-generation antipsychotic drugs had serious side effects of their own, namely a risk of increased blood sugar, elevated lipids and cholesterol, and weight gain. They can also cause a potentially irreversible movement disorder called tardive dyskinesia, though the risk is thought to be significantly lower than with the older antipsychotic drugs.

The original target population for these drugs, patients with schizophrenia and bipolar disorder, is actually quite small: The lifetime prevalence of schizophrenia is 1 percent, and that of bipolar disorder is around 1.5 percent. Drug companies have had a powerful economic incentive to explore other psychiatric uses and target populations for the newer antipsychotic drugs.

There is little in these alluring advertisements to indicate that these are not simple antidepressants but powerful antipsychotics. A depressed female cartoon character says that before she starting taking Abilify, she was taking an antidepressant but still feeling down. Then, she says, her doctor suggested adding Abilify to her antidepressant, and, voilà, the gloom lifted.

The ad omits critical facts about depression that consumers would surely want to know. If a patient has not gotten better on an antidepressant, for instance, just taking it for a longer time or taking a higher dose could be very effective. There is also very strong evidence that adding a second antidepressant from a different chemical class is an effective and cheaper strategy — without having to resort to antipsychotic medication.

Atypical antipsychotics can be lifesaving for people who have schizophrenia, bipolar disorder or severe depression. But patients should think twice — and then some — before using these drugs to deal with the low-grade unhappiness, anxiety and insomnia that comes with modern life.

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[Article of Interest]     The heroines journey: A young woman finds her way through her psychosis with the help of Jung and Campbell’s literature alone
By “Mary in SC”
Excerpt: I woke up one morning to find I was experiencing something very strange.   My brain seemed to have taken on a life of its own, throwing out ideas and associations like an erupting volcano.  I was still in touch with the real world and functioning normally, even fixing breakfast and carrying on a conversation with my husband and managing the children, but the strange world back behind my eyes was becoming increasingly real and demanding.  At first I was startled but then excited and even pleased: finally I was experiencing myself some of the things I had been reading about!   But as the hours went by the erupting ideas set off increasingly alien trains of thought until I was transfixed with horror, frightened almost out of my wits.  My collective unconscious, or whatever you call it, spewed out of the volcano in my brain and unmistakably informed me that the daylight world I lived in was nothing but a sham reality, a flimsy product of human imagination that could be snuffed out in an instant when a mere human glimpsed its source.  My fragile consciousness was approaching that source like a doomed moth drawn to a flame.
[…]
After a very few days of this kind of thing, I reached the limits of my endurance.  I was lying in bed one night, my husband holding my hand and bending over me, worried and helpless.  I surfaced enough to tell him that my problems were all in my mind, and I knew it, but I just couldn’t get away from them.  Finally I gave up and did the one last thing I could do, even if it meant waking up in a psychiatric ward the next day.   Our family doctor was a kind young man.  He was used to dealing with suffering people, and he was good at it.  Call the doctor, I gasped.  Please call him.  Tell him I need a shot to knock me out.  I can’t take this anymore.  Please call him.
[…]
Then I remembered something Jung wrote about the sacred marriage that was part of the symbolism of individuation.  Yes.  A sacred marriage, one that was ordinarily impossible or forbidden.  Between a god and a human, like the Greek and Roman and Christian mythologies.   Between a brother and sister, like the Egyptians.  Or between father and daughter, between me and my primary symbol of godlike authority and tradition.   A sacred marriage that would produce the sacred child, the infant Redeemer.  Here, in this dream, was the beginning of the reconciliation between the conscious and unconscious mind, between the rational and the irrational, the opposites that had to join as one.  My plan was working after all.  I was on the way to becoming a whole and individuated human being!

[Article of Interest]    
The heroines journey: A young woman finds her way through her psychosis with the help of Jung and Campbell’s literature alone

By “Mary in SC”

Excerpt: I woke up one morning to find I was experiencing something very strange.   My brain seemed to have taken on a life of its own, throwing out ideas and associations like an erupting volcano.  I was still in touch with the real world and functioning normally, even fixing breakfast and carrying on a conversation with my husband and managing the children, but the strange world back behind my eyes was becoming increasingly real and demanding.  At first I was startled but then excited and even pleased: finally I was experiencing myself some of the things I had been reading about!   But as the hours went by the erupting ideas set off increasingly alien trains of thought until I was transfixed with horror, frightened almost out of my wits.  My collective unconscious, or whatever you call it, spewed out of the volcano in my brain and unmistakably informed me that the daylight world I lived in was nothing but a sham reality, a flimsy product of human imagination that could be snuffed out in an instant when a mere human glimpsed its source.  My fragile consciousness was approaching that source like a doomed moth drawn to a flame.

[…]

After a very few days of this kind of thing, I reached the limits of my endurance.  I was lying in bed one night, my husband holding my hand and bending over me, worried and helpless.  I surfaced enough to tell him that my problems were all in my mind, and I knew it, but I just couldn’t get away from them.  Finally I gave up and did the one last thing I could do, even if it meant waking up in a psychiatric ward the next day.   Our family doctor was a kind young man.  He was used to dealing with suffering people, and he was good at it.  Call the doctor, I gasped.  Please call him.  Tell him I need a shot to knock me out.  I can’t take this anymore.  Please call him.

[…]

Then I remembered something Jung wrote about the sacred marriage that was part of the symbolism of individuation.  Yes.  A sacred marriage, one that was ordinarily impossible or forbidden.  Between a god and a human, like the Greek and Roman and Christian mythologies.   Between a brother and sister, like the Egyptians.  Or between father and daughter, between me and my primary symbol of godlike authority and tradition.   A sacred marriage that would produce the sacred child, the infant Redeemer.  Here, in this dream, was the beginning of the reconciliation between the conscious and unconscious mind, between the rational and the irrational, the opposites that had to join as one.  My plan was working after all.  I was on the way to becoming a whole and individuated human being!

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[Video of Interest] A Little Insight

Young people from the Voice Collective came together to create this stigma busting animation. The film will be used in schools and online to educate people about hearing voices and to break down barriers between young people.

From the description: Hearing voices that others around you don’t hear is much more common than most people think. This animation was created by a group of 5 young people who hear voices (aged between 13 and 18) in a bid to raise awareness of the experience in schools, and challenge stigma.

As one young person pointed out - when someone comes back to school with a broken arm, everyone crowds around to sign their cast. When someone’s struggling with hearing voices they tend to back off, unsure what to say or do. Why is there a difference?

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[Article of Interest] It’s Not Just the Drugs; Misinformation Used to Push Drugs Can Also Make Mental Problems Worse
By Ron Unger
Excerpt: When people are convinced their problems are biochemical, they are also less likely to explore the problem with others or with a therapist.  And when a therapist is convinced that his or her client’s problem is “biochemical” then that therapist is likely to focus on sending the client in for a “medication check” rather than looking deeper into what may be going on.  (“Biochemcal imbalance” theories are also great for explaining away any failures of understanding on the part of therapists!)
If people are going to understand themselves and work through emotional problems, it is essential that they get curious about their experiences and reflect on what might be triggering them.  Sometimes such curiosity or reflection results in getting valuable messages from those experiences, or at other times, it involves identifying a mistake that triggered the emotional experience, which then allows for resolution.  To use the simple example of the threat perceived from the firearm, one might either take quick action to avoid being shot, or in another situation perhaps observe more carefully and notice a movie is being filmed and that the firearm being pointed is just a prop.
Of course, experiences like anxiety and depression often have their sources in much more complex experiences, and so more complex reflection is necessary to sort out what actions to take or what interpretations to revise.  We live though in a society that does not like complexities or deep reflection, so we already have a bias toward thinking that disturbing emotions that don’t quickly make sense must just be something wrong with us.  This bias makes us think we “shouldn’t have” disturbing emotional states, so we tend to push them away or dissociate from them, which just makes it more difficult for us ever to understand their sources and decide what to do about them.
Those who market psychiatric drugs take advantage of this cultural bias to offer a seductive pseudo explanation, which is that unwanted emotional states that aren’t easily resolved must be the result of a “biochemical imbalance” or some other biological problem.   Our culture has become heavily influenced by this viewpoint, to the point where it seems the majority believe that seriously disturbing emotional states lacking easy explanations must be caused by a fault in biochemistry, rather than being something that can be potentially understood and resolved.
The sad result of this marketing effort has been to dramatically aggravate a cultural tendency to avoid deeply listening to each other, or even to ourselves.  Any mental or emotional problem which does not rapidly resolve must be “biochemical” and not worth even trying to understand; instead we should be trying to drug it away.

[Article of Interest] It’s Not Just the Drugs; Misinformation Used to Push Drugs Can Also Make Mental Problems Worse

By Ron Unger

Excerpt: When people are convinced their problems are biochemical, they are also less likely to explore the problem with others or with a therapist.  And when a therapist is convinced that his or her client’s problem is “biochemical” then that therapist is likely to focus on sending the client in for a “medication check” rather than looking deeper into what may be going on.  (“Biochemcal imbalance” theories are also great for explaining away any failures of understanding on the part of therapists!)

If people are going to understand themselves and work through emotional problems, it is essential that they get curious about their experiences and reflect on what might be triggering them.  Sometimes such curiosity or reflection results in getting valuable messages from those experiences, or at other times, it involves identifying a mistake that triggered the emotional experience, which then allows for resolution.  To use the simple example of the threat perceived from the firearm, one might either take quick action to avoid being shot, or in another situation perhaps observe more carefully and notice a movie is being filmed and that the firearm being pointed is just a prop.

Of course, experiences like anxiety and depression often have their sources in much more complex experiences, and so more complex reflection is necessary to sort out what actions to take or what interpretations to revise.  We live though in a society that does not like complexities or deep reflection, so we already have a bias toward thinking that disturbing emotions that don’t quickly make sense must just be something wrong with us.  This bias makes us think we “shouldn’t have” disturbing emotional states, so we tend to push them away or dissociate from them, which just makes it more difficult for us ever to understand their sources and decide what to do about them.

Those who market psychiatric drugs take advantage of this cultural bias to offer a seductive pseudo explanation, which is that unwanted emotional states that aren’t easily resolved must be the result of a “biochemical imbalance” or some other biological problem.   Our culture has become heavily influenced by this viewpoint, to the point where it seems the majority believe that seriously disturbing emotional states lacking easy explanations must be caused by a fault in biochemistry, rather than being something that can be potentially understood and resolved.

The sad result of this marketing effort has been to dramatically aggravate a cultural tendency to avoid deeply listening to each other, or even to ourselves.  Any mental or emotional problem which does not rapidly resolve must be “biochemical” and not worth even trying to understand; instead we should be trying to drug it away.

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[Article of Interest] Vivid Hallucinations From a Fragile LifeYayoi Kusama at Whitney Museum of American ArtAs any account of that career will tell you, including those Ms. Kusama gives, crisis mode was the source of her art. She was born in the city of Matsumoto, a few hundred miles northwest of Tokyo, to an affluent family that owned a large plant nursery and seed farm. Her father, by her account, was distant, cool and a serial philanderer; her mother, embittered by marriage, was perversely abusive.For whatever reason, she had hallucinations from a young age. She claimed that flowers spoke to her; that fabric patterns came to life, multiplied endlessly and threatened to engulf and expunge her. These neurotic fears were compounded by the grueling realities of World War II, when she was in her teens and had begun drawing and painting with ferocious concentration, clinging to art as a lifeline.Her grip on it was more than firm: it was unrelenting and propulsive. With a boldness unusual in a young woman of her day, she left home, under a cloud of disapproval, for art school in Kyoto. There she customized academic styles to her own subversive ends. In the show’s earliest painting, “Lingering Dream” from 1949, she translates the traditional theme of a floral still life into a nightmare of withered limbs and vaginas dentata set in a blasted landscape.

[Article of Interest] Vivid Hallucinations From a Fragile Life
Yayoi Kusama at Whitney Museum of American Art

As any account of that career will tell you, including those Ms. Kusama gives, crisis mode was the source of her art. She was born in the city of Matsumoto, a few hundred miles northwest of Tokyo, to an affluent family that owned a large plant nursery and seed farm. Her father, by her account, was distant, cool and a serial philanderer; her mother, embittered by marriage, was perversely abusive.
For whatever reason, she had hallucinations from a young age. She claimed that flowers spoke to her; that fabric patterns came to life, multiplied endlessly and threatened to engulf and expunge her. These neurotic fears were compounded by the grueling realities of World War II, when she was in her teens and had begun drawing and painting with ferocious concentration, clinging to art as a lifeline.
Her grip on it was more than firm: it was unrelenting and propulsive. With a boldness unusual in a young woman of her day, she left home, under a cloud of disapproval, for art school in Kyoto. There she customized academic styles to her own subversive ends. In the show’s earliest painting, “Lingering Dream” from 1949, she translates the traditional theme of a floral still life into a nightmare of withered limbs and vaginas dentata set in a blasted landscape.

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