#do you know what its like to get so socially anxious it's delusional or psychotic?

[mephorash]

I want to let the social anxiety win and disappear sometimes. Some more than others

[kindergarchy]

A Philosopher’s Madness by Lishan Chan Finished this slim volume on my way back to Singapore. Unlike accounts on anxiety which in their nature are anxiety-inducing (like Smith’s Monkey Mind), Chan’s A Philosopher’s Madness is not something that upon reading, will make you go crazy. It’s unapologetically calm in describing the state of crazy, in which you are out of touch with reality. Her language reminds me of my writing for philosophy modules in uni - squeaky clean, precise, almost clinical, without any need for garnish or embellishments. Lishan Chan studied politics and subsequently philosophy in UK. Upon returning to Singapore, she took up a research scholarship program offered by NUS in philosophy. The book aims to explore the possible relationship between philosophizing and her psychotic episode, just like how many have tried to connect existentialism with depression. I have read probably quite a considerable number of accounts on depression and anxiety, which are more common. It is very easy to fall on a spectrum when it comes to depression/anxiety, and this has a few consequences: 1) You don’t always have to label them as a mental illness 2) It doesn’t have to be a diagnosis/condition that you have to carry with you throughout your life 3) People might understand, relate, and say that it’s just a human response to a number of stressors in your life 4) People think that it is a testament to your lack of life skills, and this can be improved over time, and coming out of the rut of anxiety/depression, you’ll come out stronger 5) It will all pass (“tough times don’t last, tough people do”) 6) You pose no danger to anyone. Number 2 means that, when you are filling in a job or school application form, you don’t have to tick the history of mental illness column. It’s pretty hard to get your schizophrenic episode go by undetected, it’s easier with depressive or anxious episodes, unless in severe cases. Number 3 means that there is a fair amount of understanding for depression or anxiety. Number 4 means that, in the long run, the experience is somehow good for you. Number 6 means that you probably realize that depression and anxiety don’t have to be contagious, and the worst case scenarios are self-harm and self-sabotaging (whose consequences might bleed into other people’s lives, but it’s more likely for the sufferer to hurt herself than she to hurt others). But when you have to face the mad, you don’t know what the worst case scenario is - simply because you don’t understand why, and how, they do what they do. Everything seems possible. In normal cases, my previous sentence is motivational, in this case, not so much. It goes to show that the discomfort you experience in the presence of the mad, stems from a complete absence of understanding. It makes you wonder, are they the truly mad ones - or are you? Maybe you see yourself, your occasional nervous tics reflected in them, only tuned a few decimals louder in terms of intensity and frequency. It’s like holding a hazy mirror. You don’t want to think about this, in case understanding breeds empathy, and empathy leads you down to the path of metamorphosis - so you avoid seeking an explanation even more fervently. It’s a vicious cycle. So we see that, without ignoring the existing social stigma attached to depression and anxiety, we can safely say that schizophrenia does not get to enjoy the same amount of social sanction reduction in comparison. We call anxiety/depression patients the depressed, the stressed out, the melancholic ones. We call the schizophrenic mad, crazy, shen jing bing. This is because, I think, you can fairly reason with the anxious. Schizophrenia completely reverses and fragments your thought process - it does not start as a matter of obsessions with worries or a shift in focus. Perhaps I should blame Descartes. As a result of taking his advice in Meditations to ‘doubt as much as you can’, I attempted to do exactly that; doubt as much as I could. I questioned every statement, challenged every perception. It was the beginning of a relentless road to mental illness. You turn not just the value of truth, but also the approach to truth upside down. Inevitably, your trust in the world erodes - all that make up the world that we live in - other people, social roles, belief systems, the way the world is run. If you take thinking to its extreme, I think you can see how shaky all mechanisms we base our judgment of truth on are. Funnily enough, I think, the schizophrenics doubt everything but themselves. But should they? Does psychosis automatically render their experience invalid, once they come out of it? But the things that make sense to me when I am unwell make sense to no one else. This is what it means to be out of touch with reality. Today, I still wonder what it all means. If I had been brought to God through a period of madness rather than because of suffering and madness, would it follow that my current belief in God is delusional? If I were mad and had a religious experience, does it count as a genuine religious experience? Chan mentions at least three times in the book that she still “fears relapse”. I read a recent article on her by T Singapore a few days ago and news has it that she has not had any relapse for the past 10 years. During remission, ex-patients like Chan usually have to disseminate a relapse plan to their closest, because when you are mad, you don’t realize that you are mad. You need an observer to be there to realize that you are mad, a little bit like Schrodinger’s cat problem, or maybe a tree falling in the forest would make a better analogy. So if you don’t have an observer to say to you that you are mad, are you still mad? This leads to the gray categorization of the schizophrenia, stated in the book: Who is right? Is psychosis a mental condition or a physical condition? Is psychosis a sickness or a ‘condition’? (...) I summarize what I see as the possible positions as follows: - If psychosis is a physical disease, then the chemicals in the brain or a particular brain structure are identified with the experience of psychosis (extreme stress resulting in delusions). - If psychosis is a physical condition, then stress (for instance) is a physical rather than a mental entity. Chemicals in the brain or brain structure are not identified with the experience of psychosis, although we might recognize that there are patterns or correspondence between the two. - If psychosis is a mental disease, then psychosis would as a consequence be a mental disorder. A theory of psychosis would involve explaining the experience of beliefs that are false. The word ‘disease’ emphasizes the absence of wellness. The brain takes back stage here. - If psychosis is a mental condition, then there is no disorder or absence of wellness. Rather, experience of psychosis is simply a different and aberrant experience, one that can be explained with recourse to the individual’s perceptions and state of mind. It’s probably never one or the other. Now, no account on mental illness is complete without mentioning its undeniable correlation with creativity: This raises a question - is creativity and productivity in the arts somehow linked to emotional turmoil or unstable mental states? If so, are we losing something valuable to society by medicating anyone who shows evidence of unstable mental illness? Something that I can’t help but question though, can be found in the middle of this paragraph: Secondly, chemical imbalance might well be a parallel event alongside the conscious experience of mental illness without a necessarily causal relationship. It is commonplace scientific practice to equate correlation with causation, but philosophically speaking, there is a gap which needs to be acknowledged. As far as I’m concerned…. conflating correlation with causation is cardinal sin in any field of science. It’s fallacy. Lastly one fascinating yet slightly worrying part of the book is the appendix. This consists of Chan’s “thoughts at various stages of (her) illness.” Fascinating and slightly worrying because I think a lot of it actually make sense? E.g. Truth can only be found by slowly thinking through things. If you wish to be the sort of person who finds the truth, be prepared to accept the consequences. A person who finds the truth, or a person who is at least aware of the truth, is a person who refuses to join in the pretense. People who refuse to join in the pretense must lose the game. But have they really lost, if they fall out of the game? Have they really lost, if they move out of the periphery of the game? Without pretense, reality becomes clearer to one’s line of vision. Without pretense, it is possible to detach oneself from the various games that people play. Without pretense, it is possible to become an observer, as opposed to a spectator. One might argue that this is impossible, for there is at least one perspective that is detached observer cannot escape. This perspective is the perspective of the detached observer. To be a detached observer of yourself being a detached observer seems to lead to an infinite regress? What does it amount to? Personally, I think, if the most arduous pursuit of truth costs one’s mind, I would rather keep my mind please. I hope I’m not choosing ignorance when I say that sometimes… it gets tiring and the end justifies the means

[neverarguewithadelusion-blog]

to drop off the earth

I don’t know how to go about explaining things, why I am where I am, why I do what I do.. why I had to give my life over to another person 24/7 - so being at a loss, I’ve used “grabs” from other explanatory sites in the hope that they speak for me and somehow explain my new life.

“Living with someone who suffers from schizophrenia, prone to paranoid delusions, delusions of grandeur, psychosis and both obsessive and impulsive behaviours - even when the condition is at its calmest, stress situations trigger it. Situations such as being out of routine, to situations such as being around new people…”

…to be, in effect, a caretaker of this person, tasked every day to keep a schizophrenic stable, where even when medicated, there are outbursts, and rant attacks that can continue on and off for days” As an extension to the schizophrenia, l have learnt to deal with, and accept, the consequent disconnects, the loss of friendships, alienation and isolation. There are many, many bright spots but in the long run, many opportunities which present themselves in life are to be destroyed because of it.

“For partners of the mentally ill, they may find themselves not only in the role of primary caretaker, but primary parent and primary breadwinner as well. This is an enormous and stressful burden, and it can seem to the well partner that there are few options in the way of emotional or financial support.

So many partners are forced into choosing between their own physical and mental well-being, and that of their loved one. Guilt, self-blame, and self-imposed obligation to care for the ill partner leaves them in a situation where they sacrifice and ignore all their own needs, running the risk of physical and emotional burnout.

The well partner must establish personal limits - what behaviour is and is not acceptable. Although schizophrenia causes people to behave in ways that are not normal to their character, the well partner must recognize which behaviours are symptoms of the illness, and which are by-products of the illness (emotional stress, shame, denial, etc) and/or honest-to-god character traits. Even some behaviours that may be a symptom of the illness are unacceptable under any circumstances (these include: physical abuse, mental abuse, destructive/harmful behaviour to self, others, or property, financial mismanagement, extreme emotional abuse, or criminal actions). Your partner may not have control over his symptoms, but he can control his own reactions to them. This means they should be committed to staying in a treatment program that works, and committed to working with you as their partner to find reasonable solutions to problem behaviours.

Primary caretakers of the mentally ill must find other outlets and support for themselves - through therapy, support groups, social or community activities - to avoid becoming completely overwhelmed by their loved one's sickness. In Victoria Secunda's book When Madness Comes Home, she states: "Virtually all of the partners of the mentally ill I have interviewed have had to construct parallel lives to find a sense of emotional gratification and respite from the strain of caregiving."

“Never argue with a delusion,” one of my mentors often said. Paranoid people are fragile and ill, in the sense that they are out of touch with reality. However, they can become terrifying if fantasy turns to action. The need to retaliate against imagined assaults combined with intact “executive function” (the ability to think and plan) leads to aggressive behaviours and schemes. Caretakers, innocent people, are accused and besmirched, are traumatized”.

·         Delusions - paranoid beliefs that are not consistent with reality and that the sufferer maintains as being true despite all evidence to the contrary. Examples? That the person is being controlled, their minds read, being plotted against; it’s as if the person is losing touch with all reality. Some even exhibit the belief that they are someone else.

·         Hallucinations - hearing voices and seeing things that aren’t actually there. These are sensory experiences that the person experiences, that have no basis in reality. Hearing of voices is the most common hallucination and can be internal (coming from their own mind) or external (coming from someone else). The voices may talk to the person and instruct them on their behaviour, commanding them to engage in certain acts. The voices can also talk to each other. This is where the notion of ‘split personality’ has been confused with schizophrenia, in the past.

·         Disorganized thinking - strange, delusional ideas and thoughts, which make it difficult to carry on a simple conversation. The thoughts don’t follow a logical sequence, or at least, not logical to those around the person suffering from schizophrenia. They may also stop speaking entirely, mid-thought, or invent words and a language of their own.

…it is these positive symptoms that cause the most distress and dysfunction for a person coping with a spouse who has schizophrenia.

“It is not uncommon for people with schizophrenia to be reluctant to get help or take medication, as part of their treatment. In fact, the notion of treatment plays right into the paranoid delusions of many schizophrenics: that they are being controlled by someone, that they are being harassed. Alternatively, many believe that they don’t require treatment because the voices and conspiracies that they are anxious about are real to them, and not related to any delusion whatsoever.

Your concern, first and foremost, has to be your safety. If your spouse is refusing treatment and is being overcome by psychotic episodes, they risk becoming violent. In that case, you will need to call in a crisis team or the police to help you deal with the situation. Thankfully, violent behaviour is not a hallmark of schizophrenia: if anything, a person suffering from the disorder is more likely to harm themselves than anyone else. But physical violence is only one concern.

Verbal and emotional abuse, property destruction (example, punching holes in walls), creating hazards such as the setting of fires, substance abuse, despotic behaviour (example, not letting people in the home use the phone) are all possible behaviours that fall within the scope of schizophrenia but which, at the risk of harm to yourself, cannot be tolerated. It creates a ‘walking on eggshells’ environment you become afraid to do something that will trigger an outburst; an exhausting and debilitating way of life for those who surround the sufferer”.

Encouraging your spouse to seek treatment involves different techniques, including providing options that give your spouse a measure of control. For example, offer them the option of being accompanied to the appointment by someone other than yourself, if they are suspicious of your motives (paranoid delusion).

Once they accept their diagnosis, you can play a strong role in ensuring that they remain involved in their treatment plan.

If your schizophrenic spouse says things that are clearly false but which they believe wholeheartedly, communication has to remain positive. You don’t need to go along with what they are saying, perpetuating their delusion, but you should also not state that they are wrong or, worse, deluded. It’s best to frame a positive statement along the lines that every person has the right to believe what they want, and it’s okay for people to have different points of view.

Prepare for a crisis.

The important thing to remember in a crisis is to act to defuse it, not inflame it. Limiting visual distractions, noise, contact with other people (ask guests to leave, for example) are all important steps in calming the situation. Don’t engage your spouse’s behaviour directly but instead do everything you can to bring a sense of calm to the environment.

Don’t argue with delusions: you won’t win.

“A key to dealing with your schizophrenic spouse is to accept the disorder and educate yourself on it. You cannot argue with it. You cannot reason with it. There is no value in expressing anger or irritation when your spouse is dealing with their symptoms. It will not help you or them. Remember that you are dealing with their illness, not them.”

You need to recognize what you can and can’t do in dealing with your spouse and their illness. Respite care is an option for situations where the spouse is not able to be left alone and it’s an important one to consider, as a primary caregiver. You cannot possibly help your spouse or be present and available for the rest of your family and friends if you are exhausted to the point of a breakdown.

Find support where you can, which might be a group of spouses of schizophrenia sufferers. Your shared experiences and the ability to talk about your situation freely, without fear of judgement, is invaluable to your own self care. Despite the limitations that schizophrenia can pose on your life, you have to take care to try and keep up relationships with family and friends. They are a comfort and a link to a world that doesn’t include mental illness, which can in and of itself, create the respite you need.

Ensure that you take other steps in self care including eating properly, getting rest and exercise. It’s perhaps easy to say, but ultimately, your life cannot be subsumed by the illness that your spouse is suffering. You need to make sure that you have a life too.

Schizophrenia can make it feel like there’s a lot more take than give but it’s important to always remember that your spouse is not their illness. They are a person who needs love and care, just as you do.

“Don’t be afraid, don’t put up a defense against us, don’t brace yourself for something bad. Be there to talk and support. It may not be pleasant, personally I can be downright mean when in a bad frame of mind. But you’ll both be glad you were there.”

Listen attentively and laugh as often as you can — we often hear when people are speaking but are we always listening? There’s a difference. Often, that is all a person who is suffering needs: to know that someone is listening to them. Not making suggestions, not always trying to fix things. Just being there.

Develop coping mechanisms and rules — find ways to cope with the results of the symptoms. For example, if your spouse tends to go on spending sprees while in a manic episode, you might need to keep hold of the credit cards. If their driving becomes erratic or overly aggressive, it’s time to keep hold of the car keys. Establishing some rules when they are in a calm state can help you both deal with the times when the disorder takes over. Part of these processes needs to be planning for an emergency. If your spouse’s behaviour suddenly becomes unmanageable, even life threatening, you need to have a plan in place: who to call, after hours numbers, which hospital to go to and so on. Scrambling for this information in the middle of a crisis will only aggravate the situation, so like the boy scouts say: be prepared!

I love this man. When he is good, he is GOLDEN.

I still, on top of this, work a 40 hour week in Property Law as Personal Assistant/Conveyancing Support Clerk which is BRUTAL.

I have my family back in my life again.

My son turned 18 last week.

I have missed certain opportunities that broke my heart.

I miss the fuck out of all my friends.

I MISS THE FUCK OUT OF ALL MY FRIENDS.

So if you are reading this, please know that I think about you all the time. I wonder how you guys are and what you’re doing. I wish I was there.