#i was diagnosed with both psychosis and schizophrenia when i was 15

[phantomswolf]

psychosis is such a double edged sword. i feel bad coz like. yeah it sucks absolute wild hog balls sometimes, but i really can’t imagine a world where i wasn’t afflicted by the Curse

[ooppo]

National Bipolar Awareness day - March 30th.

I remember the first time I had a auditory hallucination (that I was aware of) was when I was, like, 15~ years old and I was sitting in my bed reading fanfiction. It was 7 at night when I heard the sound of these musical instruments being knocked together at a steady beat:

I started to look around really, really confused because like where the fuck is this sound even coming from? It sounded like it was being played right near me. So I was looking around until I found the source of the wooden knocking, which was from my stomach. Once I found the source the rhythmic knocking slowly faded until it was silent. Before this incident I had several visual hallucinations of spiders and bugs that weren't there but I attributed that to being tired (after a Google search of 'tired hallucinations') so when faced with this very loud new hallucination at 7PM when I was feeling awake, I told myself "oh. I must be tired." And went to sleep.

Moral of the story is that your brain will downplay the signs of serious mental disorders if you aren't educated in what they are. I think everyone should learn the signs of what mental illnesses look like just so they can help themselves or others. I went undiagnosed for seven years and my father went undiagnosed for nearly 50. The signs were there and obvious to both us and outsiders, but due to a lack of information that could have been cleared up by a simple search of 'bipolar symptoms' 'what are delusions' 'what kinds of hallucinations are there' these symptoms were overlooked.

Serious mental illnesses like bipolar/schizophrenia aren't as uncommon as you think. Here are some popular actors/celebrities who have been diagnosed with bipolar disorder (ones that are open about it):

I don't want to post a ton of links here so you can Google "celebrity name bipolar disorder" if you'd like to. Historically influential people with a suspected bipolar disorder diagnosis are Virginia Woolf, Vincent Van Gogh, and Edgar Allen Poe.

With national bipolar awareness day coming up (March 30th which is also Van Gogh's birthday) I wanted to post something for it.

So please learn the signs of mental illness for your sake and others. Bipolar disorder is as common as autism. They are both 1 in 100. Schizophrenia is 1 in 300. Ocd is also 1 in 100. Here are some helpful articles about the signs of these illnesses:

Bipolar

Schizophrenia

Ocd

Schizoaffective

Your mentally ill siblings aren't scary boogyman, they are mothers, teachers, artists, lovers, poet's, garbage men, deli workers, etc. They are people.

I remember when my father was diagnosed after me, he told me: "All my life people would ask me, 'what the fuck is wrong with you?' and I would always say, 'I don't know'."

You could be the reason why someone gets help.

No one in my fathers or my life knew what bipolar disorder looked like, so we suffered with it for years unknowingly.

I remember when I was learning the signs when I was suspecting my diagnosis, I had learned the signs for schizophrenia as well (since psychosis is a shared symptom between the two illnesses) and when I saw the symptoms of schizophrenia I remembered my old highschool friend who I thought was weird because he talked about how he could get called into the matrix and would go still for long periods of time when he was "transferring" from this world to the matrix world. Now I see that as possible signs of delusions and catatonia. That weird and off putting kid in school could be suffering unknowingly. Your strange uncle who accuses people of stealing his shoes could be suffering. YOU could be suffering and asking yourself why you're so weird/don't fit in/can't keep up.

So please for national disability month and bipolar awareness day learn some of the symptoms for serious disorders because you or a loved one could be suffering from it without knowing. Thank you.

[fakebookreport]

Challenger Deep by Neal Shusterman

Yooooo this book was super good! I cried so many times because it was just so relatable and accurate. This novel is actually YA literature, which I think is important to note. It follows Caden, a 15 yr old boy, through what is basically a psychotic break and leads to him being hospitalized where he is medicated and diagnosed. (It never specifies if he is diagnosed with schizophrenia or schizoaffective disorder. More on this later.) Most of the narration is 1st person, with a few sections in 2nd person, which I thought was a bold, yet necessary move. Each section is only a few pages long; I think the longest one was 3-4 pages and many others are just a page or a page and a half. Each one is also titled, which made for some both ironic and tragic juxtaposition.

The main thing this book relies on is an extended metaphor in which psychosis is likened to a journey or quest on a pirate ship. During the most intense parts of Caden’s psychosis, we find ourselves on a pirate ship where the Captain (in my opinion) represents Caden’s illness. Halfway through the book (or maybe a little farther than that) we begin to see connections to the hospital and external world. For example, a parrot plays heavily into the plot as does a Dr. Pirout. (I’m sure I’m spelling that wrong, but you get what I mean.) Another instance of this: the ship has a masthead/figurehead shaped like a woman named Calliope, who is represented by a fellow patient named Callie who always looks out the window of the hospital. 

As a person who frequently experiences psychosis pretty regularly, this book was a double-edged sword. I’m not going to go into how it affected me personally because this is a (fake) book report, not a diary. What I will say, though, is that because I’ve been in Caden’s shoes (or his ship, so to speak.) I can vouch for how accurate the narration was. Every time Caden got close to achieving what he believed his goal was (usually in order to pacify the captain,) the goal would change. It was only when he began to take medication that he was able to differentiate between psychosis and reality. 

The other thing that this book did really, really well was in how it depicted the chronic nature of schizo-spectrum disorders. When Caden is discharged from the hospital, there is discussion of the uncertainty of his path regarding finishing high school (he was hospitalized for like 9 weeks or so, and missed a lot of school), but there’s also the acknowledgment that relapses happen, that it’s probably not a matter of if, but of when he will find himself back on the pirate ship. Despite that, the novel left me feeling hopeful, that Caden could have a good life despite his illness.

I would highly recommend this novel to anyone who wants to gain a better understanding of what it feels like to develop psychosis. It was very illuminating and showed me, a person with SZA, that there are people out there who get it and seek to help others understand as well.

It’s interesting to note that the author’s son also dealt with psychosis. Many of the son’s drawings are in the novel, and the author’s note in the back says that the novel was inspired partly by that experience.

Other important features to mention: Caden explicitly says at least once that a diagnosis isn’t a one-size-fits-all sort of deal. That’s hugely important, especially for teen lit because (at least in my experience) it’s very easy for mentally ill teens to attribute everything to their illness. I know I did this when I was in high school, and I see posts about it on social media as well. I think it’s important for readers with mental illness (and just ppl in general) to know that a diagnosis doesn’t rewrite your whole story. It also did a good job of showing that medication is more of an art than a science. Caden is on several different medicines before his doc finds the right combo for him. I also loved that he was on a combo, which is the reality for many people on the schizo spectrum. He didn’t magically get better after two days, either. The novel truly exemplified the whole “recovery is not linear,” thing. 

I didn’t like that it portrayed meds as “happy pills,” (yes, that term is in there once or twice) and that it highlighted the negative side effects while not mentioning the obvious: Yes, Seroquel makes you sleepy, but it also helps you not have psychosis. Again, speaking only from personal experience, I know when I was a teen, the idea that medicine was hiding the “real me,” and dulling my creativity, etc., was very prevalent among my peers, and I could have saved myself a lot of trips to the psych hospital if I’d just taken my meds.

Overall, this was a fantastic book, and I’m so glad that there are YA books out there about schizo-spectrum disorders that don’t paint us all as monsters, but as humans.

[honeysuckle-venom]

So I wanted to write a bit about an interesting thing I’m working through that’s kind of a big deal for me.

It’s a long post about DID and psychosis and a new diagnosis, it shouldn’t be triggering but I’m putting it under a cut because it’s long

My whole life I’ve known there was something “wrong” with me. I always seemed to see the world differently from everyone around me. My brain worked very differently. And no one could tell me why. I was given diagnoses of depression, anxiety, bipolar, schizotypal personality disorder, OCD, PTSD. But none of it explained everything.

When I was 19 I started to suspect I might have DID, and I brought it up with my therapist and we talked about it over a long period and eventually she said yes, you do have DID.  It was such a relief to realize that that was what was going on with me. It felt right in a way that past diagnoses hadn’t. It explained so much of what was going on with me. And for a long time I thought it explained everything.

For the past 4 years I’ve thought that my main problem was DID and of course the (C)PTSD that goes with it. And that is a big problem, and it is something I struggle with all the time, and I do have DID.

And in the past few years I’ve made a lot of progress regarding my DID. Oh, there’s plenty of work left to do. But our cooperation and communication are worlds better than they were. And my day to day dissociation levels are much lower than they used to be. And yet despite these improvements, my functioning hasn’t really gotten better.

And I’ve realized (with the help of my therapist) that that’s because a lot of the mental health symptoms that cause me the most trouble in daily life are not related to DID. Many of them are largely related to psychosis. I’d always kind of thought of my psychosis as a minor thing, a side effect that only acted up once every few months. But it plays a much bigger role than I’d been willing to acknowledge.

When I was 15 I had what I had always referred to as a nervous breakdown. And I was talking about this with my therapist, and talking about some of the struggles I still have with psychosis (she’s well aware of all of them) and she brought up schizophrenia. She told me that it sounded like what happened when I was 15 was first episode psychosis, and that I qualify for a diagnosis of schizophrenia. We looked over the symptoms and diagnosis together and I realized that I really do fit the criteria. It’s not “official” bc it’s not written down anywhere, but she told me this week that if I wanted to use the label I could, that I qualify as schizophrenic.

And it was such a relief. It was like the last missing piece finally fell into place. Schizophrenia alone doesn’t account for all of my symptoms. DID alone doesn’t account for all of my symptoms. But together it’s a pretty complete picture. Finally I understand the trouble I have with daily tasks. Finally I understand the underlying terror I experience all the time. Finally I understand my constant delusions and occasional hallucinations. Finally I understand my scrambled thoughts and occasional inability to move or speak, or my words coming out scrambled sometimes. If you add up the symptoms of DID and schizophrenia, that’s what my life looks like. And it feels amazing to finally understand.

It also feels scary. It’s...kind of a serious thing, to be told you’re schizophrenic. It’s something I’m really wrestling with. Of course on one level having the term doesn’t actually change anything, I experience psychosis whether or not it has a diagnosis attached. But...it’s a lot. And I’ve struggled with feeling like I must be faking/like it’s impossible to have both DID and schizophrenia, although today she assured me that that’s not true. And they do feel very different, I can tell the difference, I can tell what symptoms are coming from where because of the...tone, I guess. I don’t know if that makes sense. Anyway, it feels like a really big, really scary, really validating, really confusing thing and I wanted to write about it.

[smokinginsolitude]

Ya do how do you experience Schizoaffective Disorder? if it is bi polar as well as Schizophrenia? Do you have mania?

hi! so sorry. long fucking day, (and LONG post lmfao) my meds aren’t working great, so this is perfect timing i guess haha. i have had schizophrenia since I was a child, I was always told I have a “big imagination” when I was little, but all of my ideas and hallucination and imaginary friends, etc. did not go away when they did for other kids. As I have gotten older, (now 22) my symptoms have worsened and also developed. I can now experience multiple types of hallucination (auditory, visual, tactile), have extreme paranoia, delusional sense of self (usually a sort of god-complex), scrambled thoughts and speech. Around age 15 I was diagnosed at Bipolar Type 1, but I did not tell anyone about my psychosis (besides breaking down crying in front of my family because I needed someone to look in the attic because I believed that a man was living in the attic who was going to come down in the middle of the night and r*pe me, and at some point i told a friend but she was extremely freaked out so I didn’t talk about it anymore). I did not have bipolar swings until around that age. I rapid cycle more than have much longer just manic or just depressed episodes, but will also have both. Mania for me is very physical and fast, cannot stop my body from moving, driving 100+ mph on the freeway, cannot stop talking even if i am alone, and extreme impulsive behaviors (spending money, lotsss of dangerous unsafe sex, self harm, etc.) I also become quite irritable. I cannot take SSRI’s because I will immediately go manic. Depressive episodes hit me differently depending on the intensity, but are also quite physical. In the worst of it, I physically cannot move my body (exact opposite as mania) and feel as if I am caving in completely, barely have thoughts except very negative ones, don’t speak to anyone, don’t take care of myself at all. My affect gets quite low, and many things do not phase me. (while normally I am highly effected by everything around me) I am more likely to self harm during manic episodes or one of my welllll known break downs (a very intense experience for both me and those around me). But while I have these bipolar episodes, I can go multiple weeks with only schizo symptoms without bipolar symptoms, which is what differentiates schizoaffective from bipolar w psychosis. this is just my experience but i hope it helps!!! 

[treatnow]

Op-Ed: Are Marijuana Use and Suicide Linked?

— A review of the data show there's cause for alarm by Libby Stuyt, MD April 23, 2021 Article Link Correlation does not mean causation, but that is why we do research -- to follow correlations in an effort to determine causation. Data linking marijuana use to people with suicidal ideation, attempts, and completed suicides are steadily increasing. Many states, including Colorado, have made post-traumatic stress disorder (PTSD) an approved condition for medical marijuana. As a psychiatrist having treated many people with PTSD, I know that marijuana is not the answer, similarly to why benzodiazepines or alcohol are not the answer to treat PTSD. Sure, these addictive substances work in terms of numbing the person so that they do not experience the symptoms. However, to keep the symptoms at bay, the person must use every day, sometimes all day long. This sets them up for developing cannabis or other substance use disorder and the possibility of psychotic symptoms or worsening psychotic symptoms from their PTSD. A Review of the Data A study of 3,233 veterans in a cross-sectional, multi-site study by the VA found that cannabis use disorder (CUD) was significantly associated with both current suicidal ideation and lifetime suicide attempts compared to veterans with no lifetime history of CUD. The significance persisted even after adjusting for sex, PTSD, depression, alcohol use disorder, non-cannabis drug use disorder, history of childhood sexual abuse, and combat exposure. An observational study of 2,276 veterans treated in VA PTSD treatment programs around the country found that those who never used marijuana had significantly lower symptom severity 4 months after treatment, those who stopped using marijuana had even lower levels of PTSD symptoms, and those who started using marijuana had the highest levels of violent behavior and PTSD symptoms 4 months after treatment. The 2020 National Veteran Suicide Prevention Report indicated that Colorado's rate for veteran suicides is significantly higher than the national rate. There were 217 veteran suicide deaths in Colorado in 2019 -- an all-time high and a 25% increase over 2018. The general population in Colorado has also seen a gradual increase in suicides over the years: - 795 people in 2004 - 919 people in 2009 - 1,021 people in 2012 - 1,063 people in 2014 - 1,242 people in 2018 This trend seems to mirror the increased commercialization of marijuana in Colorado. Toxicology available for suicide deaths demonstrate that in 2004, marijuana was present in 5.5% of the cases. In 2009 it was 7.1%, 11.8% in 2012, and 14.9% in 2014. By 2015, marijuana was present in 19.1% of cases, second only to alcohol, and this trend has continued each year. By 2018, marijuana was present in 22.8% of cases. Another concerning trend is that not all suicides have toxicology reported. In 2004, 92% of suicide cases had toxicology reports, while by 2018, that number fell to 70.6%. Even more alarming is the correlation with marijuana and suicide found among young people, especially adolescents. A large systematic review and meta-analysis of 11 studies and 23,317 adolescents found that suicidal ideation and suicide attempts were significantly higher in adolescent cannabis users than in non-users, with an OR of 3.5 (95% CI 1.53-7.84) for suicide attempts in those using cannabis. The 2019 National Youth Risk Behavior Survey, a cross-sectional, school-based national survey of 13,677 high-school age students found that 50% of those who used marijuana (ever or currently) reported feeling sad or hopeless. It also found that using marijuana (ever) could increase the risk of mental health challenges or suicidal behavior, and trying marijuana before the age of 13 could increase the risk of attempting suicide. In Colorado, marijuana is the most common drug found in toxicology of teens who die by suicide -- even greater than alcohol. In 2018, there were 69 teens ages 15 to 19 who died by suicide. Marijuana was present in 36.7% of the cases, but only 49 of the 69 had toxicology information available. There has been a significant increase in the number of teen suicides in Colorado in the last 5 years, up to 80 in 2019, along with a significant increase in the number with marijuana found in their system. The fact that marijuana is the number one drug found when toxicology is reported correlates with the increased THC potency and availability, and use of concentrates and increase in vaping of marijuana by teens in Colorado. A recent analysis of 204,780 youths (ages 10 to 24) with the diagnosis of mood disorders, based on Ohio Medicaid claims data linked with death certificate data from 2010 to 2017, found that 10.3% received the diagnosis of CUD. This rate is significantly higher than that reported in the general population. In addition, those with CUD were significantly more likely to engage in non-fatal self-harm and to die. Unintentional overdoses, suicide, and homicide were the three most frequent causes of death. A much larger recent study looked at commercial and Medicare Advantage claims for 75,395,344 individuals throughout the country from 2003 to 2017. It found recreational cannabis laws permitting dispensaries and lacking dose-related restrictions were associated with significant increases in assaults among people younger than 21 years and increases in self-harm for men ages 21 to 39 years, compared with states with no medical or recreational cannabis laws. Causation or Correlation? While marijuana does not cause overdose deaths, this association with violence needs to be investigated thoroughly. There is increasing research demonstrating that regular use of marijuana with THC greater than 10% can result in development of psychotic symptoms. Cannabis-induced psychosis can become permanent, even after cessation of use. A study demonstrated that the highest conversion rate (47.4%) to diagnoses of bipolar disorder or schizophrenia occurs with cannabis-induced psychosis, compared to that from amphetamines, hallucinogens, opioids, or alcohol. Younger age is associated with higher risk of conversion. There have been multiple studies documenting the association of cannabis use by persons with psychotic disorders and an increasing risk of violence. This can include violence toward one's self as well as others. A study of 1,136 patients recently discharged from acute psychiatric facilities examined the relationship between continued use of cannabis and violence and found that continuing to use cannabis is a moderate predictor of subsequent violent behavior -- even more so than alcohol or cocaine. A recent large, longitudinal study of 2,994 people with a psychotic disorder found 11.4% were using cannabis. Cannabis users were found to report a lower quality of life, being less satisfied with their family relations and financial situation, and to show more aggressive and disruptive behavior and self-harm than non-users. What's Driving the Correlation? There are multiple theories as to why there is such a strong correlation between marijuana use and violence, including suicide. Dellazizzo et al. found a moderate association between cannabis use and physical violence in youths and emerging adults, with a potential dose-response association. They offer an excellent overview of potential mechanisms explaining violent behavior, which could help explain suicidal behavior. These include the fact that cannabis use can cause or exacerbate psychotic symptoms such as delusions; alter a person's sense of reality by causing perceptual distortions; cause a person to feel anxious, panicky, and paranoid about their surroundings and others; impair executive functioning, creating problems with impulse control and decision-making; and cannabis withdrawal can cause people to feel irritable, restless, and anxious. It is logical that any of these could contribute to suicidal thoughts in someone whose mood is dysregulated by cannabis. We need more people to be aware of this strong association between cannabis use and suicide, and to conduct more research to determine its cause. Libby Stuyt, MD, is an addiction psychiatrist in Colorado. Read the full article

[shock]

jj what did it feel like with the schizophrenia onset vs the system

the thing with schizophrenia and DID (dissociative identity disorder) is that psychotic disorders and DID (even other dissociative disorders) are commonly comorbid and a lot of things that happen in those disorders overlap. 

disclaimer: for anyone reading this, my only stake in this is that i have them and can explain what it’s like for me to live with them, not that i can diagnose you! 

- my first psychiatrist said that usually one notable difference is auditory hallucinations with schizophrenia are external, while with DID they’re internal. i’m someone who experiences both - the voices of my alters, as well as nameless voices that are NOT alters. 

- people with schizophrenia more commonly have visual hallucinations, while DID ‘hallucinations’ are closer to what you’d think of as flashbacks, being trapped in memories, essentially PTSD. i experience both - so, i know from talking to some of my alters that we all visually hallucinate, but the range of those hallucinations is very wide. i see people who talk to me who are NOT my alters. but i also see my alters inside of my head. i’ve seen visions of my alters just a few times, but they’re not actually them.

- every alter has a different perception of reality, but having schizophrenia makes that even harder. most of the people with DID without psychosis, in my experience, can interact with the world as a real and concrete thing and do well with ‘reality testing’ when tested as one singular rather than a whole (ie, the host might have an excellent grasp on reality and the world). however, in my case, none of us scan well on reality testing. myself included. i am almost constantly on edge because of it. 

- every alter i’ve spoken to has delusions. this really depends on the kind of person my alters are, as my delusions are usually (but not always) very different from my other alters. we are all impacted by my paranoid schizophrenia in different ways. there is not one single alter who doesn’t experience it. it’s part of my brain chemistry.

- both psychotic and dissociative disorders have been shown to be linked to trauma and PTSD, so the idea of having both isn’t ridiculously farfetched. most people who have one have the other at some point in their lives, from what i’ve seen from all of my friends/groups/therapy.

in my case, the onset of them was mostly... i have had DID since i was only a few years old. i didn’t really recognize what it was until i had other friends who had already mostly come to terms with it who were waiting on me to understand myself.

(mine is... very obvious if you know what to look for, apparently. i was really surprised to hear that when i switch, my pupils dilate differently, my body heat changes, lots of other stuff). i started having serious behavioral issues unrelated specifically to DID - which is usually how schizophrenia first crops up in younger people.

i’d always had some strange issues because of my DID (which i didn’t really understand that i had until my mid-late teens) that i didn’t really know about except people would tell me heaps of stories i never remembered about all sorts of kinds of events, but i was having what can only be called psychotic breaks unrelated to said DID at 13, 14, 15, 16 - and they got worse with the abuse i was experiencing at those times. 

it’s very hard to differentiate, i’ve known a couple people with psychosis who have similar altered conscious states you’d see similarly in DID, personality breaks (except the biggest difference is these personality breaks usually don’t... create entire identities, or come back the exact same way twice. i’ve had some.) and the sort of incomplete amnesia that comes with fractured reality.  

and as far as i’ve seen (undocumented) with myself and other people, anti-psychotic medication often makes it harder to ‘switch’, which makes me think of other possible links that could exist between psychosis and DID. but that’s mostly all i can think of right now! 

[alyssasmuses-blog]

Josh’s mental health - a novel by me.

(obvs this post is gonna contain some triggery material like mental illness & suicide attempts & things of that nature && also maybe some scenes from the game will be here. so u kno. proceed w/ caution)

GET READY KIDS THIS IS GONNA BE A LONG ONE.

So, first of all, let’s look at Hannah’s Diary. 

On an entry dated October 29th, 2013;

I really think Josh is doing better now that he's out of the hospital. I saw him today and he seemed better. He's pretty upbeat, but he talked like he's been doing therapy for such a long time. I guess I didn't know. Mom and Dad never let on. Funny how you can not even know your own brother. I kinda need a good cry thinking about how lonely he must feel... 

Now we’re gon’ look at josh’s psych report.

Josh’s first psych evaluation took place on 06/11/2006.

So, Josh was seeing doctors for seven years before his sisters found out.

The game makes it incredibly clear that Josh was really close to Hannah&Beth, and if his sisters didn’t even know about all this, then his friends sure as hell didn’t know yet either. Meaning for seven years, his only support system was his parents. Who, as we know, aren’t exactly present in his life. So Josh, for the most part, was dealing with his mental illness completely alone. Which, given his fear of isolation, probably didn’t help his recovery.

Now, for an overview of his medication.

(06/18/2006 - 01/24/2010): Josh was originally put on Fluoxetine one week after his initial appointment. He was on it for ~4 years, stopping when the side effects became too severe for him to handle.

After that, he was put on Duloxetine for three years (02/13/2010 - 11/01/2013), stopping that when it stopped working & he claimed his mood had “badly worsened” 

(Fluoxetine & Duloxetine are both common anti-depressants--they’re generics for Prozac & Cymbalta)

After that, Josh is put on Amitriptyline, which specifically warns people with a personal or family history of psychosis should talk to their doctors before taking it, something Josh shows symptoms of later in-game, but never actually gets diagnosed with. But we’ll get to that later.

Josh’s original prescription for Amitriptyline was given to him on 11/29/2013.

But, let’s look at Dr. North’s portion of the profile;;

01/03/2010 Sarah North, MD, PhD Cranleigh Hospital Referred on 11/29/2013 after patient's response to drugs tapered badly

12/19/2013 is when he starts seeing Dr. Hill, meaning for the first ~20 days he wasn’t seeing a doctor while on new meds.

Later on, Dr. Hill makes note of Josh being suicidal while on this medication, and later takes him off of it due to him self medicating & taking stronger doses. (04/05/2014)

All of this happened within six months of him getting on this medication. Every other medication he was on up until this point worked for several years. But, given that within these six months, his sisters also went missing, it seems more likely that Josh’s mental illness--which up until a few months before the prank had been manageable enough that he was able to hide it so well his sisters had no clue--had worsened significantly, possibly even triggering his schizophrenia. But, again, more on that later.

The next medication Josh is put on is Phenelzine, which he started taking 04/15/2014. According to his psych report, he spent 30 nights in the hospital, being sent home on May 16th, 2014. Meaning that he started taking Phenelzine on his first day in the hospital.

It says that Josh is still currently taking Phenelzine, but the psych report is dated May 21, 2014, and we know Josh stopped taking his meds at some point between then and February 2nd, 2015. We just don’t know when, exactly.

So, first of all, let’s talk about Josh’s depression.

There isn’t much to talk about that isn’t made abundantly clear--despite the fact that his diagnosis of Major Depressive Disorder (Clinical Depression) clearly doesn’t cover all the bases for what he’s experiencing, it’s definitely a piece of it. Understandably so, too. His parents seem relatively absent from his life, later on his sisters go missing & are presumed dead. Anyways, here’s a short list of some of the symptoms of clinical depression && I’m just going to bold the ones Josh is mentioned to experience in his psych report & in-game

Difficulty concentrating, remembering details, and making decisions, fatigue and decreased energy, feelings of guilt, worthlessness, and/or helplessness, feelings of hopelessness and/or pessimism, insomnia, early-morning wakefulness, or excessive sleeping, irritability, restlessness, loss of interest in activities or hobbies once pleasurable, overeating or appetite loss, Persistent sad, anxious, or "empty" feelings, thoughts of suicide, suicide attempts

I’m sure Josh has experienced more of these symptoms, but these are the only ones that I’m going to discuss, given I can point out clear examples in canon.

Feelings of guilt, worthlessness, and/or helplessness//feelings of hopelessness and/or pessimism: Several times, Josh blames himself for his sister’s disappearance, despite the fact that he was completely unaware of the prank, & was passed out during it. He couldn’t do anything if he wanted to. The Dr. Hill he sees in his hallucinations calls him a psychopath. You even have the option to call Josh your least favorite character while you’re playing as him. (Which Dr. Hill will bring up later in-game if you do so.) It’s pretty clear that Josh doesn’t like himself, even if that’s how he let on when his big ~reveal~ happened.

Irritability: If you look at his phone, he yells at Dr. Hill (via text, but still) when he tells Josh he’s worried about him.

Loss of interest in activities or hobbies once pleasurable: According to his biography Josh was “studying psychology at college prior to Hannah and Beth's disappearance, which caused him to drop out.” Of course, we don’t know if he actually found his studies pleasurable, but clearly his sisters disappearing made him so depressed he didn’t even want to put for the effort anymore--also a symptom of depression.

Thoughts of suicide, suicide attempts: His psych report clearly states he was suicidal in March of 2014, a month after his sisters went missing.

Okay, okay, now we discuss the other half of his mental illness.

I’m not saying Josh definitely has schizophrenia w/ psychosis, I’m just saying Josh definitely has schizophrenia w/ psychosis.

So, first, let me explain why his behavior in-game is not caused by withdrawal of his medication, like a lot of people claim.

From his psych report;;

On withdrawal: nausea, insomnia, nightmares, agitation, hallucinations, paranoia, aggressiveness, slurred speech, ataxia, catatonia, shocks

Now, it’s true, he experiences a lot of those symptoms (I bolded the ones he actively experiences in-game) However. On Josh’s Cellphone, we see that the messages from Dr. Hill are from January 13th. That’s over 2 weeks. Not only that, but Dr. Hill’s message makes it sound like Josh is mid-planning for his prank. Drug withdrawals are serious and can last quite sometime, but there’s no way he could have all those symptoms at that intensity for several weeks. 

But !!! Let’s look at just some of the symptoms of psychosis (all of these are also symptoms of schizophrenia, but being that psychosis is a symptom of schizophrenia, I figured it’d be easier to explain it this way);;

hallucinations, delusions, disorganized/repetitive speech, suicidal thoughts or actions, aggression/hostility, depression, disorientation

Now, let’s take these one at a time.

Hallucinations: Josh experiences both audio and visual hallucinations of Dr. Hill and his sisters, along with some audio hallucinations of Chris. Every single “session” spent with Dr. Hill in the game is a hallucination, which is revealed later in the game. Very clear, vivid images, too. It’s not some shadowy figure or something that’s there one moment and gone the next.

When he starts hearing Beth & Hannah’s voices, he starts crying, “Not again.” “You’re dead.” “I don’t take orders from you anymore” He clearly knows that this isn’t real, that this is all in his head, and he even seems to be trying to cope and talk himself through it.

You can watch the scene where he hallucinates Beth & Hannah here.

Delusions: His whole prank is a giant delusion. He puts his friends through absolute hell and he laughs about it because he thinks it’s just a funny joke that’s going to make a great youtube video. He thought it was such a good idea he emailed his psychiatrist about it. Clearly, Josh isn’t a moron, if he set this out to actually hurt his friends, why would he tell anyone about it? But if it’s just a harmless prank, that’s something else entirely. And! Not a single one of Josh’s actions ends up killing anyone. That was never his intention. He genuinely believed this was all a fun joke they’d all laugh off and move on from.

Disorganized/repetitive Speech: The most clear cut example of this is the scene in the shed, but it can also be seen while in the mines, during his hallucinations. He starts rambling to himself in the shed, to the point where Mike & Chris even comment on it.

Suicidal Thoughts or Actions: (See above ^)

Aggression/Hostility: (See irritability above ^)

Depression: Josh has literally been diagnosed with depression and treated for it since he was 11 years old. Plus I already talked about this. Moving on.

Disorientation: Not only does his psych report state that he was disoriented when brought into the hospital, but we see this very clearly in the mines when Mike and Sam find him. (But that might have something to do with Mike having just slapped him while he was in the middle of vividly hallucinating his sisters).

ANYWAYS.

This was my long ass post on Josh’s mental health I hope u liked it 

Also if you need me to clarify anything lemme know !! I have a lot of personal experience w/ these mental illnesses so i’d be more than happy to explain something I might’ve forgotten :*

Anyways catch u l8r kids

[erraticfairy]

Podcast: Dwelling on the Past Mistakes Caused by Mental Illness



Once we reach recovery from mental illness, we tend to dwell on the mistakes of our past. Thoughts of failures and people we’ve hurt ruminate inside our head and make it difficult to move forward.

Why do we think about these things? Does it protect us, make us feel better, or is it way to keep us from moving forward? In this episode, our hosts discuss their past failures in the hopes it allows our listeners to realize living in the past only really accomplishes one thing . . .

SUBSCRIBE & REVIEW

“It just creeps into the deep dark depths of my head and it just goes around, and around, and around.” – Michelle Hammer

  Highlights From ‘Ruminations’’ Episode

[2:00] We are talking about ruminations today

[4:30] Ruminations feed delusions

[6:00] Gabe dwells on his past wives

[8:20] Michelle ruminates about how her brother treated her in the past

[11:00] Gabe tried to set up his brother to get in trouble

[13:00] We want Michelle to make amends with her brother

[18:00] Why ruminating is detrimental to your health.

[19:30] Gabe dwells about his biological father

[21:00] Why can’t we just get over things and move on?

Computer Generated Transcript for ‘Dwelling on the Past Mistakes Caused by Mental Illness’ Show

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: [00:00:07] For reasons that utterly escape everyone involved, you’re listening to A Bipolar, A Schizophrenic, and A Podcast. Here are your hosts, Gabe Howard and Michelle Hammer.

Gabe: [00:00:19] You’re listening to a person living with bipolar, a person living with schizophrenia, and a digital portable media file. My name is Gabe Howard and I’m a person living with bipolar disorder.

Michelle: [00:00:28] Hi, I’m Michelle Hammer and I’m a person living with schizophrenia. Are you guys happy now?

Gabe: [00:00:33] Yeah. See we changed it for everybody.

Michelle: [00:00:36] My god, don’t write any more letters. Please stay off our social media. Person first language, okay?

Gabe: [00:00:43] I think we did it. I think, you know, by doing it this way, though we have now wiped out discrimination. We’ve wiped out stigma. There’s enough beds for everybody. Homelessness due to mental illness is gone. There’s nobody incarcerated in prisons. By using person first language we have solved all of those other problems, right?

Michelle: [00:01:04] We must of. That’s why person’s first language is always number one comment we get. Absolutely.

Gabe: [00:01:09] Hang on. I’m getting a weird text message.

Michelle: [00:01:11] Oh. Oh no, what happened?

Gabe: [00:01:13] Yeah. It turns out we didn’t do anything. We didn’t do anything. Like a person first language. It didn’t. It didn’t solve any problems. No. Now people are mad at us for mocking them.

Michelle: [00:01:22] Oh, no! We mocked people? We never make fun of anything on this show.

Gabe: [00:01:27] We were always so polite and professional and educational. We never say fuck.

Michelle: [00:01:32] We never say fuck, or suck my dick, or your –

Gabe: [00:01:37] [Laughter]

Michelle: [00:01:37] God, Gabe, what are you laughing at? I’m being really serious right now. I’m a person living with schizophrenia. I am a person living with my past.

Gabe: [00:01:45] You’re a person living with your past?

Michelle: [00:01:46] My past that I dwell on with my ruminations. Now I’m going to ruminate about this situation: that I couldn’t make the world better. I need to make the world better. Gabe, I need to make the world better.

Gabe: [00:01:58] This is the worst segue in the history of our show. And that, that’s saying something. Because we’ve had some mighty awful segues.

Michelle: [00:02:08] What are we doing?

Gabe: [00:02:11] In case you haven’t figured it out, ladies and gentlemen, we are talking about things that we have ruminated on both before we were diagnosed, during like the recovery period where we’re trying to get better, and things that still kind of haunt us today and we are going to desperately eke 20 minutes out of this.

Michelle: [00:02:26] Desperately.

Gabe: [00:02:28] So Michelle what are some ruminations that like today think the last six months as longtime listener of this show know we’re in recovery. You are doing quite well despite the fact that you’re a schizophrenic. I am doing quite well despite the fact that I’m living with bipolar disorder we’ve gotten over mania depression psychosis and everything in between. But we still ruminate on things because one everybody does. We should probably start there. Do you think that ruminating about things is the domain of only people with mental illness or do you think that everybody ruminates?

Michelle: [00:02:59] I think everybody ruminates to a certain extent. It’s fine ruminating, you just can’t stop it is when it really gets out of control.

Gabe: [00:03:07] I like that we’ve challenged ourselves to put the word “ruminating” in this show as many times as possible.

Michelle: [00:03:13] How do you spell this word?

Gabe: [00:03:15] I have no idea. I have no idea that that’s really a problem for the show

Michelle: [00:03:19] Should we define ruminating for people?

Gabe: [00:03:20] Do it.

Michelle: [00:03:21] Ruminating is when you can think of the same thing over and over and over again you just cannot get it out of your head. It just goes around and around and around. Usually it drives you nuts.

Gabe: [00:03:33] So, for example, Michelle’s mother, who has absolutely no mental illness to speak of, ruminates about why Michelle is a failure.

Michelle: [00:03:42] Hey.

Gabe: [00:03:42] It just she can’t get it out of her head.

Michelle: [00:03:44] I’m not a failure.

Gabe: [00:03:45] I didn’t say that you were. I said that your mother ruminates about it.

Michelle: [00:03:47] She does not.

Gabe: [00:03:48] I mean maybe a little bit?

Michelle: [00:03:49] She doesn’t.

Gabe: [00:03:50] Okay well my mother despite having no mental illness whatsoever ruminates on whether or not I’m going to throw her under the bus on a podcast.

Michelle: [00:03:58] Does she?

Gabe: [00:03:58] I mean, probably.

Michelle: [00:03:59] I don’t know.

Gabe: [00:04:01] Yeah, I don’t think she gives a shit.

Michelle: [00:04:02] I often ruminate why I was fired from any previous job.

Gabe: [00:04:05] Do you ruminate about being fired from the job as a symptom of schizophrenia? Or is it just something that you wish you could go back in time and figure out?

Michelle: [00:04:14] Well it’s more like different situations that happened and how I wish I could have handled them differently.

Gabe: [00:04:19] But doesn’t everybody do that? Like do you ever do this? And be honest, I mean sincerely be honest. Remember we value honesty. Do you ever get in a fight with your girlfriend, and like you’re fighting, you’re yelling, you’re screaming, and then you retreat to separate corners. All is quiet. It’s over, you’ve made up and you think, “God, I wish I would have said that?” Or like you run through it in your mind?

Michelle: [00:04:40] But that’s different than ruminating.

Gabe: [00:04:42] Well, how is it?

Michelle: [00:04:43] Different for me? Because ruminating just doesn’t stop it. I’ll go around and around and around and even when I’m walking through the street walking through anything I almost will turn delusional and think I’m with those other people having that conversation start getting angry just start making the whole situation 8 million times worse than it was because I keep thinking about it over and over and over and over and over and over again. It won’t go away and if they hate it so much.

Gabe: [00:05:08] In your mind ruminating and delusions they feed each other?

Michelle: [00:05:13] Yes absolutely.

Gabe: [00:05:14] First you’re thinking about the thing. I got fired. They fired me. H.R. called walk me down with the seventh time I got. By the time you’re done you’re back in that time and place. You’re feeling it again and it’s like it’s happening right now. Even though it was three years ago.

Michelle: [00:05:26] Yes.

Gabe: [00:05:27] Wow. Does that still happen to you like in 2019? Does this still happen to Michelle Hammer?

Michelle: [00:05:32] Yes.

Gabe: [00:05:33] What’s the coping skill to get around it? Because you’re right. You’re a well accomplished person. Why do we care?

Michelle: [00:05:38] Honestly, talking about the ruminating thoughts. Because when you talk about the ruminating thoughts usually the person you’re talking to is going, “Why do you care so much about this?” You maybe talk it out a little bit, and then you’re like, “Wow. You’re right. Who cares about this dumb stupid person or this story or anything about the situation. It’s so useless why am I thinking about it so much and you can’t change the past anyway. You’re right. I talked it out. Now I feel better.

Gabe: [00:06:03] But can’t you kinda change the past?  Can’t you remember it differently? You can’t you edit it in your mind, can’t you fix the things that have gone wrong previously in the future just like with different people?

Michelle: [00:06:16] You mean like learning from your past?

Gabe: [00:06:17] No. Learning sounds mature and we don’t really like that here.

Michelle: [00:06:21] OK. So then I don’t know what you’re talking about.

Gabe: [00:06:23] Here’s a good example. I’m on my third marriage. My wife is wonderful and I love her and this marriage has stood many many years. And I have no complaints. I want to say that right now. But I’ve been divorced twice. Not nasty divorces, but, you know, things that didn’t feel good. And I’ve been through breakups etc.. So every now and again my wife will do something and it will remind me of something that my ex-wife did and I’ll think. “Wait a minute. You know I let that go when wife number two did it. So I have to fix it with wife number three.” Even though they’re a completely different person. It’s a completely different time and nothing is the same except for maybe like one little thing. Don’t you ever do that? Like don’t you ever try to set a boundary with your current friend that you didn’t set with your last friend that is now you’re like mortal enemy?

Michelle: [00:07:10] No.

Gabe: [00:07:11] No?

Michelle: [00:07:11] No. Something that I do I know I do with my anxiety but I put on other people, is that I’ll start asking them a million questions about things. And then they’re like, “Why are you asking me a million questions?” And I’m like, “Oh, it’s my anxiety. I just wondered at the time? I just wondered if you know the place? I just wanted to know what you’re going to do after? What you are going to do before? I’m like, I’m just anxious. I’m sorry. I wanted to know.” If that makes any sense.

Gabe: [00:07:33] I certainly do that, too. You know like that constant time checking thing? That you don’t wanna be late?

Michelle: [00:07:37] Yes.

Gabe: [00:07:38] So what time is it? It’s four o’clock. OK. We have to be there at four thirty. What time is it? It’s four or one. OK. We have to be there at four thirty. What time is it? Dude ,it’s still four or one. But you know some of the things that are trapped in my head that I just can’t get out are just what a bad friend I was, or what a awful son I was, or what a terrible family member I was.

Michelle: [00:07:58] Yeah, yeah.

Gabe: [00:07:58] And sometimes I get mad at the people around me because I assume that they’re still mad at me because I’m still mad at me. Does stuff like that ever happen to you?

Michelle: [00:08:09] I mean, I still hold a lot of vendettas against my brother, which I owe to him. Right? Everyone says that I just dwell on the past. Even he says that I just, like, stay on the past. About when we’re very young. Me and my brother, and how mean he was to me and everything. We would see each other in the hallway of high school, and he wouldn’t even say hello to me. Yet, when he went off to college, and we were still using AIM, and he would instant message me, I would not reply. So he wouldn’t speak to me when he saw me in high school in the hallway, yet I stopped replying to him when he went off to college. And that was not OK. Which makes no sense to me. Yet, now we haven’t seen each other in a long time because he lives in another country. And when he comes back, I now have to be nice to him. Because I guess he’s a different person now? Yet, I never got any kind of apologies or anything like that, but I’m supposed to see that he’s a different person now. I don’t know why. And we’re supposed to be good friends now or something like that. I guess, just out of curiosity, why? I’m just wondering.

Gabe: [00:09:12] Is your brother a different person now?

Michelle: [00:09:14] Apparently, he’s a different person now. I don’t know. But-.

Gabe: [00:09:18] He had to leave the country to really get away with you.

Michelle: [00:09:20] I don’t know where it changed, but I’m supposed to treat him differently now. I’m supposed to forget everything from the past, all of the abuse from the past, and I’m supposed to like him now. I don’t know why.

Gabe: [00:09:31] I haven’t heard described any abuse. What you described is a couple of adult siblings that do not talk to each other.

Michelle: [00:09:36] No. Well okay.

Gabe: [00:09:37] What’s he mean to you? Did he call you names? Wait, did he pull your pigtails?

Michelle: [00:09:39] Well, he went to karate, and he would practice all of his karate moves on me. Constant wrestling, slamming my head into the ground until my nose bleeds. Calling me Michael instead of Michelle. Calling me a boy. That kind of went with Michael. Slamming the door in my face. Not letting me play with him. Like when we’re very little. Try to use his toys, not allowed to use his toys. Actually, when my mom and dad came home with me from the hospital when I was born, and they said, “Oh, Seth, here’s your sister.” He threw a stuffed animal at me. Yeah. I don’t know why they told me that story.

Gabe: [00:10:11] So he’s your older brother?

Michelle: [00:10:12] Yes.

Gabe: [00:10:12] Because you said that he threw a stuffed animal at you when you came home from the hospital and they told you that story and you’re putting this together with all of the other issues that you had with your brother growing up when you were kids?

Michelle: [00:10:27] Yeah and my like broke my necklace too, and then blamed me for it because that I was being annoying. So he had to push me and my necklace got in the way and it broke.

Gabe: [00:10:36] This is fabulous that you bring this up and here’s why. Because in my brother and sister’s world, I’m your older brother. I was the oldest. I was incredibly jealous of my brother. One time to get him in trouble when we were kids, I took syrup out of the pantry and I dumped it on the floor so that I could frame him for doing it. Knowing that he’d get in trouble. My mother just happened to be moving faster than normal that morning and watched me do it. And even though she saw me do it, I still tried to blame him for it. Absolutely, unequivocally, just hated having him as a brother. I was a top dog. I was the oldest. I used to live with Grandma. Then my mother remarried and nine months later I got this bastard in my house and I treated him like absolute garbage. Absolute garbage.

Michelle: [00:11:22] My favorite was when he would say, “You’re stupid.” And I would say, “No, you are stupid.” And then he would say, “Well, I’m smarter than you. So if I’m stupid, how dumb are you?

Gabe: [00:11:30] You know you’re an adult now, right?

Michelle: [00:11:31] I know. But obviously I can not get over this because I don’t understand why I’m supposed to like him now when I never received any kind of apology.

Gabe: [00:11:38] What kind of apology do you want when you were growing up?

Michelle: [00:11:41] Maybe just, “I’m sorry I was a horrible asshole to you, and ignored you for years and everything like that.”

Gabe: [00:11:47] Listen I never ever ever told my brother and sister, “I’m sorry. I was a horrible asshole to you.” Ever.

Michelle: [00:11:55] So that I don’t understand, why do I have to accept him back in my life?

Gabe: [00:11:59] I mean you don’t. But do you feel good right now?

Michelle: [00:12:01] I’m being told by everybody in my family that I need to accept him back in my life.

Gabe: [00:12:06] Okay. Well fuck them. Don’t. Just sit around and think about how pissed off and angry 8, 12, and 15 year old Michelle was.

Michelle: [00:12:13] Hang on one second, we’ve got to hear from our sponsor.

Announcer: [00:12:16] This episode is sponsored by betterhelp.com secure convenient and affordable online counselling. All counselors are licensed accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to betterhelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. Betterhelp.com/PsychCentral.

Michelle: [00:12:44] Want us to answer your questions on the show? Head over to PsychCentral.com/BSPquestions and fill out the form.

Gabe: [00:12:54] We’re back, still trying to say the word rumination as many times as humanly possible. You’re 30 years old, you’ve moved on with your life. But you’re still thinking about shit that happened to you when you were literally eight years old.

Michelle: [00:13:06] Ok, I see where you’re going with this.

Gabe: [00:13:08] How is that working out for you?

Michelle: [00:13:08] I don’t know. I don’t see him. I don’t have to speak to him. And then my mom says, “Have you spoken to your brother? Have you texted him? Have you spoken to him?” Yeah. “I don’t like that you guys don’t have a relationship. Why do my children hate each other?”

Gabe: [00:13:23] Well, I mean you articulated why y’all hate each.

Michelle: [00:13:25] I know, I’m just saying, that’s what she says.

Gabe: [00:13:27] I mean, has he done anything to you as an adult? Let let’s establish that like right out. In the time that you both became adult grown people, has he? Or has he been fine?

Michelle: [00:13:36] Well, when I graduated college he was working at kind of in the design agency kind of area. His boss, the creative director, he wanted to give me some advice. So he brought me in and he looks at my portfolio and his boss said to me, “I like your stuff. I want to give you some help. I wanted to offer you like a part time internship here, but your brother said no”.

Gabe: [00:13:54] Well but you don’t know that’s true.

Michelle: [00:13:57] His boss said it to me.

Gabe: [00:13:58] Yeah, but so what? People lie all the time.

Michelle: [00:14:00] No that’s 100 percent something my brother would do. Why would he lie and say I would offer you an internship here, but your brother said no? Because why would he invite me to come there and look at my portfolio and see all of my work and give me advice? Why would he offer to do that?

Gabe: [00:14:16] If he was gonna tell you no, why did he do it at all?

Michelle: [00:14:17] He was just giving me advice. And he just said that he wanted to offer me an internship, and that he would totally do that for me, but my brother said no.

Gabe: [00:14:25] So your brother was the boss of his boss?

Michelle: [00:14:27] My brother said do not hire her as an intern.

Gabe: [00:14:31] Then why did he talk to you at all?

Michelle: [00:14:32] Because he wanted to give me advice.

Gabe: [00:14:34] Did you ask your brother about this?

Michelle: [00:14:36] No I wouldn’t want to start a fight.

Gabe: [00:14:39] But, I kinda smell a rat here.

Michelle: [00:14:41] No I don’t smell a rat here. Obviously, Gabe, you don’t know my brother if you don’t believe this story.

Gabe: [00:14:46] It just doesn’t have the ring of truth.

Michelle: [00:14:47] Actually, it does very much ring true.

Gabe: [00:14:50] Okay. Let’s say that that is completely true. It’s 100 percent.

Michelle: [00:14:52] Okay.

Gabe: [00:14:52] Let’s say it rings true?

Michelle: [00:14:54] Say it rings true?  It’s 100 true.

Gabe: [00:14:55] Right, it’s 100 percent true. I agree. How long ago was that? How many years?

Michelle: [00:15:00] I believe I was 22. Okay so it was eight years ago.

Gabe: [00:15:04] Eight years? Everybody, Michelle Hammer is 30 years old.

Michelle: [00:15:04] You said adult life, Gabe. I was bringing up something in my adult life that’s it. So you know, it’s just so you know, you said something in my adult life.

Gabe: [00:15:14] I don’t know. I do not. You’re very upset about this.

Michelle: [00:15:17] He didn’t want me to work in the same place that he was working. You said adult life there you go or not.

Gabe: [00:15:25] But you keep repeating that.

Michelle: [00:15:26] Also, my brother lives in Colombia. Colombia the country, not the college. People have gotten that very mixed up before.

Gabe: [00:15:31] Did you throw your brother out of the country?

Michelle: [00:15:35] I’m glad he left.

Gabe: [00:15:35] Okay.

Michelle: [00:15:38] Meanwhile, you know who’s never been invited to Colombia to come see him?

Gabe: [00:15:40] I’m gonna go with you.

Michelle: [00:15:41] Yeah.

Gabe: [00:15:42] Do you think the reason you’ve never been invited is because you hate him?

Michelle: [00:15:48] He’s never invited me.

Gabe: [00:15:48] Because you hate him.

Michelle: [00:15:50] Well, he’s never invited me.

Gabe: [00:15:51] Because you hate him.

Michelle: [00:15:52] He’s never invited me.

Gabe: [00:15:53] Have you invited him to your house?

Michelle: [00:15:55] He’s been to my apartment. He’s been there.

Gabe: [00:15:58] You’re upset about this aren’t you?

Michelle: [00:15:58] Well, we’re dwelling on the past, Gabe.

Gabe: [00:16:00] You want to have a relationship with your brother, don’t you?

Michelle: [00:16:03] We do not get along.

Gabe: [00:16:05] I didn’t say do you get along. I said do you want to get along?

Michelle: [00:16:08] I want him to acknowledge what he’s done.

Gabe: [00:16:13] But why do you want him to acknowledge what he’s done?

Michelle: [00:16:16] Because he acts so innocent.

Gabe: [00:16:17] I’m being really serious.

Michelle: [00:16:19] Like look, he acts like he did nothing wrong. And then the past is of the past and I should ignore it.

Gabe: [00:16:24] Listen here’s what I’m saying, you think about the things that happened as a kid and as a young adult. A lot. And it brings it up. You are clearly unhappy about this and other members of your family know that you’re unhappy about this and try to fix it. Albeit apparently poorly. And I completely agree that all of these things are true. The question that I have for you this is the only question that I want you to answer. Do you want him to apologize because you want an apology? Or do you want him to apologize because you miss your brother and you want to mend the relationship?

Michelle: [00:16:56] Yes, I would like to mend the relationship.

Gabe: [00:16:58] Ok, well then say that. Say that the reason that you think about this so much is because you’re sad that you’re fighting with your brother.

Michelle: [00:17:05] And I’ve had friends who’ve met my brother on multiple occasions and have told me your brother’s a dick.

Gabe: [00:17:11] Yeah, he sounds like a real dick. Listen –

Michelle: [00:17:13] I’m just saying. I’m just saying.

Gabe: [00:17:14] I am not saying that he is not. Your brother’s a dick. I’m saying that you need to understand your own motivation because until you do I don’t think you’re gonna get over it. And I think a lot of our listeners have somebody in their life that they feel this way about. Whether it’s a friend, a family member, in some cases it’s like a parent or a guardian. It’s somebody who helped raised them or an authority figure and they’re all ruminating on this day in and day out. And if they don’t fix the relationship or get over the relationship it either a handcuffs them in the present like it’s handcuffed to you because you’re thinking about this right now and it is occupying way too much of your space for some dude who doesn’t even live in the country. And two, you just need to let it go and decide hey look this relationship isn’t for me and stop thinking about it. Frankly I don’t think any of this has anything to do with schizophrenia. I don’t think it does. It has everything to do with the fact that familiar relationships our family our friends, that’s the kind of stuff that fucks you up.

Michelle: [00:18:10] I think what it has to do with schizophrenia is the fact that I’ll think about it and I’ll just scrape into my head and it creeps in the deep dark depths of my head and I’ll just go around and around and around and around.

Gabe: [00:18:22] You want to know who my big brother is? You want to know who does that for me? You want to know who creeps into my head and just turns around and around and won’t let go ever? My biological father. The dude is dead. He is dead and I think about him the exact same way you think about your brother.

Michelle: [00:18:41] Really?

Gabe: [00:18:41] Yeah he’s dead. He can’t apologize. He can’t make up for it. It’s over. I won because I didn’t die of alcoholism.

Michelle: [00:18:49] I can get why.

Gabe: [00:18:50] Why did you hate me? That’s all I can think about, why did he hate me? And now you’re gonna do the exact same thing that I just did for you. You’re gonna be like, “Dude, he didn’t hate you he was a dick. He was an alcoholic. He abandoned his kid.”  This is the level that we torture ourselves.

Michelle: [00:19:02] I get that though. When a parent chooses alcohol over a kid. I can understand why the kid feels very upset.

Gabe: [00:19:10] Oh, look I don’t think he chose alcohol over me. I think he chose literally anything. I think he would have chosen like a blowing leaf over me.

Michelle: [00:19:18] Sometimes, a father is just a sperm.

Gabe: [00:19:20] Yeah. You know I call on my sperm donor.

Michelle: [00:19:22] Yeah. That’s sometimes just what a father is.

Gabe: [00:19:25] But this is the biggest rumination that I have because I wonder how did he know? On the day that I was born, that I was broken and worthless? How come he knew what nobody else can figure out?

Michelle: [00:19:37] He didn’t know that.

Gabe: [00:19:37] But, I mean –

Michelle: [00:19:38] He knew he was broken.

Gabe: [00:19:41] He didn’t know that. He had a good life. He was happy. He died fine.

Michelle: [00:19:44] No, he wasn’t happy, he was an alcoholic.

Gabe: [00:19:46] Yeah, a happy one.

Michelle: [00:19:47] No, there’s no happy alcoholics.

Gabe: [00:19:50] You know that whole self medicating thing it doesn’t play sometimes. I don’t think he was self medicating at all. I think he was just a guy that did whatever he wanted and said whatever he wanted and behaved however. He was just immature.

Michelle: [00:20:00] Then he wasn’t ready to be a dad.

Gabe: [00:20:03] I mean he was very young. My mother got pregnant in high school and he was also in high school.

Michelle: [00:20:07] So ok, that makes a little bit better.

Gabe: [00:20:08] But he never made up for it. I saw him on his deathbed. He was in hospice. He had jaundice, his eyes were yellow. They told me had less than two weeks to live. And I’m like, “Do you have anything to say to me?” And he was like, “It’s your mom’s fault.”

Michelle: [00:20:23] That’s what he said?

Gabe: [00:20:23] That’s pretty much what he said.

Michelle: [00:20:25] He’s a dick.

Gabe: [00:20:26] Oh, yeah.

Michelle: [00:20:26] Like he’s a dick. Your biological dad, he’s a dick.

Gabe: [00:20:29] But why can’t I get over it?

Michelle: [00:20:31] Because he’s your dad.

Gabe: [00:20:33] Yeah I got a dad. He’s alive. He lives in Tennessee. He’s cool.

Michelle: [00:20:35] Because he’s a part of you.

Gabe: [00:20:37] And I’m not trying to be crass here, but he’s just a guy who had sex with my mom. I appreciate the DNA and all

Michelle: [00:20:45] But if you can say that, then why can’t you get over it?

Gabe: [00:20:48] Exactly. And that’s why it ruminates because the intellectual part of Gabe Howard thinks –

Michelle: [00:20:54] So are you mad at your mom for boning this dude?

Gabe: [00:20:57] No. Well, I mean, I’m mad at my mom for giving me life but that’s like a whole ‘nother episode. I don’t understand why I got to be born and why I have to be born broken and why I’m here.

Michelle: [00:21:08] There’s a reason why you’re here and there’s a purpose here and it’s.

Gabe: [00:21:12] I don’t I don’t believe that.

Michelle: [00:21:13] Purpose. I believe that there’s always a reason why you’re here.

Gabe: [00:21:17] You believe in vape pens.

Michelle: [00:21:20] You believe in Diet Coke. Maybe there’s a universe of no diet coke.

Gabe: [00:21:23] That’s mean.

Michelle: [00:21:24] You’re not there. That’s near here.

Gabe: [00:21:27] That’s mean.

Michelle: [00:21:28] You’re here to drink Diet Coke.

Gabe: [00:21:30] Michelle, seriously. Seriously, none of this is serving either one of us so why do we do it?

Michelle: [00:21:36] Because it doesn’t go away.

Gabe: [00:21:39] And why doesn’t it go away?

Michelle: [00:21:40] I don’t know why it doesn’t go away.

Gabe: [00:21:42] Exactly. Judging by our emails a lot of our listeners have this problem where they just have this thing that they just can’t get over. And if they have learned nothing by listening to this show it’s that they’re not alone. A lot of people have these things that they just can’t get over and I think that anybody listening to me and you for the last 20 minutes would think wow these two need to get over that because it’s not serving them in any way.

Michelle: [00:22:05] Just a little bit. Don’t you think?

Gabe: [00:22:06] But we’re not letting it go. I hope that maybe they listen to us and they realize how unhelpful this is to just not get over and they think wow I don’t want to be like them and they let go of their anger and the things that they’re just ruminating on and can’t get over. But I suspect that a lot of people are gonna hang on to that rumination and I hope that they find some way to minimize it because at the end of the day Michelle we have minimized it. It is not impacting us the same way at our current age. That it probably did 10 years ago. Do you think you think about this less now than you did five years ago?

Michelle: [00:22:44] Oh definitely much less.

Gabe: [00:22:45] So there really is some wisdom in time heals all wounds.

Michelle: [00:22:49] And you know living in another country.

Gabe: [00:22:52] So I had to kill my biological father. You had to send your brother to another country and now suddenly we’re getting better. That’s fantastic. That is definitely actionable advice. Everybody is excited that they listen to this episode of a bipolar schizophrenic podcast because now they can beat their own ruminations with death and deportation.

Michelle: [00:23:15] Yes.

Gabe: [00:23:16] Not every episode can be a winner ladies and gentlemen but we hope you got something out of it. Thank you for tuning into this episode of A Bipolar, a Schizophrenic, and a Podcast. Don’t forget to hop over to store.PsychCentra.com, there is a few shirts left. This is the last time. Literally the last time we will ever pitch the “Define Normal” shirts on this show. So if you have been hanging on wanting to buy one, now is the time. Thank you everybody. Please like us everywhere and we will see you next time.

Michelle: [00:23:45] He’s a dick!

Announcer: [00:23:50]You’ve been listening to a bipolar a schizophrenic kind of podcast. If you love this episode don’t keep it to yourself head over to iTunes or your preferred podcast app to subscribe rate and review to work with Gabe go to GabeHoward.com. To work with Michelle go to Schizophrenic.NYC. For free mental health resources and online support groups. Head over to PsychCentral.com Show’s official Web site PsychCentral.com/bsp you can e-mail us at show@PsychCentral.com. Thank you for listening and share widely.

Meet Your Bipolar and Schizophrenic Hosts

GABE HOWARD was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital in 2003. Now in recovery, Gabe is a prominent mental health activist and host of the award-winning Psych Central Show podcast. He is also an award-winning writer and speaker, traveling nationally to share the humorous, yet educational, story of his bipolar life. To work with Gabe, visit gabehoward.com.

  MICHELLE HAMMER was officially diagnosed with schizophrenia at age 22, but incorrectly diagnosed with bipolar disorder at 18. Michelle is an award-winning mental health advocate who has been featured in press all over the world. In May 2015, Michelle founded the company Schizophrenic.NYC, a mental health clothing line, with the mission of reducing stigma by starting conversations about mental health. She is a firm believer that confidence can get you anywhere. To work with Michelle, visit Schizophrenic.NYC.

from World of Psychology https://ift.tt/2CLZPCM via theshiningmind.com

[nulawtoronto]

Proposed Legislation to End Solitary Confinement

Following the Ontario and British Columbia Superior Court decisions that found that the use of segregation was unconstitutional (which we have previously blogged about), a new piece of legislation has been introduced which proposes to overhaul how federal inmates are separated from the general prison population. Public Safety Minister Ralph Goodale has introduced Bill C-83 to amend the Corrections and Conditional Release Act. These changes would eliminate solitary confinement and replace it with “structured intervention units” (“SIUs”). The SIUs will allow inmates to be separated from the general population if they are unable to exist safely with the other prisoners. HOW WILL SEGREGATION IN PRISONS CHANGE UNDER BILL C-83? As it stands today, inmates placed in solitary confinement are allowed two hours a day outside of their cell, but are not entitled to any human contact. Under Bill C-83, prisoners who are found to be at risk to themselves or others will be placed in SIUs. Prisoners placed in SIUs will have access to rehabilitative programming, interventions, and mental-health care. They will be visited daily by a registered health care professional and be provided access to patient advocates. These inmates will be given at least four hours a day outside of their cell and at least two hours a day with “meaningful” human contact. Bill C-83 also proposes to allow staff members to use body scan imaging technology as an alternative to body cavity searches to prevent contraband from entering prisons. Furthermore, Bill C-83 includes provisions that background and systemic factors should be considered in all correctional decisions in cases involving indigenous inmates. Correctional Service of Canada Commissioner Anne Kelly supports the proposed legislation and stated:

I believe these legislative changes will transform the federal correctional system while ensuring that our institutions provide a safe and secure environment that is conducive to inmate rehabilitation, staff safety and the protection of the public. They will also help ensure that our correctional system continues to be progressive and takes into account the needs of a diverse offender population.

LIMITATIONS OF BILL C-83 Bill C-83 does not address the time limits for segregation or the independent oversight of segregation decisions, which are both issues that the federal correctional ombudsman and rights advocates have been lobbying for. Furthermore, if this bill passes, this legislation will have no effect on the use of solitary confinement in all provincial jails. These jails are made up of pretrial prisoners and those inmates serving sentences of less than two years. Goodale believes that the appeals by the Canadian Civil Liberties Association in Ontario and the federal government in B.C. with respect to the constitutionality of current policies for solitary confinement that are scheduled to begin next month will proceed. But, he is hopeful that this new legislation will address the concerns of all current policies and make further litigation regarding solitary confinement unnecessary. CLASS ACTION LAWSUIT A lawsuit has been certified by a Superior Court Judge as a class action lawsuit in Ontario alleging that the Ontario government violated the rights of its inmates by placing them inappropriately in solitary confinement. The $600 million legal action alleges that the provincial government has been negligent in utilizing segregation by isolating prisoners for weeks, months or even years. The lawsuit includes inmates diagnosed with severe mental illnesses (i.e. schizophrenia or psychosis) who served time in segregation in provincial facilities since January 1, 2009. Inmates who were placed in solitary confinement for 15 days or longer are also included in the class. The main issue in the lawsuit is “administrative segregation”. This takes place when inmates are isolated either to ensure their own safety or for the safety of others in the facility. Inmates are kept in tiny cells without any human contact for most of the day. Conrey Francis (“Francis”) is the representative Plaintiff for this class action lawsuit. Francis is the individual who represents the entire class in the action. Francis has spent several periods of time in prison since 1982, and was placed in solitary confinement. Francis has been diagnosed with post-traumatic stress disorder and suffers from extreme panic attacks. Francis alleges that his time in isolation worsened his mental health and he began suffering from suicidal thoughts and auditory hallucinations. We will continue to follow the developments of Bill C-83, the appeals regarding the rulings that administrative segregations are unconstitutional, and the class action lawsuit commenced in Ontario and will report any updates in this blog. In the meantime, should you have any questions regarding your legal rights and need to speak with an experienced criminal defence lawyer please contact Affleck & Barrison at 905-404-1947 or contact us online. We are highly knowledgeable and extremely experienced at defending a wide range of criminal charges. For your convenience, we offer 24-hour phone services. Full Article: https://criminallawoshawa.com/proposed-legislation-to-end-solitary-confinement/

[studyingbymylonesome]

The Many Misconceptions of Catatonia: Treatment Is Often Successful With the Right Knowledge

Catatonia, “a syndrome of altered motor behavior accompanying many general and neurological disorders,”1 is common, affecting 9.8% of adults admitted to psychiatric hospitals.2 However, catatonia frequently goes unrecognized, leading to the erroneous conclusion that it is rare. A Dutch study found that clinicians identified catatonia in only 2% of 139 patients, whereas a research team identified catatonia in 18%.3

“Catatonia is treatable, but the sad component is that the true diagnosis is often not made and appropriate treatment is not provided,” Max Fink, MD, professor emeritus of psychiatry and neurology, Stony Brook School of Medicine, New York, told Psychiatry Advisor.

The History of Catatonia

One of the main reasons for the frequent misdiagnosis of catatonia is the continuing misconception that it is synonymous with schizophrenia, Dr Fink said.

It was Karl Ludwig Kahlbaum who first made the association between psychomotor symptoms and psychiatric disorders in 1874. Kahlbaum coined the term Die Katatonie and clustered 17 motor abnormalities into a single syndrome in patients with an array of disorders, including mood, psychosis, neurosyphilis, tuberculosis, and epilepsy.4

In 1899, Emil Kraepelin categorized catatonia as a feature of dementia praecox and by 1913, catatonia had become “1 of the 8 subgroups into which dementia praecox was divided and clearly subordinated to the larger diagnosis.”1

Although this definition was by no means universally accepted and was fraught with ongoing controversy, both the Diagnostic and Statistical Manual of Mental Diseases (DSM)-I and DSM-II5,6 classified catatonia as a type of schizophrenia, which continued through the publication of DSM-III.7

However, descriptions of a toxic response to neuroleptic agents and subsequent identification of neuroleptic malignant syndrome (NMS) called this into question because of its similarity to malignant catatonia, Dr Fink explained.

Fink and Taylor argued that catatonia should not be exclusively linked with schizophrenia, leading to a change that recognized catatonia as a disorder caused by a medical condition and a features specifier in mood disorders, in DSM-IV.8,9

The development of rating scales and more effective examination procedures led to the discovery that between 9% and 17% of patients in psychiatric facilities and emergency departments met criteria for catatonia — even more among those with mood disorders or toxic states than among patients with schizophrenia.1

In the DSM-5, criteria for catatonia remained the same throughout the manual, independent of the initial diagnosis (eg, psychotic, bipolar, depressive, medical disorder, or unidentified medical condition). It was defined by the presence of at least 3 symptoms from a list of 12 and was no longer called a “subtype” of schizophrenia but rather a “specifier” for schizophrenia as well as for major mood disorders and 4 additional psychotic disorders. There was also a new diagnostic category: “catatonia not otherwise specified.”10 The DSM-5 definition of catatonia can be found below.

DSM-5 Definition of Catatonia

Catatonia is defined by the presence of 3 or more of the following10:

Catalepsy: Passive induction of postures held against gravity

Waxy flexibility: Slight and even resistance to repositioning by the examiner

Stupor: No psychomotor activity, no reactivity to the environment

Agitation: Not influenced by external stimuli

Mutism: No or minimal verbal response; not applicable in case of established aphasia

Negativism: Opposing or not responding to external stimuli, such as instructions

Posturing: Spontaneous and active maintenance of posture against gravity

Mannerism: Odd caricatures of ordinary actions

Stereotypes: Repetitive, frequent, non-goal-directed movements

Grimacing

Echolalia: Repeating the words spoken by the examiner

Echopraxia: Mimicking of the movements made by the examiner

Beyond the nosologic debate, another historical process affected how catatonia was regarded because “the bulk of psychiatric practice shifted from the asylum to the ambulatory clinic, with an emphasis on psychotherapy and the prescription of psychotropic agents,” Dr Fink noted.

In the ambulatory setting, less emphasis is placed on a medical examination and, coupled with the assumption that catatonia is associated mainly with schizophrenia, it became regarded as merely another form of psychosis, he added.

Illnesses associated with catatonia include the following2,11:

Psychiatric, including schizophrenia, bipolar disorder, depression, Tourette syndrome, autism

Metabolic, including renal failure, liver failure, ketoacidosis, vitamin B12 deficiency

Endocrine, including hyperthyroidism, hypercalcemia from parathyroid adenoma, Addison disease, Cushing disease, syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Neurologic, including encephalitis, multiple sclerosis, epilepsy

Rheumatologic, including systemic lupus erythematosus

Infectious diseases, including typhoid fever, mononucleosis, malaria

A Condition of Fear

“There are multiple causes behind catatonia, but one way to regard it is as a systemic response to unrequited fear,” said Dr Fink, who is the coauthor of the just-published book The Madness of Fear: A History of Catatonia.12

“Fear is induced in human beings in multiple ways,” he explained. “For example, if you are sick and become frightened, that fright can be manifested through withdrawal, stupor, posturing, or repetitive movements.”

“In Freudian terms, this can be seen as a defense adaptation, and the reason we can treat catatonia with sedative drugs or ECT [electroconvulsive therapy] is that we are treating the fear,” he said.

Types of Catatonia

Catatonia is not a single, undifferentiated entity but has several different forms, Dr Fink pointed out.

Retarded catatonia is the most common, consisting of movement that is inhibited by posturing, rigidity, mutism, and repetitive actions, as well as failure to respond to painful stimuli. When this presentation includes stupor, patients may require parenteral feeding and extending nursing care.11

Delirious mania is an excited form of catatonia, characterized by restless movements, talkativeness, agitation, frenzy, disorientation, and confusion.11

Malignant catatonia is “a syndrome of acute onset, fever in all but elderly individuals, and abnormal blood pressures, tachycardia, and tachypnea of life-threatening dimensions.”11 It is similar to NMS and neuroleptic-induced catatonia. Toxic serotonin syndrome can be seen as malignant catatonia associated with serotonergic drug overdose.11

Periodic catatonia is recurrent and reported among patients with bipolar disorder, in which the patient fluctuates between stupor and excitement. It is most likely to occur during a mixed mood state or period of rapid cycling.11

Agitated catatonia is often associated with self-injurious and typically stereotyped behavior, commonly seen in autism.13

These catatonia syndromes are referred to by several names, which are listed below.11,13

Catatonia Syndromes: Nomenclature

Retarded catatonia (benign stupor) is also referred to as Kahlbaum syndrome

Excited catatonia (delirious catatonia) is also referred to as manic excitement (manic delirium) (Bell mania)

Malignant catatonia (neuroleptic malignant syndrome; toxic serotonin syndrome) is also referred to as lethal catatonia, pernicious catatonia, acute fulminating psychosis (syndrome malin; neuroleptic-induced catatonia; serotonin syndrome)

Periodic catatonia (mixed affective state) is also referred to as rapid cycling mania

Agitated catatonia is also referred to as self-injurious behavior (eg, in autism)

Diagnosing Catatonia

Catatonia should be considered in every patient with dysregulated motor behavior, especially in those who also show changes in consciousness and mood, Dr Fink emphasized.

There are several rating scales that can help identify catatonic symptoms.14 A systematic review14 found the Bush-Francis Catatonia Rating Scale (BFCRS)15 to be preferable for routine use because of its validity, reliability, and ease of administration.

To verify the diagnosis, a lorazepam “challenge test” can be helpful because signs and symptoms of catatonia are commonly relieved by the intravenous (IV) administration of a barbiturate or benzodiazepine, Dr Fink said, adding that zolpidem may be considered an alternative to lorazepam.

“If you suspect catatonia, based on your observation and results of the rating scale, the lorazepam test can be useful,” Dr Fink said.

“Imagine a stuporous patient not responding, even if you pinch or stick them with a pin,” he continued. “You give them IV lorazepam and they pick up their head 5 or 10 minutes later, look at you and ask, ‘Where am I?' That's a positive response and you can treat that patient.”

The result is positive in 80% of tests in patients who have catatonia and respond to treatment. However, if the patient does not respond to the test dose, Dr Fink noted that it is repeated, or higher treatment doses are given. “If the patient does not fully respond to the sedative drug, ECT becomes the default,” he said.

High serum creatine kinase and low serum iron levels can be associated with malignant catatonia, particularly NMS, but are less useful in identifying other forms of catatonia.12

Treating Catatonia

Because catatonia is so frequently associated with schizophrenia or regarded as a form of psychosis, it is often inappropriately treated with antipsychotics, Dr Fink remarked.

Catatonia typically has a poor response rate to antipsychotics — as low as 7.5% — so they should be avoided. Introducing them can also complicate the clinical picture and promote the development of the malignant form of catatonia.2

In all patients, potential toxic precipitants should be eliminated and general medical and/or neurologic diseases should be treated.12

For those with retarded catatonia and body temperatures <39°C, parental or oral lorazepam should be administered, beginning with 3 mg/d and rapidly increasing to effective resolution, even as high as 20 to 30 mg/d.11 ECT can bring effective relief to patients with higher fevers, delirium, or physiologic risk or those who do not rapidly respond to lorazepam.11

High fever (≥39°C) is associated with various forms of malignant catatonia (eg, NMS, delirious mania). “Such states are life threatening and warrant intensive medical and nursing treatment: IV fluids, sponging, body care, sedation, and ECT — even daily ECT,” Dr Fink said.

Benzodiazepines and ECT can be used together, as they have a synergetic effect, but the dose of the benzodiazepine should be reduced because it can raise the seizure threshold.2

Most patients respond well to catatonia treatment, with up to 80% achieving relief through benzodiazepines or barbiturates and the remainder showing improvement from ECT.16 However, some patients seem to be resistant to treatment, particularly ECT. Possible reasons include chronic symptoms, diagnostic delay, high seizure threshold, and incorrect application of ECT (eg, insufficient number of sessions, short session duration, procedural failures, and concomitant use of benzodiazepines).16

Next Steps

“We can no longer regard catatonia as a psychiatric disorder specific to schizophrenia,” Dr Fink stated. Rather, “it is better regarded as a movement and behavioral syndrome with particular attributes and diverse antecedents.”

Additionally, “there has been relatively little biological, genetic, and imaging research devoted to catatonia.” It is important to begin expanding the research base and apply these powerful research tools to populations with confirmed catatonia, he said.

“Catatonia is a diagnosable and treatable entity,” Dr Fink concluded. More education is needed to reinforce this message for physicians, especially in emergency departments and psychiatric facilities.

[beewriting]

research // “kids on drugs: how pharmaceutical companies are catering to kids”

I

When I was 17, I was admitted to a partial hospitalization program at my local behavioral health hospital. I was depressed, anxious, stressed and on the brink of suicide, and I knew I needed help. If you know anything about me, you know that I talk a lot. I love talking about myself. But at this point in my life, I didn’t have the energy to talk to anyone about anything, even talking to these doctors about what was wrong with me was mentally and physically exhausting.

When I came into the hospital, I told them my story. I knew I had depression and anxiety prior to being hospitalized, but I never sought treatment. I also had trouble sleeping at night. My anxiety constantly kept me awake until 2, 3, or even 4 in the morning when I had to be awake at 6 for school. At this point, I would have done anything not to feel so empty, to feel some emotion and to get more than 2 hours of sleep at night. So I caved, and I took the medication as prescribed by my psychiatrist. My first day in the hospital I was prescribed 10 milligrams of the antidepressant, Lexapro and 50 milligrams of the antipsychotic drug Seroquel.

To clarify for those who do not know, antipsychotics work by “blocking D2 receptors as well as a specific subtype of serotonin receptor, the 5HT2A receptor. It is believed that this combined action at D2 and 5HT2A receptors treats both the positive and the negative symptoms. The atypical anti­psychotics currently available on the market include clozapine, risperidone, olanzapine, quetiapine, paliperidone and ziprasidone.” (Tung & Procyshyn, 2007). More intense side effects of these drugs include tremors, inner restlessness, muscle spasms, sexual dysfunction and, in rare cases, tardive dyskinesia, while less severe side effects include weight gain, diabetes and lipid disorders.

I also want to preface my story by saying that I was never really into the idea of being medicated, nor did I know a lot about these types of medications, at the time at least. I was put on an antidepressant, which I just assumed would make me not depressed. I was also put on an antipsychotic, and I had no idea how that worked. My doctors initially told me they gave me the antipsychotic to help me sleep. It helped. But it helped too well. After just a week of taking this medication, I was finally sleeping for about 6 hours a night, but I still felt like it wasn’t enough sleep. I’m not sure if this was just my body reacting to finally getting sleep for the first time in years, but I’m pretty certain it was the medication that made me feel like this. I felt like a zombie. I was still exhausted, even though I felt like I was doing everything I possibly could to get a good night's sleep. This medication also made me feel emotionless. I felt like I literally couldn’t be happy and it made things worse. I felt that things would never get better, and I felt this way for about a year.

Almost a year after I got out of the hospital, I was at an appointment with my psychiatrist, who told me that he wanted to try to get me off of the antipsychotics. At the time, I was completely dependent to this medication. It was the only thing that would help me sleep, and I felt like if I didn’t take it, or if I took anything else, that the darkness would come back and my anxiety would creep back up and I wouldn’t be able to sleep. If I was off the medication, I felt like I would have gotten worse, and things could have gotten very ugly. But I accepted it. I knew I had to move on, and be able to figure out a way to sleep on my own, or at least without the intense medication. My doctor then prescribed me hydroxyzine, which is an allergy medication. He promised me that it would give me similar effects to the seroquel, but without all the side effects. I tried it a few times but I knew I definitely slept better with the seroquel. This medication only lasted a few hours, so I was back into this dangerous cycle of only getting a few hours of sleep. The days I took my new medication, I felt defeated, like no medication would ever work.

Eventually, we found medications that work for me, and what these are doesn’t matter. Some days I want to just stop taking the medication altogether, but I am also so scared of what would happen and who I would become if I wasn’t on the medication. I didn’t learn until about 6 months ago, the negative effects that these antipsychotics have on your body. Things finally started to make sense, and I understood why my body did the things it did. When I was first given the antipsychotics, that first month, I gained almost 15 pounds, that never went away, no matter what I tried. I felt sluggish, and even lazy, despite being a competitive cheerleader and working out 6 days a week. My exhaustion was a side effect of this medication.

Today, I am still coping from these side effects. I have learned a lot though. I learned that my doctors put me on antipsychotics because they thought I could possibly be bipolar, and instead of treating me correctly, they just gave me the medication and that was it. When I talked to my therapist about this rather recently, he suggested the fact that I might be bipolar, but that they definitely shouldn’t have treated me the way they did. To be misdiagnosed is very insulting, and to be mistreated is even worse. I feel like I could have progressed so much better while in the hospital and even afterwards if I have been treated correctly.

Unfortunately, I am not the only one that gets mistreated or misunderstood by doctors. For example, take the case of Andrew Rios. When he was 5 months old, he had his first seizure. He was then put on epilepsy medication. At 18 months old, his medication gave him more adverse side effects, such as him acting violently and erratically. He was then prescribed the antipsychotic, Risperdal.

In Andrew’s case, he saw some of the most intense side effects of antipsychotics, at such a young age. His parents became very concerned when he started to scream in his sleep, and would talk to people that were not there. Once the family researched Risperdal, they found out that there were no antipsychotics that were approved for children younger than five years old. (Schwarz, 2015). The main issue here is that “the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the American Academy of Neurology have no guidelines or position statements regarding the use of antidepressants or antipsychotics on children younger than 3.” (Schwarz, 2015) It should also be noted that many doctors would theoretically like for there to be more studies of these drugs on young children, but they do not want to subject these kids to the dangerous and adverse side effects of the medications.

Ⅱ

The overprescription and misuse of antipsychotic medications greatly impact children specifically. This is not because most kids are diagnosed with psychosis or schizophrenia, but because doctors, teachers, and parents alike don’t always know how to deal with: autism or other learning disabilities, mental illnesses or other disorders, or just kids that are “bad” and “act out.” it is important to look at other reasons why these medications are being prescribed, such as looking at the doctors: how qualified they are to be prescribing these medications or what things may influence them to prescribe a certain drug over another. These medications are also prescribed because they are relatively cheap, and for a low-income family, it is much easier to just take medication rather than involve a child in therapies of any kind, mostly cognitive behavioral therapy or group therapies for the specific population impacted.

A reasoning behind why so many people are on these medications is that some doctors, teachers, parents or the patients themselves don’t really know how to deal with a patient's mental or physical illness. The most popular diagnosis among all ages of people prescribed antipsychotics was ADHD, which it is important to note that there is a whole other section of pharmacology dedicated to ADHD and ADD. (Penfold et al., 2013)

On “Last Week Tonight,” John Oliver talked about how pharmaceutical companies market to doctors in a very strange way, and that most psychiatrists are paid directly or indirectly by these pharmaceutical companies. Sometimes these doctors will even conduct research about certain drugs and have to say that it works because a pharmaceutical company is funding the research. The show mentioned a website where you could search your doctor and see if they got paid, how much they got paid, and what specific companies paid them. The psychiatrist that prescribed me Seroquel was getting paid over $850 a year, just from pharmaceutical companies. About $300 was from the company Astrazeneca, which created the drug Seroquel. (John Oliver, 2015)

My case isn’t the first and definitely will not be the last. Dr. Charles B. Nemeroff, chair of Emory University’s department of psychiatry reported to the university that he made exactly $9,999 from talks and research he did with the pharmaceutical company GlaxoSmithKline, but failed to report another $500,000 and also violated many of the university's policies regarding research with third party companies, in 2004 alone. (Angell, 2009)

Another influencing factor in prescribing antipsychotics is because they are relatively cheap, and much cheaper than therapy or other interventions. My parents spent well over $8000 for my hospitalization, $230 for monthly psychiatrist visits, $150 for therapy every two to three weeks, but my medication was only about $25 every month, and this was all under my private insurance. Through my research I found that therapy can treat these children that are acting out or are actually mentally ill, but it takes on average about 12 therapy sessions to see a full affect. For me, that’s 6 months of therapy, which would cost $1,800, and that’s just for my specific therapist. Medication for 6 months would cost the same as one single therapy treatment for me. It is also important to note that the “correct way” of doing things is to have “comprehensive psychiatric assessment prior to initiating psychotropic medication to determine the nature of the child’s illness and whether the antipsychotic medication is an appropriate course of action.” (Harrison et al, 2013)

Ⅲ

Many scholars, doctors and journalists alike have really questioned the ethics within studying antipsychotics on children. In 2013, the American Psychiatric Association issued a list of questionable uses of antipsychotics, basically setting guidelines for doctors prescribing these antipsychotics. Some of these limitations include: “Do not prescribe for insomnia in adults without a severe mental illness diagnosis and do not prescribe to children or adolescents for anything but psychosis.” (APA, 2013) While these guidelines are accurate and reasonable, it is obvious that they were not implemented for many doctors, or taken seriously. It’s great that we had these guidelines, but if there is no regulation or laws that essentially forces doctors to follow the rules then there isn’t much use in having the rules in the first place.

Just this year, Minnesota senator Al Franken proposed the Mental Health in Schools Act. This act promotes a school-based mental health program that is run with the Secretary of Education and the Attorney General. It increases government funding for mental health education and promotion in schools, and essentially insures that schools will have trained personnel that can deal with mental health. Although this bill is great, and it is good that we’re starting somewhere, there are not many specifics as to how this is all going to get done.

The most important thing to do to prevent these cases from ever happening is plain old good education. If we educated parents on their children’s illnesses, they may understand how it can be treated. If we educated parents about medication, they may decide they don’t want to give their children medication. If we just educated the general popular about mental illness and how to properly treat it then maybe there wouldn’t be this negative connotation attached to it.

[permanentwhiteknuckles-blog]

Snake Wrangling and Me

This essay is my beloved baby. I’ve had it threatened to be stolen and have had it edited in order to fit a certain non-profit’s agenda. Lastly, it’s been denied time and time again from being published. This is true. Everything written in this essay is my personal experience. Enjoy.

*

*’

In retrospect, my pregnancy wasn't super terrible. I had a scary moment around 20 weeks where I was pooping blood, but it was hemorrhoids that cured themselves eventually. I suffered from anemia and had some fatigue and my relationship with my husband was rocky, but we made it through. I asked for a divorce approximately 12 times, but that was nothing compared to the battles we would soon be facing.

On April 6th, 2013, Olivia was born at almost 43 weeks gestation at almost 9 pounds. I was disappointed by my birth because I had this idea that I shouldn't have an epidural and that my body was strong and capable enough to birth without medication. Despite the disappointment, I had a successful, albeit medicated, vaginal birth after cesarean. My little girl was feisty the moment she was born and ready to nurse right away. It was a huge surprise that she was a girl because we were convinced we were having a boy. It makes sense now that we could not decide on a 'boy' name at all, as if my subconscious knew.

I cherish the memories of the birth and the few weeks following. My mom helped me while I recovered from a hemorrhage, and it was so incredibly special when my 18 month old daughter met her baby sister. My heart felt full and bursting with love that I could barely contain.

After a few short weeks later, my husband had already returned to work and I realized that we were not going to be able to afford the rent if I wasn't contributing financially, so I began my search for a part-time job. I applied anywhere and everywhere in desperation. In a way, I think I also just wanted some respite after being cooped up with my kids 24/7. Emmy, my older daughter, was not coping well with sharing me and constantly bit and hit Olivia.

It didn't take too long for me to be called for a job interview. The job was an overnight position, ironically in mental health, though I did not know then that I was mentally ill. I got the job and I was elated. I felt that it'd be fulfilling and I was eager to bring some money into our home. I started immediately, and at first found it quite enjoyable. There was another girl who trained me for two weeks and we had a great time together.

But then, the two weeks were up and I was alone. Alone in a facility with mentally ill women all by myself. Granted, they were usually sleeping, but my mind and body became terrified at every sound. I could only speak to my husband on the phone for maybe 15 to 20 minutes before he'd go to bed and I'd be completely cut off from the world. All of a sudden, every creak or groan was someone trying to break in, or an irate client. I tried to distract myself with tv shows on Netflix.

There was one series in particular that I was really invested in and it was about snakes. I'm not sure when there was a transition but at some point, snakes became my actual reality which I know now was me hallucinating. It started with one large snake that followed me everywhere I went. It was quick. I could turn around fast and it'd be hiding, but I knew it was there. I could feel its presence. I didn't yet believe that it was going to hurt me, but eventually I started to.

The real world around me began deteriorating quickly as I stopped sleeping completely. Now the snake was over my shoulder, about to strike at any moment. Once my shift started, I locked myself in the office, paralyzed with fear. I had to put my feet up on the chair I was sitting on because there were snakes all over the floor and they would strike me if I set my foot down. I'm surprised that I wasn't fired. I was often in tears while with the clients because I was afraid of the snakes.

Though this position was supposed to be part time, I was working more than forty hours a week, 6 days a week. At home, I was mostly in a dissociative state. I remember bits and fragments but not details. I remember nursing my newborn but not my older daughter though I know I nursed both of them. I remember a neighbor who was nice to me, and washing cloth diapers. I remember my daughter suffering from an awful diaper rash and constantly crying unless I was holding her. I even remember somehow potty training my oldest. My mind was desperate for escape, so I escaped. I turned on the tv and made food for my oldest and sometimes myself. I honestly don't remember much else.

Surprisingly enough, my tipping point wasn't the hallucinations or the delusions. One day, I was desperate to shut my eyes for a moment. Though I wish it wasn't, this memory is burned into my mind and likely will be forever. I began to shake my baby. I stopped as quickly as I started, but for one fleeting moment, I craved silence and would do anything to get it. I called my doctor’s office that same day and once my husband got home, I went to the hospital.

I saw the social worker on duty. She asked me so many questions and at the very last minute, I explained that there was a snake following me. She told me to imagine that it was a bright color with a goofy hat and sunglasses. When I asked if that's it, she snapped that she's a social worker, not a therapist. Luckily she referred me both to a therapist and a psychiatrist, both of whom I saw the next day. I was not hospitalized. I began weekly therapy and started a combo of antidepressant, antipsychotic, and anti-anxiety medications.

These medications came with horrid side effects. All of a sudden my lower jaw had an uncontrollable tremor, my panic attacks increased and my thoughts came to me much more rapidly than before. I continued working overnights, and had grandiose ideas. I remember one evening, I began working on grad school applications and I covered the entire office floor with all my paperwork and applications, planning to tackle it all in one night. Of course that didn't happen, but hey, at least the snakes were keeping their distance. I still wasn't sleeping and if I wasn't working on something or writing page after page of nonsensical things in my journal, I was sitting in the fetal position, terrified.

I won't lie, I fantasized often about suicide. I was crazy. My husband was stressed more than anyone should be, and he was also terrified that I'd hurt the children. I knew all this and believed they'd be better off without me. I fantasized about driving the wrong way on the freeway or driving off of a cliff. I began intensive outpatient therapy 3 days per week while continuing to work full time. I can't say much about that experience because I don't remember, but I will say that after trial and error, we found a drug combo that worked and I leveled out by Christmas. My last IOP was the beginning of December, and I finally gained the confidence to quit my job.

There's so much more to my story. I battled an eating disorder and gained so much weight that I felt disgusting and that my body was completely foreign and not my own. The initial social worker that I saw reported me to child protective services and I had to prove that I was a fit mother. I ruined many family outings and constantly embarrassed my husband by doing outrageous things that made no sense. I was diagnosed with schizophrenia and lived in fear that I would never be normal again and wished that my husband would leave me. I didn't deserve him and he deserved to be with a sane person.

My story is not over. Though I do not actually have schizophrenia, I do have PTSD stemming from childhood trauma and depression and anxiety. In May of 2016, I went through an intense psychological evaluation, and it was determined then that I had a psychotic break due to postpartum psychosis. I will live with and battle mental illness for the rest of my life. I've since had another child, and am now working on my career but I am far from cured. Therapy and medication are necessities in my life, and I'm okay with that. I'm still learning.

[gossipnetwork-blog]

'Slender Man' Trial: What's Next for Geyser and Weier

New Post has been published on http://gossip.network/slender-man-trial-whats-next-for-geyser-and-weier/

'Slender Man' Trial: What's Next for Geyser and Weier

Last Thursday, Morgan Geyser was committed to a Wisconsin-based mental hospital after she pleaded guilty to attempted first-degree homicide in trying to kill her sixth-grade classmate in 2014. It was supposed to be a sacrifice to Slender Man, an online fictional horror character.

Geyser’s trial was scheduled for later in October. But a deal with the Waukesha County District Attorney’s Office prompted her to change an original plea to guilty and Judge Michael Bohren to find her not responsible for her actions due to mental disease or defect, before committing her to continue treatment in a mental hospital, according to CNN. Prosecutors asked Judge Bohren to commit her to 40 years. Doctors at the state Department of Health Service are set to evaluate Geyser by November 13th and recommend to the court how long she should remain committed to a hospital. (Geyser’s attorney did not respond to request for comment.) 

In August, her co-defendant, Anissa Weier, pleaded guilty to attempted second-degree homicide. A jury sided with her arguments and found her not responsible for her actions because she was mentally ill, and she was sentenced to three years in a state mental hospital. Last week, after Geyser’s plea hearing, the Leutner family released a statement: “Though we do not believe that an institution is where these attempted murderers belong, the current legal system does not favor victims in this situation.” They added: “With this closure, our daughter is a heroic survivor – and no longer a victim.”

Geyser and Weier, now 15, were just 12 when they were charged as adults after telling authorities that they tried killing their friend Payton “Bella” Leutner, then 12, in order to become “proxies,” or servants, to Slender Man, so that the Jack Skellington-esque Internet meme would not kill them or their families.

It was three years ago last May, the day after Geyser hosted a birthday party, when the girls played hide-and-seek in a forested area near Interstate 94. In Geyser’s retelling of accounts to Judge Bohren: “Anissa said that she couldn’t do it and that I had to,” according to CBS. Geyser “tackled” and stabbed Leutner 19 times with a kitchen knife, before “Anissa told [Leutner] to lie down so she wouldn’t lose blood so quickly, and told her to be quiet, and we left.” Geyser and Weier began walking their planned 300-mile trek to Slender Man’s mansion in Nicolet National Forest. But Leutner eventually crawled out of the forest, where a bicyclist found her and called 911. She survived surgery at a nearby hospital.

This week, Irene Taylor Brodsky, who documented the case in the HBO documentary, Beware the Slenderman, tells Rolling Stone that “the judge gave them no breaks and was punishing them to the fullest extent of the law. He was not allowing their age to be a mitigating factor and that was incredibly difficult for me as a human being to witness. They’re children.” Brodsky adds that the recent plea deal and jury decision show that “the American people can understand that there’s a lot of mitigating nuance here.”

At this time of the attack, HBO and Brodsky were brainstorming ideas on the Internet’s effects on pre-adolescent brains. As it unraveled, producers emailed an article from The New York Times on the Slender Man to Brodsky, who then found herself in Waukesha County, attending the first court appearances and meeting with both the Geyser and Weier families (the Leutner family declined to participate in interviews for the documentary). Today, when Rolling Stone asks how her impressions of the overall case or girls have changed since then, Brodsky answers, “What I came to discover in the course of making the film, I think the jury in Anissa’s case came to discover: These girls were losing their minds in the narrative that was Slender Man. You can’t say Slender Man made them crazy, but most kids don’t watch Slender Man and go out and kill somebody. You have to look at this through the prism of their mental illness.” Brodsky says the girls were involved in “a folie a deux, a delusion shared by two personalities” that allowed them to fall deep into the psychological grip of Slender Man.

Neurodevelopmental psychologist Abigail A. Baird, a psychology professor at Vassar College who was interviewed in Brodsky’s film, tells Rolling Stone that Geyser “was diagnosed with unspecified psychosis and schizophrenia” – mostly non-violent unless of a paranoid nature – and Weier was diagnosed with “a shared delusional disorder.” Geyser’s defense attorneys say that she believes she could communicate telepathically with Slender Man and see characters from Harry Potter and Teenage Mutant Ninja Turtles. Baird says Weier’s YouTube search history includes “psychopath tests,” a snake killing a mouse, a bunny eating raspberries. “Morgan continues to believe in Vulcan Mind control and the videos show you Anissa is a patch work, who was vulnerable to something violent,” says Baird, who stresses that her opinion is based on speculation.

As Brodsky sees it, the girls had a dangerous concoction of mental illness, obsession and isolation at a young age. “A perfect confluence of circumstances,” Brodsky says.

Baird agrees, and explains the susceptibility of age: “The girls were prepubescent at the time of the attack, which added another layer of immaturity. They were just old enough to feel like they had to have friends, but they were young enough to believe in Santa Claus. I can’t get my mind around trying 12 year olds as adults. Would you honestly want these girls on a jury if you were in trouble? Because that’s what that means. They’d give you life because they don’t like your shirt.”

Prosecutors and Judge Bohren have voiced concerns over how the girls apparently premeditated the attack. But Baird sees the act of adolescent premeditation much differently, saying, “kids at this age make plans to go to outer space.” But Baird draws attention to their isolation: “They didn’t have a bigger group of friends, where someone could have said, ‘Slender Man doesn’t exist.” Baird also focuses on obsession: “This is why pop musicians get so popular. If one girl likes them, all have to like them. But it’s usually regulated fluff and not harmful or violent. In Anissa and Morgan’s case, it was something antisocial.”

Of course, Slender Man alone did not force the girls to wield a knife and try and kill their friend. “People try to say that movies and music make people do violent things, but it doesn’t work that way,” Baird says. “People who are prone to violent acts feel validated by violent music and movies, so they will look for validation in those worlds. These girls were drawn to Slender Man.” 

From the Internet boogeyman’s ties to bullying, to Morgan Geyser’s dad’s tearful interview, the documentary sheds new light on a terrifying story. Watch here.

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[apsbicepstraining]

From dream to nightmare: when your seman donor has secrets

Having a baby by sperm donation is an intensely personal and psychological process. So what happens when you discover that interested donors has a genetic health ill?

Sperm donor 9623 looked good on paper. An IQ of 160. A bachelors degree in neuroscience, a masters in artificial intelligence, en route to a PhD in neuroscience engineering. A passion for crystallography, algorithms and fitness. Ontario couple Elizabeth Hanson and Angela Collins thought they had observed the perfect father for their baby.

Seven times after their son was born, Collins and Hanson discovered that donor 9623 was a college dropout with schizophrenia, a egocentric personality disorder and a criminal record. He had wasted eight months in prison for burglary, and 10 years on probation.

The sperm bank had inadvertently included the donors appoint, Christian Aggeles, in an email to the couple. A Google search did the remain. His stepfather had vouched in tribunal that Aggeless psychopathic chapters began age-old 19, well before he started donating in Georgia. Aggeless sperm led to the birth of at least 36 children worldwide.

It was like a dream changed nightmare in an point, said Collins. The couple, alongside at least three other categories, have registered lawsuits against the Georgia-based sperm bank, Xytex Corporation, which too gave sperm to British duets. Xytex disclaims wrongdoing.

Such specimen are not unique. Like Collins, Hanson and their son, numerous categories and individuals are now to access to words with vital information that their donors withheld.

The forks of such breakthroughs can be immense. The most important entity to me is[ my son] potentially facing a very debilitating life-style, Collins says. I felt like I was defrauded by Xytex and I flunked my son for having selected Xytex. In hindsight, a hitchhiker on the side of the road would have been a far more responsible option for imagining a child.

Families have registered lawsuits against the Georgia-based seman bank, Xytex Corporation. Photograph: David Goldman/ AP

What level of danger do Aggeless genes award? The building of mental health illness is complex. The genetic ingredient of schizophrenia, explains Professor Cathryn Lewis, prof of genetic epidemiology and statistics at Kings College London, is not a single gene, but is combined across many genes. There are likely to be thousands of acquired discrepancies that hold threat of schizophrenia. Each change slightly increases or decreases our danger, but nothing of them alone will enable us to predict whether someone is likely to develop schizophrenia.

Even stimulating brand-new findings in the C4 gene ask careful version. Its a single piece in a large genetic jigsaw riddle, Lewis says. Measuring one gene tells us anything about private individuals risk of developing schizophrenia.

Mental health conditions also show a mixture of interacting environment and social causes. Not to mention that many parties with schizophrenia respond to treatment and live full, productive lives.

Donor anonymity was abolished in the UK in 2005. Donor-conceived offspring are now legally entitled, at the age of 18, to information on their donors identity. However, this was not retrospectively exerted: those thoughts before April 2005( thats 21,000 people born between 1991 and 2004 alone) cannot identify their donor unless interested donors gradations forward voluntarily. Some are never even told they were donor-conceived in the first place.

Tyler Blackwell discovered as a teen in Maryland that he has 35 half-siblings. His second amaze: having the same condition that his donor parent, John( not his real refer) has not been able to divulged. Johns sister discovered the Blackwells through a family pedigree place. It transpired that John, who had not replied to their communication, had an aortic aneurysm, which had severed at persons under the age of 43. He had endured. At least three other family members were similarly altered. Tyler accompanied a cardiologist as a precaution, was diagnosed with an aneurysm and underwent surgery. Without an operation on an aneurysm of this type, the mortality rate from severance is up to 97%. When sever appears, patients typically die within six hours. There is no one who knew about it, said his mother of the sperm bank committed. If I could foretell the future, I would have picked a different donor.

Financial incentives could underlie some instances of deception. However, the UKs Human Fertilisation and Embryology Authority ( HFEA ) specifies the limit for sperm donors at 35 per clinic visit and egg donors at 750 per repetition of donation, plus expenses. These restrictions, it territory, aim to reward altruism and prevent coercion. Rules vary internationally. One California cryobank recoups your time and expenditures with compensation of up to $1,500/ month with regular motivations such as movie tickets or endow certificates for additional era and try expended by participants.

Danish semen donor 7042 unwittingly passed on neurofibromatosis to at least 11 of “their childrens”, after his seman was used in clinics across the US, Canada, Belgium, Greece, Spain, Thailand and the UK. Neurofibromatosis is consistent with brain and nerve tumors, bone deformities, visual disorder, blood pressure and read rigors. Offspring have a 50% gamble of acquiring it. Denmark has since mandated that donor sperm can be used in a maximum of 12 inseminations. In the UK , no more than 10 categories can be created using egg or seman from a single donor. Donated eggs are not risk-free, but sperm donors frequently have more offspring who are in a position pass on acquired plights to the next generation.

There is no such situation as reproduction without peril. Here i am, however, an ethical responsibility towards the child to be seen and their hopeful mothers. If a donor develops a genetic precondition years after donation, “were not receiving” arrangement at present that enforces disclosure.

Donors now must experiment negative for HIV, hepatitis B and C, and syphilis, with farther screening be a primary consideration in ethnicity such as cystic fibrosis in those of Caucasian swoop and sickle-cell sicknes in African and Afro-Caribbean populations. Guidelines state that potential donors should be assessed for positions with a genetic constituent cleft palate, spina bifida, congenital mettle malformations, psychosis and others but that decisions on eligibility should be individualised.

These screening regulations do not ever apply to the unknown number of UK citizens who travel abroad to find donors, implement unlicensed clinics or buy home-insemination kits online. Although mental evaluation is required by most international authorities, this will not table donors who have not yet developed indications of a serious mental health issues disease. For them, the diagnostic implement is time.

Genetic screening is more affordable and thorough than ever before. So, should be used turn away from the donors account and towards the laboratory? Allan Pacey, prof of andrology at the University of Sheffield, is leery. I thoughts the perfect genome probably doesnt prevail, so its actually a question of where the line should be drawn. Merely about 4% of all those who come forward to be seman donors are abode. If we were to impose a whole new prepare of exclusion criteria based on theoretical hazards, it is possible there wont be any sperm donors at all.

Frozen sperm stored in a sperm bank. Picture: monkeybusinessimages/ Getty Images/ iStockphoto

With intensified screening, donors might be diagnosed with genetic positions that would have remained undiscovered for ever, or are untreatable. Perhaps there is an statement for not knowing.

Kevin, who works in photography in London, is not only a donor-conceived being but a donor himself. He is therefore of the opinion that prospective parents should know as much as possible about interested donors medical record. But there is a stage where you have to draw the line, and say were no longer forming decorator children here, he adds.

He understands the distress of Elizabeth Hanson and Angela Collins, hitherto worries about speaking too much into particular case. Its a disgrace if beings make it overshadow the industry and take it to be some sort of wide-reaching corruption. It is one narration. Every era there are lots of children being born to duets who have fertility both problems and thats much more important to remember.

Eleven offspring have been born from his gifts. Why did he donate? I wouldnt be here if someone hadnt donated. Someone did that and thats why I am here.

Jess Cresswell detected aged 28 that she was donor-conceived. Seven years later, she still does not know who her biological father is, but find her mothers imparted her the best life they could. Since some of her own family medical record is missing, how does she feel about donor screening?

I think they should be screened but I also think that, just because they have some sort of hereditary condition, they shouldnt inevitably be excluded. Its the parents discretion; some people would rather have a child knowing theres a risk of picking something up than not, if that was their only option.

It is now easier than ever for donor-conceived parties to find their genetic pedigree. The US Donor Sibling Registry has helped connect more than 10,900 people with their half-siblings and/ or their donors. Nearly 70% of those who sign up match with a biological relative, and nearly 80% of this group competitor instantaneously. The UK has a Donor Sibling Link website.

Direct-to-consumer genetic tests have revolutionised this opening. In 2005, a 15 -year-old mailed a saliva sample to an on-line service, had his genetic code uploaded, applied a tracking website and met his biological father 10 days later. Kevin spotted a half-sister through a donor-sibling registry and two half-siblings through parentage places. He afterward unwittingly discovered some of his donors items. Two hours on, Google disclosed his donors appoint. The two have since stayed in contact.

One last concept: Aggeles received mental health medicine and picked up a degree in cognitive discipline two decades after he first registered at university. He is now working on a masters in artificial intelligence.

The post From dream to nightmare: when your seman donor has secrets appeared first on apsbicepstraining.com.

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[apsbicepstraining]

From dream to nightmare: when your seman donor has secrets

Having a baby by sperm donation is an intensely personal and psychological process. So what happens when you discover that interested donors has a genetic health ill?

Sperm donor 9623 looked good on paper. An IQ of 160. A bachelors degree in neuroscience, a masters in artificial intelligence, en route to a PhD in neuroscience engineering. A passion for crystallography, algorithms and fitness. Ontario couple Elizabeth Hanson and Angela Collins thought they had observed the perfect father for their baby.

Seven times after their son was born, Collins and Hanson discovered that donor 9623 was a college dropout with schizophrenia, a egocentric personality disorder and a criminal record. He had wasted eight months in prison for burglary, and 10 years on probation.

The sperm bank had inadvertently included the donors appoint, Christian Aggeles, in an email to the couple. A Google search did the remain. His stepfather had vouched in tribunal that Aggeless psychopathic chapters began age-old 19, well before he started donating in Georgia. Aggeless sperm led to the birth of at least 36 children worldwide.

It was like a dream changed nightmare in an point, said Collins. The couple, alongside at least three other categories, have registered lawsuits against the Georgia-based sperm bank, Xytex Corporation, which too gave sperm to British duets. Xytex disclaims wrongdoing.

Such specimen are not unique. Like Collins, Hanson and their son, numerous categories and individuals are now to access to words with vital information that their donors withheld.

The forks of such breakthroughs can be immense. The most important entity to me is[ my son] potentially facing a very debilitating life-style, Collins says. I felt like I was defrauded by Xytex and I flunked my son for having selected Xytex. In hindsight, a hitchhiker on the side of the road would have been a far more responsible option for imagining a child.

Families have registered lawsuits against the Georgia-based seman bank, Xytex Corporation. Photograph: David Goldman/ AP

What level of danger do Aggeless genes award? The building of mental health illness is complex. The genetic ingredient of schizophrenia, explains Professor Cathryn Lewis, prof of genetic epidemiology and statistics at Kings College London, is not a single gene, but is combined across many genes. There are likely to be thousands of acquired discrepancies that hold threat of schizophrenia. Each change slightly increases or decreases our danger, but nothing of them alone will enable us to predict whether someone is likely to develop schizophrenia.

Even stimulating brand-new findings in the C4 gene ask careful version. Its a single piece in a large genetic jigsaw riddle, Lewis says. Measuring one gene tells us anything about private individuals risk of developing schizophrenia.

Mental health conditions also show a mixture of interacting environment and social causes. Not to mention that many parties with schizophrenia respond to treatment and live full, productive lives.

Donor anonymity was abolished in the UK in 2005. Donor-conceived offspring are now legally entitled, at the age of 18, to information on their donors identity. However, this was not retrospectively exerted: those thoughts before April 2005( thats 21,000 people born between 1991 and 2004 alone) cannot identify their donor unless interested donors gradations forward voluntarily. Some are never even told they were donor-conceived in the first place.

Tyler Blackwell discovered as a teen in Maryland that he has 35 half-siblings. His second amaze: having the same condition that his donor parent, John( not his real refer) has not been able to divulged. Johns sister discovered the Blackwells through a family pedigree place. It transpired that John, who had not replied to their communication, had an aortic aneurysm, which had severed at persons under the age of 43. He had endured. At least three other family members were similarly altered. Tyler accompanied a cardiologist as a precaution, was diagnosed with an aneurysm and underwent surgery. Without an operation on an aneurysm of this type, the mortality rate from severance is up to 97%. When sever appears, patients typically die within six hours. There is no one who knew about it, said his mother of the sperm bank committed. If I could foretell the future, I would have picked a different donor.

Financial incentives could underlie some instances of deception. However, the UKs Human Fertilisation and Embryology Authority ( HFEA ) specifies the limit for sperm donors at 35 per clinic visit and egg donors at 750 per repetition of donation, plus expenses. These restrictions, it territory, aim to reward altruism and prevent coercion. Rules vary internationally. One California cryobank recoups your time and expenditures with compensation of up to $1,500/ month with regular motivations such as movie tickets or endow certificates for additional era and try expended by participants.

Danish semen donor 7042 unwittingly passed on neurofibromatosis to at least 11 of “their childrens”, after his seman was used in clinics across the US, Canada, Belgium, Greece, Spain, Thailand and the UK. Neurofibromatosis is consistent with brain and nerve tumors, bone deformities, visual disorder, blood pressure and read rigors. Offspring have a 50% gamble of acquiring it. Denmark has since mandated that donor sperm can be used in a maximum of 12 inseminations. In the UK , no more than 10 categories can be created using egg or seman from a single donor. Donated eggs are not risk-free, but sperm donors frequently have more offspring who are in a position pass on acquired plights to the next generation.

There is no such situation as reproduction without peril. Here i am, however, an ethical responsibility towards the child to be seen and their hopeful mothers. If a donor develops a genetic precondition years after donation, “were not receiving” arrangement at present that enforces disclosure.

Donors now must experiment negative for HIV, hepatitis B and C, and syphilis, with farther screening be a primary consideration in ethnicity such as cystic fibrosis in those of Caucasian swoop and sickle-cell sicknes in African and Afro-Caribbean populations. Guidelines state that potential donors should be assessed for positions with a genetic constituent cleft palate, spina bifida, congenital mettle malformations, psychosis and others but that decisions on eligibility should be individualised.

These screening regulations do not ever apply to the unknown number of UK citizens who travel abroad to find donors, implement unlicensed clinics or buy home-insemination kits online. Although mental evaluation is required by most international authorities, this will not table donors who have not yet developed indications of a serious mental health issues disease. For them, the diagnostic implement is time.

Genetic screening is more affordable and thorough than ever before. So, should be used turn away from the donors account and towards the laboratory? Allan Pacey, prof of andrology at the University of Sheffield, is leery. I thoughts the perfect genome probably doesnt prevail, so its actually a question of where the line should be drawn. Merely about 4% of all those who come forward to be seman donors are abode. If we were to impose a whole new prepare of exclusion criteria based on theoretical hazards, it is possible there wont be any sperm donors at all.

Frozen sperm stored in a sperm bank. Picture: monkeybusinessimages/ Getty Images/ iStockphoto

With intensified screening, donors might be diagnosed with genetic positions that would have remained undiscovered for ever, or are untreatable. Perhaps there is an statement for not knowing.

Kevin, who works in photography in London, is not only a donor-conceived being but a donor himself. He is therefore of the opinion that prospective parents should know as much as possible about interested donors medical record. But there is a stage where you have to draw the line, and say were no longer forming decorator children here, he adds.

He understands the distress of Elizabeth Hanson and Angela Collins, hitherto worries about speaking too much into particular case. Its a disgrace if beings make it overshadow the industry and take it to be some sort of wide-reaching corruption. It is one narration. Every era there are lots of children being born to duets who have fertility both problems and thats much more important to remember.

Eleven offspring have been born from his gifts. Why did he donate? I wouldnt be here if someone hadnt donated. Someone did that and thats why I am here.

Jess Cresswell detected aged 28 that she was donor-conceived. Seven years later, she still does not know who her biological father is, but find her mothers imparted her the best life they could. Since some of her own family medical record is missing, how does she feel about donor screening?

I think they should be screened but I also think that, just because they have some sort of hereditary condition, they shouldnt inevitably be excluded. Its the parents discretion; some people would rather have a child knowing theres a risk of picking something up than not, if that was their only option.

It is now easier than ever for donor-conceived parties to find their genetic pedigree. The US Donor Sibling Registry has helped connect more than 10,900 people with their half-siblings and/ or their donors. Nearly 70% of those who sign up match with a biological relative, and nearly 80% of this group competitor instantaneously. The UK has a Donor Sibling Link website.

Direct-to-consumer genetic tests have revolutionised this opening. In 2005, a 15 -year-old mailed a saliva sample to an on-line service, had his genetic code uploaded, applied a tracking website and met his biological father 10 days later. Kevin spotted a half-sister through a donor-sibling registry and two half-siblings through parentage places. He afterward unwittingly discovered some of his donors items. Two hours on, Google disclosed his donors appoint. The two have since stayed in contact.

One last concept: Aggeles received mental health medicine and picked up a degree in cognitive discipline two decades after he first registered at university. He is now working on a masters in artificial intelligence.

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