“We Were Born Sick, You Heard Them Say It”.

Looking at the cultural sociology of mental illness.  

Mental illness can be interpreted as the most solitary of afflictions to the people who experience it, but it’s the most social to those who experience its effects. It becomes difficult to draw and define specific boundaries around mental illness and distinguish it from eccentricity or mere idiosyncrasy. It’s nearly impossible to clearly differentiate  an obvious line of difference between madness and malingering, mental disturbance and religious inspiration. Erving Goffman sought to dismiss mental illness as a purely socially constructed category, limited as a mere matter of labels. By exploring the quintessentially individual act of suicide an expansion from Gothman’s mere labels can be  expounded upon. Suicide is directly linked with mental illness, by examining this relationship the most florid manifestations of mental disturbance can be observed.

Mental illness has been interpreted as a product of sociological factors, an ‘anomie’ or the failure of sociological order to adequately regulate the beliefs and behaviors of its members. It has often been questioned whether people should take the Thomas Scheff approach, whereby the medical model of mental illness is dismissed and replaced with the societal reaction model, wherein patients were the victims of psychiatry. Advances within the cultural sociology of mental illness encompasses the progressive abandonment of the prior commitment to the segregative responses to serious mental illness and the run-down of the state hospital sector, the collapse of psychoanalysis – replaced by biological basis, the psychopharmacological revolution, the so-called neo-kraepelinian revolution, and the rise of the DSM to the position of overwhelming importance  – worldwide.

Sociology demotes psychiatry to a belief in vague predispositions to nervousness or madness, with no proven bodily cause, promoting their lack of clear-cut laws pertaining to their biological research, dealing with symptoms, not signs.  Diagnosing a person’s mental illness becomes based on the judgments generated through their communications, their treatments based off their diagnosis lacking widespread specificity. Psychiatry relying on psychoanalysis also called depth or psychodynamic psychology, proposes that the mind is divided in conscious and unconscious parts and that the dynamic relationship between these gives rise to psychopathology (the study of the manifestation of behaviors and experiences which may be indicative of mental illness or psychological impairment).

Psychoanalysis becoming paradoxical because it’s concerned with the notion that we are all ill – psychopathology is ubiquitous, varying between individuals only in degree and type. These norms discerned within psychoanalysis mediated by the intrapsychic mechanisms. Norms within society imply that an ideal notion of mental illness exists, although it would be limited by its susceptibility to be meaningful to those only in a culture who subscribe to their theoretical premises, emphasizing its lack of unity and ineffectual distribution on a wider scale. Cultural notions of mental illness also initially linked  early biological psychiatry immediately with the mad, the bad and the dim. Sociology further attacks the definitions given to mental illness, arguing that the inter-dependent constituents are not defined or explained in relation to their classification of impairment, disturbance, disability, disorder etc.

“We were born sick, you heard them say it”. To reiterate the heading and these fantastic lyrics – I think that they reinforce the schema that is associated with mental illness and to an extant the relationship/pattern between cultural/environmental influences on the etiology of mental illness.

Lately I’ve been living in the daydream just behind reality’s veiled curtain. The unsuspecting whore of mental illness, my ability to be both a victim and a rational opportunist. The victim to the triggers that my mind shudders against, the twisted opportunist that seeks the deep dark insights pertaining to the inner turmoil and joy. It’s a pretty twisted sick cycle, but its ok at the moment. It’s more of an ongoing ‘normal in training’ session. I keep wondering if my psychiatrist will ever give me a ‘gold star’ or tick of approval or whether we are all merely the embodiment of an epic psychoanalysis that perceives all as ill. Relying on my psychiatrist as my state-licensed drug dealer who specializes in ‘mood-altering’ drugs, hoping to create a balance which has to be practiced every day. Do we take the early sociological stance that no one is mentally ill or abide by the strict categorizations of mental illness that are created and regulated by so few. Life is to constantly challenge all that confounds you, rejecting the notions of those who remain unsubstantiated and to remain skeptical of those wishing you to blindly follow their ideologies.

Playing Devil’s Advocate With Key Religious Figures And Mental Illness Correlations.

Disclaimer: Not my own thoughts, the research is from the Journal of Neuropsychiatry – The Role of Psychotic Disorders in Religious History Considered. This blog entry is me playing devil’s advocate to provoke debate; I’m not in any way trying to undermine a person’s religious beliefs, simply trying to encourage discourse underlying subconscious preconceptions of mental illness within religion.  

Thoughts to be considered before reading:
-Why would it be so bad if the inspirational figures in religious history experienced mental illness?
-Why do we subconsciously reject the thought that God wouldn’t work through people who have mental illnesses?
-Does being mentally ill make you exempt from God’s work and unable to meaningfully participate in worship when one in four people have been statistically proven to suffer from mental illness at some point in their lives.

The awkward moment when it becomes plausible that Jesus suffered from Schizophrenia (Just to clarify: this wouldn’t in anyway take away from his religious position, history and achievements).

A study was conducted by psychiatrists when they were presented with a concept by a paranoid schizophrenic patient, who claimed that he could read minds and was selected by God to provide guidance for mankind. The patient refused to take the medication because they stopped the voices, presenting his doctors with the question: “How do you know the voices aren’t real…How do you know I am not The Messiah…God and angels talked to people in the Bible”. The patient raised interesting questions, how does one distinguish between people with mental health disorders and those of religious figures in history?

One of the examples the doctors used in their journal article was Jesus, by examining passages within the bible they located specific areas that presented symptoms of mental illness:
Paranoid-type (PS subtype) thought content: Matthew 10:34–39, 16: 21–23, 24:4–27; Mark 13:5–6; Luke 10:19; John 3:18; John 14:6–11

Auditory and visual hallucinations: Matthew 3:16–17, 4:3–11; Luke 10:18; John 6:46, 8:26, 8:38–40, 12:28–29

Referential thought processes: Mark 4:38–40 (Figure 3); Luke 18:31

Within the New Testament Jesus exhibits behaviours that closely resemble the DSM-IV-TR– Auditory hallucinations, Visual Hallucinations, delusions, referential thinking, paranoid-type, (PS subtype) thought content, and hyper-religiosity. Through the text Jesus also displays signs of disorganization, negative psychiatric symptoms, cognitive impairment, or debilitating mood disorder symptoms. The article poses the question about whether starvation and metabolic derangements caused some of the behaviours as Jesus experienced hallucinatory-like visions whilst he fasted for 40days in the desert (Luke 4:1–13).

Jesus’ experiences appear to have occurred over the course of at least the year before his death. There is a notable lack of physical maladies which suggest psychiatric aetiologies as more plausible. There is a 5%–10% lifetime risk of suicide in persons with schizophrenia.  Suicide is defined as a self-inflicted death that has intention to end one’s life. The New Testament recounts that Jesus was aware that people intended to kill him.  Jesus took the steps to ensure that his followers were aware that his death was necessary for his return (Matthew 16:21–28; Mark 8:31; John 16:16–28). These passages appear to present Jesus to deliberately place himself in a situation wherein he anticipated his execution. Schizophrenia is often associated with increased risk of suicide.

There is a term called ‘suicide-by-proxy’, any incident whereby a suicidal individual causes their own death to be carried out by another person.  Jesus’ behaviour before his death has parallels with someone who premeditates a form of suicide-by-proxy. In the passage Mark 3: 21: Jesus was on occasion viewed as mad or “beside himself.” People from Jesus’ hometown and the religious authorities of the day also did not accept his message. Subsets of individuals who have psychotic symptoms appear to be able to form intense social bonds and communities, despite having distorted views of reality. The study analysed the religious figures from a behavioural, neurologic, and neuropsychiatric perspective. The research indicates that the experiences of the individuals coincide with psychotic symptoms, suggesting that manifestations of their experiences had a primary or mood disorder-associated psychotic disorder basis.

A main goal of this research was to evaluate the influence of individuals with mental illness and their effects on shaping the Western civilization, hoping that the findings will help to increase compassion and understanding in relation to mental illness. Within the research it should be noted that they did use explicit passages from the bible, but each passage should be examined in its own context. It is generally acknowledged that biblical scholars are not unanimous about the literality of the scriptures nor are psychiatrists completely unanimous about the DSM (basically the bible of psychiatry). The research conducted a form of psychological profiling by people that aren’t saddled with the preconceived notions and biases that encumber those that have studied their field in depth, allowing a fresh take on ideas that have been overanalysed by people in the same area of study.

Only by joining multiple areas of study can any true concept of history be interpreted, attempting to remove the elitist theories that dominate popular thought. It needs to also be acknowledged that historians aren’t the sole area of study that can interpret history, other fields of study have valuable insights that historians can lack.  The article didn’t stipulate and designate that religion was the cause for psychological symptoms, neither did it go into the scientific explanation, but it still needs to be acknowledged that religion does play a dominating role for some psychoses, especially with delusions. Does the motivating factor of religion in mental illness make it a definable feature??

I’m increasingly intrigued by the article when it encourages speculation on our inability to disprove that a person who is schizophrenic is a mouthpiece of God or is suffering from psychoses. The opposing opinions from both sides need to be taken into consideration; biases from long term studies ultimately detract from the viability of the research. The study showed the correlations that religious historical figures had with the current DSM, they acknowledged their limitations, like either psychological or biblical should do, my main question is this: why would it be wrong if they had suffered from a mental illness, it doesn’t detract from their accomplishments or their religious foundations, each person’s beliefs will always be grounded, who’s to say that God didn’t use psychoses to achieve his end.

I didn’t want to post this all week, didn’t want to ruffle anyone’s feathers. I came across this article, it really interested me, I understand its controversial, I am in no way promoting and detracting from either side and hope my post won’t be interpreted as such. Thank you.

Author and Article Information

From the Dept. of Neurology, McLean Hospital, Harvard Medical School, Belmont, MA (EDM, BHP); Dept. of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA (MGC); Dept. of Neurology, Massachusetts General Hospital, Harvard Medical School, Belmont, MA (EDM, BHP).

Murray, E., Cunningham, M. and Price, B. (2012). The Role of Psychotic Disorders in Religious History Considered. JNP, 24(4), pp.410-426.

Setting The Fox to Guard The Hen House. The Blind Leading The Blind. Psychiatry’s Grand Confession.

I don’t understand how I’m so late to this uptake.

Psychiatric drugs are now a commodity, consumers passively learning to live with and in many instances enjoy. Discovered by accident and lacking an explanation in relation to why they worked. Initially it appeared that psychiatry had found magical pills which ‘fixed’ depression. Doctors attributed the success of psychiatric drugs to chemical imbalances in their patient’s brains which were fixed as a result. Friedman told Times readers, “just because an S.S.R.I. antidepressant increases serotonin in the brain and improves mood, that does not mean that serotonin deficiency is the cause of the disease”.

I now see my psychiatrist as my state-licenced drug dealer. Specialising in ‘mood-altering’ drugs just like street dealers. “Irving Kirsch’s meta‑analysis of antidepressant trials revealed as being just as efficacious as the SSRIs was … heroin”. The chemical imbalance theory is a sham; used merely to reassure people.  No test result can demonstrate that your brain has a chemical imbalance. The pharmaceutical companies appear to have no idea how exactly their psychiatric drugs work, with no confirmable tests that there is a chemical imbalance.

I have always said that psychiatry and psychology were areas of grey, I misunderstood that our complete diagnosis was based on theories and not concrete scientific data. We are medicated based on our symptoms and the current DSM.  I feel violated by the advertisements, a victim of marketing programs, nicely hiding their lack of knowledge about why their treatments work. I’ve been actively sold repeatedly by the psychiatry industry on the concept that bipolar disorder was a chemical imbalance.

Ronald Pies’ article in Psychiatric Times “Psychiatry’s New Brain-Mind and the Legend of the Chemical Imbalance” acknowledges that the chemical imbalance theory is falsified, merely promoted by pharmaceutical companies even though the psychiatry community were aware that this theory was incorrect. Many patients are given the rationale that the illness is based off a chemical imbalance. The concept of chemical imbalance is definitely last-century thinking, low serotonin levels aren’t likely to cause depression as a study has shown that a normal person depleted on serotonin doesn’t become depressed, maybe an abnormality in the serotonin system instead.

Psychiatry has failed to debunk the chemical imbalance hypothesis which misled public opinion. We have been collectively labelled bipolar, restricted to categorisations and a diagnosed ‘box’ of people with a variety of different aetiologies, believing us to be all the same. It’s becoming an over-common diagnosis; the frequency of both legal and illicit drugs playing a vital role in facilitating mania and the diagnostic criteria for a bipolar diagnosis which has expanded with each new DSM.

I’m going to begin the road to un-diagnose myself, believing that I suffered from Iatrogenesis in relation to drug-induced hypomania. My hypomania was a reaction from anti-depressants, I am aware of the counter argument that I was still hypomanic after the medication had completely left my system, but I still believe there is a point to be argued. I’m going to conduct a new search for holistic well-being and medication free approaches.

FEB 2015 update: A holistic approach has currently failed,  send reinforcements.

New Research On The Aetiology Of Bipolar Disorder.

John D. Pettigrew and Steven M. Miller argue that the underlying pathophysiology for Bipolar Disorder remains elusive, the disorder being strongly heritable but acknowledging that genetics are complicated. Pettigrew and Miller use the term inter-hemispheric switching which looks at trait-dependent biological markers associated with bipolar disorder. Proposing that bipolar disorder is the product of genetic propensity of slow inter-hemispheric switching mechanisms which can become ‘stuck’ in one particular state. Pettigrew and Miller state that slower switches are more ‘sticky’ in contrast to faster switches, hypothesising that the clinical manifestations of bipolar disorder can possibly be explained by hemispheric activation, which could be caught on the right (depression) or the left (mania). The research is based on rates of perceptual alteration in binocular rivalries that appears to be slower in bipolar disorder subjects who are in euthymic states in contrast to the normal controls.

The research data showed that bipolar disorder patients clustered on the tail end of the distribution indicating a slower alternation rate. The Rivalry Alternation Rates: Bipolar Affective Disorder (n = 18) vs  Non-Clinical Controls (n = 49). Subsequently the euthymic state of the bipolar subjects at the time of testing suggests that slower rivalry rates can be a trait marker for bipolar disorder. Limitations of this study are related to subjects that have unipolar depression who demonstrated slower rivalry rates, although these subjects were to a lesser extent in contrast to bipolar subjects. The model of “bipolar disorder slow switches are ‘sticky’ switches because the intrinsic channel abnormalities that cause the slow oscillation rate also make the switch more likely to be held down in one state by external synaptic inputs”. A neuronal sensitivity with bipolar disorder argues that it would “lead to increased hemispheric output (in response to a stressor) and might therefore increase the likelihood that the switch will be held down (‘stuck’) on the side favouring that hemisphere”.

Pettigrew and Miller propose that the data suggests that bipolar patients have an increased ‘stickiness’ due to reduced intrinsic currents and greater extrinsic synaptic inputs from stressors, resulting in the patients being ‘stuck’ in a depressive or manic episode as a consequence of a stressor. The research proposes that the wide variety of data is indicative of hemispheric asymmetries of mood and mood disorders. Overall the results of the tests in inter-hemispheric switching might also be applicable to understanding the physiological rhythms of mood, cognitive style and other aspects of human brain function. Pettigrew and Miller outline that there have been reports that creativity is enhanced in subjects with mood disorders and also their relatives in contrast to the general population.  The controversial reports of increased creativity raise the potential for an understanding of the consequences associated with slower inter-hemispheric switching and the rhythms of cognitive style that could reveal neural mechanisms of human creativity.

Please note: this is not an academic essay merely a series of different research I found interesting.

Related/interesting sources:

Altshuler, L., Suppes, T., Black, D., Nolen, W., Leverich, G., Keck, P., Frye, M., Kupka, R., McElroy, S., Grunze, H., Kitchen, C. and Post, R. (2006). Lower Switch Rate in Depressed Patients With Bipolar II Than Bipolar I Disorder Treated Adjunctively With Second-Generation Antidepressants. AJP, 163(2), pp.313-315.

Bost-Baxter, E. (2013). ECT in Bipolar Disorder: Incidence of Switch from Depression to Hypomania or Mania. Journal of Depression & Anxiety, 01(05).

Bottlender, R., Sato, T., Kleindienst, N., Strauß, A. and Möller, H. (2004). Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder. Journal of Affective Disorders, 78(2), pp.149-152.

Buckley, P. (2012). The Neurobiology of the Switch Process in Bipolar Disorder: A Review. Yearbook of Psychiatry and Applied Mental Health, 2012, pp.388-392.

Calabrese, J. (2001). Drug-induced switch rates and their impact in bipolar disorder. European Neuropsychopharmacology, 11, pp.S95-S96.

Goldberg, J. (2010). Substance Abuse and Switch From Depression to Mania in Bipolar Disorder. AJP, 167(7), pp.868-869.

Kauer-Sant’Anna, M. and Yatham, L. (2007). Comment on “antidepressant treatment-emergent switch in bipolar disorder: a prospective case-control study of outcome”. Rev. Bras. Psiquiatr., 29(1), pp.86-87.

Koszewska, I. (1995). P-2-65 Pharmacotherapy in depression during switch from depression to mania in patients with bipolar affective disorder (BD). European Neuropsychopharmacology, 5(3), p.296.

Niitsu, T., Fabbri, C. and Serretti, A. (2014). P.2.d.031 Predictors for manic switch at depressive episodes in bipolar disorder: the Systematic Treatment Enhancement Program for Bipolar Disorder. European Neuropsychopharmacology, 24, pp.S431-S432.

Pettigrew, J. and Miller, S. (1998). A ‘sticky’ interhemispheric switch in bipolar disorder?. Proceedings of the Royal Society B: Biological Sciences, 265(1411), pp.2141-2148.

Is Early Onset Bipolar Disorder a Myth?

I’ve always been curious about a child’s ability to exhibit all the required symptoms of Bipolar to meet the criteria. The other possibility involves the symptoms developing over time to eventuate into Bipolar disorder with the component of environmental factors and the individual traits of the child. My own personal example is severe childhood insomnia and anxiety, aided by my genetic predisposition to the disorder (biological father had BP1). I then question whether the insomnia was merely a symptom that demonstrated that Bipolar disorder was present during my childhood but in varying degrees. As a child I was a very clean individual that would cry at people not washing their hands or leaving a mess, I would also go into a ‘seek mode’ to find particular objects with an obsessive stubbornness that didn’t abate until I had found what I had been searching for, during these times I would also have head and neck aching pain – which was a generalised discomfort or pressure in those areas. Looking back at these times as an adult they highly correspond to my symptoms I currently exhibit during an episode of hypomania.

The psychiatrist who wrote this abstract (40years experience in clinical child psychiatry) believes that prepubescent Bipolar disorder is a misdiagnosis, ascertaining that the children diagnosed with Bipolar Disorder are predominantly based on violent outbursts which are produced by chaotic home life (Kaplin, 2011). The critique by Stuart Kaplin promotes the argument that there is no conclusive biological test for any psychiatric diagnosis. Kaplin further argues that paediatric Bipolar Disorder doesn’t even meet the DSM-IV criteria, stating that children don’t exhibit the appropriate levels of mania and depression that define Bipolar Disorder, bipolar is characterised by extreme contrasting mood poles. Kaplin does recognise that the DSM-IV largely ignores different symptoms that should be based on age and their psychological development, instead the DSM-IV takes a simplistic approach to all ages of development and has one set of criteria, a very ‘one size fits all’ approach.

Children that are diagnosed with Bipolar Disorder don’t seem to display the clear-cut episodes that the disorder is primarily based on. Etiology of psychiatry is always based on the psychiatrist’s perception of the symptoms, presenting ambiguous diagnoses based on areas of ‘grey’ within science. Children that are diagnosed with Bipolar disorder additionally display constant symptoms, episodes not deviating from their usual behaviour. Even with children meeting the manic criteria through their irritable mood, the irritable mood usually isn’t from a distinct period of time, not different from their normal functioning. Children displaying bipolar-like symptoms can also be categorised under a series of other disorders, fitting each accordingly. If a child also exhibits grandiose behaviour or euphoria it can also be attributed to the ability for the majority of children to present ‘grandiose’ orientated behaviour through their games and high imaginative ability.

Overall no objective science can adequately diagnose children to have early onset Bipolar disorder even if they have some symptom indicators, usually in my opinion it’s the environment factors that enhance the childhood symptoms to further develop into the classic Bipolar Disorder standards that are recognised by the DSM-IV.

This is just my opinion. 🙂

MEDS Debate: Bipolar IN Order VS. Bipolar Dis-Order

Being bipolar without disorder.

Tom Woottom “I would rather be on meds with Bipolar IN Order than off meds and still in Dis-Order.”

The simple ‘checklist’ that defines my life, the DSM gives an exceedingly brief checklist to illustrate depression, mania and hypomania, how can I now be defined by these symptoms?!! The list serves to reinforce the confounding issue that the authors can’t empathise with the experiences of those with Bipolar disorder. Symptoms don’t define the disorder; symptoms serve to find a reason why they are suffering or incapacitated. I don’t believe that having the symptoms of depression or hypomania always equal an ‘illness’, if the disorder is managed (medication) and you are merely cycling through emotional stages without having a dysfunctional life, than that to me isn’t a disorder, instead it is a very well controlled series of symptoms that the person is living with but isn’t being incapacitated by. Yes I am bipolar, but with the medication I don’t classify it as a ‘disorder’, disorder implies an unmanaged condition.

The dogmatic science behind the DSM is supported by commercial interest, lacking deeper understandings and direct experiences. Don’t let yourself be trapped by dogma, whereby other people’s thinking determines how you live. To be successfully bipolar isn’t to ‘cure’ it or be off medication, it’s about the ability to function while depressed or manic, even when taking medication.

Tom Woottom: “Medicine can help moderate the intensity during the Freedom Stage of Bipolar IN Order, but they cannot get you IN Order by themselves. The role of medication becomes more peripheral as one moves through Freedom Stage to Stability and is largely irrelevant once one reaches Self-Mastery. There is no point in taking something to lower the intensity when intensity is no longer an issue.”

Another perplexing issue within the medication debate and the considered ‘disorder’ is the perception of depression, having a number of signs and symptoms of the depressive syndrome aren’t a diagnosis, instead people need to identify what disorder is producing the symptoms. There are two types of depressive syndrome: primary or secondary. Secondary is most commonly caused by substance abuse a medical illness (hypothyroidism etc), if no foreseeable aetiology can’t be found then the depression is diagnosed as primary. Overall mental health is usually completely misunderstood, at the moment I don’t think I’m suffering from a disorder, but that could easily change like the weather. I believe I’m on the path to mastering the dis-functionality that has plagued my life in the past, it’s not a short path, but I know it’s worth it and taking my medication definitely helps me to find the things in life that will make me more stable.