Looking At The Glass As Half Full

Thank God for Mental Illness (Photo credit: Wikipedia)

I found this article on Medscape the other day and the contents of it are weighing heavily on my mind. Throughout my life, I have read articles and interviews that proposed highly intelligent and/or creative people were more likely deemed crazy than the general population. Having a rather high IQ myself, this generalization and it’s implications always bothered me. Being labeled “mad” or “crazy” has typically been associated with negative connotations and consequences.  Why is that, I wonder?

I propose that society stops looking at mental illness as behavioral problems and mental disorders and starts looking at them as alterations in brain circuitry. Addressing these issues from a neurological wiring standpoint will go a long way in reducing the stigma attached to the diagnosis and researching treatments that address neuro function as opposed to abnormal behavior. Some of the very factors that contribute to a diagnosis of mental disease are the same ones that contribute to what society considers giftedness.

If a patient presents with a fever, a doctor does not automatically assume ear infection and begin the recommended treatment. Why then would a patient present with say…..depression…..be automatically treated with antidepressants and assume a behavioral  problem instead of a brain disorder? It’s all in how you look at the glass. There is creativity and genius in what society calls madness. We need to accentuate the positive before we pounce on the so-called abnormal behavior. Let’s remove judgement and explore the neurobiology of this class of illness.

The article I am referring to is below.

Creativity and Mental Illness Link Confirmed

Caroline Cassels

 Oct 24, 2012

New research confirms that mental illness is significantly more common in individuals who are in creative professions.

A 40-year, nested, case-control study of almost 1.2 million patients and their relatives showed that bipolar disorder (BD) is more prevalent among individuals in artistic or scientific professions such as dancing, research, photography, and writing compared with individuals in the general population who are not in these professions.

Further, the study revealed that schizophrenia, depression, anxiety, and substance abuse are more common among authors, and that this group was 50% more likely to die by suicide than the general population.

“If one takes the view that certain phenomena associated with the patient’s illness are beneficial, it opens the way for a new approach to treatment,” lead author Simon Kyaga, MD, who is a consultant in psychiatry and a research fellow in the department of medical epidemiology and biostatistics at the Karolinska Institutet in Sweden, said in a release.

“In that case, the doctor and patient must come to an agreement on what is to be treated, and at what cost. In psychiatry and medicine generally, there has been a tradition to see the disease in black-and-white terms and to endeavor to treat the patient by removing everything regarded as morbid,” he added.

The study was published online October 11 in the Journal of Psychiatric Research.

Comprehensive Study

According to investigators, previous research into the potential link between creativity and psychopathology has been “hampered by sample size and lack of standardized tools to assess creativity.”

In addition, they note that to be conclusive, any study examining this association should also address patients’ relatives.

The researchers extended their previous 2011 population-based study on the link between creative occupations and schizophrenia, BD, and unipolar depression.

In this new study, the researchers also included schizoaffective disorder, anxiety disorders, alcohol abuse, drug abuse, autism, attention-deficit/hyperactivity disorder, anorexia, and completed suicide.

Because previous research suggested a high prevalence of psychopathology in authors, the researchers examined this group separately. They also attempted to validate previous findings, showing there is a familial association for creative professions with schizophrenia and BD by using a larger dataset that included patients’ first-, second-, and third-degree relatives.

Finally, they looked at whether the proposed association was influenced by IQ.

More Morbidity in Authors

The investigators analyzed data from Swedish total population registries, in which the occurrence of creative occupations in 1,173,763 patients with mental health disorders and their nondiagnosed relatives were compared with that of matched population control participants.

With the exception of BD, the investigators found no positive link between psychopathology and overall creative professions.

However, the researchers found that authors suffered from schizophrenia more than twice as often as control participants. The investigators report that authors were also more likely to be diagnosed with unipolar depression, anxiety disorders, alcohol abuse, and drug abuse and to die by suicide.

Even after the investigators omitted all authors with any psychiatric diagnosis, they found there was still a trend for authors without diagnosed psychopathology to commit suicide more frequently than control participants (odds ratio [OR], 1.45; 95% confidence interval [CI], 0.97 – 2.16; P = .07).

“Thus, regardless of psychopathology, being an author seemed to increase suicide risk,” they write.

The investigators also noted that this study confirmed results from their earlier study, which showed that family members of patients with BD or schizophrenia were “significantly overrepresented” in creative professions.

They also found a link between creative professions and being a sibling of individuals with autism and being a parent or sibling of an individual diagnosed with anorexia nervosa.

Further, the researchers report that IQ was generally higher in people with creative occupations but lower in individuals with psychiatric disorders and their relatives compared with people without a mental health diagnosis.

The authors have disclosed no relevant financial relationships.

J Psych Res. Published online October 11, 2012. Abstract                                                                  

Related articles

• Creativity Linked To Mental Illness In New Large Scale Study (medicalnewstoday.com)
• Link Between Creativity and Mental Illness Found in Large Study (sciencedaily.com)

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A Case For Coordination Of Care To Include Mental Health Professionals

I came upon this article written about a small research study performed at the University London College.  Upon completion of reading it, I was struck with the proverbial “AHA” moment…..thinking to myself that we should have looked into this before. How many of you have experienced a friend or loved one being hospitalized in the ICU?  My guess is that most of you have had this experience…..probably with an older member of your clan. Were they ever the same when they were released back home? If not, was it more of a mental health issue than a physical one? Were they depressed? Were they anxious, moody, or agitated easily? Did they suffer from sudden onset sleep disturbances or excess fatigue? Did you think to yourself…..well, maybe this is part of their physical ailment or this is part of aging and disease? I can tell you that those have been my thoughts in the past when faced with this issue.

After reading this article and looking at the study it was based on, I can’t believe I hadn’t thought of this before…..maybe they were suffering from mental illness brought on by their hospital stay. This certainly makes a strong case for the development of new standard practices in hospital settings. For so many, many years the fields of medicine and mental health have been separated…..or is the right word segregated?  This is especially true of our traditional Western health practices. We as consumers need to push for more integrative care…..not solely focusing on physical ailments, but treating the person as a whole including their mind. There are some truly amazing pioneers in this area such as Candace Pert and Bruce Lipton, but much more needs to be done. With that said, I have included the article here for all of you to read. I would love to hear your thoughts.

 

Can Psychological Interventions Help ICU Patients?

By TRACI PEDERSEN Associate News Editor
Reviewed by John M. Grohol, Psy.D. on October 20, 2012

Psychological interventions may reduce the mental health problems experienced by many intensive care patients, according to University College London researchers.

The researchers in a new study found that more than half of those who were discharged from intensive care went on to suffer psychological problems.

Researchers further investigated the causes of poor mental health in certain intensive care unit (ICU) patients once they were back home and supposedly “well.”

The study looked at four groups of risk factors (clinical, acute psychological, socio-demographic and chronic health) during the ICU admissions of 157 patients.

Three months after hospital discharge, the patients were assessed to see if they had any symptoms of post traumatic stress disorder (PTSD), depression or anxiety.

While certain drug treatments were identified as clinical risk factors for psychological problems, it was discovered that having acute stress reactions while in intensive care was an even stronger risk factor.

“The research showed associations between sedative drugs such as benzodiazepines, the length of time a patient was sedated and the likelihood of them feeling depressed, anxious and traumatized in future.

“However we found that acute stress reactions felt by a patient in the ICU was an even stronger risk factor,” said Dr. David Howell, clinical director of critical care at University College Hospital.

“As well as looking at modifying our drug treatments, we may need to invest more time in the psychological care of a patient and find ways to prevent psychological suffering in the ICU which can affect the quality of their life in years to come.”

The study found that “level three” patients — those who received mechanical ventilation for over 24 hours or had had two or more organs supported — suffered considerable mental stress both during and after a general ICU admission.

Three months after a hospital discharge, 27 percent had probable PTSD, 46 percent had probable depression and 44 percent had anxiety.

The strongest risk factors were as follows: duration of sedation (for PTSD); use of benzodiazepines (for depression); use of inotropes and vasopressors (for anxiety) and use of steroids (predicting better physical quality of life).

The most notable finding, however, was that acute stress reactions in the ICU were stronger risk factors than clinical factors.

“Our hypothesis is that patients suffer stress and delirium in the ICU due to invasive treatments and powerful drugs received, and those who suffer those stress reactions are more likely to have adverse psychological outcomes in the long-term,” said Dr. Dorothy Wade, health psychologist in critical care at University College Hospital.

A short psychological questionnaire, called the I-PAT (Intensive Care Psychological Assessment Tool), which is used by nurses to assess any changes in the mental well-being of patients, is now being validated by Wade and her colleagues in the critical care unit.

Furthermore, a variety of methods including relaxation, breathing exercises and therapeutic approaches are used to help patients feel safe and more assured. Picture prompts, wearing eye masks and playing soft music can also diminish patients’ distress.

“These are all relatively simple interventions which staff can undertake at the bedside as part of holistic care,” said Wade.

More funding is needed, however, to investigate the effects of these techniques on a patient’s long-term mental wellbeing.

“Research into psychological recovery from critical care is vitally important and more needs to be done. We’re really proud of this study and our work developing the I-PAT, and excited about the next step, which is to examine the effects of psychological interventions while patients are in critical care,” said Howell.

The research is published in the journal Critical Care.

 

The View From The Rabbit Hole

Jessie Willcox Smith’s illustration of Alice surrounded by the characters of Wonderland. (1923) (Photo credit: Wikipedia)

dissociative identity disorder 2 (Photo credit: hunnnterrr)

It’s 2:04 AM where I live. Just pulling out/coming around from the scary part of dealing with Dissociative Identity Disorder. When I first accepted this diagnosis, it came after several months of denial. I had lost time here and there, chalked it up to my body’s response to trauma and physical ailments that would just “shut me down”. I thought I would fall asleep at inopportune times and wake with little or no memory of what had happened. I was being treated at the time with antidepressants and some anti-anxiety meds and was aware of anecdotal tales of other people who had similar time lapses during their days. But then something happened that made me reevaluate all that….and scared me to death.

I live in a suburb outside of Philadelphia. One late afternoon I woke up/ came too in an unfamiliar place. I found myself sitting on a bench in Chicago O’Hare airport departure area. One problem…..three days of my life were missing, I  dressed for Philly weather and not the October chill of Chicago, I had a ticket stub in my pocket, and I had NO IDEA how I had gotten there. Family members back home had no idea where I was, and I had no idea how I had gotten to Chicago….or why. Fear gripped my heart and soul. My thinking was still a bit muddled. I managed to make it back home and immediately started on a quest for answers. I won’t bore you with all the details along the way, but then it happened again. This time, I had a witness who provided me and my health professional team with a first hand account of my bizarre behavior, physical transformation, personality change, and his impression as well as his fear. He at first thought I had been invaded by some “evil spirit” and my behavior from his point of view just defied logical explanation.

Well, this was my first confirmed and verified account of DID…..although in hindsight there had been others.  Since then, I have transitioned/ dissociated many times. It took a good two years for me and my treatment team to find an approach that showed hope for recovery…..after much trial and error. I do not have many of these extended episodes of losing time anymore, but it still happens. The number one trigger that I am still trying to  find ways to cope with in a healthy way is that of direct or perceived violence directed towards me.

It’s not perfect. I am not cured. But I have made real strides toward recovery with the goal of integration or coöperation within the distinct and unique personalities residing in my physical body. Conventional psychology states that severe trauma from early childhood…..events so horrible that they produce emotions that are truly too overwhelming for the preschooler to handle, cause a split in the development of self…..allowing for alternate personalities to emerge as a protective mechanism for the one being abused.

It has been a humbling experience, dealing with this diagnosis. It also comes with a whole host of personal, medical, career, relationship issues that i never dreamed were possible before I actually lived them.  And there is no ONE treatment plan that works for all people…..as is the case with most psychological issues, it is trial and error.

So, I have made real progress in my recovery. But I know I am not out of the woods yet. My recent surgery and interaction with the traditional medical system sent me into a brief relapse, And for anyone out there who has never experienced this emotional illness,  the best analogy I have for it comes from Alice in Wonderland. It truly feels like I fall down a rabbit hole and enter an alternate world that cannot be rectified with my view of reality…..yet it happens.

Imagine waking in the morning, going about the routine of you day, and then somewhere along the way your entire memory just goes blank. You think this has lasted for few minutes, but everything else in the real world shows you that it has been days. Terro then sets in…..what did i do, where did I go, did i do something to hurt myself or others. In a word Terror.

So dear friends, I recently fell down that rabbit hole again. And I am trying to quickly resume my recovery and get back on track. But it takes time, and support. I do not have a history of drug abuse or alcoholism. I held a six figure salary job as a female home builder developing new home communities up and down the East coast of America, I raised my children, and gave much time, knowledge, and inspiration to the young women around the country competing in élite level gymnastics. But all that is all on hold now.

As scary as this sounds, and believe me it terrified me at first, I am determined to move forward and creating a second adulthood on my terms in a way that allows me to give back…..to contribute. Thanks for hanging in there, reading this post, and trying to understand. I am here as a source of support and information for all people dealing with mental illness of any kind. I appreciate all the support I have received along the way, and wish to pay it forward.

Related articles

• DID: Dissociative Identity Disorder (justsouno.wordpress.com)

Advice? Prayers? Help Needed And Requested Please.

Live surgery webcast from Christiana Care Center for Advanced Joint Replacement (Photo credit: Christiana Care)

So, my WordPress friends and family, I am facing  a daunting problem. As reported in an earlier post this week, I was experiencing some severe mouth pain that I felt was connected to unpleasant memories and feelings. I actually was feeling better and thought I was out of the woods. But I am not. Today I was informed, and shown radiological proof that I have osteomyelitis in my jaw that is unresponsive to antibiotics. A portion of my lower  jaw needs excision, removal and replacement with cadaver bone. And because of my artificial joints being highly susceptible to a migrating infection, this needs to happen quickly. Okay. Breathe.

Surgery is scheduled for next week on the condition that I obtain cardiovascular clearance, hematological oncology clearance, and orthopedic clearance in addition to the standard pre-surgery screenings. And it is a short work week here in the US due to Labor Day. Whew. On the bright side, since this is now a medically urgent problem and not a dental one, medicare health insurance will cover a large part of it.

Here is where I ask for much-needed help.  In addition to the typical trepidation one feels when they face surgery, I have the added mental health terrors. Already, I am struggling to BE with my urges to dissociate and horrific combination flashback body memories of having my nose and mouth covered from childhood abuse. I have reached out to all my treating practitioners and my small…..okay teeny, tiny…..support system, but I am feeling very overwhelmed. So, I am asking all of you for your thoughts, prayers, advice, and good wishes because I believe very strongly in the power of collective thought energy. I thank you all in advance for your support and empathy.My usual resolve (which I have worked very hard at) is crumbling now. But I am trying to get back to a space of peace and acceptance.  I will keep on going…..somehow.