We might all be monsters one day

Some of this may sound a bit dated, but it’s written because of a post yesterday on Gin & Tacos called “Incurable“- about how smart, regular people become bitter right-wing fanatics.

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A primary component of stigma against people with mental disorders is belief that the population is inherently violent. If I may forward my own theory, I think in the past decade we have seen an even more radical belief. It’s gone beyond ‘the mentally ill are violent’ to ‘all great acts of violence are done solely by the mentally ill.’

We can never forget what happened at Newtown. The subsequent blame game has important lessons as well. Wayne LaPierre ran a dedicated campaign to deflect responsibility from guns to quite literally anything else. Violent video games, the collapse of the nuclear family, and most frequently, mental illness. Had he been speaking about blacks or Latinos, his tone would have been considered hate speech. The Economist wrote a feature in the aftermath about the campaign, and conclude, bluntly, that “when he talks of mentally ill ‘monsters’ and ‘lunatics’ walking the streets in such numbers that all prudent citizens must arm themselves to the teeth, he is slandering both them and his country, just as surely as any American-hating bigot.”

The APA concurred in several publications, including this statement:

The association objected to LaPierre’s assumption that horrendous crimes such as the one committed by shooter Adam Lanza are commonly perpetrated by persons with mental illness. In addition, he conflated mental illness with evil at several points in his talk and suggested that those who commit heinous gun crimes are ‘so possessed by voices and driven by demons that no sane person can ever possibly comprehend them,’ a description that leads to the further stigmatization of people with mental illnesses.

That bolded portion leads me to my point. It’s the move from tendency to sole causality. In the NRA’s view, and the view of a large portion of the American public, regular ‘sane’ people don’t commit terrible crimes. Ever. That sentiment is dangerous. I’ll talk a little about the present then jump over to a historical example.

A couple years back I read David Neiwert’s The Eliminationists: How Hate Talk Radicalized the RightIt opens with a man walking into a Unitarian Universalist congregation during a children’s play, firing a shotgun. He killed two and injured seven, and they found in his truck a short manifesto blaming liberals for ruining America, and lots of material by right-wing talk radio and television personalities. The UU church took out a full page ad in the New York Times in which they declined to hate in favor of love, perhaps their finest hour in recent years.

So was this shooter completely insane? Or was he made violent by extreme political talk, over months and years? In this case, was it perhaps not genetic mutation but cultural influence that cause him to strap dozens of shotgun rounds onto his person and enter a sanctuary to kill indiscriminately?

Similarly, are those that shot Muslims and Sikhs in the aftermath of 9/11 totally insane, or lashing out in grief and pain to make someone pay? Is not racism learned rather than a born trait?

Is every person in the US military insane when they plan and execute military operations that may kill far more civilians than Adam Lanza ever did? What about business executives who cut corners to increase profits, which could injure or even kill workers or members of the public?

Perhaps these things make people insane, and thus capable of great crimes. If that was the case, why is the NRA’s rhetoric, that  ‘The only thing that stops a bad guy with a gun is a good guy with a gun” bravado exempt from that trend? Even if some people are just by birth monsters, it is absurd to think that monsters cannot also be created- or that people can deteriorate at some point.

This doesn’t even touch how hypocritical groups like the NRA have continually been about mental illness. Dumping stigma on a group will not lead to more people getting treatment and being less of a threat to themselves and (possibly) others. It will keep people from getting treatment, because it is now thought of as a synonym for evil. The rhetoric is self-defeating, which reveals what it was all along- typical political scapegoating. Any speech by any politician of any background that identifies something else as the problem, yet is disinterested in taking steps to solve it, is not worth the paper it was printed on.

This whole process, which started well before Newtown but has organized itself since then, is about denying our collective capacity to do horrible things. You can see this in any discussion of a genocidal regime or dictator- as usual Hitler is the most visible, but there are dozens. People treat Hitler as a different species- something unique for all time, that could never be replicated. And in that, they let their guard down, and forget that as twisted a soul as Adolph Hitler was, he was still a human. He has more in common with each of us than society would ever like to admit.

To think that the ‘regular’ section of American life couldn’t possibly commit horrible atrocities is naive. It’s not all at the feet of mental illness, just like how Newtown wasn’t all at the feet of guns or violent media. But the more the United States public is willing to accept reality distortion to meet short-term political goals, the less will be done to make all citizens safe from criminals- of all types.

 

 

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The Istanbul Convention- domestic violence gets the spotlight

Today, Andorra became the 10th country in the Council of Europe to ratify the Istanbul Convention (text of the convention here). The document establishes definitions and legal standards for domestic violence, violence against women, forced marriages, and female genital mutilation. While the signatories need the teeth to turn these standards into the legal reality, it is encouraging to see an entire document devoted to the many types of gender-based violence.

Also, go Andorra.

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In dust and blood- Syria’s civil war shuffles past its third anniversary

Aftermath of a barrel bomb attack, Aleppo, Syria. Credit: Firas Badawi//Reuters

Aftermath of a barrel bomb attack, Aleppo, Syria.
Credit: Firas Badawi//Reuters

Last week the UN human rights head released a report indicating widespread use of torture by the Assad regime and many parts of the armed opposition- in particular religious hardliners.

An activist group estimated the total death toll in the Syrian civil war to be 150,000 a month ago. Hard numbers are difficult to come by, given that outside journalists are often targets.

After an initial nonviolent period, the Assad regime began using lethal force on protestors in April 2011. Thus it could be said that the Syria we see today was birthed three years ago.

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In velvet spleandor

In velvet spleandor;
meandering, undulating;
to a place where no line runs;
straight;
and no word said;
with grand clarity;

gleaming towers;
they shine;
shimmer;
into shade then shadow;
to a place where form and function;
matter not;

to a place where love and hate;
disease, vitality;
flow free;
and never can the captured see;

never can the captured see;

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Misdiagnosis, fear, the journey towards recovery

from the Mayo Clinic

from the Mayo Clinic

The San Jose Mercury News has a fantastic news feature out- “Misdiagnosed Bipolar: One girl’s struggle through psych wards before Stanford doctors make bold diagnosis and treatment.” It relays the experience of a middle-schooler (Tessa) who developed a series of violent and bizarre symptoms- not over a long period of time like many mental disorders, but within a couple of days. Several successive psychiatrists diagnosed Tessa as bipolar, although two Stanford doctors (Jennifer Frankovich and Kiki Chang) believed her symptoms matched a new and poorly-understood condition- Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). Her brain wasn’t out of balance- it was under attack from its own immune system.

Misdiagnosis is all too common. In juveniles there is an ongoing war between psych professionals as to what bipolar disorder even is in that context. For the DSM-V standards, a controversial new disorder, Disruptive Mood Dysregulation Disorder (PDF), has been added. It will help better explain the huge spike in children diagnosed as bipolar, but don’t meet all the criteria. Or maybe DMDD doesn’t exist. Depends on who you ask.

A fear I have had is that when I switch to a new psychiatrist, they won’t understand my unique case and diagnosis. My current psychiatrist has a decade of data on my mood, symptoms, and reaction to medication- but that doesn’t all carry over to another person. That’s why I went to the Stanford Bipolar Disorders Clinic some time ago, and got a full intake with one of their experts. In short, that person agreed completely- I fit the criteria for bipolar II disorder, my mood swings are seasonal and rarely linked to stress or other aggravating factors. Together, there is a solid dossier of important information of who I am, and what the last nine years have been like for me.

A major issue some with bipolar symptoms have when they walk into a clinic and meet a doctor they’ve never seen before. Unless they’re actively in a manic or hypomanic episode, they may be diagnosed with major depression, and be given anti-depressants. This is a numbers game- more people have depression than bipolar. Looking at official numbers, it’s about 3:1 if you include chronic minor depression. However, anti-depressants are the worst thing one could prescribe for a bipolar. I have personal experience on this issue.

In 2012 I had a long period of chronic fatigue and depression- it was decided that a jolt of antidepressants for a short period could help break that.

And it did! Oh boy it did.

The situation was more complicated, however. Part of the reason I was so tired was that I had some untreated infection that eventually cleared. My body was getting more active and energetic on its own. The medication just shot my mood into the stratosphere. It wasn’t a typical manic episode (as type II I shouldn’t get those), but it was more intense than any episode before. This was my last major crisis; chain of medication aggravating the situation.

It’s terrifying to develop strange symptoms suddenly. Anyone who has had it happen in their family or among their friends knows the sense of anxiety and fear. That’s the nature of mental illness; it can happen to anyone, and each case is unique. Medication that works well for most may be worthless. Rare side-effects can crop up, even for people who had never had adverse reactions to medication before.

As with PANS, there may be other considerations that we don’t even know at this point. It’s 2014, science has made gigantic steps in the past decade, let alone the past century. Yet many neurologists think PANS is bullshit, and research on it is in its infancy. If Jennifer Frankovich and Kiki Chang are correct, then many families may get their children, wives, husbands, siblings back from the darkness. Still others are waiting for a diagnosis and a treatment.

 

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Where demons dwell

Dimly lit,
patrons quiet,
assaulted by a Top 40
single that cracked the
top ten, despite
popular opinion-
total shit.

It stirs
voices quiet
yet clear, precise
a decade’s pain
crystallized

Fun?
Disappointing?
Forgotten, really
the stenographer
erases
the night before;
bourbon as
a burning salve
to an open wound
lying deep
where demons dwell
where the mind wishes to forget

 

 

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Holding your two selves together

BipolarColor

Image by Andrew Mackay.

Growing up, I was diagnosed with anxiety at an early age. From age seven onward therapy was a regular aspect of my life- it was just another after school activity. Some kids went off to learn viola, I went to a biofeedback room to learn how I could control the fear and unease that ruled my life.

That was the diagnosis up until just before I turned fifteen- anxiety. General anxiety, social anxiety, separation anxiety. It was something, a vague combination of all the ways one can feel out of place and time. There were constants. To this day I hate calling people on the phone, which dates as far back as I can remember. But it was in flux. Maybe some of this was obsessive-compulsive disorder (a psychiatrist theory). Or just a weird adolescence. Perhaps I suffered the same fate as many ‘gifted’ children- a dysfunction around others, even those I had a lot in common with.

The lay of the land changed when the moods formed a pattern and my problems found a name. Ever since, life has been about reconciling old issues with newer ones. What is anxiety to me? Where does it fit now? Is it fully independent of bipolar, its own sovereign disorder- or perhaps that they feed each other in a cycle much like the steady sin wave that governs my mood swings and struggles with the extremes of bipolar disorder.

Anxiety, as it stands shortly before I turn twenty-four, is a symptom. A special sort of symptom, fed by hypomania followed by depression. It is the metaphorical headache that comes with reconciling two wildly different, but very real persons. After engaging in stupid or dangerous things while manic, my depressive self must deal with the social ostracism and humiliation. I’ve heard classmates and friends telling me they prefer the funny, hypersocial me- the same one I fear and hope never reappears. Each cycle one self creates commitments, strange friendships, debts monetary and not- then the other self must sift through them. A constant reminder of behavior that is both at times shameful and bizarre. Why did my depressive self let all this crap pile up? Why did my hypomanic self blow all that money?

To me, bipolar disorder is not just the two selves with little in common. It’s the attempt to be sinew, and connect the various fractions into a coherent self. It’s difficult and demanding- and gives me great anxiety. But anxiety is not a standalone issue- it is the water gushing from the crack on the dam. You can buy all the buckets you can find, and gather the water to keep it from flooding what lies below- but the water will never stop. The crack needs to be fixed. Thoreau spoke that “There are a thousand hacking at the branches of evil to one who is striking at the root”. Day-to-day maintenance is so overwhelming that in the past I could rarely ponder “why am I anxious?”

This present period of stability is incredible. It far surpasses the most raucous fun of hypomania, and it is the most treasured possession I have. It has allowed me to understand symptoms from a new perspective- the major cause is being controlled, so what still bothers me?

And anxiety is still there. I don’t like calling even close friends on the phone, or knocking on a stranger’s door. The anxiety is less widespread and reminds me more of my pre-bipolar past, talking with a soft-spoken psychologist and trying to control my breathing and body temperature with biofeedback. This is what remains, once the anxiety of reconciliation is kept to a dull roar. Like the tremor in my right hand from lithium, it’s okay that it exists. I can handle it. I’m okay.

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