Mental health and “coolness”

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Had a few conversaions recsetly about people faking mental illnesses, specifially people faking DID. Now whenever these topics come up the first thing I think is “why would anyone fake this?” and the most common reply is “attention” or “be look cool”. Now ok the attention one I sort of get, but to look cool? really? How exactly is essentially saying “so ye, I was raped and abused as in infant and so my mind sort of split as a defence mechanism, so now I don’t remember large chunks of my life, I get awful headaches, doctors don’t trust me with medication, I can’t hold down a job and I get confused by really simple stuff” cool? Maybe I am just out of the loop and misunderstand the meaning of the word “cool” but to me the fact that a person was ABUSED is not a “cool” thing and pretending that you were abused just so that you have something to say when conersations start to die is also not a “cool” thing.

I don’t know, I just don’t get it… living with this is HELL 90% of the time. The constant noise, the never knowing what day it is, the never being able to plan anything as you’ve no idea if you are going to be functional let alone “you” on any given day, the “waking up” in unknown places and haing to go into a shop to ask “excuse me, thais may sound like an odd question, ut what city is this?”, not to mention the flashbacks, the nightmares, the insomnia, the “flashes” that make nosense, the fact that no therapist will touch you with a barge pole so you are constantly being bumped from one psych to another, etc…

Just some thoughts… Also if anyone I’ve been talking about this with reads this: none of this is a critism or anything like that, it’s just basically me thinking out loud and wanting to get some peoples opinions in order to help me to understand.

Some petitions

The feelings of an abused child

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An attempt to express the feelings that a child goes through during an abusive upbringing. This needs some editing, I wrote it while still semi-dissociaty after a flashback while the feelings were still there so the grammar and stuff needs looking at.

They claim that they love and care for you, but that you need to be taught about the horrors and evils of the world to be made stronger. They both protect and comfort you, but also place you in situations where you feel that you are going to die you experience pain so intense that you cannot think; your head spins; our insides burn; you can no longer remember who you are or why you are here.

All you know is pain, all you feel in desperation. You consider crying out for help, but no one will listen, you can’t stop nor change what is happening. No matter that you do or say the pain will never stop. You are told the pain and suffering, the fear and horror is for your own good. Told that you need discipline, that you asked for it with your misbehaviour. Betrayal seems like too simple a word to describe the feelings of pain, loneliness and isolation.

When you try to talk about the pain you are told that you must be crazy: “nothing bad has happened to you”, “stop looking for attention”, “shut up already”. Each day you begin to feel more and more like you no longer know what is real. You stop trusting your own feelings as no one else acknowledges them so you must be over-reacting.

You learn to do everything that you are told with the upmost compliance, you forget everything that you ever wanted or hoped for. The pain is still there, lurking beneath the surface, but it is easier to pretend it’s not there, to bury the horrors that are in the deepest darkest corners of the mind.
The pain grows to an unbearable level, until your feelings start to shut down, you become numb: lonely and desperate you begin to give up on the senses that make people feel alive. You feel dead, you wish you were dead, there is no way out and there is no hope.

Self-harm – the reality

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Self-harm is generally defined as acting to deliberately injure yourself physically. The exact form of harm varies, some forms being invisible or don’t leave a wound, whereas others are visible, damaging the skin or other outer area. These visible forms (especially cutting) are seen as a more common form, but due to the secrecy held by many self-harmers regarding the activity and their reluctance to seek medical attention make it difficult to judge the real scale of self-harm.

Some people always harm using the same method, others use different methods based on what is available at the time or what will be easiest to hide. Some people who engage in self-harm do so only on specific parts of the body, others will vary in what area they harm, though many do say that they favour one area, failing to get the same degree of relief/comfort/pain/etc from other areas.

One very important thing to remember when discussing self-harm is the difference between acts with the intention of causing harm to the body and acts with the intention of ending ones life. In some ways these two actions could be seen as opposite to one another, with suicidal actions aiming to escape from life by ending it, whereas self-harm is an attempt to cope with life with the aim of continuing it. However, it is important to be aware that self-harm is often very closely linked to suicidal thoughts and attempts. Statistically those who self harm are many times more likely to attempt suicide than those who do not. Even those who are not suicidal may risk their life unintentionally if their harming becomes serious. Most teenagers say they harm in an attempt to express distress and escape difficult situations, but every year some lose their lives, even though this was not their aim.

How common is self-harm?

As with many emotional and mental health issues, where so many keep their suffering a secret, it can be very hard to gain accurate figures.  Another important consideration is that often even the friends and family of the person will be unaware of the self-harm, to such a degree is this secrecy.. What we do know though is that in the UK alone self-harm is responsible for over 150000 admissions to A&E a year, and this is only counting those who admit to their wounds being self inflicted. Research conducted anomalously through charities and support groups also indicate that only about 15% of people who self-harm will seek medical attention for their wounds, so this 150000 really can only be seen as the tip of the ice-berg.

People of all ages and from all backgrounds may at some time engage in self-harm, though it is most commonly seen among adolescents.  The NICE report into self harm indicates that the average age changes of adolescence have been removed, but for many the issue will continue into adulthood. Self harm seems to be more common in females than in males overall, though in fact more boys than girls under the age of 10 are admitted to hospital due to self-harm. In adolescence, girls may be around two or four times likely than boys harm in different ways and may be more likely to cover it up as the result of an accident or a fight. Self harm also occurs in adults, and there is some evidence that adults who self harm are at greater risk of serious consequences such as suicide attempts or hospital admission.

One group of adults who seem particularly vulnerable to self harm are prisoners, over half of female prisoners on remand say that they have self-harmed at some point in their lives. This may be because some of the common triggers of self-harm are more common in those who are vulnerable to committing crimes than in the general population, the actual prison environment may also serve to cause self-harm as prisoners are likely to know others who self-harm, may be discouraged from openly expressing emotion, and are often unlikely to gain access to support for mental health issues.

Is it worth it?

This is a sensitive area, but it needs to be discussed I think. I started self-harming at the age of 6, I am now 23, in that time I have had a bit of  a love/hate relationship with the act. Self-harm doesn’t just cause instant damage; there can be long-term effects, as well.
Each method of self-harm has it’s own variety of physical long-term risks from scaring to internal damage. Cutting is seen as the most common form of self harm, this has many risks not only scarring – cutting your skin can have more serious consequences. If you are cutting your wrist, you’re not very far away from the mechanics of the inside of your arm, every year lots of people injure tendons, nerves, blood vessels and muscles. And although some of these can be repaired, if you cut a major nerve in your wrist you can be left with permanent weakness or numbness in your hand. Burning is similar to cutting in that it causes damage to the skin and can leave a scar, but burns are far more likely to become infected which creates it’s own set of problems. Chemical burns, however, can cause massive destruction and people can even lose limbs. Potentially it can be life threatening.
Because of the fragility of the head and brain, repeatedly banging your head against a wall or another object could do long-term damage. While there hasn’t been particular research into head banging as a form of self-harm, researchers have investigated whether footballers are at risk of brain damage through heading footballs and in 2002, a coroner ruled that Jeff Astle, a former England World Cup player, died from a brain disease that was caused by constantly heading footballs. Meanwhile, research from America found that the greater the number of times a ball had been headed, the more that reaction time and flexibility of thinking was reduced.
An overdose of any drug is not healthy for your body, and the effects will vary depending on what you took, and the quantity. The main organs affected by paracetamol overdoses are your liver and kidneys. Assuming the initial effects are treated, there is then a chance that long-term organ damage can occur.
There are other forms of self-harm too which are equally dangerous, but these are less common so I will not discuss them here.

The effects of self-harm those are not just physical. The act and the resulting scars make you feel like an outcast, people judge you for what you have done, you feel guilty and ashamed which causes a decrease in self-esteme and people to retreat from society and from the help and support that is out there. When a person has relied on self-harm as a form of coping for a long period of time it also becomes their main coping method, when things feel too much the mind automatically goes to self-harm any and all alternative methods of coping are thrust from the mind until it feels as if self-harm is the only way to feel better. Due to this recovery from self-harm requires not only being able to let go of an act which you have come to rely upon but also relearning other ways to cope and to deal with things which occur in life. This is a long and difficult process.

Self harm is a legitamate coping mechanism, but there are better ones out there. When you self-harm you get a temporary release, but once that’s faded the problem is still there with the added issue of isolation, shame and possibly a hospital visit. In short, no, self-harm is not worth it, but for many it has become their sole method to getting through life. So no, self-harm is not a good thing, it’s not something that should be celebrated nor taken lightly, but it also should not be ridiculed and those who suffer and struggle with it should not be shuned for the act. People need support and understanding not isolation and insults.

Common mis-diagnosis’s and co-mobidies of DID

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On average a multiple will be in the mental health system for 7 years prior to diagnosis and during this time may receive several varying diagnosis’s. They often include:

Temporal lobe epilepsy’

Dissociation is more common in patients with temporal lobe epilepsy than in any other neurologic disorder. The clinician should refer patients with dissociative symptoms for a thorough neurologic workup to rule out the presence of temporal lobe epilepsy or other organic processes. The standard EEG is of little help in distinguishing MPD from temporal lobe epilepsy because a high rate of nonspecific abnormalities has been detected in patients with MPD, most commonly bilateral temporal lobe slowing.

Schizophrenic disorders

The differentiation between dissociation identity disorder and schizophrenia can be made along several lines.

Patients with schizophrenia hear voices emanating from the external world, whereas patients with dissociation identity disorder hear voices originating from within the individual’s own head.

Patients with schizophrenia may experience visual hallucinations, although they are less well formed than those observed with certain other brain disorders. Patients with MPD occasionally experience hypnagogic phenomena.

Poor reality testing is observed with schizophrenia, whereas patients with MPD have essentially intact reality testing.

Tangential or loose associations accompanied by inappropriate affect are commonly observed with schizophrenia. Patients with dissociation identity disorder may have circumstantial association with appropriate affect.

Borderline personality disorder

Borderline personality disorder has been diagnosed in 70% of a sample of 33 patients with dissociative disorder and in 23% of 70 patients with dissociative disorder. Putnam acknowledged that a large number of his cases resembled Briquet syndrome or somatization disorder, but, like other investigators, he proposed that once the diagnostic criteria for MPD are satisfied, MPD should be considered the superordinate diagnosis because working with the alternates can provide a therapeutic device that cannot be used in the unified individual.

Malingering

Malingering is said to be an important differential diagnosis in times when an obvious gain may result from mental health intervention. Malingering is the deliberate and fraudulent production of false and exaggerated symptoms to deceive observers for secondary gain that is recognizable with an understanding of the individual’s circumstances.

Dissociative amnesic disorder

MPD may prove difficult to distinguish from other dissociative amnesic disorders. With other dissociative amnesic disorders, behavior may be complex, but recovery is often complete, recurrences are less common, and the onset of amnesic spells may be intimately related to stressful events or to ingestion or intoxication.

Mental health and the political parties pledges

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Many people, politicians included, assume that mental ill health is a medical issue that affects a small number of people. By many political parties mental health is seen as a security treat and a drain on the ecconomy, but the people behind the disorders are forgotten about.

In fact, one in four people experience mental health problems, and it costs the economy £77 billion per year in England alone – so mental health is very much a public health issue. We need candidates to understand that social factors – such as crime, debt, unemployment and poor housing – all affect our mental health and wellbeing, so there are things they can do to improve mental health in their constituency.

The Conservative party are committed to repealing the Human Rights Act (HRA). In their manifesto they state: “To protect our freedoms from state encroachment and encourage greater social responsibility, we will replace the Human Rights Act with a UK Bill of Rights”. The Labour party and the Loiberal Democrats both oppose the repeal of the HRA.

There is widespread opposition to the repeal of the HRA among leading voluntary and community organisations. The HRA represents a clear statement of the fundamental rights of British citizens and is a vital tool for holding government to account and protecting our civil liberties. It defines the relationship between parliament, citizens and the courts. As the alliance of leading voluntary organisations co-ordinated by the British Institute of Human Rights has pointed out that the HRA can provide a lifeline to individuals from all walks of life, from elderly people in care homes to disabled children and those who struggle with mental illness. It is a protection for us all and in particular for the marginalised and vulnerable in our society. If the Conservatives did repeal the HRA then this suggests that a Conservative government intend to water down our rights and would be less accountable to the courts.

In their election manifestos, Labour has promised more than 8,000 new psychological therapists, the Conservatives have pledged to increase access to “talking therapies”, and the Liberal Democrats say they would improve access to counselling and protect mental health services. Yet despite such promises, Monitor, the independent regulator of NHS foundation trusts, sent out a letter to the organisations it oversees this month warning UK mental health providers to prepare this year for extra cuts, which mental health charity Rethink estimates could amount to £50m.

Mental illness could almost be called the invisible killer, which is why it is the first to be neglected when there are cuts to be made. However, the current downturn has created a greater demand for mental health services, as Roehampton University in south London found this month. Its study with children’s charity Elizabeth Finn Care showed that 71% of people who lost their jobs last year displayed symptoms of depression.

Upon closer inspection of the parties manifestos though some disturbing things can e seen. The Conservatives, for example, mainly only mention mental health in relation to “a threat to society” and in terms of “financial cost” even going as far as to insist that everyone with a mental health disorder should get back to work within 3 months and then implying that anyone who cannot should essentially be on an in-patient programme… Now this may just be me, but does that not sound a bit like “contribute to society or be instritusionalised”? The Conservatives seem to completely fail to relise two fundermental facts: 1) for some sufferers of mental illness employment is not a practical option, and 2) studies have shown that many people with mental illnesses do better and recover mre easily when they remain in the community with support rather than being put into hospital.

Other than Labours promice to add 8,000 new psychological therapists mental health isn’t really mentioned in their manifesto, and they also fail to explain where these 8,000 therapists are coming from, how they will be paid for, nor how this will help the mental health system.

Out of the main 3 paties the Liberal Democrats are the only ones who have pledged to protect the mental health services from cuts, which to me implies that the other 2 parties may be planning to make said cuts.

Out of all the parties the best policies on mental health and disability in general are defantly set down by the Green Party, but they were never really likely to win the election, though they did gt one seat which I was impressed by 🙂 .

So anyway… This election has been a complex affair and as yet we can’t predict much. But one thing I think we can say is that improvements in the mental health service are unlikely and unless we get a hung parliment which gives the Liberal Democrats some degree of infuance then we are likely to face cut in the near future.

The UK election and mental health

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Mental health has been dubbed the ‘Cinderella service’, traditionally neglected by health policy makers and receiving proportionally low funding when compared to its burden on society.  The launch of the National Service Framework for Mental Health in 1999 by then Health Secretary Frank Dobson was intended to show the new Government’s commitment to this area.

There have been few specific commitments from the Conservative Party on how they would propose to improve mental health services. What we do know is that the Conservative Party wants to see an increase in the number of people with a mental illness returning to work, indicating that they recognise the full economic costs of this condition. So basically we cost too much by being ill?

Of cource the Conservatives seem to fail to recognise that for some mental health sufferers employment will not be a practical option, and that instead volunteering projects may help them to regain confidence and self-esteem. But meh, just worry about how much our illness costs you, that’s fine… until you become one of the 1 in 4 effected by mental illness that is…

Mental health would be a big winners in the event of a hung parliament. As the polls have narrowed speculation has begun about the issues on which the Liberal Democrats may exert pressure in a partnership with a minority Government. Mental health has been an issue on which Nick Clegg has sought to take a leadership position. He has explicitly stated, for example, that budget cuts should not hit mental health services and has proposed extra support to help those from whom the recession has caused mental health problems.

Specific proposals include training debt advisors to recognise mental health problems, allowing individuals to freeze their credit rating so that they won’t be given new loans or credit cards, and encouraging banks to offer people who have declared mental health problems supervision of their accounts.

These are the sort of detailed interventions in mental health policy which are often not heard from either Labour or the Conservatives. So it is just about possible that in a coalition government – or if we end up with a Lib Dem-supported minority administration – mental health services may end up being accorded greater priority.

Freud and dissociative identity disorder ( DID )

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The majority of patients in Josef Breuer and Sigmund Freud’s book Studies on Hysteria (Breuer & Freud, 1895/1983) were described as having been victims of sexual abuse and up until 1895 Freud considered that the majority of his patients were suffering from the aftermath of sexual abuse in childhood.

Freud then rejected this idea. There has been a great deal of speculation regarding this decision. Freud’s biographer, Ernest Jones (Jones, 1953), proposed that given many of the fathers of his patients were part of his own social circle, it would have been difficult for Freud to publicly state that his patients had been sexually abused as children.

to then explain the symptoms of his patients, in the absence of any real trauma, Freud produced a socially acceptable theory that denied the reality of childhood sexual abuse. Once the memories of sexual abuse reported by personalities were rejected by Freud as not being memories of true events, then the interpretation of the nature of these additional, or ‘alter’ personalities had to change.

Whereas others, such as Morton Prince (Prince, 1905/1978), had embraced the idea that there could be parallel rational conscious activity which could be described as “subconscious” or “co-conscious”, Freud rejected this idea and invented his unconscious (Freud, 1915/1995). From this point onward Freud referred only to an unconscious as distinct from a subconscious (Ellenberger, 1970.).

The unconscious of Freud, therefore, was not able to hold accurate memories, assume rational control of the body, or to think as would a rational adult. If the sexual abuse was not seen to be true, then the alter personalities (or the “unconscious” for Freud) must be irrational.

Despite the many great contributions made by Freud, this theory and the acceptance of his theory meant that many victims of sexual abuse were not believed and many patients with multiple personalities (or Dissociative Identity Disorder – DID) were to be misdiagnosed. For most of the twentieth-century the reality of many DID patient’s condition was also rejected as their appearance did not fit accepted theory.

Hazel Hall is fundraising for Rethink – JustGiving

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Rethink is an amazing charity, which works to help everyone affected by severe mental illness recover a better quality of life. As a person with PTSD and dissociaitive identity disorder I value highly their work, esspecially their anti-stigma camapains, in supporting those with mental illness and making it so that we are treated as equal citizens.

I chose the 3 peaks challange as before my mental health declined hiking and climbing where 2 passions of mine. Now, however, I fnd the very consept of going outside to go shopping or even to collect the post a struggle. So in August I shall be climbing 3 peaks (Ben Nevis, Scafell Pike and Snowdon) within 24 hours




Hazel Hall is fundraising for Rethink – JustGiving

£6.72 pays for a 30 minute call to  the National Information and Advice Service (NIAS)

£150 will pay for someone experiencing mental illness to attend a training workshop

£1,000 covers the costs of our life saving NIAS for a whole month

Trauma, Memory and the Brain

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Trauma changes our brains on a fundamental level, the psychologically traumatised brain causes inscrutable eccentricities which can (and do) cause it to overreact – or misreact – to stimulus and the realities of life. These neurological “misreactions” become established in part due to the effect that trauma has on the release of certain stress-responsive hormones, such as norepinephrine, along with the effect upon various areas of the brain involved in memory – particularly the amygdale and the hippocampus.

The amygdale is the part of the brain responsible for communicating the emotional importance and evaluation, via the thalamus, of sensory information to the hippocampus. In accordance with the amygdales evaluation the hippocampus will activate to a greater or lesser degree, and functions to organise this information and integrate it with previous similar sensory events. Under a normal range of situations and conditions this system works well and effectively to consolidate memories according to their emotional priority and content. However, at the extreme upper end of this hormonal activation, as with traumatic situations, a breakdown occurs. Overwhelming emotional significance registered by the amygdale actually leads to a decrease in hippocampal activation, this results in some of the traumatic input not being organised properly, not being stored as a unified whole, and not being integrated with other memories. This results in isolated sensory images and bodily sensations that are not localised in time or even in situation, nor integrated with other events. In effect these fragments of memory float about in the mind, ready to reappear at any moment.

To make matters even more complex, trauma may temporarily such down Brocas area, the region of the brain which translates experience into language, the means that we more often use to relate our experience and feelings to others and even to ourselves.

Regular memories are formed and are subject to meaningful modification, they can be retrieved when needed and can be conveyed to others through language and expression. In contrast, traumatic memories include chaotic fragments, which are sealed off from modification or modulation. Such memory fragments are wordless, placeless, and eternal. Long after the trauma has receded into the past the brains record of them may remain a fractured mass of isolated and confused emotion, images and sensations which can ring through the person like an alarm at any moment.

These sensations and feelings may not be labelled as part as belonging to memories from long ago, in fact they may not be labelled at all, as they may have been formed without language. They merely are, they come forward to take over the body giving no explanation, no narrative, no place or time, they are free-form and ineffable.

The traumatised brain has, effectively, a broken warning device in its limbic system. A bit like an old fuse box where the fuses tend to melt for no reason, reacting to an emergency when there is none.