#i'll never know i guess

[postmodernmulticoloredcloak]

This has evoked so many emotions in me and the prevailing one is a sense of... hauntingness.

We have just started understanding so many things. Not many years ago the only thing we knew about the human brain was that we knew pretty much nothing about the human brain.

We sneer at psychiatric practices and theories from the past but people in the future - possibly a near future, not even a far away one - will look back to our progressive times and be freaked out by what we are doing now, the mental institutions we have, the medication we fill our sick people with.

It's not a bad thing, of course. It means hope. But I also grieve for the lives, the happinesses, the joys and serenities that have been lost and are being lost because discoveries that will be taken from granted later have arrived too late for many.

Story from the Washington Post here, non-paywall version here.

Washington Post stop blocking linksharing and shit challenge.

"The young woman was catatonic, stuck at the nurses’ station — unmoving, unblinking and unknowing of where or who she was.

Her name was April Burrell.

Before she became a patient, April had been an outgoing, straight-A student majoring in accounting at the University of Maryland Eastern Shore. But after a traumatic event when she was 21, April suddenly developed psychosis and became lost in a constant state of visual and auditory hallucinations. The former high school valedictorian could no longer communicate, bathe or take care of herself.

April was diagnosed with a severe form of schizophrenia, an often devastating mental illness that affects approximately 1 percent of the global population and can drastically impair how patients behave and perceive reality.

“She was the first person I ever saw as a patient,” said Sander Markx, director of precision psychiatry at Columbia University, who was still a medical student in 2000 when he first encountered April. “She is, to this day, the sickest patient I’ve ever seen.” ...

It would be nearly two decades before their paths crossed again. But in 2018, another chance encounter led to several medical discoveries...

Markx and his colleagues discovered that although April’s illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain.

After months of targeted treatments [for lupus] — and more than two decades trapped in her mind — April woke up.

The awakening of April — and the successful treatment of other people with similar conditions — now stand to transform care for some of psychiatry’s sickest patients, many of whom are languishing in mental institutions.

Researchers working with the New York state mental health-care system have identified about 200 patients with autoimmune diseases, some institutionalized for years, who may be helped by the discovery.

And scientists around the world, including Germany and Britain, are conducting similar research, finding that underlying autoimmune and inflammatory processes may be more common in patients with a variety of psychiatric syndromes than previously believed.

Although the current research probably will help only a small subset of patients, the impact of the work is already beginning to reshape the practice of psychiatry and the way many cases of mental illness are diagnosed and treated.

“These are the forgotten souls,” said Markx. “We’re not just improving the lives of these people, but we’re bringing them back from a place that I didn’t think they could come back from.” ...

Waking up after two decades

The medical team set to work counteracting April’s rampaging immune system and started April on an intensive immunotherapy treatment for neuropsychiatric lupus...

The regimen is grueling, requiring a month-long break between each of the six rounds to allow the immune system to recover. But April started showing signs of improvement almost immediately...

A joyful reunion

“I’ve always wanted my sister to get back to who she was,” Guy Burrell said.

In 2020, April was deemed mentally competent to discharge herself from the psychiatric hospital where she had lived for nearly two decades, and she moved to a rehabilitation center...

Because of visiting restrictions related to covid, the family’s face-to-face reunion with April was delayed until last year. April’s brother, sister-in-law and their kids were finally able to visit her at a rehabilitation center, and the occasion was tearful and joyous.

“When she came in there, you would’ve thought she was a brand-new person,” Guy Burrell said. “She knew all of us, remembered different stuff from back when she was a child.” ...

The family felt as if they’d witnessed a miracle.

“She was hugging me, she was holding my hand,” Guy Burrell said. “You might as well have thrown a parade because we were so happy, because we hadn’t seen her like that in, like, forever.”

“It was like she came home,” Markx said. “We never thought that was possible.”

...After April’s unexpected recovery, the medical team put out an alert to the hospital system to identify any patients with antibody markers for autoimmune disease. A few months later, Anca Askanase, a rheumatologist and director of the Columbia Lupus Center,who had been on April’s treatment team, approached Markx. “I think we found our girl,” she said.

Bringing back Devine

When Devine Cruz was 9, she began to hear voices. At first, the voices fought with one another. But as she grew older, the voices would talk about her, [and over the years, things got worse].

For more than a decade, the young woman moved in and out of hospitals for treatment. Her symptoms included visual and auditory hallucinations, as well as delusions that prevented her from living a normal life.

Devine was eventually diagnosed with schizoaffective disorder, which can result in symptoms of both schizophrenia and bipolar disorder. She also was diagnosed with intellectual disability.

She was on a laundry list of drugs — two antipsychotic medications, lithium, clonazepam, Ativan and benztropine — that came with a litany of side effects but didn’t resolve all her symptoms...

She also had lupus, which she had been diagnosed with when she was about 14, although doctors had never made a connection between the disease and her mental health...

Last August, the medical team prescribed monthly immunosuppressive infusions of corticosteroids and chemotherapy drugs, a regime similar to what April had been given a few years prior. By October, there were already dramatic signs of improvement.

“She was like ‘Yeah, I gotta go,’” Markx said. “‘Like, I’ve been missing out.’”

After several treatments, Devine began developing awareness that the voices in her head were different from real voices, a sign that she was reconnecting with reality. She finished her sixth and final round of infusions in January.

In March, she was well enough to meet with a reporter. “I feel like I’m already better,” Devine said during a conversation in Markx’s office at the New York State Psychiatric Institute, where she was treated. “I feel myself being a person that I was supposed to be my whole entire life.” ...

Her recovery is remarkable for several reasons, her doctors said. The voices and visions have stopped. And she no longer meets the diagnostic criteria for either schizoaffective disorder or intellectual disability, Markx said...

Today, Devine lives with her mother and is leading a more active and engaged life. She helps her mother cook, goes to the grocery store and navigates public transportation to keep her appointments. She is even babysitting her siblings’ young children — listening to music, taking them to the park or watching “Frozen 2” — responsibilities her family never would have entrusted her with before her recovery.

Expanding the search for more patients

While it is likely that only a subset of people diagnosed with schizophrenia and psychotic disorders have an underlying autoimmune condition, Markx and other doctors believe there are probably many more patients whose psychiatric conditions are caused or exacerbated by autoimmune issues...

The cases of April and Devine also helped inspire the development of the SNF Center for Precision Psychiatry and Mental Health at Columbia, which was named for the Stavros Niarchos Foundation, which awarded it a $75 million grant in April. The goal of the center is to develop new treatments based on specific genetic and autoimmune causes of psychiatric illness, said Joseph Gogos, co-director of the SNF Center.

Markx said he has begun care and treatment on about 40 patients since the SNF Center opened. The SNF Center is working with the New York State Office of Mental Health, which oversees one of the largest public mental health systems in America, to conduct whole genome sequencing and autoimmunity screening on inpatients at long-term facilities.

For “the most disabled, the sickest of the sick, even if we can help just a small fraction of them, by doing these detailed analyses, that’s worth something,” said Thomas Smith, chief medical officer for the New York State Office of Mental Health. “You’re helping save someone’s life, get them out of the hospital, have them live in the community, go home.”

Discussions are underway to extend the search to the 20,000 outpatients in the New York state system as well. Serious psychiatric disorders, like schizophrenia, are more likely to be undertreated in underprivileged groups. And autoimmune disorders like lupus disproportionately affect women and people of color with more severity.

Changing psychiatric care

How many people ultimately will be helped by the research remains a subject of debate in the scientific community. But the research has spurred excitement about the potential to better understand what is going on in the brain during serious mental illness...

Emerging research has implicated inflammation and immunological dysfunction as potential players in a variety of neuropsychiatric conditions, including schizophrenia, depression and autism.

“It opens new treatment possibilities to patients that used to be treated very differently,” said Ludger Tebartz van Elst, a professor of psychiatry and psychotherapy at University Medical Clinic Freiburg in Germany.

In one study, published last year in Molecular Psychiatry, Tebartz van Elst and his colleagues identified 91 psychiatric patients with suspected autoimmune diseases, and reported that immunotherapies benefited the majority of them.

Belinda Lennox, head of the psychiatry department at the University of Oxford, is enrolling patients in clinical trials to test the effectiveness of immunotherapy for autoimmune psychosis patients.

As a result of the research, screenings for immunological markers in psychotic patients are already routine in Germany, where psychiatrists regularly collect samples from cerebrospinal fluid.

Markx is also doing similar screening with his patients. He believes highly sensitive and inexpensive blood tests to detect different antibodies should become part of the standard screening protocol for psychosis.

Also on the horizon: more targeted immunotherapy rather than current “sledgehammer approaches” that suppress the immune system on a broad level, said George Yancopoulos, the co-founder and president of the pharmaceutical company Regeneron.

“I think we’re at the dawn of a new era. This is just the beginning,” said Yancopoulos."

-via The Washington Post, June 1, 2023

[egophiliac]

WAIT when did he get FANGS

[barghest-land]

drawings from paleo expedition to dagestan, done right on the trip. sometimes messy when it was cold and rainy, but i won't correct it. i think it's cool to leave it just the way it was done, and not retouch it after. there will be more drawings later, but those will be done from home

[caliartcat]

klavier you're gonna have to be more direct than that

[fedoraspooky]

dusting off the ol' running Mabel meme after all these years because i am Tired

[whatlurksbean]

Hypothetical reigns

an exploration of where I think they'd be if they had been chosen by The Tide instead of Trouty.

Hake would fail, and sturgeon would rule with an iron fist.

[nouverx]

WHY SO SERIOUS?? 🎉 Nika is here to party!!

A little unfinished project I started on flipaclip last year while the Luffy and Kaido fight was still happening in the anime :D

[gayofthefae]

Girl, I'm so sorry, but if you he really was gonna tell her he loved her before Argyle interrupted them, I would not want somebody to say to me

"I guess, I just, I don't know, I guess I just wanted to say that I love you."

You guess you love me? What, you don't know? Be sure then come back to me.

[thesmokinpossum]

If My Body Could Speak, Blythe Baird | The Godfather, Mario Puzo | My Father's House, Sylvia Fraser | To The Daughter Who Secretly Longs For Her Mother’s Affection, Lynne Shako | Storms from Jupiter, Wanda Deglane | DO NOT REPLY, @filmnoirsbian

[mobius-m-mobius]

You wanna hear a good story? Listen to this one.

Mobius + comfort

[beatcroc]

what, didn't you know most amphibians shed and eat their skin? what did you think was going on there, peppino? this is normal frog stuff. come on now.

many more sketches bc i had way too many thoughts about this to try and illustrate all in a comic. horrid beast fp agenda ❤

[hoofpeet]

Various experimental doodles paired with [part of] yesterday's journal entry 👍🐄

[egophiliac]

"IT WAS SUPPOSED TO BE A JOKE" As someone who's been playing TWST since march and stopped going out of my way to be spoilerfree after I got stuck at Overblott!Jamil? That's honestly been one of my favorite things about it - seeing something in fanart or a comment you think is just fans joking, only for it to be canon. "The economy!", "May I also throw a tantrum?", Malleus' gargoyle thing, and... everything about Rook being my top examples.

there's a whole bit in Trey's platinum birthday card where he goes on about how he became increasingly obsessed with mustard for like a week straight until the other students held an intervention. how are you supposed to talk about this. how can you bring up something like Trey's descent into mustard obsession to the point that the other characters are worried for him without it sounding like the most obvious lolrandom "he mentioned it once and now fandom acts like he puts mustard in everything" joke. also, how can I slip this into every Twst post from now on, because I need everyone in the world to know that this is a real canon fact about Trey "I'm just an average normal guy (who sticks my hands into people's mouths and owns 20 toothbrushes and used to eat flowers off the side of the road)" Clover.

for bonus points, 1) the punchline is that he still doesn't even like mustard that much, 2) he's saying all of this to Leona, and 3) Leona is actually kind of invested in Trey's mustard story for some reason, which is the most unbelievable part of all of this to be honest. (then Trey gets distracted by a painting of the Cheshire Cat and Leona takes the opportunity to powerwalk away to freedom before they can start talking about dijon versus spicy brown or whatever and extend this bit even longer)

[barghest-land]

ata tu corazón, mi amor, y arrástralo por la tierra

[kaiserouo]

Machines wearing clothes is another level of sexiness.

Bonus:

[seiwas]

for writing game, iwaizumi + assistance <3

hope this sparks some inspo and thank you in advancee

hi there!! thanks for sending in a prompt 🫶

contains: friends to lovers (ish), halloween parties, reader is dressed as catwoman, expletives, iwaizumi is thiiiiis 🤏 close to murdering seijoh4 (jk)

iwaizumi + assistance

this is a set-up.

iwaizumi knows he shouldn't have fucking believed anything the boys "promised" him back when they assigned him this costume.

the suit is fucking tight, spandex digging into his groins and all other crevices that definitely should be aired out after after a few hours. he's had to constantly readjust his stance almost every few minutes, the black fabric compressing his thighs and torso, significantly constricting the range of motion his shoulders and arms are typically used to. if anything else, it could double up as a back brace from how rigidly straight it's kept his posture all night.

he'll give it to makki though; he did outdo himself sourcing this year's costumes―this batman set looks pretty damn legit.

except for one tiny problem.

there's no fucking pee hole. it's a zip-up, zip-down one-piece situation. and that normally wouldn't be a problem, except that oikawa "accidentally" knocked over a cocktail straight into his pants, the sickeningly sweet liquid now seeping straight into the fabric and past his boxers―cold and sticky as it touches his skin.

and so, the problem: his pants are wet, it makes him want to fucking pee, and coincidentally, the only vacant bathroom is across the hall, at your apartment.

this is why he believes this is a set up. that, and the fact that you're dressed in an outfit strikingly similar―just with cat ears.

he's been asked five times in this party if you're in matching couple outfits.

it catches him off guard, flusters him because of how badly he wants to say yes. but, you're just friends, and he doesn't even think you like him that way (despite mattsun and oikawa practically begging him to confess. makki tells him he thinks you're going to do it first).

so he politely smiles and says no, but you look good, your costume clinging to you in all the right places. thank fucking god he has a cape because he's pretty sure he spent the first 30 minutes in the party hiding his boner.

"hajime, it's fine, i swear," you stand beside him in front of the conveniently locked bathroom in oikawa's apartment. from the other side of the door, he's pretty sure he hears mattsun and his girlfriend mumbling. maybe fucking? who knows. "you can just use the bathroom in my apartment."

he glances at you before closing his eyes, contemplating, before finally agreeing to you.

"okay."

if he's being honest with himself, friends is definitely an incomplete label to what you are. as oikawa's neighbor, you are conveniently around all the time; and oikawa being oikawa, the ever-social butterfly, he's somehow managed to carve a space for you in the friend group.

(never mind the fact that oikawa's sniffed him out from the moment he first introduced you.)

you were a crush, then a friend, and now you're someone he picks up from work and drives back home three times a week, because he "has to train oikawa." you don't question it, even when you both know he stays over for dinner way past the gym's open hours.

"you know where it is," you open your apartment and urge him in.

"sorry again," he turns to face you.

"yeah, yeah, just pee!" you laugh, shoving him towards the bathroom door.

getting out of the suit is manageable, and he's able to wipe off a bit of the cocktail that's leaked to the suit and his boxers just to make sure it isn't gross and sticky when he gets home later. peeing is a big relief once he gets it over with, but it's when he has to suit up again that things become difficult.

stretching out the spandex one body part at a time is a workout in itself―the hardest task being when he has to pull it over his shoulders, adjusting it to fit properly over his arms and chest.

but then the zipper breaks.

and he truly thinks makki has fucked him over.

iwaizumi contemplates what to do next for a good, good while. he tries calling oikawa, only to no success every time; no way in hell is he calling mattsun in the middle of having sex. and calling makki isn't even an option; he'd never hear the end of it.

then you knock on the door, your voice soft and concerned as you ask, "hajime? you good in there?" you hit it spot on, too, "do you need help with your suit?"

iwaizumi presses his palms to his eyes. he's a rational man, straightforward and logical in thinking. there is literally no other option for him right now but to ask help from you. again.

fuck.

.

it's 30 minutes later when oikawa barges in your door, and the sight that greets him is iwaizumi in nothing but a hoodie (the hoodie you borrowed some time ago) and his boxers, with his hands on your waist as you hover your hairdryer over the crotch of his batman costume―cat headpiece off and all.

"you finally got together?!"