#like more consistent clusters than mental illnesses

[queerforscience]

Summary: Unmasking Autism by Devon Price has a lot of good insights, but in my opinion could use more nuance about the harms experienced by early diagnosed autistics and autistics who can't mask.

I've been listening to the audiobook of Unmasking Autism by Devon Price. There's a lot of really good information in it and a lot that's really relatable as a late diagnosed, trans, fairly high masking autistic and I have a few criticisms of it:

It seems that Dr. Price falls into the common "grass is greener" pitfall. The book is focused on the harms of masking and the way that oppression forces many marginalized people to mask. It also discusses the way that this causes many marginalized people to not be recognized as autistic, which robs us of a valuable tool for understanding ourselves and our struggles. I felt that the way these very really harms were discussed sometimes minimized the also very real harms that come with being diagnosed as autistic as a child, especially for marginalized people. These discussions also didn't acknowledge the fact that some autistics cannot mask and experience specific harms because of that.

Similarly, I felt there were some missed chances to emphasize the internalized ableism component of the urge to distance ourselves from the label autism. This was framed in a discussion about how certain stereotypes about autism can make it more difficult to recognize and identify with autism within ourselves, but many of those stereotypes, like "the nonverbal toddler in bulky noise cancelling headphones at the grocery store, do represent some very real autistics who are also valuable human beings. This was addressed some later in the book than when this criticism first arose for me, but I think it's something that should have been more emphasized throughout. Similarly, there could have been more emphasis that people who do fit certain other labels also deserve to be treated better when when discussing the stigma that comes with some misdiagnoses autistic people commonly receive, such as personality disorders.

At least as far as I've gotten, there's a fair amount of discussion of eating disorders among autistic people, but this discussion has been strictly about restrictive eating disorders and primarily anorexia. It's fine to focus on that, but if you claim to be discussing eating disorders generally you also need to talk about bingeing. ARFID should also be included, especially if you're talking about autistics!

There's a lot of discussion about maladaptive drug use and substance use disorders among autistic people, but so far I feel there's been a lack of recognition that drug use can be adaptive as well.

So far, I think I would overall recommend the book. However, I do also worry about what people reading it without also having heard the perspectives of high support needs and/or low masking autistics may take away from it. Similarly, I also think people reading it should be sure to seek out the perspectives of people who do identify with BPD, NPD, schizophrenia, and other highly stigmatized disorders that autistic people are sometimes labelled with.

[damagedcoda6669]

how did youknow youbhad bpd? what were the main "symptoms" ?? soryif it comes off as personal or uncomfy you dont hsveto answer

(im rlly rlly rlly autistic abt bpd PREPARE 4 AN ENTIRE BIBLE ABT HOW I DISCOVERED I HAD IT)

ive exhibited symptoms of bpd my entire life (it usually starts 2 present in childhood or early adulthood, it comes from childhood abuse/neglect) i only started 2 notice something was wrong in my tweens/early teens, when malachi became my favorite person and every1 was calling me mentally ill and weird and obsessive. ive known my entire life i was neurodivergent (first started therapy at 6 or 7, diagnosed with bipolar + autism + adhd + depression + anxiety RLLY early on) but there was something else that felt wrong 2 me. at that age i didnt rlly know what 2 search 4 or who 2 talk 2, so i just went on google and searched "love disorders" and obsessive love disorder came up (which isnt even in the DSM iirc) and i posted on google plus saying i likely had that and was shot down IMMEDIATELY 4 "self diagnosing" so i didnt revisit it again until a few years later.

after my breakup in 2021 i felt like it hurt WAY MORE than was normal. i stumbled across a video abt bpd during that time period and it resonated with me way 2 much. im impulsive, i have angry outbursts, im constantly suicidal, i self harm, i have extreme mood swings, i dont know who i am and ive always just mirrored other ppl, i dissociate, i have black and white thinking, i view ppl as all good or all bad and i split, i have consistently unstable relationships, i get attached 2 ppl more than i should be, and i have a paralyzing, nauseating fear of abandonment. i have every symptom in the diagnostic criteria.

i brought up the possibility of me having bpd with my mom i think (i had no one else 2 go 2 becuz all of my friends abandoned me and my parents took away my internet access) and i was shot down again, with my mom saying the CLASSIC "(insert family member) has bpd and shes crazy. ur normal. stop pretending theres something wrong with u. if u had bpd u'd be vindictive and petty and evil. do u think ur those things?"

once i figured out how 2 get my internet access back, maryland dude forced the bpd label on2 me becuz he wanted 2 explain my "abusive" behaviors (he was abusing me but tried 2 gaslight me in2 thinking i had a victim complex and that it was the other way around) and i became uncomfortable with the label becuz he made it seem like if i had bpd then i was a bad person. i continued researching the disorder becuz it still resonated with me even though i was now insecure abt it.

i became comfortable with the label again after he abandoned me, and i brought it up with my therapist. my therapist would HEAVILY DENY that i had bpd, telling me that "if u had bpd u would be attempting suicide 4 attention" "u fit the diagnostic criteria but ur autistic so all of ur symptoms can just be attributed 2 autism srry" "ive had clients with bpd and if u were like them u wouldve had an outburst in my office and be yelling at me by now" and she would even smile at me whenever i brought up my bpd becuz she thought it was funny that i thought i had it, i think. the first time i brought it up with her she told me "its rlly irresponsible 2 self diagnose after reading liek two articles online abt some extreme disorder becuz u think ur broken. ur not broken. dont self diagnose with bpd" and i had to EXPLAIN 2 HER that i wasnt self diagnosing and that id researched it in depth 4 years actually and that she was making assumptions. horribly ableist towards ppl with cluster b disorders, this is a MASSIVE RED FLAG but i didnt switch therapists becuz i was still living with my parents at this point and i felt out of control in every aspect of my life 4 this reason, i didnt even see switching therapists as an option.

then in 2023, while i was homeless, i got evaulated by a psychiatrist. i discussed my bpd with him and finally got diagnosed. i told my therapist i was diagnosed with bpd and she said something like "well im not always gonna be able 2 catch everything" BUT I WAS TELLING U ABT MY BPD 4 MONTHS!!!!! so glad i dont have that therapist anymore but now i dont have one at all, so liek.. hrmmm >:c

im gonna end this by saying.. self diagnosis is valid!!! its so hard 2 get a bpd diagnosis becuz its so demonized and stigmatized, that even those in the mental health system r ableist towards the disorder and those who have it. diagnosis is not always an option with disorders like bpd, and thats so frustrating. its so hard 2 find help becuz every1 thinks ur crazy. but ur not crazy!!! i love all my fellow bpders, i know how agonizing and it is 2 live this tormented life. if u suspect u have bpd, the bpd community welcomes u and supports u!!! and i do 2 :3

[ravenkinnie]

do you think jinx is good rep for bpd people? I see many saying she's accurate but I also see others call her terrible rep not bcs inaccuracy but bcs of how violent she is and how she could give a negative impression of bpd

I mean, the use of the good representation casus is usually what I have a problem with because wheat does good representation even mean. I mostly see people judge it on basis of whether the character makes the whole ass community look nonthreatening amd sympathetic which I loathe - to me, it should be judged on character construction level, is this aspect of the character consistent and written with the same attention to emotional beats, inner logic and narrative as everything else? and jinx is because her emotional landscape is key to the show as a whole and is written with the same attention to her humanity as every other character, she is not a caricature

i say this as someone who has bpd and has interacted with bpd communities so many times over the years but bpd does make you a difficult person to form relationships with, if it didn't you wouldn't have bpd khkgkj I realise that when you search bpd you will never find actual resources for people with bpd like you would with depression or anxiety but usually articles written by frustrated dudes who have beef with their crazy exes and people love to chalk everything up to cluster bs being inherently insane or sth. this is why you need to get rid off the black and white thinking that judges people on moral value like they are fictional characters because irl people who you have problems with probably have more going on than meets the eye - which doesn't absolve you of giving other people the same grace you want to be given but it means no one is just evil or not

sometimes mental illness will make you a really shitty friend or partner and recognising how those actions affect people in your life and taking responsibility for them IS part of recovery that is extremely uncomfortable but it doesn't mean its not human and shouldn't be portrayed in media just because its complicated. and sometimes a bitch chooses to remain a cunt kbjbkbj

[reveregret]

𝒟𝑜 𝓃𝑜𝓉 𝒾𝓃𝓉𝑒𝓇𝒶𝒸𝓉 / 𝐵𝓁𝑜𝒸𝓀𝓁𝒾𝓈𝓉

❥ Yan fetishists / self-proclaimed darlings

❥ Yan roleplayers / writers I don't really mind if you do these things, but if this is the theme of your acc please don't touch my posts. I don't appreciate my struggles being put into a fictional context!

❥ Believe any mental illness is inherently abusive Cluster Bs are more than welcome here. If you don't like them, leave!!!

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❥ Racists / anti-semites / white supremacists / anti-BLM

❥ Pro-contact paras (big 3) I'm fine with paraphiles being around as long as they are able to recognise what's wrong and don't promote contact

❥ Porn blogs If your blog consistently contains visual NSFW you're likely to be blocked. I'm less strict about textposts but it can still fall under the radar

❥ Blank blogs If you don't have at least a profile/banner or description on your blog, you may appear as a bot and may be blocked as a result

𝐵𝑒𝒻𝑜𝓇𝑒 𝓎𝑜𝓊 𝒻𝑜𝓁𝓁𝑜𝓌

❥ If you dislike people who do "yan stuff" irl then I am not for you! I don't encourage anything without consent but I'm working through some habits and mindsets.

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last updated: January 8, 2025

[mithliya]

do you think radblr used to be better a couple of years ago? as a crypto looking in it seemed a lot more positive and less divided overall than it is now, but maybe that was just from my outsider’s perspective. hope you’re having a good day 💗

honestly idk if i’d say it was necessarily better, maybe just.. different? the plus side is there were fewer conservative orbiters, but it was also more ableist & just as drama-filled. it was also consistently lesbophobic. back then ppl seriously would argue that bisexuality is some mental illness & ppl with certain mental illnesses are automatically bisexual, “cluster bi” (in reference to cluster b) & there was this one popular woman who would praise an anti-feminist woman and she was like. worshipped on radblr. i also had rape wished on me multiple times, got basically doxxed, ppl posted pics of my mother & got her info too, someone would literally post pics of homes for sale in my village in bahrain, etc… so it was still toxic as hell for sure

[thatnarcissisticfeel]

recently one of my siblings got severely (physically) ill, so now everyone is paying attention to them only, and completely ignoring my problems and how i feel and i really feel like im going to lose it. even before i hardly ever got any real attention but now it’s even worse. i don’t even give a fuck about what happens to the sibling but i have to pretend like i do because otherwise i’d automatically be seen as a “bad person”. i’m so sick over this bc like i’m always the one to get ignored and dismissed by the majority of people. idk what to do like i’m considering taking drastic measures like overdosing on drugs on purpose or committing a crime just to make someone notice me - even if in a bad way. i’ve already always hated my siblings because my shitty parents obviously love them more because somehow i’m the only one that had to get all the mental issues. i keep getting into arguments but it doesn’t change anything and then they start insulting me too and i feel even worse. i really don’t know how to go on. i wish i could run away and leave and make them regret how they always treated me but i’m in a situation where i can’t do that at the moment and i’m stuck at home for at least a few more months

hi! i'm so sorry to hear that, not only that your sibling is ill but also that as a result you aren't getting any attention. your problems are real too, and it's awful that they're being ignored. that being said, and i know this is easier said than done, but please keep yourself safe. harming yourself isn't the answer, especially not in the long run. it's incredibly fucked up that they insult you, and i hope that you're able to get out of that situation soon.

you aren't a bad person, the way you're feeling right now is super common with npd/cluster b in general. it's not right that you always get ignored, no one deserves that and it's especially shitty when you have a disorder like this that makes it hurt even more.

if it's at all possible, getting out of the house will be a huge help - even if you can't technically move out yet, just getting away for a few hours each day might prove to be a good idea. especially if you can interact with people who can consistently give you attention in a healthy way, although i do know that this is unfortunately easier said than done. either way, i hope you're able to get out permanently/for good soon.

[dream-sans-mogai]

It lost popularity because disabled people dont want to bring it up but disability appropriation should be brought back as a term. That's what alot of these muds and pseudo-transabled terms are. You want to have a disorder but dont actually have it so you either pretend you have it or make up a ton of terms that basically are transabled without having to own it with stupid nonsequitors that allow you to claim enterance into our community without ever actually facing our oppression (no, someone calling a slur on the internet and your doctor clocking you for faking is not ablesit oppression.)

No, needing glasses or contacts doesn't make you "basically blind". No, your untreated unmedicated personality disorder is not a mental disability. No, your alter doesn't actually have that mental illness unless you do and you don't, that's just your assumptions about what that illness would look or feel like and has zero bearing on the reality of said illness. At this point y'all are turning the very real term of " atypical dysphoria" into a dog whistle for transid shit. It gets so misused so often and for everything that only really transids and diet rqs use it but expect people to respect you.

The mogai community has been trampling the disabled community forever then wonder why we all leave. We left cause you said you have the right to the word cripple cause the "headmate" you got off a bulid-a-headmate blog "came with a missing leg" and now you "totally understand the experiences of amputees". You have a mental illness, please seek help, it's not normal to want to be a system let alone have a physical or mental disability.

If you want one, either or both of these two things are true: 1. You do not understand the reality of disabled people and thus, believe it's just a cluster of symptoms Instead of the very real class struggles we deal with not just in public but also in private and often results in suicide due to how badly we are treated or 2. You understand the severe and terrible experiences of being disabled and still choose to pretend to have or genuinely want it and do not understand that wanting to be disabled doesn't actually make you disabled and is often a result of a desire to self harm with no outlet. Like... Not hurting yourself in the usual way but wanting to get by a car to be paralyzed is not only not a normal neutral desire but often the symptom of severe mental illness and a desire to self harm.

This is not normal and I don't even mean that in a pro-psych way, you need help. That is just one of many symptoms that can very very easily result in suicide. If you are having those desires consistently, especially if it's something thays consuming you and you think about it every single day and it's one of the few things you can focus on, especially if you want it as a result of an accident to remove personal accountability for causing that injury, that is a sign of something being very very wrong in your mind. This is not normal behavior that harms no one, this very quickly results in people maiming and abusing themselves. The mogai community is so scared of alienating people, they are trying to normalize intrusive thoughts. Yes, they are common in people with Ptsd but are very very often the symptom of a bigger problem and if you have them, get your ass in therapy. Common dosent equal normal and therefore harmless.

Im writing this in big text, Wanting to stab people or yourself or cut off body parts or desire a severe mental illness (often one that isnt invisible and is taken much more seriously than what most people actually have) is a cry for help and signs that you may become a danger to yourself and others. These are not normal and often are a symptom of a much bigger and much more serious problem. They are common and often do not result in anything but they can and are used as hallmarks showing where your head is. Therapists, professionals, use their frequency to measure mental turmoil. People with Ptsd, depression, anxiety, OCD, etc who are in healthy situations and are considered " getting better/ok" do not have these fantasies and intrusive thoughts with any or even semi-consistency.

If you are having these fantasies and desires more than twice a week, please ffs go get help. Especially if they are depressing or scaring you and are either lead or followed by self harm desires and suicidal thoughts. You are not a bad person for having intrusive thoughts and fantasies of disability or severe mental illness, they do not mean your inherently evil, violent or ableist. They do however mean that you may not be realizing how bad your self hate, depression, PTSD, etc are actually getting because these thoughts and desires, especially consistently, are your brain crying for help and considering every option it can to either cope with or escape a situation that's scaring it.

Do not listen to a 16 yr old on here saying it's totally normal to want to kys every 3 days and making flags and identities for wishing they were limbless, these are warning signs to you and others that something must change and you need to get help before the thoughts turn to fantasies and you feel the need to turn them into reality. Most people who actually hurt themselves say it was a passing thought that originally scared them, then became an obsessive fantasy then resulted in them hurting themselves and end up regretting it horribly. Please listen to them. This is not normal and we want you safe, happy and healthy and you are not safe, happy and healthy fantasizing about hurting yourself and trying to make that part of your identity. If you can't stop due to the fact disabled people are telling you they are hurting us and our community, do it for yourself.

[postmoderntongues]

I’m learning at 31 years old that I don’t have an accurate relationship with memory or reality on a cognitive level. My reality is unstable so my story is inconsistent and becomes even more inconsistent when I’m TRYING to tell what I perceive in that moment to be the truth instead of keeping track of what I’ve already said and where it would fit or contradict and what was my perception of the truth was when I started talking. People think I’m dishonest because I’m so honest that I can’t keep track of a shifting reality to give a consistent story. I scramble stories with other stories and plug the wrong people into memories. I experiance delusions that i can usually only detect if something about the delusion can be proven materially physically impossible, I confuse dreams with reality, Im medicated to the point where i experience the world in 3 second intervals like a fucking goldfish and on top of that im autistically gullible and will believe what somebody tells me unless im confident that i know something that contradicts what they are saying. Frustrating af. Im not shady. Im not sneaky. Im not a liar. If anything I became a writer to say things honestly that I couldn't say as myself. When im wrong about something or something doesnt mesh, POINT IT OUT TO ME outside input from people i trust who are not gaslighting or manipulating me helps me to fact check whatever the closest thing to objective reality is. It isn't a moral choice its cognitive. its symptoms of something very very wrong with the my brain, which is an organ.

Ive had it blamed on everything from extreme preverbal trauma to behaviorally-mirrored reactive attachment disorder to CPTSD to bipolar psychosis to schizo spectrum to possible early signs of hunting's to Autism to HPD/Cluster B to DID/OSDD to early onset Alzheimer's or dementia to pure O OCD to long-term medication side effects and at this point IDGAF what the name for it is ive been labeled literally every name in the DSM none of it means fuck all unless they know how to fix it or at least relieve the pain.

Yall like to be tolerant about mental illness when we are the MPDG and artist and savant and the big tiddy goth BPD girlfriend until something gets unflattering or severe or scary and you're forced to address the unfortunate fact that for some of us it isnt a variety or different flavor or different processing system some of us are CHRONICALLY AND POTENTIALLY TERMINALLY VERY FUCKING SICK

Vote like you know somebody who is too severely mentally ill to participate in most aspects of society, because you do. Vote like you know somebody whose symptoms pose a threat of becoming an immediate public danger if left untreated because you do. Vote like you know somebody who is potentially a federal or state budget cut away from becoming a disenfranchised street person and therefor a problem for a lot more people than just myself because you do Vote like you know somebody who spends a significant portion of their lives in high security state psych wards and needs them to provide a comfortable and dignified quality of life or will be discouraged from seeking much needed help in a crisis and once again potentially becoming your personal problem or the problem of somebody you love if state psych wards continue to offer a standard of living that is a literal punishment because you do

Like we're not just going to quietly die if aid gets cut it's just going to be the immediate severe problem of whoever is unfortunate enough to cross our path in the midst of a severe untreated episode instead of a minor inconvenience for the community as a whole. Investing in my comfort, dignity, and access to treatment is literally an investment in YOUR safety as a member of the public, more of an investment than any police bonuses or robotic stop and frisk dogs. You can do it for the completely selfish reason of self preservation. You can literally not give a fuck about me, im not asking you to give a fuck if i live or rot, im asking to care about YOURSELF as the member of the public, the price you pay to keep me from becoming an immediate dangerous problem to my community is not even a fraction of the amount I could cost in damage and even more importantly the potential for it to impact you personally. Investing in social services isnt about charity or feeling good or doing good deeds, its insurance you pay because it is cheaper of the alternative cost of letting people like me loose to our own devices with no standard of life to lose. Defunding public services is the equivalent of taking everything valuable to you and abandoning it unlocked with the windows down in the most crime-ridden neighborhood you know of. The oligarchy wants you to want to defund these programs not only because if they focus you on the dollar ur giving to people like me you wont notice the millions in corporate subsidies and outrageous upper management costs and the prioritization of shareholders and the worker exploitation thats ACTUALLY making you broke but because they sleep in gated communities with security staff and laser-sensitive home alarm systems. They know that chances are somebody like me isnt going to get somebody like them if my symptoms are allowed to escalate untreated, its going to be a common person like you or your loved ones who experiences the consequences of inadequate mental healthcare.

Nothing needs to be unselfish. Im telling you right now what to consider if you want to make the most selfish, self-preserving choice possible.

[hatredmadeofgold]

Raiden most definitely has Anti-Social Personality Disorder

— An essay by a fan who also has ASPD

Side note by author: This essay will be updated in the future (a new post will be made). Hello, my name is R and I was diagnosed with Anti-Social Personality Disorder when I was 23 years old back in 2018. I also study in the field of psychology and medicine, so I know a thing or two about mental health. In this essay I want to elaborate why I think that Raiden doesn’t just suffer from (complex) PTSD but also Anti-Social Personality Disorder and I base this interpretation on canon evidence, research I did on the mental health of former child soldiers as well as my own experience with the disorder.

In the following text Anti-Social Personality Disorder will be shortened to ASPD.

What is Anti-Social Personality Disorder?

ASPD, also known as Dissocial Personality Disorder/DSPD in the ICD, formerly known under the name Psychopathy or Sociopathy, is a Cluster B (the ‘dramatic’ type) personality disorder known under the ICD-Code F60.2 or the DSM-V Code 301.7.

The reason why I will not call ASPD Socio- or Psychopathy in this essay is that these terms have been obsolete since the introduction of the DSM-IV in 1994, the disorders have been merged into one disorder as well as the fact that the ASPD community widely regards these terms as the equivalent of a slur (If you do not have the disorder yourself, do not, under any circumstances, use these words. There are words such as ‘asshole’ that describe shitty people better than you being downright ableist in your choice of words. Note that the subreddits r/aspd and r/sociopath are overrun by illness fakers and people who refuse to get better, they do not represent people with the disorder really well).

According to the DSM-V, ASPD is described as the following:

“A. A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:

1. Failure to conform to social norms with respect to lawful behaviours, as indicated by repeatedly performing acts that are grounds for arrest,

2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure,

3. Impulsivity or failure to plan ahead,

4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults,

5. Reckless disregard for the safety of self or others,

6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honour financial obligations,

7. Lack of remorse, as indicated by being indifferent to or rationalising having hurt, mistreated or stolen from another.

B. The individual is at least age 18.

C. There is evidence of conduct disorder with onset before age 15 years.

D. The occurrence of antisocial behaviour is not exclusively during the course of schizophrenia or bipolar disorder.”

What the diagnostic criteria of ASPD does not list is that people with the disorder often times also have low affect, which is indicated by shallow, rather fleeting, inconsistent emotionality as well as a partial or complete lack of affective (emotional) empathy. This is likely caused by chronic emotional dissociation and is irreversible.

People with ASPD are capable of feeling every emotion, but the operative here is can, not will. Often times the emotional experience is reduced to feeling content, bored, apathetic and angry or irritated. Everything else is very much background noise that can be ignored with ease. Also people with ASPD are able to use cognitive (learned) empathy, but often times this is used to manipulate. Some people with ASPD are self-aware, either through diagnosis or life experience. It is possible to have a completely normal life with this disorder and people around the person with ASPD do not notice that they have anything at all, because we are pretty much capable of faking emotions very well thanks to great observational skills. However, this does not apply to every person with ASPD.

ASPD is caused by prolonged abuse, neglect and/or trauma in (early) childhood which likely involved heavy exposure to violence. Poverty is also linked to the likelihood of someone developing it. A genetic link is being researched but has yet to be proven to be able to cause this disorder without any of the aforementioned. The so called ‘warrior gene’ theory is pretty much bullshit, as it is argued that it can only appear in people of European ethnicity. This theory is pretty much racism at its finest and therefore anti-science.

Antisocial Behaviour in former Child Soldiers

“Anti-Social and Disruptive Behaviour

PTSD is also significantly associated with negative behaviour against an individual’s own family, the expression of anger and hostility to others, and self-harm (Burton, Foy, Bwanausi, Johnson, & Moore, 1994; Deykin, 1999; Deykin & Buka, 1997; Dodge, 1993; Dutton e al., 2006; Friedman & Schnurr, 1995; Golding, 1999; Joshi & O’Donnell, 2003; Lewis, 1992; Perry & Pollard, 1998). Research shows that former child soldiers have difficulties in controlling aggressive impulses and have little skills for handling life without violence. These children show on-going aggressiveness within their families and communities, even after relocation to their home villages (Wessels, 2006). In a qualitative study, Magambo and Lett (2004) reported that former child soldiers in northern Uganda mainly applied physical violence to resolve conflicts. Although the children sympathised with victims of violence, they could not even think of non-violent alternatives, reflecting an absence of adequate social skills.

Most former child soldiers have spent several critical years of their development in captivity, under the constant threat of abuse and manipulation by their commanders.

Most probably, this period affects the development of a personal and collective identity (Kanagaratnam, Raundalen, & Asbjornson, 2005). In general, children exposed to war and child soldiering show a strong identification with their own group (Gloeckner, 2007; Jensen & Shaw, 1993), and develop a worldview dominated by political and nationalistic categories (Feshbach, 1994). In the Gloeckner (2007) study, it emerged that the longer children had stayed in abduction, the stronger was their rebel-related collective identity. But it may be that their collective identification might occur post hoc after return to their home communities. Gloeckner explained that questions and discussions of family and community members about the cruelty of the LRA’s actions may activate a process of reasoning about what had happened. Former beliefs about ‘right’ and ‘wrong’ actions might clash with current ones, and in order to regain cognitive homeostasis, identification with the rebel group is aspired. Interestingly, this study showed a positive correlation between collective identification and reactive aggression (physical and verbal aggression and anger). In addition, Gloeckner (2007) reported that formerly abducted children with PTSD might be especially vulnerable to accepting simplistic models of ‘good versus bad’ – a black and white worldview, which is a known cognitive distortion. Although a rigid political view might be protective during exposure to war events, it might facilitate violent behaviour after returning from the fighting to individuals’ home communities.

Children living in conditions of political violence and war have been described as ‘growing up too soon’ and ‘losing their childhood’ (Boothby & Knudsen, 2000; UNICEF, 2005, 2006). Levels of conscience seemed to be significantly related to the severity of PTSD symptomatology, but also with negative schematisations of self and others and lower self-efficacy ratings (Goenjian et al., 1999; Joseph, Brewin, Yule, & Williams, 1993; Saigh, Mroueh, Zimmerman, & Fairbanks, 1995).“

- The Psychological Impact of Child Soldiering (by Elisabeth Schauer and Thomas Elbert)

“Behavioral Problems

Former child soldiers exposed to brutal episodes of war-related violence face a range of behavioral problems. In addition, post-conflict factors may contribute to varying degrees of vulnerability to adverse behavioral outcomes. According to Lev Vygotsky the child’s culture and community that he lives in largely affects his development. Vygotsky believed that important learning by the child occurs through social interaction.

For a number of years child soldiers spend time with adult militants under strict rules and regulations. The children were constantly exposed to hostile situations that had negative impact on their psychosocial wellbeing. The children’s thinking pattern and cognitive schemas changed in to more aggressive and violent direction. The children were indoctrinated to perform atrocities without asking questions. They witnessed the gloomy realties of war that made drastic changes in their behavior. The children who had committed atrocities in the past have high risk of developing conduct disorders or anti-social personality disorder and addiction problems if their mental health issues are not appropriately addressed.

In Nepal, Kohrt and his team in 2008 concluded that post-conflict factors such as stigma might contribute to adverse mental health outcomes. Former child soldiers in his sample showed significantly higher symptoms of depression and PTSD compared to matched controls even after adjusting for exposure to traumatic events. In 2010 the researcher Betancourt did a prospective study to investigate psychosocial adjustment in male and female former child soldiers in Sierra Leone using 156 male and female child soldiers. Over the 2-year period of follow-up, youth who had wounded or killed others during the war demonstrated increases in hostility. It has been reported that former child soldiers in Uganda had various behavioral problems and some of them were charged with anti-social activity after their demobilization. Over 70% of prisoners in the juvenile crime unit in the Gulu District, Uganda are former child soldiers, incarcerated on charges of rape, assault and theft.

Social relationships play a key role in child’s behavior as explained by the Psychologist Urie Bronfenbrenner. Nested interacting spheres of social relationships that determine individual behavior and well-being are the fundamental components of analysis in social ecology. When these children were abducted and kept in camps, they had no way of having healthy social relationships.”

- Psychosocial Problems Of Child Soldiers (by Professor Daya Somasundaram and Dr. Ruwan M. Jayatunge)

These to excerpts from two different essays on the mental health of former child soldiers speak for themselves. ASPD is also the only personality disorder that is associated with child soldiers.

Although Raiden had been in treatment when sent to the United States, it doesn’t seem that the treatment had been appropriate enough to prevent him from developing ASPD. It’s mentioned in the Metal Gear wiki that he had at least become ‘outwardly stable’, however, we can see from how he behaves in canon that he hasn’t processed any of his trauma whatsoever. To treat PTSD or any personality disorder, appropriate trauma therapy is required. This has obviously not been the case for him, as he’s incredibly mentally unstable and violent. Even the introduction of nanomachines in his body through the Patriots hasn’t prevented any of his behavioural problems although they did successfully suppress his memories of his trauma, as we learn in MGS2.

The way Raiden shows traits of ASPD

Shallow Affect and Lack of Empathy

Albeit Raiden is portrayed as an emotional person, his emotionality often consists of anger and aggressiveness, and he doesn’t seem to be particularly empathetic either.

In fact, his lack of empathy (and how he justifies his actions to himself) is even being called out by Jetstream Sam in the 4th chapter of Metal Gear Rising. He is also shown to have no reactions to allies dying (Emma Emmerich in MGS2 and Naomi Hunter in MGS4) and is just awkwardly standing there like a cardboard cut-out. While Snake doesn’t show or say anything in these scenes either, his stance is not awkward like Raiden’s.

Raiden is also often told to calm down by various characters throughout the franchise when he is reacting to things with anger or aggression to an almost inappropriate level and he never takes it well. Neither is he good with receiving criticism, and will verbally attack the person who criticised him.

Kevin Washington also calls him creepy for how Raiden describes the cyborgs he is killing like ‘walking vending machines’.

It is also said in the script of MGS2 that Raiden in general has trouble understanding other people’s feelings.

Failure to conform to social norms

“Companies like ours — yours — bend the law as they see fit. Why not bend it when it can save innocent lives?” — Raiden to Boris in MGR

The entire game of Metal Gear Rising basically encompasses this whole part of Raiden. He is seen to be breaking the law out of an emotional urge (which Blade Wolf comments on as well after the awakening of Jack the Ripper) because seeing the children in the lab in Guadalajara being turned into cyborgs against their will triggered him. We learn that he doesn’t act like this because he is some kind of hero protecting the weak (as he is always trying to tell everyone including the player for the first half of the game), he does this out of selfish reasons — to have a reason to kill. His morality is quite grey. Sure, he is on the side of the ‘good guys’ — but his methods are cruel, the style of an anti-hero.

“Not that much of a hero after all, right?” — Raiden to Blade Wolf after killing Monsoon

He shifts his morality as he sees fit — same as the companies he is criticising. Armstrong points out their “kindred spirits” as he is dying at the end of the game as well and we as a player understand that our enemy is right. To achieve our goals, we went overboard with everything and justified our violence — Raiden’s violence — with doing the ‘right’ thing.

Manipulation and Deceitfulness

“So it was artificial on my end too. It was just a game, not the real thing.”

Raiden says this to Rose after she confesses to him that she is a Patriot spy and it almost feels like a confession. The way he says it is very callous, unlike how he talked to her before (and he reverts back to his ‘usual’ self later on anyway), it feels like a ‘mask slip’ where he says what he truly feels. I think about this scene a lot and it makes me believe that Raiden did not truly love Rose until he actually lost her (MGS4). Basically ‘not recognising what you had until you lose it’. People with ASPD often get into relationships to get something out of it – be that getting rid of boredom, money or sex – and they go very far when it comes to faking emotions such as love. It is often said that we cannot love, but this isn’t true. Love to us is more of a conscious choice of committing to someone rather than an emotion and can be very mature when it’s honest. We are also very obsessive lovers, which can turn very toxic very fast if not self-aware and controlled.

Impulsivity and the failure to plan ahead

Stabbing himself to impale Vamp without thinking through that he is going to bleed out, quitting his job at Maverick without thinking through how he is going to pay his bills in the future and the entire ordeal that is the World Marshal incident are what I can list on top of my head where Raiden acts very impulsively.

Aggressiveness, Abusive and Violent Behaviour

In MGS2, Rose mentions that Raiden ‘raised his hand against her’ when she tried to enter his room. This translates to more than just a slap in the face (and even that is horrible behaviour when you are in a relationship) if we look further into Raiden’s behaviour across all the games in which he appears. In the same game we learn that Raiden genuinely enjoys murder. He asks Snake about it, horrified about himself, if he does the same which Snake denies.

In MGS4, Rose talks to Snake about Raiden and why they aren’t together anymore. She speaks about how he became a violent alcoholic (Substance Use Disorder is highly common in people with ASPD) as he was unable to cope with his traumatic memories resurfacing. She implies that he got into regular fights as well, saying so by mentioning that he came home covered in cuts and bruises. We don’t know for sure, but it is likely that Raiden also hit Rose as well but she doesn’t outright say it. She just states that she is scared of him.

“I am worried about him, of course, but… I am also afraid of him.” — Rose about Raiden in MGS4 If you look closely at the scene in which Snake mentions Raiden’s family in MGS4, you get a quick glimpse of Raiden trying to hit Snake — only to break down and fall to his knees, crying. His willingness to physically assault people who are close to him is another one of these signs that speak for ASPD in him.

“Resolving everything with violence, is that it, Raiden?” — Sam to Raiden in MGR

“Feasting on the insides of your enemies?” — Monsoon to Raiden in MGR

Both Sam and Monsoon call out Raiden for his violence in MGR and how he justifies his actions with ‘protecting the weak’ which we learn in the same chapter, is a load of bullshit. Raiden confesses that he fights for the pain he feels — or likely, the adrenaline rushes one gets from it — when being hurt in a fight, that protecting the weak was a lie he told himself to ‘keep himself in check’ and that he thought that he could live a normal life, with his friends and family having his back. However, this didn’t work out and he found himself back on the battlefield and we finally learn why and the reasons are just as shallow as the rest of him.

Reckless disregard of the safety of self or others

Raiden’s recklessness in MGS4 could also be read as suicidal ideation, which is also something a lot but not all people with ASPD experience. Impaling himself and cutting off his own limbs are things I would consider ‘reckless disregard for the safety of self’ as he does this without thinking things through. In his fight with Vamp he definitely didn’t want to die in the end, so I suspect this to be him not thinking things through (which he does a lot, acting on impulses). The same goes for his wish to walk through the microwaves instead of Snake (and god I wish he would’ve gone instead of Snake), which Snake points out is suicidal and that he has a whole life to live still.

In MGR, Raiden decides to eradicate World Marshal, the largest PMC in the universe at the time of the game, entirely by himself. He raids its Headquarters with total disregard for his own safety or that of others, as he is just ‘lucky’ that the parts of Denver he is getting through, are blocked off from the public. Raiden doesn’t harm civilians — but he doesn’t particularly care if they die either. We know he’s lying to himself about being the good guy. Although his team is unofficially supporting him, he has no backup in case something happens.

Consistent Irresponsibility

Raiden is shown to be consistently irresponsible. He doesn’t hold himself accountable for his actions by lying to himself about his morality and basically gaslighting himself and others about his behaviour. He doesn’t listen to work instructions — Kevin calling him out in the first chapter of MGR for it — and therefore fails missions. He is also shown to constantly argue with the colonel in MGS2, always trying to get out of the situation he is being put into and not taking responsibility.

Lack of Remorse

In MGS2 we learn that Raiden enjoys murder without feeling any particular hard feelings about it. He is terrified about the realisation but doesn’t feel any particular feelings of guilt for it. Neither does he ever mention that he regrets having physically or emotionally harmed Rose in any of the games he appears in (Rose has issues too — they both definitely act like nothing bad ever happened between them at the end of MGS4 and I wish them both a nice stay in the psych ward).

Raiden’s justification to kill in MGR is to ‘protect the weak’ which later turns out to be a complete lie he tells himself and others to seem like the good guy. He’s very much gaslighting himself into believing this throughout the game until Sam and Monsoon confront him about his behaviour and hypocrisy and Raiden drops the mask and reveals his true intentions: that he fights to feel pain in battle, because he gets high on it and that he very much enjoys murder.

“Who protects the weak from the man who ‘protects the weak’?” — Monsoon to Raiden in MGR

In MGR you can also cut off the clothes of civilians you saved. If you do so, your teammates call you out for it. Raiden then does half assed apologies for it, even laughs when being called a nasty creep. He genuinely finds it funny to apparently terrify innocent civilians and doesn’t show any remorse when being called out for it.

Summary

Looking back, Raiden does show many traits of a person with Anti-Social Personality Disorder throughout all the games in which he appears. Although MGR is a lot more “in-your-face” with it, the mainline games show him having those traits very much as well (to be diagnosed one must meet 3 out of 7 listed criteria points, so even if you regard MGR as non-canon, he would still meet the criteria from what we learn from the mainline games). The fact that a lot of former child soldiers struggle with this disorder as adults adds to my theory that he has it. I often see people argue that MGR was not the direction that they would like to see Raiden go and that he is too ‘brutal’. In my opinion, MGR was the more realistic ending for him. I have ASPD and I know that white picket fence home lives just don’t work for people like us. We grow so bored, we start to fuck up shit for ‘fun’ and ruin our lives that way or get addicted to drugs. Raiden choosing the battlefield, finally accepting who he really is (‘Jack the Ripper’), is the more realistic and healthier ending for him than him just lying to himself and being on edge all the time, potentially ruining his marriage that way in the span of a year or two. Love cannot heal extreme childhood trauma, sorry guys. And Raiden seriously needs therapy.

[ndcultureis]

Rules, DNI, Intro, & More!

This is a “x culture is” blog for all neurodivergent folks. So anyone with autism, ADHD, PTSD, dyspraxia, dyslexia, tourette’s, personality disorders, or any other mental illness, psychological/neurological condition, or non-neurotypical neurotype! This includes self-DX folk as well. This was inspired by all the other “x culture is” blogs out there! 

This blog is run by Mod Emri (She/They), Mod Aki (He/Him), Mod Milo (they/he/it) and formally Mod Corvid (They&/Them&) and Mod Theseus (voi/voice)!! Queue is currently posting 11 times a day. Asks are always appreciated.

Submission Rules

Please keep your asks to nd culture submissions only, or at the very least being neurodivergent related!! We’d also appreciate it if you didn’t ask for advice as we’re not able to provide help in that department.

Start submissions with “neurodivergent culture is” or some variation (”autism culture is,” “dyspraxia culture is,” “PTSD culture is,” etc.) Asks will be deleted if they don’t follow this.

Keep all fandom/shipping/character talk vague. We do not know every fandom and may not feel comfortable handling specific fandom or media related submissions.

Try to keep your asks free of discourse, we want this to be as positive a place as possible! (Vagueing about your own struggles or life is fine, though.)

Please try to use tone tags if relevant!

DNI

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We will try to tag everything appropriately, but please let us know if you want anything tagged that we have not been tagging or forgot to tag! (Things we currently try to tag for.)

If you would like to ask us any questions, please read our FAQ first! It’s underneath the cut. Any questions that have already been answered in our FAQ will be deleted and ignored.

FAQ

What’s the difference between “neurodiverse” and “neurodivergent” and why do you use the term neurodivergent instead of another term?

Despite the term “neurodivergent” seeing some use in modern clinical settings and research, it is not a medical term with a consistent set medical definition, and was not coined in a medical or scientific context. The term “neurodivergent” was coined to describe a broad and generalized community of anyone who in any way does not fit the most common or “average” neurotype. Any situation involving any sort of psychological or neurological “abnormality” or “divergence” as compared to the general population counts under this definition. As mentioned before, it is not a medical term; it is a term which serves the purpose of creating and describing a community which has historically and continuously been marginalized. The term “neurodivergent” has often been conflated with the term “neurodiverse” which is a completely different term with a completely different meaning and context. “Neurodiversity” is a term used specifically to describe ADHD, autism, and in some cases a few other conditions in a small and specific group. It was coined decades ago in the context of education, specifically, but has now seen some use to describe the general community of people with these conditions. All neurodiverse conditions fall under neurodivergence, but neurodivergence is a very broad umbrella term that includes far more than just the conditions classified under neurodiversity. The coiner of the term “neurodivergent” has themselves explained this issue in their own post, here.

We use neurodivergent for a few simple reasons, but the biggest one is that it’s accurate. We’re not just talking about neurodiverse people on this blog, even though all of us are neurodiverse. We’re also talking about everything from epilepsy to CPTSD to depression to NPD. This blog is meant to include the entire community of all neurodivergent people, which means everyone who is not completely neurotypical or of the most common/average neurotype. Though this is our primary reason, there are also others. The term “neurodivergent” was not coined to medicalize or marginalize neurodivergent people, as medical terms and diagnoses historically have. It was coined to describe and unify the broad community of all people who in some way do not fit the neurotypical standard and thus face marginalization based upon lacking that privilege. The term is inclusive and was created by an actual neurodivergent person with the actual community of neurodivergent people in mind.

Us using “neurodivergent” and specifically being a neurodivergent blog and community doesn’t stop anyone from have specific spaces for specific conditions or groups of conditions. If someone wants to make a neurodiverse-culture-is blog, we would gladly support it! We are all neurodiverse, after all. However, we are specifically a neurodivergent blog and community, which means we include all neurodivergent conditions beyond just neurodiverse ones. Broad and inclusive communities and community spaces do not stop more specific ones from existing, they just help unify oppressed people, which is good for more reasons than we can fully list.

Does (insert mental illness/condition/disorder) fall under the neurodivergent umbrella? Do I “count” as neurodivergent if I have/am (insert mental illness/condition/disorder)?

The answer, 99.9% of the time, is yes. If you are in any way, shape, or form not completely neurotypical and of the most common/average neurotype, the answer is always yes.

As discussed in the previous answer, the term “neurodivergent” is a broad community term that describes any person who in any way is not 100% of the most common and average neurotype. This means that any given mental illness or psychological condition, as well as any neurological conditions, fall under this definition. You don’t even have to have a specific label, you just have to fall outside of the average or “default” neurotype in some way. This, again, is all from the exact words of the person who coined the term neurodivergent. It is a term to describe a marginalized community, not a clinical or medical diagnosis or group of diagnoses. That is how it was coined and how it has been used, despite its somewhat significant misuse.

We’ve gotten an absurd amount of questions asking if specific conditions, or even people themselves, “count” as neurodivergent. Unfortunately, the fact that this misinformation and worry is so widespread makes a lot of sense. Not only is there a common misconception that neurodivergent and neurodiverse are synonyms, but there is an immense amount of ableism even within disabled and neurodivergent communities. We’ve gotten seemingly genuine requests before to change our entire blog to exclude people with specific conditions. The fact that some neurodivergent people face much more oppression and stigma than others has created a power imbalance within the community, and some neurodivergent people who face this oppression the most or in the most intense ways lose sight of the fact that those who face less than them still are marginalized on the same basis that they are. After all, we’re all neurodivergent. We all do not have the privilege that fully neurotypical people have. By having broad communities like these, we unite all of the people facing this same struggle and being marginalized on the same basis, even if that marginalization often looks or functions very differently. There can still be, and still are, specific communities for specific identities and experiences. Those who face specific experiences can and do have their own spaces and communities relating to those issues. A broad umbrella for all people who face a certain type of marginalization does not erase these specific, smaller communities, nor does it erase the specific struggles of those who face more marginalization than other marginalized people.

We wish we could take the time to compassionately answer each and every request, but the amount of them is huge and they are all essentially the same, with essentially the same response. You can imagine that gets very repetitive very quickly. If you’re here because you were going to ask whether something (or whether you as a person) “counts” as neurodivergent, this is your answer.

Also, consider that you are not erasing space for others by taking up space in this community. You do not cheapen the struggles of others by also having struggles, even if those struggles are less severe or serious. You still deserve space in our community. If you face any kind of ableism or experience any kind of neurodivergence, no matter how "minor” you or others may think it is, that always matters. We need more voices like yours at the table.

I have a question that wasn’t answered here, where/how can I ask it?

First of all, as respectfully as possible, is this a question you can answer by doing some very simple research? There are some very basic questions people with certain conditions get asked quite a bit, and if Google can easily answer something then you have no reason to ask us. If your question something else (what our personal experiences are, specific advice on your own experiences, complicated or inaccessible information about neurodivergence or specific conditions we have, etc.) then you’re welcome to ask us whatever respectful questions you might have. Keep in mind our rule about advice; this is a submission blog and none of us are professionals. Also note that The Corvidae Collective (Mod Corvid) is always open to answer questions on their& blog @mogai-corvidae​ about any of their& identities or experiences, which includes general neurodivergence and many specific conditions. If you’re looking for more in-depth answers, that might be a good place to ask.

[queerautism]

BPD brain anon from this weekend popping in again for an unnecessary update/more inbox rambling, completely unrelated to all the syscourse stuff (which is gross, my heart goes out to OCD anon for their mental illness being used as a talking point).

I'm monoconscious and don't have enough of a sense of self to really recognize any personality changes, beyond any blatantly insane moments (that usually stem from having two Cluster B personality disorders and a cocktail of other mental illnesses). I kind of consider whatever was happening to me this weekend as one of those insane moments, but I DO still think something funky is happening in my subconscious. At the very least, I'm now thinking I'm considerably less "solidly singlet" than I'd thought. I've had a headmate before but I always figured that was more me thought-puppeting responses than an actual headmate.

I could also be doing the BPD brain thing where I convince myself that [thing] is actually a major facet of my identity even though it has literally never come up before, and I, with my lack of consistent self, just go "yeah that looks like it checks out" and adopt it as my identity for YEARS to come. Which is part of why I look back on my previous headmate with suspicion instead of just, accepting that he existed.

I always have a mental dialogue with myself, a back and forth between brain-in-charge and the peanut gallery. Sometimes there is no peanut gallery and my head is void of thought and self. Sometimes there IS a peanut gallery weighing in on my thoughts, and they all speak in my voice. Sometimes I feel like there's a dozen different people saying things but I know they're all the same person, y'know? All NPCs controlled by the same DM. Like this is a game between brain-in-charge and... something submerged in the very back of my brain.

When I was having my Episode, I tried asking myself about it and got some real weird emotional responses, the kind I could feel in my chest and gut even if they weren't really in my brain. I don't remember most of the questions I asked or what caused what responses, but I do remember trying to contact my old headmate. He didn't show up (which I expected, he's been gone for like 12 years), I asked if he was just another puppet, and wham got that gut punch emotional reaction.

Thus: Something Funky Is Happening In My Brain But 🤷‍♂️🤷‍♂️IDK What🤷‍♂️🤷‍♂️

At this point I am just liveblogging the process of sorting out my feelings into your inbox, sorry about that 😔 I'm defo gonna have a talk with my therapist about this tomorrow though.

No worries, thank you for sharing your experience! It sounds like you're processing a lot, so it makes sense it'd take some time. I'm glad you can talk it through with your therapist tomorrow.

I'll say, I know some people with BPD do consider their plurality to be related or caused by it. Like, considering the lack of consistent self a part of it, instead of a reason to be suspicious of the concept, if that makes sense?

[ketchupstrain]

I came up with 2 ocs to help me try and visualize how I kind of feel about my gender and myself as a whole (whoever that may be).

First there’s Formless, It’s a Genderfluid gendervoid entity, It is pansexual and panromantic, mute, and an emotional empath to anyone around It. Voids uses the pronouns He/She/They/It/Voids! Voids also is permanently dissociating and always lowkey uncomfortable . It is black with white and tired eyes, with a gradient wispy lower half.

The other oc I made is an android named Cluster. It is agender, asexual, and aromantic. It communicates only through Bleeps and Bloops and no words. It is capable of emotions but is more logic oriented. It is very good at Grounding Formless, and it uses They/It pronouns. It is boxy and grey and has a mouth consisting of 4 sharp angles.

I came up with Formless because I never have truly seen myself as a human, always a formless, shapeless entity with emotions and functioning mental illnesses. I’ve been trying to see myself as more than just a body, more than just a suit of organs, more than just a label of my gender (or a lackthereof?).

I came up with Cluster because when I dissociate (which feels ever present nowadays…) i feel like a robot going through life. The only thing It is better than I am at is Grounding from Dissociation lol

I want to try drawing more of them together, I really love them together. And I hope I can try and discover myself as I draw more of them

[juniperpublisherscasestudies]

Juniper Publishers- Open Access Journal of Case Studies

A Neurological Presentation of Intravascular Large B-cell Lymphoma: a Rare Cause of Multi-Territory Strokes

Authored by J Newman

Abstract

Intravascular Large B-Cell Lymphoma (ILBCL) affects one in a million people. Here it presented as dysphasia and leg weakness in a forty-five-year-old woman with a history of mental health issues. The initial investigations showed multi-territory infarcts for which we were unable to find a treatable cause. Her condition progressed and she unfortunately died. Although rare, ILBCL ought to be included in differential diagnoses of multi-territory strokes, however, the diagnosis is commonly made post-mortem. Here we discuss common presentations of ILBCL. We note the proximity of her worsening psychiatric symptoms to the time of her death.

Keywords: Lymphocyte cells; Psychiatric symptoms; Intracerebral haemorrhage; Neurological manifestations; Intravascular large B-cell lymphoma

Introduction

Intravascular Large B-Cell Lymphoma is a rare subset of Non-Hodgkin’s Lymphoma that involves the pathological proliferation of lymphocyte cells within capillaries and other small blood vessels [1], causing their occlusion.

As the clonal proliferation is intra-vascular there is relative sparing of the surrounding tissue, making it more difficult to diagnose. The presenting symptoms vary according to the organ affected, although the skin and nervous system are common. When occlusion occurs intra-cerebrally the result is often a stroke.

The importance of identifying the aetiology of stroke in the afflicted patient is well recognised, as it can help direct management and treatment. This is particularly relevant to patients with multi-territory strokes, recurrent strokes, and those who are affected at a young age.

Our patient had worsening psychiatric symptoms leading up to her final admission and diagnosis. We note the proximity of these events, as psychiatric symptoms of ILBCL are poorly documented.

Case Report

A forty-five-year-old Caucasian woman was seen in the emergency department at a tertiary hospital in the UK. She presented with a two-day history of mumbling speech and acting withdrawn, left-sided leg and facial weakness, and right arm spasms. She had a background of depression and had presented acutely to community and hospital psychiatric services 5 months prior to this admission (we do not know the nature of that presentation). Her current medication included olanzapine 10mg daily and venlafaxine MR 300mg daily. Initial examination demonstrated an up-going right plantar response but no other focal neurology.

A CT head scan revealed low attenuation signal changes in the right cerebellar and right frontal lobes. Although her presentation appeared more psychiatric than organic, she was kept in to investigate her symptom complex and CT findings.

A subsequent MRI head demonstrated multiple areas of restricted diffusion in different vascular territories (Figure 1a). There were also foci of high T2 signal changes in the supra-tentorial white matter, with some demonstrating restricted diffusion. Considering the different territories, and different ages of these lesions, a cardio-embolic source was the most likely cause of these infarcts. Her trans-thoracic echocardiogram (TTE) was normal, as was her carotid Doppler. A lumbar puncture showed normal CSF. At this point she developed episodes of seizures corroborated by EEG.

We undertook investigations for lymphoma, and the blood tests showed little except a raised lactate dehydrogenase (LDH 400iU, plasma viscosity normal, blood film normal, haemoglobin 115g/L). We also discussed the possibility of vasculitis. However, her blood results and MR Angiogram did not show any positive findings.

A full-body CT scan was performed to look for other neoplastic lesions, but this was normal. We started high-dose corticosteroids as an empirical treatment for vasculitis.

Two weeks after this, she started to deteriorate. Her seizures became more frequent and her dysphasia more pronounced. A repeat MRI brain (Figure 1b) showed an increase in size of the lesions in the medial frontal and parietal lobes. New lesions in the corpus callosum and left thalamus showed restricted diffusion. The cerebellar, right medial frontal and parietal lesions enhanced with contrast. Long- and short-term MRI head spectroscopy did not show any evidence of a lactate peak to suggest mitochondrial disorder. This picture was consistent with a diagnosis of vasculitis.

Her condition continued to decline. Her GCS dropped to 7 and did not fluctuate, a repeat CT head revealed a right-sided intracerebral haemorrhage (Figure 2). Given the multitude of insults and progressive nature of her symptoms the difficult decision was taken to adopt a palliative approach for her symptoms. She died a day later.

Discussion

Intravascular Large B-Cell Lymphoma is a rare subset of non-Hodgkin’s lymphoma (NHL), affecting one in a million people [2]. First characterised in 1959 [3], it is known colloquially as “the great imitator” [2] due to its diverse range of presentations. It causes disease by a clonal expansion of lymphocytes within small blood vessels [1] resulting in end-organ damage. In retrospective analyses of case reports, around 90% of intravascular lymphomas are of B-cell origin. Unlike other NHL presentations, there is relative sparing of the lymph nodes [4].

There are two forms of ILBCL, Western and Asian. The former presents, as in this case, with neurological or dermatological symptoms [4]. The Asian variant typically presents with multi-organ failure, pancytopenia, fever and bone marrow involvement.

Common manifestations of the Western variant are dermatological (nodes, plaques, nodules, purpura etc.) and neurological (Table 1). Neurological manifestations are present in two thirds of patients and can include mental status changes, seizures, paralysis, aphasia, dementia, motor deficits, neuropathies, paraesthesias and cerebral haemorrhage as well as many others [5].

One meta-analysis [2] published a table of presenting features from seven major studies. Of the 154 patients, 54% presented with CNS involvement, 45% with cutaneous involvement, and 41% with fever. Two of the most common biochemical findings associated with ILBCL are a raised lactate dehydrogenase (LDH) in up to 90% of cases, and anaemia in two thirds of cases [4]. There may also be a raised erythrocyte sedimentation rate, weight loss or fever.

The diagnosis of ILBCL is made by biopsy [6] of affected tissue, which typically shows malignant lymphoid cells in the lumen of the small blood vessels. One of the difficulties in diagnosing this disease comes from the intravascular location of the pathological cells, and the sparing of surrounding tissue making it difficult to identify pathological cells on biopsy (Figure 2). Bone marrow involvement with positive biopsies have been shown in about one third of patients [4]. There is also evidence that for all presentations, a biopsy of macroscopically normal skin is over 80% sensitive as a test for ILBCL [6], providing an alternative to brain biopsy.

Contrasting theories exist as to why these B-cells have a predilection for capillaries. One theory posits the pathological expression of certain cluster differentiation factors (CD11a and CD49d), which enhances binding to capillary epithelium expressing ligands for these factors (CD54 and CD106) [7]. The other suggests that an absence of surface molecules (CD29 and CD54) disrupts lymphocyte homing and leads to an aggregation in small vessels [8]. It may be that as well as understanding the pathogenesis of this illness, elucidation of any aberrant surface molecule expression may also aid the development of target-specific treatments.

If it is identified early, ILBCL can be treated with anthracycline-based chemotherapy regimens. Typically, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone (CHOP) therapy is used –with rituximab in patients with specific B-cell markers. This shows better response and higher rates of remission than alternative regimes [9]. However, only 33% of treated patients survive 3 years [9].

Cutaneous presentations of ILBCL have a better prognosis than other variants [4]. Factors indicating a poor prognosis include elevated LDH and advanced disease with presence in several sites [10].

When considering differential diagnoses it is important to consider ILBCL as a well-recognised cause of stroke (ischaemic or haemorrhagic) despite its low incidence.

This case is important as it demonstrates a specific neurological presentation of ILBCL and illustrates the difficulty of making a diagnosis, as well as the aggressiveness of the condition. We should also not dismiss worsening psychiatric conditions as being a manifestation of the illness – however unlikely – given the close temporal association.

Learning Points

a) Intravascular Large B-Cell Lymphoma often presents with neurological symptoms (in North America and Europe) and is a rare cause of multi-territory infarcts.

b) The intravascular confinement of the clonal expansion of pathological B-cells causes end organ damage by ischaemia.

c) Diagnosis is made by tissue or bone marrow biopsy; but being intravascular it is usually made post-mortem.

d) Biopsy of macroscopically normal skin also has the potential to be diagnostic.

e) Raised LDH and anaemia are common findings.

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[crackcrocs]

DEATH WILL ONLY BE THE BEGINNING #1

1. The backbone to my emotions

As someone who  cannot conceptualise  time in any way whatsoever, I want to say sorry to my loved ones. I'm aware I still need to send my friends messages every once in a while and remind them I still want to be their friends and I need to actively work on this. I need to overcome this fear stopping me from being present and accepting peoples love and support. I want to break free from me and I want to feel content being on this earth, I want nothing more than to enjoy experiences with my loved ones. I love you I love you.

I am a young charismatic, creative individual learning to do things differently so I don't always have the same outcomes. I suffer from a Cluster B Personality Disorder; under the same umbrella of mental health I also experience extremely intrusive thoughts on a daily basis, that can become obsessive and compulsively hyper fixated thoughts in an instant. I have anxiety, depression and a lot of the time I’m deeply dissociated to a point where I struggle to believe I’m even real, even when I do know I am real- I have no attachment to my limbs or body as a whole and only feel alive in a spiritual sense or when I self harm. I don't want to get too into my illnesses; as I’m not someone who really likes labels, just know that everyday is a battle and each personality that exists within me is different. I wouldn't say drastically, however its evident for me and living with so many different masks can be intense. Especially when you've tried to convince people that you're just one solid mould in the hopes they don't perceive you as an intense person. I am going to try to take you through a few of my altars and moods starting with the emptiest subconscious alters that I call the backbones of my emotions to the more powerful  energetic ones that haven't managed to yet consume me over the years. I hope this can give people an insight.

Overall I present a pretty confident front, I like to appear like I’ve got my life together even though I’m so far from it, sometimes I’m not sure ill even find the strength to go on long enough in attempt to get my life together, which is a real problem but it's the sad truth. Don't waste time reading this if you're easily triggered as this piece of writing will consist of real and genuine feelings. I’m in no attempt trying to create content for people who enjoy turning blind eyes and wishing they didn’t see this so I’ll give you a fair warning. I'm not responsible for your triggers, whereas I’m responsible for the things I’ve done. I might have cared too much at one point, but I will not hold myself captive to those situations nor will I regret them. I want the lies, deceit and hurt that I’ve committed against loved ones to end, my secrecy has done enough damage and its exhausting pushing people away even though that’s not usually the intent, truth is I am so embarrassed of myself. I'm private, secretive and mysterious but I’ll also talk about my childhood trauma after like 5 minutes. I guess this says I’m happy to talk about my trauma because it's what I know and am comfortable with, I just struggle to tell anyone the real suicidal me behind my problems. I hate that I’m so young and feel like a dead person already.

I tend to act out or distance myself due to fear which isn’t clear at first if you know me, but does become obvious. I might appear as someone with no care in the world, like I’m unbothered, but I assure you that's the African pride combined with the Leo pride. I also don't want people to treat me like a footstool, which has happened when I’ve come off ass too passive. I care so much and over think absolutely everything, it's literally my only way of thinking. I have little to no self esteem and I have no clue who confidence is unless under the influence of something, be it weed, alcohol or psychedelics (which I don't take much of because I enjoy them and don't want to abuse them) I mean I can function sober, I don't even like to be out of control high or drunk, but as Chief Keef once said, I hate being sober. #i'mTrash4thereference. Although I’m not fully healed and functioning yet, I’m a developed character with both positive and negative traits. At the moment I’m going back and fourth between 'just stop trying' and 'you cant give up'. Sometimes depression is kind of like looking at yourself through a window, there’s this part of your brain that understands it'll pass, but you’re so far into despair that its impossible to see the way out, its a lot like being trapped. I am having a bad patch right now, the difference between this one and the last one is I’m more self aware with less of a desire to go on. At least I’m no longer suffering from paranoia and thinking everyone's out to get me all the time or that I’ll get trafficked walking home from somewhere, but depression and mania are so bloody invasive and there’s always that little voice in my head telling me ill never be good enough. Executive dysfunction kills my motivation because I have so many things to do and I cant pick anything to start first, it gets worse when my depression gets worse too. I'm not lonely though; I have a few people who care for me- and while I'm trying to not involve them in the metal episode, they are around to talk to and that means so much. My friends are super encouraging even though I've only briefly mentioned that I'm having a sad time right now, and that's awesome.

I hate that no matter how much better I get there's still this deep desire to get worse. I don't feel like a real person. I just feel like a collection of what people want me to be and various mental disorders. It would be so cool if I could admit to the world I have a personality disorder without feeling disgusting and without fear.

I've had plenty time to reflect upon every bit of thought that created the barbed wire surrounding my logical brain, I want to feel okay to be alive, but I so strongly just want to die. I am tired of fluctuating from feeling extremely vigorously suicidal to passively suicidal; where I just don't have the energy to carry it out myself. It's gotten way past the point that it doesn't matter what kind of day I have, I think about killing myself all day. Sleep is an escape from life and I'm always tired and wanting to 'sleep'. Deep down I feel like I’m waiting for the right time to end my life and it's not the right time yet because I still have a footprint to leave behind, I still have journal pages I want to burn. I cant just jump off the highest accessible building or mall car park I could find just yet- I don’t just want to ruin others by hurting them with my death. It's sad to think I grew into this mindset, waking up wishing I was dead.

Being abandoned by many people in the past made me doubt people and think everyone was out to get me or wanted something from me, it made me feel hurt and lone. So I felt it would be better to let people down before they could hurt me so I wouldn't repeat the same cycle when forming new connections. It wasn't intentional but I could just silence myself due to fear.

I just found myself feeling immensely hopeless, like I was too internally enraged at the external world to be able to trust anything of it. I definitely do want to get better because I’m tired of feeling this way, it's so exhausting and I hate pushing people away from me like I’m poison. I need to allow people to accept all of me.

Before picking up these coping mechanisms when I was younger and more insecure; I wanted to be a part of the world, I had this strong urge to fit in. I had to learn how to manage my anxiety and socialising became more exhausting stemming from my fear of being 'odd' or 'different', I didn’t want to be called out for being different- it was not a compliment at that age, it always felt like a being the joker in the card deck. I was intensely afraid of being judged or labelled as such. Being told I was a 'weirdo' didn't help at all, that type of criticism is what got to me the most. People made me feel like I needed to change, like I was too African, even in a joking manner it didn't help- because although I was okay with who I was, I did feel like I had to change and westernise myself to fit in. I ended up hanging around with people that didn't care, doing stupid things I didn’t even want to do, dating people I didn't connect with. Eventually I got tired of people using me for entertainment, tired of catering to those who refused to understand. I still have to admit there were many periods that I lowered my frequency to be on the wavelength of others that did not match mines at all, I hate that I'm someone who always feels the need to explain myself so people don't think I'm a bad person and even though I don't owe it to everyone and now I am able to make better choices and I'm no longer easily influenced, it still hurts that i was ever around people that made me feel like I was over exaggerating my mental health or uncomfortable to a point where I learned to downplay it or the mention of it. Now as a coping mechanism I’ve become so facetious and sarcastic about my trauma it's a struggle to take myself seriously at times. Users and abusers belittled me to such a point where I felt they'd underestimated my intelligence and most of all humiliated me. It made me tired of justifying myself so now most days I’m just a mute, but I really do finally have good people in my life who deserve some sort of explanation and it's a shame they don't get to be experience a truly present consistent me. It’s just after having the wrong eyes on me, I don’t want anything to see me. I hate attention because I’m so embarrassed of myself I don’t want to be noticed. People looking at me make me want to kill myself.

I've been told to move past my rage, to let go and become a grounded and level headed person. I've been told there is hope for all of us. Must be nice to believe that, all I could wonder was what it was like to get angry without getting homicidal and suicidal. Even on most days where nothing extreme would happen besides negative emotions, my brain still travelled to a dark realm. I've come to a point where I want to live in my daydream universe wile I physically rot away. That's my business. Sometimes I feel as though all my friendships are on a timer, or more so it's that my timer is about to go off, so I subconsciously shy away and make sure i have no deep friendships. Just in case my head decides to do something stupid.

I don't want to have no friends, I want to have friends and I do value friendships so much more than entitled relationships, I just have a difficulty maintaining friendships because it's exhausting for me, it takes a lot of energy to be social and on a level that isn't just superficial where I can just let go and allow myself to fully be. Sometimes I have a hard time relating to other people, and thus I may feel I don’t belong or don’t quite fit in- causing me to feel irritated, paranoid or even in pain during social situations. It's not always this bad, and I don't mean for it to sound dramatic. It's different when In person and I’m really relaxed and comfortable with the company. However virtually socialising and expressing will always be extremely anxiety enducing and its something I need to overcome especially going into this new phase of Artificial Intelligence.  So if I start to drift away it most likely isn't a reflection of you. The cycle goes I need alone time to recharge then I realise how long has passed and I just feel so bad I haven’t gotten back, I tell myself I’m an awful friend for dissociating for so long, and then I don’t know how to explain that so my anxiety rises, mood drops and I spiral back into a pit of depression, often wanting to relapse but refraining from doing so. Sometimes I manage to get out of the pit, but by then so much has piled up I don't know where or how to begin again.

I don't feel like I could have a normal friendship as well as romantic relationship. It's hard for me to long term imagine myself being fully relaxed enough to let my guard down and not reluctant to express. I don’t think there’s any condition where ill just be came and enjoy a connection without worrying that the other person isn’t putting in as much effort, or they have an image of me, or that I’ve amplified the emotions and even though I feel them that way do they really understand me or love me as much. Silence is so upsetting and I hate the fact I do it when I'm afraid of myself or don't feel good enough. I never intent for it to become 'the silent treatment' because in reality its not treating anyone, it's more a reflection of what I’m internalizing and not wanting or being unable to project and express those feelings without feeling like party pooper, an attention seeker or 'too deep'. I don't mean to give people false hope, I love the people in my life so much and every one I’ve met on this journey. I'm learning to look at life through a different lens and the people who contributed to my suffering will not be the definition of me. People have led me to believe so much and strung me along, not letting me go- and I realised those entitled controlling abusive relationships were not serving me. I couldn't keep doing it. Now even though I want closeness I end up pushing people away or leaving them in the dark because of fear, especially of something new because I've never experienced anything good and true for a long enough duration of time to rid me of that fear. I also have fear of rejection or hurting, I fear becoming too emotionally invested and becoming co dependant so I end up wanting to avoid the pain than actually wanting to experience the joy and growth the relationship could offer, so I end it before it begins to avoid any possible pain. I feel like I don't deserve these connections,and sometimes the depression runs so deep I have to push people away in case I want to do something stupid- I don’t want them to feel at fault, or obligated to be able to handle me. Sometimes I really can just only be with myself and my thoughts so I hide but it may appear that I’m pushing others away because of my isolation and neglect.

With everyone I know, I get this feeling that they're too good for me, their energy is so radiant and loving but I feel so broken and don’t want to depend on that. I've had perfectly ideal people come into my life and I feel they’re too good for me because I have a lot of work to do on myself first, primarily I need to build up confidence and self esteem because it's the root of most my issues. I want to relate to people, share our deepest fears and wishes without fear of judgement. It's not that I don't want to get better, I simply cannot remember what it was like to have an actual honest to god normal personality. The feeling of being a mentally unstable chameleon is all I have  now. I AM my illness, that's the only identifier I have left. I can't remember normality.

I understand that I’m lucky and I’m not ungrateful for the things and people I do have, it doesn’t mean that my life doesn’t suck because of those lucky things. I often think about if someone created technology to transfer life to another, I’d happily give them mine because they'd live it much better than me, I’m not worth anything to myself. I never wanted to be someone to cause pain on the people I love but now I do, even if that’s just through silence. I just disappear when I haven’t been doing well and  although I know things get better, recovery isn’t linear and that not all my days are bad, I just have extreme chronic feelings of emptiness.

I struggle to trust people because I don't want to be hurt but I need people so much, I hate feeling unloved. It's so overwhelming because I feel everything so extremely as if I’m going to explode.

My sense of self and reality feels destroyed, my future and dreams are uncertain and it's hard for me to move on, sometimes it scares me what I’m doing to people without the intention of it, being too much or not enough- or at least feeling that way. It's hard for me to give myself a reason and it's not on the people around me to fill my empty void, I hate forcing people to be my friend or understand my illness. I cant expect anyone to want to- it feels like I’m holding their hand while they pull it away; and even though it's not the case I feel awful, I constantly feel like I’m in a more pessimistic head space. I'm worried people will realise I'm as pathetic as I say I am.

[dajokahhh]

Alright, time for some pretentious sociological-esque rambling. This is gonna be long as hell (its 1822 words to be specific) and I don’t begrudge anyone for not having the patience to read my over-thought perspectives on a murder clown. CWs for: child abuse, 

I think a lot of things have to go wrong in someone’s life for them to decide to become a clown themed supervillain. A lot of people in Gotham have issues but they don’t become the Joker. I think that as a writer it’s an interesting topic to explore, and this is especially true for roleplaying where a character might be in different scenarios or universes. This isn’t some peer reviewed or researched essay, it’s more my own personal beliefs and perspectives as they affect my writing. I think villains, generally, reflect societal understandings or fears about the world around us. This is obviously going to mean villains shift a lot over time and the perspective of the writer. In my case, I’m a queer, fat, mentally ill (cluster B personality disorder specifically) woman-thing who holds some pretty socialist ideas and political perspectives. My educational background is in history and legal studies. This definitely impacts how I write this character, how I see crime and violence, and how my particular villains reflect my understandings of the society I live in. I want to get this stuff out of the way now so that my particular take on what a potential origin story of a version of the Joker could be makes more sense.

Additionally, these backstory factors I want to discuss aren’t meant to excuse someone’s behaviour, especially not the fucking Joker’s of all people. It’s merely meant to explain how a person (because as far as we know that’s all he is) could get to that point in a way that doesn’t blame only one factor or chalk it up to “this is just an evil person.” I don’t find that particularly compelling as a writer or an audience member, so I write villains differently. I also don’t find it to be particularly true in real life either. If you like that style of writing or see the Joker or other fictional villains in this way, that’s fine. I’m not here to convince anyone they’re wrong, especially not when it comes to people’s perspectives on the nature of evil or anything that lofty. Nobody has to agree with me, or even like my headcanons; they’re just here to express the very specific position I’m writing from. 

The first thing I wanna do is set up some terms. These aren’t academic or anything, but I want to use specific and consistent phrasing for this post. When it comes to the factors that screw up someone’s life significantly (and in some instances push people towards crime), I’ll split them into micro and macro factors. Micro factors are interpersonal and personal issues, so things like personality traits, personal beliefs, mental health, family history, where and how someone is raised, and individual relationships with the people around them. Macro factors are sociological and deal with systems of oppression, cultural or social trends/norms, political and legal restrictions and/or discrimination, etc. These two groups of factors interact, sometimes in a fashion that is causative and sometimes not, but they aren’t entirely separate and the line between what is a micro vs macro issue isn’t always fixed or clear.

We’ll start in and work out. For this character, the micro factors are what determine the specifics of his actions, demeanor, and aesthetic. I think the main reason he’s the Joker and not just some guy with a whole lot of issues is his world view combined with his personality. He has a very pessimistic worldview, one that is steeped in a very toxic form of individualism, cynicism, and misanthropy. His life experience tells him the world is a cold place where everyone is on their own. To him the world is not a moral place. He doesn’t think people in general have much value. He learned at a young age that his life had no value to others, and he has internalized that view and extrapolated it to the world at large; if his life didn’t matter and doesn’t matter, why would anyone else’s? This worldview, in the case of my specific Joker, comes from a childhood rife with abandonment, abuse, and marginalization. While I will say he is definitively queer (in terms fo gender expression and non conformity, and sexuality), I’m not terribly interested in giving specific diagnoses of any mental health issues. Those will be discussed more broadly and in terms of specific symptoms with relation to how they affect the Joker’s internal experience, and externalized behaviours.

His childhood was, to say the least, pretty fucked up. The details I do have for him are that he was surrendered at birth because his parents, for some reason, did not want to care for him or could not care for him; which it was, he isn’t sure. He grew up effectively orphaned, and ended up in the foster care system. He wasn’t very “adoptable”; he had behavioural issues, mostly violent behaviours towards authority figures and other children. He never exactly grew out of these either, and the older he got the harder it was to actually be adopted. His legal name was Baby Boy Doe for a number of years, but the name he would identify the most with is Jack. Eventually he took on the surname of one of his more stable foster families, becoming Jack Napier as far as the government was concerned. By the time he had that stability in his mid to late teens, however, most of the damage had already been done. In his younger years he was passed between foster families and government agencies, always a ward of the government, something that would follow him to his time in Arkham and Gotham’s city jails. Some of his foster families were decent, others were just okay, but some were physically and psychologically abusive. This abuse is part of what defines his worldview and causes him to see the world as inherently hostile and unjust. It also became one of the things that taught him that violence is how you solve problems, particularly when emotions run high. 

This was definitely a problem at school too; moving around a lot meant going to a lot of different schools. Always being the new student made him a target, and being poor, exhibiting increasingly apparent signs of some sort of mental illness or disorder, and being typically suspected as queer (even moreso as he got into high school) typically did more harm than good for him. He never got to stay anywhere long enough to form deep relationships, and even in the places where he did have more time to do that he often ended up isolated from his peers. He was often bullied, sometimes just verbally but often physically which got worse as he got older and was more easily read as queer. This is part of why he’s so good at combat and used to taking hits; he’s been doing it since he was a kid, and got a hell of a lot of practice at school. He would tend to group up with other kids like him, other outcasts or social rejects, which in some ways meant being around some pretty negative influences in terms of peers. A lot of his acquaintances were fine, but some were more... rebellious and ended up introducing Jack to things like drinking, smoking cigarettes, using recreational drugs, and most important to his backstory, to petty crimes like theft and vandalism, sometimes even physical fights. This is another micro factor in that maybe if he had different friends, or a different school experience individually, he might have avoided getting involved in criminal activities annd may have been able to avoid taking up the mantle of The Joker.

Then there’s how his adult life has reinforced these experiences and beliefs. Being institutionalized, dealing with police and jails, and losing what little support he had as a minor and foster child just reinforced his worldview and told him that being The Joker was the right thing to do, that he was correct in his actions and perspectives. Becoming The Joker was his birthday present to himself at age 18, how he ushered himself into adulthood, and I plan to make a post about that on its own. But the fact that he decided to determine this part of his identity so young means that this has defined how he sees himself as an adult. It’s one of the last micro factors (when in life he adopted this identity) that have gotten him so entrenched in his typical behaviours and self image.

As for macro factors, a lot of them have to do specifically with the failing of Gotham’s institutions. Someone like Bruce Wayne, for example, was also orphaned and also deals with trauma; the difference for the Joker is that he had no safety net to catch him when he fell (or rather, was dropped). Someone like Wayne could fall into the cushioning of wealth and the care of someone like Alfred, whereas the Joker (metaphorically) hit the pavement hard and alone. Someone like the Joker should never have become the Joker in the first place because the systems in place in Gotham should have seen every red flag and done something to intervene; this just didn’t happen for him, and not out of coincidence but because Gotham seems like a pretty corrupt place with a lot of systemic issues. Critically underfunded social services (healthcare, welfare, children & family services) that result in a lack of resources for the people who need them and critically underfunded schools that can’t offer extra curricular activities or solid educations that allow kids to stay occupied and develop life skills are probably the most directly influential macro factors that shaped Jack into someone who could resent people and the society around him so much that he’d lose all regard for it to the point of exacting violence against others. There’s also the reality of living in a violent culture, and in violent neighbourhoods exacerbated by poverty, poor policing or overpolicing, and being raised as a boy and then a young man with certain gendered expectations about violence but especially ideas/narratives that minimalize or excuse male violence (especially when it comes to bullying or violent peer-to-peer behaviour under the guise of ‘boys will be boys’). 

Beyond that, there’s the same basic prejudices and societal forces that affect so many people: classism, homphobia/queerphobia, (toxic) masculinity/masculine expectations, and ableism (specifically in regards to people who are mentally ill or otherwise neurodivergent) stand out as the primary factors. I’m touching on these broadly because if I were to talk about them all, they would probably need their own posts just to illustrate how they affect this character. But they definitely exist in Gotham if it’s anything like the real world, and I think it’s fair to extrapolate that these kinds of these exist in Gotham and would impact someone like The Joker with the background I’ve given him.

I have no idea how to end this so if you got this far, thank you for reading!

[kamalkantimage]

Arogyavardhani Vati – Uses, Functions And Therapeutic Benefits

Arogyavardhani Vati.

clad by the vernacular names Arogyavardhani gutika, Arogyavardhani rasa or Sarvroghar vati is a supernatural home grown cure utilized for treating a heap of sicknesses mostly of the heart, liver, stomach, digestive tract, nerve bladder, skin, teeth and gum.

The word 'arogya' implies 'great wellbeing' while 'vardhani' means 'improver', for example an ayurveda detailing that can totally kill illnesses and improve or advance great wellbeing.

Consistently, this home grown cure is generally referenced in the antiquated ayurvedic writings of Rasaratnasamucchaya for the treatment of kustha for example sickness and furthermore valued as Sarvarogaprashamani for example a solution for a wide range of sicknesses. It is additionally unequivocally pushed in the writings of Bhaishyajyaratnavali for treating yakritvikara for example liver issues. The comprehensive study of Ayurveda likewise guarantees the utilization of this strong drug for jaundice, skin diseases, fever, oedema, acid reflux and corpulence.

Arogyavardhani vati

Readiness Of Arogyavardhani Vati

Fixings:

2 pieces of each Triphala

a. Haritaki - Terminalia chebula organic product skin

b. Bibhitaki - Terminalia bellirica organic product skin

c. Bhumi Amalaki - Emblica officinalis organic product

3 pieces of Shilajatu (mineral pitch) - Asphaltum

4 pieces of Guggulu for example Indian bedelium (gum) - Commiphora mukul

4 pieces of Chitrakmool for example base of Indian leadwort - Plumbago zeylanica

22 pieces of Kutki - Picrorhiza kurroa

Juice concentrate of Nimba leaf (Neem) - Azadirachta indica (according to necessity)

1 piece of Shuddha Parada (natural sanitized mercury)

1 piece of Loha Bhasma (debris got from iron)

1 piece of Shuddha Gandhaka (natural decontaminated sulfur)

1 piece of Abhraka Bhasma (purged and handled mica)

1 piece of Tamra Bhasma (debris acquired from copper)

Starch (restricting operator)

Technique for arrangement

Technique:

The home grown fixings, for example kutki, chitramool and triphala are powdered and put away in isolated water/air proof vessel.

Shilajit and guggulu are refined through swedana measure utilizing triphala kwath.

New nimba patra swaras (for example neem leaf remove) is set up by granulating and pressing the leaves.

The home grown powders are blended in with the neem concentrate and exposed to the bhavana cycle (for example implantation of powder with liquid) for 3-4 hours.

The powder is then air dried at a temperature of 60°C.

Sanitized shilajit and Amritadi guggul are then blended in with the air-dried powder.

The metallic remains of loha, tamra, abhrak, parad and gandhaka are exposed to the mardana cycle (for example granulating) to get dhatukajjali (a compound of mercury)

All the above fixings are blended homogeneously in a blender.

Ultimately, the coupling specialist is added to hold the powder particles together.

Circular tablets or vatis are set up by moving them onto your palm or utilizing tablet making machine for extreme amount of blend.

Elements of vati

Restorative Benefits of the Ingredients:

Triphala:

It is a powdered blend of 3 powerful myrobalans in equivalent amount in particular amlaki, haritaki and bibhitaki. The powders when included any plan goes about as a powerful cure against a large group of maladies like blockage, weight, acid reflux, fart, jaundice, iron deficiency, asthma, throat contamination, hair issues and pyorrhea.

Shilajatu:

At the point when natural issue gets caught under layers of rocks more than many years and are exposed to extraordinary weight and temperature conditions, a thick clingy exudate is gotten which is profoundly plentiful in minerals like triterpenes, fulvic and humic corrosive. This rejuvenative cure is exceptionally fundamental for kidney stones, dysuria, phthisis, breathing issues, sickliness, epilepsy, heaps, oedema, mental failures and skin contaminations.

Guggulu:

This is a gum tar got from the bark concentrate of the mukul tree. The concentrate is then sanitized with triphala decoction to utilize it in different ayurvedic plans. It holds high importance in the treatment of cardiovascular issues, hypertension, weight, joint inflammation, and atherosclerosis.

Chitramool:

Chitramool is gotten from the sun-dried base of the Chitrak plant. The root extricate is incredibly basic in advancing processing, animating hunger and dealing with a large number of infections like stomach torment, anorexia, hemorrhoids, rhinitis, hack, sprue, liver issues, feminine issue and barrenness.

Kutki:

This incredible ayurvedic spice is profoundly successful in normalizing the tridoshas and has a katu rasa (for example severe sharp taste), consequently the name. The severe spice is useful for treating liver issues, stomach related problems, respiratory issues, skin diseases and furthermore disposes of poisons from the body.

Nimba:

The new neem leaf remove utilized in this detailing builds the restorative adequacy of the item. An amazing cancer prevention agent, neem remove disposes of free revolutionary from the body subsequently effectively partaking in treating intestinal worm pervasion, vision issues, acid reflux, ulcer, heart diseases, blood issue, liver issue, teeth and gum contamination.

Sanitized Metallic Ashes:

The metallic remains utilized in this plan are totally filtered through a progression of steps called sodhana (refinement), mardana (granulating) and swedana (disintegrating). These cinders are utilized for making the kajjali for example a combination of parad which is compelling in normalizing the tridoshas in the body. Among these different cinders, loha bhasma is profoundly compelling for treating liver issues, spleen issue, pallor, hernia and impotency while abhrak bhasma is utilized for treating extreme cerebral pain, dementia, Alzheimer's infection, epilepsy, vertigo and so on. Also, tamra bhasma is possibly helpful for acid reflux, nerve stones, liver and spleen development.

Starch:

This is utilized in an insignificant amount as a coupling specialist to hold the powdered particles together when defined into vatis or tablets.

Different advantages of arogyavardhani vati

Advantages and Therapeutic Uses:

Instilled with a large group of restoratively successful fixings, the ground-breaking ayurvedic plan is firmly upheld for its viability in a heap of diseases.

Powerful Digestive Stimulant:

Arogyavardhani vati is a brilliant stomach related definition. The counter pretentious property of this item lessens the development of gas in the wholesome waterway, along these lines diminishing fart, swelling and stomach distension. A higher centralization of the Kutki spice, makes this vati a strong starter, which builds hunger, decreases heartburn, animates better ingestion of supplements in the body and subsequently advances a sound stomach related framework.

Fixes Skin Diseases:

The plan is a mysterious solution for treating different skin contaminations. The bounty of triphala in this plan is exceptionally viable in eliminating the AMA poisons from the body. The mitigating and powerful pain relieving properties of this vati is very useful in treating skin break out and dermatitis. Being stacked with cell reinforcements, Arogyavardhani vati rummages free extremists from the body and its antipruritic nature lightens tingling sensation caused because of unfavorably susceptible conditions like psoriasis, dermatitis, skin inflammation, burn from the sun and so forth.

Advances Weight Loss:

Ordinary utilization of the vati improves body digestion and fixes liver illnesses, stomach issues and heftiness. The basic supplements in the plan satisfies the yearnings aches and forestall indulging and thus can assume a urgent part in one's weight reduction routine.

Treats Liver Problems:

Arogyavardhani vati having powerful mitigating and hostile to viral properties is very successful in dealing with different liver issues like hepatitis, jaundice and greasy liver. The cholagogue idea of the natural definition invigorates the emission of bile from the liver into the small digestive system and furthermore effectively takes an interest in cleaning out the unnecessary bile from the body before being assimilated, consequently lessening dangers of spleen and liver issues.

Fixes Heart Ailments:

Arogyavardhini vati goes about as a strong cardiovascular cure. It fortifies the heart muscles, improves the sarcoplasmic reticulum elements of the heart and limits arrhythmias. By managing the heart rhythms, it successfully decreases the danger of heart blocks, blood clusters, cardiovascular failures, ischemic cardiomyopathy, mitral spewing forth, and so on. It likewise lessens hypertension and monitors circulatory strain levels, This is best ayurvedic treatment for heart blockage.