#stressing me out to the point of depressive episode with psychotic symptoms??

[18-toe-beans]

perhaps Consider that i am not doing well and will not be doing well for a while— Sorry y’all.

[ikamigami]

I think that there's something going on with Sun.

In this post I'll be talking about how recently Sun is acting a little bit odd.

We all know that Sun was worrying about Moon even before Earth told him what Moon was planning to do. So it's not that weird that he's more stressed. But there are some things that makes me think that there's more going on with Sun. Something which Sun hides from others - probably because he doesn't consider it to be a big deal or even a real issue..

I talked plenty of times about how people suffering from depressive psychosis often don't say anything about their symptoms. We saw that with Sun as well. Sun didn't open up about having hallucinations on his own. Both Earth and Moon found out by accident. Because they were there when Sun was hallucinating.

I said that it wouldn't be surprising if Sun was hiding his symptoms once again after feeling better. I've seen people saying "how Sun would be hiding his issues for so long?" etc. And that's a good question. But answer is really simple - this disorder is just like that. I like to think about it as a silent disorder. Also Sun probably thinks that he's okay. So why he would bother anyone about his "not a big deal" issues..

Beside that I was hiding my symptoms for more or less a decade so...

And with what I said recently that I think that Sun may not be that much aware of what exactly is going on with him - he's only slightly aware which is common for people suffering from depressive psychosis hence why they hide their symptoms because they feel ashamed and they feel like a burden and Sun also may think that it's not that important which he even told that Earth - it wouldn't be surprising that he could have another psychotic episode without him realizing it.

It's most probably that his family thinks that when hallucinations ended and that he seems fine that it was just a one time thing and not that he might be suffering from disorder - Sun also thinks the same.

And here's the thing. In depressive psychosis it's hard to tell when next episode may happen. Often times a person suffering from it will experience a relapse after receiving treatment (even many years after the treatment). So what about when someone isn't treated for depressive psychosis or if treatment isn't specifically for depressive psychosis (and we all know that Earth isn't a professionalist) - having another psychotic episode is more likely to happen.

So now when I explained some things we can get to the point of this post.

Sun is acting odd recently.

I already talked about Sun's line "sometimes I wonder if it'd be better if Moon and I never separated" from second therapy episode and explained what it is a callback to and what it probably means.

So let's talk about other "odd" things.

On second family therapy episode near the end Sun walked up to a radio to turn it off and under his breath he said "please stop". The issue is that radio wasn't even on. This may mean many things. But when we consider what Sun said that he's paranoid about Moon's state - he didn't explain what he meant. And I think that it was a bad thing. Sun expressed having paranoid thoughts before which is quite common for people suffering from psychotic disorders. From my own experience - it's hard to ignore paranoid thoughts especially if they're persistent and it's worse if they're accompanied by delusions. So to say it shortly, Sun is probably very stressed out. But my point is that I think that Sun is hallucinating once again.

Another thing is when Earth went to talk with Sun and Lunar about Moon's situation (before they learned what Moon is up to) Sun was standing silently waiting for donut to come back. This whole situation was bizarre. And considering how Sun seemed unresponsive and that he barely had any reaction to what Earth told him that Moon might be up to something bad (even though Moon talked with Sun about what if Ruin was still here and if it'd be okay to sacrifice him to bring Solar back which definitely should've clicked in Sun's head).. and then he was just gone. He left the Daycare because he had a break but why he left before Earth got back? And why he didn't inform anyone that he went home - cause I think that this is what he did, right? I found these things to be odd..

Another thing is when Papyrus appeared in the Daycare Sun was literally spamming words from his mouth.. it was odd to me that no one even said anything about it in the comments. Why Sun was talking so fast? The change in speech is common for people suffering from psychotic disorders. And we had plenty of examples when Sun was either talking faster so it was hard to understand what he's saying or he was mumbling to himself which often times was very hard to understand or even hear what he was saying..

Another thing was in yesterday's episode - Sun went for donut to bring it back to the Daycare and he was talking about someone who takes the donut out and thinks that's funny. But who Sun could possibly be talking about? Dazzle? Jack? Kids? Maybe kids because that's what he told Earth previously. But I find it quite odd because it wasn't happening before. I just find it odd.

But what's more important is that Sun said that he was tired of doing things. He said that he could sleep forever - hmm and never wake up? Seems like he's depression is talking. This is something more concerning also considering that Moon from that dimension mentioned a few times how depressed and sad Sun seems.. to which Sun denied it - but like I said he probably thinks that he's fine because it's not a big deal and others are in worse state like Moon for example.

If there was more things that you found odd in Sun's behaviour let me know ^^

But I'm really concerned that Sun's mental state is worsening but the worst thing is that he isn't even aware of this..

[kelmping]

memory post incoming (last update: nov 7)

i don’t. remember much. pre-gowpenny. i only have a couple of memories, and they’re… weird.

i was born on december 13th, 2002. a friday. because fucking of course it was. my mom raised me on her own until i was about eight, at which point i started to tumble through the foster system. i don’t know what happened, but it was definitive that i would never and could never return to her care.

i know i was an undiagnosed autistic (which i. figured out later), along with some other stuff (anxiety, depression, adhd, ptsd, a separate complex ptsd diagnosis…) so i wouldn’t be surprised if it turns out i had memory problems. (the rest of my system does too, so.)

i know that i was kind of a loner, though. people tended not to like me, so i just stayed out of their way unless i needed something. sometimes that meant sitting alone to read at recess as a kid. sometimes it meant just staying low and quiet and hoping to whatever the hell is out there that nobody found me wherever i was sleeping on the streets.

suicide cw: i wasn’t. always. super crazy about being alive. i found out i couldn’t die the hard way. and even then, i tested it more than once.

i experienced psychotic symptoms, though not always with the same regularity. as i got a handle on my magic, they eased up, but i’d go through stretches that lasted for weeks without too much… intrusion? it was manageable. but then there would also be stretches of time where i didn’t trust myself with my wand and told my familiar to fuck off back to iowa. my friends were a really big help ;;;

jammer was my first best friend. k and sam started out as regular friends, but we all got closer as time went on. (i took after jammer a lot, heh. that’s social mimicry for you.)

he also had locs similar to lou wilson’s, with the bleached ends from mismag and the length from fantasy high.

k kept going by dream among the four of us, so i use their names (as well as she/they/he/xe pronouns) interchangeably.

i did have a silly crush on them. we dated, just like in canon. but i also dated jammer, and k also dated sam, who was… the label i would use now for the two of us would be an unspoken queerplatonic partnership.

i wasn’t really. as… giggly. as brennan played me being, when i first told philtrum i didn’t want to be magical. i was more, just. scared. apologetic. i was worried she’d toss me out on my ass with no help either way.

oh my god. you have no idea how stressful it was to listen to the first part of episode 4. i already knew i hadn’t given up my magic, but watching it play out was… whoof.

i think there were some minor differences between what happened in canon and my actual reactions. i don’t remember them very well, though.

i just. collapsed. after the whole thing with sam and the shadow. grabbed sam as tight as i could and broke down sobbing. and i was. really. really lucky to have such amazing friends.

the fuckingggg. stupid goddamn tournament arc. k is so fucking cool, and i was like. genuinely fucking scared i was gonna kill that guy from rosewood or rosewand or whatever the hell his school was called. that bravado was allllll me just channeling jammer as much as fucking possible. i was shaking as i got ready. probably still as the duel actually started.

the duel went differently than it did in canon. i guess the roll was low, or too high, or. something. i don’t know. but i didn’t just send that kid to hell, like, mentally. he was physically dead for between five and thirty seconds. time is. an enigma. and i just stood there shaking as he dropped.

as soon as i snapped out of it i rushed forward to… i don’t know, try to help somehow? but nurse stitchnit pushed me aside and resuscitated him. i almost sobbed when he started breathing again, even though he was coughing up blood.

the guilt of that ate away at me for a long time. it still does, sometimes. but he lived, and i’m very glad he did. and, frankly, glad he was able to tell me to fuck off afterwards. good for him. lord knows i deserved it.

needless to say, it was much less, uh. jubilant. i just wanted to sit down and be left alone, but i was lucky to have friends who understood that i both shouldn’t be completely alone and couldn’t talk about it.

jammer’s link with alexis had lingering effects that manifested both magically and as scars and chronic pain. most of the time he was alright, but overworking himself would wipe him out for weeks.

i love my friends. a lot. like, yeah, i was dating k and jammer, but. all three of them were my fucking family. sometimes we’d all end up sleeping on a couch in the common room, or in a single. twin. bed. with four teenagers in it. it was a mess, and physically uncomfortable at times, but i literally never felt emotionally safer than when we were all just hanging out and doing fuck all.

nurse stitchnit is like. almost a dad to me? like a surrogate, adoptive dad. he was always the adult that i trusted most. he offered to let me stay with him at the end of the school year, actually. i had plans, though.

the holiday special. um. the party? when i felt that darkness creeping up? instant panic attack. hence the, uh. freaking out. apologies for that.

pretty sure the icy water inside tad was, like. magical in the sense that it was cold enough to cause frostbite with too much contact, similarly to how human blood is hot inside the body. it “damaged” my hand like when i grabbed penfrew.

also. broken ribs. not fun. i was concussed too, and i just wanted my friends close, but it hurt to hold them too tightly.

i guess the “roll” of my timeline that dream did to heal me failed, because i remember that the recovery took a while and was pretty miserable. thankfully, i was also pretty out of it. and my friends and nurse stitchnit made sure i knew i wasn’t alone. they took good care of me.

i was asked at one point why i slept, like. curled up? i didn’t really realize i did it. something, something, autism, something, something, growing up really tall while trying to avoid being noticed Too Much. probably. i dunno.

at the end of the year, i went to stay with my friends for the three months of break. jammer, then k, then sam. i don’t remember a lot of specifics, but i know their families were at least nice.

i showed up in the background of some of sam’s streams by accident, while i was staying with her. i had a weird little mini-fanbase within her fans? it was. interesting. kinda flattering, kinda weird. that one comment section spell came in handy. (eventually i did a stream with her. it was a lot of fun, honestly.)

sam encouraged me to start my own channel, so i decided to document my experiences as a first-generation mage living with both psychological issues and genuine curses. it had a pretty wide range, from relaxed gaming streams and pictures of myself and my friends to dream’s multi-hour video essays about social issues that i’d helped write. (i eventually learned to separate that stuff out, though, considering i gained a sizable following despite still being fairly reserved.)

at some point, jammer effectively said this:

down the line, years post-gowpenny, we had a daughter named bailey. biologically she was sam and jammer’s, but all four of us were her parents. (sam was mom/mama, k was ren/renny, jammer was papa/pop, and i was dad.) we all loved her more than anything, and the day she was born was one of the best of my life.

at an indeterminate point post-gowpenny (after we’d all graduated), i lost my right leg from about the knee down. unfortunately for the others, i also Could Not stay still, and spent more time than i probably should have using them as makeshift supports. mostly jammer, since he was the closest to me in height, but sam and dream were just as willing to help me out. and i’m pretty sure stitchnit ended up needing to carry me a couple of times…

[whitecatcrime]

mental health thoughts after the last reblog

you know, i wasn't sure if i should post this here, but i just reblogged a post related to it, so here we go. i still feel vulnerable posting these thoughts, so i still might delete this later. btw this is also kind of long. sorry.

note: i definitely feel like i'm probably over reacting to a lot of this, but do feel free to correct me on anything.

ANYWAY, okay, how do i start talking about this? i'm no fan of the DSM, but i've been doing research on something, and it lead up to doing research on psychotic disorders and disorders with psychotic features. back when i was in my teens, i was diagnosed with MDD "possibly with psychotic features" before i knew much about psychosis. i was told that my narcolepsy was causing the weird brain stuff that could be related to that because, well, it can cause psychotic-like symptoms. but anyway. i should get to the point.

during the time i got that psych exam, and during years surrounding it, i was dealing with catatonia (based on what a therapist said), hallucinations that really stressed me out (mostly episodic), and weird beliefs (the example i like to give is the time where i believed an imposter took over my partner's body because i've talked about it enough tor remember it, even with my shitty memory), and more. i would either have few-hour long episodes that happened when my BPD stuff was acting up or longer ones that were more more random (i think).

anyway, i don't really bring these experiences up to psychs because they usually change the subject or are like "you don't seem like someone who's psychotic." (reminds me of the psychiatrist that looked at "R/O BPD" on my exam results and was like, "you just don't seem like you have BPD. i can tell as soon as patients walk into my office!" and therefore didn't even look for it. (and then another psych, later on, said i fit the criteria, but whatever).

back to the point. it's been really hard to tell if what i'm experiencing is depression or negative symptoms. after upping certain medications, i don't think i've experienced the "depressed mood" symptom for a long time, which makes my psych nurse wonder if i'm even experiencing depression. (though i know that you don't need the "depressed mood" symptom to be in a depressive episode, so idk.) but one thing i've noticed is that the symptoms of depression i do experience are also negative symptoms. plus i experience negative symptoms that aren't criteria for depression. whatever these symptoms are have potentially taken over my life more than most things.

but one big detail is that i stopped experiencing positive symptoms (except for when i'm on weed). i was out of an episode for a few months (longer than usual), and then started an atypical antipsychotic, and now i haven't experienced them in years, whatever the reason is.

it could be the medication, but i don't think that usually makes positive symptoms... go away completely? i've also been researching residual psychotic disorders (or the "residual stage" of schizophrenia for example), which aren't in the DSM-5 (they were in the DSM-4, but i'd figure it's still a phenomenon), and i've only spent like 5-7 hours researching total, but it seems to... fit? but obviously there could be something i'm missing.

i'm not claiming i fit the criteria of anything i've been talking about. it really just makes me wonder how what's going on would be labeled. i hope i'm not too ridiculous for wondering about this.

[hauntedselves]

i had therapy today and we went over this. scary and LONG but i think it was a good idea and worth it!

essentially we just went through what i’d written above and she said what she thought about it.

StPD: ehh... most of it can be explained by autism & trauma, as well as my episodes of psychosis. not something she’d diagnose me with, but still something that i feel comfortable self diagnosing with

dyscalculia: not in her ballpark, so i’ve gotten a referral to the university clinic where the PhD students practice psychology (since that’s a hell of a lot cheaper than other methods) for a cognitive assessment (for dyscalculia, and my cognitive functioning more broadly). she thinks it’s likely though. also mentioned that time distortions are common in autism (and i know they are common in ADHD and dissociative disorders as well)

SzPD traits: she said “you flat out just don’t have schizoid PD”. i agree, and i think the traits i do line up with is also autism + trauma, as well as depression (for the anhedonia, avolition, etc). good to hear her perspective though

NPD traits: this one was interesting because she thinks that everything in my list can either be accounted for by trauma, autism, or just normal human experiences except my “belief of being special/unique”. but that one symptom alone isn’t enough to be diagnosed with NPD traits, so we’ll just.... note that and move on i guess lol

EDs: she agrees with me that i “definitely have disordered eating”, but she’s hesitant to put a label on it (or specify eating disorder instead of disordered eating) until we discuss it more. again, autism & trauma, as well as internalised fatphobia and diet industry bullshit. she was leaning into ARFID more than AN though.

ADHD: another interesting one... we’re gonna screen for it, not necessarily because it’s something she’d pinpoint as a possible diagnosis but more because she wouldn't want me to miss out on the literally life-changing medication that might help me if i did have ADHD. so it’s still definitely on the table.

OCD: also interesting (i use that word way too much...). again, autism + trauma, but she said i “definitely have intrusive thoughts” and “episodic” OCD which i didn’t know was a thing...

CPTSD: yep. no argument there. she also brought up that DID is under the CPTSD umbrella but with distinct symptoms for a separate diagnosis

psychotic thoughts: she said she wouldn’t say “psychotic features” but she would say “psychotic episodes“ that are tied to stress, trauma, and also function as / were developed as coping skills, especially in childhood. also has more weight because my dad is psychotic (either schizophrenic or depressive schizoaffective depending on who he talked to at the time, though he doesn’t agree with either of those dx’s)

pathological demand avoidance: we didn’t talk about this one much, just that it’s very common (especially in autistic kids) and usually people grow out of it. i have to do more research into how it presents before i can pinpoint how or if it affects me now in adulthood

there was also one other thing that i didn’t include in the above post, and i’m not gonna publicly share what it is, but we did talk about it and it was hard and scary... i’m glad my appointment was on the phone and not in person. the distress it causes is more important than the actual symptoms, (as with any disorder really), but there’s a lot of yuckiness and discomfort that comes with it. the main thing is that i do have insight and awareness, which is important when it comes to this particular thing.

we also talked a lot about how symptoms =/= diagnosis and diagnosis is just a convenient, agreed-upon framework mostly for quickly sharing information with other professionals, though of course it can feel good to have something to point to. all stuff i agree with but good to hear from a Professional (TM) herself.

she said she would be hesitant to diagnose me with any PD... but she diagnosed me with BPD when we first met (or rather, i’d already been diagnosed, and she agreed with the diagnosis)... idk what that means - she probably just forgot, but i’m. insecure lol

she said if she were to write a list of my diagnoses, it would be: CPTSD, DID, ASD, transient (mostly) stress-related psychotic episodes, and disordered eating

i’m still self-dx’ing with StPD, because i think it makes sense for me, even in addition to autism + trauma, and i’m still gonna self-dx with NPD traits, ADHD, OCD traits, and the dyscalculia diagnosis that i’m 100% sure will be confirmed when i get that cognitive assessment.

tl;dr: stpd sorta, szpd traits no, npd traits no but also sorta, ed yes, adhd maybe, ocd sorta, cptsd yes, dyscalculia probably but also pending assessment.

here's the big self dx email i'm going to send to my psychologist. (the diagnostic parts of it at least). i prefaced it with a bunch of "please don't think i'm being attention seeking though attention seeking is part of npd which i'm self dx'ing as having traits of so if that counts towards it then you can totally think i'm being attention seeking but i've put a hell of a lot of time and thought into this i didnt just read the dsm criteria and decide i had it thanks~"

Keep reading

[honeysuckle-venom]

hi! how’d your doctors and you decide you had schizophrenia vs. psychosis for other reasons, such as psychotic symptoms or episodes linked to dissociation or stress? What was the process of figuring this out like? How do you experience your schizophrenia vs. the DID and trauma symptoms?

Hi there! Thank you so very much for the questions!

There are many wonderful questions here and I like to talk about this stuff, so it's going to be quite long.

I'll start with the first question. I was diagnosed with schizophrenia this past September, although my therapist actually thought I had schizophrenia for a long time before telling me lol (which I'm fine with and understand in the context of my treatment). The actual DSM criteria for schizophrenia is pretty minimal, and most people with some form of psychosis could qualify for a schizophrenia diagnosis, but other forms of psychosis would need to be ruled out.

It's important to note that positive symptoms (delusions and hallucinations) are not the only symptom of schizophrenia. I experience positive symptoms of schizophrenia in the form of severe delusions and occasional hallucinations. I also struggle significantly with negative symptoms such as avolition and with disorganized thinking, speech, and behavior. Negative symptoms sometimes appear similar to depression, and in cases of schizoaffective disorder it can be hard to disentangle the two, however I do not suffer from depression and rarely feel sad or hopeless, yet I struggle significantly with daily tasks such as feeding myself, cleaning up, etc. I generally experience few mood symptoms, eliminating schizoaffective, depression with psychotic features, and bipolar as the cause of my psychosis as well. Disorganized thinking and behavior is also I believe more common with schizo-spec disorders than psychosis caused by trauma or dissociation. I have physical disorganized behaviors such as severe tics, being unable to move for long periods, and doing odd actions such as pouring water on myself when psychotic for no reason I can think of, so that points more towards classic schizophrenic symptoms than some other psychotic disorders as well. So the amount I struggle with negative symptoms and disorganized symptoms points towards a schizo-spec diagnosis, and my lack of mood symptoms eliminates schizoaffective.

My psychosis symptoms are also independent of my dissociation. Whether I'm highly dissociated or fairly grounded, I experience similar amounts of psychosis, indicating that the two are separate. Additionally, I've had DID my whole life, but while I've had some delusions since I was very young, I developed full blown schizophrenia after a severe psychotic break as a teenager, and that kind of psychotic break followed by years of negative symptoms and ongoing psychosis is typical of schizophrenia, not of dissociation-related psychosis. Also, my grandmother and cousin on my dad's side are both schizophrenic, and schizophrenia has a strong genetic component.

As for it being stress related, psychotic episodes within schizophrenia are often set off by stress, so those aren't mutually exclusive. The main suggestion for preventing positive symptoms besides medication is actually to reduce stress.

Now as to the question of whether my psychosis is trauma-based, my therapist and I actually don't have the standard medical view of schizophrenia. I believe that while schizophrenia clearly has a genetic and physical component, environmental factors play a more significant role thank many people think, and I believe my schizophrenia is actually largely caused by trauma. I may have had a predisposition towards schizophrenia, but I believe trauma is what caused it to fully develop. My therapist has a psychodynamic background, and psychodynamic theories generally view psychosis as the result of the treat of annihilation of the self, and I also approach these things mainly from a psychodynamic background. But my psychosis doesn't connect directly to my trauma, and trauma triggers aren't the main indicator of whether I'll have a psychotic episode or not, and the content of my psychosis is often very bizarre and pretty far removed from the realities of my trauma. That combined with the severity of my negative and disorganized symptoms and the genetic component mean that my experience is much closer to classic schizophrenia than to people who deal with occasional trauma-related psychosis.

As for the process of figuring all of this out, we figured it out fairly slowly. My therapist brought up the possibility of schizophrenia long after she first suspected I had it. She brought it up 7 years into my treatment with her, although she had suspected since year 1. She knew that I wasn't ready to hear it until recently, and she was right. She had a very long time to observe me and think about possible explanations for my symptoms, and schizophrenia was where she landed. After she brought it up with me and I started to do some research, so much made sense to me. I had struggled for a long time with feeling really inadequate because it was so hard for me to care for myself, and I I had known for a long time that I had psychosis but I didn't really like to think about it or know what to make of it. When the concept of schizophrenia was brought up as a reason, for about 5 minutes I was defensive and said "No way." Then I learned more and suddenly everything clicked and it felt like I finally understood what was wrong with me. It was a scary process, because a lot of what you hear about schizophrenia is scary and misleading and can make you feel hopeless. But it was also validating and a big relief to have an answer. Over the past several months, she and I have continued to discuss the concept of schizophrenia, how it makes me feel, and where to go with that diagnosis. Getting the right word was definitely not the end of exploring the symptoms or the diagnosis itself as a concept.

Your last question, how I experience schizophrenia vs DID and trauma symptoms, is connected to another ask I just got on the topic, so I’m going to stop this one here and answer that ask and talk more about the differences there because this has gotten so long.

[somecunttookmyurl]

Hey, quick question if you feel like answering bc. Obviously v v personal BUT. Just got a diagnosis of bipolar type 1 and have occasional what I am... guessing? Are? Auditory hallucinations?? Previous label was "hahaha mind playing tricks on me where I hear ppl talking and then no one is home whoops". Since I'm currently rattling my psych upside down until treatment falls out, would you say this might be psychotic symptom like you mentioned? I am just. At my wits end (tm) and any bit of "yeah thats worth asking abt" or "nah barking up the wrong tree" would be a godsend. Just as like. Some virtual coffeeshop chatter

Auditory hallucinations are distinct from your own internal thought processes. Which means you need to actually hear them and not simply think the words, if you follow me. Hearing something which has no external stimulation and which you perceive (at least temporarily, before you realise) as real. What you are describing is an auditory hallucination which is, technically, your mind playing a trick so you’re not wrong.

Around 10% of people experience hearing voices at some point in their lives and it is not necessarily psychosis. For example, actute stress, sleep deprivation, drug use and even excessive caffeine consumption can cause that to happen. Such causes are called “transient causes” and are not psychotic in nature.

(that isn’t the case here, i doubt, since you say it’s recurring that’s just a PSA)

If you have a diagnosis of Bipolar I then yes, this is likely a psychotic symptom and you should tell your psychiatrist about it as some antipsychotics are also used to treat Bipolar and that would likely be more useful than just a mood stabiliser.

Unless of course that is a) the only psychotic symptom you experience and b) it doesn’t bother you that much. In which case you just gotta decide whether it’s worth the hassle of interacting with a psychiatrist on purpose like. Psychotic symptoms in Bipolar Disorder are not uncommon, and can occur in any episode (mania, depression, or mixed). It’s actually the majority, at around 70% of patients. You may experience any of the following:

Hallucinations - seeing, hearing, or sometimes smelling something which is not there Delusions - a belief something is true when it is not. for example during my psychosis i have a firm belief that i am alredy dead (which i also logically know isn’t true so that’s a fun trip)

Paranoia - believing yourself to have done something terrible, or that others want to hurt you and cannot be trusted

Unusual thought patterns - disjointed (entirely unconnected) or racing thoughts that may also lead to confused or disorganised speech Lack of insight - being unaware that your own behaviour is unusual

I hope that’s helpful! If you want me to go and find some actual papers for you on bipolar psychosis lmk

[g00by3]

hey so my current health teachers mental health cirriculum sucks (i cant spell) so i made a list of most mental health disorders w info on each one. i plan on sending it to her but first i wanna check: is there any edits i should make? is there any misinformation or things i left out? pls let me know!! (paper below the cut):

Mental Health Disorders

Mental health disorders are a range of disorders that alter one's way of thinking, functioning, moods, and behavior. These disorders are often stigmatized but education about definitions and breaking down common misconceptions can help break the stigma. Breaking the stigma can help individuals get help while struggling with any of these disorders.

Trigger Warning for in-depth discussion of mental illness

Depression

Depression is a mental health disorder characterized through constant feeling of sadness, hopelessness, and general loss of interest in hobbies. These feelings impact your day to day life.

Types of depression include:

Major Depression/MDD (Major Depressive Disorder)- The technical term used by health professionals to describe the most common form of depression.

Manic Depression [Bipolar Disorder]- Bipolar Disorder was previously known as manic depression, and the term manic depression is outdated. The term “Bipolar disorder” was released in the DMS-3.

Seasonal Depression/SAD (Seasonal Affective Disorder)- A mood disorder with a seasonal pattern. The cause is believed to be due to the variation of light exposure in different seasons. Depression in winter is the most common form of SAD.

Psychotic Depression- A disconnect from reality due to a depressive condition, which can involve hallucinations, delusions, paranoia, etc.

Anxiety

GAD or Generalized Anxiety Disorder is a disorder in which a person exhibits excessive anxiety most days, for at least 6 months, about a variety of things. This worrying impairs daily functioning. Anxiety can be related to a plethora of things such as health, social interactions, work/school, etc.

Types of anxiety include:

Panic Disorder- A type of anxiety disorder in which a person has recurring panic attacks. A panic attack are periods of extreme anxiety, often including increased heart rate, sweating, nausea, and other physical reactions.

Social Anxiety- Anxiety towards social or performance situations. People with social anxiety worry about how others will perceive them or their actions, which often causes them to avoid social situations.

Separation Anxiety Disorder- A disorder commonly seen in children (while still possible to occur in adulthood) in which an individual has anxiety about being separated from people they have an attachment towards.

PTSD

A type of anxiety disorder caused by experiencing, or witnessing a traumatic event. PTSD stands for “post-traumatic stress disorder.” In the World Wars it was known as “shell shock” and “combat fatigue” among the soldiers. Can be caused by a variety of things, such as war, death of a loved one, violence, abuse of any kind, natural disasters, car accidents, etc. Not everyone who goes through something traumatic develops PTSD though, as everyone’s brain works and processes things differently. PTSD includes symptoms of nightmares, flashbacks, body memories, etc.

C-PTSD or “Complex-PTSD” is a specific type of PTSD. This disorder occurs when trauma is long-lasting and repeating.

Eating Disorders

Eating disorders are a group of disorders characterized by severe and persistent disturbance in eating behaviors as a way to alter one’s weight and/or physical appearance.

Common types of eating disorders include:

Anorexia Nervosa- Individuals who struggle with this disorder often restrict their calorie or food intake, or carefully manage what they eat as a means to lose weight. Some people may also purge through the use of laxatives or self-induced vomiting, may over-exercise, and/or may binge eat. The distinction between “atypical” and “typical” anorexia is harmful and unnecessary as both are dangerous and cause the same amount of psychological as well as medical damage.

Bulimia Nervosa- A disorder in which an individual binge eats, or consumes large amounts of food in a short period of time, followed by purging.

BED (Binge-Eating Disorder)- A person with this disorder consumes large quantities of food in a small period of time, often to the point of discomfort, and experiences negative emotions in regards to it afterwards. These emotions include shame, guilt, or distress.

EDNOS (Eating Disorder Not Otherwise Specified)- When an individual meets many, but not all, of the diagnostic criteria of anorexia and bulimia.

DID

DID or Dissociative Identity Disorder is a disorder caused by repeated childhood trauma before the age of 7-9, which is when a child’s ego state is supposed to integrate but is unable to do so due to this disorder. It is described as the presence of two or more dissociative identities, or alters, with amnesia between them. People with this disorder are known as “systems” and alters are all individual identities. Previously known as MPD (Multiple Personality Disorder) until 1994, DID affects approximately 1% of the population worldwide.

OSDD (Otherwise Specified Dissociative Disorder), previously known as DDNOS (Dissociative Disorder Not Otherwise Specified) until the DSM-5’s release in 2013, is a disorder therapists may diagnosis when a patient experiences distressing dissociative symptoms that impair daily functioning, but don’t meet the full criteria for another dissociative disorder. OSDD-1 is a dissociative disorder that serves as a catch-all for individuals with symptoms that do not perfectly align with diagnostic criteria for another dissociative disorder.

The two types of OSDD-1 are:

OSDD-1a- A type of dissociative disorder in which alters are present but less distinguished and cannot “front” (take control of the body), but can passively influence one another. Amnesia is also present.

OSDD-1b- Distinct alters are present, can front, but there is no reported amnesia.

Other types of OSDD are:

OSDD-2- Derealization (feeling as though reality, or one’s surroundings aren’t real) without depersonalization (feeling disconnected from one’s body, thoughts, mind, memories, etc).

OSDD-3, OSDD-4, OSDD-5- Similar to DID symptoms, but due to brainwashing, dissociative trace, Ganser syndrome, etc.

OSDD-6- A dissociative disorder in which symptoms are unclear.

Bipolar Disorder

Bipolar disorder is a condition in which extreme mood swings with acute highs and drastic lows occur. This condition was known as manic depression until 1980. A manic episode is when a person with bipolar experiences increased euphoria, motivation, and hyperactivity, a decreased need for sleep, and oftentimes experiences feelings of being “godlike” or invincible. Manic episodes can also lead to impulsive behavior.

There are two types of bipolar disorder:

Bipolar I- At least one manic episode has occurred, with hypomanic and major depressive episodes occurring as well.

Bipolar II- At least one depressive episode and hypomanic episode. but a manic episode has never occurred.

OCD

Obsessive Compulsive Disorder is a disorder in which a person gets stuck in a pattern of obsessions and compulsions. Obsessions are intrusive thoughts that trigger negative feelings that are intense and distressing. Compulsions are behaviors that a person with OCD partakes in to control these intrusive thoughts, or manage their distress. OCD is beyond just wanting to be clean or needing everything to be symmetrical- it is an exhausting disorder that negatively impacts one’s daily life.

ADHD

ADHD stands for Attention Deficit Hyperactive Disorder, and is characterized by symptoms of hyperactivity, difficulty paying attention, and impulsivity, all of which impact an individual negatively in two or more settings. ADD (Attention Deficit Disorder) was a term used to describe individuals with symptoms of ADHD minus the hyperactivity, but as of the release of the DSM-5, it is an outdated term.

Body Dysmorphia

This is a mental health disorder in which a person fixates on a flaw in their appearance to the point where it is distressing and may cause a person to avoid social situations. Oftentimes this flaw seems minor, or even nonexistent to others, but to a person with body dysmorphia, it is anxiety-inducing.

Gender Dysphoria

Severe psychological distress due to an incongruence between one’s gender identity and their sex assigned at birth. Seen in lots of transgender individuals, but not all.

Psychotic Disorders

A kind of mental health disorder that impacts one’s mind and mode of thinking. These disorders often cause a disconnect from reality.

Types of psychotic disorders include:

Schizophrenia- A person with schizophrenia experiences changes in behavior, hallucinations, and delusions, all lasting longer than 6 months. These symptoms often affect the person in their daily life or relationships.

Schizoaffective Disorder- Symptoms of both schizophrenia and a mood disorder can be an indicator of schizoaffective disorder.

Delusional Disorder- A disorder in which an individual experiences a delusion (a belief that is held, but false) involving a real-life situation that isn’t true. Examples are: being followed, having a disease, and being plotted against. This delusion must be at least one month long. The five primary types of delusions are: mood or atmosphere, perception, memory, ideas, or awareness.

Personality Disorders

A personality disorder is a type of mental health disorder where an unhealthy pattern of thinking, functioning, and behaving occurs. This causes significant problems in an individual's life.

Types of personality disorders include:

BPD (Borderline Personality Disorder)- A mental health disorder with symptoms of: intense fear of abandonment, a pattern of unstable intense relationships, distorted sense of self/identity, dissociation, impulsive and risky behavior, suicidal threats or threats of self-harm, intense mood swings, inappropriate anger, and chronic emptiness.

ASPD (Antisocial Personality Disorder)- A disorder identified by patterns of disregarding or violating other’s emotions or wellbeing. A person with ASPD may not conform to societal norms, may lie or manipulate others, or act impulsively.

NPD (Narcissistic Personality Disorder)- A pattern of demands for admiration and/or a lack of empathy for others. A person with this personality disorder may view themselves as superior, expect to be worshipped or treated as above all else, or feel entitled to whatever their heart desires.

Avoidant Personality Disorder- A disorder characterized by being extremely shy, sensitivity to criticism, poor self-esteem, and feeling anxiety towards the way they are perceived.

OCPD (Obsessive Compulsive Personality Disorder)- Similar to OCD, as both have obsessions with rituals, habits, and cleanliness, but distinctly different. OCPD is a pattern of absorption in cleanliness, control, perfection, and schedules.

Paranoid Personality Disorder- A disorder in which a person is suspicious of others and their motives, seeing them as evil or bad. A person with this disorder may believe people are out to get them, or hurt them, or lie to them, and may avoid confiding in others due to this paranoia.

Histrionic Personality Disorder- A pattern of attention seeking and strong emotions. A person with this disorder will take extreme measures to be the center of attention, such as alter their appearance or act out.

Schizoid Personality Disorder- A pattern of detachment from social relationships, and difficulty expressing emotion. A person with schizoid personality disorder often chooses to be alone, and doesn’t care what others' views on them are.

Schizotypal Personality Disorder- People with this disorder have a pattern of being uncomfortable in close relationships. have distorted thinking, or eccentric behavior. They may behave in ways that seem strange or believe odd things.

Substance Use Disorder/Drug Addiction

Substance Use Disorder is a disease that impacts a person mentally and physically, and affects nearly 21 million Americans. Drug addiction happens when a person is unable to control their use of a drug due to a variety of reasons, despite the harm it causes.

Conduct Disorder

A serious disorder in which a child/teen displays a pattern of disruptive or violent behavior, and has trouble obeying rules.

SOURCES:

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/depression#types-of-depression

https://www.nimh.nih.gov/health/topics/anxiety-disorders/

https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

https://www.verywellmind.com/what-is-complex-ptsd-2797491

https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders

https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia

https://www.healthline.com/health/bulimia-nervosa

https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed

https://www.dpt.nhs.uk/our-services/eating-disorders/what-is-an-eating-disorder/eating-disorder-symptoms/eating-disorder-not-otherwise-specified-ednos-symptoms

https://www.isst-d.org/wp-content/uploads/2020/03/Fact-Sheet-IV-What-Are-the-Dissociative-Disorders_-1.pdf

https://www.healthyplace.com/abuse/dissociative-identity-disorder/dissociative-identity-disorder-did-statistics-and-facts

https://did-research.org/comorbid/dd/osdd_udd/did_osdd

https://plurality-dictionary.fandom.com/wiki/OSDD-1a

https://en.wikipedia.org/wiki/Other_specified_dissociative_disorder

https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

https://iocdf.org/about-ocd/

https://www.cdc.gov/ncbddd/adhd/index.html

https://www.cdc.gov/ncbddd/adhd/diagnosis.html

https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/add-adhd/difference-between-add-adhd

https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/symptoms-causes/syc-20353938

https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria

https://www.webmd.com/schizophrenia/guide/mental-health-psychotic-disorders

https://www.webmd.com/mental-health/delusions-types

https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463

https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237

https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders

https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112

https://www.addictioncenter.com/addiction/addiction-statistics/

https://www.webmd.com/mental-health/mental-health-conduct-disorder

also damn if you read all of this, hope ur ok lol

i literally just wrote this for fun in four hrs bc im hyperfixating on researching mental health disorders rn.

[vampiricsheep]

sorry still mad about that last post. do you know how many shitty psychs i went through to get my current one? 4. I was discouraged a lot of times by it, and the ONLY reason i kept looking was because i had to be involuntarily hospitalized after trying and failing to manage my disorders. and i cannot stress enough how important it was for me to find that 5th professional who did work. 

I know theres a lotta shitty professionals BUT there are SO many conditions that are damn near impossible to live with unmedicated. there’s this stupid fucking stigma against medication and professional care I see time and time again on social media, and yes, I know it’s often other mentally ill people spreading it! but someone with depression isnt gonna have the same experiences as someone with psychotic symptoms. someone with anxiety or adhd isnt gonna understand bipolar unless they have it too.

and, to be fucking blunt, I didnt stop trying to kill myself until I got on my current medication. I have so many fucking scars, not just out of self-hate or feeling hopeless in my living situations, but specifically because im bipolar, and that turning point between a manic and depressive episode with no stasis in between had me with the feeling of hopelessness knowing i was gonna feel like this time and time again for the rest of my life, and with the manic energy and lack of self control to keep from acting on the impulse to end it. until I got on my current medication, my ptsd had me breaking down in public, forgetting who I was or what i was supposed to do because I had the overwhelming need to run and hide and disappear before I could be hurt. the flashbacks would damn near possess me. I lost a job because someone raised their voice at me and the chemical fuck-up of my brain led me to hide in the bathroom and scratch my arms open, and that wasnt something therapy alone was gonna cure.

if you dont need medication, if therapy is enough, im glad for you! it must be nice! but dont you fucking dare tell people to avoid psychs at all costs. people die because they dont think there’s any point in seeking help, and feeding into that helps nobody.

[niflim]

headcanon: mental health, psyche, etc.

beneath the cut is both an explanation of dysthymia ( persistent depressive disorder ) in addition to major depressive episode, post - traumatic stress disorder and acquired brain injury via mako poisoning in the context of cloud’s life.

i hope to present this information in a completely analytical way, free of any perceived bias. so it is also my hope that you inform me if i have in any way misstepped. it’s not my intent to offend, merely to provide my view on what cloud experiences, which i understand can sometimes be a dangerous thing in today’s world. this is a long post, but i do hope that you at least give it a skim ! i apologize for the blockquotes, if i could’ve linked individual sections, i definitely would’ve.

dysthymia & major depressive disorder. cloud develops dysthymia during his childhood. i wouldn’t call it simply major depressive disorder because his behavior doesn’t occur for mere weeks at a time. it’s on a larger scale and persists for at least two years ( one year in children and adolescents ). most people would assume that any depressive disorder would cause someone to become, well, depressed. but the interesting thing about adolescents is that they are actually more prone to irritability than so - called ' depression ’. 

criterion as per the dsm - v ( taken verbatim ) is presented below:

‘ a. depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.

note: in children and adolescents, mood can be irritable and duration must be at least 1 year.

b. presence, while depressed, of two (or more) of the following:

poor appetite or overeating.

insomnia or hypersomnia.

low energy or fatigue.

low self-esteem.

poor concentration or difficulty making decisions.

feelings of hopelessness.

c. during the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in criteria a and b for more than 2 months at a time.

d. criteria for a major depressive disorder may be continuously present for 2 years.

e. there has never been a manic episode or a hypomanic episode, and criteria have never been met for cyclothymic disorder.

f. the disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.

g. the symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g. hypothyroidism).

h. the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. ’

symptoms that apply: insomnia, low self - esteem, poor concentration / difficulty making decisions, feelings of hopelessness.

i’m going to be tackling this going down the list.

a. in cloud’s childhood, cloud comes off as fairly irritable, especially towards tifa’s friends. his lack of self - esteem showed itself in a heightened opinion of himself, as arrogance tends to. he decided he was better than the other kids, therefore he shouldn’t be bothered that he can’t hang out with them. this is relatively weak, admittedly, to what i will be discussing next. it’s only one symptom as opposed to the two required. 

b & c. the event that took place when he was nine and tifa was eight, after the death of her mother and the trip to mt. nibel, really hammers the point home. because of his perceived incitement of the expedition rather than his attempt to help tifa, he was met with the ire of the adults and dissuaded from talking to tifa. this introduces way more irritability in the form of cloud’s anger problem and inappropriate feelings of guilt that are associated with an episode of major depressive disorder.

according to an article published by the h.arvard medical school: 

‘ symptoms can grow into a full-blown episode of major depression. people with persistent depressive disorder have a greater-than-average chance of developing major depression. while major depression often occurs in episodes, persistent depressive disorder is defined as more constant, lasting for years ’.

at least, cloud experiences a major depressive episode ; at most, he develops the full - blown disorder. given that he’s been experiencing persistent depressive disorder with at least two points in his life where he has had a major depressive episode ( mt. nibel, failing to make it into soldier, during advent children ), i’d wager that the latter situation is the reality. 

d. since major depression disorder is chronic and tends to come in episodes during particularly taxing times, it can still be present when one is diagnosed with dysthymia. major depressive disorder comes with four additional symptoms: excessive guilt / feelings of worthlessness, s.uicide ideation, loss of interest, psychomotor agitation / r.etardation. cloud does indeed experience excessive guilt, as discussed above, and i would wager that he does go through a period where he has feelings of worthlessness and he definitely loses interest in making friends.

e, f, g. i wouldn’t classify cloud’s ‘ substance - related illness ’ / mako poisoning as grounds for a manic episode. nor does it cause substance - related depression ; this is merely the situation framing his contact with mako.

h. this condition causes a lot of issues in cloud’s social life as shown by his relationship to the other kids ( though it was in part due to their exclusivity ) and his easy - to - anger personality.

i believe that it is also worth noting that the aforementioned article also reveals that ‘ some people with persistent depressive disorder have experienced a major loss in childhood, such as the death of a parent ’. cloud went through the loss of a father at an early age, i headcanon around age 5 / 6, and growing up without a fatherly figure can be rough for a child. i know without a doubt that claudia could only do so much to make sure her son grew up fine. that is not to bring her down or any single mothers down, there is no doubt she loved her son dearly, but it still isn’t something that can be ignored. i’m sure cloud owes his open mind, kindness, and protective nature to her, and that is also something that made him vulnerable to the other kids’ teasing, leading cloud to become depressed and try to be tough and hide his emotions.

post - traumatic stress disorder. it goes without saying that cloud has experienced multiple traumatic experiences in his life. there’s the events at mt. nibel & tifa’s coma, the nibelheim incident, and zack’s death. so instead of proving the trauma that is undoubtedly there, i will instead be speaking of the symptoms that he experiences due to the disorder.

criterion as per the dsm - v ( taken verbatim ) is presented below:

a. exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

directly experiencing the traumatic event(s).

witnessing, in person, the event(s) as it occurred to others.

learning that the traumatic event(s) occurred to a close family member or close friend. in cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.

experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains: police officers repeatedly exposed to details of child abuse).

note: criterion a4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.

b. presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:

recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). note: in children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.

recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). note: in children, there may be frightening dreams without recognizable content.

dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) note: in children, trauma-specific reenactment may occur in play.

intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

c. persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:

avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

d. negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).

persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “i am bad,” “no one can be trusted,” ‘the world is completely dangerous,” “my whole nervous system is permanently ruined”).

persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.

persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).

markedly diminished interest or participation in significant activities.

feelings of detachment or estrangement from others.

persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

e. marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.

reckless or self-destructive behavior.

hypervigilance.

exaggerated startle response.

problems with concentration.

sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

f. duration of the disturbance (criteria b, c, d, and e) is more than 1 month.

g. the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

h. the disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

a. we’ve already established that cloud fits this criterion because he has the disorder.

b. cloud experiences intrusive or recurrent memories of the traumatic event (1) in addition to dreams that put him as a player in the burning of nibelheim. he usually takes zack’s role until his memory is restored (2). given that cloud has multiple instances in which sephiroth visits him in a vision while he is awake, there also some instances when they’re just that ... visions / flashbacks of his trauma outside of the influence that sephiroth holds on him (3). cloud experiences distress and pain whenever he’s visited by a vision of sephiroth or the mention of zack’s name (4, 5).

 c. though his behavior is certainly the closed off sort, he doesn’t avoid tifa. in fact, he is drawn to her as a survivor of the event and a supposed dear friend. he does, however, present himself as emotionally closed off, for the most part, save for some softer moments where he acts protective of his newfound friends (1, 2).

d. cloud definitely misremembers the events surrounding the nibelheim incident and zack’s death, instead becoming confused by the memories zack told him about and believing himself to be zack (1). cloud is instilled with the belief that despite now being a merc, he has to be the perfect soldier which would require him to be strong, resourceful, and careful with his emotions. he takes a no -  nonsense approach to life. this tends to fail (2). cloud feels somewhat responsible for tifa’s father’s death even in his false memories and, also, later feels responsible for zack’s death once he knows the truth. he feels that it is in some way his fault (3). cloud maintains a somewhat pissy attitude for the first half of the game, but, ultimately, this doesn’t entirely apply to him (4). cloud feels a diminished interest in being friends with tifa’s friends, especially after the incident that caused his initial trauma and feels even more separated and detached from them. this is also how he handles his initial interactions with the members of avalanche, though they eventually get through to him (5, 6). he’s emotionally closed off, as mentioned above, and is more prone to anger. but people who show him understanding and the praise / acceptance / acknowledgement he secretly wishes for, he cracks a smile.

e. he is easy to anger and gets into fights with the other kids after mt. nibel (1). cloud, somewhat recklessly, goes off to become a soldier. though not conditionally reckless, i do think it’s odd that simply trying to impress someone could push him to do something like that. maybe some part of him wanted to be more than he was, not just to earn tifa’s attention (2). cloud is very alert and aware of his surroundings. it’s in part battle instinct, in part training, in part trauma - induced (3). this one is hit or miss, it really depends (4). no problems with concentration, unless in the throes of a vision (5). we experience how restless cloud is in how easily he wakes up. when tifa knocks, when there’s the clone next door, when he’s at aerith’s house. he’s a light sleeper (6).

f. yes, it’s been more than a month.

g. this does cause social issues.

h. given that this condition was present before cloud’s mako poisoning, it is not the result of a substance. however, mako poisoning did make things worse.

acquired brain injury - mako poisoning. one of the causes of an abi happens to be poisoning compared to trauma caused by an impact or injury in the event of a traumatic brain injury. injuries of this sort can create permanent or temporary damage to one’s psyche --- cognitive, physical, emotional, or behavioral. this happens to cloud twice. given that he doesn’t necessarily recover from his mako poisoning entirely before falling in the lifestream again, his already active condition actually worsens. without zack’s stories to supplement his memories the second time, he completely loses himself and remains vegetative until tifa aids him in piecing together their shared past. it’s not all her, as cloud does have a hand in it, showing that he hasn’t completely lost himself, his mind is merely scrambled in a sort of dissociative amnesia that requires outside help to set right. this contributes to his depression and anger issues ( though, admittedly, they’ve diminished for the most part in his soldier state ). this also contributes to his memory loss. if anyone is curious, i can attempt to write more on this later !

sources: dsm - v, abi wiki ( the sources here checked out ), h.arvard health publishing.

[deadstrangeblog]

A respectable young man disappears without a trace after getting into a scuffle at a popular Bulgarian holiday resort. Nobody has heard from him for almost 5 years, and his case is as maddening as it is frightening. What happened to Lars Mittank?

One of the strangest cases I’ve ever come across is that of Lars, a German man who vanished from an airport in Golden Sands, Bulgaria. The GIF you see above shows him sprinting out the airport for an unknown reason, just hours before he was supposed to board his plane back to Germany. For reasons unknown to us, Lars, who had a good career at a power plant, experienced something in the airport that made him run for his life. He leaves all his bags and belongings and flees the building. Witnesses then came forward to say he jumped a barbed wire fence and ran off into the woods surrounding Varna airport, never to be seen again. At the time of writing this article, it is June 2019, and still no clues have been unearthed that might help us to explain Lars’ sudden disappearance. No forensic evidence, no further witness reports. Tragically, it’s almost as if Lars Mittank no longer exists.

But what made him run? An interesting factor involves a possible brain injury Lars may have received from a fight with football fans. Lars was a devoted fan of German football team, Werder Bremen, and he found himself in the middle of a heated argument involving a group of Bayer Munich “hooligans”. According to Lars’ friends, the 4 football fans, who have never been located, wanted to teach the 28-year-old a lesson. They reportedly hired some Russian men to attack him, and Lars was beaten by the unknown assailants. After the attack, he was encouraged by his mates to visit the doctors and was subsequently diagnosed with a ruptured eardrum and persuaded to undergo surgery. Strangely, Lars did not want this surgery performed in Bulgaria, and said he would stay in the country alone until he was better. Bearing in mind that the surgery is relatively uncomplicated, cheap, and quick, it seems strange that he would refuse.

In case of a middle ear infection, the doctor wrote him a prescription for an antibiotic, Cefzil 500. He went to a pharmacy, and he bought the medication.

It was pretty risky for Lars to board a plane due to his medical condition, so he was forced to stay behind while his friends jetted back to Germany. Now completely alone, he rented a room in a “dodgy hotel” that was a favourite among the town’s prostitutes and drug-dealers. This is when the usually laid-back German’s mental state changed entirely; At 11:50 p.m, an unusually panicked Lars phoned his mother and said that something seemed wrong. He explained he feared for his life and begged his mother to cancel his credit card. After she did this, Lars left the hotel without his belongings and phoned his mother three hours later, whispering into the phone. “Four men are following me. I’m hiding on the roof above them” Minutes later, he sends a text message. “What is CFC 500?” He seemed to be referring to his medication, which doesn’t make much sense on the surface as he would obviously know what medication he was taking and all possible side-effects. Or would he? It’s entirely possible that if Lars was mentally unbalanced (through drugs, a traumatic brain injury, or a psychotic episode), he would be totally confused.

Now arriving at the airport via taxi at six a.m, Lars calls his mother once again. “I’m so glad I made it to the airport!” he says tearfully. Hearing little more from her son, his mother became worried and found herself forced to purchase the last-minute plane tickets for her son. Bizarrely, Lars arrived at the airport without buying his flight home. Being a cautious, well-prepared individual, this was completely out of character for him. She also transferred a sum of money into her son’s bank account, and she convinced him to see the doctor at the airport. He was examined by Dr. Kosta Kostov. Dr. Kostov reported that Lars was nervous and his erratic behaviour meant that he couldn’t settle. Dr. Kostov found it extremely difficult to perform further tests on the young man, as he as becoming gradually more incoherent and agitated. At some point, the examination was interrupted when one of the airport’s employees came to talk with the doctor. He was a construction worker, wearing a formal uniform. According to Dr. Kostov, this is when Lars became panicked and ran. This is the last sighting we have of Lars, and he remains missing.

To summarise this tragic case, I firmly believe that Lars was experiencing psychosis in what were probably his final hours. Whether he developed this temporary but frightening condition through possible drug-abuse, the brain injury, or otherwise, there’s no doubt that Lars was suffering, frightened and ultimately alone. The most common symptoms of psychosis are feelings of intense paranoia and delusions, as well as erratic behaviour and a general distrust of those in authority. Isolation also plays a huge part in the initial onset of psychosis, which is perhaps why Lars booked into a hotel in a strange part of town, alone, and refused medical help. More eccentric theories range from Lars being part of a drug-trafficking ring, to him being an international spy. Such theories are quickly dismissed due to the events leading up to his erratic behaviour, (excessive drinking, the possible drug-use, stress, brain-injury), and it’s more likely that Lars did indeed suffer from a major depressive (psychotic) episode. Whatever the truth, the case of Lars Mittank remains a tragic mystery.

[h-didanart]

It is. It has for a while.

I do agree that the benefit of doubt should be given, but in the opposite direction, we cannot expect the show runners to know the exact intricacies of mental disorders and all their characters’ psyches, tho taking that as the characters themselves having wrong assumptions about things is a very valid take. I do believe Sun’s issues are portrayed well enough, at least his depression, ocd, and ideation since those are the ones I can recognize the most, but it sounds like you understand the character a lot more than me so I will take your word. You’d be surprised how often writers can accidentally write something as complex and intricate as that, so I could see some of those being in accident, but at some point it does seem very purposeful, perhaps the show runners realized this aspect and decided to lean on it? You could also be right on it all being purposeful however, I’m just putting my thoughts out.

Uh, yeah, generally speaking media isn’t very good at portraying this kind of things, especially Hollywood, and especially when it comes to highly stigmatized disorders and symptoms such as bpd and psychosis respectively.

That’s a very good observation, it did seem like an alternate dimension for a while, what with its own story and events.

I actually didn’t know that, huh. I suppose it makes sense for a break to center around a delusion when triggered by external events and stressors rather than from a psychotic disorder itself, good to know. (And agreed, neither of them has it)

I read about that symptom, and I immediately thought of how Moon’s reaction to the nightmare makes sense with his personality. It all matches up. He would act like that, maybe the aggressiveness in the end was slightly out of character but the guy was having a really bad time so I can’t blame him for getting like that.

Tho I do want to mention a point a friend raised when we were discussing this episode before we switch to Sun. Moon still couldn’t differentiate between reality and dream when he woke up but every time any other character had a nightmare they could tell it was a nightmare when they woke up. From this my friend believes this episode marks the start of a psychotic breakdown for Moon, and I too feel like this might lead to a breakdown, even if Moon already kinda had one less than a month ago (?)

But enough about Moon, onto your points on Sun.

Yes, he was very different, ruthless, determined, apathetic, from what I remember. 

The point you raise about Eclipse and later mention about his manipulation make me link the two events actually, perhaps Sun took those words to heart and it bled through during his breakdown, various things of the ‘Running from the government’ arc stuck around after all.

Agitation and restlessness, also saw those symptoms, and also saw Sun very much being like that, running all day from bunker to bunker with only one goal in mind. (This kinda gave me the thought that maybe Sun is also bipolar since the symptoms also line up with a manic episode, but I forgot the other symptoms so I really can’t tell (and psychosis is also common in bipolar) anyways—)

Huh, didn’t think about that one. Most of my knowledge of hallucinations is that they can affect any sense and can be triggered by a lot of stress. 

Ooh, yeah, I too noticed that but didn’t immediately connect it to today’s episode and Moon. Both Sun’s Bloodmoon hallucination and Earth’s (sorry for mentioning them) Bloodmoon nightmare knew exactly what the two were feeling, and exactly what would terrify them. They were personifications of their fears in the shape of their trauma. So yeah, comparing those guys and the Solar and Ruin Moon interacted with really brings the difference to light.

Okay now that’s standing out to me a lot. I know Sun has a bad self esteem and terrible view of himself, so I usually thought of it as just a core view of himself he held, with the guilt being another core thing of his because of his and Old Moon’s relationship. But if it’s a delusion… that would fit as well, and would make this a lot sadder, the guy really truly believes himself to be at fault for so much…

Oh it was fine, you did a good job! I understood. 

Yeah, the paranoia also points to a possible breakdown methinks. Overall, Moon is extremely stressed, extremely anxious, and probably sleep deprived, a terrible combination that can only get worse if//when Creator comes around to mess it all up. 

That’s a valid line of reasoning, and you know what? You have my full support, that is a logical development and fits well with the character’s actions and feelings.

Also I strongly doubt that Moon is hallucinating/has delusions..

And I doubt he had psychotic break..

Probably Frank/Forkface was messing with him probably to show him what could've been.. This weird nightmare had a lot of Moon's fear included so I think that's that..

Nothing indicated Moon having psychotic break so it would be completely out of nowhere..

I'm slightly annoyed with people saying that Moon has psychotic break because they somehow didn't see Sun having it when Sun had shown signs of development of psychotic episode before having it unlike Moon..

[aquagenesis]

This is by no means a vent post or anything I just need to discuss topics and ideas.

It’s so bizarre how, for most of my life, I did have psychotic tendencies and explicitly schizophrenic symptoms.  I would get disoriented on a school bus and want to make a big show of it; storm up to the bus driver in a fit of rage and demand to know where I was being taken.  I would ask incoherent, nonsense questions in class that would get me a resounding look of “what the fuck are you talking about”.  Friends in particular would always take the time to step in and allow me to re-phrase what I was asking because they would learn to understand sometimes information is jumbled in my head, which I am not aware of.

It happens on here too, though I’ve gotten better at it.  What begins as a cohesive argument in my mind eventually spirals into a whirlpool of me repeating the same three things, the same three points, the same three everything while pretending it’s something different.  Because I have voices in my head that take over and make it hard to focus.  I thought everyone heard voices, because how else do you process information?  But for other people, it’s not voices.  Not ones they can hear, at least.

The only thing that ever stopped me was, incredibly, what I think my paranoia was.  I was too afraid of making a scene because I thought, assuredly, they’d always tell me they were going to kill me.  I would stand up to assert myself only to get pulled back down in my own head with “if you cause problems, you will die”.  I thought that was survival instinct.  I prided myself, in fact, on my survival instincts because of things like that.  Because I believed every person who utilized and prided their autonomy was doomed to die for their arrogance.  How can you exist so unabashedly in life when you know death is something you cannot hide from and cannot know the origin of?  Standing up for yourself is putting yourself in harms way; the lines between “what is paranoia” and “what is formative child abuse” are too blurred for me to even care “which one it is” because they’re both the same.

It’s just knowing I was so schizophrenic.  Knowing I was so blatantly delusional; I’d get called delusional all the time because I wasn’t living in reality.  My original self was already forced to be so separated from its body because of infant-aged trauma when I felt “normal” it already wasn’t me.  Every time I’d stabilize myself in a deeper level of my own psychosis I’d get punched down through another one, like a personal version of Dante’s Inferno.

Of course I developed a dissociative disorder.  How else was my psyche supposed to survive losing family members who cared about me, how else was it supposed to survive losing everything.  The personality I shifted into to appease my conditions were never good enough; they never protected me enough.  It’s so fucked up my brain already had to put me in another reality to cope with not receiving basic physiological needs as an infant and then had to shatter and reform reality after reality because anything was better than living in real life but nothing protected me enough, nothing justified anything enough, nothing could make me feel like I was living how I was meant to.

And then I wonder why I got so deep in it.  I wonder why that’s all I knew.  It was.  Living in delusion was the only thing that kept me from being suicidal, because it made me believe something grand was meant for me at the end of it all.  I only broke down because, after everything, after five years of eviction and homelessness, there was still only despair ahead.  Now I’m 26. an entire high school education away from 30 but abysmally depressed I had to spend all this time helping myself, and continue to, in the vain hope one thing would ever happen to me to make life worth it.

All I needed was to be pushed into reality, to be shown and taught nothing happened to me in some grand plan.  All I needed was a therapist who would listen for long enough in my Anime Tragic Backstory to tell me, “Hey man, that was fucked up, but it’s not like you have to forgive them.  You don’t have to be tortured by anything.  You can leave other people; you can leave them too.”  But therapists are no longer trained to listen to trauma and try to work out anything formative that could have happened to someone.  I didn’t know I was schizophrenic.  Nobody cared enough to tell me I was unless it was through the “well...you have The Disorder.  we have to keep you to make sure your SCARY PSYCHOTIC EPISODE--you’ve seen American Psycho, right?--doesn’t make you do that to yourself or someone else.” lens of “take this medicine and it’ll fix something you don’t think is a problem, because psychosis deludes the brain into thinking it isn’t delusional”.

And there was nothing anyone could have done; my untreated schizophrenia prevented me from being able to work.  My delusions would go unchecked, people wouldn’t know I was stretching the truth and neither did I.  Through the lens of insanity I doomed coworkers to bitter rivals, others to beloved friends, and still others to unworthy of my respect with nothing in between.  My life was a grand path to luxury and respect from the bottom of the earth; who wouldn’t be adored to know me?

I would tell people time and time again I was schizophrenic, I was psychotic, I experienced delusions.  I was cast as “the good outcome” of a psychotic condition and my experiences, the only true part of my life, were chalked up to “well there Luke goes with his silly little rants again”.  I was abandoned to spiral because I was “okay”; I didn’t experience delusions where I thought I was God (anything remotely attached to that was different, I said it was different), my psychosis never drew me to suicide.  Everyone else who claimed they were schizophrenic were automatically compared to me and regarded as “good” or “bad” with no regard to what was swimming around in my brain.  If I didn’t have a god complex before (I did, but I said I didn’t, so there’s no blame here), I certainly developed one then.

But I knew I wasn’t someone to be compared to, because I did experience delusions where I thought not that I was God but some higher being, I was drawn to suicide at the drop of a hat.  But then I couldn’t admit to those things being so much deeper than they were, because everyone else who experienced these things were “bad” schizophrenics.  I was supposed to have this together; I knew I had no right to judge people with my same condition because I knew I was no better than them.  If I had a best friend I’d known all my life, I would probably go to them with my ever-wavering mental condition too.  That’s what I craved; the ability to tell someone about what was happening to me.

And it’s not like I ever thought I was entitled to people, you know, listening.  I never expected anyone to look me in the eyes and tell me “Hey buddy you know you don’t really seem in reality” because if someone said that to me I’d probably freak out and doom them to “Bitter Rival Plus” for the rest of my life.  It was the attitude that I was redeemable because of how well I handled everything, the way I never let my symptoms show, the way a one-time freakout seemed more preferable to everyone else but me because “at least he only got that bad once”, as opposed to the risk of smaller breakdowns more often.  I lost my ability to realize I had control over myself because the admittedly bad symptoms everyone else experienced, which I did too, never were offered support.  I was told a story of a mutual once-friend who threw herself off a roof in the midst of a schizophrenic breakdown.  The pitilessness of it all told me I would never find sympathy in admitting my faults.

It’s hard because if it were depression, if it had been depression, this would have been solved eons ago.  Anyone can go to a friend and talk through a depression; nobody can go to a friend and talk through a psychotic episode without your companion growing frustrated as you’re unable to grasp reality.  Once is fine, twice is annoying, thrice is overwhelming.  I can feel it just as anyone.  Nobody wants to talk to crazy people.

And what do people think that does, exactly?  Do you think your delusional friend can really have a talk once, be told they’re psychotic, and immediately know?  How do we have thousands of articles dissecting every aspect of anxiety, from work to generalized, but none to tell the everyman that “psychotic people suffer from a condition that prevents them from differentiating reality from fantasy”.  or, we do tell people, but it still follows the same rules of once is fine, twice is annoying, thrice is overwhelming.  Depression is a mental condition that causes extended states of misery.  Anxiety is a mental condition that causes extended states of stress.  Psychosis is a mental condition that causes extended states of, well, delusion.  Someone who wakes up already delusional is not going to be able to tell you “when it started”; everything has always felt this way.  Now that they can see clearly, because they feel energized (because they are delusional), “nothing is wrong” and they are left to spiral into whatever rabbit hole they fall into.

If we know it’s harmful to tell people with depression and anxiety to “get over it”, why are psychotic people different?  Why is it so hard to go into a relationship and be told, explicitly, “I have a psychotic condition”, and follow through as you would anyone else?

“Because psychosis is different.”  No further context needed.

[tidesreach]

if you could rewrite skam italia season 2 to more accurately represent bpd and its symptoms, what would you change?

The short answer is I wouldn’t really change anything. But the reasons for that require explanation, so buckle in, this is going to be a long one.

I think accuracy is a subjective term when applied to portrayals of mental illness. Because people have very varied experiences. So what would be an accurate portrayal of BPD for me might not necessarily be accurate for someone else. Since the revelation of Nico’s diagnosis and my various posts on the subject, I have had messages from numerous other borderlines. A lot of them – like myself – related to Nico in many aspects. But there are also some who didn’t – or who did in some aspects but not others. The fact of the matter is that it’s not possible to portray a disorder like BPD in a way that is wholly accurate and relatable to everyone in all aspects because people have such varied experiences. If you’re interested in another portrayal of BPD, I recommend watching Crazy Ex-Girlfriend. For me, some aspects are incredibly relatable – sometimes uncomfortably so – but others are not. But that doesn’t mean those aspects are inaccurate. Another portrayal of BPD is the film Girl, Interrupted (one of my absolute favourite films) – however, some people with BPD (myself included) relate less to Winona Ryder’s character, who is the character diagnosed with BPD, and much more to Angelina Jolie’s character. Like I said, it’s subjective.

It’s also important to note that though there are nine diagnostic criteria for Borderline Personality Disorder only five are required for diagnosis. So one person could have almost completely different experiences to another. And even if you do meet all of the same criteria as someone else with BPD your symptoms may manifest in different ways. For this reason people’s experiences with BPD can be incredibly varied. I meet all nine of the diagnostic criteria (it’s like winning a really shit lottery) – so I have experience dealing with all of them, but how I experience them may be very different to the way someone else experiences them. As an example: people deal with fear of abandonment in different ways. Some people self-isolate as a way to avoid abandonment. Some people may appear “clingy” e.g. they will send constant texts and make frequent phonecalls. Some people experience what we call “splitting”. Some people experience all three. Basically, we all have our own individual experiences and there’s no one way to be borderline. Symptoms can manifest in so many different ways.

I’m putting this under a read more to save everyone’s dashboards because it’s quite lengthy. But if it interests you, I’ve listed the DSM-5 diagnostic criteria for BPD and how Nico’s symptoms accurately fit into that.

The nine diagnostic criteria for BPD are quite broad and are as follows:

Frantic efforts to avoid real and imagined abandonment.

A pattern of unstable and intense interpersonal relationships, often characterised by extremes between idealisation and devaluation (also known as “splitting”).

Identity disturbance: Persistently unstable self-image or sense of self.

Impulsive behaviour that is reckless and potentially self-damaging (e.g. overspending, excessive alcohol or drug use, reckless driving, unsafe sex, binge eating, spontaneous decision-making, the list goes on).

Recurrent suicidal behaviour or ideation and/or self-harm.

Emotional instability (intense mood swings) e.g. intense episodic dysphoria, euphoria, irritability, or anxiety that can last from hours to days

Chronic feelings of emptiness and loneliness

Intense anger or difficulty controlling anger

Stress-related paranoia or severe dissociative symptoms (feeling disconnected from the world, or your own body, feelings, thoughts and behaviours)

It’s difficult to know how many of the criteria Nico meets as we have very limited background information to go on. After all, this is Martino’s season. Everything we see of Nico is in relation to Martino. Which makes it even more difficult to portray something like BPD. We have no inside knowledge of Nico’s thought processes, his past behaviours or what led to his diagnosis (hey, Ludo, can we uhhhhh get a Nico season please?). But he has to meet at least five of the above criteria to have been diagnosed. From what we have seen, the five he definitely meets are:

Frantic efforts to avoid real or imagined abandonment (the back-and-forth with Marti, ignoring his texts then telling him he wants to be with him, freezing Marti out after his ill-advised comment on mental illness, going back to Maddi, the flipbook and the antidote, suggesting that he leave and his refusal to let Marti look at him when he was in a depressive state).

Impulsive/reckless behaviour (breaking into the pool at Halloween. Taking his mum’s car and driving to Bracciano. Milan in general.)

Emotional instability (I don’t think I need to give you specific instances here because his emotional instability becomes quite evident in general).

Chronic feelings of emptiness and loneliness (his speech about solitude in Nel Mio Letto explains this feeling perfectly).

Stress-related paranoia or severe dissociative symptoms (Milan, again).

He also shows clear signs of:

A pattern of unstable and intense interpersonal relationships (his parents, Maddalena, probably his friends/the boy he liked from his previous school. But we have limited information on his interpersonal relationships outside of Marti – though that’s unstable for most of the season thus is a sign in itself – so whether there is a distinct pattern of unstable relationships is unclear at this point, but it’s very likely given what information we do have. Whether he experiences splitting or not is unclear, too).

Identity disturbance (when he asks Marti if he should get a haircut and a tux to meet his dad, when he proposes à la Love Actually, when he’s staring at his reflection in the hotel room window, when he’s rapping Earl Sweatshirt and boxing in the bathroom – these could all be signs of an unstable identity, but I wouldn’t categorically define him as having persistent identity disturbance since we don’t know if it is in fact a persistent symptom).

So, Nico meets at least five but very likely seven out of the nine diagnostic criteria. The only two he hasn’t shown any signs of are:

Recurrent suicidal behaviour or ideation and/or self-harm.

Intense anger or difficulty controlling anger

So, to reiterate, accuracy is subjective. Nico’s symptoms were incredibly relatable for me personally. They’re just not the only symptoms and not the only way symptoms can manifest. Like I said, I experience all nine of the diagnostic criteria. So it wasn’t even a 100% accurate portrayal for me because I experience other symptoms too (splitting, anger/rage, suicidal behaviour and self-harm, among others). But I did relate a hell of a lot to the symptoms Nico did experience and the way he experienced them. I’m also incredibly grateful they didn’t focus on the suicidal aspect because there’s a lot of stigma surrounding BPD in regards to suicidal behaviour being manipulative, and if not handled well it might have been counterproductive. It was so important to me to have such a hopeful portrayal for that reason, because we are often portrayed in a terrible light.

I think the main thing that confused people regarding accuracy was Nico’s episode in Milan. Because it looked similar to Even’s manic episode in the OG. Which I understand. But it wasn’t the same thing. Many people with BPD, myself included, experience psychotic symptoms. Psychotic symptoms such as severe paranoia, hallucinations, depersonalisation, derealisation or distortion of beliefs and perceptions aren’t uncommon (there are a bunch of studies on this if you’re really interested, because health professionals are still trying to determine the cause and frequency of psychotic symptoms in BPD patients). They’re generally triggered by stress. I’ve experienced brief episodes of psychosis on and off for years. This is what Nico experienced in Milan (triggered by the stress of his parents and Maddalena trying to control him) – Nico truly believed that he and Marti were the last two people on Earth. To me, his episode looked like severe dissociation leading into brief psychosis – or psychotic symptoms, if you will (episodes of psychosis in BPD tend to be brief). So while I understand that it was confusing, it was, in fact, a fairly accurate portrayal of psychotic symptoms in BPD. I had a far more severe reaction to Nico’s episode than I did to Even’s because I saw so much of myself in him. Would it have been helpful to portray Nico’s psychotic symptoms in a way that wasn’t so similar to Even’s manic episode? Absolutely. But the fact remains that it was accurate and it made sense in the context of the season and the metaphor that Nico got caught up in of him and Marti being the last men on earth. It wasn’t random, it was cleverly interwoven.

Sorry for how long this got, but I felt like to answer this question required some explanation. To summarise, I actually don’t think I would change anything. There’s a reason I relate so much to Niccolò. But I don’t contest that others with BPD might not have found it as accurate a representation as I and others do. That’s absolutely their right. Because symptoms are incredibly varied and we all have our own individual experiences.

[jaydier-blog1]

A Guide to Writing PTSD & Psychosis

Something I’ve noticed over my (too many) years on Tumblr is that sometimes, first-hand accounts of mental illness can be hard to come by. It’s totally understandable, and it took me a long time to get to this point, but it can put writers in a bit of a bind who aren’t satisfied with only the DSM-5 and Wikipedia to accurately portray their muse(s)’s MI. That being said, hi, my name is Holo, and I’ve been living with PTSD and comorbid psychosis for almost a decade at this point, and I’d like to share some of my experiences.

This is by no means a complete or exhaustive guide. The thing about brains is that apparently they’re complicated, and that means that everyone develops MI differently. While there are broad strokes that are generally consistent across diagnoses (and said broad strokes are typically what make up the ‘criteria’ of any MI), not everyone will have every single symptom, and not everyone will display the symptoms they do have the same way. I really do recommend using these sorts of guides as guides to writing MI, rather than actual rules.

I’mma start with some basic definitions. PTSD is post-traumatic stress disorder, which is a disorder that develops after witnessing or experiencing a traumatic event. Not everyone who goes through trauma will develop PTSD, and I believe the actual statistic is somewhere between 20-30% (double-check my factcheck before you quote me on that, please). Comorbid mental illnesses (or comorbidities) are MIs that occur with or alongside the ‘primary’ illness, usually because of said ‘primary’ MI. For example, my psychosis is comorbid with my PTSD; it is because of my PTSD that I have psychosis.

Psychosis itself is more of a broad term than a specific diagnosis, and it will generally assume one (or more) of three forms: 1) delusions, 2) hallucinations, and 3) disordered thoughts. I personally struggle mostly with delusions and hallucinations, and I don’t particularly experience disordered thoughts, so that’s what I’ll mostly focus on.

Before I move on, though, I want to share something that an old psychologist of mine told me and that I’ve never really forgotten: it’s possible, and even common, to experience and exhibit occasional symptoms of MI without ever actually having that particular mental illness. A random delusion or general panic attack does not mean your character has psychosis or PTSD. Again, brains are complicated, and what defines a MI diagnosis is the consistent, pervasive presence of multiple symptoms that interfere with the patient’s day-to-day life. You can have obsessive-compulsive tendencies without having OCD. You can be anxious without having anxiety. You can be depressed without having depression.

Another thing is that a lot of MI have symptoms that overlap (which is why comorbid MIs are, again, pretty common). My PTSD comorbidities include depression, anxiety, claustrophobia, and psychosis. In fact, when I first started displaying my PTSD symptoms, I was diagnosed with depression because that was the comorbidity that showed up most prominently at the time, and it took several more years before my doctors and I realized that my depression was a symptom and not the full illness.

Alright! Let’s see if I can break down things into more manageable chunks to talk about.

PTSD

PTSD symptoms are wide, varied, and incredibly subjective from person to person. In my experience, this variance starts with what exactly was the trauma that the PTSD is originating from. Someone who was in a war, for example, will have different triggers and experience different symptoms than someone who was abused (and even then, someone who was verbally abused will once again have a vastly different PTSD experience than someone who was physically abused). Figuring out what your character’s trauma was that caused them to develop PTSD is your vital starting point.

In my experience, PTSD tends to develop slowly. One of the things doctors look for when diagnosing PTSD is that patients are still suffering after six months have passed from the initial trauma. After my initial trauma, I thought I was fine. I was asymptomatic, until months later when symptoms started to creep up on me (and as I mentioned earlier, at first it appeared primarily as depression, and I didn’t even connect it to my trauma at the time).

I experience hypervigilence with my PTSD. I am always aware of where I am, looking for possible exits and escape routes. I get nervous and anxious if I feel trapped in a room or area. (I tried going to a corn maze once. It was a bad time.) I also have an exaggerated startle response. If someone sneaks up on me, accidentally or otherwise, I’m going to react much more dramatically than other people. It’ll frighten me a lot more than it would someone whose startle response isn’t so pronounced. At worst, I’ve had experiences where someone sneaking up on me and startling me as a joke sent me into a full panicked meltdown. (I’d been having a rough time before that, but it was the straw that broke the camel’s back, so to speak.)

To which I’ll segue rather smoothly into things building up! I find it really difficult to ‘destress’ and relax if I have a lot of small triggers and uncomfortable situations pile up on me within a short period of time or without respite, to the point where something rather minor can set off an entire chain reaction and end up with what looks like an extreme overreaction.

Panic attacks can look different from person to person, or even day to day. Sometimes, panic attacks show up for me as in inability to focus, irritation and snapping angrily at every little thing while my hands shake to the point where it’s difficult for me to hold things. Other times, it’ll look like a screaming, crying mess, huddled up in a ball in a corner on the floor. How people express panic attacks varies greatly, and no one way is an ‘incorrect’ portrayal of your character’s panic attacks.

Flashback episodes are an easy, prominent way to showcase PTSD in media, and so it’s something that a lot of people are familiar with, but in a very narrow way. While it’s possible for someone experiencing a flashback to completely lose touch with their current reality and experience an exact repeat of their traumatic incident, that’s rarely the case. More often than not, my flashback episodes feel more like an overlay, where both reality and my flashback are happening at the same time. Innocuous things will suddenly seem much more ominous and dangerous, I’ll mistake the people around me for those who were present during my traumatic incident, and I tend to experience hallucinations (which I will go into more detail about later on). Someone in a flashback episode could even experience age regression, usually back to the age they were during the initial trauma. Flashback episodes and how someone experiences them are extremely personal, and I strongly suggest doing more research on the topic to find more varied accounts, and piece together how your character would respond to these events, if they even experience flashback episodes at all.

I’d like to take this next moment here to mention triggers. Triggers are highly subjective, depending on the person and their trauma, and they can often be obscure and strange. A particular scent or a familiar name could easily be enough to make someone extremely uncomfortable. Sometimes, triggers are only marginally connected to the initial trauma, or not seemingly connected at all. Conversely, something that might seem like an obvious trigger might not be a trigger at all! Brains are fucking weird like that. Also, a very common experience with PTSD (or any MI with triggers) is that day-to-day life is disrupted in favour of specifically avoiding known triggers. Crowded places will trigger my aforementioned claustrophobia, and so I will often avoid social outings, to the detriment of my friendships and familial relationships. (Which is a good example of triggers having nothing to do with trauma, actually. I was alone when my initial trauma happened. Why the hell am I afraid of crowds. @brain explain this) And not only this, but some days a trigger might not affect me at all! Triggers are so, so subjective. They’re a minefield of possibilities and dangers that can shift on what sometimes feels like a daily basis. It can be a real headache to deal with. Taking the time to get into the mind of your character and deciding what triggers them and what doesn’t it another important part of defining how you write their struggle with PTSD.

Psychosis

Since it’s what I have the least experience with, I’ll talk about disordering thinking first. Disordered thinking is pretty much exactly what it says on the tin, and people experiencing disordered thoughts can appear distressed, confused, and have issues articulating their emotions, even to the point of not being able to form full sentences or fully acknowledge questions being asked of them. I strongly suggest doing more research on this topic outside of this post if you think it might apply to your character.

Delusions are, again, fairly self explanatory. Delusions are probably my most prominent version of psychosis that I struggle with on a daily basis. Personally, the most frustrating part of delusions is that I’m well aware that they aren’t real, but I can’t shut them off anyway. In general, my most common delusions is that Person X is out to get me/is trying to sabotage me. Logically, I know that this is ridiculous, but I still have the anxiety and panic that that situation would induce. While I’m sure there are psychotic people out there who cannot distinguish their delusions from reality, and that is absolutely a valid way to portray it, I have personally never met someone like that. It seems to be a lot more common that delusional psychotics are aware that their delusions are not real, and yet we are still forced to change our patterns of behaviour to accommodate for that delusion as if it were real regardless.

Hallucinations are broad and come in way too many forms. Media likes to portray hallucinations as full-bodied apparitions that are indistinguishable from real life, and while that can be correct, I find that I rarely experience those. Most of my hallucinations are tactile hallucinations. These are hallucinations where I feel as though I’m being touched by someone or something, usually in a negative way (these hallucinations can even trigger or be triggered by a flashback episode). There are also auditory hallucinations, visual hallucinations, and even olfactory and gustatory hallucinations, although I’ve never had experiences with the latter two. Often, I find I can fairly quickly differentiate hallucinations from reality, just by doing a quick check around me. If someone is not touching me, the feeling of a hand on my arm is a hallucination. Visual hallucinations (of other people) tend to not interact with the rest of the world the same way a real person would. Auditory hallucinations do not have an obvious source, and those around me won’t react to the noise. And, of course, the usual disclaimer of everyone who experiences hallucinations experience them differently applies here too, this is just my personal experience with hallucinations.

In conclusion

PTSD and psychosis are both broad MIs with a lot of complexity that vary from person to person. I fully encourage you to continue your research into these MIs and discover what is right for your character(s). I’d like to reiterate that this post is non-exhaustive and has focused on my personal experiences with my day-to-day life as someone who has these MIs. This post is absolutely available for you to reblog if you’d like, and my ask box is right here if you have any questions or discussions you’d like to direct to someone willing to be a first-person source on these topics.

I hope I’ve helped! Now go forth and write! :D

[cyanidelacedvodka]

Hello friend. I was just curious about the symptoms of BPD. When you have an ‘episode’, with the crying and feeling sad stuff, how long does it last frequently does it occur? As in do you get them multiple times a day, or once a week, or a couple a month? And does each one last for minutes or hours or days? Thank you, I understand if you don’t want to reply btw I’m just curious and want to find out more about this disorder. Thanks!

There's a lot of symptoms to BPD (Borderline Personality Disorder), since it's mainly caused by childhood trauma (but also is found to be hereditary to a degree), so it's rather complex.

The DSM-5 classifies someone as having BPD if they display at least 5 out of the following criteria:

Frantic efforts to avoid real or imagined abandonment (not including suicidal / self-mutilating behavior)

A pattern of unstable and intense interpersonal relationships, usually alternating between extremes of idealization of people, and devaluation / pushing away people.

Persistent unstable self-image or sense of self; no sense of who you are.

Impulsivity in at least two areas that are potentially self-damaging (i.e. spending, sexual activity, substance abuse, reckless driving, binge eating). (This doesn't include suicidal or self-mutilating behavior.)

Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

Affective instability due to a marked reactivity of mood (i.e. intense episodic dysphoria, irritability, or anxiety that usually lasts a few hours, and only rarely more than a few days)

Chronic feelings of emptiness

Inappropriate, intense anger or difficulty controlling anger (i.e. frequent displays of temper, constant anger, recurrent physical fights)

Transient, stress-related paranoid ideation or severe dissociative symptoms

Usually symptoms start showing around adolescence or young adulthood; warning signs include:

Disturbances in experiencing oneself as unique, poor boundaries between self and others, and poor emotion regulation;

An inability to soothe themselves adequately, resulting in excess emotional reactions to stresses and frustrations; maladaptive attempts at self-soothing, suicide threats, self-harm, and angry behavior;

An unstable sense of self with poor ability for self-direction and impaired ability to pursue meaningful short-term goals with satisfaction;

Marked instability in functioning, affect, mood, interpersonal relationships, and, at times, reality testing;

Disturbances in empathy and intimacy;

A pattern of impulsivity, risk taking, and poor self-image

A lot of these symptoms and signs can also overlay PTSD, bipolar, Major Depressive Disorder, and multiple anxiety and psychotic disorders, so it's always best to talk to a therapist or psychiatrist if you're suspecting you may have BPD. BPD is also comorbid with many of these too, so having a combination of BPD with any of these disorders does put you at a higher risk; I always stress finding a therapist, psychologist, and/or psychiatrist to help you if you suspect you might have BPD.

While BPD is not curable, it is manageable with medication and therapy. Dialectical Behavior Therapy (DBT) is probably the most effective in helping those with BPD manage their symptoms, and help one cope when things flare up. And a fun fact; Dr. Marsha Linehan, who developed DBT, has BPD herself! The therapy was designed by someone with BPD, for those with BPD (though it's also effective for those with mood disorders, addiction, and those who are chronically suicidal and self-harming).

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For my personal experience, my episodes can range from a few hours to a few weeks, depending on if something triggered it (i.e. an interpersonal conflict vs sudden paranoia). Usually the occurance of the more random episodes can be culled with medication (an overarching depression/anxiety medication, and then for me, something for my dissociation episodes), though I'd say the random ones tend to hit every other week, more often if I've been exerting myself emotionally. These tend to be intrusive thoughts of self-harm, paranoia that people I care about are dead, impulses to do reckless behavior (lately it's been wanting to do hard drugs), and bouts of irritability. I probably cry at least once a week lol

Major episodes that last for a week or more are usually caused by an interpersonal conflict; it can be a fight, or a shift in dynamic. One big thing I struggle with is the fear of abandonment and being replaced. My favorite person (FP) is polyamorous. They're also my ex. We've had a bumpy road together (as it would be expected for someone with BPD) and I have a hard time distinguishing feelings sometimes, because I either feel a lot and in extreme, or nothing. For the longest time I've harbored feelings for them, but at this point we've been able to work things out. They've essentially put me in the same position that they are for me, their "favorite person", their "best friend". But whenever they get a new partner, I often have a hard time coping with the possibility of their partner "taking my place" -- basically, if they can provide for my FP the same things I do, I worry they won't need me anymore. Obviously my FP hasn't done anything to cause this fear to be rational, but it often triggers really bad episodes of self-harm, negative self-image, and dangerous impulsive behavior as I struggle to find a sense of purpose and numb the extreme paranoia of possibly being abandoned. Thankfully, my FP is very understanding and open, so whenever I have those feelings come up, I do my best to talk to them about it and they help reassure me that I'm still their best friend, they still want me around, etc.; I'm hoping that DBT will help me cope better with this kind of thing in the future.