Sunday, May 16, 2010

Dissociative Disorder is Not Schizophrenia: Truths and Myths about Mental Health

This is a topic I've wanted to discuss further here for quite some time. Many people in the general public confuse Schizophrenia with Dissociative Identity Disorder (D.I.D.), formerly known as Multiple Personality Disorder. Some people also believe having Schizophrenia means that you have "split personalities". Those of us who have personal experience and know more about the illness understand that this is far from the truth. There are, however, some similarities between D.I.D. and Schizophrenia, which lead, too often, to doctors misdiagnosing people with one of these illnesses when the people have the other illness. That happened to me, as well. I have written about it before here, but it's been quite some time.

One of my first obsessive thoughts was that I had been abused and blocked the abuse out of my mind. It's not the point of this post to painstakingly detail that story and try to explain it, but I just want to mention that, long before I knew I had psychotic symptoms, I believed I had been abused. And then, when I developed psychosis, I believed that the problems I was having were based on a trauma history. It was not difficult to find mental health professionals who encouraged that belief, and books that reinforced it. In 1999, I was living in Baltimore, and I saw a therapist at a hospital that has a trauma treatment program there. She said that I had a dissociative disorder (not D.I.D. but Dissociative Disorder Not Otherwise Specified). We discussed the different "parts" of myself.

Later, when I lived in Virginia, and was having more and more mental health issues, cutting myself again, starving myself, not being able to sleep, having horrible anxiety, and panic attacks, feeling suicidal, etc.....I saw, briefly, a couple of other therapists and went into three different hospitals several times within the span of two years. I also had frequent contact with the local program for survivors of rape and sexual abuse, as I believed that such things were the root of my problem. Almost all the time, when a woman believes she was sexually abused as a child, she probably was. But when a woman with psychosis believes this, it is not unusal for her to be incorrect. I have met other women in hospitals who believed the staff members were coming into their rooms to rape them every night. I had the same belief. Obviously, this was not occuring (which is not to say that it has never occured to anyone, just that in these cases it definitely was not). As a feminist, it's hard to talk about this topic, because I don't want to be accused of making people think sexual abuse is not common or not real. But as myself, I have to be true to my own experiences, so I am trying to explain to you how I came to think these things, when these things, most likely, were not true.

One of the authors on dissociative identities whose writing I read online back then was a Dr. Colin Ross. I recently saw him on television in a special about Dissociative Identity Disorder. This man has been made quite famous, and likely quite wealthy, through his writings on trauma and dissociation and his specialized treatment centers where these issues are specifically addressed. I almost went into his treatment center in another state at one point, after reading some of his writings. When I was delusional, many things I read or saw came to be part of my delusions, specifically when I would obsess about them. As I obsessed more and more about trauma and dissociation, I even grew to believe I was a Manchurian Candidate programmed by the federal government to assassinate people and work as spy. Psychosis does things like this to your mind, and it has nothing to do with how intelligent or rational you are. Things that are absolutely ridiculous and bizarre come to seem quite true, and in my experience, these delusions were cemented into my mind with things that I read which encouraged my delusional beliefs, and people who I spoke to who had the same types of delusional beliefs themselves.

I met some of these people at a trauma treatment center I was in twice at the Psychiatric Institute of Washington. The Center, as it was called, was founded in part by Christine Courtois, author of books on incest. When I was there, literally almost everyone on the unit (which was very small and had not more than 13 patients), was diagnosed with some type of dissociative disorder. The three who I got to know well there were all diagnosed with Dissociative Identity Disorder. Two of these friends I made thought they were ritualistically abused by satanic cults, the Masons and other groups. (Note: You are probably aware that really going through that kind of thing and then forgetting it all your life until you, as an adult, are diagnosed with a dissociative disorder, is not all that common, but I'm not going to debate how common it is or is not here at the moment.) I came to think the same thing about myself, only it got worse and worse in my case until I was absolutely sure that I was a victim of all kinds of mind control programming. That was the explanation that seemed to fit the weird occurences happening in my life and my mind at the time. Things were so bizarre, I needed some kind of explanation for them. The only explanation that made sense which I could find was this - I was programmed. My brain was held hostage, I thought. I was right about that, just wrong about what was holding it hostage.

Now, after years of medication that has helped restore my sanity, and a few years of therapy with a good, solid, logical, knowledgeable therapist who does not go around quickly dispensing the diagnosis of Dissociative Identity Disorder and who, in fact, assured me many times that there is no way I have that disorder, now, I know for sure what my real issues are. I no longer believe the delusions and no longer believe that much of what I read back then about trauma was accurate in the first place. Much disinformation can be found on the internet, and if you look at a lot of conspiracy theory sites, you can find pretty much most of the delusional realm I lived in written about by somebody else. This includes my delusion that there were hidden concentration camps in the United States waiting to take in people for slaughter during the end of the world. I have seen that in writing. I also believed it for years. Some of my most bizarre beliefs, like the thought that I was pregnant for four years and that people ate human beings and called it "bread" - well, you won't find anybody writing about those. But about the other, earlier delusions, it is disturbing that there are websites that helped to solidify those thoughts in my mind.

There is, as I was explaining at the beginning of this post, a lot of confusion in the world about Schizophrenia, Schizoaffective Disorder, and other disorders of psychosis. Most people do not understand these illnesses and what they really involve. Most people still think that what they saw on One Flew Over the Cuckoo's Nest in the 1970's or last week on a cable channel demostrates reality. It really doesn't, in many respects. There has been a lot of parent-blaming, and particularly mother-blaming in the psychiatric world in the past, and even today by people who do not necessarily know much about mental illness. Women-blaming has been a pretty popular pass time in most regions of the earth since the day Eve supposedly gave away that apple. Unfortunately, it has even been done by the scientific community in regards to mental illness. The "schizophrenogenic mother" is a term you won't hear of too often today, but try doing a Google search and you'll see what I mean. Next, see if you can find a page on a "schizophrenogenic father", ie. a father who caused schizophrenia. You'll find there is no information about such fathers out there. But there is plenty of outdated information blaming women for causing their children's Schizophrenia. Check out this video for a brief overview: http://www.whenmedicine.org/MedW/Home.html.

I read about this in a recent feminist book called Bluebird, by Ariel Gore. This book does an excellent job of explaining some of the psychiatric profession's maltreatment of women and blaming of women for everything under the sun. Let's be clear: there is no evidence that childhood abuse actually causes Schizophrenia or Schizoaffective Disorder. There is no evidence that the kind of mom you have has anything at all to do with whether or not you develop such a mental illness. There is a big difference between actual psychosis, which is a biologically based brain disease, and trauma-based problems such as Post Traumatic Stress Disorder or dissociative disorders. They are not the same thing. My mother didn't cause my illness. Whether or not she did anything wrong or whether she had any problems of her own has nothing to do with this illness or why I got it. Similarly, I can't blame it on anybody else, including my father, and I wouldn't want to blame it on anybody anyway. I would like to see the day when society holds a clear understanding of what psychosis is, and when medical professionals, including therapists, know very well what the symptoms of psychosis are and how they differ from dissociation. I could have been correctly diagnosed ten years ago, and given the proper treatment. But I wasn't. I was given a bunch of misnomers for labels and no actual helpful information at all.

To be fair, it is hard for anybody to know when a person is psychotic, particularly the person herself. You don't want your first instinct to be that the person you are treating in a therapy session is imagining everything she's talking about. Indeed, such an assumption would do terrible harm to many people seeking help. But there is a need for clear distinction between what is real, and what is not real. When a person is psychotic, the worst thing you can do to that person is to affirm her completely delusional world as reality and pressure her to fall further down the rabbit hole. Likewise, it is not really helpful to tell a psychotic person you think she's psychotic, at some times. There are, however, times when it is appropriate to tell someone this fact. I found that I had to almost die of a horrible suicide attempt before a doctor would say to my face that I was psychotic and give me a correct diagnosis. I had to go in and out of hospitals for years, in different states, with different diagnoses, and never really getting any help that lasted at all, before I found out the actual problem. This is not an uncommon story. Indeed, far more research is needed in the field of mental health, and of course this requires more funding.

And more funding is sorely needed for adequate mental health treatment. Our community mental health centers are underfunded and the evidence of that fact is everywhere around us. People are living on the streets because they are not receiving appropriate treatment for their illnesses, and this occurs right outside my apartment door. There are people in jails who have never been put on the appropriate medication and kept on it long enough for it to work, and such treatment almost never occurs inside jail cells. In his landmark book, Crazy: A Father's Search Through America's Mental Health Madness, Pete Earley describes the fact that the Los Angeles County jail houses more people living with mental illnesses than any mental health treatment center or hospital in the entire United States.

Until our society considers mental health an actual priority and funds the research and treatment needed by millions of people in an adequate manner, we are going to continue to have misinformation, and a lack of appropriate education on mental health issues. We will continue to have the ignorance that allowed people to say mothers caused their children's Schizophrenia for years, or that women who were outspoken must have been insane. Or that people who live with mental illnesses/ psychiatric disabilities are dangerous criminals for the most part and are more likely to be a serial killer on Law and Order than your next door neighbor who seems so perfectly "normal".

So, in honor of mental health awareness month (May), I would like to call for this: adequate diagnoses, adequate, helpful (and not harmful) treatment, drugs with fewer side effects so you can both not be psychotic and not be obese at the same time, no more blaming of mothers for the mental illnesses of their offspring, no more mislabeling, no more pop psychology books based on nonsense and bad science or no science, no more ignorance about mental health. No more injustice for people living with mental illnesses. We need to, simply, change the world. It starts one person at a time. Are you with me?

2 comments:

Jamie said...

Thanks for sharing all this. So much of what you write rings true. I starting having troubles mentally when I was around 12 years old. Even when I was 17 and attempted suicide the doctors still didn't want to diagnose me with depression. They said it must just have been stress or something. The mental health profession still has a long way to go. As consumers we have a lot to learn too. We need to be vocal and advocate for what we need. Thanks again for sharing. It was amazing to me how many times I thought "That's just like me!" when reading your post.

Jennifer, aka beautiful mind, complex life said...

Thanks for stopping by, Jamie. I agree, the mental health field does still have a long way to go. Thankfully, we have made some progress since the time of insulin treatment, straitjackets and lobotomies, but we haven't really come far enough if almost every available antipsychotic medication causes obesity and diabetes, and all medications are so overpriced that people without insurance or a ton of money can't get the help they need. The consumer movement will make the changes necessary happen, I think. We are a strong bunch of people; we just need to get more organized.

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