Invariably: “Instinctively Joyful” (Chapter. 1)
Written by Andi Bazaar, Scott Wynné Schofield, Hugo-licharré Freimann, Yevhn Gertz, Henrie Louis Friedrich, José Schenkkan Joseph | March 15, 2024
“The second leading cause of disability, the most common mental health issue affecting more than 10% of the population at any one point. Depression comes in multiple forms from major depressive disorder, seasonal affective disorder and dysthymia to name a few.”
There is mental uneasiness, dissatisfaction, discontentment and restlessness even in multimillionaires also kings. Some kind of sorrow, misery or pain is invariably present even when they are in the height of enjoyment of worldly pleasures. Show me a human who is perfectly happy.
Knowing the difference between someone disregarding your pain n someone simply tryna see you beyond your sorrow will save you a lot of time and mental battles.
The locking away the testimonies of so many innocent victims who had so much pain, hurt, sorrow, sadness, depravity, anguish and the mental torture all those victims are now going to suffer because there will never be justice for them. This is a state cover up, its corruption!
People see the glory but don't know the story, put some respect on what God has done and is doing in my life. It took separation, hard work and dedication for me to get my health and mental on track. It took several years of great pain and sorrow for me to smile.
Throughout the history of clinical psychology, there have always been disorders that were used to discriminate. In modern psychology, it is borderline personality disorder. Not saying it is not real, but many professionals simply put “difficult” patients in it.
The idea that forgiveness can help us heal especially for deep traumas isn’t necessarily true. Survivors often feel pressure to forgive those who hurt them, but it isn’t done to help those survivors. The sole purpose is to help ease the conscience of those who hurt them.
LET’S TALK ABOUT DEPRESSION
“The second leading cause of disability, the most common mental health issue affecting more than 10% of the population at any one point. Depression comes in multiple forms from major depressive disorder, seasonal affective disorder and dysthymia to name a few.”
When we are depressed, we can feel an increased or decreased appetite, an increased or decreased sleep, a lack of motivation to do anything from showering to getting out of bed to even taking a shower. Every task becomes a mountain, it can feel like the world is Slowing down or going faster and we can’t keep up.
In terms of feelings, it can lead to an intense feeling of sadness, numbness, emptiness, etc as you can see, depression comes in many forms and different combinations of symptoms and its impact on our daily life is huge.
For some people, depression can have a biological component. Parents that have chronic depression can have children who also have chronic depression, it can also be a result of our environment or both combined. For those who went through or are going through anxiety, depression usually follows because the intense anxiety takes a lot of energy to the point that depression becomes expected as a result of the underlying anxiety.
It is hard to talk about all the environmental causes of depression because there are so many. Lack of social support, parents who are dismissive and neglectful, an unhappy relationship, anxiety, genetics, a toxic workplace, financial stressors, poverty, etc can all lead to that feeling of hopelessness and helplessness and ultimately depression.
This is the reason why it can affect so many of us, it doesn’t discriminate and research shows that it tends to affect everyone. Depression can also lead to suicidal ideation as a way to control our faith and stop the pain or the numbness, it is important to get treatment for depression whenever we feel those lasting symptoms of depression.
One option is through medication, there are so many medications out there designed to increase chemical and neurotransmitters in our brain. One of the famous ones is serotonin, these medications act by increasing the presence of that chemical in the brain and opening up neurotransmitters to accept more of it. For people who may have chronic depression, it can be very helpful to simply take one medication and feel better.
Therapy is also very efficient especially "Cognitive Behavioural Therapy" (CBT) because it focuses on a restructuring of the way we think and behave and can help alleviate those symptoms long-term. Depression can also naturally happen on a cycle where we feel bad for a period of time and then good for a period of time even when that happens, it is good to get it under control to improve quality of life.
There is a reason that depression is the most common mental health issue, it is connected to so many other mental health categories, can come from so many sources (biological, psychological, social) but fortunately is treatable.
If you suspect or know that you have depression, please know that there are many medications designed to help you out there and therapies that work really well. You deserve to have a better quality of life and not continue to suffer, if you know someone who is going through depression — be there for them without judging.
The worst that you can do is tell them “go take a shower” / “get out of bed” / “when are you going back to work?”, etc... and can lead to depression getting worse.
People who have depression are aware that they need to get up and do things but just can’t. Instead, offer to go with them to the doctor or a therapist for support or even drive them there even if they refuse, don’t try to force them to go. When they are ready, they will take you up on your offer.
For those of you going through depression, it can be isolating and feel that nobody can understand what you are going through. Try to reach out to someone you love and trust, to get out of that isolation, there are groups and forums online of people going through depression, you can visit those in moderation to see that there are others who go through the same and can understand you.
Do your best to connect with your doctor, a therapist and start your journey to recovery. As always, I am here to answer any questions.
LET'S TALK ABOUT "BORDERLINE PERSONALITY DISORDER" (BDP)
One of the most complicated to solve and the most stigmatized even within the mental health healthcare system.
BDP is characterized by a lot of opposing behaviours such as being angry with a loved one, but also being scared that they will abandon you. Individuals with BDP tend to harm themselves a lot but generally not cross the line to where it is lethal. There can be some emotional blackmail (not intentional) where the person with BDP will harm themselves if they do not get what they want.
There is a lot of stigma within the healthcare system due to the fact that clients with BDP require a lot of attention and can be emotionally draining, this is because clients with BDP are more likely to have transference meaning that the therapist becomes a figure that is reminiscent of someone they know in their own lives.
They can at times harm themselves if they do not get enough attention from their therapist or try other things to get the therapist's attention, this had led many professionals to not accept clients with BDP simply to avoid complications. Also, the stigma comes in because whenever someone is a little confrontational or assertive in therapy, they can be called and labelled with BDP even though that is not the case at all.
While it is true that clients with BDP can take a lot of work, it is definitely something that can be managed and there is a lot of success in their recovery. As a professional, I accept a maximum of 3 clients with severe BDP at any one time. This is because there will be a lot of work for each one and I want to be present for everyone while also avoiding burnout.
In terms of treatment, the most successful one is called "Dialectical Behavioural Therapy" (DBT) invented by Marsha M. Linehan who saw that there was a gap for certain individuals for whom CBT did not work or was inefficient. DBT focuses on certain elements of change but the biggest element from DBT that does not exist in CBT is acceptance.
Accepting who we are is a big component because we will often loath ourselves and want to harm ourselves but when we accept and make peace with who we are, we are less likely to engage in harmful behaviours.
I hope that this small summary of BPD can be a little helpful in better understanding it, don't hesitate to ask any questions or ask for additional details.
LET'S TALK ABOUT MENTAL HEALTH LABELS (BDP, MAJOR DEPRESSIVE DISORDER, OCD)
They have become mainstream and used very (too) often. However, these labels also come with some dark sides that we perhaps don't talk about too often. Let's try to have that conversation.
It is important to remember that unlike physical illnesses, psych ones are quite arbitrary. We can't find OCD or depression the same way we can a bacteria or injury. Therefore, those categories are quite arbitrary. Experts choose what fits and what doesn't in each category.
This is very visible for those who work in the field of mental health, our guidelines and diagnostic criteria changes every few years mainly guided by a diagnostic book called the DSM. What this means is that a label 5 years ago may not be relevant today and vice versa.
There are some good sides to these labels, it helps validate the suffering of individuals and bring legitimacy to the process. There is already way too much stigma attached to mental illness and some people may even doubt its existence. It can be a relief to know what we have.
It helps people make sense of what they are experiencing, we generally know what depression/anxiety mean. When we mention it to people, they have some idea of what it may look like. It also helps people find a community of individuals that may have gone through something similar.
However, it is a double edge sword. Many of these labels stick to the person for a very long time, which means it can be used to stigmatize them for example "people may refer to someone as the anxious or depressed person even when they have fully recovered."
We don't do that with physical illnesses, no one refers to me as Bronchitis even though I had quite a few in my life but if I tell someone I have a lot of anxiety — it is something that would follow me for longer than the anxiety remains. It is important to be careful.
Especially because in many of our native countries, confidentiality is not something that we are strong at. Medical files can leak or doctors/therapists may share it without our consent to family members, these labels can also be used to dismiss people and dehumanize them.
If someone with anxiety goes to their doctor, they may dismiss them simply because it is their anxiety flaring up rather than make sure it is something that they could be experiencing. As you can see, there are quite a few bad sides to these labels. How can we navigate that?
First of all, be open with your mental health workers and doctors. Tell them that they can give you a diagnosis but not put it in your file, it is important to keep that line of communication open and make sure that they know what you consent to and not consent to.
- If you don't like labels at all, you can tell your therapist or doctor you are not interested in knowing exactly what it is, but just want help in fixing it. You are in charge of your recovery and it is important to be hands-on in order to make sure you get the best out of it.
- If you live in a country that stigmatizes mental health too much, ask not to have a file open about your mental health that other healthcare providers can see. That way, it is something that remains perfectly confidential. I hope that this helps make some sense of these labels.
"No, it is not a (mental disorder) that causes suffering and impairment — it is events, circumstances, relations etc that cause suffering and impairment." Absolutely!
This (the argument that the "mental disorder" has causal agency) is very odd logic indeed and is oxymoronic in respect to other statements (made by the same individuals).
So, we're told that the diagnoses are merely "constructs" or helpful (or otherwise) labels for observed patterns of human experience. The label then, can't *cause* anything (other than confusion and lead to iatrogenic harm through the mistakes of clinicians), we're told that they are aetiologically neutral which again speaks to the idea of a "social construct" and indeed we're told (with a degree of frustration) that we don't even have to point out that they're social constructs that's a given and yet, those commentators seem to have forgotten their own advice, as they're now claiming that these unequivocally "social constructs" have different epistemological roles, as entities that have causal agency.
My conclusion (and I'm sorry to be criticalbut apparently it's ok to be critical as long as you don't have the temerity to criticise diagnoses from outside the profession) is that the underlying assumption — violating the principle of aetiological neutrality is that what we're *really* talking about is an assumption of an underlying pathology a disorder or dysfunction in structure or process which gives rise to the phenomena listed in the diagnostic criteria and has effects has consequences, has agency and which is reflected in the diagnosis?
- If so (if that assumption is right), then all the claims of aetiological neutrality, of the universally agreed idea that these are social constructs, that the diagnoses merely label patterns of observed phenomena rather than reflecting disease are misleading.
- If I’m wrong and all those claims for diagnosis are still held to be true, then (and coming back to the start of this thread), then the diagnosis the "mental disorder" can indeed *cause* nothing.
As Henrie Louis Friedrich so correctly pointed out, we have events and circumstances in our lives that have consequences. Sometimes, inappropriately, in my opinion, those experiences are pathologised as "disorders" and it’s so very sad that then we start down the route of searching for dysfunction (rather than addressing the problems), medicating (with all the iatrogenic harm that follows), misleading people struggling to make sense of their experiences here, weaving intellectual Möbius strips from the philosophy of causality.
LONGITUDINAL ASSESSMENT OF MENTAL HEALTH DISORDERS AND COMORBIDITIES ACROSS 4 DECADES
The supplement is well worth reading includes detailed reporting of bifactor and corr'd factor models, l/t psychopathology epidemiology, etc. e.g. 86% sample qualifies for at least one l/t Dx which forces a reconsideration of how we conceptualize mental illness.
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(pic) CO-MORBIDITY IS THE NORM
Over time, individuals show homo continuity, hetero continuity, waxing/waning and discontinuity: "Tracing all 1037 participants across time revealed 692 mental disorder life history patterns, of which 605 (87.4%) were unique to 1 person."
P-factor relates to all psychiatric epidemiology metrics and "brain health" (indexed by multivariate structural classifier output) but ES is very, very modest: "By age 45 years, participants with higher p-factor scores showed older brain age (r = 0.14).
Some key take-homes — "In contrast to assumptions of diagnosis-specific research and clinical protocols, we found evidence that virtually no one gets and keeps 1 pure diagnosis type."
"This study has implications for public understanding. Mental disorder eventually affects almost everyone. Some mental disorder life histories resemble a fractured leg or influenza, disabling but short-lived. Other mental disorder life histories become chronic or recurrent. ...
"However, people meeting diagnostic criteria experience impaired functioning and many absorb health care resources. Public health education about the ubiquity of disorder could reduce stigma and promote earlier and increased treatment uptake, facilitating prevention."
"Rather than viewing mental disorders as rare,
members of the general public should expect at least 1 bout of mental disorder in their lifetime.""There are implications for etiological research. First, finding specific causes matched to specific disorders has been a highly desirable but elusive research goal, 46 but the present findings suggest that causal specificity may be unrealizable because mental disorder life."
"Histories include diverse disorder, a third implication is that etiological research might productively embrace dimensions that quantify variation in mental disorder life histories. The findings here suggest that dimensions such as age at onset, duration,
diversity or the p-factor may reflect patients’ lives (especially in inpatient settings) better than any particular differential diagnosis can."
— to be continued...
A SPECIAL THANKS TO:
- Andi Bazaar (Writer)
- Mark J. Levstein (Co-Editor)
- Yevhn Gertz (Director of Photography/Co-writer)
- dr Oliver Schofield MD (Consulting)
- dr Seth Gryffen, MD (Consulting)
- dr Khaan, MD (Consulting)
- Timothée Freimann schofield (Photographed)
- Clayton Euridicé Schofield (Editor/Journalist)
- Scott Wynné Schofield (Publicist/Co-writer)
- Henrie Louis Friedrich (Analyst/Co-writer)
- Jwan Höffler Conwall (Art Interior Design)
- Hugo-licharré Freimann (Ass Director/Co-writer)
- Shot at GQ’s Studios by José Schenkkan (Co-writer) and Benjamin Schenkkan Joseph
- In appearance by "Gregory O’Connor Jr" (Model)
- In collaboration with "The Me You Can’t See UK" (TMYCSUK) / @tmycsuk
