Its a Mad Mad Mad Mad World

Having spent much of the week trying to get help for a client with a serious mental health problem I have found myself pondering (in a very un-Russell Brand way) on the devastating effect mental illness has on the sufferer and their family and friends. One of the books I am reading at the moment, 'Relative Strangers, A Life After Death' by Mary Loudon is an account of her family's experience of dealing with her sisters mental illness and the helplessness they all felt as their daughter/sister spiralled out of control, and ultimately died, not off as expected, by taking her own life, but by cancer, a horrible, murderous disease but one that is much more acceptable than a mental illness. Mary and her sister Catherine had the same upbringing, the same early experiences and, one would think, the same chances in life but as Mary says 'It looks as if Catherine and I began our lives at the same place but we didn't. She had schizophrenia and I did not'.

The book is a difficult read at times, but is beautifully, not sensationally, written and Catherine’s story is told with poignancy and flair. But it isn't only Catherine’s story; it is the story of a family trying to deal with a loved one who is devastatingly 'different'. And different in a way that makes living a 'normal' life impossible for all concerned.

Growing up with a step father who has Manic Depression, now known as 'Bipolar Disorder' I know first hand the devastation it causes a family. This mental illness has become almost trendy with some high profile suffers such as Stephen Fry and Kelly Katona and I have read reports that claim it can add to a persons fabric of life, making them more creative, giving them more confidence. If its the confidence to live a life full of drama and controversy - well yes, it certainly can do that. The flip side is dispondancy and sadness.

Bipolar disorder - previously known as manic depression - is a condition that affects your moods, which can swing from one extreme to another. If you have bipolar disorder you will have periods, or ‘episodes’, of depression and mania. The depression and mania that are associated with bipolar disorder are characterised as follows:

•depression - where you feel very low, and
•mania - where you feel very high; slightly less severe mania is known as hypomania.

Both extremes of bipolar disorder have a number of other associated symptoms. Unlike simple mood swings, each extreme episode of bipolar disorder can last for several weeks or longer. The high and low phases of the illness are often so extreme that they interfere with everyday life. During a manic phase of bipolar disorder, you may feel very happy and have lots of ambitious plans and ideas. You may spend large amounts of money on things that you cannot afford. Not feeling like eating or sleeping, talking quickly, and becoming annoyed easily are also common characteristics of bipolar disorder. During the manic phase, you may feel very creative and view mania as a positive experience. However, during the manic phase of bipolar disorder, you may also have symptoms of psychosis. Ah yes...psychosis. That led to a bundle of laughs, let me tell you.

Reading the above clarifies things for me slightly but it is a very clinical description of the nightmare me and my sister grew up with. The fear and confusion about what was going on, the negative feelings for my step father, a man who had, until his first onset of mania, been kind and gentle, who now terrified us and wanted to cause us harm. Seeing my mother, who was supposed to be our protector, flee in fear, leaving me and my little sister to deal with the fall out has impacted on our lives to this day. It made us make choices we were far too young to make. We lost our peace of mind. Sometimes I fear forever.

It's funny that I left home to live with someone else whose childhood had been blighted by mental illness. His mother had schizophrenia and this led to all four children being put into care at various times. The effect of this is still apparent today and none of them are leading what could be classed as productive lives. It didn't help that their father had what could be described as a 'Personality Disorder'. He certainly showed all the signs of having a 'Antisocial Personality Disorder' which included:

Persistent lying or stealing
Apparent lack of remorse or empathy for others
Cruelty to animals (and children!)
Poor behavioral controls — expressions of irritability, annoyance, impatience, threats, aggression, and verbal abuse; inadequate control of anger and temper
Recurring difficulties with the law
Tendency to violate the boundaries and rights of others
Aggressive, often violent behavior; prone to getting involved in fights
Inability to tolerate boredom
Disregard for safety

Schizophrenia & Antisocial Personality Disorder = a match made in hell. No wonder the kids have grown up such problems.


Wikipedia:

Personality disorders, formerly referred to as character disorders, are a class of personality types and behaviors that the American Psychiatric Association (APA) defines as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it".

These behavioral patterns in personality disorders are typically associated with severe disturbances in the behavioral tendencies of an individual, usually involving several areas of the personality, and are nearly always associated with considerable personal and social disruption. Additionally, personality disorders are inflexible and pervasive across many situations, due in large part to the fact that such behavior is ego-syntonic (i.e. the patterns are consistent with the ego integrity of the individual) and are, therefore, perceived to be appropriate by that individual.

The onset of these patterns of behavior can typically be traced back to late adolescence and the beginning of adulthood and, in rarer instances, childhood.
Diagnosis of personality disorders can be very subjective; however, inflexible and pervasive behavioral patterns often cause serious personal and social difficulties, as well as a general functional impairment. Rigid and ongoing patterns of feeling, thinking and behavior are said to be caused by underlying belief systems and these systems are referred to as fixed fantasies or "dysfunctional schemata" (Cognitive modules).

Working with families, some of whom are headed by parents with mental illness and/or personality disorders, or who are themselves the casualties of growing up with parents who had mental illnesses or personality disorders is the cause of sleepless nights. Knowing that a child is being dragged around streets in the middle of the night because mum thinks her home is bugged and the neighbours are spying on her, knowing the child witnesses her mum burning papers and chanting curses in the living room, knowing that food is not easy to come by because mum is convinced that it is all poisoned, knowing that her mum has suicidal thoughts and that she may, if no one steps in and removes the child and sections her, kill both herself and her daughter keeps you awake at night. Thankfully in this case the police and social services have taken action and for this weekend at least mum and daughter will be safe. But what next?

On a lighter note - I have been accused in the past of having a 'Borderline Personality Disorder'. So I took an online test.

Result:

Disorder | Rating
Paranoid: Low
Schizoid: Low
Schizotypal: Low
Antisocial: Low
Borderline: Low
Histrionic: Moderate
Narcissistic: Low
Avoidant: Low
Dependent: Low
Obsessive-Compulsive: Low

Quick Summary:

People with histrionic personality disorder are constant attention seekers. They need to be the centre of attention all the time, often interrupting others in order to dominate the conversation. They use grandiose language to describe everyday events and seek constant praise. They may dress provocatively or exaggerate illnesses in order to gain attention. Histrionics also tend to exaggerate friendships and relationships, believing that everyone loves them. They are often manipulative.

Symptoms of Histrionic Personality Disorder:
•Needs to be the centre of attention
•Dresses or acts provocatively
•Rapidly-shifting and shallow emotions
•Exaggerates friendships
•Overly-dramatic, occasionally theatrical speech
•easily influenced; highly suggestible

Hmmmm, I am not overly convinced of this although I can identify to the description for those with HPD as 'these individuals are lively, dramatic, enthusiastic, and flirtatious.' Yep, hands up to that. As for 'they may be inappropriately sexually provocative, express strong emotions with an impressionistic style, and be easily influenced by others. Associated features may include egocentrism, self-indulgence, continuous longing for appreciation, feelings that are easily hurt, and persistent manipulative behavior to achieve their own needs.' Certainly not! Well, maybe a bit...but then again I only scored a 'Moderate'.

Having an awareness of the following is useful, both in dealing with ones own feelings and behaviours but also in communicating with other people who may be displaying certain behaviours:

Borderline Personality Disorder is considered to be the most common personality disorder. The diagnosis of Borderline Personality Disorder is somewhat controversial because it is difficult to diagnosis. Some classic symptoms of this disorder include an intense fear of abandonment, emotional intensity, unpredictable mood swings, impulsively, obsessive ruminating, paranoid distortions and self-destructive behavior.

People with Borderline Personality Disorder have immense difficulty regulating their emotions. They display a marked hypersensitivity to other people and the stress of social interactions and emotional intimacy that leaves them on an emotional roller coaster that is terrifying to themselves and others. People with BPD become so overwhelmed by their own emotions that they lash out at their loved ones in unpredictable rages or turn their fear and anger inwards and act self destructively.

Individuals with Borderline Personality Disorder find it more difficult to distinguish reality from their own misperceptions of the world and their surrounding environment. While this may seem like a form of delusional disorder at times, it is actually caused by their intense emotions overwhelming their regular cognitive functioning. This is why people with BPD can sometimes excel in academia and the work place and yet totally lose control in their personal and family lives.

The most distinguishing characteristic of Borderline Personality Disorder is a tendency to see things in black and white. People suffering from this disorder live in a world of extremes. They either idealise or vilify everyone they meet. Often they veer between idealising a loved one and devaluating them causing great turmoil and misery in that loved one’s life. Situations these people encounter are viewed as either ideal or disastrous. It doesn’t take much to upset their equilibrium. A frown from a co-worker or neighbour may send them into a rage and their spouse and family members may have to listen to obsessive ruminating about this co-worker’s personality and actions for several weeks afterward. A neighbour may be shunned as a result of a facial expression, a throwaway comment, or a broken lunch date. A family member may be cut out of the will after displeasing the BPD by some minor action or because the BPD has fabricated in their mind, actions or motivations that never occurred.

Individuals with Borderline Personality Disorder are generally not psychotic, however their behavior can seem “crazy” to those closest to them. They often have extreme mood swings that cycle very rapidly through out the course of a single day. They are irritable and anxious much of the time. BPDs are often suspicious and distrustful of loved ones and others without real cause. They experience cognitive distortions and accuse loved ones and others of doing things they haven’t done and of having sinister motives for the simplest of actions. They feel they can never get enough love and affection to make them feel happy and secure. Loved ones feel they are constantly “walking on eggshells” fearful of doing or saying the “wrong” thing least it set off the rage of their borderline family member.

Some people with Borderline Personality Disorder engage in self-destructive behaviors such as over spending, overeating, promiscuity, criminal behavior, substance abuse, prostitution, and eating disorders. A subgroup of BPDs is involved in chronic self-mutilation for example purposely burning and cutting their skin.Some BPDs cut their skin so often that they are referred to as "cutters". Suicidal ideology is common at some point in many of these people’s lives.

At times people with Borderline Personality Disorder feel empty, spacey and unreal. Central to those with borderline personality is an identity disturbance, a feeling of being empty and out of sync with the rest of humanity. They may have a deep-rooted secret belief that they are evil. Often Borderline’s may project their own feelings of inferiority on to loved ones whom they then devalue and abuse. Some BPDs physically abuse their loved ones, kicking punching, slapping and gouging their loved ones with their fingernails. They act verbally abusive to people they know well while putting on a charming front for other people, thus fooling coworkers, neighbours and therapists who may not believe family members stories of abuse. They may appear competent and even excel in some situations while acting extremely out of control in others. Child and spousal abuse is common.


Borderlines are “love addicts”. They are terrified of being alone. They may rush into relationships and try to establish intimacy as quickly as possible, having sex on the first date, or sharing intimate details of their lives at a very early stage. They idealise the new partner at first, but this idealization quickly turns to devaluation and disillusionment when the person fails to live up to their ideals.


Experts believe that borderline personality disorder, like most psychiatric disorders, is caused by a combination of biological factors, genetic factors and environmental experiences. Those who believe that environmental experience is the primary cause focus on the delicate relationship between children and their caregivers in the early years of life. Many believe that child abuse or neglect is the main cause of Borderline Personality Disorder. Some experts believe the loss of a parent at an early age can lead to a person developing the condition. Violence, traumatic separation, substance abuse or incest frequently marks the Borderline’s childhood history. The relationship between mother and pre-borderline child is often revealed to have been confrontational or even hostile.

Wow!!! That just about covers I know!

Except me of course.