How I Became My Own Psychiatrist

L. Kline
41
2520

Today marks the tenth week of working as a clinician at a private psychiatric hospital where five years ago I was a patient. In a different place in my life, I voluntarily admitted myself when thoughts of self-harm became too overwhelming to manage.

Four years before that hospitalization, I had consumed my last drink after spending most of my twenties on an alcohol-fueled spree sustained by long periods of manic energy (a symptom in today’s world but a gift in others). This ostensibly successful propulsion allowed me to secure my first graduate degree and employment in conventionally respectable jobs until alcohol’s incitement ran its course. In that final year of use, I walked out of a corporate position, left my partner, and drove 1,500 miles to my childhood home all in about a week in an act of unconscious self-preservation. Two weeks after arriving home to my unsuspecting family, though, I attempted to end my life and woke up in a psychiatric hospital. A year-and-a-half of recovery work later, I experienced my first sober manic episode; I managed to avoid hospitalization with the help of a keenly perceptive therapist I had started seeing a few months before, alongside a good dose of lithium. And then the real fun began.

Of all the stories I could tell of the psychological pain, the grieving for my past and dashed future, and the endless pursuit of healing, there is one story that upsets me most. That is the story of the psychiatric violence I’ve experienced since my diagnosis, observed in peers, and witnessed carried out by prescriber colleagues. While medication may at times play a role in healing, I struggle to see past the psychiatric discipline’s deficits: its lack of humility, its questionable scientific rigor, its embrace of specious claims, its cozy relationship with Big Pharma, and most of all its frequent denial of the suffering it’s capable of inflicting upon those desperate for relief.

My mental health and substance-use recovery work unearthed a history of trauma. Yet it is the benign (I hope) ignorance of psychiatrists that has caused me the most pain since finding sobriety. Instead of relying on memory to recount these prescribing mishaps, allow me to share primary sources.

A few months after scribbling down a Bipolar Disorder diagnosis on my chart, my then-psychiatrist abruptly stopped an SSRI I had been taking for eight years. About three months later, I experienced nearly daily panic attacks for 33 days, each attack lasting about an hour, sometimes more than once a day.

Random scrawl from my notebook during that time:

Damnit, happening again

Walking around house, got flushed

Panic all day

Driving

Walking on the street

Middle of the night

Cat lying on my legs

Hiding in the bathroom

Ran out of meeting

Almost hit pedestrian

Meeting with sponsee

Walking around the parking lot

Fuck

A few days after the panic attacks — which I had never experienced before — took over my life, my psychiatrist prescribed Xanax with the knowledge that benzodiazepines had played a role in my first hospitalization. I reluctantly took a round blue pill or two during the worst of the attacks and stopped leaving the house for fear of killing someone or myself while driving to a recovery meeting. The attacks ended soon after my psychiatrist re-started the antidepressant. Still new to this world, I brushed it off and returned week after week to my prescriber’s office. That springtime month of crippling panic attacks ranks as the most scarring experience in my recovery journey.

Coming in at number two is my adventure in Seroquel withdrawal, again precipitated by a botched taper plan that was too short and too drastic. Like the SSRI withdrawal, I documented the antipsychotic experience in my journal to share with my prescriber, hoping this would be helpful information for my “treatment.”

* * *

For last 10 days or so, sleeping only 3 to 4 hours a night. Difficult to nap during the day, if at all. Feeling more and more sleep deprived.

Last Seroquel taken Thursday evening – 50 mg

Friday – started hitting a wall, akathisia, mind shutting down. Starting seeing lights (repetition of real lights) that were not there and my cat running around/in front of me while the actual cat is on a different floor. Decide to take 1 mg Xanax ER at bedtime along with regular meds (lithium, Lamictal). Slept 3 or 4 hours.

Saturday – up around 3 or 4 am. Hit a wall. Feeling super fucking crazy. Could not go back to sleep. Pacing picks up. Restless legs when trying to lie down. Intense tension in shoulders/upper arms, the type I will get during panic attack. Around 10:30 am, take AM meds (but just 25 mg Zoloft – usually 50mg – and 1.5mg Vraylar). Decide to take 1 mg regular- release Xanax. Doesn’t do shit. Feeling like I’m going to die. Took 10 mg of Vistaril. Nothing. Getting crazier. Take another 10 mg of Vistaril. Nothing. At some point take two ibuprofen. 

Did not want to take Seroquel – just wanted to get through this as part of the withdrawal. Didn’t want to have to deal with this process again.

Continue pacing and dying slowly. Roommate starts freaking the fuck out. Realized I missed a voicemail from on-call provider suggesting I re-start Seroquel. Finally gave in around 4:30 pm and took 400 mg Seroquel. Went to bed at 5 pm and woke up Sunday morning at 4 am. Feeling slightly better. Went back to bed at 6 am. Slept until 8 am. Back to bed around 10 am and slept another 30 minutes or so. Took AM meds, 25 mg Zoloft – usually 50 mg – and 1.5mg Vraylar. Mind starting to feel clearer and feeling less insane. Akathisia continues, however. 

Pacing most of the day Sunday with brief moments of akathisia cessation. Stops around 8:30 pm. 

Spoke to on-call provider around this time. Explained situation, and she said it sounds like akathisia. Advises I take 200 mg Seroquel and regular meds (lithium, Lamictal). And also 50 mg of Vistaril. Took all meds at 10 pm. Went to bed at 10:30 pm. Fell asleep ~15 minutes later. (Note: I only have 80 mgs left. Eight 10-mg tablets.)

Woke up this morning at 5:30. So about 7 hours of sleep. Less akathisia. Went back to bed around 7:30 am and slept about 30 minutes. Feeling better with slight akathisia and some discomfort/pain in the biceps area. 

Have not yet taken AM pills – Vraylar and Zoloft

 Saturday was in the top 3 worst days of my life. No exaggeration.

 * * *

Thankfully, I no longer shudder when I think about that horrific week, and I am no longer angry at my prescriber (who will never be held responsible for medical negligence) for suggesting a taper schedule based on who knows what instead of empirical evidence or common sense.

My second and hopefully final hospitalization had occurred just a few months before the Seroquel disaster. During a period of low mood, my psychiatrist started a game of Russian Roulette with medication changes. Weekly appointments ended with new prescriptions, and increasing suicidal ideation and planning landed me in the hospital I work at today— only to have my medication regimen reverted back to the original pre-hospitalization plan. The abnormally overwhelming suicidality ultimately abated with continuing therapy and hard work.

A month after termination from this prescriber, I moved to my second and current psychiatrist, who supposedly has expertise in working with those with bipolar illness. What follows is a message I sent to him regarding what I termed at the time “the Vraylar withdrawal and propranolol experiment.”

To: Dr. “X”

An update on the last few days of the Vraylar withdrawal and propranolol experiment.

Weds.

Last dose of Vraylar to stop emerging (internal) akathisia

Friday

Took 10 mg propranolol at 8 am. Moderate akathisia – physical and mental.  Paraesthesia at random intervals in random places.

Took 10 mg propranolol at 2 pm. Call with Dr. “X” at 3 pm. Evening felt mostly okay – just aftermath emotionally.

Saturday

Morning okay – just aftermath stuff. No propranolol. Started getting worse (akathisia, crazy thoughts, suicidal ideation, paraesthesia located mostly in shoulders – lots of heat, weak legs) around 1:30 pm. Becoming and more and more intense. Comes and goes in waves.

At 6:30 pm, took 20 mg propranolol. Next hour became as nearly as intense as when I was withdrawing from Seroquel. At 7:17 pm, called the on-call doctor and left a VM. Suicidal ideation, self-harm, drinking all became options in my head. 

Around 7:30 pm, the symptoms cooled off a bit. Moderate symptoms through the rest of the evening. Waves on and off. On-call doctor called back around 7:40 pm and told me to take 20mg propanolol on Sunday if needed.

Sunday

Mild symptoms in the morning. Ongoing paraesthesia with heat in my shoulders. Took 200 mg ibuprofen at 11:30 am. Heat in shoulders became better but with waves of akathisia and tunnel vision.

Took 200 mg ibuprofen again at 3:30 pm. Heat begins to dissipate more. Akathisia begins to wane more around 5:00 pm. Occasional minor wave through the evening. Emotional hangover. 

 Monday

Woke up and felt okay for about 30 minutes. Mild paraesthesia set in. Took 200 mg ibuprofen at 9:00am. Starting to feel better again. Mild waves of paraesthesia and tunnel vision/akathisia continue. Took another 200mg of ibuprofen at 1:45 pm. Hoping this is the last of it. 

 * * *

The DNA test for psychiatric medication response I took weeks after this “experiment” predicted that I would have a severe reaction to propranolol, and unfortunately, it was not “the last of it” as I had hoped. Paraesthesia-like sensations such as tingling, heat, and numbness have become a chronic response to stress and intrapsychic unease, discomfort I had not experienced before. Fortunately, a laundry list of “self-care activities,” including exercise, meditation, ongoing psychodynamically-oriented therapy, better nutrition, nootropics such as NAC and L-theanine, a solid sleep routine, and body-focused somatic experiencing have helped calm this and other life traumas. Not a doctor’s prescription pad.

Returning to school to enter the mental health profession (both to learn more about my own challenges and to help others heal), I dove into the literature on psychotropic medications, prescribing and deprescribing, the etiology of “mental illness,” and psychosocial interventions that do not require the intervention of a psychiatrist. I weaned myself off two drugs with reasonable guidance from my new psychiatrist. Considering stopping the SSRI I had re-started after the panic attacks episode, I reviewed countless websites and dissected dozens of tapering anecdotes shared online. I spent months scouring the empirical literature on SSRI discontinuation and found little that mirrored the experiences I had read and discussed among my peers. I located exactly one published paper with a comprehensive and transparent review of the side effects of withdrawal from various SSRIs, including the one I was taking.

Over the course of a few appointments with my well-meaning psychiatrist, I listened politely as he talked about halving my antidepressant pills every couple of days and hoping for the best in my next psychotropic-cessation experiment. I ignored his recommendation, and with the support of my cat and my therapist, I laid out a seven-month taper plan and marked up a wall calendar in my bathroom noting which days to take which dosages. I took my last pill the morning of June 4, 2020, and started another day of teletherapy as an outpatient therapist with a taste of joy and a touch of dread. I know, however, that I’m not completely out of the woods. I suspect that seemingly random days of acute anxiety, a run of sleepless nights, and occasional brain zaps are my bodymind telling me I continue to heal.

My therapist said to me a few months ago, “You are your own psychiatrist” (for better or worse). I am more conversant with the latest literature on the medications I still take than my prescriber is (and I suspect he knows this, too). While I consider his opinion and clinical judgment, I no longer accept every word that comes out of his mouth as the Gospel truth. I also know that I am quite privileged to be a white male with a support system, financial means, and an educational background that helps me staunchly advocate for myself in the language of medicine.

Today, I take two mood stabilizers (down from six or seven medications at one point or another). I struggle with cognitive side effects: increasingly worrisome challenges with memory, verbal fluency, and cognitive dulling. My goal in the next year is to taper off one of these medications and possibly the second some months (or years) later. I’ll continue to make these changes under the medical supervision of my prescriber and the holistic supervision of my therapist and friends, but I will not allow myself to succumb to the psychotropic violence the discipline of psychiatry has inflicted upon me.

I wish that my story were unique. Sadly, it is not. I am comforted to know, however, that some psychiatrists – perhaps even colleagues on my unit – do grapple with the state of the discipline and earnestly attempt to understand survivors’ stories so they can do the work of healing and stamp out violence in the field. After all, the word psychiatry is rooted in Latin, loosely meaning “healing of the soul,” and I sincerely hope that the discipline undertakes the honest and humble work of healing its own soul before trying to heal mine.

 

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

41 COMMENTS

  1. I am going to prove to be that one child in class with personal hygeine issues that nobody wants to play with after I say this next bit…

    I found my withdrawal better when I realised for myself, and this is just my own experience, that my horrendous hourly, daily, monthly, yearly akathesia from a decade of antipsychotics, ceased the very day I quit!

    The quality of physical agitation from akasthesia, to me, is bodily different to the felt disruptive energy surges from wild hormone chaos that comes in a three month long tsunami after quitting drugs. It matters to make the distinction because without it, there is no quitting. If you think that getting off the drug will not wave goodbye to the worst aspect of the drug, akasthesia, you will feel demoralised by an apparent lack of healing. Let me see if I can describe the akasthesia I experienced on antipsychotics. It was an inner feeling of the sort of alarmed jolt you might feel if the floorboards had suddenly dropped, but that single jolt is joined by a never ending seamless succession of such jolts and they affect your “whole body”, not a separate part of it as if you are an onlooker to a disobediant part. Because your “whole body” is swept up in akasthesia it demands a “whole body” movement out of whatever position your body is in. So if you are sitting you have no choice but to rise out of your seat, and if the akasthesia settles upon your “whole body” when you are sranding, which it does, in a mere second, then you have no choice but to sit again…up….down….up….down…pacing forwards….pacing backwards….every….hour…of….your…short….mortal…existence…for….a…decade….

    The akasthesia is not in and of itself “anxiety” or “panic”, it is more bodily than the realm of emotions, though you can have a totally fed up feeling about suffering all day from it, just as you can feel that way about bodily pain. But how you feel “about” pain…is not bodily pain. I am not saying that if you feel something about pain then you dont have pain. Not saying that at all! You can have “both” going on simultaneously, and each is uniquely rotten and requiring stuff of you.
    Now after I quit, my akasthesia stopped. I felt FANTASTIC that it had. And it proved to me that the evil pills were the cause of the akasthesia and not me. Now a few days after quitting, the withdrawal syndome party rolled into town. This decked me off and on for months, with excruciating anxiety surges, manic highs even though I am schizophrenic, insomnia all night, hot skin, dry mouth, I am not going to bore anyone with the familiar details…but one thing I know for myself is this…I have been left with extraordinary bursts of restless leg syndrome. There is a link to this and Parkinson’s disease. And Parkinson’s disease is all about the dopamine. And antipsychotics are all about the dopamine. My restless leg syndrome has me up twice a night. It also shows up half an hour after eating or even drinking water. I suspect that whatever the nervous system does when one eats triggers a brain surge of whatever sets off the Parkinsonesque movement disorder restless leg syndrome. What this looks like is I cannot sit down. I have to stand and stroll about for twenty minutes until it all subsides, ostensibly by my digestion or hormonal gooshes settling down. Now if I were “anxious” and welded my “anxiety” onto my restless leg syndrome I might amplify both the anxiety and the restlessness. Luckily I no longer have any anxiety after quitting pills and getting through the long withdrawal phase. I can see the restless leg syndrome for what it is, long term damage in my brain from antipsychotics. But it is vital not to catastrophize that whilst coming off. This is because catastrophizing is what your delirious mixed up brain is trying to do with all the alarming readjustments it is trying to get on top of, and you really have to master your tendency to catastrophize all by yourself because achieving that goal is going to stengthen you and ensure you stay pill free.

    A person crushed under a concrete hotel after an earthquake knows two truths…
    1. What is going on right now is a disaster and I need to sort myself into a more comfortable position.
    2. In order to get through this disaster I have to acknowledge how awful it is but not indulge the urge for disaster mentality, and so I have to “ignore” that it’s a disaster, to plough through it.

    I am concerned that there is almost a vogue or crowd hysteria about using the word “akasthesia”, as if it is the sole benchmark word for suffering. But what this may do is….
    a. Let Big Pharma companies get away with the fact their actual drugs cause that effect. Rather than that effect of akasthesia lingering and seèm to be apparently stemming from something woolly, like wrong tapering or rough withdrawals.
    b. Make commonplace and therefore trivialize the harm that those who have had akasthesia from taking antipsychotics for many years may feel. If absolutely everyone gets akasthesia even a week after taking herbal night pills then the torture if it becomes a mere normalized whinge.
    c. If those on heavy psych drugs who experience akasthesia such they want to come off, if they think the akasthesia does not go away they may never bother trying to quit pills that might be making them feel suicidal.

    I am not saying that restless leg syndrome is not almost intolerable to live with, check out restless leg syndrome forums and you will find much desperation for a cure of it. And check out anxiety forums and you find the same. And let me say that the anxiety surges that come during withdrawals are so severe that it is a blessing that they are that bad, since the extreem nature of them alerts you to know that its neurochemical and not anything you are doing wrong. It is like the pain of moving a broken arm from under a collapsed hotel, at least you know you are heading in the right direction if you scream. I just say this not to minimize in any way your experience of anguish and utter torment. Withdrawals are dreadful. But life is so sweet after them. Restless leg syndrome can be lived with like a soldier lives with a war wound. Restless leg syndrome can affect the arms instead, and yes it can rarely affect the whole body but it is unusual. Along with it I have experienced tremor frequently. Especially at night. I think nothing of it anymore. I even enjoy its jaccuzi buzz. The after effects of a life on antipsychotics are many. So don’t think I am dismissive of the despicable damage they do. I am vehement that they should be stopped until a proper enquiry is done. I salute every courageous withdrawer who walks the path to freedom.

    • I should add that I have found the best thing for restless leg syndrome is standing for about twenty minutes, to reconfigure the circulation in my legs, that and walk about a bit, even indoors at two in the morning. Take no drugs for it. Not even herbal drugs. No miracle cures. The brain will be trying to heal slowly, slowly. Drugs prevent that ultimate mending. Have faith…

      • Hi Daiphanous,

        My good luck was that I was able to come off the drug causing Akathisia (LAI injection), and go on another tablet type Drug that didn’t cause Akathisia (and reduce this drug carefully over the years).

        I believe these researchers (below)..

        https://www.kcl.ac.uk/news/withdrawing-from-antipsychotics-an-analysis

        ..advise that it’s possible to reduce right down on Neuroleptics .

        I remember telling my Psychiatrist that my problem was, not only that I was incapable of functioning, but that I was incapable of watching my favourite program on television in a normal sitting position.

        I also had Acute Akathisia Episodes within which I could have easily killed myself.

        • Thank you, Fiachra. I think someone should research the Akathesia experienced on antipsychotics since I believe the hell of those sensations you mention, and I recognize also, are not the same buzzed sensatons people get in withdrawal, which can be equally horrendous at times. My akasthesia made me unable to read a chapter of a book. To read you need stillness. Unless you are one of those rare people who can miss lamposts in streets whilst striding and leafing through a nose-close novel.

  2. This is an interesting article; however, I need to say, like Officer Friday in the old Dragnet TV series, as far as psych drugs, don’t start, and if you have started, quit now. Honestly, although, I am no “expert”, I can see little to no difference between the “street drugs” many coming in to the country through “drug cartels” and the psych drugs prescribed by these psychiatrists, etc. Their offices may appear cleaner and the violence less violent and subdued, otherwise. . . That is why I suggest it is far better to get involved in a hobby, a sport, a nearby church, a class, etc. It is far better to feed the brain and mind with spirit or with ideas or with art, etc. Then you avoid what happened to the author of this article and what has happened to so many, many of those who have contributed to this site, other like-minded sites or still hide, probably in plain sight. The only way to save a nation, a world is to say no to drugs, because this is effectively one very effective way to renounce the devil and all his ways. And the devil is in the details of these drugs. I suspect that when the history of this time is written, much of the violence, unrest, suffering, etc., will likely be attributed to the usage of these drugs by vulnerable people who got conned by an army of humbugs. Thank you.

  3. Psychiatry, just like all “mental health work”, is a sickness. Look a little deeper and maybe you can find the “cure”. Excuse me, the “recovery”. “Recover” yourself from psychiatric profession disorder completely (some say “retire”), and we will all be better off.

  4. STAY AWAY FROM PSYCHIATRY

    I’ve been away from Psychiatry for a long time after nearly being killed several times in the process of leaving. My records (at Galway, Ireland, from the 1980s ) reflect near death experiences, with Medically Prescribed Abrupt Drug Withdrawal, and then success with my personal choice of a Slow Drug Taper:

    Kings College London 2020:-
    https://www.kcl.ac.uk/news/withdrawing-from-antipsychotics-an-analysis

    But theres a chunk of my Records Missing where I had discussed my reasons for requesting Drug Withdrawal i.e. the Psychiatric Drugs had been causing movement problems and disability – and my Psychiatrist had been blaming me for this.

    Robert Whitaker describes Neuroleptic Drug Withdrawal as potentially having a “High Anxiety” Effect, and he says that it can depend on how a person copes with this “High Anxiety” that can determine whether they Break Free from Psychiatry (or Not).

    I survived my Neuroleptic Drug Withdrawal through figuring out how my “High Anxiety” worked, and how to get around it. If I hadn’t figured this out, I wouldn’t have survived.

    Psychiatrist (and Healer) Dr David R Hawkins describes similar to what works below:-

    https://youtu.be/YWvIZ9Dcyb8

    [We know that at least 50% of ‘Schizophrenia’ is genuinely misdiagnosed, anyway]

    • I think that I have survived my withdrawal from all these psychiatric drugs (and I was on many drug cocktails for many years—pretty much from 1991-2013 minus about two or three years) because I did not know I was surviving. The drugs in their odd way stopped me, rather than I stopped them. My brain and body said in collaboration, it is either the drugs or us. I had no choice. Of course, there were a few psychiatrists who tried to keep me on a drug or two or three. Lithium was the last drug that became so toxic to me that I had to stop; however, the silly psychiatrist wouldn’t listen to me and continued to prescribe although I told her No. She wanted to protect me. I wanted to protect me, too, so I quit all these crazy drug-wielding psychiatrists for good. I mean not to be religious or evangelize, but, I chose Jesus over psychiatry. Perhaps, that is how I got saved, although the virus has severely curtailed any “church-going” or related activities. It may not be Jesus for someone else, and I don’t know about this “high anxiety” as described by the esteemed Robert Whitaker, I can say, if you are involved in psychiatry and related fields, especially as a “patient” but in all areas, get out now. It could save not only your life, but, someone else’s life, too. Thank you.

      • I think the person suffering has every right to identify their “problem” or “issues” however they would like to view them. My objection is when another person tries to take that right away by deciding for you what your “problem” is. It would be one thing if they are saying, “You have a brain tumor” or “Your blood pressure is higher than normal.” But instead, they are judging their clients/patients/whatever based on some set of arbitrary rules and pretending they know what they’re talking about.

        I respect YOUR views on your condition/situation WAY more than any “professional” who might come along and condescend to “diagnose” you!

        • I like your clarity of thought although I have for myself often wanted a diagnosis from other people. And people have been giving them since the first cave man trepanation. It is what people do! My mother diagnoses me as too emotional. My cousin diagnoses me as too willful. My old boss diagnosed me as too poetic. My friend diagnoses me as being too solemn. And quite frankly I like nothing more than diagnosing a
          menacing stranger up a dark alley as a nutter. And when I am upset I want my best buddy to magically diagnose my upset as something profound or heroic or stoic so that my upset can stop being dismissed by both my best buddy and myself. It is called wanting to be taken seriously. Upset people find ingeniously creative ways to achieve that to make yesterdays upset seem nothing like the scale and magnitude of todays upset. Manipulation to get help is a survival skill we all like to think we never use on other people, but not one person on the planet does not communicate sometimes in manipulative ways to secure support. Even beta wolves do it when they go limp and submissive and lie as flat as a charming doormat to an alpha wolf. The cry of “feed me” “feed me” is esential to look after your bodily self. In humans that cry may sound like “tell me what is wrong with me?”. I am not saying all this is a goodthing or a badthing…it is just the way life pans out. Humans want what other people “think” of them. Even lovers do it. So the wish for diagnosis, which is a “thinking of me thing” is understandable. It is not about a pathological wish to seem “special”, though a jealous or almost narcissistic bully will always want to tell someone that their “special” way of merely wanting to feel special is a big problem for “the world”. Anyway the tendency to want to diagnose villains up dark alleys is understandable, as a mode of survival. For these reasons I do not think society will ever get rid of the phenomenon of the diagnosis or label. Here come a batch of new ones in HiTOPs and Power Threat Meaning Framework. So my interest is less in the direction of mulling over the legitimacy of fussy little diagnosises and more in the direction of pinpointing why a bland diagnosis, or indeed anything at all, may become a slur or a mechanism for bullying. But the diagnosis itself is not the same thing as the bullying that may come under it or over it or around it. Todays darling diagnosis is tomorrows deviant diagnosis. And the reverse is true. Bulima as a diagnosis was almost once an aisle to be a long suffering Diana Princess, everyone felt fine to have that princess diagnosis, but suddenly with so many people saying they had it, it got mocked as being an attention seeking whinging diagnosis. It was still the same diagnosis but adoraton turned to bullying, which crept in under the diagnosis. Bullying will creep in under ANY word, Jew, Black, White, Gay, Woman, whether it is a diagnosis or not. I feel that if society is to end bullying it should look more at what causes it, not what bullying weaponizes, which could be anything from the missile of a classroom eraser to this week’s slur word. Describing the weapons or words of bullying is the waste of time simple bit, describing why bullies feel an underlying need to ostracize another human being is the hard bit, and my guess is it is hard because in doing so you have to have a deeper understanding of human motives and human imbalances and where these come from…and doing that inevitably leads to realizing that most bullies are deeply wounded inside…and this makes maintaining an “us and them” stance against the wounded bully very awkward. And…sigh….humans like to do the “us and them”. And often they will do an “us and them” against the “us and them” of the wounded bully, which gets the world drowning in “us and them”, which probably exacerbates the rather ordinary seeking and bestowal of diagnosis, and may even ramp it up because all the millions of “thems” who are shouting at the millions of other “thems” become menacing figures up a dark alley who should be given a snooty or academic or political diagnosis.

          Not saying this to play the I have the answer game. I cannot stand that fucking game. Nor to critique or nitpick you fine clarity. More that I have felt cheered and welcomed and enabled by your consistent polite restraint and measured tone to just whisper my Alice in Wonderland dozy doormouse tea party mumble.

          • Bullying is, indeed, the more fundamental problem. Psych labels are merely the bully’s tools.

            I appreciate your clarity about why you wanted a “diagnosis.” I’m sure your feeling is shared by many, that lacking a “diagnosis” means you are not taken seriously. But I would toss out the question: why in our society is it necessary to have a “diagnosis” to be taken seriously? Maybe that is a problem even more fundamental than bullying itself!

        • This is reasonable, Steve.

          Of course, if that word ‘schizophrenia’ had never been introduced to the diagnostic lexicon, I wonder what others ways individuals might come up with to describe their experiences that were less destructive. And I wonder if we didn’t have a cultural concept of these experiences being “out of control” or “tormenting” if they would instead present and be perceived more as creative coping or guiding presences. I think it’s next to impossible to extract the cultural influences of such phenomena from our experiences of them and that conflicts with creating meaning out of them. It’s a chicken and egg kind of thing.

          • I agree absolutely. The word has been “polluted” by the cultural context surrounding it, at least for me. It is associated in our culture with violence, destructiveness, lack of value, and shame. It is interesting that in other cultures in which “voice hearing” is more accepted, “Voice hearers'” voices are actually more positive and helpful. How we choose to view phenomena and how we choose to name them has power. At a minimum, that power should not be usurped by the “professionals,” but I’m afraid most of these labels have already been appropriated culturally to the point that their personal meaning is difficult to untangle from their cultural meaning.

  5. my best guess (?) is that ‘patients’ who come in with sufficient leverage (education, social class, overall clout…probably helps to be male, heterosexual, and white…) can ‘haggle’ with the shrinks. before I managed to get over it (and get over myself, to be perfectly honest), I was able to haggle. To my credit, I wasn’t haggling for anything amazing or euphoric, just…fewer drugs, lower doses, less toxic pills. ok. that’s where I was, not too long ago, so…I sort of ‘get’ your position, to a certain extent. and yet…

    personally…where I am now…I don’t want to ‘haggle’ or ‘be my own psychiatrist’ any more than I want to cooperate in any other form of oppression, slavery (Szasz), or slow-motion (self) destruction. over it, thanks.

  6. Why do you need a diagnosis to be taken seriously? It is a fascinating question.

    Why do you need tears to have your sorrow taken seriously?

    Walk down a street and just say you are sad, when you feel like ending your life, but dont show tears and of the few who might ask you why you are saying you are sad, maybe one will sit ten minutes with you and try to help you by cheering you up or cracking a joke, but you feel suicidal and you show no tears, no outward signs to help them take seriously that you are way way more than just sad. They may be busy or suffering gastric reflux or needing the bathroom and they have to “take seriously” their own need, and so in assessing and judging your sadness comes a “prioritizing” of either their need over yours or your need over theirs, and they will check to see if your need seems urgent and outward signs will help them reach that. So you may want to let those tears flow and you may want to “give them more words” to give them some comprehension of the craziness going on in you and your suiciadal notion. You can tell them all about your weird uncle and all about your not getting into the school you wanted to and all about the loss of your great aunt Mary Jane and on and on and on, hours and hours of details that will make the passerby helping you feel faint with hunger and late for work and bursting for the bathroom and quite possibly loathe you for making them feel so stressed they now feel suicidal, which is something you dont want on your guilt record or it will make you suicide quicker, and they dont want to burden you with their now feeling suicidal or it might make them follow suit in a double suicide. A word for your anguish is a necessary shortcut. It gets accross the gist. And to be honest for many people it shuts up the helper from their saying something trivial or even assuming they “know all about your sort of grief”. What you may want is compassion and help but it may be a specific kind of response that takes into account your hallucinations. If you just say you are hallucinating your helper may wonder if you are
    on LSD or have post natal psychosis with a dead newborn in your handbag.

    But like I maybe said somewhere else, my free choice to use the term schizophrenia is not for one reason but many, the biggest being it helps me cope with my hell to call it that word.

    Look, I am 100% in agreement about giving people actual informed consent about all psychiatric drugs if they choose to try them, personally I think all the globes pdychistric pharma drugs should be buried under a Chernobyl lid of concrete so they cannot be used on anyone, but I am not you or you or you or you. I see you are all great people in here, people of heart and passion. People determined to make life better for millions by helping them feel less shame about whoever they are. I just feel that lots of movements at the moment are a bit like the Women’s Rights Movement when it got taken over by radical feminists who would not tolerate any woman who did not grow their armpit hair.

    Schizophrenia is my shaved armpits.

    • Beware: If you take these psych drugs long enough, you will probably lose your armpit hair and other hair that women in the States usually shave. As far as a diagnosis, all doctors, even the very extremely questionable, i.e. psychiatrists want to use the terminology surrounding “diagnosis.” It, I guess helps to simplify things for them. However, I, think, the concepts of “diagnosis” and “diagnostics” actually should only apply to robotics, computers, vehicles, airplanes, et. These two words, “diagnosis” and “diagnostics” should never apply to any living thing, i.e. breathing, etc. especially human beings, etc. All creatures, great and small, including plants, need not “diagnostics.” They need Love, which is the anthesis of “diagnosis and diagnostics.” Thank you.

      • Hmm.

        My sister was “diagnosed” with terminal ovarian cancer. My father was “diagnosed” with terminal brain tumour. My cousin was “diagnosed” with terminal breast cancer. All dead now. Not that nowadays I believe in death. In my teens I have been “diagnosed” with suicidality. If I were living in the year 1670 I might have been “diagnosed” with melancholia, or “diagnosed” with a broken heart, or if my brain zaps were occurring in the medieval epoch by a monastic herb smelling apothecary I might be “diagnosed” as having falling down sickness.

        I just do not see how “diagnosis” of a tumour is not a loving thing.

        You can cite a million examples of where some shit has used a person’s diagnosis to humiliate them.

        But then I suppose if I wanted to go down that track….I can likewise tell you of a million moms and dads who hate their kids. I can also tell you of several billion parents who love their kids. Do the millions who do not love their kids mean we all have to get rid of all moms and dads the world over and the “way” they love, because the sitty moms and dads do not know how to love?

        Would love to continue this debate just now but I have a letter to write.

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