Thursday, February 9, 2023

Comments by bron76

Showing 29 of 29 comments.

  • I think the suffering from Depression and BPD can be quite real. However, the medical model can do nothing much for these conditions and often changes in their own behaviour and education will be helpful. I would assume this is why such therapies such as DBT can be effective because for the most part it is teaching people how to relate to each other and how to manage overwhelming emotions

  • Consider the diagnosis of Bipolar Disorder or Borderline Personality Disorder. One of the key symptoms is the extreme mood swings but yet it is very difficult to tell the difference between a mood swing of Borderline PD or Bipolar Disorder. The treatment is very different. Bipolar is mainly treated with medication for the purposes of mood stabilisation (I think the main class of drugs is anti-psychotics). Borderline Personality Disorder is mainly considered untreatable or it is treated with psychotherapy.

    Borderline Personality Disorder is the most hated disorder amongst Mental Health professionals to the extent that many will avoid persons with the diagnosis like the plague. So they are less likely to be medicated and they are likely to have less interactions with the mental health profession. It is also known that at least partial remission is available for BPD sufferers regardless of treatment and with counsellling many will go into full remission and no longer qualify for the diagnosis. Bipolar disorder on the other hand is a highly disabling and many will not be able to enter the workplace or have any occupational success.

    Could it be that the diagnosis of Borderline Personality Disorder is a blessing in disguise, that is an insurance policy against harmful interactions with the mental health profession and psychiatric drugs? as I understand most Bipolar sufferers I know are on disbaility, and yet the BPD sufferers with similar set of symptoms go out and work and for the most part achieve some success. Does BPD (despite the chronic suicidality) mitigate sufferers from the risk of harm from the mental health system due to the fact the mental health system refuses to listen to them

  • The problem is that words used to often lose meaning or people become cynical

    I keep thinking of a dictionary of mental terms

    To identify those who interact with the system
    Patient – totally appropriate when the person is dealing with a doctor or nurse
    Client – totally appropriate for allied health professions
    Service user – for those who attend recreation of psycho education programs
    consumers – only appropriate when you eat chocolate cake. This is the one I would like to see eliminated

  • It still may not be in your genes. It may be a social issue. For example a child may learn to be anxious from a mentally ill parent, they may learn to abuse substances from their parents.

    Dbt therapy teaches that borderline personality disorder is a result of biology plus environmental factors.

  • Well in a biblical sense man was created in the image of God and in a Christian sense this is what make mankind different from the animals. This would be the Christian explanation for the origins of free will. However knowing people who inhabit mental health often have a pathological hatred of Christianity I would note that other religions also have explanations of free will

  • I did take them a few times. But fortunately it was only a low dose and they didn’t prescribe them for post discharge and I was in there for less then 2 weeks

    I went in there after deliberate self injury and I was discharged feeling extremely suicidal. I think it was partly due to the drug exposure and partly to the bitch nurses exposure. Fortunately no prescription afterward and I had a gp who
    doesn’t believe in benzos.

    Lastly, they were considering a diagnosis of borderline personality disorder a condition for which there is no agreed on medication protocol.

    I think there are certain advantages of a bpd diagnosis. It is a stigmatised diagnosis amongst mental health professionals so they don’t want to deal with you. It is also seen as a diagnosis where hospitalisation is not recommended. (Or it is to be as short as possible) it is a condition that many cry baby mental health professionals won’t deal with

  • I have type 2 diabetes and are on metformin. What I know is managing my blood sugars definitely helps with my mental health

    I also have obstructive sleep apnoea I know a CPAP machine helps my sleep and helps my mental health

    What I know is that when I was in hospital they offered drugs which increased blood sugars and worsened the sleep apnoea so I was doing wacky stuff such as stealing cutlery. I remember the stealing blankets blog and was wondering was the next step the dining set

  • Dementia, as shown as deterioration on a MRI. Now we know that many try and pass off schizophrenia as a brain disease by brain damage caused by anti psychotics as disease process

    Consider a brain tumour … it is obvious it is there and the abnormal tissue growth affect brain function which includes behaviour

  • Yes. Not only have the ability to identity what you would like to do, but also have the means to implement it.

    1. Consider the case of advanced dementia (that is a real brain disease) … as time progresses you lose your memory, ability to problem solve and so on. As a consequence you lose your free will

    2. Consider an involuntary mental health patient. They have the cognitive ability to make decisions but they may not have the freedom to do so. I know a couple of people on outpatient commitment who must submit to an injection of long acting anti psychotics, but yet if they refuse the police will come to their home and take them to hospital. So their free will has been limited. While they have a right of review this may not get them the result they want

  • I would agree, that those who are on disability payments for mental health issues should not be tarred with the same brush as those who choose to profit massively from the mental health industry. Often the label of a mental health condition comes with some dire pronouncements about their work capacity.

    Personally I find MH professionals tend to veer towards one of two extremes about assessing a persons long term work capacity
    1) Either they believe they have no capacity
    2) Or they need to pressure the patient/client to push themselves to the limit

    I don’t think either view is useful for me. View 1 is insulting, View 2 might put me in the hospital

  • As far as the clubhouse goes. I think a well managed clubhouse would be beneficial. I am defining it as a social group facility which is entirely non clinical. The problem with this is that if you don’t get money from the government where do you get it from. Most of those with mental health problems cannot afford to pay very much at all.

  • A number of my friends are teachers and work with young kids with EDs because they are in their classes. Peer support is a great concept, but not when it becomes merely about telling war stories about psychiatric system

    Eating disorders can be deadly but I wonder if part of the danger comes from the unrelenting nastiness that eating disorder patients are subjected to while in hospital.

  • oldhead, you obviously don’t understand the link between starvation and death or you have never had a 30kg girl tell you that they are too fat. A teacher friend of mine said they had to spend a month or so breaking up a group of young girls because they were encouraging each other to starve. It was only detected when one of the girls had a heart attack and nearly died

    You seem to have this hippie notion that all citizen-organised supports are beneficial and this is incorrect.

  • I was in an inpatient unit less then 3 years old last year. They served food from a cafeteria window. It was of reasonable quality and there was a regular supply of fresh fruit and veg. This is a public hospital and I wasn’t charged a cent for my stay

    While the most of the staff were pretty good, there were a few staff I didn’t like. Some of the nurses were pretty hysterical when it came to dealing with self harm, they don’t understand the idea of stopping self harm is never about locking people away or creating physical barriers.

  • When I was in hospital for self harm the nurses thought it was a great idea to lock my bathroom at night which was very inconvenient when I had a vicious case of gastro. One of the nurses thought my issues were mental health related and tried to feed me anti psychotics (despite the fact I didn’t have a psychotic disorder). Then told me off and told me I needed to wait for the day staff to come in before I could access the toilet again. This happened at 4am and day staff start at 7am thus a 3 hour wait. I became so agitated that I smashed a ceramic plate in the shower a few nights later. I got told off by the psychiatrist for being will full. Apparently I needed to be confronted. I bet that evil nurse never got confronted about her nasty behaviour. It wasn’t just that episode, she was just a judgemental cow.

    As far as ED support group goes, the problem with informal groups is that they could promote unhealthy behaviour and perhaps having a older peer or a team of peers + a psychologist could ensure the relationships keep on the right track. Because they don’t provide any facilitation of peer support it goes underground.

  • Peer workers over here tend not to be terribly distinguishable from ordinary mental health workers. Some of the basic roles they need to fulfill are

    1) Group facilitator
    Subject matter experts who also have an engaging communication style should be considered the gold standard.This would include experience in delivering to those with MH issues. Someone with a professional cooking background will always do a cooking group better then someone with mental health training only.

    2) One on One
    It is the quality of wisdom that people need. Peer workers need to have insight into the limits of their knowledge. I think they need to be trained in the following things

    1. Common Psychiatric Diagnosis

    Consider the diagnosis of Borderline Personality Disorder. I recall a manager of a mental health day service near where I live express sadness that people with PD’s are condemned to a miserable life as there is no way of improving their condition. Would I recommend that service to someone with BPD! No! It is not healthy for people with BPD to be anywhere near any worker who would rob them of hope.

    Peer workers need to have insight into what the symptoms are of the most common mental health diagnosis and also related treatments. Back to BPD medication is so often not recommended, but a peer worker who has schizophrenia might be wondering.

    2. The workings of the mental health system. That is how does someone get admitted to hospital either voluntarily or involuntarily. Forced outpatient treatment. Mental health patient rights

    3. Peer workers who work in the community need to know what the local hospital inpatient ward looks like and vice versa

  • Most of the peer worker roles advertised in the city I live in require a drivers license, a certificate qualification at least, and practical experiences. There is little differentiation between a mental health worker who doesn’t have lived experience and those who do.

    Here are my concerns about the peer workforce.

    1) There is no vetting of a person’s experience. I would assume that if you identify as having a lived experience in mental illness no one will challenge your experience. I live in a big city and occassionally you see news of people trying to pass themselves off as veterans, telling porkies on resume. It is not a far stretch for someone to get a peer worker role without having a genuine lived experience.

    2) The type of lived experience. The lived experience of someone with mere depression is much different to someone with schizophrenia, bipolar or other very severe psychotic illness. The type of experience that someone with a personality disorder, post natal depression, an eating disorder or PTSD is also a very diverse experience.

    My friend with schizophrenia has yelled at me for not taking drugs, partly because it was her experience that drugs managed the schizophrenia and helped the associated depression. She thought I was being irresponsible for not taking anti depressants. I told her she was out of line. I never criticise her for her choice in treated. Another observation is that many people who are on anti-psychotics express envy to those mental health patient not on drugs. When I was in the in patient ward last year a fellow patient wanted to know how I could do art in the context of the side effects from the medication (noting the tremors), then she remembered I didn’t take those drugs!

    The other point of diversity is the social background. The upper middle class bipolar patient probably has little to offer the person who has come from a deprived background. The tea totaller would have trouble relating to the patient with the dual diagnosis of drug and alcohol problems and the resulting mental health problems.

    3) Identification of potential Peer Mental Health Workers

    Organisations would be better identifying service users who have the potential to be peer workers and train them up. Ask them to look for potentially great people in dark places Often those with mental health issues don’t come from neat backgrounds. It is a shame that there is exclusion criteria such as education or a lack of a license will stop many people with excellent potential to be peer workers due to the rigidity of the environment. I would also exclude those with prior community services experience being hired as peer workers as you cannot distinguish between their professional background and lived experience (but of course they should be welcome to apply for the positions their professional background qualifies them for)

    4) Mental Health services tend to love blind compliance

    I always wonder to the services contribute to psychosocial disability by insisting on mind numbing compliance. I always wonder that the only people identified as potential volunteers are the completely obedient and when the hell raisers are often exited or dismissed as having no potential and they are the people who probably have the most potential.

    You are not going to attract the best people to peer roles if it is about blind compliance.

  • In the Ward I was in, it was split into High Dependency Unit(HDU) and Acute Care with the more violent people going to the HDU. It did follow Wilberforce’s model. I smashed a plate in the shower and they threatened me with a trip to HD and made out that HDU is the equivalent of walking head first into Armageddon. They forgot I lived in public housing, 20 steps away from a drug dealer so there is nothing much that scares me anymore.

  • I was admitted to the local hospital mental health unit in herein Australia in late 2017. One of the other patients asked if she could photocopy some of my art. I thought that was kind of cool. Mental health is located in a standalone building and the actual ward was on level 3.

    The funniest thing was the smoking policy. The ward inside and outside in the garden is completely smoke-free, but yet you will always find dozens of cigarette butts in the garden. The door to the garden is made of glass so you can see a nurse coming from a mile away. The smokers on the ward generally run a swat style operation where one smoker acts as the lookout while the others smoke while hiding behind one of the gardens. This is a fine achievement that should be applauded as these people have overcome the effects of the medication they have been given

    BTW I don’t smoke and I hate the smell of smoke as it makes me sneeze a lot.