Dave's Progress. Chapter 79: Understanding What Happens.

I am writing this post in response to a comment left on my last blog by "corfubob". He stated, "people do not readily believe anything can go wrong with the mind, even in some cases when it happens to them. 'It's all in the mind', others say, meaning 'not real'... Help us all understand what happens".
For some reason this comment resonated with me. I hope that this blog has gone some way to explicating what happens when things somehow "go wrong" with the mind, but I would still like to give some explanation of what I know about such illnesses.
Perhaps it will be better if I stick to my own condition, namely schizophrenia, as I am certainly not an expert on all mental health conditions and have done most research in to my own illness.
As far as I know, most mental health conditions are either "reactive", meaning that they occur due to the impact of some trauma or event, or "endogenous", meaning that they simply come out of the blue, for no apparent reason.
In my own case, I at first believed that my condition was "endogenous", that it had hit me somehow out of left field, and it began with a quite severe episode of depression, which, also, was the first diagnosis I received. Depression involves a feeling of low mood, of inadequacy, low self-esteem, guilt and lack of hope. Often one can be so debilitated that even getting out of bed in the morning becomes a difficult task. In severe cases people can lose a significant amount of weight, become unmotivated, tired and listless and can even develop a depressive psychosis, where their feelings of negativity become so overwhelming that a delusional framework begins to be formed which is apposite to their thinking.
The stigma which surrounds depression, then, is often to do with the fact that it is not taken seriously enough, is regarded as merely "having a bad day" or is often met with the hugely annoying line, "well, we all get depressed sometimes". But the gap between depression as it is experienced in day to day life and as it is experienced as an illness is huge. Indeed, they are far from the same thing. So much so that the writer William Styron, when describing his own depression in his book, "Darkness Visible", suggested that the name of depressive illness should be changed to a "truly arresting designation" which fully captures the true extent of the debilitation that the illness causes.
Indeed, when I first got ill, it was as if people, including those closest to me, mistook this awful disease for a mere attack of teenage angst or worse, laziness. Blame may have been laid where none should have been. As I myself did not really understand what was happening, it was extremely difficult to articulate what was going on to my loved ones, as even, by then, the mere act of talking seemed to be difficult.
However, as my illness progressed, it seemed evident to me that this was not simply depression I was suffering from. It was as if my feelings of depression were eventually replaced by, not a low mood, but rather a dulling of the senses, an incapability to experience either great joy or great sadness. This feeling of "nothingness" I later came to know as "anhedonia", and it is one of the negative symptoms of schizophrenia, one which I have written about in this blog.
So, as I had suspected, there was more to my illness than depression, but again, such symptoms can be and were mistaken for a mere attack of teenage angst. I should say here that in most instances, with this type of schizophrenia, for there are many different "types", the initial break-down usually comes in the late teens or early twenties.
Indeed, as I have thought about it and as my illness progressed later in to a delusional and hallucinatory psychosis, I have come to see that perhaps my illness was more to do with an initial trauma than I had first thought. The wrench of leaving home for university, the loss of close friends and girlfriend, who also had a termination at that time, all, I believe, now, added to the stress and pressure I was under, eventually leading me in to a, what is called in mental health practice, severe and enduring mental health condition. I have come to think that my seeming initial emotional numbness to these events and inability to articulate my feelings over them did not mean that I had no feelings, but rather meant that all my grief, loss and anger at these situations found its expression in my demise in to insanity. I feel I have now emerged, cleansed, purged of those deep and hurtful feelings.
Although notions about what causes schizophrenia are a seeming hot-bed of debate, there now seems to be a general movement in new thinking about the illness which sees the role of trauma or some emotional upheaval as central to the experience of the condition. Professor Marius Romme, for example, a leading light in the CASL (campaign for the abolition of the schizophrenia label) campaign, has suggested that the "new name" for schizophrenia should be "post-traumatic psychosis", as he sees that it is invariably some traumatic event or deep hurt which lies at the root of the disease. While others remain more open about notions of causality, this seems far from the medical model currently practiced by most psychiatrists, where schizophrenia is seen as an illness of the brain, a chemical imbalance which should and can be put right with medication, with questions of emotional upheaval being put most definitely on the back-burner.
Although many see that medication has a definite role to play in someone's recovery, and indeed, I myself would not deny that medication has its part to play, although as I have often said in this blog I resent its often disturbing side-effects, this new thinking has opened up new ideas as to how the illness can be treated. For example, some have actually, instead of treating the psychosis aspect of the disease, concentrated on the trauma side, with, according to fellow member of the CASL campaign Paul Hammersley, some good results.
So, as my own understanding of schizophrenia has grown, I have begun to feel that it was some trauma in my past which led to my own illness. Everyone's experience of such things, however, it must be remembered, is very individual to them. There are, after all, around eleven types of schizophrenia listed in the diagnostic manual. I can only give my own thoughts on "what goes wrong" when mental illness strikes. Perhaps I should say here, then, that it is not, as many believe, some sort of character flaw or personal weakness which leads to such things, but often deep and harrowing experiences which are somehow not articulated at the time.
I hope, then, that in its own small way, this post has helped some of you "understand what happens" when things go wrong. Without wishing to sound foreboding, it can happen to anyone, and this should, I think, evoke something like understanding in any right-thinking mind, rather than the stigma which continues to be perhaps as much of a problem as mental illness itself.
That's all for now from your normal, average delusional and paranoid man.


bazza said…
Thanks for this insight David. Having seen from very close range the effects of a 'nervous breakdown' on a family member I find this post illuminating.
This person is now completely off medication but seems to have undegone a personality change.
He is 'fixed' at an earlier age and is rather paranoid but otherwise OK. Does that sound familiar to you?
David said…
Dear bazza,
Glad that this post was useful in some way to you.
I feel that terms like "nervous breakdown" are often polite euphemisms for more stigmatising labels like, of course, schizophrenia. I do not see anything wrong with this, but it would be useful to know what the medical diagnosis of your family member is in order to pass any judgement.
As far as I know, mental illness can induce personality changes in more severe cases. I felt this happened with myself and I told psyschiatrists about it and they confirmed that it can happen.
However, overall, the situation of your family member does not really sound that familiar to me. I have not really known anyone who has become "fixed" at an earlier age.
Indeed, although I hope all the information I print in this blog is accurate, it is from my own perspective, and I feel people should always seek "expert" advice should they have problems of their own.
Hope I have been of some help, though, bazza, and thank you for your comment.
Also, I feel somewhat remiss in not recently commenting on your own blog, so I shall definitely surf over soon!
With Very Best Wishes,
珍盈洪 said…
klahanie said…
Dear David,
My sincere apologies for not responding sooner. I know you have been anxiously awaiting my comment. So it is indeed, better late than never.
Once again an insightful and rather lengthy posting.
I wont go into some drawn out comment about the 'nature, nurture' debate. I can relate to much of what you have noted from my own perspective. My own situation seems to have a direct bearing on traumatic and overwhelming negative influences that sabotaged my own mental health well being. As you know, I too, have alluded to the fact that many folks believe that mental illness could never happen to them.
Sadly, it sometimes takes a person to become mentally ill to realise that the stigma surrounding mental health, is an unfair stigma that must be eliminated.
I hope that your posting brings further awareness to those who are experiencing mental health problems or just wish to learn more.
Thank you for this, David.
With kind wishes, Gary.
dcrelief said…
Dear David,
Thank you for inspiration to explore my own issues, to reach a healthy path.
In peace,
David said…
Dear Gary,
Thanks as ever for your support and comments.
I can only hope that this blog goes some way to raising awareness of mental ill health and the unfair stigma which surrounds it, a cause I know you are equally dedicated to.
Thanks once again,
David said…
Dear dc,
Great to hear from you again and I am very glad that my blog inspires you to "reach a healthy path".
I shall be over to comment on your blog soon.
Thank you and with Very Best Wishes,
家唐銘 said…

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