urocyon: Grey fox crossing a stream (Default)
I got a pretty bad PTSD attack, finally replying to a comment on the epilepsy post, and thought I would write a little about it.

I've talked about the medical PTSD before, but this might help illustrate how that kind of thing can happen. A few days ago, rather coincidentally when I was thinking about needing to see the GP to try to get my blood sugar managed better and try to get a neurologist referral, I ran across the NAS Patients with autism spectrum disorders: information for health professionals sheet, which I hadn't seen before. I really, really wished that (a) it had been around when I was little, and (b) somebody had known it applied to me.

It also struck me pretty hard again that I've tended to keep feeling embarrassed and not wanting to discuss this kind of thing, but there is no good reason that someone should be ashamed of having run into problems from un/misdiagnosed autism.

May be triggering, with medical settings and some violence )

Yeah, that was a rather extreme example, but in the back of my mind, I am still half-expecting to get treated that way.

Reading the NAS info sheet, I couldn't help but get a little more hopeful, though. At least now I do know why I behaved so "inexplicably" in overloading settings in the past, and that I did not somehow deserve shitty treatment because I'm autistic. At least with most of my mind, I'm no longer ashamed and as likely to let other people run right over me. I no longer feel crazy for getting overloaded, now that I know what's happening. And I am less inclined to let other people treat me like they think crazy people should be treated.

And I have someone who is willing to back me up--and whom I trust to do so, without deciding they know what is really good for me. Now I have a better idea of what kind of help I need from someone who goes with me to the doctor's, and can discuss what might work to keep me from getting so overloaded that I shut down and can't half remember why I'm there, much less communicate properly, in the first place. (This has been a persistent problem in past.) And I trust him not to take over with his own agenda if that should happen, and act like I have no right to complain. Hopefully, with backup, I'll be less likely to get talked down to and dismissed--or assumed to be batshit crazy--because I am not communicating the way they expect. Much less worrying about getting sectioned if I do end up having some kind of meltdown. (Also, I have Asperger's and not bipolar with psychotic features in my file now; shame this probably does make a practical difference.)

Hopefully, having backup will make the expected (if not exactly appropriate) browbeating over not having been to see the GP in years now easier to deal with. It doesn't exactly help one feel secure and comfortable talking to the doctor, getting treated like some kind of naughty child. And in past I haven't been able to say anything much, never mind object to getting talked to that way for any reason, much less because of disabilities.

Very importantly, I know that I do have the right to leave at any point, whether or not I'm able to explain myself verbally at the time. And, having actually discussed it with Ingvar, he's prepared to call the cops if anybody lays their hands on me to try to stop me. Funny how the NHS zero tolerance BS is actually described as "Policy on violent or abusive patients":
We operate the NHS Zero Tolerance Policy to safeguard staff and patient welfare. Our Team shall always show due respect and courtesy when dealing with Patients. In turn, we would request Patients to reciprocate the same. No form of aggression, verbal or physical in nature would be tolerated and may result in Patient removal and being reported to the Police.

I guess they'll call the cops if they assault you. I have already been impressed by what kind of respect and courtesy some of their staff have considered "due". Maybe you just get arrested if you reciprocate? *snort*

ETA: I do know of a couple of cases, involving people I knew back in Virginia, where similar policies were actually used against them. Including one middle-aged man who got an assault and battery conviction because he kicked a staff member who was manhandling him around and trying to strap him down in restraints because he was "argumentative". (As would most people not diagnosed with a mental illness, I imagine--turn argumentative, too, under the circumstances!) And it apparently did not make any difference to his legal culpability that he was on a 72-hour hold (in the same state hospital I was afraid of winding up in), because of a manic episode, at the time. Nor that Virginia's whole state hospital system was at that time under federal investigation for abusive and punitive use of restraints that killed people. (Including one woman who died "after lying in restraints for 300 hours, including two stretches of nearly 110 hours straight, as punishment for outbursts against staff", after they had been warned that she had health problems that might kill her if restrained.)

So I am not just being sarky here; it's a very real problem. /ETA

But, just knowing these things makes me feel less helpless and like I do have some control over what happens. As anyone should have. Maybe that will be enough to get me to the GP's for more diabetes medication.
urocyon: Grey fox crossing a stream (Default)
[personal profile] greenknight pointed out two interesting posts earlier, and I thought I'd pass them both along. One, How to keep someone with you forever, from [livejournal.com profile] issendai, talks about the characteristics of sick systems in both personal relationships and organizations. I couldn't help but be reminded of a couple of pieces casting the federal government (BIA in particular) in the role of abusive partner. Controlling and abusive tactics look pretty similar across the board. :-|

The second is [personal profile] rachelmanija's response to Robin Hobb/Megan Lindholm's recent article on mental illness and the "artistic temperament", This Is Your Brain On Drugs....

The hell of it is, both made some reasonable points.

Some personal experience )

The most important thing, IMO? Recognizing that the person is running into problems, and working with them to try to figure out what will help them cope better, in a non-judgmental manner. (This may well include medication(s), BTW.) There is no magical fix, and it really doesn't help to frame the situation in terms of fixing someone else. If what you are doing is not improving the situation, it's time to reconsider how (and why) you are "helping"--and try a different approach to working with the person until you find something that does work.

The biggest overall problem, AFAICT? Universalism, to the exclusion of pragmatic approaches to helping people lead better lives (where "better" is whatever makes that particular person happier and healthier). As I described it elsewhere:
The source of the difference--neurodiversity or culture--doesn't even matter, from a universalist standpoint:
Here’s what I mean: if I have a universalist orientation, that fact alone can make me insensitive to cultural difference. If I’m universalist, I will tend to believe there’s one set of principles to live by — everywhere in the world. That is a stance that undermines what intercultural sensitivity is all about.

This shows up all over the world when universalists are present. Think of imperialism and colonialism: it’s no accident that the main perpetrators have been nations with largely universalist orientations.

Universalists can be slow to see a need for intercultural consulting, coaching and training. What value could these services possibly add, if things are the same the world over? Or, in a weaker version: if everyone in the world wants the same things?

If everyone is assumed to be perceiving things in the same way, reacting to them in the same manner, expressing the resulting (same) emotions in the same way, while motivated by the same considerations in any given situation--any deviation from the expected pattern may well be interpreted as a sign of poor mental health. This has happened to me, and to family and friends.

Especially in the US these days, the response to a perception of mental illness is frequently to medicate the person, without really trying to find out what is going on. Nor what coping skills and/or support might help them live the kinds of lives they want. Situational distress is sometimes assumed to be a lifelong, biologically-based mental illness, though the symptoms may go away when the person's stressful circumstances change and/or they learn some better ways of coping with what's going on in their lives. (Of course, people who really do fit criteria for mental illnesses also benefit greatly from this!) A medicalized, universalist approach to human diversity seems to be what Robin Hobb/Megan Lindholm is protesting--and taking it way too far in another display of insulting universalism.

Everyone is different. Every situation is different. It's important to bear this in mind. The "oh, that's just how s/he is" approach, while very useful up to a point, can be taken to the point of the absurd (as in common usage of the "artistic temperament" idea). When has it gone too far? When you are more interested in cramming someone else into the "artistic temperament" (or similar) model than in paying attention to what very difficulties the real human being in front of you may be experiencing. If you can't do things like make sure your bills are paid on time, that's a problem, right there--and it can be worked around and/or some kind of support put in place.*** It's just the flip side of the "you can't do X and Y because you're mentally ill" coin. Binary, universalist thinking trumps actually helping the person, in either case. It's dishonest and disrespectful, besides just not being useful.

Which brings me right back around to the themes of balance and pragmatism, honesty and respect, and pretty much all the rest of the stuff I talked about in Happiness, Part 4: Seeing beauty. What has helped me the most is working on figuring out what I really want and how my brain works, doing away with a lot of the universalist "shoulds"--and working with that to find strategies that help me do what I want/need to do.

Obligatory notes ;) )
urocyon: Grey fox crossing a stream (Default)
I can't quite figure out how the tags are broken. This looks OK on full page view, displaying the cuts, but things are weirdly italicized otherwise. Trying to fix. Fixed. Apparently, DW objects to sticking a cut tag in the middle of a block of formatted text.

[personal profile] vatine is off gaming today, so I'm taking it easy and have mostly been camping in front of the keyboard. The poor dog claims he is being sorely neglected, but he does whenever at least one of us isn't petting him.

Update: It turns out that he's also afraid of heavy rain--not just thunder--so I'm going in there to sit with him after posting this!

Out of slightly morbid curiosity, I went and did the PsychCentral Sanity Score quiz [personal profile] phoneutria_fera mentioned yesterday. It requires a login, which irked me, but I went ahead and set up a throwaway account.

The results, pasted?

Your Sanity Score

Score Breakdown )

Interesting, in a fairly typical psych assessment kind of way. For anyone who doesn't know, I spent a lot of time in the psych system over things which were neither psychiatric nor psychological. I am autistic with a lot of interesting neurological stuff going on, and ended up deemed bipolar with a clunky mess of other things tacked on to cover all the stuff the mood disorder didn't.

Bear in mind that, whether they should be or no now that they're accepted as neurological, ASDs (and Tourette's) are lumped into the DSM. You wouldn't know it from this assessment. Things may have changed in practice these days, though an awful lot of kids with ASDs are apparently getting pediatric bipolar labels.

The questions weren't quite as bizarre as a lot of the ones on the MMPI--which surely gives a lot of false positives for "Hypochondriasis"--but some of them came close. Just a small sample of ambiguous ones which caught my eye:

Question quibbles )

I couldn't help but get the yes-or-no "Have you stopped beating your wife?" feeling a lot, with a lot of the phrasing.

Yeah, a good mental health professional will be able to sort out what might be contributing to a lot of these things. Some are excellent. Unfortunately, a lot are not so good, and many of those are inclined to view things through certain filters which presume a narrow range of mental illnesses above other explanations for the problems their clients are experiencing. That can work OK for some people's situations, but not so much for others. Some of the filters which pathologize people's behavior and communication--eliminating other possible explanations--are unlikely to help anyone.

Going back to the results, the breakdown was interesting--especially in light of the (inappropriate) diagnoses I picked up before. I can't say much about the anxiety and especially the PTSD, other than that a lot of what has been interpreted and treated as anxiety and phobia is actually coming from purely neurological sensory weirdness. The same with rarely going out of the house; management is very different, depending on whether this is due to real sensory overload (plus some built-up anxiety from that, and other people's distress over it), or whether it's based on some horrible trauma in your past (as was assumed). Apples and oranges.

I do have Complex PTSD, and 15+ years of largely getting treated like crap in the psych system did not help with that. On the depression front, the score seems to be so low not because I am not experiencing symptoms these days, but because I am used to dealing with it by now and it doesn't freak me out; the way I look at this has also changed, as reflected in some of the question quibbles. I've learned to do more emotional regulation, not having even known it was possible growing up. Also, some of the relevant questions do not seem to take into account that a person might have experienced chronic depression for long enough that there is not a sharp contrast between "now" and "before".

Some products of neurological things (executive function, inertia, etc.) were taken as symptoms of depression, and figuring out what's what to some extent has also helped; these things also require different strategies, depending on what's behind the difficulty. Are you having trouble getting in the shower because you're depressed, or does it have more in common with How to make a phone call, in 70 easy steps? Maybe it's a combination of the two (my, do I know that one), or something else entirely.

Video: Original Song about Executive Dysfunction "I Grinded the Coffee" by P. Lungstuffing. No spoons for a transcript right now, unfortunately.

The "Physical Issues" score does not reflect anywhere near the actual quantity (or quality) of physical problems I am having now. This is probably down to both question bias and similarly increased mindfulness helping me deal with it. On a related note, I had to get a chuckle out of the "Drugs: 0", the way a lot of people want to act about chronic pain treatment.

"Dissociation", "Borderline Traits" (ah, that old dumping ground!), and "Obsessions/Compulsions"? A combination of neurological stuff and PTSD. I was diagnosed with mild OCD because of tics which fit Tourette's criteria. One therapist suggested that I just didn't want to "improve" when I started ticcing even more under the scrutiny. Seriously.

The test was interesting to mess with, and I think it nicely illustrates a number of systemic problems. I didn't need this to tell me how sane I am now, and not surprisingly, think this assessment deeply underestimated my coping abilities in some ways while just not taking other areas into account at all. Can I clean my house? Rarely, for multiple reasons. And so on.

(Maybe I should throw in a link to my Psychiatry, freedom, and noninterference post here, for clarification. I am all for truly informed choice, and the last thing I'd want to do is tell people to buck up. Urgh.)

September 2011

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