Bipolar 2 From Inside and Out

Posts tagged ‘OCD’

Language Lost

There are many words that are specific to psychology, including diagnoses, symptoms, and therapeutic techniques. Many of those terms, however, have worked their way into general conversation. Some think this is a good thing as it makes society more aware of the language we as psychiatric patients use. Others object to this use of language. They see it as diluting the meaning of the terms.

Two of the most common words that have made this shift are bipolar and OCD. Instead of diagnoses, they’re often used as descriptions of people or things that are thought to share the characteristics of the disorders. “The weather is bipolar this month.” “Beth’s house is really tidy. She’s so OCD.” These usages are, of course, inaccurate. Weather can’t have a psychiatric disorder, and a neat house is not enough to diagnose a person with OCD.

The thing is, people aren’t using them literally. Weather being bipolar is a metaphor. It conveys the idea that the weather is changeable, seemingly randomly. Calling weather bipolar expresses the concept more vividly, which is probably why it has become so popular. Calling someone OCD is an exaggeration used for effect. They’re saying that Beth is not just neat, but excessively neat. The people who use these expressions don’t have any real idea of what the terms mean. They’ve just heard them used and have only a vague, superficial idea of what they mean.

Spoons is another metaphor gone astray. Originally, it was used to describe the depletion of energy that someone with an “invisible illness” feels when they’re required to do more than they’re capable of on any given day. Spoons are a variable commodity. The neurodivergent or physically challenged never know how many “spoons” they will have at the beginning of a day and when they’ll run out of them. It’s a very powerful metaphor which makes it easier to understand the concept.

Nowadays, however, it’s used by people who don’t face these challenges to mean simply “I’m tired” or “I’m done for the day.” But these people don’t have a widely varying amount of energy at the start of each day. Oh, they may be more or less tired depending on the quantity and quality of their sleep. But they don’t begin with so few spoons that getting out of bed requires an enormous expenditure of spoons that depletes them for the rest of the day.

The word triggers is not a metaphor, but a word that has weakened over time. In psychological terms, a trigger is something that brings back vivid memories and sensations of a traumatic incident. The person who is triggered cannot control their reactions and will experience the event as if it were actually occurring in real-time. In its new meaning, a trigger is anything that a person doesn’t like or causes them to be uncomfortable. This discomfort is minor and fleeting, and does not cause sensory overload. People who use “triggered” this way betray a deep misunderstanding of the term and often make fun of the concept altogether.

These and other terms like neurodivergent and spectrum are also frequently misunderstood or misused. Some are still being defined and arguments about what they really mean often occur.

People who use the words in their specific, technical sense sometimes speak of “reclaiming” them. They are offended by the perceived misuse of the various terms and want to restrict them to their original, technical meanings. They want other people to stop using them in their new senses. They feel the new usage cheapens the words.

The thing is, language doesn’t work that way. Once a word or phrase has “escaped into the wild” and is being used with a different shade of meaning, there’s no getting it back. No matter how much you try to educate people about the “real” meaning of the word, most people will not even realize they are using it “wrong” and won’t stop using it in the new sense. In fact, the first dictionary definition of bipolar is “having or relating to two poles or extremities,” not the disorder. The non-psychiatric sense of OCD as an adjective hasn’t made it to the dictionary yet, but it’s only a matter of time now.

Personally, I can think of things a lot more heinous than describing me and the weather the same way. Is it ignorant? Yes. Is it insulting? Probably. I just think it’s a waste of time correcting one person at a time or trying to educate the masses about it. Millions of people are still going to do it, and there are more important things to educate them about.

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Mental Health

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What’s Good About Drug Commercials?

I’ve often bitched about TV (and, I assume, magazine) ads for psychotropics. I’ve said that I despise the fact that they make the entire public their own experts on what they need and shills for “Big Pharma.” I’ve complained that they hamper doctors by encouraging consumers to “ask if drug X is right for you” and to accept no substitutes. I’ve also said that the ads present unrealistic pictures of very serious mental conditions by making depression, for example, no worse than the flu or a hangover.

Nonetheless, I’ve decided that drug commercials do have some beneficial purposes and effects. They aren’t all evil after all. They send messages to the viewing public that are actually positive. These messages contradict the prevailing public conception that people with mental illnesses are different from other people – that the entirety of their lives is taken over by their illness. People with bipolar disorder change from the depths of despair to uncontrollable, laughing lunacy within the span of hours or even minutes. People with OCD are picture-straighteners and tile-counters. People with schizophrenia are violent criminals or raving crazies, often hospitalized for life. None of these brain illnesses can be treated, according to the general wisdom.

Modern drugs have improved people’s lives and improved the general public’s conception of what mental illness is like.

First, more of the commercials now present understandable views of what some mental illnesses are like. They do this primarily when they use analogies or metaphors. Bipolar mania is like climbing a house of cards that is destined to collapse inevitably at some point. Depression is like darkness, and medications can lessen it by bringing light. They even make the symptoms and side effects more understandable: tardive dyskinesia, for example, is depicted with actual twitches, intractable movements, and mobility issues.

Also, the ads do emphasize that there are treatments, if not actual cures, for disorders that the general public views in a stereotypical way. Take schizophrenia, for example. Most people associate schizophrenia with homelessness, psychosis, and/or raving unintelligibly. Yes, those are sometimes the consequences of the disorder, but they’re far from the whole story. I’ve seen commercials for schizophrenia medications that show a man with a family playing guitar, two women with schizophrenia calmly discussing their symptoms, and a comparison of daily pills and twice-yearly injections for treatment. They humanize an illness that too many view as intractable and untreatable.

I stand by most of my criticism of ads for psych meds. They are shallow and simplistic. They do promote self-diagnosing and self-prescription and demands on doctors. They minimize the good that talk therapy can do, concentrating instead on medical and pharmaceutical interventions. At the same time, though, these ads promote more accurate, healthier views of mental illnesses, even the most severe. They portray people who have the illnesses as having alternatives, socially productive lives, and “normal” interactions with others despite their psychiatric conditions.

I have no scientific evidence to support this theory, but my guess is that after viewing these ads, often several times a day, a poll would reveal changes in attitude. That, combined with the public service announcements about depression and even ads for telemedicine therapy sessions, may indeed make it more likely that people who live with these conditions without realizing it to better understand their own possible mental problems and those of their friends and family, and to have greater empathy toward them.

And those are good things. May the trend continue.

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Mental Health

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When Your Thoughts Run Away With You

Overthinking. It’s something we all do at times – so many of us that it cannot really be said that it is automatically related to mental illness. But in some cases, it is a symptom.

Let’s start with depression, a subject about which I know a thing or two. When I was in a depressive phase of my (undiagnosed) bipolar disorder, I could, as the saying goes, overthink a ham sandwich (once I actually overthought a BLT). When I was depressed and/or anxious, it seemed as though I had a recorder in my head that would play back for me every stupid thing I had ever done – even such a small thing as handing the wrong person a glass of water. At random moments, the memory would pop up, usually with full color and sound, and I would again castigate myself for being so stupid.

I agonized over decisions. Should I call a friend to tell him or her about a phone call I received that might affect them? One time it was the right thing to do, with positive consequences. Another time it was also the right thing to do, but with negative consequences. Dilemmas like that made it even more difficult to know what to do. Indecision paralyzed me. When I couldn’t figure out the consequences ahead of time, I couldn’t know if my decision was correct. Of course, this is true of most people and many decisions, but the dilemma would derail my thoughts and leave me vacillating.

Intrusive thoughts are quite often symptoms of depression and bipolar disorder, and they can be valid or nonsensical. Are my children getting an appropriate religious education? Where is my passport (when no trip is remotely planned)? They can keep one awake at night.

Psychologically speaking, overthinking and intrusive thoughts are definitely symptoms of OCD. Did I lock the door? Better check three times. Did I leave the stove on? Better check four times. Has the milk in the refrigerator expired? Did my cat get out the door when I wasn’t looking? Better go out and look around. Will I throw up when I ask my boss for a raise? Better not try. Does my aching knee mean I’m getting arthritis? Should I call my doctor about it? Will he think I’m imagining it? My mother only loves me because she’s my mother, not because of who I am. These kinds of thoughts can be disabling, crippling, or at the very least painful. They can cause you to doubt yourself and everything you do.

In mania, overthinking comes later. While you are spending or gambling or having risky sex or driving recklessly you don’t question it. It’s only later, when the episode wears off, that you have intrusive or obsessive thoughts. Oh, my God, why did I do that? How can I ever pay for all that? Are my finances so screwed up now that I can’t pay my rent? Did I binge drink and hurt someone? I’m so ashamed. I feel so guilty.

Cognitive Behavioral Therapy (CBT) may be one way to confront your intrusive thoughts and push them aside in favor of more productive thinking. Talk therapy of the usual sort may help you develop coping mechanisms for when your thoughts run away with you. And psychotropic medication may lessen or eliminate the underlying problem that causes you to have intrusive or obsessive thoughts. In my case, it was the latter two. I still get stymied by some decisions, but I don’t lie awake and think about them. I discuss them with someone else (my husband, my therapist) to get feedback. Then I make a decision and stick with it, or move on to thinking about something else.

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