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A Song of Ice and Fire / Other Topics / insanity and functionality

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Min
User ID: 0074284
Feb 11th 7:01 AM
An interesting topic popped up in my mind. It was stirred by a report I am doing, where I am going to film a mother and her autistic daughter. This mother told me that autism is the least explored mental illness. Doctors don't even know if it is mental at all.

This brought us to the question of what madness is. Is it not just that insane, or mentally handicapped people go to places that we cannot follow? Where is the boarder? Do they not go to places, see things that we cannot reach or fathom?

In our society, the boarder is easy. Function. This mother of an autistic child said a very intelligent thing. "Our society does not care if someone is happy or not. It just cares if someone functions properly". She also has an older son, who went to highschool, studied at the university, and is working successfully in his job. He's 34 now. He had problems as a boy, but all doctors said it was because of the psychological problems caused by his mentally disabled sister. Now, at the age of 34, they found out that he has very slight signs of autism, too. No one found out before. No one cared. Because he _functioned_. Is this the right approach? The diagnosis goes by function, not by personal happiness. And even the healing attempts go by function. If a mental disorder is found out to be irreparable, well, the patients are just kept quiet with medicamentation, so that they at least do not disturb the society.

Where is the boarder? Is not any author schizophrene in some way? He creates a world he flees to, with breathing creatures, with characters he observes. Does not any painter, writer or other artist do this? The only difference to the mentally disordered seems to be that artists channel their madness into something widely accepted as art. Is not the boarder between genius and madness there where no one can follow your thoughts anymore? Who sais those people are _disabled_? Is there not a possibility that they are far more _enabled_ than we are, that they have access to worlds of knowledge we have not? They just do not function according to the rules of our society.

Where is the boarder? Who has the right to decide?
Ser Gary
User ID: 1523284
Feb 11th 7:31 AM
What's that old saying? "There's a thin line between genius and insanity." What you're saying may well be true, Min. Despite reaching the end of the 20th century, we still seem to know so little about the human mind. What is an autistic savant, for instance. Genius? Semi-comatose?
Min
User ID: 0074284
Feb 11th 8:24 AM
Yes, the thin line. But the approach our society has towards the mentally "disabled or disordered" does not go by the individual.
The strongest change from the middle ages to our times, despite the discovering of book print, of America, despite the fall of Constantinople, the biggest change was the discovery of the individual. Sometimes it seems to me we have not come pretty far since then.
Ser Gary
User ID: 1523284
Feb 11th 10:09 AM
Perhaps the true discovery of the individual self can be attributed to Freud and his ilk. The late 1800s??? Prior to that time, it was easier to just hide these people -- which wasn't a whole lot different from how prisoners were treated. In a lot of ways, we're still hiding them from society, aren't we?
KAH
User ID: 0541004
Feb 11th 10:59 AM
Well, there's only so much you can do.

Norway's psychological health care is a total shambles, and it seems we can hardly even take care of those that are _severely_ mentally ill - people who are a menace both to themselves and others.

I don't know whether this is the case in other countries as well, but in such a situation as we have here, it would seem prudent to look for people who clearly cannot function properly, and see that they get the care they need first.

That done...should we go further? Should unhappiness be another criteria to look out for, when we have helped those who does not function properly?

In my mind, unhappiness is a perfectly normal trait - it would seem a bit difficult to differentiate between those who need help and those who don't. Besides, I think it might be infeasible for society to _make_ people happy. Contentment may be achieved, but happiness must primarily be generated by own power.
Jeff
User ID: 1536664
Feb 11th 1:31 PM
That's a great point, Min, we do tend to focus on ability to function rather than happiness.

It may be because the need to function is more of an imperative. If someone cannot perceive their environment with some accuracy, and cannot make logical connections to interact with that environment, they cannot live. They will die without outside care and so _require_ immediate attention. Because its such an imperative, it is very easy to observe when someone can't function.

Individuals who are unhappy _can_ survive, which means they will have more of an opportunity to find some way out of their unhappiness. I know that happiness is essential for a good life, and in the long-term may be essential for survival. But happiness is a relative thing that can vary widel over time. Unhappiness can be difficult to detect because it is such a relative quality. When is unhappiness the product of mental illness, and when is it the product of circumstances?

I guess I would also say that happiness has received much more attention recently, at least here in the U.S.. Anti-depressants like prozac very popular, which is a sign that the problem of chronic unhappiness is at least being recognized and treated by some folks.

Aerian
User ID: 1557854
Feb 11th 4:47 PM
What a fascinating discussion!

Min, you raised some questions that has been on my mind a lot of late.

It often seems to me that when dealing with what are often called mental illnesses, doctors frequently fall into the attitude that their patients need to be fixed. The frequent approach is to prescribe any one of several antidepressents, which they understand very poorly. Sure it makes the person functional, but the side effects can be awful. Last winter I spent every morning having the dry heaves, because of the meds my shrink put me on. I tried lower doses, but they weren't effective.

I finally decided that I'd rather figure out how to live with clinical depression, than try to deal with the sickness, muscle spasms, short term memory loss, and panic attacks that I had gone through while looking for a medication that would let me be "normal".

When I went off my meds, I realized something else . . . during the entire three years I'd been on medication, the part of me that is an artist had been inhibited. A very frightening discovery for someone who has always partially defined herself as an artist. Now, barring an emergency I will not go back to the meds.

I don't recommend my course for all people, its too personal a choice. And not all "disorders" are as easily dealt with. Some of my friends find the side affects caused by meds a minor inconvenience compared to what their lives had been like. Others refuse to seek help at all, because they prefer to be the way they are in spite of severe conditions like autism, and obsessive compulisive disorder.

What I think needs to change is the approach to dealing with people like my friends and I. In the course of therapy I would much rather have been taught skills for coping with depression (which in my case is caused by chronic chemical imbalances in my brain as opposed to outside circumstances) instead of being automatically medicated. It seems like that would be more beneficial in most cases, saving the medication for those who can not deal with it on their own. The medications in use now are very poorly understood, and tinker with brain function all across the board, in my mind they should not be as prescribed as often as they are.

My ideas are based mostly on experience and the experiences of some of my friends who also live with "mental illness." As you might have guessed, I don't like that term, I don't think of either them or myself as sick, just different. Sort of like being, born with some sort of physical handicap -- I don't need to be fixed just helped to live with it.

On a side note, there is a high correlation between artistic ability and bipolar disorder, as well as scientific genius and some personality disorders.
Bill Hall
User ID: 8562343
Feb 11th 6:09 PM
Min,
You might want to look at the book by Temple Grandin, "Thinking in Pictures." She's an autistic who is quite functional, and you get a glimpse of how her mind works. A common limitation of autistic children is the inability to model what other people know - the contents of their mental pictures of the world around them.

Everyone:
The medications for treating mental disorders are bad, but IMHO better than prefrontal lobotomy and shock treatment. It's amazing that anyone regained rationality after those "cures."

For me, the quality of life is perhaps the most important criterion, not happiness, not freedom from pain. Life in a drug-induced haze would be inferior to pain or depression enlivened by moments of joy in accomplishment and sharing, in the full knowledge that the moments will not last. (Come to think of it, that's almost a definition of old age.)

Disorders of the brain undoubtedly produce unusual perspectives and cause us to make connections we ordinarily would not see. But LSD is no magic lens through which to view the world. Take their insights, like those of shamans high on mescal, as puzzle pieces, not as revelation.

Yes, I have personal acquaintance of madmen and survivors of LSD experiments, lobotomies, and shock treatments. No, the schizophrenic and paranoid are not happier for lack of attention to their problems.

For those who cannot fight their way to rationality, we should provide support, just as we do for those who cannot feed or dress themselves due to gross physical disabilities. I think the kindest approach is to find the level of self-determination that each can handle, and to grant them that much freedom of action. To the extent that their actions are unlikely to endanger others.

I will decree that, just as soon as I get out of this padded cell.

Aerian
User ID: 1557854
Feb 11th 8:56 PM
Bill you said what I was fumbling to say, much better. Sometimes personal experience and the related emotions cloud my ability to express my self. Thank you.
Min
User ID: 0074284
Feb 13th 3:57 PM
Aerian, thanks for sharing that.
You raised an important point. Your artistic abilities. That was what I meant with the question "is this not what artists go through all the time".
Years ago, I was going through a really hard time. It was like walking on the edge of a dark abyss. To make a long story short, doctors discovered schizoid tendencies and all sort of nasty stuff. :-)
And I was very lucky then. I came to a doctor who left me a choice. He told me: "There are two possibilities. All that you have can be cured with a therapy and medicamentation in not that long a time. All that there is "anormal" can be quenched sooner or later. But that will make you loose all your abilities I know you cherish. Your emphathy, most of your creativity, and foremost the emphathy you have for people. Good or bad, it will disappear: The lucid dreams as well as the nightmares, the visions as well as the wonderful Stories". I asked him: "What's the other possibility?" And he tol me that it would be harder, take much more time, but that it would be to balance it, to make me live and deal with it in a way that I could "function" _and_ be happy with it. I chose that way. It _was_ hard work. But now, I know I will never fall into that abyss. But it still is there, and all my stories, my poems, and my emphathy for others feed on this abyss, too.

I am infinitely glad and grateful I chose the harder path.
So am I insane? Was I ever? Are you, Aerian? I don't think so. Who has the right to decide?
Aerian
User ID: 1557854
Feb 14th 2:43 AM
Min, you were lucky in your doctor, he sounded quite wise. I'm very glad you made the choice you did.

In many ways, the pharmeceutical companies scare me. I don't know about Germany, but over here were have glossy Prozac ads in magazines, that seem to imply Prozac is an easy answer. Its very creepy.
Aerian
User ID: 1557854
Feb 14th 2:49 AM
Min, you were lucky in your doctor, he sounded quite wise. I'm very glad you made the choice you did.

In many ways, the pharmeceutical companies scare me. I don't know about Germany, but over here were have glossy Prozac ads in magazines, that seem to imply Prozac is an easy answer. Its very creepy.
Min
User ID: 0074284
Feb 14th 6:42 AM
I know I was lucky. Well, after the luck came hard work, but this man certainly was an exception. After I had made my choice, the way of medicamentation was out of question for me. I have never taken anything harder than aspirin in my life, and the doc would never have given me any medicamentation of _that_ sort, even if I had wished it (which I didn't).

But, you see, Aerian: It is possible. It IS possible. I am the living proof. You can keep what is precious and still learn to live a normal and happy life... relatively normal ;-))).
Aerian
User ID: 1557854
Feb 14th 3:13 PM
Normal? Nah . . . too dull.

Jeff
User ID: 1536664
Feb 15th 9:16 AM
From another perspective....

My wife had severe post-partum depression. It lasted for over a year and she became a completely different person to my, her friends, and her family. Crying every day, thoughts of suicide, etc. For over a year.

Finally, she went and saw a doctor who said that she was clinically depressed. He put her on a low dose of a selective seratonin uptake inhibitor called Paxil.

Within 6 weeks she had returned completely to herself. She wasn't a different person -- she was the same person she was before the depression. Apparently, childbirth had changed her chemical balance and the medication was needed to restore it to pre-childbirth levels. She can remember what it was like when she was depressed and is very thankful for the Paxil.

I'm not saying that medication works for everybody. Obviously, those medications can be overprescribed for people who don't need them. But I do think that medications _can_ be a good thing even when the effect is to "change" your mood.
Sphinx
User ID: 8882983
Feb 15th 5:15 PM
Min, Aerian - I agree _so_ much. I'll be the first to admit I'm not one to get depressed, so some may think that I am ill-equipped to comment, but it seems to me that there are _reasons_ why people get depressed (even if they don't seem like good reasons to other people). Sure, if the reason is a chemical imbalance, then another chemical may well cure it, but if it's things that are wrong with your life, a happy pill may put a smile on your face, but it won't fix your problems, and will just remove the pressing urgency for you to do so yourself.

Going back to an earlier point, I think that insanity and genius are not just next to each other, but that the whole scale is actually a circle. Imagine 'insanity' at one end, 'genius' at the other, but then link the whole thing so that if you move round it, from 'normal' you pass through genius and insnity in order to get back to noraml. In fact, 'normal', whilst furthest fron 'insane', is also furthest from 'genius'. (and, IMHO from interesting).

Insanity, like morality, is defined by the majority. I cannot for the life of me remember the name of the Scottish pyschologist who seriously poses the question 'how do we know that the 'mad ones' aren't in fact sane, and it is we who are 'mad', but he has a good point. If 99% of the population were schizophrenic, we'd put straightjackets on the other 1%. Humans fear what they don't understand. In fact, you could even say that genius is just insanity with a good PR guy.
Min
User ID: 0074284
Feb 16th 7:00 AM
Jeff, of course there is no black and white, on no side of the medal. I also agree that medicamentation may work in several cases. It did with your wife, and there _are_ cases where it would be necessary. Your wife had a different problem, if her chemical balance was disturbed by the childbirth. And there are other cases, too. If suicidal thoughts are involved, or if people become actually dangerous to others, there might be the need to quell things with medicamentation. First. But it should not be the end. It sould not be the end of accepting and questioning, for sure.

Sphinx, the circle is a very good explanation. It makes a whole lot of sense to me.
Jeff
User ID: 1536664
Feb 16th 8:04 AM
Just to keep things rolling, I'll disagree with the Scottish psychologist. Being able to function is a definite dividing line. Folks who are catatonic or hebephrenic cannot survive without someone to care for them. Put it this way, 99 catatonics and hebephrenics wouldn't put me in a straightjacket because they couldn't form the necessary coherent thoughts and perform the necessary actions.

KAH
User ID: 0541004
Feb 16th 8:13 AM
OK, I'll admit to ignorance. What is a hebephrenic?
Min
User ID: 0074284
Feb 16th 12:00 PM
Kay, you don't admid to ignorance, you admid to be non-native-speaker. Which does not show in your other posts. I don't know either. Jeff?
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