Thought for the Day:
Hallucination means “your dream doesn’t match my dream.”
Thought for the Day:
Hallucination means “your dream doesn’t match my dream.”
…Anosognosia brings questions of the origin of self-awareness to the forefront. How can someone lose the ability to know when she is or is not moving? Is this some type of elaborate Freudian defense mechanism, or is this person entirely unaware of her illness? How is self-awareness represented in the brain, and is this representation isolated from or attached to awareness of others? Though none of these questions are fully answerable at this time, research into anosognosia has provided scientists and philosophers with insight into some of these ancient questions of human consciousness.
By way of BeliefNet:
[The] defilements are like a cat. If you feed it, it will keep coming around. Stop feeding it, and eventually it will not bother to come around anymore.
-Ajahn Chah, “Still Forest Pool”
From “365 Buddha: Daily Meditations,” edited by Jeff Schmidt. Reprinted by arrangement with Tarcher/Putnam, a division of Penguin Putnam Inc.
Early manifestations and first-contact incidence of schizophrenia in different cultures. A preliminary report on the initial evaluation phase of the WHO Collaborative Study on determinants of outcome of severe mental disorders.
Psychol Med. 1986 Nov;16(4):909-28.
Sartorius N, Jablensky A, Korten A, Ernberg G, Anker M, Cooper JE, Day R.
The results provide strong support for the notion that schizophrenic illnesses occur with comparable frequency in different populations and support earlier findings that the prognosis is better in less industrialized societies.
Interesting web site. It’s about how we define the moment of death. They are turning Emergency Medicine on its head.
If you have advance directives, a living will or a DNR order, it’s because you don’t want to wind up a vegetable after a medical emergency or because you have an incurable, fatal condition. Advanced directives are NOT intended to force the ER doctors to let you die when medical treatment can easily fix you right up. With the exception, of course, of folks whose religion forbids medical treatment.
When I was a whitewater rafting guide I had to be certified in Advanced First Aid and Life Support. This program took four weekends to complete. It was hard for me to put in that kind of sustained effort, now that I think about it, but it really helped my confidence on the job. The point of the course was to enable the guides to stabilize someone injured on the river until we could get real medical help. And it wasn’t a far stretch to consider CPR in case a guest had a heart attack on the river.
Read the UPenn web site. Look at the powerpoint presentations. Read the doctors’ curriculum vitae.
Again: it’s about how we define the moment of death.
Google “cellular reperfusion injury” and read a few of the articles that come up.
Your cells don’t die right away when you die. When oxygen-deprived they go into a kind of stasis and even after several hours a doctor can still extract undamaged, living cells. They haven’t stopped, they’ve just slowed down. You don’t fade out in that first magic 5 minutes. You fall into a deep coma, then actual cell death takes hours – or longer.
This is completely different than what the public and most of the medical profession believes at this time. The current belief is that no pulse equals death. Which really sucks for a few folks who have temporary a artificial heart that whirrrrrs instead of beating. But I digress.
So if you want to define death in terms of brain activity as monitored on an Electroencephalogram (EEG), well, the EEG can only measure down to about 0.5 Hz. This is a limitation of our technology. As you fall asleep brainwaves slow from 30Hz maximum down to around 4Hz. If you go into a deep coma, they slow down even more. No brainwave equals death, then. Except that our technology has serious limitations. Well, it turns out that brain cells go into stasis too.
Now here’s where it gets weird.
Think about what they do in the ER. It’s all about reperfusion, getting oxygen back into the brain as quickly as possible. Jump-start the heart, pump oxygen into the lungs, get a cold patient warm. Well, it turns out that if you pump too much oxygen into a cell that’s in stasis, it self-destructs. That magic 5 minutes isn’t the time that it takes the cells to die. The magic 5 minutes is the time it takes for some of the cells to go into stasis, that is, enough that the self-destruction, or apoptosis, causes wide-spread damage to the body on reperfusion. The heart seems to be the most susceptable organ.
The gist of the web page I linked to is that if someone is brought into the ER suffering from cardiac arrest, they have a better chance at survival if the ER doctors immediately cool them down and add some chemicals to prevent apoptosis before beginning slow reperfusion. The Resuscitation Medicine department at the U of P is working on establishing a new set of protocols.
Where it gets scary is here:
If they bring you in after the magic 5 minutes, present ER protocols can’t save you. Not without massive, permanent damage to the heart and to the brain. They declare you, and that’s it. The body is sent to a funeral home and cremated or injected with preservatives, sometimes long before the several-hour deadline (so to speak) is up.
No wonder the Irish hold wakes. The British, after discovering that an unsettling number of people had been buried alive – used to attach bell cords to the wrists of folks they buried. Saved by the bell.
IRL your family can decide to keep your brain-dead corpse alive despite anything you said in life. Witness what poor Terri Schaivo’s parents did to keep her mindless body alive long after her spirit was gone.
I’ll be watching the Rescusitation Medicine story with great interest.
Before you think I’m defending the borderline, let me state uncategorically that I avoid them like the plague in real life.
Here’s a good article that explains why borderline personality disorder is often misdiagnosed as bipolar disorder.
While a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger, depression, and anxiety that may last only hours, or at most a day. These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse. Distortions in cognition and sense of self can lead to frequent changes in long-term goals, career plans, jobs, friendships, gender identity, and values. Sometimes people with BPD view themselves as fundamentally bad, or unworthy. They may feel unfairly misunderstood or mistreated, bored, empty, and have little idea who they are. Such symptoms are most acute when people with BPD feel isolated and lacking in social support, and may result in frantic efforts to avoid being alone.
I’d like to put forth the observation that psychology in the US is mainly concerned with predicting and manipulating the behavior of large numbers of people. There is little or no acknowledgement of an internal landscape, because you can’t measure emotions – you can only measure how they are expressed. The psychologists aren’t healers, they are agents of social control.
So. “Personality Disorder” means that a certain type of personality has been pathologized because their behaviors are uncomfortable to others. The behaviors relate to the coping style – but the real problem is that the person has a damaged ego. They have to rely on others to give them clues as to who they are!
The borderlines experience an overwhelming fear of abandonment. All of the crazy behavior is to prevent you from leaving. Unfortunately, the set point is so low that most of what you do looks like abandonment. Abandonment in this context doesn’t mean left alone to rebuild their life – which majorly sucks but isn’t the End of the World. Abandonment means that who they are has been taken away from them. They have little “I” so they have to be part of a “we.”
You can teach a borderline to withhold their emotions with Dialectic Behavioral Therapy (among others), but I’m not entirely convinced that any therapy changes the real problem. It has very little to do with wanting to change, and everything to do with the fact that the fear of abandonment is so deep that – well, damn, you practically have to tear down the whole house to fix the foundation. You see?
Here is the website for Dr. Marsha Linehan, Ph.D., ABPP, who developed DBT.
Great news! Two new bipolar t-shirts in the [tag]Manic Mall[/tag]. The first one, called “Crazily is…” is the [tag]Chinese[/tag] characters for [tag]bipolar disorder[/tag] cut-and-pasted from a [tag]medical[/tag] site in China. A back-translation on babelfish tells me that the Chinese have an interesting perception of us. Interesting as in the ancient Chinese curse, “May you live in interesting times.” Click the picture to see the shirt, “Crazily is [tag]hot-tempered[/tag] the depression!”
The second t-shirt should have been the first shirt, since I was researching it when I came across the translation above. It inspired me to create the Official Bipolar Planet® World Tour 2007 [tag]t-shirt[/tag].
Well, I was looking at an Israeli search engine that links to [tag]Pendulum[/tag] Resources and got curious. Is [tag]manic depression[/tag] a world-wide problem? Do some cultures accept “eccentric” behavior more than others do? How did they treat manic-depressives before lithium? I am very curious about it. A very quick trip to world-wide googles helped me find dozens of ways to say “[tag]bipolar disorder[/tag]” and “manic depression.” It really is a Bipolar Planet®.
Someone pointed out to me that I didn’t include the English words for bipolar disorder or manic-depression. Oops! I thought it went without saying that English-speaking countries are nuts.