Introversion no longer in DSM-5 Proposal

[Eileen]

Fuck the DSM, frankly. Arbitrary rubbish that changes with popular opinion - you won't learn anything about yourself or anyone else from it.

I would agree on "fuck the DSM" and largely with the sentiment that it changes with the times. I don't think it's entirely rubbish, though--it has its use. The problem is how much power the mental health profession allows it to have and what therapies it implicitly dictates (and the funding for the project is horrifyingly associated with that). But mental illness IS a thing, and it IS helpful to be able to talk across disciplines about it, which is the main advantage of the DSM. (Still, I agree: fuck the DSM.)

 

[prplchknz]

so if they take schizoaffective out does that mean i'm no longer sick *prays they are*

 

[Viridian]

I'm not familiar with the CID; I feel like I've learned about an alternative to the DSM and can't recall the details. What is it? A cursory google search did not help me.

Oh, sorry, I meant the ICD! It classifies all kinds of diseases and conditions in addition to mental disorders. You can browse it here.

 

[Eileen]

Oh, sorry, I meant the ICD! It classifies all kinds of diseases and conditions in addition to mental disorders. You can browse it here.

Oh! Interesting. I'm not sure if this is what we've talked about in class or not. However, one of the criticisms that is often posed for the DSM is that it is too medicalized; given that, I imagine that a lot of people still find it problematic (I take a fairly moderate point of view in that respect and don't know enough about this yet to comment).

 

[Eileen]

so if they take schizoaffective out does that mean i'm no longer sick *prays they are*

It's an interesting problem, isn't it? As a non-medical aspiring professional, I would ask you if you think you're "sick," if your experiences get in the way of you accomplishing activities of daily living or achieving [reasonable--there's another can of worms, right?] goals that you set for yourself.

 

[Viridian]

Oh! Interesting. I'm not sure if this is what we've talked about in class or not. However, one of the criticisms that is often posed for the DSM is that it is too medicalized; given that, I imagine that a lot of people still find it problematic (I take a fairly moderate point of view in that respect and don't know enough about this yet to comment).

Well, it wouldn't be much of a diagnostics manual if it wasn't medicine-focused, would it?

 

[Eileen]

Well, it wouldn't be much of a diagnostics manual if it wasn't medicine-focused, would it?

yes. this is why i have a more moderate position than some.

 

[Thalassa]

All of the personality disorder diagnoses are really, really problematic--but since we're talking about what's in the DSM, I hardly think you can say, when looking at the checklists of symptoms, that borderline has more to do with extraversion than histrionic does. HPD is pretty damn externally-focused--not that BPD isn't, but HPD seems moreso to me.

im not sure why - histrionic is merely expressive - someone who has a seductive personality, who is openly emotional, etc.

I could get into it more, but I dont even think being histrionic is pathological, its more like personality traits that annoy certain kinds of people. It merely means being dramatic, for the most part. You could potentially see this in IxFx but I would agree its more of an F thing.

To me histrionic personality disorder is just sexist, finding sexually confident women threatening even while similar behavior is encouraged in men, and it would be combined with expressiveness of emotion, that bugs some people, they call it emo now, but there have always been femme fatales and flaming gay men and strippers and I think even the old gothic movement was pretty theatrical at its core. So was punk.

BPD on the other hand is entirely external, the person with BPD doesn't have a stable sense of self, acts out, hates being alone. Besides people with BPD are pretty sick, the ones Ive known.

I think people with HPD are usually more highly functioning and may be written of as annoying or entertaining, depending on who is around them.

BPD needs to stay in the DSM far more than HPD or even NPD.

 

[Thalassa]

so if they take schizoaffective out does that mean i'm no longer sick *prays they are*

honey schizoaffective is in the bipolar spectrum, and on the severe end of the spectrum because it involves schizophrenic type symptoms; its not a personality disorder

 

[Thalassa]

Another thing I want to add here is that I dont think HPD should be clustered in with BPD under any circumstance because a defining HPD feature is pride in ones self, unwillingness to conform, while people with BPD have a poor sense of self.

HPD people are also more highly functioning, and in my estimation are being perceived as eccentric or annoying but that doesn't make them sick.

For example an emo kid who dresses theatrically and is emotionally expressive may just be...being themselves, not being shallow or demanding to be the center of attention.

I really think HPD is a perception issue, by the outsider. Its devaluing a certain kind of person who may be totally functioning, but different.

I was only briefly diagnosed with this by one person aNd Im fairly certain its because I said I was an adult entertainer.

No bueno.

People with BPD also often break the law or hurt others, while people with HPD are again...annoying? Non conformist? Irritatingly sexy?

I dont think it belongs in the DSM.

 

[Eileen]

Perhaps we can stop talking about "people with BPD" as if they are a monolith, on account of them not being a monolith.

Anyway, I'm not arguing for the presence of HPD in the DSM. My original point was that we do, in fact, pathologize certain kinds of extraversion as well as introversion, which sucks.

 

[Eileen]

honey schizoaffective is in the bipolar spectrum, and on the severe end of the spectrum because it involves schizophrenic type symptoms; its not a personality disorder

But a question to consider is, if you take a diagnosis out of the DSM, does it suddenly cease being a pathologized phenomenon? Will a person with schizoaffective disorder, should the disorder no longer be categorized, merely be imaginative/intense/in tune with a different or deeper or alternate reality (or some other language) (like a person with HPD is merely proud and confident)?

There *is* a certain amount of arbitrariness to diagnoses; we have identified "normal" and "functional" and diagnosed what doesn't map up properly.

 

[prplchknz]

honey schizoaffective is in the bipolar spectrum, and on the severe end of the spectrum because it involves schizophrenic type symptoms; its not a personality disorder

sweety i know schizoaffective is not a personality disorder. I never said it was, and it's on the spectrum if its the bipolar subtype. and schizoaffective is a mood disorder AND schizophrenia, not schizophrenic like symptoms

 

[Thalassa]

[MENTION=5]Eileen[/MENTION] my sister is schizoaffective. When she is unmedicated she believes there are cameras in doorknobs and wears sweaters in the middle of summer.

When she's medicated she is a sensible and hardworking yet artistically gifted ISFJ.

My bffs mom was also schizoaffective and shot herself in the head in her early forties. She called my friends dad the devil and said his children were demon spawn and she bit my friend on the arm.

Schizoaffective is one of the most debilitating psychiatric illnesses one can have, bc you have the mood problems of bipolar combined with schizophrenic hallucinations.

Prplchknz may be a milder case, but I do know she has said she's heard voices.

I believe if you're crippled by your illness you should seek help.

I personally am cyclothymic, and I would not argue that I dont need help, because I asked for help, it was not forced upon me.

 

[Eileen]

My mother has schizoaffective disorder. I am familiar with it. Like I said, I think the DSM has its uses. But there is a certain amount of arbitrariness to it nonetheless.

 

[Thalassa]

[MENTION=5]Eileen[/MENTION] I dont think there is anything arbitrary about someone who has very low functioning or dangerous behavior being called ill.

Im flabbergasted that anyone even would suggested schizoaffective isn't an illness. Its not "being creative" it ruins peoples lives.

Fortunately they have better meds now than they did 20 years ago so that my sister will not suffer the same fate as my friends mom, who was institutionalized for long periods of time, dependent, and then died by suicide, as well as abusing her children in the process.

And meds do not change the real personality either. My sister was an ISFJ before she showed severe symptoms and took meds. She was always a very structured and self sacrificing high Fe individual, who said things like if she were wealthy she would still stay where she is from.

She also does better art work and learns better when medicated.

Ill argue for certain things being not necessarily pathological, but schizoaffective disorder is not one of them, I know better, and think its destructive to suggest otherwise.

 

[Eileen]

An interesting alternative perspective to consider re: hearing voices and other things we call hallucinations is the Hearing Voices Network.

My mother was extremely sick for much of my childhood. Her proper medication and stress management has been essential for all of us. That said, I sometimes wonder if the phenomenon of hearing voices/seeing things/understanding things differently/what have you would be internalized and expressed differently in a context that didn't call it illness. It's hard to say. Schizophrenia is actually a worldwide phenomenon (there are, surprise! some mental illnesses identified in the DSM that do not appear to exist in other parts of the world) and it is certainly debilitating. But there's reason to believe that medication makes it permanently debilitating, while other approaches (like community supported approaches specifically in China) may allow for more normal, happy lives in between episodes.

Obviously, I don't know the answer to all of these questions I have. I just wonder. And I hope for new treatments that won't ravage brains and lives so much as medications often do. It makes me sad that my mother will probably always be on medications that give her dry mouth and tremors (and it makes me sadder that lots of other people live with far, far worse).

 

[Eileen]

[MENTION=6877]Marmie Dearest[/MENTION], my approach to most things is with an openness to learning more or considering things differently. My work now is in mental health; I take care to treat people first, regardless of what labels are attached to them.

 

[Thalassa]

[MENTION=5]Eileen[/MENTION] I dont think meds are ravaging my sisters brain. If anything she could slip into catatonia or other severe schizophrenic symptoms if she is NOT medicated. Early treatment keeps it from getting worse.

My friends mom didn't get the help she needed early enough.

Meds help your brain to create normal pathways which is why some people can go off of them.

The longer your pathways are making crazy, the less likely you are to "return."

my sister sounded more sensible the last time I talked to her than she even did two years ago, just thinking ahead and making responsible decisions and being confident rather than lost

shes able to live with her husband and takes care of her children

my friends mom couldnt do that because of lack of meds and/or less advanced medicine

and many unmedicated people do more damage to themselves with street drugs or large quantities of alcohol

 

[Eileen]

I spent the last year working with people with severe and persistent mental illness out in the community. Perhaps there are some situations outside of *your experience* that lead *me* to believe something different from you!

And you seem to read my posts rather selectively. I acknowledged the importance of medications (with stress management) in my family's experience, but I have read some things that make me wonder if there's a different way to help people living with severe and debilitating mental illness, as well as things that make me question whether "illness" is precisely the right word.