Tag Archives: Alcoholism

S – #AtoZChallenge on Mental Health

Welcome to day 19 in the #AtoZChallenge on mental health. We’ve arrived at the letter S. Here goes.

Self-Injury

Self-injury or self-harm is the deliberate infliction of wounds upon oneself. Some scientists make a distinciton between self-injury and self-harm. Self-injury is then seen as leaving relatively minor, local wounds such as cuts or burns. Many people with depression, anxiety or emotion regulation issues such as in borderline personality disorder self-injure. Self-harm then is the infliction of grave harm onto the self, such as amputation. This is seen more often, according to these scientists, in people with psychotic disorders such as schizophrenia. In reality, of course, only a small portion of even the most severely psychotic patients engage in severe self-mutilation.

In DSM-5, non-suicidal self-injury was introduced as its own mental health diagnosis. Prior to that, many people who self-injure were misdiagnosed, often with borderline personality disorder. The DSM-IV guidelines even said that, if someone self-injured to cope with overwhelming emotions, BPD should be diagnosed, even though BPD has nine criteria, five of which must be met for a diagnosis.

Self-Medication

Self-medication refers to the abuse of alcohol or drugs with the goal to cope with mental health problems. It can also refer to the use of prescription medications that haven’t been prescribed to that specific person. Many people “self-medicate” with alcohol, even though alcohol does not have any medical benefits (except in mouthwash). In fact, it can make symptoms worse. Same for drugs. For instance, many people with psychotic symptoms use cannabis because it seems to calm them, even though it is in reality thought to worsen psychotic symptoms.

Of course, some drugs sold on the streets actually do help with certain symptoms. For example, people with undiagnosed ADHD might start using stimulant drugs to counter their symptoms. It is for this reason that self-medication needs to be taken very seriously. In my post on dual diagnosis last October, I addressed the complicated relationship between alcohol or drug use and mental illness

Survivor

Many people were and still are treated for mental illness against their will. In the antipsychiatry movement, people who come out of (forced) psychiatric care are seen as survivors. Many mentally ill people have indeed endured traumatic experiences at the hands of professionals. Many also have had other traumatic experiences, which may’ve contributed to their mental health condition. As such, they’re also survivors.

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A – #AtoZChallenge on Mental Health

Welcome to the #AtoZChallenge on mental health. I discussed many topics related to mental health already last October for #Write31Days. As I menitoned in my theme reveal post for the #AtoZChallenge, I’m going to give short descriptions of several words for each letter (sometimes though I have only one). For today, my letter A post, I have quite a lot of words. Here goes.

Acute unit


Also called “admission unit” in the Netherlands, here is where people go if they’re in crisis. The acute unit is for short-term treatment only: up to three months. Even so, some people stay there much longer. Like, I spent sixteen months on an acute ward because the rehabilitation unit didn’t want me.

Addiction

Though addictions are typically treated in separate units or even by separate agencies than mental illnesses, many people with a mental health diagnosis also have an addiction.

Admission

The process of getting admitted to a psychiatric unit. If people are admitted to an acute unit, this is usually through the crisis service or psychiatric liaison in the emergency department. On treatment units, such as for eating disorders or personality disorders, people usually get admitted through their outpatient treatment team. An admission interview typically consists of a brief assessment of one’s symptoms and some standard questions (eg. does the patient know where they are and what date it is). Details of the patient’s initial treatment may also be discussed.

Aggression

Aggression is quite common among mentally ill people, especially those in inpatient care. This may not be a politically correct statement but it’s true. Most times, this consists of verbal aggression, but nurses and patients sometimes get attacked physically too.

Alcohol

Alcoholism is not as common among mentally ill people in inpatient treatment – they often take their addictions out on other drugs. However, still you get the occasional alcoholic on an inpatient mental health unit. Most instituttions don’t serve alcohol in the cafeteria, though near my institution is the railroad store where they do sell alcohol.

Attention-Seeking

Us mentals are supposed to crave attention more than do people without mental illness, hence the common belief that a mental illness is “attention-seeking” behavior. Well, let me tell you: mentally ill people often keep their symptoms hidden for a long time and most don’t crave attention more than do mentally healthy people.

Attitude

A similar myth about mental illness is that it’s an attitude problem. It’s not. I wrote a post on mental illness and attitude last October. The idea that mental illness is an attitude problem is very damanging to people with mental illness, who often have a lot of shame as is. There is a group of people wiht an attitude problem here and they’re the people who think they can judge another person’s attitude like this.

The Five Stages of Grief in the Recovery Process from Binge Eating

When browsing blogs on mental health on Mumsnet, I came across a blog on recoveyr form alcoholism. While there, I found a post on the five stages of grief in substance abuse. You are probably familiar with Elisabeth Küber-Ross’ five stages of grief in bereavement. These same stages apply to some extent to those recovering from an addiction:


  • Denial: people feel that they do not have a problem concerning alcohol or substances. Even if they do feel as if they might have a small problem, they believe that they have complete control over the situation and can stop drinking or doing drugs whenever they want.

  • Anger at the fact that the addict has an addiction or at the fact that they can no longer use alcohol or drugs.

  • Bargaining: the stage where people are trying to convince themselves or others that they will stop substance abuse in order to get out of trouble or to gain something.

  • Depression: sadness and hopelessness, which usually happen during the withdrawal process from alcohol or drugs.

  • Acceptance, not merely as in admitting you have a problem with alcohol or drugs. Acceptance involves actively resolving the addictioon.

I do not have an alcohol or drug problem, but I do exhibit disordered eating. I wonder to what extent these stages of grief apply to the recovery process from eating disorders, in my case mostly binge eating. Denial is certainly common in individuals with all types of disordered eating. I for one was in the stage of denial up until quite recently. This is not merely not being aware of the problem, like I was in early adolescence. Rather, from my teens on, I did realize to some extent that my eating habits weren’t normal. I remember one day buying five candy bars at once and eating them all in one go. When my classmates pointed out that this was outrageous, I shifted from lack of awareness of my eating disorder into denial.

As I said, I stayed in denial for years. I continued buying sausage rolls for lunch every single day until the end of high school, then at blindness rehab ate candy and chips everyday. I gained rougly ten pounds in those four months at blindness rehab, thereby reaching the upper limit of a healthy BMI.

It took several more years before I moved into the stage of anger. By 2008, I was convinced I would die young, and my unhealthy eating habits were one reason for this. I hated myself and my body, yet didn’t stop eating unhealthy amounts of candy. If anything changed at all, I binged more.

I don’t know how I maintained a relatively healthy weight until 2012, but I did. I did start purging in 2011, which can be seen as either a response to anger or a form of bargaining. After all, bargaining can also be seen as trying to reduce the (effects of the) addiction while not completely trying to abandon it.

I reached overweight status in 2012, then obese a few months ago. I started going to a dietician in 2012, then quit going again, went back in the fall of 2013, quit again, and recently started going again. I am still at the stage of bargaining regarding my disordered eating. When told I just need to stop buying candy, I object. Instead, I want to lessen my candy consumption, keep it under control. Yet isn’t the whole point of an addiction not the substance, but the lack of control? I know that one difference between food and alcohol or drugs is that you can’t completely abandon food, and my dietician said that getting fruit or veggies within easy reach as a substitute for candy, is unlikely to work. After all, I’m going to keep the idea that food is an easy way out of emotional stress.