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#1 Petronus

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Posted 09 February 2006 - 10:17 PM

Discovered this article regarding Bi-Polar Mental disorder. I thought this might be of interest those of you who engage in habitual and frequent unsafe sex; and those who have a need to have sex at the expense of personal relationships. I am posting these articles not to cast judgement on the playboys and nymphos on this forum. I just feel you should know this, and seek help if you need it.

"Hypersexuality can be a symptom of bipolar disorder, and is generally associated with the manic phase of the disease. It can result in behavior that the manic person later bitterly regrets."


http://www.bipolarwo...nosis/diag1.htm

#2 bubuy

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Posted 10 February 2006 - 10:12 PM

moving to appropriate section.. :mtc:

#3 Green Lantern

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Posted 22 July 2006 - 08:11 AM

It should not be a problem if you have this ailment under control

#4 iwalkalone

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Posted 29 August 2006 - 04:59 PM

A nervous breakdown, also known as a mental breakdown; is a sudden, acute attack of mental illness such as depression or anxiety. Like sanity, the term is not recognized by the psychological community. In part, this is because the term has pejorative connotations, while this phenomenon is a normal and relatively common response to chronic stress. Often, the emerging illness is only described as a "breakdown" when the person becomes unable to function, at which point the disorder is advanced. Often, the supposed breakdown is a manifestation of career burnout.

The psychiatric community rejects the term "nervous breakdown", in part, because it is not descriptive enough of the actual disorder and symptoms. A common diagnosis that follows such an event is brief reactive psychosis.
Causes
Causes of breakdown include chronic and unresolved grief; unemployment; academic, occupational, and social stress; serious or chronic illness in a family member; divorce; death of a family member; pregnancy; and other sudden major life changes.

Whatever the cause, the message to the sufferer is that they now become aware of their limits of tolerance to stress, the usual outcome eventually is a more robust personality that interacts with stresses of life with more self care, although this may take time—sometimes years.


Duration
During a nervous breakdown, a person will go through a series of complex emotions: usually ones that he/she can't comprehend, or will refuse to comprehend. While these and other emotional/physical feelings vary greatly, the following is usually expected:

Extreme anger/confusion: Usually a person starts these emotions shortly before "breaking down". But once they have shut off themselves from comprehending their feelings, they usually become confused to the point that they become angry: and may release this in manners of depression (mood), destruction, self destruction, and many other passive/violent forms.

Crying: Because of the confusion and anger brought out by the breakdown, once the person begins to start to open up to interpreting their emotions: they will cry from the extreme emotional stress that they are now trying to relieve themselves of.

Loss of appetite: This may be brought about because of one of two reasons. The person experiencing the breakdown may be so upset with their situation that they starve themselves out of self-destruction; or they may do it because their mind is so confused in trying to reason through the high levels of stress that it does not feel the need to eat, almost as if eating is the last thing on the persons' mind.

Longer Term Durations Nervous breakdowns can last for up to six months if left untreated. During this time the patient is disoriented, has delusions of outer worldy abilities and often requires hospitalization. It is not known whether holistic treatments are sufficient in curing the patient but traditional medication goes some way to making sure the patient is tranquilised and therefore gets sleep; something that is often most needed. Ultimately, what they need is to have their mind rest and sleep, in whatever form it can be delivered, sleep is the best treatment in the early stages.


Effects
Most commonly, nervous breakdowns are short, normally not lasting more than a week; however they are often the external symptom of an underlying mental illness that if left untreated can lead to serious repercussions and have a lifelong effect on the sufferer.

A nervous breakdown is the acute manifestation of such illness and as such can lead to suicidal ideation or attempts at self-harm. The sufferer typically experiences what they feel as the total breakdown of ability to deal with even the most minimal stresses of day-to-day living and at its most extreme can become entirely non-functional and withdrawn.

Experiencing a nervous breakdown often predisposes the sufferer to the likelihood of further episodes, particularly if left untreated. However, this is not necessarily the case, and some people may have a one-off breakdown and no further episodes. Moreover, although treatment and medication may be necessary in some cases, some people are able to make a rebound without treatment. Although the recovery phase can take several years, it is possible to achieve it and to lead a successful life. That requires a high level of self-awareness and self-belief on the part of the person who has undergone the breakdown. The description above is scientifically recognized either as a clinical depression,or Manic(bi polar type of)Depression,Basically Nervous breakdown scientifically speaking is a condition closest to 'Anxiety attack/s',often refer to as Panic attack/s. While delutions or halucinations are psychotic in nature,and best example of such condition that manifested by Psychosis (Psychoses)in addition to brief episodes of such which appears to be often affect some individuals who suffers from Manic Depression,typically in the Branch of Psychiatry the condition of Schizophrenia(Psychotic desorder),in which an affected individual suffers from audio & or visual hallucinations. http:www.freewebs.com/interbiomedical/ is a website that once get sufficient support'll not only educate the public about the subject,but'll also attemp to find a cure to it!.

Edited by iwalkalone, 29 August 2006 - 05:00 PM.


#5 Smooth T

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Posted 30 August 2006 - 01:12 AM

Thanx for the 411. Is this a condition of someone you know?







*med

#6 iwalkalone

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Posted 31 August 2006 - 08:16 AM

Thanx for the 411. Is this a condition of someone you know?
*med


umm.....me? :unsure: :blush:

#7 silvercross0816

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Posted 31 August 2006 - 08:45 AM

umm.....me? :unsure: :blush:


Hi, 'iwalkalone' !

You have to find out whats causing it, to cure it.

Usually, "breakdowns" are caused by extrinsic factors. Someone / something is causing the breakdown. "Drowning" your sorrows sometimes doesnt help. The advice of psychologists is to find an alternative activity in which you re-focus your energy into more positive and acceptable thoughts. :boo:

#8 Smooth T

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Posted 31 August 2006 - 11:32 AM

:( I feel for you, kahit na hindi pa kita nakikila ng harap harapan. :flowers:
Maganda ung sinabi ni silvercross. I'm not a psychologist/pyschiatrist but I've had patients with this condition. While it is really helpful to have a professional ear to listen to the patient, the patient's social network plays an even greater role in relieving the patient. I mean friends, relatives, who recognize the condition and helps the patient find and keep this alternate activity.

Iwalkalone, there are people who truly care and can help if you just let them in....

Edited by Smooth T, 31 August 2006 - 11:36 AM.


#9 ej_qn

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Posted 26 September 2006 - 07:44 PM

Due to my vertigo not going away I've had other symptoms like heartburns and panic attacks which results in my body tremmoring. I went to another neurologist na kilala ng previous neuro ko kasi we have a problem with scheduling kasi the day my neuro has a clinic is the day may trabaho ako. Nwei, I went to this new female neuro and the she adviced me that nothing physically is wrong with me but I need to check back on her within a month or two to have my muscle twitchings checked out to see if it's just benign or there's something really wrong. But first she adviced me to go see her psychiatrist friend to help better evaluate my condition and to give me the proper medications. I just called a few hours ago and the secretary of the clinic answered. Everything was ok, I had my appointment date set but there's one BIG problem.......... the secretary informed me that the initial consultation is P2,000! Darn, to my surprise I just said..."OH, ok" then put the phone down.

My questions are:

1)Do you guyz know any other psychiatrists? I've had a psychiatrist back in 2004 kaso nasa Australia na siya and he doesn't even charge in the 1k mark for the initial consultation and he's a great psychiatrist. Sayang, I only had 2 sessions with him.

2)Is it really that expensive? Govt hospital yung clinic na pupuntahan ko pero ang mahal naman masyado. My parents are aleady saying that's it's not worth it, they're probably gonna tell me things that I already know eventhough they try to be scientific about it when really all you're after are the names of the medications they're gonna give to you. If the medz work and it's not an S2 drug then fine, just buy them.

#10 xuaeenr

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Posted 20 October 2006 - 08:15 AM

You can check out Dr. Josefina Genuino at Manila Doctors. She's very good. She takes care of patients from children to adults. I have brought brought my child to her before and I'm very satisfied with her help.

#11 M16A2

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Posted 03 November 2006 - 05:52 PM

My sister is having problems with his husband. His husband had graduated with honors from
college and a post graduate course. He finished his masteral degree in AIM in only
one year with honors. He also get very high results with different types of test (e.g english test
needed for immigration, i.Q. test, Critical thinking, reasoning).

However, he was considered as an underachiever, he landed a job as a clerk and worked his way
up to manager.Then after the company closed its operations. He exerted very little effort to look
for another job and he does not think of any other alternatives to keep himself busy, like establishing
a business venture, join associations, become a consultant, etc. All he does now is watch tv all day
and sleep.

i've been trying to convince my sister that he is evidently an intelligent person but a very lazy one.
She finds that hard to accept coz according to her if she has the same level of intelligence her husband
has, she would definitely become president of a company or a director of the board or an entrepreneur.

Is there any psychological or psychiatric term or explanation for this type or kind of person?

#12 Yama

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Posted 03 November 2006 - 09:06 PM

nah, hes just a very smart bum

#13 taboolover

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Posted 05 November 2006 - 01:55 AM

Sounds like he's insecure and has poor self-worth.

Then again, maybe he's burned out or suffered a lot of stress from his last job. Maybe he's taking some time out to rest and recover.

But if he's been underachieving for a longtime, it's more likely that he lacks motivation, and this has many causes.

As for the wife, i understand her concern but it doesn't help the situation if she's comparing her husband to herself. That just adds unnecessary pressure. He is an individual with a different personality and set of circumstances.

#14 Green Lantern

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Posted 17 November 2006 - 03:25 PM

Hello Kara,
I've been away for awhile and it has been some time since you posted anything on this topic. I hope that you have seen the silver lining around the clouds that surrounded your circumstances.

Nice avatar by the way.....artsy

#15 Green Lantern

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Posted 17 November 2006 - 05:13 PM

I concur with taboolover.
Try and find a way to motivate him without causing undue pressure

#16 Green Lantern

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Posted 18 November 2006 - 05:50 PM

It is a little difficult to distinguish between a manic state and a happy state if you are Bi-polar

#17 iwalkalone

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Posted 28 November 2006 - 03:23 PM

oh...kala ko ba may psychiatrist dito????? :unsure:

#18 pussycatdoll

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Posted 28 November 2006 - 04:54 PM

Everything was ok, I had my appointment date set but there's one BIG problem.......... the secretary informed me that the initial consultation is P2,000! Darn, to my surprise I just said..."OH, ok" then put the phone down.

My questions are:

1)Do you guyz know any other psychiatrists? I've had a psychiatrist back in 2004 kaso nasa Australia na siya and he doesn't even charge in the 1k mark for the initial consultation and he's a great psychiatrist. Sayang, I only had 2 sessions with him.

2)Is it really that expensive? Govt hospital yung clinic na pupuntahan ko pero ang mahal naman masyado. My parents are aleady saying that's it's not worth it, they're probably gonna tell me things that I already know eventhough they try to be scientific about it when really all you're after are the names of the medications they're gonna give to you. If the medz work and it's not an S2 drug then fine, just buy them.


Hello, saw this thread while I was reading the board index. I'm not sure if this post will be too late to help you out, but I know a couple of psychiatrists you may want to check out. They don't charge as much as the doctor in your anecdote above -- I know for a fact that the younger one only charges about 500-1,000 for a consultation -- but I can't vouch for the older one. I also have a friend who is a resident psychiatrist for a government hospital, but I'm not sure if they are still allowed to take on civillian patients; I think they may have already overshot their allowable limit for civvies. If you still need the information, feel free to PM me. :)

As for self-medicating, I would strongly suggest that you consult a doctor even if the drugs you're planning to take are non-S2 drugs. Non-regulated drug use can really fry your kidneys and liver. Actually, this can happen even if you're taking regulated drugs. I know people who have had to get regular dialysis after medications for their other illnesses finished off their renal systems. Please, think twice before self-medicating; it can lead to a lot of pain and problems for you in the end.

Hope this helps. Good luck with your condition. I have vertigo myself, but fortunately it's not bad enough to need medication. My good wishes are with you. :)

Edited by pussycatdoll, 28 November 2006 - 04:55 PM.


#19 iwalkalone

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Posted 30 November 2006 - 05:58 PM

. . . self-mutilation is distinct from suicide. Major reviews have upheld this distinction. . . A basic understanding is that a person who truly attempts suicide seeks to end all feelings whereas a person who self-mutilates seeks to feel better.

Living with self-injury
"to be nobody-but-myself in a world which is doing its best, night and day, to make me everybody else means to fight the hardest battle which any human being can fight, and never stop fighting" -- ee cummings

This is about a disorder...quite common but least discussed..
Thare are actually alot of people suffering from this...men and women alike ( even here in MTC)...but are all too ashamed to talk about it. Admitting to the people in your life that you self-injure is analogous in many ways to the process of coming out as gay or bi. Naturally, people who do not suffer from this disorder may never get it...why?

"Why do people deliberately injure themselves?
Drowning in the dark blood of would-be brothers who,
beyond the pressing of fingers, those for whom
the slice is only the beginning, and a different kind
of light comes in, begs recognition and peace of mind."
-- Judybats

This may be the aspect of self-harm that is most puzzling to those who do not do it. Why would anyone choose to inflict physical damage on him or herself?

Anyways....i found this article...and it's really informative. I hope this helps those who are suffering from SI disorder and for those who are not...well....for you guys to fully understand that this is real...it's a mental disorder...yes...but it's not like we're going to bite :P


#20 iwalkalone

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Posted 30 November 2006 - 06:01 PM

What self-injury is
NOTE: This section contains potentially distressing material. If you self-injure now or have in the past, please make yourself safe before reading this section; it may intensify your urge to harm.
Classifying self-harm
We all do things that aren't good for us and that may harm us. We also do things that inflict injury but that are primarily intended for other purposes. Some self-harm is culturally sanctioned, while other types are seen as pathological. Where does one draw lines?
An easy line to draw is that of deliberate, immediate physical harm being done. For example, cutting your arm or hitting yourself with a hammer are clearly self-injurious acts. Things like overeating, smoking, not exercising, etc., are harmful to a person in the long run but immediate physical damage is not the desired effect of the behaviors. What, then, about things like tattooing and piercing, where physical modification of the body is deliberate and is the desired effect?
The first step in classifying self-harm, as demonstrated by Favazza (1996), is to sort out what makes a type of self-injury pathological, as opposed to culturally-sanctioned. Socially sanctioned self-harm, he found, falls into two groups: rituals and practices. Body modification (piercings, tattoos, etc) can fall into either class.
Rituals are distinguished from practices in that they reflect community tradition, usually have deep underlying symbolism, and represent a way for an individual to connect to the community. Rituals are done for purposes of healing (mostly in primitive cultures), expressions of spirituality and spiritual enlightenment, and to mark place in the social order. Practices, on the other hand, have little underlying meaning to the practitioners and are sometimes fads. Practices are done for purposes of ornamentation, showing identification with a particular cultural group, and in some cases, for perceived medical/hygienic reasons.
Non-socially sanctioned (pathological) self-harm can be classified as either suicidality, self-mutilation (which is further broken down into major, stereotypic, and superficial/moderate), or unhealthful behavior.
Kahan and Pattison (1984; Pattison and Kahan, 1983) tackled these taxonomic problems. They began by identifying three components of self-harming acts: directness, lethality, and repetition.
Directness
refers to how intentional the behavior is; if an act is completed in a brief period of time and done with full awareness of its harmful effects and there was conscious intent to produce those effects, it is considered direct. Otherwise, it is an indirect method of harm.
Lethality
refers to the likelihood of death resulting from the act in the immediate or near future. A lethal act is one that is highly likely to result in death, and death is usually the intent of the person doing it.
Repetition
refers to whether of not the act is done only once or is repeated frequently over a period of time It is defined simply by whether or not the act is done repeatedly.
The following table gives examples of each combination of these factors:
Repetitive In Nature? Direct Behaviors Indirect Behaviors
High lethality Low lethality High lethality Low lethality
yes taking small doses of arsenic over time self-injury: cutting, burning, hitting, etc. type 1 diabetic not injecting insulin smoking, alcoholism
no gunshot wound to head major self-mutilation terminal cancer patient refusing chemo walking around downtown alone at 3 a.m.
Definitions of moderate/superficial self-injury
Perhaps the best definition of self-injury is found in Winchel and Stanley (1991), who define it as
...the commission of deliberate harm to one's own body. The injury is done to oneself, without the aid of another person, and the injury is severe enough for tissue damage (such as scarring) to result. Acts that are committed with conscious suicidal intent or are associated with sexual arousal are excluded.
Mosby's Medical, Nursing, and Allied Health Dictionary (1994) contains the following definition:
Self-mutilation, high risk for
A nursing diagnosis . . . defined as a state in which an individual is at high risk to injure but not k*ll himself or herself, and that produces tissue damage and tension relief. Risk factors include being a member of an at-risk group, inability to cope with increased psychological/physiological tension in a healthy manner, feelings of depression, rejection, self-hatred, separation anxiety, guilt, and depersonalization, command hallucinations, need for sensory stimuli, parental emotional deprivation, and a dysfunctional family.
Groups at risk include clients with borderlines personality disorder (especially females 16 to 25 years of age), clients in a psychotic state (frequently males in young adulthood), emotionally disturbed and/or battered children, mentally retarded and autistic children, clients with a history of self-injury, and clients with a history of physical, emotional, or sexual abuse.
Malon and Berardi (1987) summarize the process they believe underlies self-injury:
Investigators have discovered a common pattern in the cutting behavior. The stimulus...appears to be a threat of separation, rejection, or disappointment. A feeling of overwhelming tension and isolation deriving from fear of abandonment, self-hatred, and apprehension about being unable to control one's own aggression seems to take hold. The anxiety increases and culminates in a sense of unreality and emptiness that produces an emotional numbness or depersonalization. The cutting is a primitive means for combating the frightening depersonalization.
This seems to coincide with the definition given in Mosby's of someone susceptible to self-harm.
This site is concerned mainly with moderate/superficial self-harm, which is direct, repetitive, and of low lethality. Stereotypic self-mutilation tends also to be direct, repetitive, and of low lethality, whereas major self-mutilation (discussed below) is direct, not repetitive, and of low lethality. Moderate self-harm can be further divided into impulsive and compulsive.
Varieties of Self-Harm
Self-injury is separated by Favazza (1986) into three types. Major self-mutilation (including such things as castration, amputation of limbs, enucleation of eyes, etc) is fairly rare and usually associated with psychotic states. Stereotypic self-injury comprises the sort of rhythmic head-banging, etc, seen in autistic, mentally retarded, and psychotic people. The most common form of self-mutilation, and the topic of this site, is called superficial or moderate. This can include cutting, burning, scratching, skin-picking, hair-pulling, bone-breaking, hitting, deliberate overuse injuries, interference with wound healing, and virtually any other method of inflicting damage on oneself. Both in clinical studies and in an informal Usenet survey, the most popular act was cutting, and the most popular sites were wrists, upper arms, and inner thighs. Many people have used more than one method, but even they tend to favor one or two preferred methods and sites of abuse.
Compulsive self-harm
Favazza (1996) further breaks down superficial/moderate self-injury into three types: compulsive, episodic, and repetitive. Compulsive self-injury differs in character from the other two types and is more closely associated with obsessive-compulsive disorder (OCD). Compulsive self-harm comprises hair-pulling (trichotillomania), skin picking, and excoriation when it is done to remove perceived faults or blemishes in the skin. These acts may be part of an OCD ritual involving obsessional thoughts; the person tries to relieve tension and prevent some bad thing from happening by engaging in these self-harm behaviors. Compulsive self-harm has a somewhat different nature and different roots from the impulsive (episodic and repetitive types).
Impulsive self-harm
Both episodic and repetitive self-harm are impulsive acts, and the difference between them seems to be a matter of degree. Episodic self-harm is self-injurious behavior engaged in every so often by people who don't think about it otherwise and don't see themselves as "self-injurers." It generally is a symptom of some other psychological disorder.
What begins as episodic self-harm can escalate into repetitive self-harm, which many practitioners (Favazza and Rosenthal, 1993; Kahan and Pattison, 1984; Miller, 1994; among others) believe should be classified as a separate Axis I impulse-control disorder. Favazza (1997) suggests that until repetitive self-harm is recognized as a separate category in the DSM, practitioners should diagnose it on Axis I as 312.3, Impulse-Control Disorder Not Otherwise Specified.
Repetitive self-harm is marked by a shift toward ruminating on self-injury even when not actually doing it and self-identification as a self-injurer (Favazza, 1996). Episodic self-harm becomes repetitive when what was formerly a symptom becomes a disease in itself (as seen in the way many people who self-injure describe self-harm as being "addictive"). It is impulsive in nature, and often becomes a reflex response to any sort of stress, positive or negative. Just like smokers who reach for a cigarette when they're overwhelmed, repetitive self-injurers reach for a lighter or a blade or a belt when things get to be too much.
In a study of bulimics who self-harm, Favaro and Santonastaso (1998 ) , used a statistical technique known as factor analysis to try to distinguish between which kinds of acts were compulsive in nature and which were impulsive. They report that vomiting, severe nail biting, and hair pulling loaded on the compulsive factor, whereas suicide attempts, substance abuse, laxative abuse, and skin cutting and burning loaded on the impulsive factor.
Should self-injurious acts be considered botched or manipulative suicide attempts?
Favazza (1998 ) states, quite definitively, that
. . . self-mutilation is distinct from suicide. Major reviews have upheld this distinction. . . A basic understanding is that a person who truly attempts suicide seeks to end all feelings whereas a person who self-mutilates seeks to feel better.
Although these behaviors are sometimes referred to "parasuicide," most researchers recognize that the self-injurer generally does not intend to die as a result of his/her acts. "[S]uicide attempts are reported not to provide relief, to be repeated less frequently, and to have less communicative value" (van der Kolk et al., 1991). "Patients with the [proposed Deliberate Self-Harm Syndrome] often suffer social ostracism and, in desperation, may attempt suicide (Favazza et al, 1989) [emphasis added]. Thus, although self-injurious behavior is not suicidal in intent, it can easily lead to suicidal ideation or even, when a self-harmer goes too far, suicide itself. Herpertz (1995) notes that self-injurers distinguish between self-injurious acts and suicidal ones, and Solomon and Farrand (1996) say "Although the [self-injurious and suicidal] acts themselves may blur, their meaning does not. What does emerge, though, is a link between the two acts in that one (self-injury) is an alternative to the other (suicide), and is preferable." In a review of the literature on self-injury, Favazza (1998 ) notes that only recently has it become generally recognized that self-harm is a morbid form of coping, one which is often turned to when suicide seems inescapable. He writes that "traditionally it has been trivialized ([delicate] wrist cutting), misidentified (suicide attempt) and regarding solely as a symptom [of borderline personality disorder.
Further support for the distinct nature of self-injury comes from a study of psychiatric diagnoses among self-injurers as opposed to attempted suicides (Ferreira de Castro et al., 1998 ) . On Axis I, 14% of self-injurers (SI) were diagnosed with major depression, as opposed to 56% of the suicide-attempters (SA). Alcohol dependence was diagnosed in 16% of the SI group, but in 26% of the SA group. Only 2% of the SI group were considered schizophrenic; 9% of the SA group were. The SI group was more likely to be dysthymic (12% vs 7%) or to be diagnosed with adjustment disorder with depressed mood (24% vs 6%). Of course, the fact of a suicide attempt may have influenced the depression-related diagnoses.
This study also revealed similar disparities in Axis II diagnoses of those whose self-harm was directed toward suicide and those whose was not, although 9% of both groups were considered borderline and 0% of each were considered to have avoidant personality disorder. There were sharp differences among rates in the other personality disorders -- dependent: 13% SI, 7% of SA; schizoid: 2% SI, 5% SA; and histrionic: 22% SI, 4% SA. It seems clear, then, that those who self-injure in order to die and those who do it in order to cope present very different psychiatric profiles.
Informal surveys collected via the net reveal that many of those who injure themselves are strongly aware of the fine line they walk, but are also resentful of doctors and mental health professionals who mistake their incidents of self-harm as suicide attempts instead of seeing them as the desperate attempts to stave off suicide that they often are.
Is self-injury the same thing as Munchausen's or some other factitious disorder?
Again, NO. Little research has been done on whether there is a connection between SI and Munchausen's or similar syndromes, but uneducated medical professionals sometimes conflate the two. In SI, the person is injuring to escape unbearable emotional and physiological tension; in Munchausen's the injuries inflicted are deliberate and calculated to produce specific symptoms that will lead to a medical hospital admission. Although some people who self-injure desire hospitalization, it is almost always to a psychiatric ward and not to a general medical floor. Clients with Munchausen's, on the other hand, shy away from psychiatric care and seek to be admitted on the medical service.

Why do people deliberately injure themselves?
Drowning in the dark blood of would-be brothers who,
beyond the pressing of fingers, those for whom
the slice is only the beginning, and a different kind
of light comes in, begs recognition and peace of mind.
-- Judybats
This may be the aspect of self-harm that is most puzzling to those who do not do it. Why would anyone choose to inflict physical damage on him or herself? There is evidence that self-injurers, when faced with strong emotion or overwhelming situations, choose to harm themselves because it brings them a rapid release from tension and anxiety. These situations cause an increase in physiological arousal, and self-injury quickly drops that level of arousal close to baseline. The self-injurer may feel release,but even if s/he feels guilty or angry afterward, it won't be an oppressive, pushing, demanding tension-filled feeling like it was before.
More insights into the reasons behind self-injury can be gained from two valuable sources: objective and subjective.
Subjective: What self-injurers say SI does for them
Miller (1994) and Favazza (1986, 1996). among others, discuss several possible motivations:
· Escape from emptiness, depression, and feelings of unreality.
· In order to ease tension.
· Relief: when intense feelings build, self-injurers are overwhelmed and unable to cope. By causing pain, they reduce the level of emotional and physiological arousal to a bearable one.
· Expression of emotional pain
· Escaping numbness: many of those who self-injure say they do it in order to feel something, to know that they're still alive.
· Obtaining a feeling of euphoria
· Continuing abusive patterns: self-injurers tend to have been abused as children. Sometimes self-mutilation is a way of punishing oneself for being "bad."
· Relief of anger: many self-injurers have enormous amounts of rage within. Afraid to express it outwardly, they injure themselves as a way of venting these feelings.
· Biochemical relief: there is some thought that adults who were repeatedly traumatized as children have a hard time returning to a "normal" baseline level of arousal and are, in some sense, addicted to crisis behavior.
· Obtaining or maintaining influence over the behavior of others
· Exerting a sense of control over one's body
· Grounding in reality, as a way of dealing with feelings of depersonalization and dissociation
· Maintaining a sense of security or feeling of uniqueness
· Expressing or repressing sexuality
· Expressing or coping with feeling of alienation
Miller also notes one explanation for why such a large majority of these patients are female: women are not socialized to express violence externally. When confronted with the vast rage many self-injurers feel, women tend to vent on themselves. She quotes the feminist poet Adrienne Rich:
"Most women have not even been able to touch
this anger except to drive it inward like a
rusted nail."
As Miller says, "Men act out. Women act out by acting in." Another reason fewer men self-injure may be that men are socialized in a way that makes repressing feelings the norm. Linehan's (1993a) theory that self-harm results in part from chronic invalidation, from always being told that your feelings are bad or wrong or inappropriate, could explain the gender disparity in self-injury; men are generally brought up to hold emotion in.
Objective: What the researchers have found
People who self-injure tend to be dysphoric -- experiencing a depressed mood with a high degree of irritability and sensitivity to rejection and some underlying tension -- even when not actively hurting themselves. The pattern found by Herpertz (1995) indicates that something, usually some sort of interpersonal stressor, increases the level of dysphoria and tension to an unbearable degree. The painful feelings become overwhelming: it's as if the usual underlying uncomfortable affect is escalated to a critical maximum point. "SIB has the function of bringing about a transient relief from these [high levels of irritability and sensitivity to rejection]," Herpertz said. This conclusion is supported by the work of Haines and her colleagues.
In a fascinating study, Haines et al. (1995) led groups of self-injuring and non-self-injuring subjects through guided imagery sessions. Each subject experienced the same four scenarios in random order: a scene in which aggression was imagined, a neutral scene, a scene of accidental injury, and one in which self-injury was imagined. The scripts had four stages: scene-setting, approach, incident, and consequence. During the guided imagery sessions, physiological arousal and subjective arousal were measured.
The results were striking. Subject reactions across groups didn't differ on the aggression, accident, and neutral scripts. In the self-injury script, though, the control groups went to a high level of arousal and stayed there throughout the script, in spite of relaxation instructions contained in the "consequences" stage. In contrast, self-injurers experienced increased arousal through the scene-setting and approach stages, until the the decision to self-injure was made. Their tension then dropped, dropping even more at the incident stage and remaining low.
These results provide strong evidence that self-injury provides a quick, effective release of physiological tension, which would include the physiological arousal brought on by negative or overwhelming psychological states. As Haines et al. say
Self-mutilators often are unable to provide explanations for their own self-mutilative behavior. . . . Participants reported continued negative feelings despite reduced psychophysiological arousal. This result suggests that it is the alteration of psychophysiological arousal that may operate to reinforce and maintain the behavior, not the psychological response. In other words, self-injury may be a preferred coping mechanism because it quickly and dramatically calms the body, even though people who self-injure may have very negative feelings after an episode. They feel bad, but the overwhelming psychophysiological pressure and tension is gone. Herpertz et al. (1995) explain this:
We may surmise that self-mutilators usually disapprove of aggressive feelings and impulses. If they fail to suppress these, our findings indicate that they direct them inwardly. . . . This is in agreement with patients' reports, where they often regard their self-mutilative acts as ways of relieving intolerable tension resulting from interpersonal stressors. .
Herman (1992) says that most children who are abused discover that a serious jolt to the body, like that produced by self-injury, can make intolerable feelings go away temporarily.
Brain chemistry may play a role in determining who self-injures and who doesn't. Simeon et al. (1992) found that people who self-injure tend to be extremely angry, impulsive, anxious, and aggressive, and presented evidence that some of these traits may be linked to deficits in the brain's serotonin system. Favazza (1993) refers to this study and to work by Coccaro on irritability to posit that perhaps irritable people with relatively normal serotonin function express their irritation outwardly, by screaming or throwing things; people with low serotonin function turn the irritability inward by self-damaging or suicidal acts. Zweig-Frank et al. (1994) also suggest that degree of self-injury is related to serotonin dysfunction. More information on the likely role of serotonin in self-injury can be found on the psychopharmacology page.
Those who self-injure may have personality characteristics that increase the likelihood of their self-injury. Haines and Williams (1997) found that self-mutilators reported more use of problem avoidance as a coping strategy and perceived themselves to have less control over problem-solving options. This feeling of disempowerment may in turn be related to the chronic invalidation many self-injurers have experienced.

Edited by iwalkalone, 30 November 2006 - 06:32 PM.





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