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July 2, 2009 12:25 PM   Subscribe


 
I have a bipolar invisible friend.
posted by qvantamon at 12:36 PM on July 2, 2009


Related: the daunting case of a 6-year-old schizophrenic (LA Times link).
posted by scody at 12:36 PM on July 2, 2009 [22 favorites]


That article scody links to is a gripping (and terrifying) read.
posted by yoink at 1:25 PM on July 2, 2009


That article scody links to is a gripping (and terrifying) read.

Absolutely. The accompanying video is well worth watching, too.
posted by a little headband I put around my throat at 1:55 PM on July 2, 2009


Actually, the link between bipolar and schizophrenia has long been known to psychiatrists and researchers in this area. In fact, some countries are known to err on the side of calling intermediate conditions bipolar, while others err on the side of calling them schizophrenia.

And there are intermediate conditions: when you have someone who believes they are God tormented by devils, it's not always easy to tell if its paranoid schizophrenia or mania.
posted by Maias at 2:00 PM on July 2, 2009


That poor kid. Her poor family.

It's fascinating - and wonderful - that they're discovering more about schizophrenia, and its (genetic) relationship to bipolar disorder. But how do you go about finding a cure for something that is the result of not one or two mutations, but thousands?
posted by rtha at 2:02 PM on July 2, 2009


Now seems like a good time to remember that we don't know that "schizophrenia" is one thing in any meaningful way. If we think of schizophrenia as a unitary disease, then we should be surprised to learn that it can be caused by mutations in any of thousands of different genes (see the Tierney post). If we think of it as a cluster of superficially related dysfunctions, it makes much more sense.
posted by grobstein at 2:23 PM on July 2, 2009


(The Independent piece seems to draw its "hopeful" conclusions from a model with N in the 10,000s and several thousand explanatory variables.)
posted by grobstein at 2:28 PM on July 2, 2009


Not a shock to most people suffering from either: Schizoaffective disorder

"The diagnosis was introduced in 1933."
posted by Brocktoon at 2:48 PM on July 2, 2009


I've seen this happening big time in cancer research: We're discovering a great deal about cancers on the molecular level, and everything we're learning tells us how much more complex they are than we'd believed way back... oh, yesterday. It's like a Mandelbrot zoom.
posted by Faze at 2:55 PM on July 2, 2009


Umm, so there are tens of thousands of rare gene defects that cause schizophrenia and schizophrenia-like symptoms. Despite the doom and gloom of the second essay this is actually pretty great news. While it's true that there won't be any one-shot genetic treatment to cure schizophrenia, by examining the different proteins connected to the genes we can evaluate which parts of normal molecular messaging break down. Because so many different gene variants cause schizophrenia, in very different forms, it stands to reason that these genes identified are involved in similar processes in different areas. Different proteins can break down in the same process and have the same general effect on behavior.

Granted, the staggering variance in the genes is daunting but even having a small subset of the genes identified is a huge step forward that allows us to begin to examine the function of these genes in regulating neuronal activity.
posted by scrutiny at 2:57 PM on July 2, 2009


Well, the good news, such as it is, is that it isn't caused by cannabis.
posted by gingerbeer at 3:17 PM on July 2, 2009


I used to be schizophrenic, but we're okay now.
posted by jamstigator at 6:07 PM on July 2, 2009


Stay classy, jamstigator.
posted by dirtynumbangelboy at 7:36 PM on July 2, 2009 [3 favorites]


I have a bipolar invisible friend.
posted by qvantamon at 5:36 AM on July 3


Bipolar disorder doesn't cause hallucinations.

I used to be schizophrenic, but we're okay now.
posted by jamstigator at 11:07 AM on July 3


Schizophrenia doesn't cause multiple personalities.

Seriously, if the best you have to offer Metafilter is LOLMentalIllness snark, at least get your facts straight. Or, you know, you could try contributing thoughtfully to the discussion.
posted by embrangled at 10:11 PM on July 2, 2009 [2 favorites]


An honest question: Is it as insensitive and/or offensive to throw out the word 'crazy' around a schizophrenic as it is to say 'retard' near a developmentally disabled person?
posted by Fezzik's Underwear at 10:39 PM on July 2, 2009 [1 favorite]


I have a bipolar invisible friend.
posted by qvantamon at 5:36 AM on July 3

Bipolar disorder doesn't cause hallucinations.


Actually it sometimes does, although not as often as schizophrenia, e.g here states:
"At admission, the cross-sectional prevalence of current hallucinations among 4972 hospitalized subjects ranked: schizophrenia (61.1%), bipolar mixed (22.9%), bipolar manic (11.2%), bipolar depressed (10.5%), unipolar depressed (5.9%)"
posted by Ruaidhri at 11:06 PM on July 2, 2009


I've met people with mental illness diagnoses who called themselves 'crazy' with an air of wry, self-aware humour. I've also heard the word used thoughtlessly to describe people who were really struggling, and I don't think the people who said it realised just how callous it made them sound.

Words like 'retard' and 'crazy', along with a variety of racial and sexual slurs, have different emotional impacts depending on who they're said by. If you're removed enough from a group or issue that you need to ask whether a word is appropriate, it's a good sign that you should probably tread carefully and avoid using the word. I would never use 'crazy' to describe a particular person with a mental illness, although I'd gladly call crazy behaviour for what it is.
[/derail]
posted by embrangled at 11:14 PM on July 2, 2009 [1 favorite]


thousands of tiny genetic mutations – known as single nucleotide polymorphisms

A mutated SNP is not necessarily a mutated gene or gene product: it could code for the same aminoacid, it could code for a different aminoacid but with the same polarity without any change in the functionality of the protein, it could code for a different aminoacid that will affect the folding of the protein without any changes of functionality, etc.

Genetic has come a long way from the early the belief of one gene, one disease. The focus of research now is on what changed proteins are associated with what disease, and on how pharmacogenetics can aid in the treatment of these diseases. The treatment of chronic myelogenous leukemia with Gleevec is one of the amazing results of this focus.

As for hallucinations and other symptoms of mental illness, the NAMI course I took to learn how to deal better with my son's illness has taught me that the spectrum of symptoms is a continuum from one disease to the next and that in addition to sufferers of schizophrenia, schizoaffective disorders and bipolar disorders, severely depressed people can also experience hallucinations, visual or aural.
posted by francesca too at 5:52 AM on July 3, 2009


the early the belief
posted by francesca too at 5:54 AM on July 3, 2009


Is it as insensitive and/or offensive to throw out the word 'crazy' around a schizophrenic

Yes, to throw out the word "crazy" around them is insensitive.

But after they're gone, go nuts.

(Seriously, is anyone's moral sense so nuanced and developed, that they would object to one saying, "that person's crazy," after an encounter with a schizophrenic person?)
posted by jayder at 7:08 AM on July 3, 2009


As someone with severe mental illnesses in my immediate family tree (schizophrenia, major depression) and being bipolar, myself, I appreciate the link and the discussion. Sorry, but this is about to get long.

In that second article it seems like the author is hand-wringing that nature turned out to be more complex than those easy scenarios we hoped up. This is a reaction I don't particularly understand, but I can handle. Phrasing it as a 'historical defeat', however, is patently backwards. This is very obviously not a "step back". We know more than we did before, which is progress. I can understand the disappointment in the nature of this new knowledge, but if the main complaint is 'the reporters made this discovery sound really good, and it is really good, but it's not the kind of good I like', well, sorry, but maybe we could go with a rallying cry instead of a quiet sob in the corner.

Anyway, as to the question if calling someone crazy is offensive or not, I've finally started learning that if it offends even one person, it's offensive. Seems like a simple lesson, I know, but I had some trouble with it. Personally I refer to my medication as my 'crazy pills' and like to pretend that if I didn't take it I would be covered in mud and wearing five hats, but that's mostly because it's amusing to me and we all need to laugh sometimes. If someone in the street were to call me crazy, however, I would probably either glare at them or break down sobbing, depending on my mood, and I'm only bipolar. If you know someone is schizophrenic, rather than calling them crazy, it would probably better to say that he or she has schizophrenia. It's a disorder that way, not simply a behavior, and that is more sensitive towards that fact.

In terms of bipolar disorder, a decent memoir on it (and a true one) is An Unquiet Mind by Kay Redfield Jamison. Obviously each person experiences these sorts of disorders differently, and to different degrees, but it paints a good picture of how bipolar disorder can be. And it certainly covers Ruaidhri's and francesca too's correct statement concerning hallucinations, which I can also attest to.
posted by six-or-six-thirty at 9:02 AM on July 3, 2009 [3 favorites]


Is it as insensitive and/or offensive to throw out the word 'crazy' around a schizophrenic as it is to say 'retard' near a developmentally disabled person?

Not to get all high-and-mighty, but I'd say that the use of the word 'retard' should not depend on how near you are to anyone at all, in the same way that the use of other offensive terms should not depend on proximity to a member of a minority.
posted by not_that_epiphanius at 9:34 AM on July 3, 2009 [1 favorite]


I've always found it a bit puzzling that "retarded" became the dreaded R-word that must not be spoken. I mean, it simply means "delayed"--the idea being that normal intellectual development has been halted or impeded. How that is in any way more insulting than "disabled" or "impaired" or "challenged" or any other term you might imagine is beyond me. It's like trying to find the difference between "colored person" and "person of color."
posted by yoink at 10:15 AM on July 3, 2009


It's not because of any inherent meaning. "Retarded" is a bad word because it was appropriated as a pejorative in the popular language. Sometimes there is what Steven Pinker calls a "treadmill" effect: a clinical, technical word is adopted; it's appropriated as a pejorative in the popular language; and then a new technical term must be chosen to avoid the negative connotations.

Of course, this is sort of a losing battle against the natural associations of the term. Stupidity is regarded as bad, so terms that indicate stupidity come to have bad associations. The current tactic calls for using terms that are either too clunky or too vague to catch on as insults ("developmentally disabled").
posted by grobstein at 11:42 AM on July 3, 2009 [3 favorites]


Idiot and moron were also clinical terms at one time, just like retard. Yet we are all perfectly fine with only two out of three of those words these days.

Which is, frankly, a little retarded.
posted by five fresh fish at 12:35 PM on July 3, 2009


Anyway, as to the question if calling someone crazy is offensive or not, I've finally started learning that if it offends even one person, it's offensive. Seems like a simple lesson, I know, but I had some trouble with it. Personally I refer to my medication as my 'crazy pills' and like to pretend that if I didn't take it I would be covered in mud and wearing five hats, but that's mostly because it's amusing to me and we all need to laugh sometimes. If someone in the street were to call me crazy, however, I would probably either glare at them or break down sobbing, depending on my mood, and I'm only bipolar. If you know someone is schizophrenic, rather than calling them crazy, it would probably better to say that he or she has schizophrenia. It's a disorder that way, not simply a behavior, and that is more sensitive towards that fact.

Is it insensitive to call a schizophrenic person "crazy"? Yes, but that doesn't mean it's incorrect. In fact, it would be insensitive to call a crazy person "crazy," just like it's insensitive to call a stupid person "stupid." Crazy is not a precise term, but certainly many people in the schizophrenic spectrum are crazy. But one should try to be nice about it.
posted by grobstein at 12:52 PM on July 3, 2009


I've finally started learning that if it offends even one person, it's offensive.

In that case: Everything. Is. Offensive.

Six bajillion people in this world, you can be sure that anything you say is sure to offend someone.
posted by five fresh fish at 1:38 PM on July 3, 2009


I've always found it a bit puzzling that "retarded" became the dreaded R-word that must not be spoken.

I have nothing against the appropriate use of the word. Grobstein nicely points out the difficulty.

"Retarded" was probably coined in part as a reaction to the misuse of terms like idiot, imbecile and moron. Unfortunately, it was even less descriptive. Having a mental handicap (the term I've settled on, despite objections from some quarters) actually has little to do with retardation, or even delay, as there is an implication that 'if only we could remove the delay, then this person would be more like me'. There is usual no identifiable delay in this sense in a person with a mental handicap.

As Grobstein points out, it's harmful to use the connotations that accumulate about a group - Jews, Gays, or folks-who-carry-themselves-a-little-differently-than-most-of-us - as a shortcut in describing those connotations.

A likely reason that using 'retard' this way is still as acceptable as it is, is that the group being maligned is uniquely unable to defend itself, defined as it is, in part, by it's lack of linguistic and cognitive sophistication.
posted by not_that_epiphanius at 2:20 PM on July 3, 2009


Is it insensitive to call a schizophrenic person "crazy"? Yes, but that doesn't mean it's incorrect.

I agree.

In that case: Everything. Is. Offensive.

Six bajillion people in this world, you can be sure that anything you say is sure to offend someone.


I'm glad you've grasped the point.
posted by six-or-six-thirty at 10:41 PM on July 3, 2009


So what is your point when you say "I've finally started learning that if it offends even one person, it's offensive"?
posted by five fresh fish at 7:10 AM on July 4, 2009


My point is that everything will offend someone. I had thought that was fairly self-evident in the statement. You can't, therefore, say that anything is 'not offensive'.

So the ultimate result of this is simply that you should be careful with what you say, at least if you have any intention of trying to be 'sensitive'. Chances are that, if you don't know someone, using a somewhat 'riskier' word (like 'crazy' or 'retarded' -- given the incredibly negative skew society has assigned to it) might not be the best move. This is assuming you don't want to intentionally be insensitive.

And, of course, you can mistakenly offend people by choosing one word over the other. All you can really do is try. I'm not even saying that everyone should be walking on eggshells all the time. I'm just saying that it's good to be aware, even if you do choose the insensitive route.

Is this really such a contentious thing?
posted by six-or-six-thirty at 5:26 PM on July 5, 2009


Dunno about contentious.

So how do we change these "incredibly negative skew" words into words that are… just words? Or do we just give up and relegate them to the dustbin of history?

My preference is to reclaim them. Doing so takes away their power.
posted by five fresh fish at 7:13 PM on July 5, 2009


So how do we change these "incredibly negative skew" words into words that are… just words? Or do we just give up and relegate them to the dustbin of history?

My preference is to reclaim them. Doing so takes away their power.


In that case, just to reiterate:
"I'm not even saying that everyone should be walking on eggshells all the time. I'm just saying that it's good to be aware, even if you do choose the insensitive route."

That's all I'm going to say on this, as I'm not really interested in getting into a reclamation vs. avoidance debate, and that's certainly not why I came into this thread.
posted by six-or-six-thirty at 7:53 PM on July 5, 2009


Okey-dokey. It's all good.
posted by five fresh fish at 9:33 PM on July 5, 2009


It's worth asking why the word crazy is offensive.

When I use the word crazy I mean out of touch with reality. That's a commonplace definition, if not the only one, and people may reasonably think that this is what you mean when you use the word.

People are crazy when their beliefs are distorted and/or their behaviour is bizarre. Everybody gets a little crazy sometimes. Get really drunk and you'll get really crazy, right? In that respect the word crazy seems quite inoffensive, though it may or may not be insensitive to joke about how crazy someone was last night.

People who are mentally ill can become exceedingly crazy, no booze required. When that happens, they may or may not be able to get back to reality without help. Giving them help may mean helping them see their false beliefs as false, or putting them in the hands of professionals (voluntarily, or in some circumstances involuntarily), or hiding all the knives in the house, or just making sure they have the space and time they need to calm down. Giving them what they need may require being a bit paternalistic (or extremely paternalistic if they end up in a locked ward), but if you do it right they may thank you when they recover.

Calling a schizophrenic person crazy is offensive (I think) because it implies that they are crazy all the time. If so, what they say is never reliably true. They will always need to be supervised and scrutinized because they simply are not capable of managing their own lives. Those assumptions are false, since schizophrenics who are on their meds and otherwise getting whatever help they need are usually in touch with reality, and are capable of living their own lives. That's why calling a schizophrenic crazy is offensive going on evil -- you're saying that they are and always will be helpless or dangerous. It's bad enough coming from you, but imagine what effect those assumptions can have when they are made by a boss, or by a police officer.

So yeah, here's what I think:

1) you can say that a person was acting crazy when they are/were acutely ill. That's perfectly fine so long as you know that the people around you are not sensitive about the word. Keep in mind that people may be sensitive because...

2) equating being schizophrenic with being crazy means excluding schizophrenics from society. It's saying that they should be assumed to be a danger to themselves and others no matter how healthy they may seem, and saying they are unlikely to make much of a contribution to society. Calling schizophrenics crazy makes you a bigot, or at least makes you sound like a bigot.
posted by justsomebodythatyouusedtoknow at 12:04 PM on July 7, 2009 [1 favorite]


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