Saturday, June 17, 2017

Job discrimination and mental illness

Recently I've applied for a number of library government positions in southern Oregon where I'm fairly sure I met the minimum requirements but was never even asked for an interview. The basic requirements were the following: a high school degree and some experience working in a library.I wonder if there is some way to report discrimination at the level of a job application if it was due to age, mental illness(I admitted a disability) or gaps in employment? I have a recent seven-year gap in employment due to illness of parents and self. My father had heart problems and died in 2011 and my mother has dementia since 2009 due to a stroke. I additionally experienced a psychotic episode in 2010. During that period( 2010 - 2017) I volunteered for two years in a college library, assisted a person with research on a book and have taken care of my mother who has a moderate level of dementia.

Since I have a bachelor's degree in Biochemistry/Psychology, five years experience working in a library(OHSU/ Lewis and Clark) and two years experience supporting systematic type health reviews in the Portland VA, I feel more than qualified for a position that could be filled by some one with lower qualifications. I have also applied for some office assistant positions at a university which I'm sure I met the minimum qualifications but was never even asked for an interview. I think my gaps in employment in addition to age ( which can easily be looked up) prevented an interview. I think when employers see large gaps they sense something is wrong health and or personality wise. I love how people are angry at the unemployed/disabled while at the same time discriminating unjustly against them. An excerpt from a medscape article  and a second article summarizes it best.
Work is a major determinant of mental health and a socially integrating force that is highly valued. No single social activity conveys more of a sense of self-worth and social identity than work. To be excluded from the workforce not only creates material deprivation but also erodes self-confidence, creates a sense of isolation and marginalization and is a key risk factor for mental disability.
“Once they heard that word that’s it. Sometimes I think it’s worse than telling them you’ve been in jail. Once you mention that their face changes and their body language changes and you know you won’t get the job”.
“I applied for a government job and they said the mental state wasn’t quite what they were looking for.”
I believe that discrimination due to mental illness was at play also when I lost my last position with the VA. I overheard conversations toward the end about me which strongly hinted that my health was problematic and that they needed to be cautious about getting rid of me. This came from a medical doctor who should be more enlightened on the topic. In the end, they gave much of my work to an intern who was doing it for free and when I protested my position was eliminated.

Is there any recourse here? Obviously if one reports discrimination he/she will probably not get the position or even if he/she did probably wouldn't want to work there because of potential retaliation. This issue bothers me on principle and also obviously for financial reasons. Reporting employers like this would feel like time well spent but in the long-term might be bad strategy. I think employers know this and this is why this crap persists.

Friday, March 24, 2017

Is it possible to be chronically depressed and optimistic at the same time?

Is it possible to be chronically depressed and optimistic at the same time?

A couple of months ago I came across an article in Elite Daily about people who tend to run late and one common feature was that they were optimists. I am one of those people and I tend to run around 5 minutes late for most of my appointments. I can remember being late for school in fifth grade and having to sprint to school most days. A positive byproduct of this was I won a number of awards in track and field. Despite the lack of awards for most of my life this pattern continues and for some reason it is hard to break. continued

Wednesday, January 25, 2017

Is there a correlation between Dysthymia, personality and the MBTI?

I have been diagnosed with Dysthymia (Persistent Depressive Disorder) in the past and I was reluctant to accept the diagnosis. Even though I have spent most of my life dealing with depressive like symptoms, for some reason I refused to identify with the label completely. In the past, when a teenager and young adult, I experienced mostly depression and occasionally normal/ hypomanic periods. As I have stated in my about section, I experienced severe depression in the morning and normal/hypomania in the evening with quite a regularity. Many clinicians would describe this as diurnal variation in the context of a mood episode but I am not so sure. continued at Mood Spectrum Indigo

Monday, January 9, 2017

Mentally ill rights tied to women’s rights

Mentally ill rights tied to women’s rights

I've noticed there is an association between depression and female traits in many people's minds. People with depression are often seen as overly sensitive, weak, indecisive, unstable and perhaps just neurotic. Many of Freud's patients were women who were often seen in a negative light and that still continues today.

Yesterday I came across an article in the Atlantic regarding how women like Hillary are viewed as candidates. Generally strong women like her are viewed in a negative light and when I say strong, I mean being the opposite of clinically depressed. Hillary is a woman with more male characteristics and Trump supporters are attacking her at the moment for being overly male, "Trump that bitch", and somewhat ironically also for being weak as well when focusing on her health. According to some psychologists the reason might be that some men feel emasculated by a women leader. continued on Mood Spectrum Indigo

Sunday, January 8, 2017

Is there a connection between migraines, seizures and depression?

For most of my life I've experienced fatigue and headaches. It wasn't until relatively recently though that it occurred to me that my fatigue might be related to having migraines. In 2009 after reading about the connection between mood disorders and migraines I convinced my GP to let me try Valproate to prevent migraines. During that time though I experienced a psychotic reaction and the focus on treating the migraines was some how lost. I also tried Propanolol but it had such a sedating effect I couldn't tolerate it for long. I felt like I was about to pass out the entire time I was on it.

A young woman holding her painful head
A young woman holding her painful head
Recently after some reflection it occurred to me that the symptoms that I was experiencing for most of my life in addition to the fatigue were those of a migraine. A few of those symptoms include the following: problems with temperature regulation, stiffness in neck and jaw, sensitivity to light, sensitivity to sound, tingling sensation, problems finding the right word, stomach problems and sleepiness. According to research people with chronic fatigue are more likely to experience migraines. These studies according to Healthrising support my hypothesis to a degree.
Two studies suggest as many as 75% of people with chronic fatigue syndrome experience migraines and that most migraines in ME/CFS are undiagnosed.  Agreeing that migraines are common in ME/CFS, WebMD, which has very little to say otherwise about chronic fatigue syndrome, states ME/CFS is one of five disorders  with high migraine rates.
Given the long list of migraine symptoms and the considerable overlap with ME/CFS symptoms (visual disturbances, sensitivity to light/sound, weakness, pins and needles, speech problems, nausea, vomiting, increased urination, etc) .the low diagnostic rates may not be surprising.
What additionally supports my hypothesis is that my chronic fatigue started around age twelve which coincided with the start of menstruation. Women according to statistics are more likely to have migraines, depression and chronic fatigue. Oddly, I also occasionally experienced a brief remission of depression and fatigue during menses.

I think my migraine like headaches started when I was rather young, age six. Around that time I experienced a concussion after falling off of a bike. My pediatrician thought at the time that my headache was related to diet- specifically chocolate. At this time after reading about head trauma and migraines I think my condition might have something to do with the concussion and it might be exacerbated by diet and hormone levels.

There is also an epileptic or kindling connection here. According to some recent research migraines are a type of seizure and kindling in the past has also been used to try to explain the recurrent nature of major depression. This is an excerpt from a 2014 study that examined the relationship between seizures and migraines.
What they found was completely unexpected. Adding basic conservation principles to the older models immediately demonstrated that spikes, seizures and spreading depression were all part of a spectrum of nerve cell behavior. It appeared that decades of observations of different phenomena in the brain could share a common underlying link.
The idea though that my fatigue could be a low level migraine is controversial because it differs from the definition of a chronic migraine. A chronic migraine includes many of the symptoms that I listed above however it includes moderate pain as a criteria. I generally experience the pain as mild. Perhaps I should try to more aggressively and persistently pursue this migraine hypothesis. I generally don't have much faith in my insights but maybe I should since many have been supported in the past.

Saturday, January 7, 2017

Boundaries of mental illness

Boundaries of mental illness

Isn't everyone a little mentally ill? This seems to be the prevailing idea on my FB feed via memes. One of these memes says, " relax...we're all crazy, its not a competition". When I see this I feel annoyed but at the same time I wonder is there a clear boundary between normal and abnormal? As someone who has experienced psychotic depression, OCD and Dysthymia I'm annoyed because that large of a spectrum invalidates my difficulty to a large degree. I think these people mean well because they are trying to include me as normal but on the other hand  saying that I don't have much to complain about.
The competition part of the meme is particularly interesting since this is the feeling that I get from many people regarding mental illness or any other condition like chronic fatigue which is hard to distinguish from normal. I have long learned not to bring up my problems in anticipation of competitive people. Unfortunately this includes medical doctors who think they are more fatigued than anyone else.

The ability to function well has often been where the line has been drawn between normal and abnormal. This is probably the most practical way to make a distinction however I always wonder function at what level? Are you talking about brushing ones teeth or doing calculus? What complicates this further is that depression often strikes when ones abilities are uncertain, often in college.

People on the antipsychiatry side, such as Moncrieff, are not helping this problem either since they emphasize the lack of objective physical evidence for mental illness. This is good in a way since it will encourage new and innovative thinking regarding mental illness but bad because it reinforces the idea that people with mental disorders some how lack will power.
While it is true that physical evidence is lacking via lab tests this doesn't mean that at some point in the future there won't be some test. I find this obsession with the past and present on the part of antipsychiatry somewhat odd. Jung might say these people tend to prefer sensing because they focus mainly on the past and present while people who prefer intuition focus more on the future.

As someone who prefers intuition I tend to focus on recent research and consequently the future. At present there appears to be some hope regarding research focusing on inflammation, the microbiomesleepdiet and a variety of genetic studies.

Here is an excerpt from one article discussing research on inflammation and it's relationship to glutamate. The idea that glutamate plays a major role in mental illness is not new but it's relationship to inflammation and depression is new and exciting to me.
"Our results suggest that inflammation markers can guide us to which depressed patients respond best to glutamate blockers," says lead author Ebrahim Haroon, MD, assistant professor of psychiatry and behavioral sciences at Emory University School of Medicine and Winship Cancer Institute. "This could be an important step toward personalizing treatment for depression."
"Still, we think that one of the ways that inflammation may harm the brain and cause depression is by increasing levels of glutamate in sensitive regions of the brain, possibly through effects on glia," he says.
We focused on the basal ganglia because we had previously seen that a treatment for hepatitis C virus that arouses inflammation and can trigger depressive symptoms could also increase glutamate levels there," Haroon says.
Most recently a gene that is involved in synaptic pruning has been recently implicated in schizophrenia. So, there is still some hope and reason to believe eventually there will be a physical basis for mental disorders. Perhaps the boundaries of pathology will have to change as well since there is still much that we don't know about the nervous system.

Friday, January 6, 2017

Mental illness and mass shootings

Mental illness and mass shootings

Recently a well known psychiatrist, Dr. Gail Saltz, and Obama stated that most mass shooters aren't mentally ill. I'm a little perplexed about this since the most recent shooter, Chris Harper Mercer, and many others have at least a personality issues if not an actual personality disorder. A personality disorder is considered a mental disorder and according to Wikipedia mental illness and mental disorder are used interchangeably.

Most mass shooters are angry loners, not mentally ill. Mentally ill more likely to be victims 
According to Saltz they tend to be loners with anger issues. Seems fairly obvious but I'm guessing there is more. They tend to often have a preoccupation with becoming famous and getting some kind of revenge against an unfair world. This could indicate some issues with narcissism and antisocial behavior. Additionally, there seems to be some depression however not the clinical variety. All of these mass shooters know they will not survive so the act is essentially suicide.

One solution to this problem could be to somehow screen students using psychological tests such as the MMPI when they are matriculated into college. After that ones that showed a tendency towards that behavior could be monitored closely. I'm sure at this point psychologists have a profile of this type of person.Many would claim an invasion of privacy but so is getting shot at. The rights of the individual have to be balanced against the rights of the group. At the moment they are too much in favor of the individual.
According to DSM-IV, a mental disorder is a psychological syndrome or pattern, which occurs in an individual, and causes distress via a painful symptom or disability, or increases the risk of death, pain, or disability; however it excludes normal responses such as grief from loss of a loved one, and also excludes deviant behavior for political, religious, or societal reasons not arising from a dysfunction in the individual.[
It's interesting, looking at this DSM-V definition of what a mental disorder/ mental illness is, how it has to cause distress to the individual. What about relatives and society? Perhaps if these mass shooters don't fit any definition the DSM-V needs to add a label just for them.

Here are a few articles I've read since writing this post that discuss the same topic. It appears one could profile these mass shooters but the description could apply to a lot of people. Mental health is part of the picture but not necessarily the most beneficial thing to focus on. A history of violence appears to be a better predictor.