blog moved

August 25, 2007

This blog has now moved to:

http://empiricalinsanity.net

See you there!

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blog migration and dichotomy article

August 23, 2007

I’m working on setting up my blog on its own server. If you use http://empiricalinsanity.net to access this blog, things may be down/absent/weird at that URL at times in the next couple days. https://empiricalinsanity.wordpress.com will stay pointing to this version. Apologies.
More Dichotomy Week stuff: A call to end the notion of a mind-brain split, in an article in Psychiatric News from earlier in August.


knowing what your triggers are isn’t enough

July 26, 2007

Like other (non-psych) medical problems, mental illnesses can be exacerbated by situational triggers.  And the theory is, if you figure out what those are, you can avoid them.  Personally, I’m pretty sure I could avoid the majority of things that make me extremely stressed, but my stepping out to preserve my mental health would often offend and anger other people.

For example, tonight I had made plans with a relative to go over to their house for dinner after work.  I’m leaving out a lot of stressors, but they decided we were going to a friends’ house instead, and we got to the house about an hour after I normally eat dinner.  The friend had not started planning dinner – she only started going through the refrigerator after we got there, trying to figure out what she had that she could feed us.  There was chaos in the kitchen and I wasn’t anywhere familiar and I really wanted to just leave.

But you can’t walk out on a family friend you haven’t seen in ten years who invited you over for dinner, just because she didn’t have dinner ready when you got there.  Especially when she’s clearly stressed out – if you walked out on someone who was displaying social penitence for something, you’re going to make them feel pretty awful.

Whenever people talk about feeling trapped by social requirements, someone always wants to say “Of course you can, look at me, I do it all the time!” which is funny because that person is usually the one person in the room everyone thinks is an asshole, but who doesn’t know they’re an asshole, because they’re not socially sensitive enough to know that they’re shooting themselves in the foot over and over.

The point, of course, is not that people who feel trapped by social requirements are unaware that they are free agents; the point is that social requirements (if you prefer, intense expectations) have consequences whether you follow them or break them, and sometimes avoiding a trigger means lots of different triggers instead.  So you take the least worst course of action that you can make for yourself.

So I did that. I feel bad, this entry is late, and there’s no science.  But, I didn’t feel bad, offend someone, make them angry at me, and feel worse and have no entry at all because I was too strung out to concentrate.

Stuff like this contributes to mental health being so difficult to achieve and maintain.


Break-from-the-usual Friday: The hottest thing since Johnny Depp

July 20, 2007

What could be hotter than Johnny Depp, you ask? The answer is: the sexiest, awesomest citation manager ever. No, wait, don’t run away (skip to the bonus picture of the baby miniature donkey, at least). Zotero is a Firefox extension that captures citations from the webpage you’re viewing (automatically, if you like), along with associated full texts, webpages, images, and more. It stores everything for you, lets you tag entries with multiple tags, lets you store as many notes as you want on an entry, and they’re working on collaboration support, so that you can share your library, contribute to mutual libraries, etc. It not only solves the problem of having to switch between Word, a reference manager, and your browser, and cut-and-paste and retype things manually, and it lets you keep track of lots and lots of information and organize it in ways that let you make better use of it. In short, leaps and bounds better than anything that existed before. Big step forward in helping us do better research, and helping humanity, and all that warm fuzzy stuff that I sincerely believe in, and the kind of thing that I want to (after I’m finally out of school) help make happen.

And now, the baby miniature donkey!

Baby miniature donkey

So cute. So awkward.



schizoaffective disorder: what the hell is it?

July 15, 2007

Schizoaffective disorder is a less well-known diagnosis than schizophrenia, depression, or bipolar disorder, and it tends to confuse people. It was categorized under schizophrenia in earlier versions of the DSM, but in the current version you have to have a mood episode for a “substantial portion” of the time, as well as having psychotic symptoms outside of a mood episode.

That last bit is important because some people with bipolar disorder have psychotic symptoms during manic periods, and some people with bipolar disorder and some people with major depressive disorder have psychotic symptoms during depression. But (according to the DSM-IV) they don’t have psychotic symptoms outside of mood episodes.

But we don’t know from this what schizoaffective disorder actually is. Is it having both a mood disorder and schizophrenia at the same time? Is it a separate disorder from either? (And what about if your depression isn’t long enough or severe enough to be schizoaffective disorder and you get diagnosed with schizophrenia with comorbid depression? Is that a totally different thing?)

Goodwin and Jamison do a quick review, which I will summarize:

The five major schools of thought are:

  • a separate disorder (but it doesn’t run in families, so this seems less likely)
  • “an intermediate form on the continuum of psychosis” (I think this means that if you think of disorders as lying along a continuum of psychosis, like you could think of bipolar symptoms as lying along a continuum of severity, schizoaffective is inbetween schizophrenia and bipolar with psychotic symptoms)
  • comorbid schizophrenia and depression/bipolar
  • more severe bipolar
  • less severe variant of schizophrenia

Another school of thought might be that schizoaffective disorder is actually several different things, which is what they tentatively suggest (we’re a little short on actual research to draw strong conclusions):

  • People who are primarily manic and less pronouncedly psychotic may have an especially severe form of bipolar disorder (suggested by studies showing that it is more associated with bipolar disorder and has a worse course: Gershon et al, 1982; Coryell et al., 1990).
  • People who are predominantly psychotic and have less prominent, exclusively depressive symptoms may have a less severe variant of schizophrenia (suggested by studies showing outcomes or neuropsych profiles similar to schizophrenics: Brockington et al, 1980; Tsuang and Coryell, 1993; Evans et al, 1999).
  • People who have about an equal mix are the unlucky bastards who just happened to get both a mood disorder and schizophrenia.  (suggested by the epidemiological prevalence of the disorder being a fraction of a percent, about what you’d expect for those two just happening to co-occur: Kendler et al, 1993, 1996).

Again, this is still speculative and we don’t have enough research to confirm (or deny) it.  But it’s pretty interesting, no?  Maybe we’ll get a bipolar 0.5 to complement I and II?  Since all the love’s been going in the other direction, maybe it’s time the crazier among us got a little more attention.  And what kind of “less severe” schizophrenia manages to hit you with something akin to major depressive disorder, yet still be less disabling than regular schizophrenia?


a peek into the future

June 29, 2007

I’m probably going to switch to posting longer, higher-quality stuff once a week or so, and post news stories or tidbits the other days of the week.  Attempting to do topics justice while still posting frequently doesn’t go so hot with a full-time job.  (I’m having a lot of fun, though.  Here and at the job.  But not, you know, too much fun.)

Here is a sampling of topics I’d like to write about at some point (not in any order).  If anyone votes for anything, I’ll bump it up in the schedule.  If anyone wants to propose a topic, I’ll drop it in the list as long as it’s vaguely appropriate.

  • medication for youth (this has a vote already)
  • antipsychotics for youth
  • worries about personality and perceptions of self with regards to medication
  • relapse rates in bipolar
  • kindling
  • violence rates/types (both by and against the mentally ill)
  • creativity and medication
  • firearms (second amendment, deaths by suicide)
  • transient mental disorders (like hysterical fugue, that was once popular and is now almost gone)
  • more on culture and mental disorders because I ❤ culture
  • evolutionary psychology/biology of mental disorders (because I ❤ evolution)
  • culture and evolution with regards to mental disorders (because I ❤ the interrelationship of culture and evolution more than almost any academic topic)
  • approaches to decreasing stigma and stereotypes
  • weird crap I find on the internet
  • multiple personality disorder, soulbonds, and theory of mind (i.e., lots of speculation)
  • otherkin, and fringe religious beliefs: I don’t believe you’re really an iridescent winged fox like you think you are, but I don’t think you’re mentally ill, either
  • these weird things you have to get differentially diagnosed with and that almost no one has (like cycloid psychosis and brief psychotic disorder): what the hell are they?
  • inaccuracies in science reporting
  • symptom clusters in unipolar depression: withdrawal vs. support-seeking
  • Munchausen’s (people faking disorders including mental illness for personal gain)
  • dumb things people say – not the standard dumb things like”depression means you’re weak” but new fun wacky stuff
  • Is schizoaffective disorder a form of schizophrenia, a form of bipolar, its own thing, or something else?
  • spectrum disorders, public perception, and identity politics
  • other identity politics stuff
  • legal stuff (I don’t know enough about this yet to break it down into subcategories)


misc

June 28, 2007

I was in the second of two all-day meetings today.  The first I got through by being actively interested plus taking adderall, but by today I was so tired of paying attention that the adderall wasn’t much help. (It doesn’t fix not wanting to pay attention, luckily; the first add medication I tried caused me to pay attention to everything anybody said no matter what even if I really wanted to think about something else.)  So tonight is Random Facts From Goodwin & Jamison (2007) Night, instead of semi-coherent post on something substantive night.

  • People first developing bipolar disorder are, on average, 22.2 years old.  In 1990 that figure was six years higher for studies with similar inclusion/exclusion criteria.  Why? They mention a couple hypotheses: more people are being diagnosed bipolar instead of schizophrenic (and psychotic features appear to show up earlier), and antidepressants and stimulants are kicking off episodes earlier than they would naturally have occurred.
  • A few entries from a long list of conditions and drugs reported to precipitate manic episodes: influenza, Syndenham’s chorea (movement disorder caused by infection), bromide (a sedative used in the late 19th and early 20th centuries), and Q fever.
  • Apparently lithium during pregnancy isn’t anywhere near as likely to lead to a heart defect as we used to believe.  (But you still shouldn’t breastfeed on it.)