I have an acquaintance. His ex-wife called me up and asked me to convince him to go see a psychiatrist, because his behavior has become unbalanced. So, I met with him today just to see what was going on. We had coffee and hung out for a few hours. During that time, I was treated to long, rambling, stream-of-consciousness type lectures. He talked at length about several conspiracies, involving, among other things, Microsoft and the people who make Nilla wafers. At one point, he told me he was Jesus and his mother was a virgin when she had him. He also spent a lot of time rambling about “the Jews” and numerous conspiracies involving them. Anyway, he’s agreed to go see a doctor with me this week. I’m not asking for a diagnosis. There’s clearly something wrong with him, and I’ll leave it to the doctors to figure out. Here are my questions.
I saw this guy at New Years, and he seemed fine. Since then, he’s quit drinking, and apparently, this erratic behavior showed up shortly afterwards. Has quitting drinking been linked to mental illness before?
I’ve never known him to be racist, but some of the stuff he was saying about Jewish people was really disturbing. Is racism a trait which often shows up in mental illness?
If you had spoken to me in January of 1980, you would have found nothing particularly unusual in the conversation. Around March of 1980, while I wouldn’t have said I was a product of a virgin birth, I probably would have either said or strongly hinted that I was the second coming of the messiah; I would have explained how the names of a folk-music performer and the director of the campus Rape Crisis Center, when you analyzed them, explained how they represent forces at work within feminism and human sexuality and religion and spirituality, and that everything set in motion since the time that Genesis was written is coming to a head right now. And I would have handed you a xerox copy of something that looked like this.
There wasn’t a damn thing wrong with the wiring in my brain, AFAIK. I did get invited to talk to the nice doctors, and when I agreed (knowing quite well that it was the considered opinion of those doing that asking that I was a lunatic, but erroneously expecting to be dealing with someone who would claim that my behaviors were ‘acting out’ some kind of messed-up repressed stuff having to do with my potty training or failure to deal with my Oedipal issues with my Dad or something), I was placed on a locked ward and deprived of shoelaces and belt; I did not get to talk to the nice doctor right away and could not leave of my own accord either.
Anyhow… content-wise, religious concepts are emphasized as the most important (along with sexual, political, and racial and a few others), and when a person gets excited about new thoughts and ideas in that zone enough to get a bit of distortion going, it tends to spill into similarly-huge and important areas.
Your acquaintance might be best off if left alone to sort things out. Psychiatric intervention tends to do more harm than good, especially if the person is not harming anyone and is merely subscribing to some thoughts that strike you as weird as batshit.
I’m not yet licensed to provide a diagnosis, I’m about 6 months away from certification and a 1 1/2 from licensing. Anyway, there is really very little information to go on to make a true and accurated diagnosis. Not that I would do that officially anyway. But, there are several possibilities: prodomal schizophrenia (early signs), manic phase of a bipolar disorder, psychosis from drugs, psychosis, beginning of delrium, early alzheimers, or maybe he was just a weirdo before but the drinking kept it under wraps. Whatever the problem, he needs professional help. Even if this is a single episode of some one-off, bizarre firing of the neurons.
Worse, he could have something as nasty as a brain tumour. Which is why I’d never recommend that someone who changes that radically just be left alone.
Hunter, I’m surprised and a little disappointed that you say this. I’d be very surprised if you have any evidence to back it up. I’ve always admired the way you consistently warn people about the risks of psychiatric intervention, that it can do more harm than good, that a person who is the object of such intervention may have their rights stripped from them, that there are sound reasons why a person may reasonably wish to refuse psychiatric treatment, and that a person who does choose to undergo psychiatric evaluation or treatment should be aware of these things. I agree with much of what you have to say about these things, and where I disagree or withhold judgment, I nevertheless think you present a well-reasoned, valid, and often insightful viewpoint that is seldom encountered. I would miss your comments sorely if you were to stop making them.
Despite all this, I find it unlikely that psychiatry does more harm than good in a majority of cases, which is what I assume you meant by saying it “tends to do more harm than good.” In my experience, you’ve always limited yourself in the past to telling about your own experiences, explaining (very adeptly) the current status of psychiatric medicine and research, and describing the relevant laws. I don’t think I’ve ever noticed you making such a sweeping factual statement without any supporting evidence, or so much as an IME or IMO.
Of course, if you do have a reputable study that would back up your claim, I’d be excited to read it. (I know the reasons it might be unlikely a reputable study would back you up, even if you are correct, but I don’t know how else you could justify your claim.)
I should rephrase. The OP is talking specifically of bringing down the psychiatric intervention upon a person who, based on that post, is not currently seeking it. And who is likely to get enmeshed in the delights of involuntary psychiatric treatment.
I should have said: “Psychiatric intervention requested or imposed by someone other than the intended recipient tends to do more harm than good”.
This sounds very, very much like my mother in law, who’s manic depressive and has been in and out of mental hospitals for the past 20 years. Right now she’s hospitalized (she only gets “put away” when her behavior turns violent, usually after she’s done considerable damage to her own financial well being) and if you call her up she’ll tell you how she’s pregnant with triplets (she’s in her early 60s) and how the “German Jews” are out to get her, or, alternately, that she’s Anne Frank.
How old is your friend? I don’t think my MIL became symptomatic until her late teens or early 20’s, although it sounds like your friend is older than that.
I don’t think I’m bringing down anything on him. He’s only going to see a doctor with me. I asked him, and he agreed. I didn’t twist his arm or anything. If he refuses treatment, there’s not much I can do about it. He hasn’t exhibited violent or suicidal behavior, and in this state, that’s about the only way you can force involuntary treatment on someone.
He’s late twenties. At this point, he’s lost his job and his apartment, and he’s relying on his ex-wife, his family, and friends for support. But so far, no violent tendencies (that I’m aware of).
Perhaps your friend has substituted another drug for alcohol. Is there such a drug that would produce such symptons?
Another question. Is he harmful to himself or others? If not, why not leave him be?
I’m not sure. He mentioned he had a bottle of Depacote(?), but he said he wasn’t taking it and it was an old perscription.
As I stated earlier, he’s exhibited no violent tendencies that I know of.
Because he’s not leaving anyone else be. He’s not supporting himself, and he’s been verbally abusive to his family and his ex-wife. Is everyone just supposed to send him money indefinitely? Perhaps you’d like to donate?
He’s not going to have money or a place to stay shortly, and then what? I’m supposed to just watch while he gets booted onto the street without making a minimal attempt to get him help?
If I can get him into a steady treatment program (whether its counseling or medication, that’s something he’ll have to figure out with his doctors) and get him on disability, then hopefully things will work out for him. The alternative that’s being suggested in this thread–to let him alone–strikes me as being rather callous and uncaring.
Drinking and taking drugs are sometimes done in an attempt to self-medicate an underlying mental illness. Thus, it seems possible that when the person stops drinking/drugs the symptoms of the underlying illness may become more pronounced.
Since you seem willing to offer up a medical opinion on how to treat the patient in the OP, would you be so forthcoming to say what was wrong with you, mentally, at that point?
Moderator Advice
And this kind of advice is not welcome in General Questions. AFAIC, this is medical advice, and unless you’re licensed to offer it, keep it to yourself.
I was quite excited with some powerful new understandings I could not as of yet put into words; it’s a state of mind that tends, often enough, to lead to elision of the difference between a symbol or metaphor you’ve chosen to represent an idea, and the idea itself. It’s also a state of mind in which you can’t rely on the everyday reality-check of having other people verify your perceptions: you’re entertaining ideas you don’t think other folks are cognizant of, so you’ve given yourself at least temporary permission to believe things (and build upon them to conclude or derive yet more new things) that other people do not believe. That sounds pretty harmless except that in reality most people don’t engage in a whole lot of truly original though, and we as a species depend to a great deal on reciprocal feedback, a sort of “did you see what I saw?”, a good portion of which we’re scarcely even aware that we’re doing.
In short, I was a bit out of touch with reality, but in a normal healthy sense that could happen to anyone in that context. I may have more of a tendency to slip into such mental states, but if I do that still doesn’t make it a disease. Calling it a disease is a value judgment. Since the content itself (after a few proddings, rethinkings, and cullings, to be sure) has proven viable (and earned me several good grades in college and grad school plus a published article in a peer-reviewed journal), my value judgment is that my wiring was working exactly as I would want it to in such circumstances.
You are a moderator and I am not, but I do not share your opinion or perception that I was offering medical advice. Political advice, perhaps. I do consider myself qualified to offer the political opinion that forced psychiatric treatment is not in the best interest of the involuntary recipient. It is a civil liberties issue, and an issue of the right to make one’s own medical decisions.
If it is your intention to issue an official warning to me that I am not to ever offer that opinion again on this board, I need you to clarify that, and if that is indeed what you intend then I will find it necessary to ask the moderators and board admins in general for a review of the matter, as while I would abide by it for the interim as a decision by a moderator, I would continue to view it as a bad call.
If you merely mean that it’s not appropriate in GQ because debates don’t belong in GQ, that’s sort of a different kind of matter. I do see your point there. I will state that at the time I posted, the OP had not indicated that the person had expressed a willingness to speak with psychiatric professionals, which also casts a different light on matters. I would submit that if that were not in fact the case (as it did not appear to be in the original post), it would be most reasonble to move the thread from GQ to GD, as posting “I know this person who seems a bit nutso to me, so I’m going to talk to the psychiatrists about him and express my concern that he’s in need of involuntary incarceration, so anyway I was wondering some things about that kind of mental illness…” is inherently controversial and if that had, indeed, been what was going down the thread would bloody well belong in GD.
I just want to clarify here. I’m not asking for any type of diagnosis. I’m not related to him, I’m not his conservator, and I’m not his guardian–in short, I have no legal authority to make medical decisions on his behalf. And even if I did have the authority, I’m not qualified to do so anyway.
But otherwise, this thread has been informative. Thanks for all the responses.
I didn’t mean any offense by referring to his state of mind as an “illness.”
AHunter3, during my discussion with my friend, he made several statements of a factual nature which simply could not have happened. Did you do this as well?
Hmm. I’ll ask my acquaintance to make a list of all his prior doctors so the one we go see can have his full medical history. It didn’t occur to me that he might have been in treatment before this. He didn’t mention it to me.
What was the “value judgement” of the medical professionals involved? If you feel like sharing.
I see no reason to move the thread to Great Debates. The OP asked two rather simple things:
You immediately posted about your experience and said
To me, you were offering medical advice, mainly based on your experiences of 25 years ago.
If YOU want to debate whether intervention is good or bad, then start a thread somewhere other than General Questions.
You said
You were, IMHO, offering Medical advice. Your post certainly was political in nature, but it was medical advice.
Feel free to take it up with higher authorities. It was not an official warning–I give those out sparingly, IMHO. But don’t offer that medical advice in a thread in General Questions again.
