I want to have a mental disorder

I Wish I Had An Illness...Mental Or Physical

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

You were sitting in the cafeteria with co workers having lunch when one of them said, “I wish I could get sick.” That was followed with a chorus of others who fully agreed and said, “Yeah, a mental health day.” All of them made their reasons clear, they wanted some time off from work so they could lie in bed or go to the movies.

For the sake of clarification, this is not the same as Munchausen Syndrome, a serious mental illness, in which someone deliberately gets sick or injured. It is not even the same as having a hypochondria, defined as being preoccupied with fears of having an illness.

Those workers stating that they need a day off and a bad cold would help them get that day, are really saying they need to get away from daily stresses. They want a day to “catch their breath.”

However, isn’t it possible that a few of these people have deeper, underlying reasons for this? I believe the answer is “Yes.”

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I even heard one psychotherapist say he wished he had a psychosis just like his patients in the hospital. Why would an otherwise healthy person wish they had a mental illness? There is nothing romantic about it. In point of fact, suffering from schizophrenia is awful, as many of those patients have told me.  So, why would a healthy person want such a thing?

Here are a few guesses about this, all based on observations of people in psychotherapy. These reasons embrace both wanting a physical as well as mental illness.

1. From what I learned in working with patients in the psychotherapy office, there are parents who range from those who are over protective and keep their children home from the very first sneeze, to those who send their kids to school regardless of how sick they are because they are neglectful. I believe it is agreed that neither extreme is helpful to children.

2. In the case of children who are kept home for minor reasons, there is a risk of the child learning that illness, even minor ones, is a way to stay home and be nurtured. Unwittingly, the parent is reinforcing the notion that it’s good to stay home, sleep late, play with toys and watch television. The child then grows up and transfers this type of behavior to work. After all, for this individual, staying home feels a lot better than going to work.

3. Parents who send their children to school sick are not necessarily neglectful. Some of them believe it’s not good to cater to children. They want their kids to take responsibility even when they are ill.

Of course, there are those who are neglectful and do not care.

4. Some people who want to have an illness and stay at home, may have a deep seated need for attention, above and beyond what they believe they can get at work.

5. Then, there are those who need an excuse to avoid daily responsibilities, whether at work or at home. Any type of illness, from depression to fever becomes a rationalization for doing nothing except, perhaps, as a way to get lots of sympathy.

6. For those who are depressed and extremely anxious, there is a lack of energy to get up and out of bed and into the outside world. Sadly, this can look appealing to someone who wishes they had an excuse to stay at the computer playing video games.

7. Low self esteem and self doubt can be so anxiety provoking that there is a strong need to practice avoidance.

8. For the psychotherapist who wished he could be like his psychiatric patients, there is an expressed desire to get away from the exhausting and stressful work and to be nurtured, just like his patients. He then did admit that he would never want the type of awful problems that come with schizophrenia, such as hearing voices and experiencing other types of frightening hallucinations.

9. Finally, there was the patient with schizophrenia who was in the hospital after suffering another decompensation, and who told me she keeps going off her medication because she is fearful of being mentally healthy. Handling bills and the chores of daily life felt like too much for her. On medication, she was aware of the obligations she had. Off the medication, she did not have to deal with reality. This was a woman who did not have a loving and caring family who would help her adjust to life as a healthy person. If, at the time, she had that family support, she might have made it.

What are your comments, questions and experiences with this type of problem?

Allan N. Schwartz, PhD.

Keep Reading By Author Allan Schwartz, LCSW, Ph.D.

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Disease of the generation: why does everyone think that they have mental disorders?

21 minutes Denmark Ermekkyzy

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Psychiatric or mental disorders are other than normal mental states that include disturbances in thinking and behavior, as well as emotional instability.

The opposite of disorders is mental health - a state of well-being in which a person adequately assesses his own capabilities in order to cope with life's difficulties, be productive and help others.

What are mental disorders and how they manifest

Mental disorders include depression, bipolar disorder, schizophrenia, acute psychosis, dementia, mental retardation, and developmental disorders, including autism spectrum disorders.

There are several versions of the origin of mental disorders. According to one of them, it is currently assumed that mental disorders are caused by joint interaction of hereditary, biological, psychological and social factors.

The influence of biological characteristics on the development of mental illness is undeniable: for example, negative symptoms of schizophrenia are associated with a decrease in the activity of the functions of the prefrontal cortex of the brain.

Sometimes a disease develops because a person has a vulnerable heredity, and frequent stress and background experiences can cause an intense manifestation of symptoms.

Speaking of symptoms, people with different problems present differently and include physical (pain), emotional (anxiety), behavioral (substance abuse), cognitive (memory problems) and perceptual symptoms (seeing or hearing what others cannot see or hear).

What the statistics say

According to the World Health Organization for 2019, at least 264 million people worldwide suffer from depression, 45 million from bipolar disorder, 20 million from schizophrenia and psychosis, and 50 million from dementia.

The year 2020 is coming to an end in many ways has changed the situation in the world, including the discovery of new causes of mental disorders. So, in one of the articles in The Lancet magazine it is said that the coronavirus pandemic caused a rapid surge in mental illness in the same way that a Spaniard once developed neurological disorders in people.

Professor Robert Yolken conducted a study examining the statistics on the provision of assistance to more than 69 million people since the beginning of this year and found that people with coronavirus are more likely to experience depression, insomnia and anxiety disorders.

According to other experts, mental disorders associated with covid may be caused by the body's immune response to an unfamiliar virus or psychological stress resulting from forced self-isolation, awareness of the proximity of a potentially fatal disease, fear of infecting others and becoming infected yourself.

WHO warns that economic shocks, job loss and loss of income can also be causes of widespread psychosis.

According to 24Khabar, at least 190,000 adults and 35,000 children are registered with psychiatrists in Kazakhstan. In addition to them, there are those who do not recognize professional help, resort to alternative medicine methods, or are completely unaware of the presence of their own disease.

Is being sick today fashionable?

It used to be fashionable to imitate “tumblr girls”, who wore predominantly black clothing, languidly lined their eyes, posted blog posts about being tired of misunderstanding the whole world and represented the image of painful unfortunate people.

Their distinguishing feature was unhealthy thinness, because the trend for the style of "tumblr" originated earlier than for body-positive. The desire to lose weight reached the point of absurdity: every second around dreamed of getting anorexia, bulimia and other eating disorders, which can also be attributed to mental disorders, and the phrase “I have depression” sounded from our lips several times a day.

Social networks have driven into their heads that it is aesthetic, beautiful and liked by others - what else do teenagers need to be completely happy?

Mental disorders have become a way of self-expression and attracting attention for many people who, it would seem, should be glad that they have nothing to do with them.

We addressed a few questions to the psychiatrist Sultan Abenovich Nesipbaev, Candidate of Medical Sciences, and talked about his view on the development of mental disorders, the consequences of self-diagnosis and the possibilities of professional assistance.

What caused the trend towards mental illness?

“I can't see a significant increase in calls among clients, so the fashion for mental disorders is invisible to me.

I think the only thing that has increased is people's need for awareness about mental illness, which is primarily due to the globalization of the Internet and the excessive flow of information that it offers us.

However, modern people tend to experience problem situations too keenly, and the more energy and strength they spend on experiences, the less of them remains to maintain a healthy mental state.

If a person is prone to feign illness, then this can be associated with Munchausen's syndrome, which mainly occurs as a result of escaping from other problems and unwillingness to take responsibility.

It is worth noting that people who are subject to the fashion for mental illness do not visit specialists because of their mentality and habits: if necessary, a person will consult any doctor, but he will turn to a psychotherapist as a last resort.

Have you noticed an increase in young patients diagnosed with mental illness?

“People come to solve problems regardless of a certain age - among my patients there are 16-year-old teenagers, as well as people of middle and old age. It would be wrong to say that mostly young people are converted.”

Do you see a link between the pandemic and the mental illness trend?

“The connection definitely exists, because a person lives in a social environment with an established culture. Any mental illness is, first of all, a social illness associated with the events taking place around each of us.

Each person individually reacts to external circumstances depending on life experience: someone is unable to withstand the stressful situations of life due to the sensitivity of his nature or the lack of proper resistance to life's difficulties, and someone, on the contrary, only becomes stronger in such life conditions .

The pandemic that suddenly overtook the world reflected this vividly. Many people, having lost their usual life in conditions of instability in the global financial markets, fell into a state of uncertainty.

Studies have shown that people isolated from society during the lockdown, trying to adapt to new conditions, experience stress much more often than during normal times.

Since the beginning of the pandemic, I have also begun to notice an increase in complaints from people who are under pressure at work and in society, who have difficulty with social distance and are forced to spend days on end within four walls. Recently, the only case of coronaphobia in my practice was recorded: a middle-aged patient was so afraid of contracting covid that he did not leave the house for several months, while experiencing frequent anxiety and insomnia.

Another worrisome point is the overwhelming tendency of young people to leave the country. The economic and political environment around them is putting pressure on young people to feel that the root of their anxiety and emerging mental problems lies in the country in which they are located, and if they leave, they will be able to get rid of the problems.

What is the risk of self-diagnosis of diseases?

“Mental disorders are no less important diseases than physical ones, for which correct diagnosis and high-quality treatment are also important. There is a huge amount of information on the Web about the symptoms and manifestations of diseases, in which you can easily get confused. It is very important to be able to listen to your inner state.

If you feel that something is wrong with you, then it is better to consult a specialist, because even a disease correctly diagnosed by you will not receive the right treatment, and the lack of timely treatment, in turn, can aggravate the situation.

Why do people want to be sick?

The first thing that comes to mind is a tendency towards psychotherapy . People began to develop the idea that seeing a specialist when you really need help is a normal approach, indicating a healthy attitude towards your mental state.

In 1952, the American Psychiatric Association directory contained 103 diagnoses, and in 2000 it was already 365. In the fifth version of the directory, the number of mental disorders becomes even greater. People are constantly learning about new intricacies of diseases and it becomes interesting for them to try on the symptoms for themselves.

No less important role is played by public confessions, the fashion for which originated several years ago. Since then, netizens have not missed the chance to make a resonant announcement for their subscribers - some talk about their experiences after suffering a miscarriage, others at the same time declare manifestations of chronic depression, OCD or panic attacks.

The more confessions of mental instability (especially from media personalities) we hear, the more subconsciously it seems that we are ordinary and backward from society, if we do not have them.

In addition, the topic of mental illness has been actively romanticized in literature and the film industry in recent years. Remember the bipolar handsome Ian Gallagher from Shameless, the maniac with symptoms of schizophrenia, who managed to turn into the object of adoration of the audience of Netflix's "You", the Joker - the most beloved psychopath of representatives of any generation, the main characters from the Bates Motel based on the Hitchcock classics or Hannibal Lecter performed by Mads Mikkelsen.

Each character suffers from his own mental disorder, which makes him so special in the eyes of the audience. And this, in turn, leads to mass imitation of favorite characters.

We want to be closer to the screen character we like so much, so we invent similar symptoms.

The same situation arises when idols admit to their own mental problems, and in a burst of admiration for them, we want the same disease for ourselves in order to be, for example, closer to Kanye West, whose manifestations of bipolar disorder are followed all over Twitter, or to Angelina Jolie, who has a tendency to depressive disorders.

Fashion for mental disorders can lead to consequences that are not usually thought about. For example, devaluing serious illnesses, using illness as an excuse for unacceptable behavior, or forming stereotypes that lead to social harassment.

But in recent years there has been a tendency to take care of their mental state: people are beginning to learn more about the symptoms of mental illness and methods of their treatment.

What if I have a real problem?

It is very important to catch the very moment when the state flows from mood swings into an absolute unwillingness to live.

Do not forget that if you are in a critical situation, there are opportunities to seek psychological help. It can either consist in a global psychiatric study or psycho-correctional impact, or be limited to individual, family or marital psychotherapy.

Self-awareness is the foundation of mental health. A person can independently make efforts to change the perception of reality from negative to positive, thereby reducing the risk of getting a severe brain disease. Observing oneself from the outside, a person gets the opportunity to understand his own reaction to stressful situations and keep it under control.

How to cope with emotional stress so that it does not lead to further development of the disease?

1. Take 30-40 minutes of daily walking.

2. Spend time with people you feel comfortable with.

3. Do what you enjoy.

4. Organize a daily physical activity of at least 15 minutes.

5. Cut down on social media and negative news.

6. Attend a concert, exhibition, sports tournament or other activity that brings you pleasure

7. Find a new hobby.

8. Try music therapy - listening to music for half an hour every day.

Contacts of hotlines

— Hotline Open Almaty 1308 for residents of Almaty (338-33-88 for city phones), in addition to practical advice regarding the quarantine regime, provides psychological assistance.

- The Scientific and Practical Center for Mental Health for all residents of the Republic of Kazakhstan provides free consultations of psychological assistance at +7 (727) 272-76-90 every day from 09:00 to 16:00.

- Round-the-clock hotline for social support of the population of the Republic of Kazakhstan: 8-800-080-77-71.

- The National Helpline for Children and Youth offers to call 150 or write to WhatsApp at +7 (708) 106-08-10 if there are problems at school, family, or simply there is no one to talk to.

- Public Fund "Amansaulyk" offers psychological assistance, which can be obtained by calling the hotline 8 (727) 220-71-87 or online on the website.

Sometimes the causes of mental disorders should be looked for in an unhappy childhood - Nauka - Kommersant

The development of mental disorders is based on many reasons - both psychological and biological, the latter often associated with heredity. Childhood traumas, primarily various types of physical, sexual and emotional abuse, have a significant adverse effect on mental health.

Photo: Sergey Kulikov, Kommersant

We can observe a typical scene of emotional abuse of children every day in any Russian city: a mother or father screaming at a child. It often happens that the mother herself is subjected to violence (at least emotionally) by her husband, or one or both parents in childhood was in an aggressive environment for which an increased tone and systematic humiliation from others - parents, teachers, peers - is the norm. A serious trauma for a child is the observation of domestic violence: for example, when a child sees his mother beating his father or even just hears vicious skirmishes between parents.

In terms of the severity of adverse consequences, childhood abuse is equated with child neglect, which, in turn, is subdivided into physical and emotional. An example of physical neglect: the baby is crying in wet diapers, he is cold and uncomfortable, but the mother is busy with her own affairs (or drunk) and does not pay attention to him. An example of emotional neglect is the indifferent reaction of parents to crying and other manifestations of a child's mental distress.

Modern research shows that the severe stress of childhood can have irreversible consequences for the development of the brain and psyche. Associated with childhood abuse or even simply a lack of parental love are personality changes such as reduced self-esteem and self-doubt, a tendency to anxiety and bad mood, and the ease of guilt. Adverse consequences of the adversities of childhood of the opposite nature are aggression and a tendency to criminal behavior. Numerous studies indicate a significant and very strong association between adverse childhood events and many psychiatric disorders, including depression, anxiety, personality disorders, and even psychosis, including in patients with schizophrenia. It is shown that violence against children worsens mental health not only in childhood, but throughout the life of the individual. According to researchers from the Institute of Psychiatry at King's College London, who studied 23,544 cases of depressive disorder, child abuse not only significantly increases the risk of developing depression in the lifetime, but also contributes to its adverse characteristics, such as protracted, recurrent and insufficient response to antidepressants. Decreased self-esteem, depression and anxiety caused by childhood trauma increase the individual's need for alcohol and other psychoactive substances, including nicotine and illicit drugs (it should be noted that people with mental disorders are much more likely than healthy people to abuse alcohol and other psychoactive substances, and individuals with addiction from psychoactive substances are much more likely to find symptoms of depression, anxiety and other mental disorders). Alcohol allows you to quickly and easily overcome the psychological discomfort associated with everyday adversity or mental disorders, and this, among other reasons, is associated with its ability to cause dependence. Thus, at the heart of the problems with alcohol that occur in not too happy people and people with a vulnerable psyche, very often there are medical factors, and not the notorious "licentiousness" and "weak will". The well-known American child psychologist Linda F. Palmer says that the stress experienced in infancy can have irreversible consequences for the whole life of an individual.

Photo: Sergey Kulikov, Kommersant

The hardships of childhood not only cause harm to the psyche, but also disrupt the processes of normal development and maturation of the brain, interfering, in particular, with the normal formation of brain regions that are associated with memory, attention and other cognitive (cognitive) ) functions. Thus, mistreatment of children can cause them poor academic performance, as well as a lack of ability to learn throughout their later lives. This mechanism (along with other reasons) explains the difficulty of climbing the social ladder for people from the aggressive social ranks.

Under the influence of severe stress, including childhood mental trauma, the volume of the hippocampus decreases with subsequent weakening of its functions. The hippocampus is an ancient and important structure of the brain, the normal functioning of which is associated, in particular, with the consolidation (fixing) of memory, the formation of new nerve cells (the so-called neuroblasts) and the processing of negative emotional experience. Atrophy of the hippocampus under the influence of severe stress can lead to irreversible consequences.

German neuropsychologist Thomas Elbert believes that severe childhood traumas (for example, a child being held hostage by terrorists) can permanently destroy a person: “If a child has experienced mental trauma, then he remains vulnerable all his life. Some experts see this as an adaptation to a dangerous environment, a survival strategy. Personally, I don't think so. Rather, a person rests on the ceiling of their capabilities. This (hippocampus - authors) is a weak spot in the brain. We're just not built for such a monstrous experience at such a tender age." Quite remarkable in the above statement is the refutation of the persistent idea that the hardships of childhood temper character. Resistance to external aggression can increase one's own aggressiveness (hence the tendency of some individuals with a dysfunctional childhood to violence and violent crimes) and the ability to fight back offenders (if it does not lead to personality changes of the opposite kind - subordination and readiness to again become a victim of violence), but almost always severe mental trauma leads to increased mental vulnerability, and therefore, provokes susceptibility to mental disorders.

It should be emphasized again that traumatic for the child's psyche is simply the lack of parental (primarily maternal) love, which can be observed in outwardly prosperous ("decent") families. A typical example from clinical practice: a family with a high social position, parents are busy with a career, the daughter does not receive sufficient emotional care - despite the fact that the family does not lack anything material. The daughter is brought up in excessive severity. Mother (partly intentionally, partly due to the coldness of her character) never praises her, but at the same time she never misses the opportunity to point out incorrect behavior (things in the house are scattered), imperfect academic performance (four for dictation instead of five) and so on. What happens to the child? The girl grows up with low self-esteem (at the same time, she has a high intellect and a very good appearance, but the girl does not appreciate both the first and the second). Low self-esteem and a tendency to self-deprecation persist, despite an excellent school certificate and the ease of getting into a good institute and subsequent prestigious work. The girl is devoid of ambition and career aspirations, but quickly rises through the ranks, because she is smart, professional and responsible - she will never let you down. It is worth noting that people with a tendency to anxiety are often a gift for the employer - they never put off anything for tomorrow, they do everything on time and with excellent results, they are demanding of themselves and most of all they are afraid of not living up to expectations and appearing in a bad light in front of management. Due to low self-esteem, the girl marries the first person she meets (despite her excellent external data, she believes that no one needs her), and such a marriage naturally turns out to be dysfunctional.

Such children may have an early onset and lifelong feeling of guilt towards their mother (“mother doesn’t love me because I didn’t deserve her love”). Unsuccessful family life exacerbates the tendency to anxiety and depression caused by childhood trauma (lack of maternal warmth) and further reduces self-esteem. The mood is lowered, nothing pleases in life (at work - incessant workloads and constant fears of not coping with them, at home - a narrow-minded husband with whom there is not even anything to talk about), no inspiring prospects are visible. And of course, the girl blames only herself for what is happening to her. The feeling of one's own unhappiness and worthlessness prompts one to start drinking sometimes - mainly at corporate parties or in the company of friends (the alcohol debut took place late, but let's not forget that the girl was brought up in strictness). Alcohol helps a lot to get away from unpleasant experiences, and the girl is gradually drawn into the habit of drinking without company; this happens all the more easily because the maternal grandfather drank heavily and was repeatedly treated for this. When a girl first finds herself in a psychiatric hospital, where she went at the insistence of her husband and where she was diagnosed with alcohol addiction combined with depression, and her mother found out about this, her mother’s first and almost only reaction was accusations of ingratitude (“I raised you, gave you you an education, and how did you pay me for it? Drunkenness?!”). The doctor's attempts to explain to the mother that it was she (for which, however, she cannot be blamed) who passed on to her daughter the genetic predisposition to alcohol abuse inherited from her father and crushed her daughter from childhood, turned out to be futile and only led to the fact that the mother's anger turned to himself.

It would be superfluous to say that the mother's reproaches strengthened the old feeling of guilt towards the mother and aggravated the patient's discomfort (after all, she herself punishes herself for her alcoholism, attributing it to her own promiscuity). There are quite a lot of unloved children among people prone to depression, anxiety, doubt, low self-esteem and other types of mental distress, among individuals who are in need of alcohol, and therefore one of the surest ways to raise a healthy child is simply to love him. And it is extremely important at the same time not to hide your love from the child - this is very convincingly stated in the brilliant essay "Generational Trauma" by psychologist Lyudmila Petranovskaya.

How can infantile stress be, dooming a child to subsequent visits to psychiatrists and far from always successful treatment? The child is crying because he is alone, his diapers are wet and he wants to eat, but the parents do not come to him: they read or heard somewhere that from the first days in life, children should be kept in strictness for their own good, so as not to to spoil that you need to feed the baby by the hour, and not when he asks for it, and that you should take him in your arms less often.

It must be admitted that the authors of this article are very skeptical about the psychoanalysis of Sigmund Freud. Many postulates of psychoanalysis (especially early, classical) seem to us speculative and speculative. But with what the psychoanalyst, without a doubt, hit the "top ten", it is with the doctrine of early childhood trauma.

The British psychiatrist and psychoanalyst John Bowlby states that from the first days of life, the child should be "in a warm, close and uninterrupted relationship with the mother or her substitute.

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