Mental Illness Wars: Four-Way Death Match

[Hustler]

It's time we had it out once and for all. There's a lot of talk about all of these disorders here, and, seeing as how I'm an insensitive jackass, I want some resolution as to which one wins the Mental Illness Wars. I'm posting this in the INTP forum because I don't want to see one single post or vote by some retarded NF; I want the straight dope from the people who actually count.

I'm not going to say which, but I'm wavering between two of them.

[fripping]

whoa whoa whoa, what about depression?

[!diom]

Avoidant personality disorder is another good one.

[Hustler]

Look, there are obviously lots of great mental illnesses. I mean, what about schizophrenia? That's arguably the king, but I wanted to restrict this to something most relevant to this forum. I could have included "depression" or something like Major Depressive Disorder, but that's kind of weak-sauce.

[kali]

Schizotypal PD is more relevant to this forum than post-traumatic stress disorder. That being said, Bipolar Disorder triumphs all on the poll.

[!diom]

I've seen more talk about autism, specifically Asperger's, than anything else. ADHD is another much talked about but lame and easily treatable disorder.

[Hustler]

Schizotypal PD is more relevant to this forum than post-traumatic stress disorder.

No it isn't, n00b. PTSD has gotten a lot of play at INTPc over the years. I just mentioned it in a post yesterday, for instance.

[Hustler]

I've seen more talk about autism, specifically Asperger's, than anything else. ADHD is another much talked about but lame and easily treatable disorder.

Come on. Asperger is wack, and damn near all the Asperger talk at this forum has been bogus. I think MacGuffin said all that needed to be said about that one, so it wasn't going to get in on this poll. Autism is borderline, but isn't quite in the same league as these others. (SWIDT?)

[kali]

Whatever gramps, at least 54 people (http://forums.intpcentral.com/poll.php?do=showresults&pollid=121) can relate to schizotypal here, and I'm going to argue that PTSD is automatically sub-par as a mental disorder simply because it's necessarily catalyst-dependent.

[Hustler]

Whatever gramps, at least 54 people (http://forums.intpcentral.com/poll.php?do=showresults&pollid=121) can relate to schizotypal here, and I'm going to argue that PTSD is automatically sub-par as a mental disorder simply because it's necessarily catalyst-dependent.

Maybe that just makes it even realer. Besides which, who's to say the other ones aren't triggered by some catalyst? Also, similarminds is a bogus site and the tests there are for n00bs and dilettantes.

[!diom]

Asperger is wack, and damn near all the Asperger talk at this forum has been bogus.

I agree, but I do know of at least one legit aspie (http://forums.intpcentral.com/showpost.php?p=343067&postcount=32). I'm sure there are more, but that guy seemed pretty debilitated by it. He also placed in the Scripps National Spelling Bee, is working towards a PhD, and definitely had the stuff to smoke everyone here in the IQ challenge.

I'm on a pointless tangent.

[ryan_m_parr]

I don't want to make people jealous.

[Spartan26]

Bipolar Disorder - Lawd, hammercy on the INTP soul that can't find internal mental peace. Despite heavy self medicating others won't be able to tell when one would be in a manic episode. Series of unchallenging, low paying jobs, constant battles w/cable company over charges, possible stroke at 50 from lack of exercise/liver damage. Verdict: Global warming or migrant killer bees could cause demise before disease. low risk

Obsessive-Compulsive Disorder - too busy washing hands and unlocking/locking doors to leave the house and be a threat to anybody - buzz

Posttraumatic Stress Disorder - an INTP w/PTSD, a walking time bomb. Will either kill self or go on a rampage at the mall. Good thing person would have disdain for crowds and go at an off time or more people would be hurt. Winner

Schizoid Personality Disorder - Most of us don't have much in terms of social safety net. I'd think two strikes and you're out here. People too smart for own good and shake off taking meds. Homeless in 6 mos tops. Threat Neutralized

[!diom]

Whatever gramps, at least 54 people (http://forums.intpcentral.com/poll.php?do=showresults&pollid=121) can relate to schizotypal here, and I'm going to argue that PTSD is automatically sub-par as a mental disorder simply because it's necessarily catalyst-dependent.

My guess is there's not a single active member on this forum with Schizotypal PD. Most people here probably have a very poor conception of what it is because all they know is what they read online, and I say it's one of those things you have to see IRL to grasp.

[!diom]

One of the better fictional examples of Schizotypal PD:

Kramer
Kramer II

[qualia]

Bipolar Disorder - Lawd, hammercy on the INTP soul that can't find internal mental peace. Despite heavy self medicating others won't be able to tell when one would be in a manic episode. Series of unchallenging, low paying jobs, constant battles w/cable company over charges, possible stroke at 50 from lack of exercise/liver damage. Verdict: Global warming or migrant killer bees could cause demise before disease. low riskBitch, please, manias and hypo-manias can turn into psychotic episodes. The occasional psychotic rage means we'll occasionally actually choke a bitch. Or kill ourselves. It's more often us that dies, but don't underestimate our capacity to fly off the handle when truly psychotic manic. Still, some bitch gets choked and everyone gets scared shitless in the process.

Fucking lucky I'm Bipolar II, Bipolar I people tear shit up.

PTSD's pretty hardcore, but have to root for the home team.

[bluebell]

Boringly straight answer: you can be functional without meds and minimal therapy with PTSD (even complex-PTSD) if you work through the trauma shit enough. Bipolar seems to require ongoing medication to be functional.

[Hustler]

Bitch, please, manias and hypo-manias can turn into psychotic episodes. The occasional psychotic rage means we'll occasionally actually choke a bitch. Or kill ourselves. It's more often us that dies, but don't underestimate our capacity to fly off the handle when truly psychotic manic.

The suicide rate for persons diagnosed with bipolar disorder is merely 0.4%. That's much lower than the 3.4% of people with major depressive disorder who commit suicide. But, if you think that's bad, about 50% of people with OCD experience suicidal tendencies and 15% have attempted suicide. I'm not sure how many actually succeed. Suicide risk is low for schizoids. It's extremely variable for people with PTSD, since PTSD itself can manifest in many ways, but I can't seem to locate any great data on that.

About 4.9% of schizophrenics commit suicide and 0.04% of people with no diagnosed disorder do.

[kali]

My guess is there's not a single active member on this forum with Schizotypal PD. Most people here probably have a very poor conception of what it is because all they know is what they read online, and I say it's one of those things you have to see IRL to grasp.

You contradict yourself there buddy - you claim that it's "one of those things you have to see IRL to grasp". If so, then how can I take your guess that no one here is schizotypal seriously, especially since I'm presuming you've never met any of the 54 people I linked to?

You obviously aren't even convinced of what you're saying, since that post was peppered with low-modality words like "my guess.." "most" "I say", as if refuting your propotions is almost impossible since they're under the guise of your belief system and not something falsifiable - something karl popper would have frowned upon. Jesus, I hate people who are antagonistic towards my posts for the purposes of spite and nothing else; It shows a weakness in repressing bias.

[qualia]

Can confirm there was once one guy here with honest to God schizoid personality disorder. Not schizotypal, but half way there, right?

[qualia]

The suicide rate for persons diagnosed with bipolar disorder is merely 0.4%. That's much lower than the 3.4% of people with major depressive disorder who commit suicide.The first number is per year, the second is lifetime risk.

Let's clear this up a little, (http://linkinghub.elsevier.com/retrieve/pii/0006322395002952) so we're comparing apples to apples. Suicide attempts of people with bipolar disorder are roughly double that of unipolar depression in that study.

I'ma say that if you've met someone with bipolar disorder who, over a lifetime, never had suicidal ideation, ask them if they've also won the lottery, 'cause that's some luck.

Second, When we attempt suicide, we kind of mean it. (http://www.medscape.com/viewarticle/567282) One in three attempts are successful, which is thirty times more likely than the general population. You'd have to double the success rate to have comparable successful suicides in OCD or unipolar depression to have a similar number of suicides per I forget this unit, but you get the idea. They're both terrible and crippling, but they're not as deadly.

Schizophrenia probably has a similar successful suicide rate to bipolarity, (http://pn.psychiatryonline.org/content/40/8/48.full) and as high or higher attempt rate.

I'm a little funny on this source, but schizophrenia seems more likely to have a lot of comorbid conditions, with like 1/5th of schizophrenics also being bipolar. If you have bipolar disorder and schizophrenia, this source claims a 70% lifetime suicide attempt rate. (http://www.pendulum.org/depres/dep.schiz.htm) I think schizophrenics "win" because of the high likelihood of comorbid conditions and how badly it fucks with them.

But of the choices given, bipolarity seems to win in the want to die category over unipolar depression and OCD.

[Chaselation]

The focus seems to be on suicide rates. While an obvious source of peril, the tangent life ending effects may out weigh suicide.

Not stating this as fact just as an hypothetical to make a point. Bipolar is treatable (at least for some) and would presumably result in a functioning individual at least for stretches. Perhaps this would allow for a lower stressed medically keep person. Contrasted with a OCD person for which there is no recourse for improvement and so fearful as to never see a doctor or even pick up an aspirin for a headache. They might be subjecting their bodies/minds to medieval like conditions.

I looked for such data but could only find it for bipolar disorder. "The average female with bipolar disorder with an onset at age 25 will lose, on average, 9 years in life expectancy, 14 years of lost productivity and 12 years of normal health compared with normal controls (US DHEW, 1979). This is in addition to the risk of suicide."

Similar data for all the contestants would be required for the full picture. Quality of life is also relevant but likely too subjective to measure.

[!diom]

You contradict yourself there buddy - you claim that it's "one of those things you have to see IRL to grasp". If so, then how can I take your guess that no one here is schizotypal seriously, especially since I'm presuming you've never met any of the 54 people I linked to?


There's no contradiction. You see it for yourself IRL to grasp it, and then you use this basic grasp of the disorder to realize that there's very little chance that a person with schizotypal PD would manage to stick around on this forum. There may have been schizotypals who came here in the past only to be banned or seriously ostracized, that's why I'm talking about active members.

[avolkiteshvara]

PTSD

Much cooler neurosis and think I might have/had a touch. Victor Charlie Tengo FTW

[Lurker]

Hmm. As for quality of life impairment, chance for improvement, and functional damage done (aka, you're gonna end up homeless), I'm going to protest that Major Depressive Disorder wasn't included. It's considered "weaksauce" only because the terminology is so overused. A severe, recurrent, treatment-resistant depression can result in psychosis, an inability to even swallow, and complete immobility. It's all a matter of degree. Mild depression isn't even in the same ballpark. So, my vote would go for MDD, if that was an option.

Since it isn't, I'm honestly torn between OCD and PTSD. Both are pretty treatment resistant and severely disabling. Sufferers of bipolar disorder are often misdiagnosed, imo; often they seem more like borderline personality disorder cases. In cases that aren't misdiagnosed, it's very disabling (then again, so is BPD), but somewhat more responsive to medication than any of the other conditions listed. Usually, bipolar sufferers can build up a better support system, which helps.

As for schizoid personality disorder, I'd label it the least disabling, at least in terms of patient suffering and functional impairment.

I kinda wish I could change my vote to OCD. No one has much sympathy for an uptight, anal retentive ass who compulsively engages in repetitive self-destructive behavior. Less sympathy = less support in all arenas.

[Roger Mexico]

You know, out of all the "wars" threads, I find this one the most confusing and possibly pointless (and that's saying something).

What, exactly, are the criteria being used to vote? Which one would I rather have? Which one is worse? Which one is more interesting? Which one is "cooler"?

Offhand I'd say the two most prevalent disorders among forum users here are OCD and Schizoid. But this is isn't based on any kind of statistical analysis, and may simply reflect a stereotype about INTP's. (Loners with an excessive devotion to strange hobbies) Who here is bipolar? I'd think of that as more an NF thing. (Having "mood swings" requires having moods, which requires having feelings. Do INTP's have feelings?)

I've been diagnosed with PTSD, fwiw. It does kind of suck, but I sometimes wonder how much of it is a "disorder" and how much of it is a rational response to experiences most people don't have and what they reveal about humanity/life/the universe/everything.

Meh

[Lurker]

@ Idiom: I think you have AvdPD, not SPD. Traits you describe align more with avoidance than schizoid behavior. Dated descriptions of SPD lump the two together.

The stereotype of a person with SPD is someone who *desires* no real human connection, so they aren't feeling friction like you have described. Avoidants suffer a very painful push-pull sensation with others.

[aphemix]

I skimmed through this whole thread and I still can't even tell what the poll is about. Am I voting for most debilitating disorder? Disorder most representative of INTPc? The disorder that is my personal favorite? None of these options seem particularly worth a vote to me either way.

[Lurker]

Offhand I'd say the two most prevalent disorders among forum users here are OCD and Schizoid. But this is isn't based on any kind of statistical analysis, and may simply reflect a stereotype about INTP's. (Loners with an excessive devotion to strange hobbies)

I'd say avoidant and schizoid, but close enough. Schizoid posters aren't likely to make many waves on the forum.


Who here is bipolar? I'd think of that as more an NF thing. (Having "mood swings" requires having moods, which requires having feelings. Do INTP's have feelings?)

Of course INTPs have feelings. I don't think there's a relation.



I've been diagnosed with PTSD, fwiw. It does kind of suck, but I sometimes wonder how much of it is a "disorder" and how much of it is a rational response to experiences most people don't have and what they reveal about humanity/life/the universe/everything.

Meh

It's a rational response to an irrational situation (TM!). Anything that impairs your day-to-day life to the extent that it causes distress or decrease in function can (and should, imo) qualify as a disorder.

And anyway, there's always a spectrum of intensity from mild to severe.

Edit: I assume we're voting for most debilitating.

[Digital Future]

oppositional defiant disorder?

[Hustler]

The first number is per year, the second is lifetime risk.

Let's clear this up a little, (http://linkinghub.elsevier.com/retrieve/pii/0006322395002952) so we're comparing apples to apples. Suicide attempts of people with bipolar disorder are roughly double that of unipolar depression in that study.

I'ma say that if you've met someone with bipolar disorder who, over a lifetime, never had suicidal ideation, ask them if they've also won the lottery, 'cause that's some luck.

Second, When we attempt suicide, we kind of mean it. (http://www.medscape.com/viewarticle/567282) One in three attempts are successful, which is thirty times more likely than the general population. You'd have to double the success rate to have comparable successful suicides in OCD or unipolar depression to have a similar number of suicides per I forget this unit, but you get the idea. They're both terrible and crippling, but they're not as deadly.

But of the choices given, bipolarity seems to win in the want to die category over unipolar depression and OCD.

I'm sorry, but those are the worst sources I've ever been linked to. I can't read any of that shit without signing up for some psychiatry website, which I'm obviously not going to do. You're right that the 0.4% figure for the suicide rate of persons with bipolar disorder is per annum, though it's hard to figure what that translates to for a lifetime, seeing as how the disorder can be onset at different ages and can come and go from people over the years. Also, you have no figures for the success rates of persons with OCD; you can't simply lump them into the general population.

I will say that bipolar and OCD definitely have higher suicide rates than schizoid personality disorder. PTSD is hard to quantify, though some googling indicates an attempt rate of 27%.

[Hustler]

You know, out of all the "wars" threads, I find this one the most confusing and possibly pointless (and that's saying something).

What, exactly, are the criteria being used to vote? Which one would I rather have? Which one is worse? Which one is more interesting? Which one is "cooler"?


I skimmed through this whole thread and I still can't even tell what the poll is about. Am I voting for most debilitating disorder? Disorder most representative of INTPc? The disorder that is my personal favorite? None of these options seem particularly worth a vote to me either way.

Just vote.

[aphemix]

Just vote.ok, voted OCD.

am I in a Forest?

[rainfall]

Can't choose between BD and pstd.

[Harion]

i voted bipolar bec i'm borderline bipolar
so i win!

[qualia]

I'm sorry, but those are the worst sources I've ever been linked to. I can't read any of that shit without signing up for some psychiatry website, which I'm obviously not going to do.I apologize on the first link. Here is the abstract:


The lifetime rate of suicide attempts among subjects in the Epidemiologic Catchment Area database with bipolar disorder, unipolar disorder, and any other DSM-III-defined Axis I disorder were determined. The latter constituted a control or reference group. The lifetime rates of suicide attempts of persons in these diagnostic groups were 29.2%, 15.9%, and 4.2%, respectively. Multivariate logistic regression analysis was used to calculate the odds ratio of subjects within a diagnostic group having a history of a suicide attempt relative to subjects in a second group. The odds ratio of subjects with bipolar disorder having a history of a suicide attempt relative to subjects in the control group was 6.2 (df 1, x(2) = 5347.2, p < .0001). The odds ratio of subjects with unipolar disorder having a history of a suicide attempt relative to subjects in the control group was 3.1 (df = 1, x(2) = 4785.2, p < .0001). The odds ratio of subjects with bipolar disorder having a history of a suicide attempt relative to unipolar subjects was 2.0 (df = 1, x(2) = 697.9, p < .0001). Bipolar disorder has a strong relationship to a history of suicide attempts relative to unipolar disorder and other Axis I disorders.

For some reason, the second links just fine from google, but does not from here. It's a really great and comprehensive article on the subject, and I wish I could quote the whole thing.

Well, maybe I can:

Assessing Suicide Risk in Patients With Bipolar Disorder: An Expert Interview With Jan A. Fawcett, MD
Editor's note: Suicide is a devastating outcome of depression, and patients with bipolar disorder spend more time depressed than manic. Clinicians who treat people with this mental illness must use all tools at their disposal to prevent suicide as they work with the patient and family to stabilize mood and improve function. Jan A. Fawcett, MD, professor of psychiatry at the University of New Mexico School of Medicine in Albuquerque, has devoted his career to the study of mood disorders and suicide. In this interview with Medscape's Jessica Gould, Dr. Fawcett provides clinicians with the latest thinking about assessing and managing suicide risk in patients with bipolar disorder.

Medscape: What do you think clinicians should consider when evaluating suicide risk for patients with bipolar disorder?

Jan A. Fawcett, MD: Clinicians should know that, on average in the United States, 1 suicide occurs for every 30 attempts. In bipolar patients, it's 1 suicide for every 3 attempts,[1] which confirms the increased risk of suicide in patients with bipolar disorder: their attempts are 10 times more lethal.

Since suicidal behavior is much more likely to result in death in bipolar patients than in the general public, one wants to be as careful as possible with these patients. The first thing the clinician wants to know is the patient's current clinical state and whether he or she is having any suicidal ideation.

If a patient is having suicidal ideation, the clinician should inquire about specific suicidal plans by asking questions like, "Have you made a suicide attempt? Have you been thinking about it? Have you been planning it?" A lot of people have vague suicidal ideation, but not as many have specific plans. Some people rehearse plans in their mind, and that is a very serious situation.

You also want to know if the patient is severely agitated. Bipolar patients sometimes have mixed mood states, in which they're both depressed and manic at the same time. In other words, they're not euphoric like most manic patients, they're irritable and they have increased energy. That's a particularly risky situation for a bipolar patient.

Medscape: Why does the bipolar mixed state pose such a risk?

Dr. Fawcett: The mixed state, specifically the rapidity of mood changes, is harder to monitor. You can't treat the patient's depression with antidepressants because that can induce mood cycling. Although the patient may show an initial improvement, the patient's course may deteriorate into mixed states or rapid-cycling bipolar disorder. And the increased energy and impulsiveness of a mixed state combined with the pain and hopelessness of depression create a situation in which the likelihood of suicidal behavior is increased. Those are unstable states that should be prevented.

The other issue, which goes into some of my own research, is if the patient is experiencing severe anxiety, such as anxious thoughts the patient can't stop. This could be a serious risk factor for suicide. In a recent study of 32,000 bipolar patients' records,[2] the highest risk factor for suicide was being male and having a comorbid anxiety disorder, compared with being young and having a substance-use disorder, which predicted attempts but not necessarily suicide.

Medscape: What are the challenges inherent to medicating patients with bipolar disorder who might be at risk for suicide?

Dr. Fawcett: Depressed patients with bipolar disorder often don't remember their manias very well. So sometimes it's difficult to get a history of a prior mania because patients forget them or believe that they were normal during their mania. If you treat such patients with an antidepressant, you may worsen their condition, putting them at greater risk if they develop mood cycling or a mixed manic state. So that's one thing that makes the treatment of depression in a bipolar patient more complicated than it is in a unipolar patient. The other challenging situation is the patient with current agitation or rapid cycling who has to be more stable before you can address the depression.

Medscape: In a 2005 article you wrote for Medscape,[3] you said, "Certain forms of psychotherapy, particularly dialectic behavioral therapy, and perhaps cognitive behavioral therapy and interpersonal therapy, may reduce long-term suicide risk." Please explain that.

Dr. Fawcett: When assessing patients with bipolar disorder for suicide risk, the clinician should have 2 issues in mind. One is short-term risk, which requires treating the patient's anxiety or the severity of the mood cycles. This would be treated as discussed above with medications that can rapidly reduce anxiety and agitation. That's not when the patient needs the psychotherapy. In long-term risk management, however, these therapies might be effective. Dialectic behavioral therapy can help people with impulsive behavior and destructive impulses, which is particularly helpful for people with a personality disorder, who tend to act out their conflicts instead of thinking or talking about them. Traditional cognitive behavioral therapy addresses the state of hopelessness, which is related to suicide and the feeling that nothing's going to improve. The rate of reduction of suicide is greatest in bipolar patients who stay on sustained medication treatment for 6 months or more.

Medscape: What are you most hopeful about in treating bipolar patients who are at risk for suicide?

Dr. Fawcett: Well, I think the growing recognition of the importance of anxiety as a treatable factor in reducing suicide risks is very exciting. This has emerged only during the past 5-7 years, with studies showing a greater risk for suicidal behavior in patients with comorbid anxiety disorders. Meanwhile, Greg Simon showed that suicide, not just suicide attempts, was related to anxiety.[2] Severe anxiety symptoms may require additional treatment with clonazepam or second-generation antipsychotic medications, which have been found effective in reducing severe anxiety and agitation when given in addition to other mood-stabilizing medications.

Medscape: What's the biggest challenge clinicians face in reducing suicide and suicide risk among patients with bipolar disorder?

Dr. Fawcett:: Well, the challenging part is obtaining information to assess the immediate risk of a patient for suicide, which is a difficult assessment to make. Every study that's tried to determine predictors of suicide has found that there are no predictors -- at least not statistically significant ones -- that tell a clinician that a patient is going to commit suicide. We need much more information on what makes suicide highly foreseeable in the immediate future. I think that would help clinicians a great deal.

You don't want to overdiagnose bipolar disorder, but you don't want to miss it. The clinician must know if a patient has a history of suicidal behavior or plans. If the patient is having significant anxiety, the clinician wants to know that too, and address it in treatment because antidepressant and mood-stabilizing medications alone don't help that.

Still, it's very much an uphill battle to diagnose and intervene to prevent suicide in a free society where patients have choices and, because of depression, hopelessness and discouragement, may have given up on the possibilities for recovery. It's probably the clinician's most difficult task. There are people at high risk that we're losing; we need to find ways to treat them. It's a constant challenge.

This interview is published in collaboration with NARSAD, the World's Leading Charity Dedicated to Mental Health Research.


References

[1]Baldessarini RJ, Pompili M, Tondo L. Suicide in bipolar disorder: risks and management. CNS Spectr. 2006;11:465-471. Abstract

[2]Simon GE, Hunkeler E, Fireman B, Lee JY, Savarino J. Risk of suicide attempt and suicide death in patients treated for bipolar disorder. Bipolar Disord. 2007;9:526-530. Abstract

[3]Fawcett JA. Suicide and bipolar disorder. Medscape Psychiatry & Mental Health. 2005;10. Available at: http://www.medscape.com/viewarticle/510318_6 Accessed December 9, 2007.

[!diom]

@ Idiom: I think you have AvdPD, not SPD. Traits you describe align more with avoidance than schizoid behavior. Dated descriptions of SPD lump the two together.

The stereotype of a person with SPD is someone who *desires* no real human connection, so they aren't feeling friction like you have described. Avoidants suffer a very painful push-pull sensation with others.

As I may have said somewhere before, it really all boils down to how you present yourself to a mental health professional. From what I've had explained to me, both schizoids and avoidants desire some level of human connection. However, schizoids obviously desire much less, perhaps just one important relationship, and have an easier time resigning themselves to a solitary life. When I was asked directly by my therapists if I wanted more friends or a relationship, I've always answered either "No", "It depends", or "I'm not sure", partly because it feels somewhat shameful to admit to, and partly because I'm really not sure most of the time. I don't want to be in a relationship just to be in a relationship. I wouldn't want to be in a bad relationship, or even in an average or passable one. It would have to great, near perfect, in order to justify me making the effort to maintain it. Either that, or it would need to be effortless. So, line up every girl in the world and my answer will be "No" 99.9&#37; of the time, yet I, of course, would still prefer a perfect relationship to being alone. Sex that I don't really have to put in effort to get is another thing entirely, but, really, how often does that happen? Not being willing to put in the effort to pursue sexual encounters is pretty much the same as not having any interest. It doesn't matter what you think or type on an internet forum so much as what you show to other people in your day to day life.

[BAJ]

Ah, I've been mentally ill. The court said so.

However, my main disorders weren't listed in the poll.

[teleforce]

^ Idiom's post:

i'm not going to pretend to be an expert, but i would think that certain stuff a person writes on the internet can definitely matter when it comes to observing mental illness. it's important to realize that occasional (or frequent, even blatant) "deluding"/whatever may be characteristic of their suspected disorder, and it goes without saying that there's a limit to what day-to-day behavior can show. schizotypal and schizoid individuals, for example, do not necessarily differ much in terms of observable behavior, so diagnosis must be based on something pertaining to the person's actual thinking (hinted by the "how" and "what" of expression, which could include the internet) in addition to behavior/interaction. which also goes without saying.

the internet is a funny one because so much depends on the nature of discussion.

i also want to mention that this type of attitude towards relationships isn't exclusive to SPD by any means.


Schizotypal PD is more relevant to this forum than post-traumatic stress disorder. That being said, Bipolar Disorder triumphs all on the poll.

i would think that it's common, or at least not unheard of, for schizoids to be mistakenly diagnosed as schizotypal and vice versa. i'm skeptical in general about the "accuracy" of diagnosis 'cause it's a fact that crazy traits overlap and shit, but i'm not sure about the actual rate of mistaken schizoid/schizotypal diagnosis (and it sounds hard to google and impossible to know). unless i'm missing something, the main things distinguishing schizotypal from schizoid is the inability to accurately interpret others' actions and emotions (leading to delusion and paranoia) and rejection of people as opposed to indifference. in all other respects the two sound kind of similar, as it's also not unheard of for schizoids to exhibit schizotypal behavior/thinking. i see a lot of room for overlapping and confusion--again, unless i'm missing something.

this stuff is kind of new to me. it's interesting i guess.

anyway, i would've voted for schizotypal if it was an option because i love that fuckin' movie taxi driver. it's just the coolest one, you know?! :cry:

(oh, and i was one of those 54 people...)

[!diom]

schizotypal and schizoid individuals, for example, do not necessarily differ much in terms of observable behavior

Yes, they do, and very much so. In terms of being observably "crazy", a schizotypal person is about halfway between schizoid and schizophrenic. They generally look crazy, act crazy, and say crazy shit on a consistent basis. They don't hallucinate and they're not completely broken off from reality like an untreated schizophrenic, but, unlike schizoids, they would never be mistaken for normal if they didn't have trouble with interacting with people and weren't socially isolated.


unless i'm missing something, the main things distinguishing schizotypal from schizoid is the inability to accurately interpret others' actions and emotions

No, the following (bolded) are traits found in schizotypals not found in schizoids (straight from the DSM):

Ideas of reference (excluding delusions of reference)
Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, bizarre fantasies or preoccupations)
Unusual perceptual experiences, including bodily illusions
Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
Suspiciousness or paranoid ideation
Inappropriate or constricted affect
Behavior or appearance that is odd, eccentric, or peculiar
Lack of close friends or confidants other than first-degree relatives
Social anxiety that tends to be associated with paranoid fears rather than negative judgments about self.

People read this kinda shit and probably think to themselves, "Well, I have strange ideas", but schizotypals are in a whole 'nother league. A schizotypal, for instance, might think that the frequency of their bowel movements have a significant effect on the fluctuations of the US economy -- and sincerely, wholeheartedly believe it while basing certain aspects of their life, like what they eat, around it. They would also freak out if someone criticized them for having such an irrational idea. This is why I think they wouldn't last at a site full of INTPs.

[teleforce]

Yes, they do, and very much so. In terms of being observably "crazy", a schizotypal person is about halfway between schizoid and schizophrenic. They generally look crazy, act crazy, and say crazy shit on a consistent basis. They don't hallucinate and they're not completely broken off from reality like an untreated schizophrenic, but, unlike schizoids, they would never be mistaken for normal if they didn't have trouble with interacting with people and weren't socially isolated.



No, the following (bolded) are traits found in schizotypals not found in schizoids (straight from the DSM):

Ideas of reference (excluding delusions of reference)
Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, bizarre fantasies or preoccupations)
Unusual perceptual experiences, including bodily illusions
Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
Suspiciousness or paranoid ideation
Inappropriate or constricted affect
Behavior or appearance that is odd, eccentric, or peculiar
Lack of close friends or confidants other than first-degree relatives
Social anxiety that tends to be associated with paranoid fears rather than negative judgments about self.

People read this kinda shit and probably think to themselves, "Well, I have strange ideas", but schizotypals are in a whole 'nother league. A schizotypal, for instance, might think that the frequency of their bowel movements have a significant effect on the fluctuations of the US economy -- and sincerely, wholeheartedly believe it while basing certain aspects of their life, like what they eat, around it. They would also freak out if someone criticized them for having such an irrational idea. This is why I think they wouldn't last at a site full of INTPs.

okay, i'm just trying to understand this. do you have a link that elaborates on "degrees of crazy and the lines we draw"? i want something to read.

edit: it looks like this schizoid --> schizophrenia spectrum is one theory, but are there others? i can't stick around the computer all day so yeah...

also, i'd like to see another example that isn't that kramer guy, preferably drawn from reality. and not funny.

edit 2: the wikipedia article for SPD mentioned something called millon's subtypes of schizoid. (http://en.wikipedia.org/wiki/Schizoid_personality_disorder#Millon.27s_subtypes) two of them, the "depersonalized" and "remote" schizoid, are described as having schizotypal traits, which suggests (the possibility of) some kind of overlap, or at least a blurry division.

[Hustler]

edit 2: the wikipedia article for SPD mentioned something called millon's subtypes of schizoid. (http://en.wikipedia.org/wiki/Schizoid_personality_disorder#Millon.27s_subtypes) two of them, the "depersonalized" and "remote" schizoid, are described as having schizotypal traits, which suggests (the possibility of) some kind of overlap, or at least a blurry division.

There's overlap between all of the disorders, really. Especially just about any disorder and depression. But, for instance, a lot of the traits !diom just listed as being schizotypal and not schizoid could also be schizophrenic. I guess this is why psychiatrists get paid the big bucks; they can supposedly figure out which of several possible disorders a person has and then medicate/treat accordingly.

[Jennywocky]

As far as which wins, it might matter whether you have it or someone else does.

Schizoid, for example. I think it would be a bitch in terms of keeping friendships and a job, but mostly because you're just unable to connect. If you yourself are indifferent to the lack of connection, then it's more of a bitch for the people who want to love you.

OCD can be a pain in the ass for people who have it AND those around them. The compulsive behavior is a slavery of sorts, and you'd waste lots of time focusing on things that aren't really important in terms of being successful in life. Meanwhile, if you're freaking out every time someone AROUND you doesn't keep things structured the way you need, they're not going to want to be around you either... which messes up your life worse, because who will want to be with you? And no matter how lonely you are, wouldn't it be easier just to live alone so you can control your own environment? So that is a more serious contender.

But PTSS can really fuck up your life. I mean, if you are having inappropriate fight/flight responses to innocent or manageable events, the flare-ups of aggression and paranoia are going to create some very awkward social and employment situations.... and if you're having unpredictable flashbacks that leave you momentarily (or longer) unable to function? That really puts some limits on ALL your activities. Your quality of life is going to go way down, if you can hold a job at all. At least OCD allows for some control over your environment, even if it's a draining and MANIACAL amount...

As far as Bipolar: I watched it destroy the life of one of my best friends. He's finally stable and afloat again, but it ruined his career, almost ruined his family, and almost ended his life. He's sane and cool now, but... Uggh.

To add another one: ... borderline. I have to say, I lived with this girl for a year. I thought she was normal going into it. An ISFP. I thought we could manage to share a place well enough. That was until I started dealing with Sweet Chick / Freaking Insane Bitch flipflops. She'd be sweet and nice for awhile, then start withdrawing and get passive-aggressive, leave me nasty notes around the house, but if I confronted her to resolve the issue she'd claim nothing was wrong.... and then send nasty e-mails to me a short time later, pages and pages of just venemous spiteful dumps of why I was such a terrible human being... and then when I'd respond to her, she'd genuinely be confused as to why I upset with her letters because "she was just explaining how she felt" and didn't mean to be mean.

(When I shared one of the letters with a friend or two, they were just like, "God she's a complete whackjob.")

Once I came home to change for a party, and she acted weird and rushed out the door... and I went upstairs to find blood all over the sink and on the walls. She didn't answer her cell phone. I had to clean up the mess. My Christmas party was mucked up because I spent all night wondering if she was dead. I finally got in touch with her a day later (she never returned my calls) and she didn't understand why I was upset and worried about her (whereupon I chewed her out, once I knew she was still alive) and didn't want to tell me about the cutting so as not to "ruin my party" the night before.

Just lots and lots of crazy unstable shit, and no way to predict it.

Her people skills were horrible. She's one of the most well-intentioned people I know who has no idea how to communicate. She'd go online and post lots of really nasty things about herself, even after people would say affirming things, then be confused about why no one would talk to her after awhile.

But to tie it to topic: She was pulling all this a final time the month before our lease ended, so I forced a discussion that she was acting sporadically in... and at some point I made a general comment (i can't even remember it) and out of the blue she screams at me, "DON'T YOU DARE CALL ME BORDERLINE!"

Hmmm. I'm like... "I didn't call you borderlin--"
"YES YOU DAMN WELL DID! <ETC>."

She's 50 and actually an aide who works with disturbed teens, so she probably hears a lot about borderline behavior.

I can't say Borderline beats PTSD and the others, but it's just hell to deal with. I was really glad to grab all my things and move when the lease ran out. She was just as crazy as hell.

(Note: I think there was a good chance I would have been diagnosed with Avoidant at one point in my life... but no, I was still functional... barely... and didn't make other people's lives hell. It's not really up there with PTSD, OCD, or Borderline.)

I'm going to have to vote Bipolar though.

[!diom]

edit 2: the wikipedia article for SPD mentioned something called millon's subtypes of schizoid. (http://en.wikipedia.org/wiki/Schizoid_personality_disorder#Millon.27s_subtypes) two of them, the "depersonalized" and "remote" schizoid, are described as having schizotypal traits, which suggests (the possibility of) some kind of overlap, or at least a blurry division.

Of course there's overlap, but that's why they have diagnostic criteria. For the traits I mentioned, you would need to show at least 5 of them, each in a wide variety of situations, and meet the general criteria for being diagnosed with a PD. This is how most of the overlap is cleared up.

[BAJ]

Mine has usually been Major Depression with psychotic features, and personality disorder (NOS). Also, alcohol abuse, if you want to call that a disorder.

However, reading the DSM and other texts, I find I have lots of characteristics of OCPD, Schzoidal PD and maybe a little OCD.

Yet, my treatment team released me, so I guess I'm sane enough.

There is no choice for Depression or "other" in the poll.

[Lurker]

As I may have said somewhere before, it really all boils down to how you present yourself to a mental health professional. From what I've had explained to me, both schizoids and avoidants desire some level of human connection. However, schizoids obviously desire much less, perhaps just one important relationship, and have an easier time resigning themselves to a solitary life. When I was asked directly by my therapists if I wanted more friends or a relationship, I've always answered either "No", "It depends", or "I'm not sure", partly because it feels somewhat shameful to admit to, and partly because I'm really not sure most of the time. I don't want to be in a relationship just to be in a relationship. I wouldn't want to be in a bad relationship, or even in an average or passable one. It would have to great, near perfect, in order to justify me making the effort to maintain it. Either that, or it would need to be effortless. So, line up every girl in the world and my answer will be "No" 99.9&#37; of the time, yet I, of course, would still prefer a perfect relationship to being alone. Sex that I don't really have to put in effort to get is another thing entirely, but, really, how often does that happen? Not being willing to put in the effort to pursue sexual encounters is pretty much the same as not having any interest. It doesn't matter what you think or type on an internet forum so much as what you show to other people in your day to day life.

I think what you reveal about yourself on an internet forum may be more genuine than your public persona because your guard is down somewhat, and you are here because you want to be. You get something out of this, something resembling social contact.

I can see why you were diagnosed with SPD because of the way you responded to the questions; however, I'm still questioning it. I have an issue with the distinctions the DSM IV TR draws between the schizoid and avoidant personality disorders anyway. To be honest with you, I've never known anyone (personally) who fit the DSM criteria for SPD because it is so stringent.


A. A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood (age eighteen or older) and present in a variety of contexts, as indicated by four (or more) of the following:

neither desires nor enjoys close relationships, including being part of a family
almost always chooses solitary activities
has little, if any, interest in having sexual experiences with another person
takes pleasure in few, if any, activities
lacks close friends or confidants other than first-degree relatives
appears indifferent to the praise (http://en.wikipedia.org/wiki/Praise) or criticism (http://en.wikipedia.org/wiki/Criticism) of others
shows emotional coldness, detachment, or flattened affect

B. Does not occur exclusively during the course of schizophrenia (http://en.wikipedia.org/wiki/Schizophrenia), a mood disorder (http://en.wikipedia.org/wiki/Mood_disorder) with psychotic features, another psychotic disorder (http://en.wikipedia.org/wiki/Psychosis), or a pervasive developmental disorder (http://en.wikipedia.org/wiki/Pervasive_developmental_disorder) and is not due to the direct physiological effects of a general medical condition. It is a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria (http://en.wikipedia.org/wiki/Personality_disorder#General_diagnostic_criteria).


I think the key is your motivations (covert), not how you choose to express yourself (overt). I don't think your psychologist is right.


The differences between avoidant and schizoid personalities can be hairline thin. Your last post swayed me more than anything I've previously read by you, though, for what that's worth. Still, you seem more interested in people and their opinions of you than say, Seawolf (the best forum schizoid example I can think of :) ). You also reach out for advice more than I think someone with SPD would, and you definitely desire attention (normal enough!). Okay, this post has become pretty rambling. I stop now. *bow*

[Madrigal]

To add another one: ... borderline.

Interesting story. My little sister is borderline and bipolar. She'll get fired up over any kind of real or imagined disrespect, and put you in the strangest social situations - sometimes involving you in a confrontation, which she has no problem carrying out to its final consequences. Also, self-harm and emptiness, suicidal thoughts, etc. Imagine that and bipolar... nobody knows how to medicate her.

[Spartan26]

Bitch, please, manias and hypo-manias can turn into psychotic episodes. The occasional psychotic rage means we'll occasionally actually choke a bitch. Or kill ourselves. It's more often us that dies, but don't underestimate our capacity to fly off the handle when truly psychotic manic. Still, some bitch gets choked and everyone gets scared shitless in the process.I'm seriously not trying to be funny when I say this but over the years, of all the bipolar people I've met and/or heard about through first hand witnesses, not once has the bipolar (typically male) person gone off on someone bigger than them. This isn't mere coincidence on my end, do you think?

Also, I'm not saying it's a/c cabin at summer camp but there's upside to bipolar. Long periods of creative output. and 2) I'm not sure the clinical terminology but heightened sexual desires and sensitivity. I had a gf who wouldn't so much as step out her apt for 3 days to get the mail but sometimes when we're together I'd barely blow in her ear and she'd be through the roof. It was after the fact but my ex would remind me of this lady. (http://www.youtube.com/watch?v=QeknVqdDAGA)

[qualia]

I'm seriously not trying to be funny when I say this but over the years, of all the bipolar people I've met and/or heard about through first hand witnesses, not once has the bipolar (typically male) person gone off on someone bigger than them. This isn't mere coincidence on my end, do you think?It's an overwhelming fight or flight reaction, is what it is, and you don't cease complete contact with your environment. Bigger people are going to tend to trigger flight a bit more. However, it's not way uncommon to have someone's "oh shit, I'm crazy" moment be something like punching someone huge for no good reason and getting beaten up and waking up in custody or something.

Don't believe we're more creative, you find some dumb bipolar people, and you don't hear from them because they're dead or so bad off you wouldn't look at them twice in a Wal-Mart. I think the smart ones have to have a lot of perspective and a lot of odd ways of making things make sense, need some outlet to self-stimulate and that can make us creative.

Can confirm every stimulus, good or bad, is turned up to eleven. I think that's an upside, but since you maybe spend twenty minutes in bed a day on average in an active relationship, it doesn't really balance out.

[Perseus]

Yes, they do, and very much so. In terms of being observably "crazy", a schizotypal person is about halfway between schizoid and schizophrenic. They generally look crazy, act crazy, and say crazy shit on a consistent basis. They don't hallucinate and they're not completely broken off from reality like an untreated schizophrenic, but, unlike schizoids, they would never be mistaken for normal if they didn't have trouble with interacting with people and weren't socially isolated.



No, the following (bolded) are traits found in schizotypals not found in schizoids (straight from the DSM):

Ideas of reference (excluding delusions of reference)
Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, bizarre fantasies or preoccupations)
Unusual perceptual experiences, including bodily illusions
Odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
Suspiciousness or paranoid ideation
Inappropriate or constricted affect
Behavior or appearance that is odd, eccentric, or peculiar
Lack of close friends or confidants other than first-degree relatives
Social anxiety that tends to be associated with paranoid fears rather than negative judgments about self.

People read this kinda shit and probably think to themselves, "Well, I have strange ideas", but schizotypals are in a whole 'nother league. A schizotypal, for instance, might think that the frequency of their bowel movements have a significant effect on the fluctuations of the US economy -- and sincerely, wholeheartedly believe it while basing certain aspects of their life, like what they eat, around it. They would also freak out if someone criticized them for having such an irrational idea. This is why I think they wouldn't last at a site full of INTPs.

Joey Gallo was a Crazy ESFJ. They can be induced to commit suicide. Madness is TNP.

[!diom]

Joey Gallo was a Crazy ESFJ. They can be induced to commit suicide. Madness is TNP.

If there are any members who might be schizotypal, then you're one of them.

[kali]

If there are any members who might be schizotypal, then you're one of them.

I'd say aphemix too, but that seems to be largely drug-induced.

[aphemix]

I'd say aphemix too, but that seems to be largely drug-induced.gee, thanks!

nah, I have a pretty fair understanding of the character of schizotypal disorder just from reading about it and such, and I know it isn't me. My cognition is good and my affect is good. I am markedly socially adept and enjoy other people.

I am most similar to schizoaffective disorder, bipolar type. (http://en.wikipedia.org/wiki/Schizoaffective_disorder#Bipolar_type) Particularly if my ideations are considered delusional and my mania is considered episodic. Paraphrenia (http://en.wikipedia.org/wiki/Paraphrenia) is another solid candidate, but it is vague. I would then qualify for a substance-induced psychotic disorder due simply to my drug history in the presence of a psychotic disorder.

good thing I know better than the mental health field.

[kali]

gee, thanks!

nah, I have a pretty fair understanding of the character of schizotypal disorder just from reading about it and such, and I know it isn't me. My cognition is good and my affect is good. I am markedly socially adept and enjoy other people.

I am most similar to schizoaffective disorder, bipolar type. (http://en.wikipedia.org/wiki/Schizoaffective_disorder#Bipolar_type) Particularly if my ideations are considered delusional and my mania is considered episodic. Paraphrenia (http://en.wikipedia.org/wiki/Paraphrenia) is another solid candidate, but it is vague. I would then qualify for a substance-induced psychotic disorder due simply to my drug history in the presence of a psychotic disorder.

good thing I know better than the mental health field.

[not really on topic] I had a dream last night where you responded to my post with "I don't believe you". :joft: I need to stop frequenting INTPc lol.

[aphemix]

[not really on topic] I had a dream last night where you responded to my post with "I don't believe you". :joft: I need to stop frequenting INTPc lol.was your claim false?

[kali]

was your claim false?

It was this post (http://forums.intpcentral.com/showpost.php?p=1298451&postcount=54) - The guy really did tell me that, but I can't testify to any actual fetus-gobbling activities.

[YHWH]

Thought it was about killing those 2 prostitutes.
I believed you.

[Perseus]

If there are any members who might be schizotypal, then you're one of them.

This I call the Information Deficit Syndrome.

http://www.millon.net/taxonomy/schizotypal.htm

One compass point on the Spinning Top.

http://www.millon.net/taxonomy/index.htm

[Lurker]

Do you people have any idea how disabling OCD can be? I'm skeptical. I mean...we aren't just talking about checking one too many times to make sure the door is locked.

.

I would shoot myself.

Some psychologists speculate that there is a relationship between OCD and schizophrenia.

[lowtech redneck]

Do you people have any idea how disabling OCD can be?

Unfortunately, yes.

Most people seem to mistake it for Obsessive-Compulsive PERSONALITY Disorder, in my experience. Part of the reason might be that most obsessions/compulsions are internalized, and we become masters at projecting normality, so people assume we are not suffering most of the time.

[Perseus]

Do you people have any idea how disabling OCD can be? I'm skeptical. I mean...we aren't just talking about checking one too many times to make sure the door is locked.

.

I would shoot myself.

Some psychologists speculate that there is a relationship between OCD and schizophrenia.


Yep, OCDs would drive their partners MAD!