Mental Health Monday–A Joke Is An Epitaph To An Emotion (Nietzsche)

This is a post from 2010, when I first started blogging! I came across it the other day, and it resonated with me, so I decided to share it again with you.

On Friday, I had the honor of meeting a trusted colleague and friend for tea. I must say, he’s one of my most reliable coaches on my writing journey. Whenever I’m discouraged, I know I can go to him. He offers me unconditional support, sound advice, and tactful critiques. And he pays for dinner!

Halfway through my cup of Earl Grey, I realized not only does my friend have a knack for producing fascinating topics to explore, he also has an encyclopedia’s amount of information cataloged in his brain. One of his most remarkable talents includes an incredible penchant for remembering quotes and lines from songs and poems.

Anyway, during the course of our discussion, we touched upon emotions and how people cover them with jokes in order to suppress the pain of their impact. (In “psychiatry speak,” humor is considered a mature defense mechanism. It’s something relatively healthy people employ in the face of hardship and stress.)

My friend aptly pointed out this quote from Nietzsche:

“A joke is an epitaph to an emotion.”

What an important idea to remember. Not only is this pertinent to my work in psychiatry, it is also useful to keep in mind when I’m writing. For the most part, anger and sadness come relatively easy to me as I construct a scene. It’s simple enough to describe yelling, slamming fists, and storming out of rooms. I’ve used several terms for tears and grieving too. What I get stuck on is humor. I can do the subtle stuff, sure–the puzzled expression, the dry joke, even the comical slip and slide on an icy sidewalk. But true laugh out loud humor eludes me.

As a good friend should, my literary cheerleader triggered a cascade of thoughts leading me to action from that simple quote. So often in my writing, I am in the moment explaining the direct, raw emotion. I’m left to wonder, where is the space to incorporate a humorous reflection, a comic relief character, or a joke to lighten an overly negative mood?

My new task, then, is to scour my writing and look for spots where humor can be incorporated. I am certain including little punches of laughter and happiness will make my characters more well rounded, more dynamic, and more human.

Epitaphs don’t only have to be on tombstones.

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Mental Health Monday–Featuring Transcend by Christine Fonseca

Accurately capturing and portraying psychosis is extremely difficult. In cinema, you can use special effects, sound effects, even CGI graphics to crate hallucinations and altered perceptions.

But how does one do it via writing?

I think a fantastic example of a character’s descent into madness is TRANSCEND by Christine Fonseca. Described as Phantom of the Opera meets Black Swan, this dark, YA, (and I’d add historical) novel takes the reader on a roller coaster ride of emotion, intrigue, betrayal, paranoia, delusion, love, horror, tragedy, and rage.

It’s an intense, quick read, just by its nature–Christine doesn’t let you take a breath!

A unique twist is the alternating point of view–FOR ONE CHARACTER! It’s a bit jarring, but I suspect that’s the author’s intention to keep the reader guessing.

What’s most captivating about it to me is that even after I finished reading it, I still had more questions.

Check out Christine Fonseca’s blog HERE.

What books have you read that capture mental illness particularly well?

If you have a character that needs “shrink-wrapping,” don’t hesitate to ask me a question, here in the comments, on Twitter (see sidebar), Facebook (see sidebar), or email me @ laurabdiamond@yahoo.com.

Remember, these posts are for writing purposes only and are NOT intended for medical advice or treatment.

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Mental Health Monday–Coping with Illness

Linda Gray asks the following question:

When a person has the possibility of inherited life-threatening disease hanging over her head, and the parent (mother) who may have passed it along to her has died from it, what type of person (character traits) can stand up to that situation with courage and the ability/determination to do whatever possible to live a full life, as opposed to living in dread of developing the disease and dying from it, too?

This is a FANTASTIC question!

Let me reference a particular illness that has physical and psychiatric complications and is heritable (passed down from generation to generation).

HUNTINGTON’S DISEASE is a neurodegenerative disorder with cognitive, psychiatric, and physical symptoms. It is autosomal dominant (which means 50% offspring inherit the disease). It’s particularly tragic because symptoms often develop AFTER childbearing years, so the disease can be unwittingly passed on to the next generation.

It can cause memory disturbance, dementia, psychosis, depression, irritability, and can/does affect muscular coordination. In fact, people develop what’s called “chorea,” which is an abnormal, involuntary, writhing movement of the limbs and torso. Progression can vary, but it often leads to such significant impairment that the person can’t care for themselves and need nursing home level of care.

Genetic testing is available if someone wants to find out if they have inherited the gene. Counseling and education is strongly advised (to help the person cope with the possibility of getting bad news).

This would be devastating news for anyone to hear and certainly a person’s personality makeup has a huge impact on how they handle it. Too many factors go into personality development to predict for certain, but upbringing (caring and nurturing vs cold and neglectful or abusive), experiences (witnessing a parent/loved one go through the disease process), genes (more information is learned daily about the heritability of mental illness and various temperments), and coping skills all play a roll.

Now, every human being on the planet has experienced adversity, suffering, etc. BUT, HOW WE COPE WITH IT CAN MAKE ALL THE DIFFERENCE. Therefore, I’d posit that someone with strong coping skills (such as having good problem solving strategies) who is facing a potentially life-altering or life-threatening disease can have a “better” response to such news than someone with poor coping skills (such as having poor problem solving strategies).

Coping skills vary widely. Some people turn to obsessive thinking, alcohol, tobacco, drugs, yelling, breaking things, cutting, or suicide attempts/gestures. Others turn to talking with others, exercising, asking for help, building a support network, and relying on religion or another method of devloping inner peace (like meditation).

Now it’s your turn. What factors would help or hurt someone when dealing with devastating medical news?

Remember, these posts are for WRITING PURPOSES ONLY and are not intended for medical advice or treatment.

Please don’t hesitate to ask a #MentalHealthMonday question if you need a character “shrink-wrapped.”

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Happy Labor Day!

For the US, today is a holiday for all us laborers.

See y’all on Wednesday when I discuss platform when writing in different genres.

Remember, Mondays are reserved for Mental Health Monday posts, so if you have a character that needs to be shrink-wrapped, don’t hesitate to ask and I’ll host your question here!

I’m still posting my #MentalHealthMondayWritingTips on Twitter. I’m @DiamondLB if you want to follow (link is on the side bar).

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Mental Health Monday–Of Alters and Core Personalities

Lydia Kang CC’ed me on an email from a writer who is devloping a character with Dissociative Identity Disorder. Super cool! As a result, I’ve decided to repost an oldie, but goodie post on Dissociative Disorders (in green). I have further comments below, specific to HOW TO WRITE A CHARACTER WITH DISSOCIATIVE SYMPTOMS.

The DSM-IV (Diagnostic and Statistical Manual IV) categories various forms of dissociation (a disruption in memory, awareness, identity, and/or perception).

• Depersonalization disorder: period of feeling detached from one’s self; this is often seen in anxiety disorders such as panic disorder and post-traumatic stress disorder…or if you stare at yourself in the mirror for too long. Go ahead, try it. Go on.
• Dissociative Amnesia: a person experiences significant impairment in recall of personal information, often resulting from a serious trauma; duration varies; often spontaneously remits
• Dissociative fugue: a person “forgets” who they are and may travel to a different city & pick up an entirely different life; this may last hours to days or longer, depending on how severe. It can spontaneously remit and is usually the result of a significant traumatic event.
• Dissociative Identity Disorder (previously known as Multiple Personality Disorder): a very rare disorder where a person’s psyche is fractured into several (2-100) different personalities. These personalities are known as “alters,” and each has his or her own way of behaving. Depending on the severity of the situation, the person may or may not be aware of their alters. If the individual is not aware, the times when alters “take over” are experienced as black outs or “lost time.”

It is purported that DID develops as a means of self-protection. Often, those with DID have experienced significant abuse as a child and the personality fragments into several different “people.” This allows the “main personality” to compartmentalize trauma and function in the face of it.

People with dissociative disorders do not choose to become another personality. The idea is that it is out of their control. With therapy, a person becomes more aware of their alters and learns to communicate with them until they are reintegrated.

Dissociative disorders are challenging to treat because people are often reluctant to come into treatment and co-morbid conditions such as mood disorders, anxiety disorders, psychotic disorders, and substance use disorders can occur.

That’s all well and good, but how does one go about WRITING a character with DID???

The key to distinguishing each alter personality is to make sure each alter HAS THEIR OWN VOICE. It’s imperative that there’s some clue binding each alter together, especially with the core (the personality seen most) personality. For example, alters are generally aware of the core and can comment about them while they are being dominant. Furthermore, an alter may try to hurt the core (via cutting, burning) or may engage in activities the core wouldn’t ordinarily do, like going to a club, bar, having a one night stand, etc. Whoever the core encounters would be surprised by their “odd” behavior. It would be excellent fodder for a tension-filled dialogue and scene.

DISCLAIMER: The information in this post is for WRITING PURPOSES ONLY and is NOT to be construed as medical advice or treatment.

Check out Lydia’s post on Medical Mondays and Sarah Fine’s blog, The Strangest Situation.

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Mental Health Monday–#MentalHealthMondayWritingTips

Accurate emotional reactions from characters are CRUCIAL to pull in your reader. On the other hand, an over- or under-reaction jolts your reader out of the story and they just might put your book down.

Working these issues out comes with practice, keen beta readers, crit partners, and skilled editors. There are also several resources and tools out there to help you. I’m sure you’ve heard of The Emotion Thesaurus by Angela Ackerman and Becca Puglisi and you’ve likely visited their blog, The Bookshelf Muse. And perhaps you’ve read The Writer’s Guide to Psychology by Carolyn Kaufman.

I’ve been posting various mental health topics in an effort to help writers portray their characters accurately too. Now, in addition to my regular Mental Health Monday posts, I will be supplementing mental health writerly tips on Twitter!

My Twitter: http://twitter.com/DiamondLB

Be sure to follow me on Twitter for these little tidbits. (And, I’d be most delighted if y’all would help me out by tweeting this post and retweeting my tweets to spread the word.)

Please use the hashtag: #MentalHealthMondayWritingTips

I’m gonna pay it forward by giving away a copy of The Emotion Thesaurus to one lucky commenter!

Also, please check out Amie Borst’s blog today–she’s hosting a MEGA AWESOME GIVEAWAY!!!! TWENTY-FIVE authors are involved, including yours truly.

Don’t forget to pop over the Lydia Kang’s blog to check out her series, Medical Monday. She’ll be back in late August.

(image found on Goodreads)

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Mental Health Monday–Telepsychiatry

You’ve perhaps heard of surgeons using robotics to perform surgery on someone in another city, state, or even country?

Well, psychiatrists can also evaluate and treat patients remotely. Called telepsychiatry, it’s a relatively new method of connecting providers with clients when distance is a limiting factor.

I’ve never done telepsychiatry, but know colleagues who have. I’d imagine it could be challenging, considering we use all our senses (including smell) to evaluate clients. On the other hand, a client usually has a therpist or case worker present with them, while the psychiatrist communicates via camera/TV.

So, writers, if you have a character in an isolated location and they need a therapist/psychiatrist, make sure they have access to the interwebz and maybe even Skype.

Let me know if you have any writerly mental health questions, and I’d be happy to answer them here on Mental Health Monday. Check out Lydia’s Medical Mondays as well and Sarah Fine’s blog, The Strangest Situation for more psych related topics.

Remember, these posts are for WRITING PURPOSES ONLY and are NOT to be construed as medical advice or treatment.

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Mental Health Monday–Zombie Apocalypse and Bath Salts

So…

The news has been rife with stories of cannibalism lately. I’d say the subject itself isn’t new, but the gruesomeness and the occurrence of it in “civilized” cities is alarming to say the least. (Zombie experts have long warned of this day, I might add.)

Hmmm, maybe the Mayans are onto something.

*shudders*

Anywho, the dude in Florida (who attacked someone and ate parts of their face–YUCK and YIKES!) was high on something called “Bath salts.” Not to be confused with the fragrant, soothing stuff we add to our baths, bath salts (in the illicit substance world) is actually a concotion of synthetic stimulants including mephedrone, MDPV (methylenedioxypyrovalerone), and methylone.

Symptoms of intoxication include:

Agitation, paranoia, hallucinations, chest pain, high blood pressure, tacchycardia, and suicidality.

(Source: WebMD)

It’s been described as worse than LSD, PCP, esctasy, and meth.

I would readily agree.

We’ve seen cases of this locally and people intoxicated on this stuff (who end up on the inpatient psych unit) are often very difficult to keep calm and difficult to treat because our standard anti-psychotic medications are not as effective in treating bath salt induced psychosis.

Some of the people we’ve treated never recover (meaning they have chronic, severe symptoms of psychosis for months or longer after intoxication on bath salts) and end up being transferred to the longer term facility for prolonged inpatient care.

PSA: PLEASE DON’T USE THIS STUFF!!!!

EDIT: PICTURES REMOVED TO AVOID COPYRIGHT INFRINGEMENT. CLICK ON LINK BELOW TO SEE IMAGE F YOU’RE INTERESTED.

Photo credit

Mental Health Monday posts are for writing purposes only. They are not to be construed as medical treatment or advice.

If you have a writerly mental health question, please don’t hesitate to ask!

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Mental Health Monday–Gotta Have a Sense of Humor

Things can get pretty intense on an inpatient psychiatric unit. Particularly in the spring when people get more revved up and we tend to see more symptoms of mania.

To keep things in perspective, we try to use humor (it’s a MATURE defense mechanism, just ask Anna Freud) to diffuse our frustration and anger.

Here’s some of my favorite jokes (click HERE to go to the website):

Welcome to the Psychiatric Hotline.
If you are obsessive-compulsive, please press 1 repeatedly.
If you are co-dependent, please ask someone to press 2.
If you have multiple personalities, please press 3, 4, 5, and 6.
If you are paranoid-delusional, we know who you are and what you want. Just stay on the line so we can trace the call.
If you are schizophrenic, listen carefully and a little voice will tell you which number to press.
If you are depressed, it doesn’t matter which number you press. No one will answer.
If you are delusional and occasionally hallucinate, please be aware that the thing you are holding on the side of your head is alive and about to bite off your ear.

Once I had multiple personalities, but now we are feeling well.

I don’t suffer from insanity, I enjoy every minute.

I used to be indecisive. Now I’m not sure.

The best thing about being schizophrenic is that I’m never alone.

Just because you are paranoid doesn’t mean people aren’t out to get you!

Hypochondria is the only illness that I don’t have.

I’ve always been a hypochondriac. As a little boy, I’d eat my M&M’s one by one with a glass of water.

What jokes have you come across that really get you laughing?

EDIT: May I just add that this is NOT intended to offend anyone. Actually, I’d probably be dialing #1 repeatedly myself. And I am VERY indecisive…I think.

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Mental Health Monday–Dissociation

Young Adult writer, Erin Danzer, asked me about DID–Dissociative Identity Disorder. She’s hard at work on her WIP, so why don’t you pop over to her blog, say “Hi!” and give her some encouraging words.

Here’s a reprise of one of my earlier posts highlighting DID:

The DSM-IV (Diagnostic and Statistical Manual IV) categories various forms of dissociation (a disruption in memory, awareness, identity, and/or perception).

• Depersonalization disorder: period of feeling detached from one’s self; this is often seen in anxiety disorders such as panic disorder and post-traumatic stress disorder…or if you stare at yourself in the mirror for too long. Go ahead, try it. Go on.
• Dissociative Amnesia: a person experiences significant impairment in recall of personal information, often resulting from a serious trauma; duration varies; often spontaneously remits
• Dissociative fugue: a person “forgets” who they are and may travel to a different city & pick up an entirely different life; this may last hours to days or longer, depending on how severe. It can spontaneously remit and is usually the result of a significant traumatic event.
• Dissociative Identity Disorder (previously known as Multiple Personality Disorder): a very rare disorder where a person’s psyche is fractured into several (2-100) different personalities. These personalities are known as “alters,” and each has his or her own way of behaving. Depending on the severity of the situation, the person may or may not be aware of their alters. If the individual is not aware, the times when alters “take over” are experienced as black outs or “lost time.”

It is purported that DID develops as a means of self-protection. Often, those with DID have experienced significant abuse as a child and the personality fragments into several different “people.” This allows the “main personality” to compartmentalize trauma and function in the face of it.

People with dissociative disorders do not choose to become another personality. The idea is that it is out of their control. With therapy, a person becomes more aware of their alters and learns to communicate with them until they are reintegrated.

Dissociative disorders are challenging to treat because people are often reluctant to come into treatment and co-morbid conditions such as mood disorders, anxiety disorders, psychotic disorders, and substance use disorders can occur.

Several well known movies and books about individuals with DID exist. Three Faces of Eve, Sybil, and the United States of Tara are more entertaining views into this tragic disorder. There are several textbooks discussing the identification and treatment. Click here for a link to an Amazon search page for DID.

Psychiatrist Richard Baer documented treating a woman (Karen) with 17 personalities in Switching Time. Here’s an excerpt as presented by ABC News. A linkto a video with Karen by Good Morning America.

DISCLAIMER: The information in this post is for WRITING PURPOSES ONLY and is NOT to be construed as medical advice or treatment.

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