Rachel Firasek, blogger and soon to be published author of, Passion of the Soul, asks:
My character thinks she’s suffering from mental illness. How would she be evaluated and diagnosed?
Based on symptoms Rachel detailed upon further discussion, it sounds like her character could have Dissociative Identity Disorder (formerly known as Multiple Personality Disorder).
I blogged about dissociative disorders some time ago and here’s a link to review that post. Classic symptoms of DID include: losing time (because other personalities (called alters) take over and direct behavior which is generally quite different from the primary personality), finding objects missing or misplaced, feeling like other personalities are inside you, and hearing voices (usually inside your head).
Another disorder with similar symptoms would be Schizophrenia. Symptoms include: delusions (fixed, false beliefs that cannot be “talked out” of the person), hallucinations (hearing voices, seeing things, feeling things, smelling things that aren’t there), disorganized speech and behavior, and something called negative symptoms (lack of emotional response or facial expressions, lack of speaking, lack of motivation).
Significant decrease in functioning must be noted in both illnesses.
Other illnesses cause psychosis as well, such as Bipolar Disorder or Major Depression with psychotic features, substance use, Borderline Personality Disorder, and delirium (which is caused by various medical conditions, sleep deprivation, medications, and/or drugs, to name a few).
Diagnosis is usually made by a clinician (either a psychiatrist or psychologist) conducting a thorough interview (detailing current symptoms and past symptoms/episodes) as well as obtaining collateral information (from friends, family, other clinicians). Psychological testing (which can take hours to weeks of time, depending on the setting) can clarify diagnosis. So can structured interviews with specific questions targeting the various diagnostic symptoms.
People experiencing the above symptoms often are unaware that anything is wrong (in other words, they lack “insight” into their own illness) and can be paranoid, angry, mistrustful, and even hostile. As a result, one cannot simply “talk them out of it.” It is a delicate balance of offering empathy, reassurance, and education regarding their illness and the appropriate treatment.
Treatment often includes anti-psychotic medications (with the use of anti-depressants and/or anti-anxiety medications depending on co-occurring symptoms/disorders)–which can improve symptoms within a few days in some cases–therapy, rehabilitation (to regain lifeskills), as well as hospitalization and intensive outpatient programs if symptoms compromise safety and ability to manage self-care.
Check out Sarah’s take on creativity as a “cover” for mental illness. Sarah Fine is a licensed psychologist. She also writes YA and is repped by Kathleen Ortiz. Her blog is The Strangest Situation. We met over the interwebz and are collaborating on writerly mental health questions! Send us your questions and we’ll answer ’em for ya! Remember this is for WRITING PURPOSES ONLY and is NOT intended to be medical treatment or advice!
Don’t forget to read Lydia’s post on Medical Monday!