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.

Mental Health Monday–Length of Stay for Teens

I was SO stoked when Georgia McBride of YALITCHAT.ORG and Month9Books fame asked me to answer some writerly psych questions.

One question was (paraphrased):

How long would a 16 year old with “hallucinations” be hospitalized on an inpatient psych unit? 


Inpatient hospitalizations for children vary from a few days to 30 days (sometimes more, depending on the severity of symptoms). Reasons for hospitalizing a child include: out of control behavior, self-injurious behavior, suicidal ideation/gestures, and aggressive/assaultive behavior toward others. 

If the child has severe and chronic symptoms that don’t significantly improve with extended hospitalization, the child may be discharged to a long-term facility to live and go to school. If the child has broken the law, they may be sent to a juvenile detention center (those stays can be months to years).

It’s important to remember that once the child becomes stable, they would need to be discharged with outpatient treatment set up for them. Without it, they’d be at risk of relapsing (having recurrence of symptoms). 

Remember, these posts are for writing purposes ONLY and are NOT to be construed as treatment or advice. 

Check out Lydia’s Medical Monday and Sarah’s The Strangest Situation for more medical and psych related topics!

Mental Health Monday–Zombies ARE Real

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All the buzz about Zombies has me freaked out. Like for real. I can handle vamps, werewolves, even ghosts. But zombies? No. Way.

And here’s why!

Zombies. Are. Real.

Named after Jules Cotard (a French neurologist who first described the condition in 1880), Cotard Syndrome is a delusion where the sufferer believes they are dead, or are putrefying, or have lost their blood or internal organs. Sometimes (rarely), it includes delusions of immortality (so in that regard, vampires are real too!)

Related to Capgras Syndrome, Cotard Syndrome can occur in Schizophrenia and Bipolar Disorder. It can also be a (rare) side effect of Acyclovir (an anti-viral medication).

Treatment includes pharmacotherapy (medication) with anti-psychotics and mood stabilizers. ECT (Electroconvulsive Therapy) has also been used.

Has anybody encountered any literature including a character who believed they were dead, decaying, or that their organs were gone?

Be sure to check out Lydia’s Medical Monday and Sarah’s The Strangest Situation.

Remember, these posts are for writing purposts ONLY and are NOT to be construed as medical advice or treamtent.

Let me know if you have a writerly mental health question and I can address it here on Mental Health Monday! 😉

 

Mental Health Monday–Capgras Syndrome

Capgras Syndrome is a delusional disorder whereby the sufferer believes that a friend, family member, spouse, or someone else they know has been replaced by an identical-looking imposter. Most commonly associated with Schizophrenia, the disorder has also been seen in brain injury and dementia. 

It was first labeled in 1923 by French psychiatrist Dr. Joseph Capgras, whose patient believed “doubles” had replaced her husband and others she knew. (Thank you, Wikipedia, for that bit of information.) 🙂

Treatment includes medications such as anti-psychotics (Haldol, Zyprexa, etc).

What books or movies have you seen where a character believes others have been replaced by imposters?

Check out Lydia’s Medical Monday and Sarah’s The Strangest Situation.

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–Othello Syndrome

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There are several psychiatric syndromes with some, well, intriguing names. Today, I’d like to comment on Othello Syndrome.

Aptly named after Shakespeare’s Othello (where Othello murders his wife because he believed she cheated on him), Othello Syndrome is a delusional (fixed, false belief) disorder whereby the sufferer believes their spouse or partner is being unfaithful. Often times, there is little to no evidence to substantiate this belief.

It can be associated with other mental illness such as, schizophrenia, delusional disorder, bipolar disorder, alcohol dependence, sexual dysfunction, and other neurological illnesses. It can also be associated with stalking (which can include multiple “interrogations” of the partner, repeated phone calls to work, surprise visits, and hiring a PI to follow the partner) and, at times, violence (either in the form of suicide attempts to harm toward others).

Different theories have arisen regarding the cause of this disorder. Some believe it is morbid jealousy whereby the sufferer’s memories are subconsciously changed and their partner’s actions are misinterpreted. Or, those with an “insecure attachment style” may be fearful and extremely anxious about their partner’s commitment.

Treatment includes anti-psychotic medications for the delusions as well as anti-depressant medications if there’s associated depression or anxiety. It is also important for the sufferer to engage in psychotherapy.

What examples of Othello Syndrome have you seen in the books you’ve read?

Be sure to check out Lydia’s Medical Monday and Sarahs’ The Strangest Situation!

Remember, these posts are for writing purposes ONLY and are NOT to be construed as medical or psychiatric advice or treatment.

 

Mental Health Monday–PTSD, A History

Last week, I discussed the symptoms of PTSD. Arlee Bird (writer and blogger–Tossing It Out) had a great follow up question.

When did the term PTSD come into regular use?

Lee is completely correct in recalling that the term “Post-Traumatic Stress Disorder” wasn’t coined until 1980 when the American Psychiatric Association added it to the Diagnostic and Statistical Manual III.

But “PTSD” has been around for far longer than 30 some odd years.

Heck, it probably goes back to the dawn of time!

Anyway…

In the Civil War, PTSD was known as “Soldier’s Heart.”

In World War I, PTSD was known as “Combat Fatigue” or “Shell Shock”

In World War II, PTSD was known as “Battle Fatigue” or “Gross Stress Reaction”

Unfortunately, prior to PTSD being called PTSD, it was thought the symptoms indicated cowardice or personal weakness.

It wasn’t until after the Vietnam War when people started taking notice. Called “Post-Vietnam Syndrome,” the new designation allowed Vietnam Veterans to push the medical and military to recognize it as a real disorder.

A big thanks to Psychiatric Disorders (d0t) com for this fascinating information!

Check out Lydia’s Medical Monday post and Sarah’s The Strangest Situation. Remember, these posts are for writing purposes ONLY and are NOT to be construed as medical advice or treatment.

Happy Writing!

Writer Wednesday–How Do YOU Revise?

Last week, I outlined a revising strategy, describing how it happens in layers.

This week, I want to address HOW to actually revise. I mean, strategies and theories are great, but when you sit down to DO something, how does it get done?

Well, thankfully, there’s no one way, which is why I want y’all to share your strategy in the comments. The more ideas we discuss, the more help people get, right?

Lemme share my technique…which can vary depending on my mood, LOL!

Sometimes, I revise using my computer. I open the document, enlarge the screen so I can see the words without squinting (I’m nearsighted, what can I say?), and read each scene paying attention to flow and plot advancement. (I change typos during this stage too, because, darn it, they’re there no matter how many times I read the damn manuscript!) Like I said last week, if a scene doesn’t advance the plot, I delete it.

I try to read as quickly as I can…not like speed reading, but more like reading in a condensed amount of time so I don’t lose the story thread and confuse details. (Time between readings makes my memory fuzzy, you know?)

Sometimes, I’ll use my iPad. It changes the “look” of the document, making it look more like a book. Somehow, it makes the words, sentences, and paragraphs seem new. I can often pick out redundancies, echoes, wonky dialogue, etc. easier that way.

Sometimes (after I’ve already revised a couple of times) I print out the document. I may still encounter lots of cutting at this stage (by then I have lots of beta feedback, several weeks or even months have passed, and I have a whole new perspective on the project), and it’s quite fun to slash a line through an entire page. I also mark up the hell out of each page, crossing out crappy bits and rewriting better bits in the margins. Then I transcribe the changes on the computer and re-read it one to two more times, tweaking as I go.

After revising the printed manuscript, I can end up with something like this:

(Note: This is not my actual revision…aftermath. But it can sure feel like it!)

How about you? What does your revising strategy entail?

Check out Sarah’s response to her question about writing expectations for the Sisterhood of the Traveling Blog chain!

Writer Wednesday–Revising Layers Should Include Chocolate, Right?

Overhauling a 80,000 word manuscript is a daunting process. You can’t catch everything at once. That’s why revising is a process that involves layering.

Your first draft no doubt contains many writing strengths. It also has a lot of rough edges. Don’t despair! Be proud of what you’ve accomplished!

And get ready to rip and tear.

Be brave with the delete key, keeping these tips in mind. 😉

Layers to consider:

The first pass through your rough draft should focus solely on what to keep and what to chuck. So, you’ve got a cute scene where your main character has a cutsy moment with her cat. If that’s the only scene with the cat, bye bye kitty. Your main character takes a shower, basking in lavender soap. FAB. But if she’s not joined by the hottie who she’s jonesing for or she’s not washing blood out of her hair to get rid of evidence connecting her to a crime, then you don’t need it.

Basically, EVERY SCENE NEEDS TO ADVANCE THE PLOT. If it doesn’t, chuck it! (I promise, it’ll be okay.)

Once you’ve determined what can stay and you’ve deleted the rest, then you can focus on the following layers:

  • Characterization–Have you described your characters so people can picture them? Have you made them interesting and quirky? Are they a cliche? (I hope not!) 😉
  • Consume Milk Chocolate
  • Character Arcs–How does your main characters viewpoint or perspective change as the story progresses?
  • Consume chocolate mousse
  • Description–Can the reader envision your setting or how your characters look? Make sure this is balanced! Too much of description can bog the pace…too little can leave the reader confused.
  • Consume chocolate cake
  • Emotion/Conflict–SHOW, don’t TELL! We want to feel what the characters are feeling, not be told, right? And if you want to keep a reader hooked, make sure the characters are at odds somehow.
  • Consume Death by Chocolate ice cream
  • Dialogue–Tighten, tighten, tighten! We don’t need the “Hi, how are ya?’s” cluttering up a page. Get to the point and be succinct.
  • Consume hot cocoa–whit or milk chocolate!
  • Action Scenes–Use strong words/verbs and make it clear.
  • Consume a dark chocolate truffle…or ten.
  • Tension–You need this on EVERY page!!!! (If there’s no tension, it may be a clue to nix something, right?)
  • Consume chocolate covered caramels until your fillings fall out.
  • Plots and sub-plots–This is something that outliners tackle ahead of time, but could still need a lot of revising depending on how the characters dictate their own story. The plot is the skeleton of your story, but it doesn’t have to be boring. Use sub-plots (maybe with secondary characters) to keep the interest alive.
  • Consume a mocha frappuccino.
  • Grammar and sentence structure–This is KEY of course. Vary your sentence length. Use the grammar to perfect your voice. Use as few words as possible. If you’ve got a lot of verbiage, you could be slowing down your pace!
  • Consume your body weight in M&M’s!

You don’t have to follow these layers in order, but I would recommend saving the grammar and sentence structure until later because why spend time perfecting a sentence if it’s gonna end up getting nixed because you don’t need that scene?

Lydia answers Sarah’s sisterhood question about expectations today. Check it out!

Mental Health Monday–Drug-Induced Psychosis

Writer Colleen Rowan Kosinski asked about Substance-Induced Psychosis.

Here are the basics:

Drugs (legal and illegal) and even some herbal supplements when taken in excess can cause psychosis. Common offenders include alcohol, marijuana, cocaine, heroin, amphetamines (meth), and hallucinogens such as LSD and PCP. Prescribed medications such as prednisone, isoretinoin, scopolamine, L-dopa (used for Parkinson Disease), and anti-epileptics can also cause psychosis.

Substance-Induced Psychosis is something we see frequently in the inpatient psych unit and psychiatric ER (crisis unit). Obtaining a thorough history (from the patient and collateral sources) as well as getting a urine drug screen can identify which substances the person ingested. Some aren’t so easy to detect however.

New to the scene are synthetic marijuana (K2) and “spice” or “incense” (with mephedrone as the active ingredient). The psychosis caused by these substances tends to be more…intense. People can become severely psychotic, with paranoia, hallucintations, disorganized and fragmented thoughts, confusion, disorientation, and a tendency toward violence. Their symptoms are also less likely to respond to medications such as anti-psychotics. They end up spending a long time on the unit and don’t necessarily recover completely.

So what’s the best treatment for someone suffering from substance-induced psychosis?

  • Keep them safe (usually in the ER or on the psych unit)
  • Try to reduce stimuli as much as possible (dark, quiet rooms)
  • Provide structure (the same routine every day helps orient them)
  • Give anti-psychotic medication such as Haldol, Risperdal, Zyprexa, etc.
  • Use adjunctive medications to help with anxiety and withdrawal symptoms, if present; Clonidine, Motrin, Immodium, Benadryl, Ativan, etc.

Like Mr. Mackey from South Park says:

Drugs are bad, M’kay?

Just don’t do it! 😉

DO check out Lydia’s Medical Monday post and Sarah’s The Strangest Situation!

Remember these posts are for writing purposes only and are NOT to be construed as medical advice of treatment.

Happy New Year!

So, 2012 is here. If the Mayans are right, we only have a few months left to do whatever we plan to while on this planet.

The natural follow up to this is a discussion on goals. (Never mind that I’m not really buying the whole Doomsday in December thing.)

Last year, I wrote a list of writerly goals. I met about half of them. But I’m not disappointed, considering I had a huge change in my work responsibilities and I had a huge battle with my mojo over the past couple of months.

This year, I’m not going to write down goals. Why?

I don’t wanna.

Some may think that’s lame, but I don’t. I know what my overall goal is:

GET PUBLISHED.

BUT, I can’t put a timeline to that. All I can do is try my best every day. If that means slamming out 5000 words or doing absolutely nothing, that’s gonna have to be good enough.

Tell me folks, what’s your approach to goals?

Be sure to send me a writerly related psychiatric question so I can address it here on Mental Health Mondays. Check out Lydia’s Medical Monday (she’s talking about telekinesis today. Cool!!!) and Sarah Fine’s The Strangest Situation.

Cheers!