Category Archives: Mood Disorders

Why Are Straight Men Generally More Depressed and Repressed Than Gay Men?

From Quora.

My answer: 

They aren’t. Repeated studies done over many years have shown that gay men have much higher rates of depression than straight men. And anxiety for that matter. It’s not even debatable. Now why this is, is not known.

Repressed? Well gay male culture is pretty wild, and sex is a lot easier to come by. Gay men have told me that getting sex in gay culture is as easy as filling up your gas tank.

Straight men have to deal with the inhibitions of women, so that may well make us more inhibited. It’s just not so easy to get sex from women if you are a straight man. It’s much easier to obtain sex of you are a gay man, which is why gay men statistically have far more partners than straight men.

Straight men have to be careful about everything we say and do. Talk to the wrong woman? Whoops, you’re a creep. Looking at that woman over there? Call the cops, that’s creepy! And that’s not to mention anything remotely resembling a come-on, where people’s reaction often seems like you set off a grenade in the room. And on and on forever and ever.

Straight society is full of cockblocking idiots of both sexes. Married men are some of the worst cockblockers of all. A lot of young married men seem to have no other goal in life but to cockblock all the single men in sight. Modern feminism is extremely puritanical, and the idiotic specter of “sexual harassment” looms over much if not all straight interaction in public and even in private. When I go out in public, it often seems like the whole world is deliberately cockblocking me. White people are by far the worst cockblockers of them all, vastly worse than Blacks or Hispanics.

Gay culture is much more Wild West when it comes to sex, and they do not have to deal with a lot of the anti-sexual nonsense that women put out as the gatekeepers of sex.

Still, a lot of straight people are really opening up about sex and having lots of sex nowadays, so we are less repressed that we used to be. But most straight men would probably be uncomfortable in orgies and maybe even threeways. On the other hand, the number of gay men who have gone to such things as orgies or have threeways is extremely high. Group sex is definitely a common aspect of modern gay life.

What with the orgies, threeways, very high partner counts and general anti-Puritanical atmosphere of gay culture, it should be no surprise that gay men are more loosened up about sex than we are.

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Filed under Culture, Depression, Feminism, Gender Studies, Heterosexuality, Homosexuality, Man World, Mental Illness, Mood Disorders, Psychology, Psychopathology, Race/Ethnicity, Sex, Whites

Cultural Left Self-Description Found on the Net

Found on the Net:

I’m an autistic, depressed, histrionic and narcissistic transmisogyny-affected nonbinary person of color.

I am serious. People are actually running around saying things like this? Incredible. It’s getting to where this sort of self-description is almost normal.

Now I do not mind mentally ill people talking about their issues, but you usually do not announce such things to everyone in the room. I have a mental disorder myself, and I even take meds for it, but almost no one knows about it because I never tell anyone. Why? Because when I do, I usually get a negative reaction.

And why would someone announce that they had personality disorders? Unfortunately, Axis 2 types and their fellow travelers such as High-Conflict Women are everywhere, especially nowadays, but they generally don’t go around telling people about it. In particular, chaotic and dramatic Cluster B types like this person almost always deny that they have the problem, and of course they never want to fix it.

And why do people go around announcing that they are depressed? What’s the point of that? I’ve experienced it myself, but depression used to be something you were ashamed of. In fact, mild depressives typically deny being depressed, often angrily. Are there that many chronic, treatment resistant depressives out there that “Depressed” becomes part of your actual identity? That’s not healthy.

I work in mental health. Almost all of the people I work with have anxiety disorders and quite a few are also depressed. I advise people to acknowledge that they have a mental disorder.

On the other hand, I do not think that people should become their disorder.

 

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Filed under Cultural Marxists, Depression, Mental Illness, Mood Disorders, Personality Disorders, Psychology, Psychopathology

On Irritable People

It’s no secret that depressives often cover up their depression with other things. The depression is usually covered up by anger, but the person doing this usually denies that they are even angry! They say they are “tired” or that you are annoying them. They’re fine. It’s you that is pissing them off. If only you will go away, then they will be fine.

But there is no way to get along with a person like this. The irritable person is using you as their punching bag. There’s no way to act good enough so they quit beating you up. And if you go away, they will just go find someone else to beat up on.

It is as if these people are giant insects with foot-long antennae twitching out at the world. These antennae are scouring the world looking for things to get pissed off about. Predictably, they find them everywhere because the world is full of things to get mad about if you are so inclined. If this person were in a good mood, most of these things would not even bother them, but they can’t see that. Because they are irritable, all this stuff they would have waved off before is now setting them off like volcanoes.

The truth is that in most cases there are no inherently irritating or infuriating things in the world.

These things are simply objects or scenarios that have little particular meaning. The irritable person experiences these things as irritating due to their internal irritable nature. So most of these things are only irritable such that the irritable person is making them be annoying. Most of these things lack real labels. They are whatever people experience them to be. The irritable person is sort of putting “tags” labeled “irritating” on these things, but many of these things most other folks would find either not bothersome, or something to be ignored, or even pleasant.

The irritable person is certain that his anger is coming from outside of him. But it’s usually not. Usually it is coming from inside of the irritable person himself who is projecting their anger out at the world onto other objects which then reflect back to the angry person like a mirror does.

But don’t ever tell an angry person that their anger is from inside them and that there’s nothing wrong with the world, and instead there is something wrong with them. They will explode with rage. Well, how did you think they would act? Anger is a defense after all.

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Filed under Depression, Mental Illness, Mood Disorders, Psychology, Psychopathology

Is There Such a Thing as Very High IQ Behavior?

Rowlii writes:

Thanks for your answer. Is there a “High IQ” behaviour?

Sort of, but not really. My mother and and all of my siblings have very high IQ’s (140+), and we are all quite different. However, three of us are quite shy and are probably introverts. The other one is more introverted than he lets on.

It is hard for me to answer this question because I have not known the IQ’s of most of the people I have known in my life. I know the IQ’s of my family members, but I never learned the IQ’s of many of my friends or even the vast majority of my girlfriends. This is not to mention the more casual acquaintances I have run into. So I have only really known maybe ~13 people in my whole life who had very high IQ’s. Obviously I have run into a lot more high IQ people than that, but in the course of life, you usually never learn the IQ’s of most of the people you meet and hang out with.

Of those 13 people, they were sometimes a bit different from each other. I wish I could say that there was something stringing them together, but I cannot.

It also depends on what you mean by high IQ. Very high IQ is usually defined as 140+ (top 1%). High IQ might be defined as 130+ (top 3.5%) or maybe even lower. It depends on where you set the bar.

Some of us are a lot more extroverted than others. I am shocked at how extroverted many very high IQ women are. Very high IQ men tend not to be so extroverted, but some of them are quite capable extroverts. Many seem quite normal, even shockingly normal. One of the sanest men I have ever met had an IQ of 160. He is also the highest IQ person that I have ever known. On the other hand, there also seems to be a tendency towards mental illness, in particular depression and manic depression. Somehow there is a connection between very high IQ and mood disorders.

I do not know any very high IQ people who have Aspergers. This is largely a myth. We are a lot better at socializing than you might think. I don’t know any very high IQ people who are social retards. I know some who are assholes, but social retards, no. Social skills and figuring your way around human interaction is an intellectual skill, and it can be learned. Most of the very high IQ people I have known seem to have learned that skill quite well.

There are a lot of questions along these lines on Quora under the IQ topic, and a lot of very high IQ people are answering those questions. The questions are along the lines of “What is it like to have an IQ of 140/150?”, etc. Then a lot of very high IQ people answer the questions. People who are interested in the topic may want to head over there are read what those people say. There are of very smart, interesting, wise and eloquent people writing over there, and you can learn quite a few things from the handy to the esoteric.

One of the answers that you see over and over is that very high IQ people say they see patterns everywhere. Many say that they are always observing all the time and looking for underlying patterns in everything they see and everywhere they go. They’re always trying to put it all together, see the big picture, or view the world in a holistic way.

To answer a question in a holistic way is to see things in a larger pattern of the whole question, so to speak, taking into account everything. It’s another way of saying seeing the whole picture. We try not see the trees and miss the forest, if you catch my drift. Sure, we look at individual trees and groups of trees and even try to figure out what they mean or relationships between them, but at the end of the day, we still want to put all of those individual trees together into some sort of a forest.

I would say that very high IQ people are a lot smarter than you think they are. You might think that they are out to lunch, but most of them are very much on the ball. I had a girlfriend with an IQ of 140, and she immediately got all of my jokes and funny little comments. It was like instantly, bam! Also I did not have to explain many things to her. She just got most things BOOM like that as fast as you could blink your eyes.

I got to know a woman with a 156 IQ recently, and she was fast as lightning. She understood everything you said and was also very curious. If she didn’t understand anything you were saying, she would ask you to explain it. Then I would explain it to her and even if it was something that she did not know much about, and when I explained it to her, she caught on very fast.

There was none of this, “I don’t know what you are talking about.” One thing that amazed me about her was how I could be talking about a subject that she obviously knew little about, and she would ask me to explain the concept. And she would pick up this previously unknown concept very quickly, faster than almost anyone I have met. When I was talking with her it was just BAM BAM BAM BAM BAM like that.

I like to play games with speech and toss in esoteric comments, analogies, references to movies, books, songs, famous people and events, sayings, famous lines and riddles. A lot of these might be odd little puns of worldplay. If you have ever read James Joyce, I am doing something like that, just playing games with language and also with knowledge. A lot of the time people don’t have the faintest idea what I am doing, so I try not to do this too much, but when I am on the ball, I can do this like crazy.

Most people think I am insane or very weird but some smart people can catch all the little jokes and references. I am not crazy at all. I am talking like that on purpose.

Sometimes I speak on multiple levels. I might say something easily understandable to anyone, but if you listen closely I am also throwing in things on a higher level so the message really has two levels, a simple lower level with the basic meaning and a higher level where I am often playing games.

I will throw in some line out of a book, a reference to an actor or a band or this or that in there. Most people don’t get the weird little word games, but it doesn’t matter because there is a basic message on the lower level in there that can be easily read and comprehended and the word games don’t mean anything anyway as I am just playing games with language and knowledge. It all depends on which levels you want to read the speech on.

Some very high IQ people are very fast. I have been told that I am fast too. Some people say that sometimes I have these funny little micro-movements around my face, mostly around my eyes but sometimes in my mouth too. One  person called them micro-emotions or micro-reactions. They say it doesn’t really look nervous but instead it almost looks there’s a fast computer in back of my face and all those little movements are the thing processing data.

A lot of the time I answer a question almost as soon as it has been asked. Sometimes I even start to answer it or I start nodding my head halfway through the sentence because I already know what the person is going to say in the rest of the sentence. Sometimes I finish people’s sentences for them.

Nothing much gets past me. I hear everything you say, and I am probably watching everything you do. I’m usually not confused. Life is not very confusing. This can work well for social skills because if you get that supercomputer working socially, you can respond to all of the little subtle changes in the conversation as it slowly changes as you are engaging in it.

Conversations are changing all the time, and you are supposed to be reacting to most everything the other person is saying or doing. They make a little movement, and you try to interpret and make some movement back. You respond emotionally to their remarks and even to their little micro-emotional changes. In a good, on the ball conservation there might be maybe 10 or more reactions and counter-reactions in a minute.

I am not sure if this is really a good thing because instead of seeing me as some with-it super smart social genius or saying,”Wow look at that guy, he seems like he has a Cray computer in back of his face – he’s so fast,” instead most people seem to think that I am weird. I am not sure why that is. Sometimes I think they are on a different wavelength than I am. I think they just don’t get it. They don’t get me.

A lot of very high IQ people will tell you that they feel that they are misunderstood. People misjudge them, misunderstand what they are saying, and either don’t understand them or read their comments in a completely different way than how they were intended. They read funny and sometimes false motives into our speech and behaviors that we did not intend to put out. This is because they are not understanding what we are trying to convey with our speech and behaviors. Once again, I think most people are just on some other wavelength than people like me and that’s why they seem to misunderstand us so much.

Very high IQ people will often say that they are good at making decisions and that they tend to make intelligent decisions because they weigh all of the possible answers to the question very carefully. On the other hand, I know some very high IQ people who live their lives idiotically and make the stupidest decisions. But that’s not because they are stupid, that’s more because of personality issues, in particularly massive psychological defenses that get in the way of rational behavior.

Just because you have a very high IQ is not guarantee against being crazy or building crazy, disordered and excessive defense systems that lead to characterological problems. Most of the poor life decisions I see very high IQ people making are not due to doing dumb things but instead there is some mental disorder going on there that is messing up their behavior.  Very high IQ people can definitely have characterological problems where their defensive structures have gotten so bizarre and excessive that they start to cause a lot of crazy and irrational behaviors.

I am not sure about people from 130-139 (high IQ or near genius), but I think they function better than a lot of us very high IQ types. With us very high IQ types, our IQ’s are so high that they are starting to get in the way of our lives, and they might even be making us strange or mentally disordered. The high IQ type is very, very smart, but an IQ in the 130’s is not going to have that correlation with mental illness and weirdness that you start seeing in some people above 140.

I have seen people in the 130’s who were very smart, and they were also superb social actors, very extroverted, etc. I spent a lot of time with two men. One had an IQ of 139, and another had a 135 IQ. It would be quite hard to say that I was smarter than either of them, and they were both whip-fast sharp, especially the 139 IQ guy, who is a relative. He is just BAM BAM BAM BAM BAM BAM BAM. He has also been an alcoholic for decades which has wrecked his life, but he is still whip-fast smart despite the decades of booze.

Once you get into the high IQ range (130-150), I don’t see a lot of differences between me and someone with an IQ of say 129-139. They seem like they are about as smart as I am. Past a certain point, I do not think the scores mean all that much. You end up with really smart people and there’s probably not a lot of observable difference between really smart people even if one is smarter than the other. You’re probably not going to be able to see how the higher IQ person is smarter because the differences all seem to wash out at high IQ levels.

Frankly I do not think that most of you want to be as smart as I am. Yes, there is huge upside, but there is also a massive downside at least for me. The downside is probably avoidable, but you still might get it. Sometimes I think it is better not to be this smart. I am so smart that it almost gets in the way of life, and most of you might not want to live like that.

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Filed under Intelligence, Mental Illness, Mood Disorders, Personality, Psychology, Psychopathology

IQ and Income: IQ Is Not Destiny

Rowlii writes: How can you be broke if there is a correlation between IQ and income? Do you count on lower IQ (like me) to finance your blog?

Come to France! The welfare state will take care of you.

More seriously, I love your blog.

I know a number of very high genius IQ people (over 140) who have no money at all and are low income if not in poverty. IQ is not everything, and even a genius IQ without EQ or emotional stability is almost worthless.

That said, a number of the very high IQ people I know are on disability. Two are on disability for mental illness, one has mental illness listed as one of the things wrong with him, and two more are on disability for a physical reason. I know another very high IQ person who has mental illness but is not on disability. 75% of the mental illnesses are mood disorders. Two have been hospitalized a number of times, and one has been hospitalized a few times.

One is chronically psychotic or nearly psychotic and is on anti-psychotic meds, and the other has been psychotic on occasion. Another has such profound Major Depression that they are barely function. One has listed an anxiety disorder as part of their disability. 2/3% are on psychiatric drugs, and the rest need to be but won’t take the pills. Only one of these people is even partly employed, and he works very part-time under the table. The highest income is $25,000/yr from disability and renting a couple of rooms in a house they own.

A friend of mine from high school has a genius IQ (the same score I have), and to my knowledge, he has never made any money. Last I heard he was living in Santa Cruz with some alcoholic older woman. He sent me a letter a while back asking for money because his car had broken down and he needed $2,500 to fix it. He was a heavy drug user and dealer for quite a few years, but in recent years, it was just pot. He had been arrested for dealing drugs.

He also had a tendency to go on wild alcoholic benders in which he sometimes did insane things. He sometimes got hospitalized when he went on these benders. He also acted very strange for many years. People said it was the drugs, but I knew him back in 7th grade before he had taken any drugs and he was actually even weirder then. He’d always been weird. He has all sorts of funny mannerisms and strange ways of talking.

My Mom has a genius IQ (150), and she spent her life as a housewife. She did hold a number of jobs later in life while still married. One of those was a paralegal, but she wasn’t very happy there. In recent years, she has worked at jobs like tax preparer and secretary at a community college.

I know someone with a near genius IQ (139) who has worked at menial jobs their whole life and never made much money. He was also an alcoholic for many years. He had something wrong with his leg due to the smoking and drinking but he refused to go to the doctor for whatever reason. It got much worse and the leg had to be amputated halfway up. This person has been an alcoholic for decades and they have also suffered from Major Depression for 35 years which was never treated or treated only with alcohol.

I recently met a woman with an IQ of 156. She was mostly a stay at home Mom of a seven year old girl. She lived off her husband’s income. For employment, she was trying to get a publishing business off the ground, but she wasn’t getting anywhere.

There are some people I have known who were very smart, but if I don’t know their IQ scores, I can’t list them. It’s not ok to discuss IQ pretty much ever in our society, so I do not know the IQ scores.

I do know a few people with genius IQ’s who have been fairly successful in life. Two out of three were females, and oddly enough, all had IQ’s of 143. One had made money in the stock market. Another worked for some oil company in Texas, but I am not sure what she did there. the man went to law school and become an attorney. Last I heard he was into real estate development, buying and selling mini shopping malls or whatever you call them.

Come to think of it, most of the very high or genius IQ people I have known in life have hardly been successful at all, and the only three I know who were even somewhat successful are listed above. Not including the near-genius, nine listed above or 75% have made little money in life, and five or 42% are on disability. Four out of 12 or 1/3 have serious mental illnesses. Five or 42% are on psychiatric meds, and two more or 16% need to be. That leaves us with 58% who are either on psychiatric drugs or need to be. 71% of the psychiatric conditions were mood disorders. Three or 25% have been hospitalized for psychiatric conditions. Only three or 25% have even been moderately successful, and only one or 8% could be thought of as quite successful.

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Filed under Alcohol, Depressants, Depression, Health, Illness, Intelligence, Intoxicants, Labor, Mental Illness, Mood Disorders, Psychology, Psychopathology

Aggression and Violence in Mental Disorders: Depression

The notion that depression is anger turned inwards has a lot of truth. But anxiety can also be seen this way as fear could be seen as aggression energy directed inwards or perhaps just energy directed inwards period. This does not mean that all anxiety disorder folks are seething with rage; actually the opposite is true. It is more that the energy the extroverts push out, at times with anger, is exactly the same energy that introverts push in,often as fear and anxiety but also as guilt and even depression.

Depression often appears like anger turned inwards as guilt and self-reproach, and that is often exactly what it is. Spend some time  around depressives if you don’t believe. It’s all their fault, and they’re no good. Sadly this is often the reason that they feel they need to die. In a word, the depressive feels that he has sinned, and he is punishing himself for that.

Depressives are not typically aggressive or violent, although some are. That is because depression often turns so much energy inwards that there is nothing left to put out into the world. In order to shoot up a mall, you need to get out of bed first, not to mention go out and buy a gun and ammo. Many depressives can’t even do that first step – they can’t even get out of bed. If they can’t get out of bed, how can they shoot up the mall? Depression is often felt as serious lack of interest in motivation.

In order to shoot up that mall, you have to be very motivated to do probably the craziest and most dangerous thing you have ever done in your life, but you also must care enough to passionately hate those mallgoers enough to kill them. Most depressives don’t even have the energy or motivation to hate much of anyone. That is why when a nasty or unpleasant person becomes depressed, they often become much nicer. I know narcissists who are only nice when they are depressed and nasty depressives who are only nice when they become much more ill. You almost want someone like that to get worse so they can better to be around.

I have been around depressives who had a hard time even talking. They would go to say something and open their mouths and say, “Uhhhhhh…” Then you would get a long silence, after which they finally might say something. They literally do not have enough energy or motivation to even talk. A depressive once told me that even getting out of bed in the morning seemed like climbing Mount Everest, a task too difficult and strenuous to even be undertaken.

However, there are angry depressives. Sometimes these people just look angry, mean and nasty, and it can be quite hard to figure out that they are actually depressed. One clue is that they are angry, miserable, wretched and clearly not having any fun. People who are never happy and appear miserable and wretched may well be depressed even if they are only angry.

My father did this a lot. I know other people who do it, and I sometimes confront them and tell them that they are obviously depressed.

Angry depressives do not wish to be told that they are depressed for some unknown reason. Perhaps it does not feel  like depression. Perhaps they have too much pride to be depressed, so they turn depression outwards into anger. And often they have convinced themselves that all of the problems of the world are other people’s fault. Thus it seems to be an insult when you suggest that they are simply depressed, which implies that their misery is not everyone else’s fault after all.

Angry depressives often drink or use drugs to cover up their depression. This is especially common in men, who frequently mask their depression with alcohol, drugs or anger.

Angry depressives are indeed dangerous to themselves and also to others. Depression doubles the homicide risk in males. Obviously it dramatically elevates the suicide risk.

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Suicide Thoughts in SSRI’s and Antidepressants in General

Johnny Caustic writes:

Always with these mass shootings, the first question should be whether he was taking SSRIs, antipsychotics, or other drugs that cause suicidal ideation in a substantial minority of takers. I suspect that the vast majority of mass shootings in America, probably around 95%, are caused by pharmaceuticals. (Which is why mass shootings were extremely rare before the pharmaceuticals were invented and marketed.)

I have been taking those drugs off and on for 25 years now, and I am still here. On the other hand, at the very beginning, I got bumped up to a really high dose on Prozac. Not only did it not effect my symptoms at all, but I got suicide thoughts something awful. They had this bizarre, creepy obsessive nature to them. They were insistent and persistent, almost like obsessions. It was almost like they were forcing you to think them, like obsessions. But you believed them, unlike obsessions. It was very creepy, but I have enough ego strength not to buy it with my own hand.

The drugs actually are very good at calming you down. When I go off Lexapro for a while, which I often do, I soon find myself getting pretty angry. I mean pick up the paper, how can you not blow your top nowadays? Anyway, I don’t really like to be steaming angry at my age as I am not an angry young man anymore and I also have high blood pressure and rage is not good for hypertension. Anyway, I take 30mg of Lexapro and the rage just dissipates and it’s, “Frankly world, I don’t give a damn,” all over again. Which is maybe the best way to be.

I took a trip recently and I bumped the Lexapro up to 40mg and even 50mg. The effect was out of this world. It made me so much better it was incredible. Almost like being high on a recreational drug. I was in a whole new saner universe. Unfortunately, you go that high and the drug kills your dick, but who needs a penis at my age anyway? It also calmed me down massively.

So the whole, “SSRI’s make you a violent maniac” thing, well, I am not so sure about that.

P. S.: There does seem to be an effect there, mostly for SSRI’s and not really for the other AD’s, but they are the only drugs that work for a lot of people, so we need them. And the suicide thoughts stuff is not common. I got it once in 25 years for a few weeks. I have had hundreds of clients who have taken these SSRI’s and no one has reported suicide thoughts or violence yet.

Plus my experience has been that SSRI’s are extremely calming and cause the opposite of rage and violence.

It is an interesting effect though, and they do not quite know what is causing it. How the Hell doesn’t an antidepressant make some people more suicidal?

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Where There Is Frustration, There Is No Depression

If you think about it, if a person is frustrated, he’s not really depressed. Or if they are depressed, they are not all that depressed.

In that sense, frustration is a good sign in terms of mental health because it means that at least some positive processes are at work.

How do we know this?

Let us think for a moment about what frustration even is in the first place. Frustration occurs when one’s goals are not being met. But look at the word goals in that sentence. The existence of goals in any person is a good sign in terms of mental health. If you have goals, you are looking to the future, and you are probably looking to the future in a positive way. A frustrated person almost always wants things to get better. They dream of better days in the future or even present, and they are frustrated that they cannot reach this better life that they want. They are living a lousy life and they are not happy with it because they think they deserve better.

Sure a frustrated person is angry, but most frustrated people are so mad about their situation that they are usually trying whatever they can do to make things better. I would argue that most of the time these efforts simply fail, but they are commendable nonetheless. A frustrated person is frantically trying to improve their lives but they are running into what seem to be insurmountable roadblocks along the way. This angers the person as these walls are blocking the way to a better life.

The main thing is, if you are frustrated, you have not yet given up. A frustrated person by definition is not hopeless. They are angry that his hopes are being thwarted. At least they have some hopes!

The essence of depression is hopelessness. I have been around depressed people my whole life and hopelessness seems to be at the heart of most fairly serious depression. In fact, if you are not hopeless, I would argue that you cannot possibly be all that depressed. The depressed person has given up. They have surrendered. They are waving the white flag and saying it’s useless to try anymore. Generally they see no hope of things getting better in the future. This is usually a cognitive distortion or false belief but it is a belief that seems to be at the heart of nearly all depression.

I have seen cases of moderate depression or what might be called dysthymia or even Depressive Personality Disorder (which needs to be in the DSM by the way). The cases I have seen were simply lifelong low-level depressions that almost seemed to be more characterological than acquired.

That is, the low level depression seemed to be an essential aspect of their character or personality. It’s how they looked at the world. They thought this view is right, proper, and correct, as all personality disordered people feel this way. As such, they don’t want to change. The folks I have met with Depressive Personality Disorder had no desire whatsoever to change which once again speaks to Axis 2 Personality Disorder as opposed to Axis 1 acquired and symptomatic.

The essence of the worldview of the people I met with this condition was pessimism. It is not so much that they felt hopeless and they were not depressed enough to have given up. They got up every day and did everything that they had to do, but they simply did not have any notions that anything was going to get better in the future. The future always seemed lousy, no matter what. But they soldier on anyway, trudging doggedly into the darkness forever looming in front of them.

So we see that depressive states are characterized by either hopelessness (where serious, acquired and Axis 1 treatable) or pessimism. These people don’t really have any goals because they can’t see anything good in the future worth having any goals about. They are not frustrated because there’s nothing to be frustrated about. Sure, the world sucks as they see it, but this is how they expect the world to be so there is no frustrated desire to see a better way. The frustrated person dreams of a better future. The depressed person has no dreams of the future as they see nothing but darkness ahead.

This hopelessness is why depressives are so often suicidal. When you’ve given up all hope, why live another day? Why stick around? You don’t see any way out and you see nothing but horrible pain and misery ahead, sometimes decades of it. If nothing good is ever going to happen and you will live in horrific pain for the rest of your life, why not just take off? End it all. End the pain. Leave. Go bye bye.

I would argue that a frustrated person is rarely suicidal. However, frustration, pessimism and hopelessness are way stations on the road to a view of having a darkening future.

Frustration is the mildest stop along this road because although the future seems dark indeed, the frustrated person has at least some hope that there’s a glimmer out there somewhere, and this is why they paddle frantically against the riptide.

The next stop is probably pessimism. The pessimist does not really lack hope. Instead they just view the future as more of the same old crap. The hopeless person and the pessimistic person both see nothing good ahead, but the hopeless person has surrendered and is not going to even try anymore, while when the pessimist sees that morning light come streaming in and he gets up to do it again, to get it up again.

The pessimist is still going to try! And there is your difference. Obviously one can move forward along this Highway of Blackened Dreams as the rest stops get progressively worse and more dilapidated. Frustration can easily lead to pessimism and then on to hopelessness. And the pessimist surely can become hopeless. This progressions of gloom are going all the time, all over the world.

So it may appear that the frustrated person is suicidal, but really they are not. What you are seeing is a frustrated person whose frustration defenses are breaking down. They stop dreaming of a better world and conclude that there will be one. From there it is a short stop from soldiering on to giving up altogether.

So a person who appears highly frustrated becomes hopeless very quickly, or moves back and forth between frustration and hopeless. And as soon as frustration moves into hopelessness, the danger begins. A frustrated person can throw up their hands and become hopeless and in an hour grab a rope or a gun and walk off the abyss. But that would not have happened had the transitioned to hopelessness not occurred. In most cases, hopelessness is a necessary and sufficient factor in suicide.

One of the dangerous things about frustration is that it can head into pessimism and hopelessness pretty quickly. Frustration is probably a risk factor for hopelessness and depression. How long the frustration lasts before it gives in and caves is probably down to ego strength. A very strong ego always sees a brighter future, no matter how black things get.

They can tolerate an incredible amount of frustration for many years and they still glimpse the light in the distance, faint as it may be. Frustration is hard to take. It is a very unpleasant state as I can attest to. Many people probably have a limited ability to cope with desires that seemed to be thwarted with no end in sight. one truism of psychology is that most people hate to fail. In fact, they hate to fail so much that if they consistently fail at something, at some point they just say the Hell with it and quit.

The ego cannot tolerate endless failure. Personally, once I persistently fail at something, I generally just throw it in and say that I am not going to even attempt that task anymore. Hence, it is understandable why many people fail or drop out of school.

School’s no fun if you keep failing all of your assignments. Why stick around and continue to fail? The ego says forget it. Repeated frustration is very hard on the ego, and who can blame the ego for feeling this way. The ego’s task is to keep you from feeling like a loser. Repeated failure spells loser, loser, loser. Just give up already and preserve some ego strength!

A frustrated person is in a sense continuing to soldier on in the face of endless failure to achieve their goals. Since people hate to fail over and over (And who can blame them?), many people probably have little tolerance for frustration. Instead they may turn to drugs, drink or nihilism. If your goals are always being cockblocked, you can always just lower your goals.

At some point, you will probably have modest enough goals that your goals are pretty easy to meet. And here we meet the people who seem to be living what most would call lousy lives yet they have simply resigned to it, do not expect anything better and have zero expectations for the future. Yet they often seem fairly happy even though they have given up in a sense. They are now easily able to achieve their reduced goals and they killed their dreams of more long ago.

It is a cliche, but there is a place for everyone in this world. The key to life is finding that little place for yourself, calling it your own, killing your irrational dreams of achieving more, accepting your lot in life with philosophical recognition, and trying to wring some sort of happiness and satisfaction out whatever cards fate has contemptuously drawn for you.

And always remember that frustration is better than it sounds. Some hope is generally better than none.

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Filed under Depression, Mental Illness, Mood Disorders, Personality Disorders, Psychology, Psychopathology

Harm OCD Versus Other Conditions: Differential Diagnosis

This is a repost of a very popular post of mine on psychology. It just received a massive update and major changes have been made. It is offered here in case you did not read it the first time and are interested in the subject.

A very frequent complaint in OCD patients is thoughts of harm, either harming oneself or others. The general rule is that the person never acts on the thoughts, although this is somewhat controversial. Some say there have been a few cases of OCD sufferers acting on their harm obsessions. It’s just that I have personally never heard of a case.

In addition, as a counselor, I have worked with countless OCD sufferers who have this particular theme over the past eight years as they come to me for help. I haven’t met one person yet who acted on the thoughts nor have I heard of anyone who has, and I have known people who have had this theme for more than 25 years.

However, sometimes sufferers start to commit the act, but they stop before they are able to carry it out.

In one case, a man had an obsession about turning his bicycle either in parked cars and pedestrians. Sometimes he would just start to act on the obsession and turn his bicycle towards the people or cars, but every time he did this, he simply crashed his bike. No one was hurt other than himself.

Generally, people read my articles and simply self-diagnose as OCD with whatever theme they have going. 100% of the people coming to me self-diagnosing as Harm OCD were in fact suffering from that very condition.

What to look for:

Resistance: I would look first and foremost for resistance. Look at how hard the person fights the thought. The harder the person fights the thought, the more likely it is to be an obsession. In fact, I would say that thoughts that are ferociously resisted are always or almost always obsessions.

Resistance to thoughts is not commonly seen in other conditions if it is seen at all. Most persons without OCD simply do not ever try to stop or fight off their thoughts. If you ask them, they will say things like, “I only think things I want to think,” and “I don’t have unwanted thoughts.” So resistance to thoughts in people who do not have OCD is probably not common.

Although it is often said that resistance is a bad sign in OCD as it makes OCD worse, I don’t mind seeing resistance. The reason is that if a person is ferociously resisting and doing so successfully, then first of all, I am quite sure I have a case of OCD so the diagnostic conundrum is over and also I know that the the OCD is simply not that bad yet.

As OCD gets worse and worse, resistance gets harder and harder. I have talked to a number of people who have gotten to the point where the thoughts have simply taken over the person’s mind and are going all the time. They can’t resist them anymore, if they ever could. Inability to resist thoughts or thoughts that have completely taken over is a sign of a more serious case.

Ego-dystonic: The person hates the thoughts, or at least it seems as if a large part of the person hates the thoughts. The new theory is that the entire self hates the thoughts and that no part of a person wants an obsession, but this is a bit controversial. Nevertheless, this is what I believe. One  hears OCD sufferers say things like, “I hate this with every fiber of my being.” That’s a good sign when they can think like that. As the condition worsens, the person gets more and more confused about whether they like the thoughts or not or want to get rid of them or not.

In an advanced case of Harm OCD, the person will feel evil and it will seem as if they like the thoughts and do not want to get rid of them. This can cause diagnostic confusion. Feeling evil, feeling like they like the thoughts and feeling like they don’t want them to go away are all aspects of advanced Harm OCD. The key here is ego-dystonicity. These feelings cause alarm and profound anxiety in the person as they feel that they are turning evil against their will or that they are becoming something that is in opposition to their true self.

Ego-alien: The person is often confused as to why they are even thinking these thoughts. One  hears such things as, “I have thought a million times, why the Hell would I even think of this stuff even one time, ever?…I love my mother/father/husband/wife, etc. so why am I thinking about killing them?” If you ask the Harm OCD sufferer if they feel angry, they will usually say that they don’t. The person is often frankly mystified why they are even having these feelings in the first place.

Another part of the ego-alien aspect is that the person feels that the thoughts are not even really their own. They know that the thoughts are just thoughts and they know that the thoughts are coming only from themselves and not from an outside entity, but nevertheless the thoughts are so alien to the person’s identity that they often seem like they are not the person’s own thoughts.

The person’s inner voice can become split into a “sane voice” and an “OCD voice.” The OCD voice can sometimes sound like it is someone’s else’s voice other than the person’s own inner voice. Really it is just the person’s inner voice morphing into a new form. This experience is so alarming that the person often fears that they are going psychotic.

Thoughts go against the person’s morals: This is the reason for all of the distress, resistance, anxiety and alarm. The thought of hurting or killing random others or loved ones or certainly people one is not angry at all with seems profoundly wrong on at least some level to the Harm OCD sufferer because typically deep down inside the person with this theme is paradoxically enough, an extremely moral person.

And oddly enough, they are often remarkably passive and non-violent. This clashing of one’s morals is what engenders the strong resistance, discomfort, anxiety, worry, and alarm.

Differential diagnosis: There are apparently quite a few people with ego-syntonic fantasies of hurting and killing other people. Sometimes it is someone they hate, and sometimes it is anyone in general, women in general, or some particular ethnicity, race or religion in general. The major problem with thoughts of harming others is that the people who are never going to do it are often the main or only ones who show up clinically.

That is, often the only people showing up inn therapy are the Harm OCD sufferers or in other words, the only people who show up for therapy are the people who are never going to commit these acts.

The people who are really thinking seriously about hurting or killing other people or who like to think about such things it and are not bothered by these thoughts, feelings, urges or plans, and they simply do not seek help. This is a real problem: truly violent people generally simply do not show up clinically asking for help to try to stop acting on their violent urges. It would be nice if they did, but they just do not.

These people are variable. Some go through life choosing to think these violent thoughts, and sometimes it is just a phase that they give up at some point. This is often seen in an  adolescent male. In some cases of course, they act on the thoughts of harming others, and these are the people you read about in the papers.

But in many other cases, they never act on the thoughts and can go years, decades or a lifetime with frequent thoughts of harming others that are never acted on even once. For every one person running around being a serial killer, there are probably 100 more  who dream of such things but due to various controls or fears, they are able to avoid acting on their fantasies. People have more control than we think. Nobody has to do anything.

Sociopathy: This is not OCD. Sociopathy develops in childhood and adolescence and is generally a long-standing problem. A non-sociopathic person simply cannot turn into a sociopath in adulthood de novo; it’s not possible. If you’re not a sociopath by age 18, you will never be one.

An informal survey of sociopaths on an Internet forum for sociopaths revealed that most to all sociopaths said that they enjoyed thinking about harming others. A typical comment was: “Thinking about hurting or killing people is one of the few things that I actually enjoy thinking about.”

So we see that most sociopaths take great pleasure in thinking about hurting or killing people. They think about it whenever they want to. If they want to think about it, they do, and if they don’t want to think about it, they don’t. The harm thoughts are ego-syntonic. They don’t feel bad about having these sorts of thoughts. Thinking about these things is simply their idea of a good time.

Unfortunately, most sociopaths never show up in a clinician’s office. Just thinking about something is fortunately not grounds for hospitalizing someone. Anyone can fantasize about being any kind of criminal that they want to be. As long at they don’t do anything, there’s nothing that the law or psychiatry can do.

Lack of guilt: You will sometimes run across people who have violent fantasies about people they hate. This is not OCD. They will often tell you that they are not going to act on the thoughts, but the fantasies sounds like a good idea since they hate the person so much. They do not feel guilty about these thoughts; instead they enjoy them. The thoughts are not resisted. A famous psychiatrist said, “A homicidal fantasy a day keeps the psychiatrist away.”

In more florid cases such as Borderline Personality Disorder or Bipolar Disorder, the person is making overt threats and seems to be capable of carrying them out. They generally don’t act on the threat, at least not homicidally, although they often commit minor acts of impersonal violence, damage property, and are generally menacing. Obviously in some cases they do commit acts of serious violence thought. But in my experience, the overwhelming majority of homicidal threats are simply empty threats.

Nevertheless, if presented clinically, this is cause for alarm, and in the US, under the Tarsakoff Rule, persons making homicidal threats can be hospitalized for making specific threats towards a specific person. In other words, in the US, if a person says, “I feel like killing people,” there is no grounds for commitment. There’s nothing to act on.

But in the US, if a person is making a specific threat towards a certain known individual that seems to be a credible threat, clinicians have to notify the person being threatened, and the person making the threats may be legally involuntarily hospitalized, although in many cases, they are not committed, or if they are, it is only for the 1-3 day minimum.

Note that it is very hard if not impossible to determine in a clinical setting exactly who is dangerous and who is not.

Potential serial killer stopped: A recent case history along these lines in a journal is instructive. A man had Bipolar Disorder. At some point in the disorder, he developed elaborate fantasies of being a serial killer. He had assembled a very fancy murder kit, including all the implements he might need. He also had a list of ~20 people he was going to kill. He had been following and observing them for some time and had taken precise notes on many aspects of their locations, travels, and behavior. He had notebooks with elaborate plans on how he planned to kill these people.

It’s not known how or why he revealed this in therapy, but he did. The threat was considered credible enough to be actionable. He was hospitalized for 1.5 years in an institution in which he underwent intensive therapy and was given medication. At the end of the period, his fantasies and desires to be a serial killer had been completely eliminated.

The team said this was a very unusual case of successful intervention. They noted that he was not a sociopath, and this was probably the only reason that he volunteered his plans in therapy and was able to renounce and be alleviated of his desires, and return to society as a healthy member. The man had some ambivalence about his plans, and this was due to his not being a sociopath.

This was not a case of OCD.

He enjoyed his elaborate plans, had been planning them for some time, had assembled kits and stalked potential victims and had elaborate, pleasurable, long-standing and ego-syntonic fantasies about homicide which were not resisted.

A person with Harm OCD will never assemble a murder kit, write down elaborate plans for how they are going to kill people, stalk potential victims or even carry weapons. The overwhelming emotion in Harm OCD is fear, and the tremendous fear will prevent them from doing any of those things.

Harm OCD sufferers often go to great lengths to keep from acting on their thoughts. Some “disarmed” themselves before they went to see another person. They would remove all “potential weapons” from their person so they could not use them to attack the person they were with. They would also   “disarm their vehicle” when another person was getting into it. They would take all potential weapons and hide them under the seat of the car so they would not use them to attack the person.

Sexual sadism: Sexual sadism is a paraphilia that almost always develops in its strong form in childhood or adolescence. The person’s preferred means of arousal involves hurting, humiliating, degrading, insulting and abusing an other person. These are people who like to hurt other people. They get off on it sexually.

A very large number of serial killers are sexual sadists. They kill in order to get off sexually. Their masturbatory fantasies since childhood or adolescence have typically involved sadism, torture or even homicide.

It is very common for serial killers to have a history of kinky sex with their wives or lovers. The kinky sex usually involved bondage, discipline, sadism and masochism.

In addition, the severe sexual sadist may have an erotic arousal to images of women who are either dead or appear to be dead. These people, typically men, collect photos of dead bodies or women who appear to be dead.

Unfortunately, sexual sadism tends to escalate over time. There have been cases of serial killers or murderers who could only orgasm if they were pretending to strangle their wives.

A rather typical case might look like this:

A gay man with sexual sadism presents for therapy. Sadism is extremely common in the gay community. His sadistic activities have been slowly escalating over time. The last time he had sex, he burned a man with cigarettes. He got so excited that he wanted to kill the man, and he had to restrain himself from doing that. He presented to therapy thinking he was out of control. He was afraid he would kill the next man he had sex with.

This is not OCD. Fantasies in paraphilias such as sexual sadism are typically very pleasurable. The thoughts, images, feelings and urges are either seldom or never resisted. So what we look for her is an ego-syntonic syndrome with a lack of resistance. In addition, we are looking for strong sadistic sexual fantasies, typically dating from an early age, that are powerfully arousing. Such fantasies will be absent in Harm OCD.

The potentially confusing aspect of paraphilias and OCD is that while the paraphilia gives the person a great deal of sexual pleasure, and they often spend a lot of time masturbating to the paraphilic fantasies, it is rather common for them to feel strong guilt after they have an orgasm and the excitement fades. Alternately they can feel a lot of guilt about the paraphilia itself as in the case of exhibitionism, voyeurism or body part fetishes.

What is going on here is something like an addiction. Paraphilias look like addictions to drugs, alcohol, gambling or pornography. The paraphilic “addict” loves his paraphilic “high” and often feels out of control with wild pleasure almost like a roller coaster ride when they are caught up in the high of the addiction. They often describe themselves as feeling out of control in this phase.

When the drug run is over or the addict wakes up with a hangover or an empty wallet at the casino or drug party, there is a crash in which the addict feels terrible that they are so powerless over their addiction. They also feel guilty and pained that they are suffering the aftereffects of the addiction. Feelings of self-loathing are common in this phase.

However, in some very bad cases of Harm OCD, violent and sadistic thoughts about torture, murder, cannibalism etc. intrude quite often during masturbation or possibly sex. This is not sexual sadism; it is OCD. This is relatively common in Harm OCD, and the sufferers often describe it as being  extremely unpleasant. The difference here is the intrusive nature of the thoughts which are generally not present in sexual sadism, where instead of being intrusive and resisted, the thoughts are pleasant and welcomed.

On occasion, a sociopath or potential serial killer will present to someone or other, more often law enforcement than a clinician. Usually they present only once and then go away. Possibly years later, they may begin killing. In one case, one of the prime suspects for the possible Smiley Face Killer Gang presented to a police station about powerful urges to drown young men. He was afraid he was out of control, and he was going to act on them. The police could do nothing to retain him.

This is not a case of OCD.

This is a sociopathic person who simply feels out of control.

In a case in the UK, a serial killer gave a warning years before killing that he felt he was out of control and was afraid he was going to kill someone.

Once again, this is not OCD.

It’s another sociopath who fears they are losing control. This person will be having strong, long-standing ego-syntonic fantasies of homicide which are not resisted. They are pleasurable to the person, but they do not want to act on them, probably due to fear of going to prison. Over time, homicidal fantasies may become stronger so that the capacity to resist putting them into action becomes more difficult. This is what happens when these people fear they are losing control.

In short, a diagnosis of Harm OCD is relatively straightforward and should prevent few problems.

What we are looking at here is the difference between problems of fear and problems of desire. OCD is a problem of fear. These other problems are problems of desire.

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Filed under Anxiety Disorders, Borderline, Crime, Law, Mental Illness, Mood Disorders, OCD, Personality Disorders, Psychology, Psychopathology, Psychotherapy, Serial Killers, Sex, Sociopathy

How Societal Ignorance of Mental llness Contributes Greatly to Lack of Insight in Bipolar Disrder

There also often problems with insight in the manic phase of Bipolar Disorder or Manic-Depression, whereas people who are depressed typically realize that they are depressed. I am not sure why mania is associated with lack of insight, but it often is.

Of course there is typically no insight during psychotic mania, but there is often no insight whatsoever during even hypomania. The lack of insight during hypomania is usually because the person is feeling so good that they don’t could possibly be ill, but I assure you that they are. The hypomanic typically says, “I have never felt better in my life!” It is hard to convince someone they are ill when they’re on top of the world and feel like a million bucks.

Another serious problem is society.

I have told you that I don’t like people much because they are stupid and this i+s one more example of that. Ordinary people are preposterously ignorant of mental illness of all kinds. There is no reason to be this way, and people have simply chosen to become ignorant about this issue out of their own free will.

Our society also stigmatizes mental illness, so that makes it so in general you can never discuss the subject in polite company without violating social rules and seeing people try to shut you down. People are ignorant of mental illness because of stigma which means that they are not even supposed to talk, read or think about it. So people have refused to educate themselves in part due to stigma.

Understanding and recognizing the symptoms of common mental illnesses is not particularly difficult, and I feel that anyone with a 100 IQ ought to be able to learn such things.

Tragically, Bipolar Disorder is one of the most misunderstood illnesses of all, and the vast majority of people, when presented with a person who is floridly manic or even hypomanic will typically not understand what is going on at all. Florid manics are often accused of being bad people, criminals, psychopaths, evil or on drugs.

I must admit that if you do not know what you are looking for, it is hard to figure out what is wrong with a floridly manic person. Instead of being high as a kite and happy, floridly manic people are often irritable, angry, aggressive, menacing, threatening, violent, paranoid and miserable. They often start using drugs or drinking with the onset of the episode, which makes diagnosis even trickier.

People seem to be even worse at recognizing hypomania. Hypomanics are often witty, charming, extroverted, ecstatically happy and full of wild plans. They can’t stop talking, they are full of wild confidence and they’re always ready for a party.

I have seen many people observe wildly hypomanic people and come away saying that they are the coolest around because they can be so effusive, engaging and spellbinding. I often try to tell these that the person is actually mentally ill, but they refuse to listen to me and shut me down.

So the problem in mania is not only that the manic usually has no clue that they are ill, but also 90% of the ignorant people in society refuse to believe they are mentally ill.

It’s a perfect storm for epidemic lack of insight, and it really doesn’t have to be that way.

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Filed under Depression, Mental Illness, Mood Disorders, Psychology, Psychopathology, Social Problems, Sociology