Mental Illnesses, Diseases, and “Disorders”

I’ve been posting on the many misconceptions that exist about various psychological terms and concepts (See, for example: Misunderstood Psychology Terms Pt 2: Personality and Character, Addiction, Codependence, PTSD, Anxiety, and Self-Esteem). The rampant misuse of terms (including many of the more familiar terms) by both lay persons and professionals has helped perpetuate many of the misconceptions about them. But changing definitions over the years has also helped confuse folks about what some terms really mean. This is especially true when it comes to the term “disorder.”

Most of us think of medical “disorders” or illnesses as something we never asked for but came upon us as the result of a bacterial or viral invasion or an unplanned, unpredictable, possibly even genetically-predisposed breakdown of one or more of our body’s systems. We certainly don’t think of such conditions as something we simply choose.  We don’t choose to cough, be congested, or run a fever simply because we like to ache, sneeze, have difficulty breathing and hack incessantly.  And while there are definitely things all of us voluntarily do that might indeed either increase decrease the chances that certain diseases might afflict us, most of the genuine “disorders” we suffer during our lifetimes are not strictly of our own making or choosing.

Many years ago, the folks in charge of labeling and cataloging mental disorders went to a strictly objective, observable behavior-oriented approach as opposed to one that allowed for hypothesized but almost impossible to prove or demonstrate underlying causes.  While this new approach solved the problem of subjectivity on the part of the diagnosing clinician to be sure, it also promoted in the public mindset the idea that all of the various “disorders” listed in official manual (presently, the DSM-V) – including the various behavioral disorders – are illnesses that afflict as opposed to patterns of behavior a person voluntarily chooses or prefers (despite the maladaptive nature of those behaviors).  While several of the conditions listed in the manual are indeed illnesses in the traditional sense (especially, for example, schizophrenia, Huntington’s Disease, etc.), the application of the term “disorder” to all the conditions listed, regardless of their underlying character, has led to some serious misconceptions.

Occasionally, misconceptions about the nature of a mental “disorder” and abuse of the term can reach an absurd extreme.  I’ve written before about the notorious child rapist Ariel Castro (See: “I Am Not a Monster”: Impression Management Ariel Castro Style) who satisfied his lust for teenage girls by carefully stalking and then abducting three young women, holding them hostage for years, and regularly assaulting them. At the sentencing hearing for his heinous crimes, Castro claimed it was wrong for others to see him as a “monster” or predator. Rather, he asserted folks should view him as “sick,” the victim of a severe pornography “addiction” – someone to be pitied instead of reviled, and someone more in need of understanding and treatment than deserving of punishment.  And only a few days after the Castro hearing, defense attorneys for three drug-dealing teenage thugs who were caught on their school bus surveillance camera beating a classmate within an inch of his life pleaded with a judge to see their clients not as hoodlums out to “teach a lesson” to a classmate who “snitched” on them to school authorities but rather as unfortunate young men who had both learning and impulse control “disorders” and who needed “anger management” and other therapies for their conditions as opposed to punishment and correction (even though, as juveniles, the worst punishment they could have received would have paled in comparison to what would be typically meted out to adults committing the same criminal offenses).  Events like those just mentioned are all frequent these days. From the congressman caught systematically funneling off hundreds of thousands of dollars in campaign funds for personal use and then claimed Bipolar Disorder made him do it, to the lawmaker turned mayoral candidate who claimed that his ongoing lewd behavior (even after “treatment”) was the result of a “sexual addiction” (see also “The End of Political Sex Scandals — Or Something Else?”), claims that mental “disorders” of some sort are really to blame for someone’s willful misconduct have become so commonplace that some folks have not only lost their outrage about such claims, but also increasingly granted them a fair degree of plausibility and even legitimacy. This begs the question of whether the concepts of personal responsibility and accountability even exist anymore. Is everyone in fact a victim in one way or another? Is all our behavior merely a product of our biochemistry, our upbringing, our environment, etc.? Do we really have as much control over our actions as most of us were taught to believe? Are the concepts of right and wrong, crime and punishment simply outdated? Is everything an illness? And perhaps, most importantly, has the “pathologizing” of almost every behavioral abnormality by labeling it a “disorder” caused us to loose sight of what a mental illness truly is?

I think that by cataloging almost all dysfunctional human behavior patterns and then slapping the label “disorder” on them has had many unintended and decidedly negative consequences.  Upon hearing the term “disorder,” many folks infer that a genuine disease process is at work that in some measure relieves a person from full culpability (It’s partly for this reason that I was inspired to write both Character Disturbance and In Sheep’s Clothing). But in fact only a handful of clinical illnesses can potentially render a person not fully responsible for their behavior. For example, individuals suffering from a delusional psychosis can commit acts — even heinous acts — because their brains (most often through no fault of their own) are not functioning normally. And in such cases, the afflicted individual can indeed lack the capacity both to judge right from wrong, and to voluntarily conform their conduct to appropriate social norms. The question of culpability, however, gets quite a bit dicier when a person induces such a state through the voluntary ingestion of powerful mind-altering drugs. Similarly, folks in the throes of a severe manic episode have been known to engage in impulsive, reckless acts — even harmful acts — that are out-of-character for them. Again, however, the question of culpability becomes a lot more cloudy if the hyper-elated state that led to the reckless or injurious behavior was brought on by the voluntary ingestion of “recreational” drugs (e.g., cocaine) known to induce or exacerbate the state.

Things get even murkier when it comes to correctly understanding the various personality disorders and their relationship to personal accountability and culpability. By definition, every personality disorder represents a “preferred” style of relating. And while we’re learning every day about the genetic and other biological predispositions to some of these disorders (and some indeed appear more constitutionally-influenced than others), none of the personality disorders relieves an individual of personal accountability for his or her actions (with the possible exception of a personality disturbance arising solely from brain damage or other neurophysiological anomaly).

There are other “disorders,” such as the developmental delays that can plague an individual that make it really hard to assess accurately how much of a person’s behavior is truly under their ability to control.  And I’ll have more to say about some of these conditions and the popular misconceptions surrounding them in next week’s post.

This Sunday’s Character Matters program will not be heard due to a special broadcast marathon on the network.  But the program on the Sunday following Christmas will be devoted to discussing this special time of the year and some of the more important themes in my book The Judas Syndrome.  I hope you’ll tune in, and, if you  have a mind to, to call in and join the conversation.

30 thoughts on “Mental Illnesses, Diseases, and “Disorders”

  1. Hi Dr. Simon! Just wishing you well and i hope you are on the mend.
    Heh! Spathtard used to say……”I’m an alcoholic Puddle, I suppose I will wrestle with that beast for a very long time”. like he was powerless to do anything about it. Don’t you hold me accountable! I’m an alcoholic! Idiot. And I felt bad because I thought maybe I should be more understanding because of my own history with drinking (which he also used as an excuse). I didn’t quit successfully over night. It took me YEARS till I finally realized it was time to start a new chapter in my life and start acting more like an adult.

  2. Dr. Simon, I thank you for your clarifying article. I have been reading about disorders for 8 years now and it does get confusing. I can see in my ex husband that it was a learned behavior when he was small that warped his way of thinking. He is a very intelligent man, but he has no wisdom.

  3. Dr. Simon, I hope and pray you are recovering well from your surgery.
    I think I understand this right, you are saying in this article that we need to be careful not to confuse disorders with accountability. Too often it seems that we tend to make excuses for ours or another’s behaviors and it turns into a reason to continue with it. In realizing that the person with addiction or alcoholism does have a difficult road to travel but that they do have choices. It is useless to be angry or play the blame game, with lots of patience and prayers there is hope. Are you also saying that sometimes in more rare cases a disorder can be where a person lacks the capacity of right or wrong; but we need to be careful of being over compassionate to the point of being too accepting and place the responsibility where it belongs.

    1. You have it pretty much right. The concept of “disorder” as presently defined includes both syndromes where reason and free will are impaired and syndromes where there is no such impairment but rather the presence of dysfunctional choice. There is only a handful of conditions that truly diminish or abrogate someone’s personal responsibility. And when we let either our compassion or a therapeutic perspective to blind us to accountability, we not only enable dysfunction but also generally perpetuate victimization.

      1. Hi Dr. Simon, I would like to propose that there IS a grey area in this topic when someone is being manipulated and torn down covertly. So a building that is not having it’s foundation undermined will stand tall and straight but when the foundation of a building is being undermined, by let’s say a water main break, it is weakened and starts to falter. cracks start to show and everything is compromised. I see this process takes place in a very slow and tiring way when you are involved with a covert manipulator. I also compare it to work hardening metal by bending it back and forth repeatedly until it breaks. At some point before it actually breaks it is already weakened and has become brittle. I really see how the back and forth, up and down, consistent game Spathtard was playing was wearing on me. I knew something was wrong but I didn’t know how wrong or what was wrong and I honestly believed he loved me and that things would work out eventually……….how could someone say it as much as he did (and more) and not mean it?It is the hardest thing to understand, let alone explain but without believing him at times……I believed him. He did have a power over me and I don’t say something like that easily. I’m not the type of person who has to be with someone………I haven’t been with anyone since him. SO, I think that a person in this type of situation and be brought to an emotional and mental point of fragility and breakdown and behave in ways they normally wouldn’t. I guess I don’t see what they do to you as any different than some kind of condition that could bring on a departure in your normal behavior.
        I can also see how this could sound like an excuse but I also see the difference between an excuse and a reason.

        1. I again feel I am with you there Puddle. You have to know what you’re dealing with exactly before your eyes can be opened and know how to deal with it and really for the most part when you eyes are fully open it’s a case of run get out of it! I am much like you in that I never felt that I had to be with someone, people might suggest there is fear of abandonment etc… but everyone feels that to a certain extent but I didn’t ever feel that I needed him on that level. I loved him and believed he loved me and of course he had me convinced that I was the one with the issues. Yeah I did have issues and can look now and know there were certain aspects caused by the situation and others that were part of my make up that I have to deal with and work through. Still when you are being manipulated it’s about searching through the pieces of the whole warped puzzle. He always appeared so calm and rational, unemotional and there I was breaking down.
          I agree we are blinded but we are blinded by love, we can’t conceive that the person we love is deliberately pulling us apart. I think unconsciously we do enable them to behave the way they do, and if I am honest there were times I should have stuck to my guns with making him accountable for things he had done but I was worn down emotionally, it’s a very difficult thing to try and do. Though honestly, I didn’t know then what I know now, and I’ve said before if I did then I would like to think I would have packed my bags earlier and kissed him goodbye. Even so there are so many other factors all packed in that little box. Hindsight is a wonderful thing and being armed with knowledge. His callousness and lack of empathy is on show now with the discarding of his only child. What sort of person does that?? I understand what he is and I accept what he is but trying to get my head around it from an emotional standpoint it still just doesn’t compute. I realise I can’t give this person any place in my thoughts…he is a nothing filled with nothing. That’s not someone who would have ever cared what things I put in place to try and bring himself to account. He didn’t care, never cared and never will. In his mind he ruined peoples lives and he was proud of that…he’s even said as much. How do you make such a person account for their behaviour?

        2. Puddle, sometimes when I read the things you write about I can relate so much. When I read “I honestly believed he loved me and that things would work out eventually……….how could someone say it as much as he did (and more) and not mean it?” I can relate so much. Anytime I something comes up I get a lot of “agreeing”, my hb will say how much he loves me, can’t live without me, he’ll cry, his facial expressions and tones convey a sufficient amount of sincerity, he would say all the right things, etc, etc. And I would think “okay, this time he gets it, this time we’ll move forward in a different direction.” The funny thing is I never expected him to make all these huge changes overnight. That’s why it’s taken so long, I knew that it would be a long hard road. But I did expect that the next time he did the same thing, and I’d address the problem, I wouldn’t get all the manipulation tactics (self-pity, blaming me, excuses, acting innocent, or a combination there-of mixed in with so many other things). I expected that if someone would say they loved me so much, that they knew how horribly they had treated me in the past (that’s what he always says, right after being confronted about something – “oh no, I used to do that in the past, but I don’t anymore” – just a funny side note)that they’d start to own up to the problem and be accountable, or maybe just maybe, he would start to step forward and, on his own, start stopping his behavior. But that has never happened, and I realize that the apologies, crying, sincerity, the fear and shame he uses as an excuse are all just another tactic, and because of my empathy I was easily duped.

          For a while now, I just walk away. I’ll say okay, if all of the apologizing, crying, etc were true then I’ll notice a long-term change in accountability for his behavior. Which of course never comes. Now when he starts his apologies, promises etc, it actually feels like my emotions shut off so I don’t get sucked in, and I can walk away actually without an ounce of empathy for him. Sounds horrible, I don’t like that about me, but it is what I need to do.

          Now that I’m not falling for his games in this way, he’ll follow me around trying to guilt and shame me, because I’m “not helping him,” “everybody needs a second chance”, “God expects me to forgive”, etc, etc. It’s like this vicious cycle. For the most part I’ve stepped outside the circle, and sometimes It’s almost funny, because he’s fighting so hard to “suck me back in” it’s almost like a hamster going around and around in it’s wheel. Every once in a while I forget myself and step back into that cage, but I am getting better at getting out.

          Anyways, he does have a lot of tactics up his sleeve, and it’s amazing to me that now a lot of them aren’t working, and he’s like a magician, pulling a new tactic out. He’s got so many, but I am keeping aware (and the I’m sorry’s etc, just don’t work anymore, actually when he attempts to play on my sympathy and get me to feel sorry for him or tell him it’s all going to be okay – after him having just hurt me, weird now that I see it in a different light – I just don’t feel sorry for him anymore, I am able to walk away. Actually most days I’m like a stone around him. Thinks are still playing on me, but at least I see more of it now, so that most of the time I at least don’t feel like I’m going crazy anymore. It’s very difficult, be very little crazy thinking going on in my head. And no matter how much he tries to guilt me, i keep reaffirming that I need emotional separation at this point (until I can take more steps), I remain involved in activities and things that build me up.

          1. Sheri, You are in a very important stage right now and learning from observation and objective sources. Honestly, I wish I could have done the same, I wish I would have known while I was still with the pig loser so I could have changed my reactions into responses and left the egg on his face. It wasn’t to be that way for me though.
            I also think that being WITH someone as you are learning what you are learning now Sheri will help you a lot in the future with these types. I am getting to a strange point where I can’t really remember things with him like I used to be able to. It all seems very surreal. Maybe it is a coping mechanism or maybe my poor old brain and heart are just worn out from all of it. I still have sadness but I certainly don’t miss him anymore. Like you said Tori, He’s a nothing filled with nothing.

          2. Puddle, thank you for that. I truly think the most difficult part of still being with him is that often it seems like once he’s realized I’ve “caught on” to one tactic, he finds a new one to throw in. I am also learning to trust my gut, I am seeing these tactics for what they are (most of the time). It is difficult sometimes not “forgetting” myself. Knowing that I have a forum I can use to work things through instead of keeping them in my head really helps, sometimes I think that I am sounding like I’m whining and complaining, but I’ve also realized that I’ve had so many experiences that I am seeing in a new light that maybe it’s okay if I get it all out of my head.
            You know these sites really help, over the past while, before I was responding, the comments you have left about your situation really helped me to come to terms with what has been going on in my relationship for the past 24 years with my hb. Sometimes I think “hey, is she talking about my hb,” then I think it’s kind of funny, because it would really tick my husband off to think that he’s almost a text-book case narcissist / covert-aggressive, for him to realize that he’s not that special and there’s a lot of other guys out there just like him, anyways his reaction would be funny to see.

            Being with him, with all the information I’ve learned from Dr. Simon’s books and messages, some of the things (although they are still difficult) actually are kind of funny when I look at them with no emotional attachment (he can throw a really good pity party for himself, and it’s actually pretty funny when looked at objectively).

            Anyways, went off track. Your experience has helped me a lot. I am really sorry that you had to go through your experiences with your ex, I truly know that it is so horrible, maybe your not being able to remember it all is a blessing, somedays I wish I could forget (or even go back to not knowing), just some days, I know in my heart that being in the dark about this character I’m dealing with is not a good thing, but somedays…

            Again, if any good can come from what you had been through, for me it is this: Reading the things you’ve written has helped shed so much light and open my eyes even more to what I’m experiencing. You have helped me realize that it is okay to be angry for what was done to me. I have spent my life being told that anger is “wrong.” For me knowing that there is some one else who I can relate to, has really helped verify my experience, when so many others don’t get it, can’t get it, possibly even think or imply that I’m crazy, they both basically told me that I HAVE to trust my hb because that’s what God’s is telling me to do. (my hb and his brother both tried to convince me that I’m the one with the problems, that my hb is the victim here – this is such a long story so i won’t get into it).

            Again, I’m rambling… just want you to know. Having someone to relate to, who is free to express themselves, free to express the anger (that we should have), free to express their emotions (this is the first place I’ve been able to express mine without being told they are wrong, or without having someone discredit them). Puddle, you seem so honest and real, you have helped me a lot … so your experience was absolutely horrible, but I hope you know that you have done great things with what you’ve gone through, things that really bring hope and light to other people.

          3. Aw!! Sheri! Thank you so much! I know how horrific these things are and if i can help you or anyone get to a better, clearer place…….it just makes me feel good to know I have helped you in any way I can. I don’t take it as a personal pat on the back, it’s just that because of the obscure nature of these ordeals and how few people really seem to understand, it really IS important to have people who share what they have been through. It was a turning point for me when I read several other stories with my mouth hanging open and my eyes popping out of my head in recognition! I just could not believe someone had had practically the same thing happening to them and that I WASN”T crazy, I WASN’T wrong………it really WAS him all along! That part felt pretty good but what followed did not. Once the rose colored glasses have been ripped off your face it is time to swallow the bitter pill of reality which for me was like swallowing shards of broken glass. That made me cry just typing it.
            Anyhow Sheri, Thank you for your very kind words but let me assure you,,,,,I am only sharing what I have learned from people who were further along than I was when I started.
            Here’s the thing……..the bare boned fact of a relationship………when you are loved, really loved….you know it. It might have it’s ups and downs and good times and bad times but you KNOW you are loved because you see it loud and clear. I wish everyone had that in their life including me, I really do. I’ll never understand why so many people don’t have that but so many people don’t.
            Never let anyone take away your anger…….it is your power and your inner voice telling you something is wrong and needs to change. Just don’t waste it on entertaining him with displays because all it will do is amuse him more than likely. Use it for you…..use it as your engine to propel you forward to a better place for you.
            I sure do wish you the best Sheri and again, I’m happy to know i have been of help to you. {{{{BIG HUGS}}}}

        3. We’re not in disagreement about this at all Puddle. And it’s even more complicated than you suggest here. As the series progresses, I’ll also be talking about these kinds of situations, including the various understandable reactions people have to toxic or traumatic circumstances that can lead to a deterioration of their usual coping abilities, and why it’s not really helpful or proper to consider some of these reactions as a “disorder” at all.

          1. “various understandable reactions people have to toxic or traumatic circumstances that can lead to a deterioration of their usual coping abilities”

            If there are exceptions, where understandable reactions ACTUALLY don’t occur, would you mention them, too? Even if just in passing?

            If there are NO overt or adverse effects after prolonged abuse(at least theoretically speaking), could it be a neurological anomaly? Psychopathic wiring(as in: a person abused doesn’t like a psychopath, but has a brain of a psychopath)? A delusional disorder? Schizoid personality disorder?

          2. Thank you for your response Dr Simon. I’ll look forward to reading more about this and more.
            I hope you are mending well and I wish you a Merry Christmas.

  4. I don’t remember if folks here have asked about personality disorders, but you bring it up, too. Good that. They are as accountable as actively conniving folks.

    Could discovery of psychic forces like autonomous complexes(Jung) have subtly influenced this? Could people view disorders as unchosen because in the shadow lurk all kinds of complexes(including the collective content that feels alien to an ego)?

    I’m thinking of different psychological schools of thought here, but still, I wouldn’t be surprised if this indeed was the case.

  5. A question I feel was left unanswered as of yet.

    A person is in a scenario where severely traumatic effects would be expected to appear in a normal person, eg. prolonged abuse, bullying, persistent harassment, rape etcetera. However, for some reason, a person doesn’t actually suffer any overt or covert adverse effects. What explanations are there for a person’s lack of normal adverse reactions?

    1. Hi J,

      There are a couple of books that might shed some light on this subject. One is Victor Frankyl’s, ‘Man’s Search for Meaning’. In the book he describes concentration camp life under the Nazis. He was studying psychology at a university somewhere in Europe. I think it was Austria. If ever there was a situation of prolonged bullying, that was it. Of course nobody thrived, emotionally. Everyone suffered extreme physical and emotional distress. The people who suffered the least were those who most would have considered the most fragile–the sensitive imaginative creative types. They were able to transcend the nightmare around them by vanishing into their imaginations and dreams.

      Another great book on this subject is Jacques Lussaryan’s “And there was light”. He was another who ended up in a Nazi concentration camp. His story is fascinating and uplifting and his observations in the camp are very useful. Who survives with their dignity and sanity intact and who crumbles?

      Another good read along the same lines is anything by a psychologist named Dubrowsky, whose theories were forged under a Communist regime, who soundly dismissed them, as they were too apolitical. When he immigrated or escaped his theories were not welcomed by the established order, in Western democratic society either. He coined the term ‘Positive Disintegration’, and describes the process of emotional breakdown,( brought on by trauma)or disintegration and then reintegration of the personality. When the traumatized individual reintegrates it is possible to incorporate the trauma, learn from it, extract meaning from it and then eventually reintegrate at a higher more expanded level of consciousness.

      Some people never incorporate trauma in a positive way and some people do. My own sense of this is those who tell you to “just get on with your life and try to forget about the experience’ don’t understand that the obsessive focus on the pathologies of those who traumatize us is a way of reintegrating our personalities while we restructure our broken defenses. These defenses are generally referred to in a metaphorical way as walls that need rebuilding. I prefer to use the metaphor of delicate lace that we created to view life and to protect us by letting in both light and shadow in a manageable way, was ripped beyond recognition by a predator. When we reconstruct our defenses we are building a new lattice to protect ourselves. The narrow angle focus and back and forth communication about our experiences helps us craft a new kind of lace, that is potentially exquisite, protective and reflective. We can reintegrate at a higher level of understanding. It comes at a great price but the potential is there.

      1. Comes at a great price, but what good is trying to do without?

        Also, LisaO, you say defences, but aren’t defenses basically coping? Isn’t there more active style of coping that aren’t aggressive?

    2. J, I wonder if you might be interpreting becoming emotionally numb and inured to an abusive person, as not suffering any of the typical emotional reactions. My sense is that some people, too, have a coping style that enables them to do a bit of an end run around their emotions. They process nasty experiences in a more cerebral fashion. If somebody is already shut down emotionally and they run in to a CD individual and the abuser isn’t able to penetrate the shut down person’s more armoured self, I guess you would describe that as surviving the experience intact. That implies, that there wasn’t a very strong or deep emotional bond on the part of the non CD person in the relationship?

      1. LisaO,

        I said ACTUALLY no effects, overt or covert. Not numbed-down, suppressed, repressed, dissociated or anything, but ACTUALLY no effects.

        Yes, it’s pretty much a throw-away remark By Tim Field in Bully in Sight. There are normal reactions to abuse and if you endure it without experiencing any traumatic effects in short or long run, Field even goes so far as to say there’s actually something wrong with a person.

        Then again, I’m thinking of pathological exceptions, things that are NOT normal.

  6. Hi J,

    Active styles of coping without aggression? Of course. I mentioned feelings of retaliatory aggression, particularly just after a discard, as being perfectly normal. Imagining soundly thumping somebody, also — normal. Wanting to humiliate those who have used us as resource then dismissed us — all normal feelings. Acting on those feelings…not the best route to go as it can backfire and if the obsession for revenge (justice) becomes a singular focus, it becomes more of a burden to the victim than anything else.

    I think the point I was trying to make is judging victim along moral lines is naive and misses the gist of their experience. The last thing most victims need is people sermonizing
    about how morally wrong it is to have feelings of desiring retaliation. It is totally off base. We are often empathetic types who are pretty morally scrupulous. That’s how many of us become hooked, in the first place. We fall for the pity play.

    “It comes at a great price” I meant that spiritual and emotional evolution, through trauma comes at a great price!

    1. That makes sense.

      I meant active coping that isn’t aggressively evil, but not defensive, either. To my ear, defensive coping sounds passive.

  7. Folks!

    As I’ve commented here, I’ve not only exercised my own thinking, but also exchanged ideas with other commenters. Information is alive here.

    Now, I’ve also talked about meditation here. I’ve been critical of the cult that utilizes transcendental meditation. However, the technique itself has worked, to my experience. You don’t need pay hundreds and thousands or join any group.

    Don’t force it. Gently let thoughts go and come back to whatever your chosen “mantra” is.

    1. And if anyone asks, that first link is organ music I stumbled upon once when I did some studying of different spiritual philosophies, including Satanism. Don’t worry, nothing to do with Devil worshipping. That’s a different thing.

      Once again, I’m sorry for the mix-up.

      1. Thank you, Dr Simon. That’s how I meant.

        Oh, would you also remove that follow-up-post of mine(and this one when you’re at it)? The follow-up-post if superfluous now.

  8. I have type 1 bipolar disorder and over the years without insurance and thus long periods of no medication, I have had to exert a ton of effort into trying not to cause trouble for others. In my most desperate moments I have even just ran away multiple times and one time wound up homeless. I can tell when I am slipping into dysphoric mania and I know what it will entail at its height.. severe delusion, mild hallucinations, extreme agitation and hostility, paranoia, etc. Many times I feel horrible and like every cell in my body is on fire but I try very hard not to be mean or hostile or rude to people. I have put forth so much effort and exhausted myself and lost many things throughout my life all in efforts not to harm others in various ways. It makes me furious when people just blame bad behaviors on mental illness because it impacts me when I am trying to get psychiatric help. If I am not acting like a raging lunatic then nobody takes me seriously when I describe my thoughts and feelings. They expect bad behavior or they don’t take me seriously. It’s a horrible and awkward situation.

    1. L, I’m so sorry for you. It’s really tough trying to get people to understand what is going on inside and where it’s coming from. I commend you for trying so hard and I wish I had something I could say that could help you. Try contacting Dr Simon on his private email address, he’s a good man and might be able to help. Puddle

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