Thursday, June 21, 2012

Mental illness in the WoW and blogging community


When I was younger, I remembered those ads on TV saying that 1 in 3 Australians will suffer a mental illness.  The official statistics in Australia say almost half of all Australians will experience mental illness at some time in their life and about one in five Australian adults will be affected by mental illness each year.


As a child my understanding of mental illness was the crazy raving loonies who talked to themselves or the ones Batman locked away in Arkham asylum.  However, now that I'm older, you realise mental illness is not just about psychosis and schizophrenia - mood disorders such as depression, mania and bipolar disorders are all part of it too.

In medical school, you get a much better idea of the whole thing.  You do time on the mental wards, and you see all these people, normal everyday people, suffering from these crippling diseases.  And they are crippling.  Not in the sense that you can't walk or anything, but you can't work.  You can't think. You can't make reasonable decisions.  The most severe ones would have electroconvulsive therapy (ECT) to cure their depression - nothing inhumane like how Jack Nicholoson was in One Flew Over the Cuckoo's Nest, but it seemed extreme.   But it did work.

These days, in my line of work anyway, mental illness seems so commonplace I hardly even notice it anymore.  And if you asked me, I would think it felt like 1 in 2 Australians would suffer a mental illness, because so many people are on antidepressants, antipsychotics these days.  I do anaesthesia for ECT and sometimes it is so amazing that someone can go from being catatonic depression to being normal and having a conversation again after a few treatments, and it's so humane now.  Modern medicine has advanced so much these days.


So why am I bringing this up and what has this got to do with World of Warcraft or blogging for that matter?

I'll use depression as the example because that is the most common mental illness.  As a medical practitioner, I mostly see the medication side of things.  In this modern day and age, I worry that the general population think that "popping a pill" can fix any problem.  It is part of the cure, and for some, it may be all the cure they needed, but most people will need more than that to fix their depression.

Look at it like trying to lose weight.  A combination of altered diet, exercise and medications (as well as fixing up any other health problems) should be the key to success.   One of those items alone CAN be enough to change your weight problem, but more often than not it will not fix it entirely, or give the desired result.

Cognitive Behavioural Therapy sounds like some of that psychology mumbo jumbo hippy stuff.  However, what CBT really does is help you understand, manage and change your thoughts (cognitions) and actions (behaviour). This form of therapy has been shown to be very effective for a whole range of things but is particularly effective if you have depression or anxiety.  But CBT could be useful for a whole variety of things!  Parenting, weight loss, anger management, conquering your phobias, how to cope with things... changing your mindset and focussing on things differently can be the key to a permanent solution.

I read a lot of blogs where people have written about or shared experiences with their battle with mental illness.  There are SO many - on my blogroll alone I would say at least one third of them have talked about their battles with depression.  Oestrus, Lil'Peanut, Apple Cider Mage, even Erinys, and most recently Aidrana have all shared their thoughts on depression.  I think, that sharing it, analysing their illness, is an excellent adjuvant therapy to go with the medication. I think writing and analysing your own behaviours is a way to doing CBT yourself without having to go see a psychologist.  Or maybe even a therapy after seeing a psychologist.  Some of these writings may help others who are afraid to share or acknowledge their disease, and helping others is always a great goal.
Image from article "Playing a video game helps Teens beat depression"

You could sort of see that happening with World of Warcraft too.  People with mental illness can feel isolated, and playing the game is one way to socialise.  A few guildies talk about their struggles with their medications and how it affects their mood disorders, and I listen, as it is all fascinating to me, as I am used to seeing the most severe cases in the hospital setting, and seeing the functioning ones gives you a sense of hope for those who are severely disabled with their disorders.  It would be cool if those with severe depressive problems could perhaps alter their thinking - you know, each of those red mobs in WoW is a "bad thought"(eg. "I'm hopeless", "Everyone hates me", "There's no hope") and destroying all those will bring balance to the World... and perhaps within their own mind as well.  But you would need a positive reinforcment too - like focussing on the positive things to make you feel more positive about yourself.  Not sure how to do that in game, I thought maybe mining or herbing, but most people see those as a chore rather than something that gives you positive reinforcement.  Gosh positively reinforcing those nodes may mean I'll never get any herbs or mines.  I would love to see if someone could turn WoW into some sort of CBT :)

For those who don't suffer a mental disorder, it can be difficult to understand someone who has one.  People who don't understand mental disorders say things like "Oh, it's a first world disease, only rich people get depressed because they're bored."  "I don't get depressed, I've got lots of things to occupy myself."  Myself, I have never suffered from a mood disorder, but that doesn't mean I don't understand how crippling it can be - I've seen those cases.  One of my colleagues once said I had mania, or hypomania.  Mania, which is elevated mood disorder, is also a mental illness - it's characterised by abnormally elevated or irritable mood, arousal, and/ or energy levels, even hypersexuality.  Mania can vary from mild mania (hypomania) to full blown mania with delusions of grandeur, psychosis, aggression or even self neglect from pursuit of the impossible of idea.

Individuals in a hypomanic state have a decreased need for sleep, are extremely outgoing and competitive, and have a great deal of energy. However, unlike with full mania, those with hypomanic symptoms are often fully functioning.  Classic symptoms of hypomania include mild euphoria, a flood of ideas, seemingly endless energy, and a desire and drive for success and hypomania is sometimes credited with increasing creativity and productive energy.  How can this sound like a mental disorder??  Personally,  I don't think that it is, as individuals with this function well.  If however they don't function well (get isolated, can't work, get aggressive or delusional) then it becomes a problem.

LOL, I'm doing what most medical students do.  90% of medical students diagnose themselves with a psychiatric disorder after doing their psych terms.  Personality disorders are classic!  If you read them, you would probably end up diagnosing yourself with one or two as well!  But I think the important thing to remember is that you have a mental illness if it affects your function (or people think it's affecting your function because your insight to your disability is poor).  If it has affected your function then it is a problem and needs some sort of intervention.  And for those of you who have conquered it, or are struggling with it, I hope you find what works for you - but writing about it, changing your mindset about it, really does help.

20 comments:

  1. Since my son (Corael) was diagnosed with Asperger's Syndrome (a high order form of autism) and Attention Deficit Disorder, life became manageable. We now had a cause to his outburst and through medication and education turn his life around. He was diagnosed when he started high school, but the symptoms were there from early primary school. He was always getting into trouble, being suspended from school, but the diagnosis changed all that. He is still disabled with Asperger's and will be for life, but through the additional education programme the high school put on, he can now cope and unless you knew he has the disorder, he acts normal.
    So I've examined myself and my friends from school and I reckon we all had some form of Asperger's. Some more so than myself. I've been lucky, as I joined the defence force at a young age (16) and this gave me the self discipline to conquer my failings. Corael is also keen to join the defence force as he feels the same way I did and I feel it will only enhance his skills to be as normal as possible.

    Ayelena

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    1. @Ayel - sometimes the diagnosis helps so much and helps you focus on a solution. Glad it was that way for Corael and your family!

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  2. "Even Erinys"!.. :p

    I was going to write a really long comment, but then I thought I'd maybe try explaining my biggest issue in a blog post over the weekend.

    At times I even feel bad for saying "I'm depressed" because I manage to function reasonably well in public. None of my colleagues or clients for example know that there is anything wrong with me. I know this because they keep coming out with stuff like "You're always so happy!!!" and "How do you keep smiling?".

    Yet on my bad days, I fantasise about dying all the time, luckily though on those days, my self loathing and esteem are so low, I don't try it because I'm pretty sure I'd screw it up and don't really fancy waking up in hospital being yelled at.

    Until recently I wasn't doing too bad, but then everything started to get messy and I've been really struggling these last few weeks. Surprisingly enough, pvp helps a bit I think because I'm focusing so much on winning/killing people, it takes my mind off everything else.

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    1. @Erinys - I am glad something is helping. Hmmm maybe imagining that tauren DK is self loathing and blood elf mage is I am hopeless and then smashing their faces is what's making you feel better. I hope things look up soon - think of all of your fans who would miss you!

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  3. Hmmm ... when I wake up and find you have done 2 or 3 posts in the morning I can kind of believe your colleague's hypomanic claim, lol.

    I remember going through what I now think of as the "great depression" years ago. I remember thinking of ending it all and I remember I was scrubbing the bathtub at the time. I thought, then why the hell are you scrubbing the bathtub stupid, you don't need to do this, or the toilet, stop cleaning. For whatever reason that struck me as hysterically funny so I finished cleaning. Almost every time I clean the toilet I still smile.

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    1. @TotA - my dear friend, only you can go from being suicidal to smiling at scrubbing the toilet. I'm not sure if anything can make me smile while I'm cleaning the toilet..... :P

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  4. Great post Navi :)

    Depression is certainly something that affects everyone at some point in their life - either personally or someone close to them.

    Medication can help but as you said you shouldn't be relying on medication alone. Never thought about PVP as a way to deal with it though!

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    1. @Bel - I'm trying to turn WoW into some kind of therapy :P I just have to think of something...

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  5. I wrote last year about Autism Spectrum Disorders (ASD) from the non-medical angle, purely because it was something that I had to deal with as a guild leader for a surprising amount of time. When I say “deal with” I mean “be aware of” because, truthfully, it requires no management other than being aware of the issue and not making raid runs miserable for members who struggled with specific issues.

    In the same vein, I think it’s worth being aware of just how prolific mental illness is and how it’s best managed within a guild environment. We’re not dealing with people that need constant attention or mollycoddled, just players that might need somebody to externally recognise when they’re having a bad day and maybe step in to take some pressure off.

    Great blog, Navimie. :)

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    1. @Zellviren - TY for visiting Mr Sentinel! :) I would like to go read that article - could you share the link? I was searching your blog with the search feature to no avail...
      But it is a great thing to write about because more and more people are being diagnosed with ASD these days - people who previously were just awkward or socially inept but these days with awareness and understanding can cope a lot better in the daily environment. WoW is the perfect environment for a lot of these people, as they often have an affinity for computers and games.

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    2. Hey, Navimie, apologies for the delay - I meant to respond aaaaaages ago but obviously got sidetracked and then forgot. I'm a dolt. x_X

      Here's the link:

      http://unwaveringsentinel.blogspot.co.uk/2011/03/potentially-touchy-subject.html

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    3. Sorry, Nav, I responded to this... But it didn't go up for some reason. It might be to do with the fact I usually start with Spinks and then get here, and Spinksville seems to override whatever's in the window. Weird. x_X

      Anyway, here's the link:

      http://unwaveringsentinel.blogspot.co.uk/2011/03/potentially-touchy-subject.html

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    4. Thanks Zell! I just found your other comment in the spam :( But since you put a similar comment up I'll keep this comment instead :)

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  6. Many a clean toilet or hastily written post have saved me.


    Navi there is a name for that syndrome, and I was trying to remember it a few months ago...it was named after a medical student...do you know what it is called?

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    1. @Matty - Which syndrome? You're making me paranoid now.. wait, is that my personality disorder exerting itself??

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  7. I was thinking of this: http://en.wikipedia.org/wiki/Medical_students'_disease The reference to the 1889 comic strip - for some reason I thought MSS was named for one originating medical student, not just a general term. As my friend told me yesterday, just because we're paranoid doesn't mean we're crazy. If I thought donning a tinfoil hat would help, I would.

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  8. Nav! I didn't know you were a doctor!

    It's true how they say that people can hide it very well- so well that people are surprised to hear that you have problems like depression.

    I'm going to my friends funeral this Saturday- it's so unreal. My friend worked in an office full of suicide distress counsellors and they never saw it coming with her. It was a huge shock for everyone- it's been such a painful week. I hope that everyone can start healing, even as difficult this tragedy has been.

    Thank you for sharing, Nav.

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    1. @Aidrana - it was your sharing of your story that inspired me. I always thought your hearing was your struggle, but to find there is more and how you get through it all always impresses me.

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