Originally Posted by Box77
Great - be assured, I will show up! Claiming that a person on say LSD loses lucidity, though - I think, you are under a misapprehension there. It's not so that people would forget or fail to have insight into their state of mind. One can talk about some mental faculties being impaired, yes - but not lucidity as in insight into the state of affairs, that's not lost with LSD normally - I will go quote in your thread, though, to demonstrate this.
Originally Posted by Box77
As far as I can remember, he notices something about the little girl who uses to appear with the other guys, and that finally, is the breaking point where he accepts his state of mind. I don't know if it happened for real or is just part of the plot of the film, but I wondered if it could be possible to apply certain logic in those altered states of mind to help people to elucidate the difference and perhaps reach certain level of lucidity like in a lucid dream.
Oh - that is most definitively possible anyway. Many people with hallucinations come to recognize and distinguish them from say real voices. Seems one can learn that with experience, and the official doctrine in psychiatry, that psychosis is out of bounds for talking psychotherapy is gone as well, including acutely. An only very recent development, though. Cognitive Behavioural Therapy seems to show good effects - esp. in gaining insight into the workings of it all, and to learn to deal and live with it. No wonder, psychoanalysis didn't work, if you ask me - they were geniuses nevertheless, though...
It's for the individual person to decide, how much "disorder" is okay with them (well - at least until it's not okay with society any more) - weighed against the sort and dose of medication which would be needed to say completely silence the voices.
Also check this out: Hearing Voices Movement - Wikipedia, the free encyclopedia
It's also possible to be deluded on the one hand, and know that it is so on the other, but still believe in the delusion - weird thing called "double-bookkeeping" and rare as far as I know, but it's possible. Like seeing it for what it is and wanting it to go away and voluntarily take meds for it while still acting and thinking in accordance with the delusion.
The DSM (diagnostic manual) - weak as it is - has these days the main criterion, if the person considers it a problem and actually suffers. Not that "something is off" as such any more. Well - I didn't look it up now - I hope, this is so and my memory with me - but anyway - progress is being made, noticeable but slowly. There has been so much barbarism in the field and still is in many places I suppose - like this insulin-shock therapy applied to Nash, and the olden days' electro convulsive therapy (ECT) without giving something to get rid of the muscle-spasms and the connected pain, which is easily possible. But at least the latter does demonstrably and often drastically alleviate severe depression - the former was just idiocy, often lethal...
What I wasn't aware of to a time, was how it's the patients themselves, having to plead for ECT these days, at least in Germany. There are high standards set, also legally, and it's a very touchy subject - no clinic wants to get into the press with electro-shocking folks - exceedingly rarely done.
New ways need to be found - and are!
Stephen Fry made an excellent documentary - in my eyes - on bipolar disorder, including his own - I can't recommend watching it enough, actually.
The second one is somewhat deeper, more personal, but also more interesting and with seriously moving stories - including his own severe depressive breakdown including finally hearing voices, which might have been the reason to make a follow-up on it. It starts with a short recap of the first one, but don't miss out on that, great interview with Carrie Fisher aka "princess Lea" from Star Wars and much more. Many people think - hallucinations - that's schizophrenia - even many doctors do. Among other things, because people lie about it, understandably. Hallucinations are perfectly within the bipolar range, delusions are actually typical for a severe mania.
Been a while since I saw it - might just as well give it another watch - I love the man anyway! Edit: I did now.
Always astounds me, how he manages to get paid, for what other people only dream of doing for some of his projects, and being such an intelligent, and eloquent and educated and outspoken person - such a fantastic comedian. I can't think of many truly "great minds" to admire these days, being completely serious here - he my hero!
Buut: What Fry didn't include, because it is very recent, actually - is that ketamine gets statistically the same or even better effects than ECT can, even in the worst of depressive cases - cases, where the latter is considered. And it works within hours!
And by involving the so called brain-derived nerve growth factor, actual anatomical activity ensues - new synapses - for more I needed to look that up in detail again. Maybe so does ECT, but by giving a trauma first, not a chemical trigger for growth and regeneration.
Typical - only with those severely ill, research is being done at the moment - lesser "evil" - why evil? Because it has a reputation as a street-drug, not because of addictive potential, which is said to be minimal - nor because it has nasty side-effects - what seems to scare people, is the idea, that it has psychedelic side effects - but even that can be (almost) done away with by giving it very slowly, or subcutaneously. It's been safely used in anaesthesia for ages. But man - people pleading to get zapped, killing themselves - good that "they" caught the message for those poor souls, for starters - who can argue with new synapses?! But how would you feel - being "only" very depressed, but not severely, not suicidal and hence denied relief, possibly total and lasting relief, and within hours?
There:
BBC News - Ketamine 'exciting' depression therapy
BBC NEWS | Health | Drug 'treats depression in hours'
What he also fails to mention in a bit of depth is that there are alternatives to Lithium, less toxic and you can stop them with less risk to relapse. They are antiepileptic drugs doing a very similar thing, they have their downfalls, too - but in comparison...
The doc with her fish-oil and omega 3 fatty acids has a good point, too - Li and the other mood-stabilizers seem to have as a mechanism the stabilization of neural membranes - and membranes are made of fatty acids, and the highly unsaturated ones are beneficial. Soo - lots of fish, babies - at least for a try! Who can argue with her 15 years of peace and even working as a physician again and with no pill whatsoever? I hope she stays in her comfort-zone and it looks so to me! Seems Britain has an anti-discrimination act out, which did it's part to enable her getting the job - being the other docs' very own token loony, as she jokes... This legislation is great, I don't think, we got such a thing here - and this docu is fantastic to combat stigma! Of course I hope for part three coming up, but hopefully not because of new troubles of his, but because of good news.
As you can guess - I'm very interested in mental health - in science anyway - in neuroscience anyway - but psychiatry especially fascinates me...
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