Varieties of madness and the difficulties in treating more then one mental disorder in a patient. In psychiatric terms psychosis is described as a severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality. The term madness is used to describe this while an individual suffering from non-psychotic terms are considered mentally ill. In recent years I have come to believe that there are different forms of madness. One doesn’t have to be psychotic to be considered mad. I believe there is a time when someone suffers from so many psychiatric symptoms that they can be considered mad. When an individual suffers from an illness which can be solely treated whether from medications, therapy, hospitalization or even ECT usually after a period of time the individual’s symptoms will ease and become more manageable. When an individual suffers from many psychiatric diagnoses and symptoms the treatment can become more complex especially when symptoms clash with each other. This can be extremely difficult, while you can focus on treating the one individual symptom you can possibly be making the other more worse or distressing. An example would be an individual with a severe social anxiety disorder yet displays symptoms of someone suffering from an attention deficit hyperactivity disorder. While being severely scared and anxious around people at the same time feel the need to attention seek and be loved. This is a diagram of an individual suffering from either one of these mental disorders and receiving treatment for them.
Social Anxiety
Normal state of mind
Seeking attention
Whether an individual suffers from Social Anxiety OR attention seeking symptoms these can be individually treated. For social anxiety a treatment of therapy and anti-anxiety medications can be used to help reduce the symptoms and for attention problems drugs such as Ritalin and/or therapy can be used. This way the individual suffering from one of these symptoms can be drawn closer to the normal state of mind. However, when an individual suffers from multiple mental disorders the symptoms can clash and cause “nowin” situations where the individual is in distress no matter what happens. Someone suffering from a Social Anxiety Disorder AND attention seeking symptoms. Normal state of mind
Attention Seeking
Social Anxiety
As you can tell from the diagram it is a very confusing state of mind which can be extremely difficult to treat as it is not individual symptoms you are treating but a variety as well as having them both clash over at the same time. This is just one example of many if you were to add other diagnosis’s the diagram would become even more complex and difficult to understand. When symptoms clash with each other it can be very distressing. I use the term symptoms not diagnosis’s because some
symptoms don’t have officially termed diagnoses behind them even though they are deeply distressing. On top of this some symptoms can even be made more intense or difficult in conjunction with side effects of medications and or other treatments. The treatment plan has got to be considered so carefully. An example would be a patient who suffers from non or little psychotic symptoms yet suffers from a clinical depression, severe anxiety disorder, social anxiety disorder, separation anxiety/attachment disorder symptoms, attention symptoms, obsessive compulsive symptoms and other symptoms which are difficult to describe. The individual first went to receive treatment for social anxiety symptoms in large groups. After intense psychotherapy/counselling little changed over the months the patient gotten worse and then displayed symptoms of a severe social anxiety disorder nearly house bound and a clinical depression by then the patient was treated with a range of treatments from Cognitive Behavioural Therapy to Fluoxetine, Citalopram, Sertraline and Circadin for sleep. After receiving all of these treatments for the required time the individual still displayed the same symptoms and also gained in some such as attention seeking, obsessive compulsive traits and many other symptoms. It went from seeking help for social anxiety symptoms to having developed a full range of mental disorders and symptoms. This is an unusual case. However, for the sufferer who experiences frequent suicidal feelings along with the other symptoms hospitalization would usually be the case if just for the clinical depression to be brought back to a manageable state. This is where it gets tricky, while the patient would normally agree this is the best plan and is desperate to get better, for this patient who has many symptoms it is still seemed as impossible because of lets say the social anxiety the sufferer can barely deal with one person let along living among other patients, doctors, nurses, administrators, cleaners and other staff. Even if the patient was to receive their own room then there would still be severe anxieties about everyone watching them 24 hours a day making the paranoia even worse. This would then produce such a feeling of anxiety that it could possibly even make the depression worse. Since the depression was initially caused by social anxiety symptoms. After three years of outpatient psychiatric treatment and no improvement the patient is moving on to more advanced psychiatric treatment in the forms of Electroconvulsive Therapy or psychosurgery (although unlikely due to the rarity of this treatment in modern times). Assuming the patients symptoms didn’t respond after a few sessions of electroconvulsive therapy then this patient would feel like they are completely alone with their condition and that it can never be treated and they have to live with the pain for the rest of their life. This would cause more intentional suicidal ideation yet to add salt to the wound the patient while so desperate to die is also too scared to die this is where the anxiety disorder comes back in and plays it’s part in the horror show the patient doesn’t know how to do it and is scared of it not being successful and ending up in hospital (around people), and is scared of experiencing physical pain, making suicide, also not an option. The patient tried a very deep course of self-help trying to change thoughts through books and motivation yet the brain was so powerful it wouldn’t give in. As a conclusion someone experiencing so much frustration, anger, jealousy, hurt, despair, sadness, continous scared feelings and sleep problems who will have to remain this way probably for the rest of their lives (thus being a form of hell where you cannot even end the torture through suicide) surely this would be considered a form of insanity. If not, then at least will develop into insanity from knowing all this will never end. This is only one experience of multiple mental distress symptoms some individuals thoughts and views are so different on any given situation (symptoms of an autistic mind) that this should be considered a form of madness because while contact may not be lost from external reality, there is evidently a difference than in those who can happily lead a normal life.