Today is the sixth anniversary of the second time I was raped, but I’m dealing with it pretty well. Actually, I’m doing great today, but apparently this is because I got it all out of my system last weekend. My boyfriend and I were drinking with friends, and I didn’t think I was all that drunk then; I felt fine until I got home. I remember throwing up, but I don’t remember anything after that. My boyfriend told me that I was afraid of the Bad People (hey, I need the euphemism, ’cause it’s awfully long and clunky to keep referring to them as “the people who raped me”), crying and saying that I had to keep my eyes closed because if I opened them, I would see the Bad People. He of course told me that there were no Bad People around, that I was safe, but I guess it took a long time for me to believe him.

I’m glad I have no memory of all of this, but I wish I hadn’t put him through it. I’m glad this weekend is better.

Apart from that, I’m fine lately, but I’m working extra hours for a few weeks, and I have almost no time to fit anything but work into my schedule. My brother, although out of the hospital, is not doing very well, but it’s going to take more time than I currently have to go into detail about that. I’m hoping I’ll have enough free time on Tuesday to manage to blog. I sure as hell won’t have any time tomorrow.

Apparently I was wrong when I said that my brother was staying out of the hospital. He was actually back in there at the time, just my parents hadn’t told me yet. He’s still there. It is not going very well. He says some of the nurses are mean. And there’s not anything I can do to help; I can’t even visit because I’m way too far away. I don’t really want to write about it any more right now. I did have a good weekend, by the way.

I’ll be out of town for a few days, so I won’t be posting until sometime next week. I’m fine. My brother’s doing less fine, but is at least staying out of the hospital. That’s good, right?

I really need a mini-vacation. Yay.

I don’t even know why I tried this again so soon, as I wasn’t expecting it to have changed already, but it has. My blog has moved from an R rating to an NC-17 rating. For completely ridiculous reasons, I might add.

This rating was determined based on the presence of the following words:

* hell (7x)
* kill (4x)
* rape (3x)
* ass (2x)
* hurt (1x)

I have no idea why it is no longer keeping track of the amount of times I’ve used the word “drugs,” since that’s the one word from before that I remember using a bunch more times since then.

In news of things that are not fast, my brother was released from the hospital five or six days ago but no one has yet contacted him regarding follow-up treatment, although of course they were supposed to. I have no idea why this surprises me. It really shouldn’t, at this point.

Stumbling back, blinking confusedly and wondering what happened to the past week.

My brother was released from the hospital after nine days there. My mom says he is doing okay, but she worries about him all the time. She is worried about what he’ll do the next time he and his girlfriend have a fight. They’re always fighting. He told her that if she took that job this summer, he’d kill himself. She took the job, he didn’t kill himself or try to kill himself, but he did have to spend nine days in the hospital.

I’m a bit hypomanic. Nothing extreme, mainly I’m kind of hypersexual and I’m also feeling like it’s stupid to be taking my medication. Usually, if I’m not taking my medication properly or if I stop taking it altogether, it really is because of the side effects. I am not the stereotypical “she stopped taking her pills because she thought she didn’t need them anymore” manic-depressive. (Almost nobody is, by the way. People just think that we are because they don’t actually believe us when we tell them how bad the side effects are.)

But I am that stereotype right now. Or at least I would be if I actually stopped taking my pills, which I have not. I want to, though. I feel so good right now. How could there possibly be anything wrong with me? Why would I possibly need drugs?

Twice in the past, I went off all of my meds without telling my doctor. I didn’t think that I wasn’t manic-depressive; I just thought I could handle it better without the drugs. Both times, I felt fine for a little while. Both times, things changed. The first time was a bit more gradual. It started out as mild paranoia, then moved to severe paranoia and delusions, and then added auditory hallucinations. Now, that was a fun six months. The second time was much more sudden. A case of severe insomnia turned overnight into serious suicidality and helped set off a chain of hospitalizations. All of that funstuff is why I decided that although I would try taking lower dosages of medication, and although I would stop taking Dope-a-max and atypical antipsychotics, I probably shouldn’t take no medication at all.

Right now, though, I feel like I’m talking about someone else. I have a hard time believing that I was ever ill. It feels like it was all a dream. I am fine. There’s nothing wrong with me. Why would I need pills?

Since everyone else is doing it, I might as well. Not jumping off a bridge (I think about that often enough by my own damn self), but the meme that CL Psych posted about giving film-like ratings to blogs.

This rating was determined based on the presence of the following words:

* hell (4x)
* drugs (2x)
* rape (1x)

I never knew using the word “hell” was such a big deal. Well, I’m going to use it all I want, and we’re going to live like kings. Damn hell ass kings!

I wonder what I have to do to push it to an NC-17 rating. Talk more about rape flashbacks? Talk even more about meds, since I’ve never even mentioned illegal drugs on this blog (until now), but apparently the word “drugs” in any context is scandalous enough?

Update on my brother: nothing to report, really. He’s still in the hospital. They might let him out this weekend. Or after this weekend. Or something. They’re not telling him a whole lot. He is bored. I would be, too.

I went to Shoppers tonight to get a prescription filled, and while I waited, I read their HealthWATCH pamphlet on Emotional Health. I was flabbergasted by the following excerpt, which I am not making up:

Doctors refer to conditions that affect emotional health as “mood disorders.” They include:

• depression
• anxiety
• stress
• bipolar disorder (manic depression)

Seriously, what the hell? Were people high when they wrote this pamphlet? Since when is stress a mood disorder? Or anxiety, either, but labelling stress a “mood disorder” is particularly stupid, since that would mean that every single person in the entire world has suffered from a mood disorder at one time or another. Sure, stress affects emotional health, but that doesn’t make it a mood disorder. An especially baffling thing about the wacky pamphlet is that there is a section on the Shoppers Drug Mart web site about emotional health, expanding upon what is in the pamphlet, and it doesn’t include a ridiculous statement about stress being a mood disorder, but does include a subsection called More than just stress which contains the line, “Because some signs of depression are similar to those that occur with stress, having some of these signs does not necessarily mean that you have depression.” Which, you know, actually makes sense.

Maybe people realized that whoever was in charge of their Emotional Health stuff was doling out very obvious misinformation and it was a lot simpler to fix the site than to fix the pamphlets?

My younger brother is like the poster boy for borderline personality disorder, but since mental health professionals seem to be looking only for BPD poster girls, none of them had ever considered this diagnosis for him. No, I’m not sure whether I think BPD is a useful construct, but he does fit the criteria to a T (except, as far as I know, the last one, “transient, stress-related paranoid ideation or severe dissociative symptoms”).

Last week, I kept mentally writing a blog post in which I would describe all the ways he fit the criteria for BPD, but refer to him as “she” until the end of the post, where I would say that there was one major lie in the post and to switch all the pronouns, I’m actually talking about a guy, not a girl. My brother can be awfully exasperating, but what really bugs me, and what that post would have really been about, is sexism in the mental health profession. About how I, a girl, have been called personality-disordered simply because I used to cut myself or because sometimes I’ve disagreed with doctors’ opinions about something, but someone who very obviously fits eight of the nine criteria for BPD isn’t diagnosed with it because he’s a guy. I’m not really interested in amateur diagnosis of anybody other than myself, but it seemed appalling that behaviour that would get a female slapped with the BPD label was ignored in a male. I never did write that post, because 1) it would have wound up being awfully long and I’m lazy, and 2) it seemed malicious to write a post delineating all of my brother’s very worst qualities when he is one of my favourite people in the world and one of my best friends.

Now there is another reason to never write that post, which is that a doctor has finally considered that he might have BPD. Until the other day, my brother’s official diagnosis was generalized anxiety disorder, but he’s been in the hospital for a couple of days because of suicidality. One doctor is saying bipolar spectrum disorder and another is saying borderline personality disorder.

As for how he is doing in there, it varies. He went voluntarily, but then when he said he wanted to leave and it was stupid and he should have just killed himself instead of going to the hospital, of course they changed his status to involuntary. For a while he was really mad that he’s stuck there because he wants to go online and see if his girlfriend is terribly worried about him, as he wants her to be. He was doing a countdown online to the day he planned to kill himself and dramatically telling his friends that it would be his “last day on Earth.” His girlfriend has a good summer job on the other side of the country and he is upset about that because he would prefer that she come home to her apartment and work at the part time waitress job that she had before she found the better job. He thinks that her wanting to make money to pay the rent for her apartment, where he sometimes lives with her for free as he has no job, means that she doesn’t really love him. My mother said today, though, that he is feeling less angry about being in the hospital now because he thinks he should stay until he feels safe.

Feelings can shift so rapidly in the hospital sometimes, can’t they? Most of the time, it’s very boring, so when anything at all happens, sometime it seems monumental and you can overreact.

This is not an anti-BPD post. My brother behaves like a stereotypical, worst-case-scenario borderline, and of course I’m going to vent about that. I realize that most people diagnosed with BPD aren’t actually like him, and I’m hopeful that whatever the hell is wrong with him, whether it’s BPD or something else or BPD and something else, he will soon get some appropriate help and will feel better and not be such a pain in the ass. Even if he is bipolar without BPD, I’m glad that somebody has finally noticed that something other than GAD is going on.

If people are going to be diagnosing Anakin Skywalker and Winnie-the-Pooh, then why not Diagnosing Lear, right? This article from The New Criterion is actually a fairly serious piece of literary criticism focusing more on things like personal responsibility and expression of emotion, but the bits at the beginning that actually are directly about psychiatric diagnosis are pretty funny:

Doctors have been trying to diagnose King Lear for more than two centuries. They haven’t succeeded, of course, for a couple of reasons that are not mutually exclusive: first, King Lear does not exist, and second he is not available for tests or examination. The latest technology, no matter how sophisticated, will never settle the matter. No imaging studies for King Lear: he was born much too soon for them, and now will never be diagnosed properly.

Not, of course, that that puts doctors off, far from it.

I know it’s not at all uncommon for people to try to diagnose fictional characters, but when a friend of mine sent me the link to this article today, I just felt like sharing it.

Psychoanalysts perceived in Lear a case of thwarted incest (they would, wouldn’t they?). A variety of diagnoses have been offered from senile dementia to manic-depressive psychosis. (No one has suggested General Paralysis of the Insane, the last stage of syphilis.) Dr. Truskinovsky, writing in the Southern Medical Journal in 2002, makes a powerful case for mania, and suggests that Lear had been suffering from bipolar affective disorder all his life.

Personally, I am against all this diagnostic effort. It is not just that, as Dr. Truskinovsky dryly remarks, it is not altogether easy to decide what constitutes the symptom of grandiosity in an absolute monarch like Lear, so few of us having either experienced or witnessed that condition of man. It is rather that the medicalization of Lear’s behavior deprives it of moral significance.

I don’t see King Lear as being manic-depressive, but then again, it’s been an awfully long time since I’ve read the play.

Lately I’ve been having too many ideas to sit down with any one of them and see it through. This includes blog posts, which I compose while trying to fall asleep at night or while pacing around my apartment, but not while actually at the computer. Today I decided that writing something short is better than nothing.

Reading about Reconcile, the doggie Prozac, reminded me of a sentence I recently came across on Borderline Personality Today’s page about BPD criteria:

Individuals with this disorder may feel more secure with transitional objects (i.e., a pet or inanimate possession) than in interpersonal relationships.

I thought it was a pretty poor choice of words. Yes, you don’t have the same sort of relationship with a pet that you do with another human being. I get what they’re trying to say here. But not being a person doesn’t make a pet an object. If a pet is an object, though, then it doesn’t matter to you if you use a quick fix for their behaviour that is convenient for you as opposed to seriously thinking about what solution is best for your pet. Note: I’m not talking here about people who have been diagnosed with BPD, even though this sentence happened to be on a site about BPD. I just mean that people who would refer to an animal as a “transitional object” seem to have the same mindset as people who would drug Muffy for piddling on the rug.

I’m not saying unequivocally that psych drugs for your pets are always 100% wrong, because I really don’t know enough about the subject. I know people who had their cat on kitty Prozac because of its OCD-like behaviour. It actually did physical harm to itself with excessive grooming and biting itself. They were worried about its physical health and obviously couldn’t be with the cat every second to keep it from hurting itself. Medication was not the first thing they tried, and their cat was only medicated on a short-term basis. The cat is now off SSRIs and is fine with only behavioural training. They also have another cat who has never had these problems.

What I am saying, though, is that the Reconcile site scares the crap out of me with paragraphs like this one:

Separation anxiety is a clinical condition in your dog’s brain. Your pet is not a bad dog. Your pet’s behavior is the result of separation anxiety.

Wow, “a clinical condition in your dog’s brain.” Isn’t that just the most specific thing you’ve ever read? What the hell does it even mean? It means “We want to convince you that your dog has a biologically-based medical condition but we don’t have evidence to support this, so we will be alarmingly vague. It is your duty to treat your dog’s clinical condition, damnit. You are a bad pet owner if you don’t get them the medicine they need.”

Does separation anxiety in dogs exist? Hell, yeah. And in cats, too — that’s what caused the excessive grooming and self-injurious behaviour of the cat I mentioned previously. But is separation anxiety “a clinical condition in your dog’s brain”? Umm…

My parents’ dog has very bad separation anxiety, but they’ve never considered drugging her because of it. They just use behavioural training, which works most of the time, and on the occasions when the dog pees on the rug or gets into the garbage anyway, well, then they just have to clean up after her.

I’m glad that Eli Lilly at least emphasizes the importance of behavioural modification in addition to drugs, but I’m sure that some pet owners will just ignore the entire training idea because medication is, you know, easier. For you, if not for your pet. Of course, just like meds in humans, the side effects of Reconcile are often the very things the drug is supposed to treat:

The most common adverse reactions recorded during clinical trials with Reconcile™ were calm or lethargy, reduced appetite, vomiting, shaking, diarrhea, restlessness, excessive vocalization, aggression and, in infrequent cases, seizures.

If you look at the product label or this journal article, you’ll see that some of the side effects were quite common, especially calm/lethargy/depression. I guess if you’re not satisfied with doping up and numbing out your children, you might want to move on to your pets, too.

Well, this wound up being longer than I expected.